'A' was a young officer of the Indian Army. While he was
standing in front of his tent on the border on the Indian side a shell exploded
on the Pakistani side and a splinter flew and passed through his neck and he
died. It was peace time. The insurer declined to pay the accident claim, while
he admitted the basic claim for sum assured, on the ground that the
policyholder was in the employment of the army and was on duty. The insurer
based his argument on the exclusion clause of accident benefit.
Read the exclusion clause again and again. You will find
that the exclusion “arise from employment of the life assured in the armed
forces or military service of a country at war (whether war is declared or not)
or from being engaged in police duty in any military, naval or police
organization”.
Please note the
exclusion does not arise from employment of the life assured in the armed
forces. Exclusion pertains to personnel engaged in the armed forces of a
country at war (whether war is declared or not). When the incident took place it was
peace time and the life assured was not engaged in the “armed forces of a
country at war”.
The insurer welcomed the interpretation and admitted the
accident claim.
The postings in the blog are quite interesting and equally helpful to the customers and the Insurers as they throw a lot of light in to the otherwise invisible areas .It is more of a review than a study.Looking for many more in the offing .
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