Case 1: Entrepreneur’s Scheme – Robbery at Outlet –Claim declined as warranty condition not complied

Background

ATakaful Operator had repudiated the claim of this participant whose outlet was robbed by an armed robber on the basis that special warranties to which the certificate was attached to were not complied with.

The Takaful operator quoted the Special Warranties as follows:-

  1. Closed circuit television (CCTV) cameras installed at strategic locations
  1. Alarm system complete with central monitoring system (CMS) linked to Police station or response team
  1. Tempered glass with iron grille protecting jewellery display rack/counter
  1. Safe box and/or vault for storage of stocks after business hours.

The Participant contended that based on the certificates provided to him since he first took up this coverage two years ago, the above warranties were not stated.

Investigation and Findings

The case manager noted the following:-

  1. The warranties mentioned above were stated on the renewal certificates which were only provided to the participant after the loss had occurred.
  1. This coverage was arranged through an intermediary which the Takaful Operator claimed have been briefed of the special warranties mentioned above.
  1. The warranties were not stated on the certificates for the previous two years.
  1. The Takaful operator was also not able to provide any documentary evidence that this warranty was communicated by the intermediary to the participant.

The Case Manager was of the view that while the Takaful Operator has the right to impose or change terms and conditions, they should provide reasonable time and written notification to the participants of such changes before the renewal. This is to enable the participants to make the necessary changes to comply with the new terms and conditions or to look for other coverage.

They should also be mindful that any communication to intermediaries should not be assumed to have reached the participants.

The Takaful Operator agreed to review their decision.

Settlement

The Takaful Operator had agreed to revise the offer and the revised offer was accepted by the Participant.