Proceedings that were being conducted against her, and as a result, her claim for compensation was rejected. However, the court ordered the insurer to pay her anyway because the policy was drafted in violation of the Auto Insurance Law .The Phoenix” refused to pay the insured a refund for damages she was required to pay due to negligent work because it did not inform her of the legal process. In 2016, the case reached the Nazareth Magistrate’s Court, which recently ruled in favor of the insured and awarded her approximately 30,000 shekels.
Insurance Liability Ruling
The important ruling by Senior Registrar Riad Qudsi makes it clear to insurance companies that if they do not meet their legal obligations and do not explain to the insured what they are signing – no exception will help them. In July 2011, the plaintiff performed work to disconnect water to a debtor in the village of Aksal for the municipal services provider “Milgam.” During the performance of the work, damage was caused to a neighboring carpentry shop, and its owner sued “Milgam” and won. However, “Milgam” filed a third-party notice against the plaintiff, claiming that the damages were caused by her negligent work – and accordingly, the plaintiff was obligated to compensate the owner of the carpentry shop in the amount of approximately 30,000 shekels.
Insurance Claim Dispute
Subsequently, the plaintiff contacted her insurance company for reimbursement of the compensation, but it rejected her, and in June 2016 she filed a claim against it for compensation of 46,000 shekels – the amount of the compensation plus the plaintiff’s debt for execution. Phoenix’s defense claim was that the plaintiff acted in violation of the terms of the policy when she did not forward the third-party notice submitted by “Milgam” to it immediately upon receipt – so that it could also defend itself, being the deep-pocketed party that was supposed to pay the compensation.
Policy Coverage Dispute
The insurance company added that the policy does not apply to the case anyway because there is a professional liability exception here, which states that there is no insurance coverage if the damage was caused due to professional negligence. the claim. Initially, the Registrar noted that the plaintiff’s contact with the defendant after the 15 days specified in the policy did not change anything regarding the defendant’s liability for paying compensation. In addition, the Registrar determined that the defendant did not prove that it would have resulted in a different result if it had received the notice on time.
Insufficient Rejection Explanation
In addition, it was determined that the rejection letter that The Phoenix sent to the plaintiff did not adequately detail the reasons behind its decision. And if that were not enough, the Registrar also drew the insurance company’s attention to the fact that the exception in the policy was not highlighted as required by the Insurance Contract Law. Therefore, the Registrar imposed on “The Phoenix” the responsibility to return to the plaintiff the amount of compensation for which she was charged. However, since the plaintiff nevertheless did not act properly when she did not include the insurance company in the proceedings against the injured .
