Claim case sharing
Change of occupation in personal accident insurance
Mr. Leung has been employed as a jazz teacher in a dance school for over three years. As his reputation increased, he decided to start his own business, creating a dance team that performs in clubs, bars, outdoor venues etc. Three weeks ago, he fell off the stage accidently which rendered him incapable of walking in the short term. He then filed a claim for weekly cash benefit for temporary disablement under his Personal Accident insurance with his insurance company. However, the insurance company declined his claim due to the change in the nature of his occupation from employee to self-employed. The insurance company stated that Mr. Leung’s current occupation was different from that which their records showed. He should have informed his insurance company when he stopped being a full-time dancing teacher and became a self-employed performer. In this case, since temporary disablement benefit is not applicable to the self-employed, Mr. Leung was not entitled to any compensation from his insurance company.
As it is very difficult to prove the attendance record of a self-employed person, the temporary disablement section which pays weekly benefit is not applicable to the self-employed person.
Occupation is a crucial factor in personal accident insurance. As insurance companies use the occupation of the insured person to assess risk exposure and to calculate the premium, it is vital that the insured person should inform his insurance company of any updates, especially a change in occupation during the insured period, in order to ensure adequate protection and prevent rejected claims due to unreported changes.
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