A statement in the motor insurance policy wording reads:
“this policy and the schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of the policy or of the schedule shall bear the same meaning whenever they appear.”
The key words we would like to bring your attention to in the above statement are: Policy and the Schedule.
It is quite common for insurance companies to not supply the policy document along with the schedule. The schedule, a single sheet is printed and handed over to the policyholder and they are informed that the policy wording can be downloaded online. These documents are both not provided together, and yet the insurer makes it clear that the policy and schedule shall be read together.
Another statement in the motor insurance policy reads:
“Notice shall be given in writing to the company immediately upon the occurrence of any accidental loss or damage.”
The words of importance here are: in writing and immediately.
In Writing: The Insurer specifies how the communication must be given by the insured in case of loss. It must be in writing. Any other method of communication being accepted is the goodness of the insurance companies. It also means that it doesn’t stop the insurer from rejecting admission of a claim since it is not informed in writing. If giving the information in writing includes all electronic communication, then it must be clearly stated so in the policy document as it is a part of the contract.
The insurer expects us to download the policy document, there is nothing wrong in it; and the insurer also asks us to intimate a claim “in writing” without clarifying what ‘writing’ encompasses.
Immediately: What is immediately? It is interesting to observe this word in other policies. The motor insurance policy uses – immediately, the fire insurance policy – ASAP, the life insurance policy prescribes the period of intimation as within 15 days.
We must know, therefore, what the insurer means by the word Immediately. For example: A person met with an accident. His car is badly damaged and he is injured. But he is contractually obligated to intimate the insurer of the loss “immediately”. In other words, should he not go to a hospital to get treated first? But rather make it a priority to inform the insurer about the loss or accident first because the Motor policy wants him to “immediately” do so. Unless, the word ‘immediately’ is not qualified, so as to make the term self-explanatory it will give the insurer one-sided freedom and the privilege to deny any claim based on the insurer’s interpretation.
“Whenever details pertaining to any accident which results in a claim or conveyed by the insured to the insurer after reasonable period…”
The phrase ‘after reasonable period’ is as vague as the word ‘immediate’. Through this word the insurer is not giving away anything except a strong indication of the possibility of denial of a claim.
“…insured shall provide the reasons for such delay to the insurer and insurer may on analysis on reasons provided by the insured condone the delay in intimation of claim or delay in providing the required information documents to the insurer.”
The phrase is: the insurer may condone the delay either in claim intimation or in providing required information or documents to the insurer. Obviously, the insured does not know what this “reasonable period” is. Either the phrase reasonable period is quantified or it stinks of ill-will of the insurer. Further, the phrase “the insurer may condone the delay” indicates the possibility that the insurer may not condone the delay. What can be a reasonable period according to the insurer may not be a reasonable period according to the insured. An element of subjectivity, confusion and ill-will is apparent on the part of the insurer to delay or to deny the claim.
Insurance is bought so that the insured is protected and does not suffer financial loss should something unfortunate happen to our vehicle. Such ambiguity in the policy wording only adds to the insured’s anxiety rather than putting them at ease.
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