The unbearable ease of the "successful method" - Walla! vehicle

2022-06-30T11:03:04.623Z

When an insurance company rejects an insured's claim, it should have a reason, and it must be a good one. What happened in this case has already crossed the border

The unbearable ease of the "successful method"

The accident was the fault of the insured, no question at all.

But from now on it is only the fault of the insurance company that tried to shake off the payment to its customer and further accused him of attempting fraud

Walla! Car

30/06/2022

Thursday, 30 June 2022, 13:35 Updated: 13:45

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The insurance company's "SS" turned out to be baseless (Photo: Kobi Liani)

The letter of rejection of the claim sent by the insurance company to its insured, Issa, a resident of Jaffa - leaves no room for doubt: this is a crook, who came to rob her coffers, while fabricating from his heart an accident that never occurred.

But the court was otherwise impressed and ruled that he was telling the real truth and required her to pay him the full insurance benefits.

This is how the infamous 'successful' method works, which wastes precious time for all of us and makes innocent policyholders unhappy.

The beginning of the annoying story, on 12/24/20, Christmas Eve, Ben Zvi Street in Jaffa.

Issa, says that he got in his car, an Audi 5 Q to pick up the holiday meal.

And so, while driving, in a moment of inattention, he encountered with the front of his vehicle a vehicle traveling in front of him.

Although the accident occurred at a low speed, since it was a vehicle from the year of manufacture 2009, which at the time of the incident was NIS 57,000, it caused him severe damage and it was defined as a "complete loss in theory" (a type of 'Total Loss').

The insured pleaded guilty, but compensation must be paid in any case (Photo: ShutterStock)

So while the holiday meal was less festive, at least he was comforted that he had purchased comprehensive insurance ahead of time, one that should be of help in these moments.

But hopes aside and reality aside.

Not long after, a rejection letter landed in his mailbox "The accident did not occur in the reported circumstances, or did not occur at all. So did the damages that were not caused at all or were caused in other circumstances and are not part of the incident."

In another part of the letter, the insurer stated that: "Clearly the liability by an appraiser on behalf of the defendant, it emerged that the source of the alleged damages could not be caused by a single accident." Exempt in the circumstances of the case. "

Now, it is important to clarify, Issa is not a criminal at all, on the contrary - a law-abiding citizen, who pays his taxes in full and on time and meets all his obligations.

So where did the insurer get the audacity to break the insurance contract she signed, which includes her commitment to pay him insurance benefits on the day of the incident?

The arrows are aimed at one place - the successful method.

Once an insurance claim is identified that allows it to evade payment, the company raises pressing arguments and tries its best to paint a picture before the court as if it were an insurance crook who came to sting its coffers.

"I'm aware of this nonsense"

What she was trying to do was prove that he was trying to treat the accident with previous damages from another accident - a situation that amounts to a scam that denies him the right to insurance benefits.

Documentation: This is what the sting of "pedestrian" accidents looks like

To the full article

An insurance company cannot dismiss a claim, alleging fraud, unless it has solid and unequivocal evidence.

And on what basis did the insurer base its serious claim?

On no actual and conclusive evidence.

An insurance appraiser on behalf of the insurer, who was questioned by the insured's attorney, Adv. Guy Bnei Moshe, from the office of Elias Panos, came to the witness stand.

Adv. Bnei Moshe: "As an appraiser, how can you determine the failures you have determined for your claim or the date of opening the airbags and belts, if you are not a vehicle engineer."

Appraiser: , Who connected the vehicle to the computer and here is the scan of the faults. "

At this point, the winning card is ostensibly drawn on behalf of the insurer.

It will pave its way to shirk its responsibility and leave the insured with nothing.

Within seconds, the picture became clear: no output was attached to the claim material indicating an inspection had been made, no decryption report and nothing.

"How are we supposed to know that the belts really did not stretch and the airbags opened at other times?"

The appraiser was asked to reply: "My opinion and an integral part of it is from the computer."

Now, an essential aspect needs to be noted: an insurance company cannot dismiss a claim, alleging fraud, unless it has solid and unequivocal evidence.

Which really did not happen here.

A car appraiser is not an expert in diagnostics, and even if it is assumed that a test was indeed performed that indicated an early opening of the pad, why was no reference attached?

Is it possible to send the insured without anything, based on an "unknown test"?

The answer is no.

In that case, the court wrote an unreasoned judgment, but in the bottom line - after hearing the evidence, the insurer was ordered to pay a total of NIS 53,495, after a 10% reduction for the remains of the vehicle, plus court fees and attorney's fees.

Adv. Elias Panos: "The court accepted our full claims and rejected the insurer's ridiculous version, which shied away from its responsibility, while trying to leave its insured without any compensation. We call on the insured to stand up for their rights under the policy for which they paid the best of their money."