What would you do if your insurance company tried to evade compensation in the hundreds of thousands of shekels for a clear insurance case, after years of paying it huge premiums for "all-risk" insurance coverage for your business?
This is precisely what a lawsuit filed by attorneys Rafael Almog and Yoav Gafni, of the Rafael Almog & Co. law firm, against the insurance company Shlomo, on behalf of a meat production and storage plant in Beit Shemesh, is about.
The lawsuit tells a story about serious damage caused to a huge meat stockpile, as a result of water and hot air entering a designated refrigeration room in the factory, where dozens of tons of meat were stored at a constant temperature of minus 18 degrees Celsius.
According to the lawsuit, at a certain point, factory employees discovered that a large stock of meat stored in the refrigerator had thawed and completely spoiled, due to the increase in temperature in the refrigerator room.
A professional investigation revealed that one of the walls of the cold room was damaged and hot air penetrated it, destroying the valuable inventory.
A certified appraiser appointed by the plaintiff conducted a thorough examination of the incident and determined that the direct cause of the thawing of the meat was water that penetrated the walls of the building through the roof, as a result of air conditioner drainage and washing of solar panels installed on the roof. The water seeped through the insulation infrastructure and damaged panels, froze and cracked the insulation layer, and thus warm air began to penetrate the refrigeration room, and as a result, the temperature rose and the huge stock of meat completely spoiled.
The appraiser estimated the damage to the meat inventory at approximately 750,000 shekels, before VAT, and the damage to the building itself at more than an additional 50,000 shekels, without additional VAT.
According to the lawsuit, once the serious malfunction was discovered, the factory employees kept an accurate record of all the meat products that were destroyed, and ensured their destruction.
At this point, the plaintiff's representatives contacted the Shlomo insurance company, which insured the factory under the Shlomo Business policy, which included extended coverage for "all risks," and demanded that the company be compensated for the full damage.
However, to their surprise, the Shlomo company decided to reject the claim outright, claiming that it was "damage resulting from poor sealing," and that this type of damage was not covered under the policy.
The plaintiff turned to the law firm of Rafael Almog & Co., which specializes in tort law and elementary insurance claims. After delving into the details of the dispute, attorneys Almog and Gafni filed a detailed lawsuit against 'Shlomo' with the Herzliya Magistrate's Court.
According to the lawsuit, the claims of Shlomo Company are inconsistent with the terms of the policy that the plaintiff purchased and are even contrary to the principles of the Insurance Contract Law.
According to attorneys Almog and Gafni, the policy explicitly includes coverage for damages caused by unexpected water and steam. According to them, the insurance company's rejection letter is based on reservations and exclusions that were not known in advance to the plaintiff.
On the other hand, in the defense that Shlomo Company submitted to the court, it accuses the plaintiff of "attempting to fraudulently obtain insurance benefits" and claims that the plaintiff did not present enough evidence and documents to prove the damage, and even reported the incident with considerable delay, which, according to the insurance company, caused significant evidentiary damage that prevents it from verifying the truth of the incident.
According to attorneys Almog and Gafni, this claim is no less puzzling, since the incident was examined by the Shlomo company, including by an expert appraiser on its behalf, and following that examination, Shlomo decided to dismiss the lawsuit on its merits, and at no point did it claim that the delay in notifying it of the incident caused it any difficulty in clarifying the lawsuit.
In the lawsuit, attorneys Almog and Gafni emphasize that the insurance company's claims are nothing less than an ugly attempt to evade payment of compensation to which the plaintiff is legally entitled, and that the insurance company's conduct is carried out in gross bad faith.
According to them, "It is unacceptable that insurance companies sell extended insurance policies to policyholders, but when an insurance event occurs, they suddenly shirk their obligation and try to hide behind reservations that were not known in advance. We are convinced that the court will see things as they are and will require the insurance company to compensate the policyholder for the full damages she suffered in accordance with the law."
As part of the lawsuit, attorneys Almog and Gafni asked the court to order Shlomo to pay their client the full insurance benefits she is entitled to, in the amount of approximately 800,000 shekels, as well as to compensate her for additional damages, legal expenses, and attorneys' fees.
The Herzliya court recommended that the parties consider a mediation process, or alternatively, appoint an agreed-upon expert to examine the professional issues in dispute.
In the coming days, the parties are expected to submit their position on the matter to the court.
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