You will inevitably be asked the question: “How many parts make up the property you want to insure?” Most of the time, the answer is obvious since it suffices to add the living rooms – bedrooms, living rooms, garages – to obtain it and to exclude the bathrooms, hallways, kitchens and toilets. However, some properties are more difficult to value. As the insurance mediator relates in one of the practical cases he had to deal with, insurance contractsHome Insurance can be (very) picky/fussy about it.
An individual who took out cover for his home was thus confronted with the following definition in his general conditions for counting the number of main rooms: “Any room for residential use with a surface area greater than 8 square meters with the exception of entrances, hallway, landing, kitchen, shower room, bathroom, WC, storage room, pantry and outbuildings.” For now, things are clear.
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Removal of part of the allowances
But the general conditions add a precision, complicated at first sight, for the count: “Any room with a surface area greater than 40 square meters is counted for as many rooms as there are slices or fractions of slices of 40 square meters. ” Translation: an area between 40 and 80 square meters must be considered as a double room, an area between 80 and 120 square meters as a triple room, etc…
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A disaster then occurred in the property. On this occasion, the insurer noted an error in the statement when reporting the claim. One of the rooms exceeded the ceiling by 40 square meters and had to be counted as two rooms. The individual is accused of having completed a false declaration, certainly unintentionally, under article L.113-9 of the insurance code. He was thus deprived of part of the compensation to which he was entitled. And again, this is the best case scenario since other insurers could have reduced the compensation to nothing.
The insurer does not have all the rights
The insurer is however at fault, believes the mediator. The notion of false declaration is surrounded by safeguards. “According to the most recent case law of the Court of Cassation, however, the false declaration can only be penalized on the condition that the insurer has asked a specific question, to which the insured has answered incorrectly.”
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This is where our individual was able to find an emergency exit. If it is well inserted within the general conditions of the contract, no definition is however specified in the special conditions. And no reference to the general conditions including this definition has been made. The individual therefore did not have all the keys in hand to give the exact answer to his insurer when he filed a claim. “Noting that this proof was not reported, the mediator invited the insurer to fully compensate the insured, without application of the proportional rule”, thus concludes the mediator
