No matter how well you think you are insured, the claim is not always paid out ‘just like that’. The insurer invokes the small print. What to do when you are dissatisfied with this?
Mr. Zuid discovers – after two weeks of absence – that water has gotten into the engine of his sloop; Mr. De Vries finds his boat in a half-submerged state in the marina: Mr. Van Buren turns out to have frost damage to his engine, and Mrs. Redder unfortunate steps aboard, falls into the water, and her boat runs into the basalt blocks of the dike miles away. They all thought they were well insured and their damages would be paid without a problem. But no… The (different) insurance companies invoked clauses in the policy conditions that in their view excluded liability for damage (and thus the obligation to pay out). In the case of Mr. Zuid it was said that he would have left the ship unattended for at least three weeks (instead of two) and that he therefore would not have acted as a ‘good family man’.
In the case of Mr. De Vries, an expert concluded that leakage would have occurred via the inner hull by not tightening the grease press. The insurer said that there was therefore no question of sufficient care/maintenance. In the case of the frost damage, it was claimed that Mr. Van Buren would not have prepared the vessel properly for the winter – even though he had outsourced this and the betreﬀende yard could confirm this.
In the case of Mrs. Redder, the insurer found that there was intentional/gross negligence and that she had been very negligent in the way she stepped aboard. The common feeling among these boat owners was: it seems as if insurers are looking for excuses not to pay out. With every boat insurance policy comes the so-called policy conditions, the well-known “fine print. Many water sports enthusiasts, however, think that all is well and neglect to study these conditions carefully. Policy conditions have broadly worded clauses that insurers regularly invoke. One that is often cited is that damage resulting from a gradually affecting process (corrosion) is excluded. But what if an improperly connected anode causes your entire speedboat to function as a giant anode, and combined with a berth – surrounded by steel ships – the aluminum tailpieces of your engine look like cauliflowers within three months? In that case, the insurer made a big deal out of saying that there was a ‘sudden gradual process’. The last word has not yet been said about this…
Are you now completely powerless as an insured in these cases? Fortunately not! Almost all insurance conditions provide a protocol in case of a dispute about the damage. Insurers often call in an expert to substantiate their position. If you do not agree with his findings, you usually have the right to request a contra-expertise. Even when such a protocol is not provided for, the law states that ‘he who asserts, must prove’. If the insurer says that you were negligent, the insurer has to prove it. If you can prove with the help of an expert that you have carried out the necessary maintenance and taken all precautionary measures, you certainly do not stand a chance in your dispute with the insurer. Incidentally, you do not have to go to court immediately. If the insurer is a member of Kifid, you can submit the dispute to the Insurance Ombudsman. He will give a (binding or non-binding) judgment. In short: do not always immediately accept the insurer’s first response. If you are in the right, then fight it. By taking another look at the case, insurers are often willing – whether or not out of courtesy – to come to a settlement after all.
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