The participant submitted an own damage claim for cost of repair of his vehicle. However, the claim was repudiated on the ground that
the vehicle was damaged due to flood, which is an exclusion under the certificate.
The participant in his appeal letter contended that he was not advised on the terms and conditions of the certificate. He was not satisfied with the explanation provided by the takaful operator and insisted that due to the unpredictable weather in Malaysia, the certificate should have covered the damages.
Investigation and findings
The following findings were noted:
1. The participant was a professional expatriate who worked with a private institution of higher learning.
2. The loss adjuster’s report revealed the following facts:
• The damages to the participant’s vehicle were confined to the lower parts of the engine. There was no obvious damage to the outer body of the insured vehicle.
• The participant was driving downhill towards a tunnel when a wave of water gushed out from the tunnel causing a flash flood. Hence, he was unable to escape from the water/flood.
• The area was prone to flooding.
• The participant had misjudged the depth of the water level and had driven into the flood.
3. The ‘Private Car Policy/Certificate’ states as follows:
‘1b: What is not covered
The events which are not covered are the exceptions listed below:
We will not pay for the following losses
(vi) Convulsion of nature
Any loss or damage to your car caused by flood, typhoon, hurricane, storm, tempest, volcanic eruption, earthquake, landslide, landslip, subsidence or sinking of the soil/earth or other convulsion of nature.’
4. The certificate coverage did not extend to cover flooding as there was no additional flood cover stated in the Schedule. There was no evidence adduced to indicate that the participant had paid additional contribution to cover flood.
Recommendation
Based on the facts and circumstances, we explained to the participant why the claim was repudiated. The participant accepted OFS’ clarification and did not wish to pursue the matter further.