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The implications of September 11: |
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Sample Policy Exclusion: Property & Casualty Policies
"War, including undeclared or civil war" and "warlike action by a military force,
including action in hindering or defending against an actual attack or expected attack,
by any government, Sovereign or other authority, using military personnel or other agents".
Sample Policy Exclusion: Travel Policies
"Loss, damage, or liability arising directly or indirectly from or occasioned by
or through or inconsequence directly or indirectly of or claim for: war, invasion,
act of foreign enemy, hostilities or warlike operations (whether war be declared
or not), civil war, mutiny, civil commotion assuming the proportions of or amounting
to a popular rising, military rising, insurrection, rebellion, revolution, military or
usurped power, or any act of any person or persons acting on behalf of in connection
with any organization the objects of which are to include the overthrowing or
influencing of any de jure or de facto government by terrorism or by any violent means"
Sample Policy Exclusion: Health Policies
Any consequence, whether directly or indirectly, proximately or remotely occasioned by,
contributed to by, or traceable to, or arising in connection with:
a) war, invasion, act of foreign enemy hostilities, warlike operations
(whether war be declared or not), or civil war.
b) mutiny, riot, strike, military or popular uprising insurrection, rebellion,
revolution, military or usurped power.
c) any act of any person acting on behalf of or in connection with any
organization with activities directed towards the overthrow by force of
the Government de jure or de facto or to the influencing of it by
terrorism or violence.
d) martial law or state of siege or any events or causes which determine
the proclamation or maintenance of martial law or state of siege
- (hereinafter for the purposes of this Exclusion called the "Occurrences").
Any consequence, happening or arising during the existence of abnormal conditions
(whether physical or otherwise), whether directly or indirectly, proximately or remotely
occasioned by or contributed to by, traceable to, or arising in connection with any of the
said Occurrences shall be deemed to be consequences for which the Insurer shall not be
liable under the Policy except to the extent that the insured shall prove that such
consequence happened independently of the existence of such abnormal conditions.
Life Policies
Act of war exclusions are rare in life insurance policies issued today, although they
have been commonly used in the past during times of war or impending war. Some life
insurers do use "terrorism exclusions," but only for individuals traveling to areas where
terrorist attacks are common.
What happened following September 11?
After September 11, almost all insurance companies issued a statement to the effect that
'This insurance company has determined that policy language excluding coverage for acts
of war does not apply to the September 11 events. This means that no insurance claims for
these tragic events will be refused on the basis of policy language relative to a war exclusion'.
What should one do now?
At a very basic level, health insurance is there to protect its insureds when they get sick or injured
and life insurance is there to compensate the beneficiary(ies) if and when an insured person dies.
But, as with everything in life, there are exclusions and conditions attached to these policies.
On the surface of it, the exclusions outlined above clearly preclude any claim which arises from
injury or death as a result of being caught in the crossfire of a civil war or a terrorist action, such
as September 11. And indeed, some insurers have designed their policies to do exactly that. However,
other insurers have recognized that there is a major difference between active participation and
'being in the wrong place at the wrong time'. They have added wording such as:
"Cover does not cease when terrorist activity is involved as long as the insured is not an
Active Participant. 'Active Participant'…means an active member of the military forces,
Police, or other special forces activated by Government or other public authorities in case
of a Warlike Operation. 'Warlike operation' means hostilities, mutiny, riot, civil commotion,
civil war, rebellion, revolution, insurrection, conspiracy, military or usurped power and martial law
or state of siege. However, cover is excluded if an insured is permanently assigned ('permanently'
means for more than 28 days) to a country after war has been declared in that country or after it
has been recognized as a war zone by the United Nations or where there are warlike operations
as described above."
This clause very clearly delineates the active participation of an insured versus being caught in
the crossfire. But what it does not address is the situation where the US State Department (or one
of its equivalents around the world) has issued a travel warning or advisory against traveling to or
living in a specific country or region of the world. Will or could a specific insurer use that travel
advisory as a way of avoiding a claim? This can only be established in advance by a written
statement from the insurance company clearly enunciating its position on such an issue.
As a starter, I would suggest that one or more of following questions need to be asked:
Am I covered if a terrorist incident or act of war occurs where I live or work? What happens if, for
example, I go to a meeting or a peaceful protest rally and such an incident occurs?
Am I covered if I travel as a tourist to a place where known dangers exist - e.g. Spain, Israel,
the West Bank, Northern Ireland, Colombia, etc? Will I be covered if, for example, I am standing
on the street minding my own business and a terrorist bomb goes off? What happens if there is a
governmental warning (e.g. State Department Travel Advisory) against going there - will that cause
the automatic denial of any claim under the policy?
What happens if I travel there temporarily for work - e.g. as a news reporter, a medical practitioner,
an aid worker, etc? Will my insurance cover me there? For how long? (For example, US medical
insurance usually provides coverage for a maximum of 60 to 90 days out of the country).
What happens if I move there to live for an extended period of time or permanently?
Will my insurance cover me there? For how long?
What happens if I am serving full-time in the Armed Forces of my country or I am called up
to the Reserve Forces and have to go to a war zone or to one of the countries described above?
Will I be covered if an incident happens to me there?
Always get it in writing
It is always easier to ask such questions before a claim arises than to fight the denial of a claim
after the event. As always, if you do ask questions, try to get the answer in writing from an officer
of the company. It is then much harder for an insurer to deny a claim when you have a letter signed by
a VP of the company stating that they would cover it. And, as a final piece of advice, never, never play
claims adjudicator. If you have a claim, even if you believe it won't be covered, send it in - and
let the insurance company deny it!
K&R Insurance
Let us assume that individually or corporately that problem has been resolved and that the health
and/or life insurance will respond as needed. Out of left field comes the unthinkable (or maybe
today, it is not so unthinkable - a member of one's family or staff is 'detained' or kidnapped
and/or an extortion threat is issued. (In today's hi-tech world, this can even include an
extortion threat based on a computer virus!) Most of these acts are carried out in order to
obtain a ransom, and in most cases that ransom is paid. Either way, money and expenses are
involved…and a relatively-unknown insurance coverage - 'Kidnap, Ransom and Extortion insurance'
(known in the insurance industry by the acronym 'K&R') is there to respond to such a situation.
It can be purchased by an individual or by a corporation for its employees and their families. Most of
these K&R policies include the services of an experienced international consulting firm specializing in
all aspects of hostage recovery, including negotiations, liaison with law enforcement agencies, and
delivery and payment of ransom funds.
In the event of an actual kidnapping, rescues are rare largely because the authorities in most
countries recognize that the safety of the victim is paramount. While the aveMost occurrence
of deaths following a kidnap is 9%, in cases involving an experienced 'kidnap management'
organization less than 2% of people are killed - almost always at the time of abduction
rather than during the negotiation. Very obviously the actual placement of these policies
on a specific person or group of people is kept totally secret in order to prevent
a claim under the policy becoming a self-fulfilling prophesy!
Emergency Evacuations
So now, the life and health insurance policies will respond wherever an individual or employee and his or her
family goes in the world and K&R insurance is in place. What else should or can an individual or company do?
As September 11 demonstrated only too clearly, the lack of well-defined and well-rehearsed contingency plans
can be a major barrier to resolving the unexpected when and if it arises. 'Unexpected' should never mean
'unforeseen'. The actual circumstances of September 11 were very obviously unexpected; the fact that one day
the WTC would need to be evacuated under difficult circumstances and the New York City emergency services
would be called on to handle a disaster of this magnitude should not have been unforeseen.
Evacuation of those who live away from their Home Country has now become part of the contingency
planning for individuals and employers. But can it be insured? 'Political Evacuation and
Repatriation Insurance' (PERI) is now available! To quote from the brochure: 'The insurance covers,
in the first place, the evacuation or repatriation of the employee concerned. It does not matter
whether he or she is stationed in a certain country for a longer period, whether they have been
seconded on a temporary basis or is simply visiting a country on a short trip'.
Even if insuring such an event is not contemplated or cost effective, developing a contingency evacuation
and rescue plan is advisable and advised. International evacuation companies, such as International SOS are
geared to assist in developing such plans in advance and in handling the execution of such plans when and if
they are needed. To handle such a situation when it has already arisen is not only foolhardy, but it could cost
lives and a lot more money than developing such contingency plans in advance. Security is illusory and planning
for future contingencies can only build on what has happened in the past. Few could have reasonably foreseen
the actual events of 9/11 - but what happened in its immediate aftermath might have been avoided with some
forward planning and coordination.
Conclusion
Just as every big building and every major city is developing plans to avoid another 9/11 situation, it is
incumbent on every individual living or traveling away from his or her Home Country and every employer of
such people to avoid the same trap. As George Santyana wrote in the early years of the 20th century:
"Those who cannot remember the past are condemned to repeat it"
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Last modified - September, 2002
© Copyright 2002 by Ibencon LLC
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