UAE: Bus driver’s injury claim faces hurdle over policy coverage limits

Question: I am employed as a bus driver. Thirteen months ago, I was involved in an accident that caused leg injuries, limiting the movement of my knee and ankle. I submitted a request to the insurance company for reimbursement of medical expenses and damages resulting from the accident. The insurance company refused to pay, claiming that my injury is not covered under the injuries listed in the insurance policy addendum. Is the insurance company correct in this claim?

Answer: According to Clause “A” of Chapter Two of the Unified Motor Vehicle Insurance Policy Against Third Party Liability, and Clause 4 of Chapter Four concerning exceptions:

“The insurance does not cover third-party liability arising from accidents caused by the insured motor vehicle in the following cases:
4) Accidents that occur to the insured, the vehicle driver, or persons employed by the insured if they are injured during and because of work, unless they have obtained additional coverage under a rider or another policy.”

Furthermore, pursuant to Civil Cassation No. 289/2024 dated 23/5/2024:

“The insurance company has the right to limit its obligation to compensation to a specific type of injury sustained by the vehicle driver. It is not obligated to compensate for injuries not included in the policy’s appendix.”

Based on the above: The insurance company is required to compensate you only if there is an addendum specifying the types of injuries, as agreed between your employer and the insurance company.

You should submit your case to a medical committee to assess your injuries and determine whether they are included in the addendum. The court will ultimately have the authority to decide whether you are entitled to compensation.