Rajesh alleged that he purchased Home contents insurance covering household goods from the DIY insurance company w.e.f. 16-02-2017 to 15-02-2018. He got his jewellery covered along with other household goods for SI of ₹
CS Professional · Insurance - Law & Practice · PYQS · December 2019
Rajesh alleged that he purchased Home contents insurance covering household goods from the DIY insurance company w.e.f. 16-02-2017 to 15-02-2018. He got his jewellery covered along with other household goods for SI of ₹ 10 lacs. An incidence of theft took place on 10-03-2017 at his house and thieves broke wooden gates and stole two silver idols from the place of worship along with two silver coins. The matter was reported to the police and he raised a claim bill for ₹ 21750 but the insurance company denied the claim. During the course of hearing, the insurance company stated that Idols in question were not covered as per policy schedule stating that Section III of the policy covers only Jewellery and not other valuables like Silver statues and silver coins as these do not fall under the definition of jewellery. Discuss the coverage available under a Householder's policy. Justify the denial of claim in the given case with supportive provisions.
Answer & Explanation:
Coverage under a Householder's Policy: Home insurance, also commonly called hazard insurance or homeowner's insurance (often abbreviated in the real estate industry as HOI), is a type of property insurance that covers a private residence, such as a condominium or renters' insurance or home or multiple unit buildings (duplex, triplex or quadplex so long as the owner lives in one of the units). It is an insurance policy that combines various personal insurance protections, which can include losses occurring to one's home, its contents, loss of use (additional living expenses), or loss of other personal possessions of the homeowner, as well as liability insurance for accidents that may happen at the home or at the hands of the homeowner within the policy territory. If a home does not meet the underwriting guidelines of a standard homeowners policy (such as more than 15-20 year old shingled roof, 20-30 year old heating system, no central heating, etc.) the residence could qualify for a limited coverage dwelling policy (DP). Homeowner's policy is referred to as a multiple-line insurance policy, meaning that it includes both property insurance and liability coverage, with an indivisible premium, meaning that a single premium is paid for all risks. Standard forms divide coverage into several categories, and the coverage provided is typically a percentage of Coverage A, which is coverage for the main dwelling. The cost of homeowner's insurance often depends on what it would cost to replace the house and which additional endorsements or riders are attached to the policy. The insurance policy is a legal contract between the insurance carrier (insurance company) and the named insured(s). It is a contact of indemnity and will put the insured back to the state he/she was in prior to the loss. Typically, claims due to floods or war (whose definition typically includes a nuclear explosion from any source), amongst other standard exclusions (like termites), are excluded. Special insurance can be purchased for these possibilities, including flood insurance. Insurance should be adjusted to reflect replacement cost, usually upon application of an inflation factor or a cost index. The home insurance policy is usually a term contract—a contract that is in effect for a fixed period of time. The payment the insured makes to the insurer is called the premium. The insured must pay the insurer the premium each term. Most insurers charge a lower premium if it appears less likely the home will be damaged or destroyed. For example, if the house is situated next to a fire station or is equipped with fire sprinklers and fire alarms; if the house exhibits wind mitigation measures, such as hurricane shutters; or if the house has a security system and has insurer-approved locks installed. Perpetual insurance, a type of home insurance without a fixed term, can also be obtained in certain areas. Justification of Claim Denial: In the given case, Rajesh alleged that he purchased Home contents insurance covering household goods from the DIY insurance company w.e.f. 16.02.2017 to 15.02.2018. He got his jewellery covered alongwith other household goods for SI of ₹ 10 lacs. During the course of hearing, the insurance company stated that Idols in question were not covered as per policy schedule stating that Section III of the policy covers only Jewellery and not other valuables like Silver statues and silver coins as these do not fall under the definition of jewellery. The claim raised was not justified and the complaint was dismissed. The claim denial is justified. The Insurance company is not liable to pay the claim.
Topics: General Insurance
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