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Claim Declined for Forgetfulness - Illegal Acts Exclusion Case Study

We usually think of an illegal act as a crime or at least, an action the insured person took that was a breach of the law. The example we often give in workshops is that a person got drunk and drove their car. Most fully underwritten insurance will pay anyway - the best policies have no exclusions at all after an initial period. Some insurance policies decline to pay for illegal acts, but many people that take these policies out assume that because they are generally law abiding, these exclusions will not apply to them. 

We invite you to consider this case, that FSCL reports. A claim was declined under the illegal acts exclusion when a passenger in a car died because she had not put her seat-belt on. We are worried about this decision, because mere forgetfulness, especially on the road, could mean many claims arise from an 'illegal act'. The lack of clarity for consumers who may not realise that an illegal act includes, essentially, a mistake or forgetfulness, that means a breach of the road rules. Road accidents are a common cause of early death and many accidents resulting in the death of the insured may have been caused, or contributed to, by acts such as straying over the speed limit (however momentarily), drifting out of lane, or failing to take another look at an intersection - thereby failing to give way.

Illegal acts exclusions could represent a much bigger problem than most clients realise. 

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