Tuesday, November 15, 2016

Insurance Claim Updates

Image result for construction site accidentConstruction site accidents have made headlines recently as it was reported that 402 workers were killed at construction sites between 2011 and October this year. Deputy Human Resource Minister Datuk Seri Ismail Abd Muttalib had revealed these statistics from the Department of Occupational Safety and Health (DOSH) in Parliament last week.
Although we might attribute these accidents as occupational hazards for construction workers, but don’t forget that recent high profile cases of construction-related accidents involve civilian fatalities, often with the victims not even in the construction site but unfortunately, not out of danger.
A couple was killed on 4 November when a piling crane suddenly came crashing down on their car when driving by a construction site. On 25 August, Joice Chin Khoon Sing’s death shocked many when a crane hook from a construction site fell down on her car in Bukit Bintang when she was drove by the area.
These accidents did not only occur this year as many instances have been reported in the last five years especially when the rate of constructions of elevated highways, flyovers or light railed transit tracks around the country has increased in tandem with the nation’s progress.
Back in June 2013, one person perished and four others were injured in Batu Maung, Penang when an uncompleted flyover connecting to the then still-under-construction second Penang bridge suddenly collapsed.
Construction sites are often in the middle of cities, with little separating them from civilians on the surrounding sidewalks and roads. Seemingly minor mistakes at construction sites can lead to major injuries to construction workers and pedestrians.
Driving or walking pass construction sites these days could lead to injuries caused by falling objects or any number of workplace tasks could go wrong and you could end up be involved in a freak accident, so these worries are warranted.
Image result for construction site accidentWith all these unpredictable accidents happening, what do we do when we find ourselves in such a predicament?
Your Car Is Insured, So Make Sure You Claim It
When it comes to mega-construction projects happening in heavily populated cities, many of us have no choice but to pass by or under construction sites daily as we commute to work.
The most frequent cause of construction-related accidents in cities is that from falling objects hitting cars so the most basic precaution is to ensure your car is properly insured.
Some people are a bit hard pressed in buying insurance policies because they view insurance as a scam but when it comes to freak accidents like this, it pays to have insurance.
And while we might grumble when it is time to pay our motor insurance, it would save us a lot of headache if something happens to our vehicle.
“If anything falls on your car and the damage comes from the construction site, you can claim on own damage first, then we would proceed to claim on the insurance of the machinery involved,” we were told by a source in the insurance industry.
According to the source, if the accident leads to death, family members should be able to claim the insurance as long as the car insured is under comprehensive cover and still active.
However, motor insurance is only limited in covering the vehicle itself and not any bodily injury that might befall us.
“For any bodily injury claim, you may claim under personal accident or you may claim against the construction company because the negligence came from them,” the source clarified.
But how much can we claim on our car?
The source said that it depends on the report sent by the workshop to the claim department of the insurance company.
Image result for mobile accident“The claim department will help check on how much will be paid as they will liase with the workshop as they will be the one to send them the report.
“They will then decide on how much is the cover based on the report,” the source said.
As the amount is on case to case basis, it is a bit uncertain on how much we would get if we were involved in these kinds of accidents.
However, at least we could get some peace of mind that some of the cost of the vehicle will be covered by the insurance company if the fault is not ours.
Life Insurance Could Help Those You Left Behind
Life insurance is not much of a priority amongst most people compared to having medical insurance, but in accidents that involve death or permanent disablement, having life insurance would ensure a somewhat secure future for our loved ones.
Although insurance companies scrutinise accidents that happen, the next of kin of the victim will be able to claim the victim’s life insurance in full in accidents that caused their death.
“For life insurance, it doesn’t matter which insurance company it is, the insurance company will pay in full based on their total insured amount.
“If their insured amount is RM1 million, then the insurance company will pay RM1 million. It is the same with any other total amount covered. There would not be any compromise in cases of accidents,” Muhammad Yahya Drahman, a Prudential insurance agent told us.
Yahya is aware that people do not trust insurance companies because of claims that these companies cheat their clients.
Image result for mobile accident“We are used to hearing that insurance companies cheat people but there is no truth in that.
“These insurance companies are large companies and they want to protect their integrity so they would not do anything untoward that would compromise it.
Each insurance company’s licence is given by the Central Bank. We are under the Central Bank so we cannot simply do something following our own whim. We are also observed by Life insurance Association Malaysia (LIAM) and Malaysia Takaful Association (MTA). These three bodies would always observe these insurance companies,” he said.
For the next of kin to claim the insurance, they would need to provide certificate of death, police report and the insurance policy book, which needs to be kept in a safe place and where the next of kin knows, and hand it over to an agent to process.
“In the event of a death, you need to return the policy book. It’s not that you cannot apply for a new book if you lost it but it would take time and would be a bit of a hassle for the agent,” Yahya said.
Moreover, the insurance company will also pay your insurance in full if you sustain severe and permanent injuries.
“For example, if you suffer from total permanent disablement, the insurance company will pay in full, and they would not have to pay their monthly insurance anymore as it would be paid by the insurance company,” he explained.
While it adds on to your commitment if you take life insurance if you do not already have one, it would help those you leave behind if you met an untimely death.
Image result for mobile accidentWhen It Comes To Making Those Responsible Pay, Hire A Lawyer To Sue Them
Although having insurance could greatly benefit the victim and the family, those claims come from your own policies and not from those who caused the accident.
If the victims were unfortunate to not have their own insurance coverage, they have no choice but to sue the company responsible for the accident. Even if the victims are covered by their own insurance, they can still file a summons as well.
Before filing the summons, the lawyers need to determine the negligence was on whose part, whether it is the victim’s fault, the construction company’s fault or it was the fault of both parties.
“If the deceased is 100% in the wrong, then the next of kin cannot do anything,” Najihah, a partner in a law firm told us.
She told us that if the negligence came from the construction company, the claim would be made against the insurance of the construction company as they are usually insured or it will come personally from the owner if the company is not.
There are two ways to go about receiving compensation from the responsible party, which is to issue a notice of demand first before bringing the case to court as it is the procedure to issue a notice before filing a summons.
“The first way is to issue a notice of demand to the responsible party, for example, by demanding payment of a certain amount.
“If the demand is ignored within the stipulated time, then the case will be brought to court,” she said.
If the responsible party were willing to settle outside of court, then they would pay the amount of the demand.
The amount that the victim or next of kin can demand from the responsible party is not fixed as it depends on the law.
“The amount that you can claim is determined by what the law allows. We cannot simply demand how much we want so that is why you need to hire a lawyer for this. The lawyer will handle everything for the next of kin or claimant,” she explained.
“You can claim when you file the notice but the lawyer has to look at all the relevant documents first. They will then quantify how much you can get after going through the list of injuries but this depends on liability, which means whether the victim was negligent in the incident as well.
“If the victim was not negligent, we will ask for full payment, but if they are, we would ask for half,” she said.
The cost of hiring a lawyer can be a concern for many private civilians but Najihah said that in accident cases, they do not take payment beforehand and would only take a percentage of the settlement paid as the legal fee.
“We do not take payment beforehand. We would only take a certain percentage from the payment once the case is settled.
“In cases that involve life, the claim is higher so it is advisable to hire a lawyer for that.
Image result for life insurance claim“And if you only have small injuries resulting from the accident, it is also better to hire a lawyer because you would not lose anything by doing so since you do not have to pay anything in advance,” Najihah advised.
In cases of public sector construction, often the government also takes action against the project’s main contractor like in the case of the second Penang bridge ramp collapse. Two construction companies were fined a total of RM85, 000 after they were charged under Section 17(1) and Section 15(1) of the Occupational Safety and Health Act (OSHA) 1994.
However, for private sector construction, it would be on a case to case basis as the recent case of the crane hook killing a civilian on Bukit Bintang, the China-based construction company BUCG, chose to reach a settlement privately with the family of the deceased. The next-of-kin of Joice Chin had stated publicly that they accepted a settlement from the construction firm and agreed to a non-disclosure clause preventing them from commenting on the settlement publicly.
In many aspects, occupational safety and health is a relatively new issue for a developing nation and Malaysian are generally quite unaware of their rights in this area.
For example, after the crane hook fatality, MCA Public Services and Complaints Department chief Datuk Seri Michael Chong had called on the government to implement a specific ruling to regulate the operation of all construction machinery, especially tower cranes.
He highlighted that currently there are no specific provision or ruling in the Occupational Safety and Health Act 1994 on the required safety perimeter for construction lifting machinery.
"Such a ruling is necessary to avoid fatalities due to construction mishaps," Chong told reporters during a press conference at his office earlier in October.
We are sure that there are many more technicalities involved when discussing occupational safety and health issues and we hope that this would serve as a guideline on what you can do if you find yourself or family members – God forbid – in such situations.

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