Shimon Cohen – Insurance

Egert Cohen

The true measure of a good Insurance Agent is how effectively he deals with Claims

EGERT & COHEN was founded by Mr. Roman Egert Z”L, who previously ran a large insurance agency in South Africa. He made Aliyah with his family in 1985, and planned to retire in eretz Israel.

However, soon after arriving here, the value of the South African Rand fell and Mr. Egert decided to make a fresh start in the insurance business. From that humble beginning, Yona Egert, Roman’s son and Shimon Cohen, Roman’s son-in-law, have carried on the family tradition of commitment to top notch service.

E & C specializes in personal family insurance solutions, while also providing the usual types of insurance. Furthermore, E & C has developed an expertise in Travel Insurance for both outgoing and incoming travelers.

An insurance agent is essentially measured by how well he/she deals with claims. Over the next few issues of Bizness Magazine, we will share with the readers some interesting real-life claims and the way our agents dealt with them.

Case 1:
Our client, a new driver, picked up a “trampist” on the way back to R.B.S. She completed her good deed by letting him off near his home (which also happened to be immediately after a traffic circle). An approaching car, while carefully entering the traffic circle, did not notice that she had stopped and rear-ended her. Usually, the classic retort is that the car at the back should have kept a safe distance, but, in this case, there was also clear negligence on the part of our client.

Case 2:
Our client was heating oil to fry a batch of chips. Suddenly, she realized that she was late for pick-up time at Gan and she raced out of the house, forgetting totally about the bubbling oil. The result: a fire in the kitchen and a NIS 20,000 claim. As in the previous case, there was definite negligence on the part of our client
In both cases, excessive negligence caused the accidents, therefore the insurance companies involved refused to pay out the full claims.

Many insurance claims are due to negligence (e.g. most motor accidents and many household claims, so why are these cases different?

There is something called contributory negligence. This basically means that the negligence is more than just a simple mistake or misjudgment. It is something that a normal person would not do.

A Court Case
Mrs. S.G. sued the municipality of Bat Yam. She had complained about a loose manhole cover outside her front door. The municipality did not take care of it and one day, Mrs. S.G. stepped on the cover and fell into the hole.

Judge Asher Goldin upheld her claim against the municipality in that they were indeed responsible, but he also reduced the claim by 30%. In his judgment, he pointed out that any normal person would not have relied only on phone calls to have the problem fixed.

In the case of a faulty manhole cover right outside one’s door, one should place some physical barrier there as well to remind themselves of the possible danger. This, in his words, was a case of contributory negligence.

Claims! Claims! Claims!
We have all been through it. Your car is perfectly parked outside the shopping center. You return to find a huge dent in the side of the car with a “sorry” note on your windshield. You have the damage repaired and then, because the other party is totally at fault, you make what is called a (ג’ צד Third Party) claim against his/her insurance. Now, what are your rights and obligations?

i) You can only claim once for the damage. Therefore your insurance company must supply you with a no-claim letter to prove that you are not claiming from your own company.

ii) You are obligated to lessen the damage as much a possible. (You cannot wait 2 weeks to repair a broken windshield and then also claim for rain damage to the seats).

iii) The other party’s insurance company has to confirm the receipt of your claim (this confirmation usually comes to your insurance agent).

iv) The Law states you must receive payment within 30 days of their receiving all the paperwork necessary for a claim. The 30 days are up and no payment is in sight? They have to add the C.O.L. linkage + 4% interest from the day that you sent in the claim.

v) What if they agree to pay only 50% of the claim (i.e. you claim for 2 doors and they agree to pay for one only)?

By law, any amount that is agreed upon by both sides must be paid and what remains can be decided in court. Therefore if you receive a check from the insurance company for 50% which requires you to sign a full waiver of future claims, you must consult with your agent before signing to make sure that you leave your options open.

For free consultation, please contact Egert Cohen Insurance at 02-623-2546,  Shimon Cohen at 050-5482192 or Yona Egert at 050-5363897 or check out our website:
Egert & Cohen Insurance is a member of the Bizness Magazine Professional Network.

Articles By Shimon Cohen – Insurance

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