Insurance company refuses to pay indemnity

You have an insurance policy good for you but you should know that the insurer can refuse to pay indemnity in certain situations.

Exclusions contained in the insurance policy

Insurance policies specifically indicate certain situations in which the indemnity cannot be claimed. For example, most damage insurance policies contain a clause excluding damage that is caused by rioting, civil war, or acts of terrorism. Many types of exclusions exist.

The insured’s failure to respect guarantees

Insurance policies can also contain conditions that the insured must guarantee to fulfill; if the insured does not fulfill these conditions, he will not be paid the indemnity if the damage occurs. For example, these conditions could be installing an alarm system in your car, installing sprinklers in a room, etc.

Intentional fault and fraud

For damage insurance, the insurer does not have to compensate the insured if the loss (the event that is the basis of the claim) was caused voluntarily by the insured. For example, an insurance company does not have to compensate a person who sets fire to his own house in order to collect money from the insurance company.

For insurance of persons, there is no similar rule in the law but an insurance policy can contain exclusions to the same effect.

An attempt on the life of the insured person

An insurer can refuse to pay the indemnity to the beneficiary of a life insurance policy if it is proven that the beneficiary killed the insured person in order to collect the life insurance indemnity.

hmehrez@mehrezlaw.com