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A 2017 claim lodged against an insurance company for turning down insurance indemnity

According to the Claim, there has been a traffic accident involving three motor vehicles, and damage has been caused to the Client’s own “Opel Vectra” as a result. The Client has applied to the Company for insurance indemnity. The Company has arranged an auto-technical expertise that measured the damage to the car to reach an estimated AMD 180,000. The cause of accident has been examined, after which the driver of Hyundai Tucson was also found to be responsible for the accident, while the Client and the other participant of the accident, the driver of “Mercedes-Benz”, have been recognized faultless. The Company has made a decision to reject insurance indemnity, reasoning that the owner of the motor vehicle found guilty is unknown. In a letter to the Financial System Mediator, the Client demanded that the Company pay the full amount of insurance indemnity against the damage caused, which amounts to AMD 180,000. After investigating the claim, the Mediator has decided to satisfy the Client’s claim lodged against the Company. Read more ... 

A 2017 claim lodged against an insurance company for turning down the insurance indemnity under health insurance

According to the Claim, Client acts as an Insured person under the voluntary health insurance contract. Because of deteriorated health condition, the Client was taken to “Erebuni” Medical Center where he had been examined and received an in-patient conservative treatment. While the Company has reimbursed medical examination costs, the money spent on an in-patient treatment and all required medicines has not been reimbursed on the ground that the Client is recognized as a 3rd degree disabled person. The Company has noted that if the medical center does not provide free in-patient treatment under the government-guaranteed orders, the Company will do it; but the matter is that it is not reimbursable for now.The Client has paid AMD 215,000 to cover the treatment costs, subject to reimbursement by the Company. The Client has filed a complaint to the Company but has been turned down, however. The Client has requested from the Company to provide insurance compensation of AMD 215,000 which the Client has paid to cover the in-patient treatment costs. Read more ... 

A 2017 claim lodged against an insurance company for turning down the insurance indemnity under health insurance

According to the Claim there has been a health insurance contract signed between the Bank and the Company, whereby the Client was an Insured person. A number of medical examinations have been carried out at “Nairi” Medical Center, with a subsequent one to be carried out four months later. The Client noted that a new contract was signed with the Company. Experiencing sharp stitches on the neck, the Client contacted the Company with a request to carry out the medical examination a little bit earlier but was denied verbally. The examination has been carried out at “Izmirlian” Medical Center and the Armenian-American Health Center for which the Client has paid AMD 10,000 and AMD 7,500, respectively. The Client has filed a complaint to “Garant Assistance”, the Company’s agent, but received a refusal. The Client does not agree with such position as the medical examination is what the specialist has assigned, which is subject to compensation. In a letter submitted to the Mediator, the Client demanded that the Company provide insurance compensation in the amount of AMD 17,500. After investigating the claim, Mediator has decided to reject the Client’s claim against the Company. Read more ...

A 2017 claim lodged against an insurance company for a disagreed size of damage and penalty applied for belated days

According to the Claim there has been a traffic accident that caused damage to the Client’s own motor vehicle “Opel Vectra 1.8”. The traffic police officers have arrived at the scene of accident and had it protocoled. An administrative proceedings followed based thereon but was abated at some point later. Having received the Expert’s opinion, the Client filed an application to the Company but did not receive any document in writing on the request within the timeframe established by law. Pursuing resolution of the problem, the Client has filed a complaint to the Company and received an answer saying that the Company has made a decision for insurance indemnity and has subsequently paid AMD 46,500 as insurance compensation, which the Client disagreed with. The Client noted that he’s been a downright suffered party of the accident, nor has he behaved in a manner that could have contravened the Road Traffic Rules. In a letter to the Financial System Mediator, the Client demanded that the Company recompense the damage caused, which amounts to AMD 120,000, and cover the fines as provided for under the Terms for the days belated. After investigating the claim, Mediator has decided to partially satisfy the Client’s demand. Read more ...