Injongo
Intshurensi yokungahlawulwanga yonyango ingangeniswa kwipolisi yomthetho jikelele. Ngokuqhelekileyo kunikezelwa njengenxalenye "yokubhengezwa kwandiswa".
Ihlanganisa amabango avela kwiinkonzo zonyango ezinikezelwa ngumqeshi ngesiseko. Nasi umzekelo.
Iindawo ezonwabileyo iinkampani ezizimeleyo ezinika indawo yokuhlala yesikhashana kubantu abanesidingo. Ikampani isebenzisa umongikazi wexesha eliqeshwe ogama lakhe linguBhete ophethe ukulimala okuncinci okugcinwe ngabantu abahlala kwindawo yokuhlala. IBhete icebisa abathengi ngezempilo kwaye iyabaqondisa kwiinkqubo zentlalo ezibonelela ngononophelo lwezempilo. Kwakhona unika uncedo lokuqala kunanoma yiyiphi na iHock Havens abasebenzi abalimele emsebenzini.
Ibhantshi eyoyolo ihlala kwindawo yokuhlala, ingaboneleli ngeenkonzo zonyango. Nangona kunjalo, iHoven Haven okanye iBhete inokumangalelwa ngumntu othi uyalimala ngenxa yeenkonzo zononophelo zezempilo iBhe enikeziwe okanye ehlulekile ukubonelela.
Legalsuit Lawsuit
Kwimeko elandelayo, cinga ukuba i-Happy Havens yiyo ebizwa ngokuba ngumshuwalense kumgaqo-nkqubo ojongene nokunyaniseka okungekho ukubandakanya ukukhutshwa kwezinto ezingekho ngonyango.
UJim ungumxhasi weHock Havens. UJim uhlala kwindawo yokukhusela ngenye intsasa xa efumanisa i-splinter efakwe kwi-forefinger yayo. UBhete uyasusa umgca kwaye uphatha ukulimala kukaJim. Akayiboni okanye ayiva kwiJim ade asebenze ngesigwebo emva kweenyanga ezintandathu. UJim uphakamisa iBhete kunye neeHovu ezonwabileyo.
Impendulo kaJim ngokubhekiselele eBhete uthi uyamncedisa unyango olungapheliyo. Ngenxa yokunyanga okungaphantsi kwakhe, umnwe kaJim waba negalelo elibi. Usulelo lwalukhuni kangangokuba umunwe wakhe wawudinga ukutshatyalaliswa. Impendulo kaJim malunga neHorld Havens ithi inyanzelekile ukuba inkampani ibe yinto enomdla ngenxa yomnxeba wakhe ngenxa yokungahoyiyo umhlengikazi ongenakukwazi. Ingaba enye yeempahla ziza kugqitywa phantsi komgaqo-nkqubo weMfanelo yeHock Havens?
UkuKhutshwa kwabaSebenzi boBuchule
Umgaqo-nkqubo wokunyaniseka weHave Havens awuyi kuwufihla i-suit malunga neBhete. Isizathu sisithuba sokubanjelwa kwi-section ethi Who Is An Insured. Ukukhutshwa kwalo kubonisa ukuba akukho msebenzi okhuselekile ukulimala komzimba okanye ukulimala komntu kunye nokukhangisa ngenxa yokunikezela kwakhe okanye ukuhluleka ukubonelela ngeenkonzo zokunakekelwa kwezempilo. Impendulo kaJim ngokubhekiselele eBhe isekelwe ukungaphumeleli kwakhe kweenkonzo zokunakekelwa kwezempilo. Ngaloo ndlela, i-suit yakhe malunga neBhete ingabandakanywa phantsi komgaqo-xanduva lwe-Happy Havens.
Kuthiwani ngesimo sikaJim malunga nenkampani? Ukugqitywa phantsi kweNkundla yokuLawulwa kweBhodi okanye ukuLawulwa kweMpahla, i-suit kufuneka ifune ukulimala komzimba okanye umonakalo wepropati obangelwa yinto. Ukuba isigwebo sikaJim sichazela ukuba ulwaphulo lomzimba ngenxa yengozi ebanjelwe ukunyaniseka kwe-Happy Havens, le ngxowa inokuthi igqitywe ngumgaqo-mboleko wenkampani.
UkuPhathwa kweeMveliso
Intshurensi yokungabikho kwempilo yonyango iquka izenzo ezenziwa ngabasebenzi abathile bezonyango abaqeshwe li shishini. Akukho ukuvuma okusemgangathweni, ngoko ububanzi benkxaso-mboleko buhluka kwi-insurer enye kwenye. Ezinye izivume zinikezela ngokukhawuleza ngokukhawuleza ngokukhawuleza ukukhutshwa komsebenzi ochazwe ngasentla. Abanye banikezela ngeengxelo ngokunyusa inkcazo yokwenyuka komzimba ukubandakanya izenzo ezenziwe ngabasebenzi abahlukahlukeneyo bezonyango abaqeshwe li shishini.
Uninzi lweemvume lukhawuleza ukukhawulelwa kwimiba ethile yeengcali, njengongikazi, ochwepheshe bezonyango eziphuthumayo kunye nabagadi be-paramedics. Ezinye zibandakanya iinkonzo ezithile, ezifana nezonyango, ugqirha, amazinyo, i-laboratory, ii-x-ray kunye neenkonzo zonesi.
Ezinye izivume zenzakala ukulimala okuvela kwinqununu yokuqala enikezelwa ngumqeshwa, nokuba ngaba ngumqeshwa wezobugcisa.
Ezinye izikhuselo ezibangelwa ngumqeshwa osebenza njengomSamariya olungileyo.
Inkcazo yezokwelapha ezingafunekiyo zenzelwe ukukhonza njengomthombo osisiseko sonyango lomsebenzi wezempilo. Ngaloo ndlela, isebenza ngokungaphezulu kwesinye i-inshorensi. Ngokomzekelo, ukuba ibango lifakwe kumhlengikazi oqeshwe okhuselekile phantsi komgaqo-nkqubo wokunyaniseka , kuya kusebenza emva kokuba i-coverage yecandelo loxanduva lomhlengikazi lisetyenziswe.
Umqeshwa oQhatywayo awufihliweyo
Kwimimiselo eyoyolo ichazwe ngentla, cinga ukuba uJennifer, umsebenzi wabarhulumente kwisiza, unobungozi emsebenzini kwisiganeko sokutshatyalaliswa kunye nokuwa . IBhete inikeza uncedo lokuqala ukuya kufika i-ambulensi. Kamva uJennifer uhlaselwe isifo kwaye uyayithatha iBhete kunye neNdawo eziThabileyo ngenxa yokulimala komzimba. Ngaba ipolisi ye-Haven Happy 'ipolisi yembopheleleko iyakuthi ifake? Impendulo ayikho.
Imigaqo-nkqubo yokuzibophelela ngokubanzi ayifuni iimboti ezichasene nabaqeshi ngabasebenzi abalimele. Iimpahla ezinjalo zikhutshwa ngaphandle kokunyanzelwa kwabaqeshwa . Iimigaqo-nkqubo zokuzibophelela nazo zibandakanya izikhwathi ezifakwe ngumqeshwa omnye kumnye. Izibophelelwano phakathi kwabasebenzi abaqeshweyo zingabandakanywa ngokungabandakanywa kwabasebenzi . Abasebenzi abalimele emsebenzini kufuneka bafake ibango phantsi komgaqo-nkqubo wokuhlawula abasebenzi . Amabango afakwe kumqeshi okanye umqeshwa osebenza naye (kubandakanywa nochwepheshe bezobugqirha abaqeshwe) abanakuphumelela.