Liability insurance refuses damage: liability and cover

1. Separate liability and insurance cover

Ask whether the insurer refuses payment because it considers you not liable or because liability falls outside the policy. These are different decisions. Kifid shows for everyday accidents that feeling guilty does not automatically create legal liability. It does not follow that personal fault is necessary for every form of liability; special situations require their own legal framework. First establish the ground on which the injured party relies. Only then will it be clear which facts matter to your defence and which policy clauses also need assessment.

2. Report the incident factually

Report who was involved, what happened and what you personally saw. Attach the liability claim and note when you received it. Do not base your account on what you think insurance reimburses. Changing the story to obtain cover can create serious new problems. Identify uncertainty clearly and keep original messages. Ask who communicates with the injured party. An apology out of sympathy is a different question from legal agreement on liability or a payment obligation; if in doubt, have important statements assessed beforehand.

3. Check who and which activity are insured

Read the policy schedule and definition of insured persons. Is the person involved covered and was it a private activity? Being a family member or sharing an address is not sufficient in itself to insure every situation. Children's position can also raise special liability questions; Rijksoverheid explains that age makes a difference. This must be considered alongside the insurance conditions. Do not adopt a general rule for all children or household members. For a business act or motor vehicle, another policy and legal framework may be relevant.

4. Examine the relevant policy restriction

Ask which provision the insurer applies and to which facts. Specific clauses may apply to an item in your custody, a special activity or an allegation of intent. Wording and circumstances determine the question; a general conclusion that borrowed items are never insured is not a reliable assessment of every policy. Create a table of main cover, restriction and relevant facts. A lawyer can determine its interpretation. Also provide the application and special agreements if you argue that this particular risk was deliberately included.

Also check whether your personal liability policy (AVP) expressly extends cover to a friendly favour or unfortunate coincidence. Under their own conditions, some policies also reimburse damage without legal liability, often up to a separate maximum. Such an extension does not turn moral guilt into legal liability and is not present in every AVP. Ask the insurer about both the liability basis and a possible contractual extension and its associated cap.

5. Keep the amount and causal link separate

Request an itemised substantiation of the damage claimed. What was the original condition, what repair is necessary and which costs have already been paid? A large replacement amount is not automatically a correct loss calculation. Preserve photographs, invoices and relevant statements without unlawfully examining someone else's belongings. The technical question of what is damaged may be separate from legal liability. Keep that distinction in your response too. If the insurer handles matters on your behalf, ask what it admits or disputes and what further information is needed.

6. Respond to claims and proceedings on time

Forward any formal demand or summons immediately and ask who handles the response. An insurer's file does not automatically mean a formal deadline is already being monitored. Obtain independent advice if unclear. You can prepare a focused internal complaint against refusal of cover; the AFM describes written complaint handling and possible next steps. Your own insurance complaint is not the same procedure as the injured party's claim. Monitor both tracks separately. Refusal by your insurer does not automatically make the other person's claim unfounded or automatically payable.

7. Fictional example: damage during a visit

Suppose a visitor damages furniture and wants to pay immediately out of embarrassment. The insurer first asks what happened and which precautions were reasonable. The visitor supplies a factual account and photographs without retrospectively making the circumstances more serious. The injured party sends a repair estimate. This fictional example predicts neither liability nor reimbursement. It shows that the moral wish to compensate someone, the legal basis and cover are separate subjects. A private payment agreement should not inadvertently be confused with an insurance decision.

8. Checklist for advice on a liability claim

Ask which liability framework applies, which cover is disputed and who conducts the defence against the other party. Discuss costs and possible conflicts of interest. Bring the complete documents so an insurance question is not answered without awareness of proceedings already underway.

• Policy, insured persons, conditions and special agreements.
• Factual timeline, original statements and photographs.
• Liability claim with legal basis and loss calculation.
• Insurer's positions on liability and cover separately.
• Formal demand, procedural documents, deadlines and communication arrangements.