Challenge
The subject was a challenge because insurance companies often consciously or unconsciously fail to accurately present and explain their insurance products and insurance conditions to policyholders, which is why policyholders are often misled and believe that they have insurance coverage for all necessary risks, which they actually do not, which could certainly have serious negative financial implications on the operations of the electricity company in the event of a damaging event.
The procedure was quite clear, first we examined and determined the client’s coverage based on the concluded insurance policies, to assess whether the risk in question was covered by the insurance, and how it could obtain compensation for lost earnings due to the interruption of the hydroelectric power plant.
Since the risk that was the source of the client’s material damage was one of the risks for which he had concluded insurance coverage with an insurance company, we determined the amount of damage due to the interruption of work, in the form of lost earnings, through expert assessment. At the time the client requested our expert assistance, he had already been compensated in an out-of-court procedure for the material damage for the damaged devices and machines, but the company refused to compensate him for the loss of earnings, explaining that the risk of financial loss was not covered by the agreed insurance and the concluded policies.
After one year from the initiation of the dispute, the first instance Court rendered a verdict in favor of the plaintiff and ordered the insurance company to compensate him for material damage for lost profits (lost earnings) due to the interruption of work, with the explanation that the plaintiff had taken out insurance policies against financial losses, paid an insurance premium and that the insurance company, with the intention of avoiding the obligation to pay damages, manipulated the fact that the plaintiff allegedly had to pay an additional premium based on the flood risk, which is indisputably covered by the financial loss policies. The first instance Court also emphasized that this creates legal and insurance uncertainty among clients, especially since the insurance company during the procedure terminated the financial loss policies concluded with the client even though they were still valid, without any reason or particular explanation.
The first-instance procedure ended positively in favor of the injured party, with an exceptionally favorable amount of compensation for damages. The insurance company decided reasonably and economically, so as not to increase the costs of the procedure and interest, not to appeal the verdict, but to voluntarily pay the damages in accordance with the injured party.
