Question:
I am the owner of a company, 6 months ago a fire broke out in my factory and it was revealed through investigations that one of the workers in my factory intentionally set the fire. Currently, the insurance company has refused to pay compensation under the pretext that the worker is the one who intentionally set the factory on fire.
My question is whether the insurance company has the right to refuse to pay compensation. What is the appropriate action to take against the insurance company to force it to pay compensation, and what is the appropriate action to take against the worker? Please advise
Answer:
I would advise the questioner the following:
The insurance company is responsible to pay the compensation. The appropriate action to be taken against the worker is to file a complaint against him in front of the police. If it was proven that he is guilty, then you have to include him in the civil compensation case which you must file against the insurance company to force it to pay the compensation.
The compensation is a matter estimated by the court as per the documents submitted including the insurance contract, the expert report, etc.
As per law, The insurer is liable for damages resulting from the unintentional fault of the insured or the beneficiary, for fire damages that occur by persons for whose acts the insured is responsible and for the damages resulting from the fire even if the fire broke out owing to a defect in the thing insured.
His liability is finished if the damage is caused deliberately or fraudulently by the insured or the beneficiary so that the insured — by a voluntary act of him — has deliberately created the danger himself or through someone else.
This is indicated in Articles 1039 and 1040 of the UAE Civil Transaction Law which states that ("Notwithstanding any agreement to the contrary, an insurer is not liable for damages caused deliberately or fraudulently by the insured or the beneficiary"). ("The insurer is liable for damage caused by persons for whose acts the insured is responsible, whatever be the nature of their fault").
