Question: Three months ago, I was involved in a car accident. I submitted a claim to the insurance company to compensate me for the agreed insurance value, but the insurance company refused to compensate me on the grounds that the accident was caused on purpose in order to receive the insurance value.
What action can be taken against the insurance company? Am I legally entitled to receive the insurance value allowance or not? May I also claim the compensation for renting a car due to the refusal of the insurance company to pay?
Answer: You are entitled to raise a complaint to the Insurance Committee claiming the insurance value and any damages you suffered, including renting a new car.
The committee, according to Article 14 and 15 of the Insurance Authority Board Resolution No. (33) Of 2019 Concerning the Regulation of the Committees for the Settlement and Resolution of Insurance Disputes, shall study and decide on the insurance dispute referred to it and the documents and details furnished to it within 20 working days from the end of its operations and receipt of all documents, details and information required for decision.
When necessary, the committee may extend this duration to similar durations.
The parties involved may challenge the decisions of the committees before the Appeal Court of competent jurisdiction within 30 days from the day after their notification of the decision. Otherwise, the decision shall be considered final and enforceable.
Chapter 2/1/a of the Unified Motor Vehicle Insurance Policy against Loss and Damage, requires the insurance company to compensate the insured for loss or damage that occurs to the insured motor vehicle and its accessories while in the vehicle, including damaged parts and spare parts, if the loss or damage arises from an accidental run over, collision, turnover or other incident, or as a result of an unexpected mechanical breakdown or as a result of wear and tear of parts by use.
Moreover, Article (282) of the Civil Transaction Law states that the author of any tort, even if not discerning, shall be bound to repair the prejudice which must be assessed to cover the prejudice sustained and the lost profit, provided it is a natural consequence of the prejudicial act.
