Insurance agreement refers to those terms and conditions which guides and regulates the contract between the insurer and the insured.
The four major keywords of Insurance are:
- 1. The Insurer
- 2. The insured
- 3. Risk or uncertainty of events and
- 4. Compensation of such risk.
In an insurance arrangement, one party known as the insured ( i.e one who comes for the insurance service) comes to indemnify for the protection against any risk that may eventually happen while the insurance company owes the duty to provide the insured with some compensation which would either be monetary or otherwise but must be reasonably equated with the risk insured against.
Now, let us agree that Mr. Thomson bought a brand new Toyota Hiace car and wishes to insure the car against any accident, the agreement would be that the car be insured against any car accident and as such would have to pay a monetary value while the insurer will on his own side ensure that he pays a compensation for such risk that may happen as specified in the terms of the agreement. The insurer will however, conduct a careful and thorough investigation on the side of the insured to discover that the accident which caused the damage did not happen out of the carelessness of the insured. Note also that if the damage which happen is one that is repairable, the insurer may decide to fix the part which got damaged but if it is one which is beyond repair, the insurance company will have to compensate the insured either a monetary value equivalent to the damaged car or any other item or by providing another car to the insured. Now, you might be confused a bit on why and how the insurer would have to pay such a whooping sum to the insured after all he was not the cause of the damage . the secret here as the answer is that the insurer possesses the right to make any move in order to recover the loss from anyone who is behind the damage. That is, he makes sure to recover from the loss by charging the one who caused the loss to the insured. He do not necessarily have to let the insured go for the recovery of the loss if not the terms of the contract would be breached.
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WHAT SHOULD I DO IF THE INSURER FAILS ME?
This is applicable to the Insurance agreement in Nigeria. In this case, you should know however that an insurer may refuse to pay or indemnify you on this following reasons; that is to say that the insurer may only refuse to pay the insured on the reason that:
- The insurance policy which the individual insured bought was not actually in force as the time when such damage happened that is to say that the policy was not active when claiming for the compensation.
- The insurer may also refuse to pay you on the reason that you said some words when applying for the insurance policy which was later discovered to be lies. that is to say that you failed to disclose some truthful fact about you which may invalidate your claim.
- The insurance policy may also be invalidated on the ground that the individual insured with purpose misguided the insurer by knowingly withholding some facts which is in existence about the subject matter of the insurance contract.
- The item which you seek the claim for is not covered by the policy as at the time of such claim.
- when you fail to follow the due processes for the payment application to be approved. if you did not follow the application processes correctly, the insurer might like decide not to pay you the claim.
- when you claim more than the supposed amount or value for which you claim. the insurer may decide not to pay you if he discovers that you have hyped or exaggerated your claim for the damage or loss
- when the condition for the policy is not obeyed, the insurer may decide not to pay you on the ground that have failed in any of the stipulated conditions.
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