Remedies Available When Your Insurance Claim is Rejected
Have you been in a situation where having submitted your insurance claim to your insurer, you subsequently receive a letter from your insurer telling you that the claim is declined (for whatever grounds) or your insurer giving you a less than satisfactory compensation? Or perhaps you have heard of such experiences by someone you know?
Insurance claims rejection (also known as repudiation) is not uncommon. Far more common would be a less than satisfactory compensation offered for the insurance claim. Faced with those scenarios, what remedies are available to the insured / policyholder?
Demand full explanation from Insurance Agent or Broker / Claims Department
If you have an insurance agent or broker who is servicing your account, get their assistance on this matter. Ask them to explain to you why the claim was repudiated. Insurers in Malaysia are required to state their reason/s for a repudiation and if you are unsure of the insurance terms used, your insurance agent might be able to help you. Alternatively, you should write to the Insurer for further explanation on the repudiation or to justify their amount offered for the claim. If the amount offered is not satisfactory, you are at liberty to appeal for a higher amount provided you are able to give good reasons for the same. The Insurer is obliged to give you a written reply upon your written appeal to the Manager / Senior Manager of the Claims Department. Read more
Lee Nian Ning’s Case. Some thoughts…
Firstly, my condolences to the families of Lee Nian Ning, Mohd Zailani Mustafa and Pang Poon Eng who perished in a recent bus crash which shocked the nation. In the horrific bus crash on 25.01.2008, 24 other passengers were also reported to have sustained injuries arising out of the crash. Many bloggers have written to convey their condolences and outrage over the bus crash - what more when they discovered through news reports that the bus driver, who escaped with injuries, had 13 outstanding police summonses issued against him. There is an ongoing effort to collect evidence and gather witnesses and victims together to file a claim against the bus company involved for the unnecessary deaths and injuries.
Based on whatever little information on Nian Ning that is available on the net and through the mainstream newspapers, I gathered that she was 21 years old at the time of the accident and was an medical undergraduate in the University of New South Wales under the Public Services Department scholarship. I presume she is still single and was not gainfully employed at the material time of the accident.
I believe that it would not be difficult for the family of Lee Nian Ning to establish legal liability in a civil suit against the driver of the ill-fated bus for negligence in controlling the bus. The bus company, as the employer and owner of the bus would be vicariously liable for the actions of the bus driver. As a passenger in the said bus, it could hardly be said that she had contributed to the accident. Therefore, the establishing of legal liability on the part of the driver and bus company should be the least of the family’s concern. Read more
Pros and Cons of Accelerating the Payout of Structured Settlements
In certain jurisdictions such as the United States (but less common in Malaysia), settlements for claims involving personal injury, workers compensation, guardianship, wrongful death lawsuits and even product liability may involve what is known as structured settlement. A structured settlement is basically an arrangement whereby the claimant get tax-free payment over an agreed period of time rather than getting the full payment in one lump sum upon settlement of their claim. This structured settlement is sometimes called annuity payment though the latter is usually subject to tax.
There are companies out there which now offer the claimant an option to sell their structured settlement for a lump sum payment instead and thus, accelerating the payment. This can be done as a one lump sum payment or partial lump sum payment (eg. you only opt to cash out half of your total structured settlement sum).
One of the advantages with such an accelerated payment is the perceived rigidity associated with structured settlement. The time factor (of having to wait) for the monies to be paid is one. Moreover, it would not be possible to add an additional beneficiary to the payee unless a court order is obtained (for obvious reasons). Another advantage of accelerated payment would be to cater for opportunity cost. The claimant may be able to use the accelerated payment to invest in certain investment vehicles which may give him better returns over the same period of time connected to the structured settlement. Read more