What is not covered under the CFP Broker’s policy?

Please note that in the list below we are providing information in respect of some of the exclusions of cover.  We urge you to carefully read the policy schedule and policy wording document which provides full details of all of the exclusions of cover.  A more comprehensive response is found in our document entitled “What is not covered under the CFP Broker’s policy”.

  1. We need to remember that the CFP Broker’s policy is a legal liability policy intended to compensate third parties for losses they allege that you have caused them to suffer. It is therefore not going to cover you for losses you might suffer (aside from your legal defence costs). So, for example the policy is not going to assist you to take legal action against a person who you feel is defaming you.
  2. Claims/complaints arising out of services rendered which fall outside your scope of practice, unless such services fall under the Good Samaritan clause where you rendered services at the scene of an emergency.
  3. Claims/Complaints arising out of services rendered prior to your retroactive cover date.
  4. Claims/Complaints which have not been timeously reported to CFP Brokers / your Insurers.
  5. Legal assistance for medical aid audits. However, you still need to notify us as soon as you become aware of a medical aid wanting to audit your practice or questioning your billing procedures. The reason for this is because if you are subsequently reported to the A/HPCSA, then the policy does respond (subject to terms and conditions) to assist you with legal defence costs.
  6. The policy does not provide cover for fines, penalties, punitive, vindictive or exemplary damages imposed on you or awarded against you.
  7. The policy responds to cover your legal liability to compensate someone. Insurers will not pay every person who might injure themselves falling at your practice or who otherwise claims payment from you on some or other basis. Legal liability on your part has to be established before the policy will pay a third-party compensation. Your legal defence costs will be covered while your legal liability is being established or defended.
  8. If it is alleged that you have overcharged a patient, the policy is not going to refund you any amounts you pay to that patient or that you agree to pay in a medical aid audit.
  9. There is no cover for any allegations of sexual misconduct in the course and scope of your practice. However, if you are subsequently found not guilty or liable, then the policy will refund you your defence costs. For this reason- you should please notify us of any allegations against you or your employee of sexual misconduct.
  10. Claims/Complaints arising out of services rendered when you were under the influence of drugs or alcohol.
  11. Claims or complaints which you were aware of in a previous policy period but failed to notify us of at the time. Although please be aware that you do have a 30-day period after the end of the policy period (31 December) to notify us of any potential claims or complaints that you became aware of prior to 31 December.
  12. Claims for cyber-liability, employment practices’ liability, directors’ and officers’ liability and commercial crime.
  13. Losses that you suffer as the result of your own employees stealing from you.
  14. If you enjoy cover under the public and products’ liability section of the policy, then you will not be covered for:
    1. Claims arising out of the failure of a Product, or any part thereof, to fulfil the purpose for which it was intended, or to perform as specified, warranted, or guaranteed; but this Exception shall not apply to consequent bodily injury or loss of, or damage to, property; or
    2. Claims arising out of recalling, removing, repairing, replacing, reinstating, or the cost of, or reduction in value of, any Product, if such liability arises from any defect therein or the harmful nature or unsuitability thereof.
  15. Claims for damage to property owned, leased or hired or under hire purchase or on loan to the Insured or otherwise in the Insured’s care custody or control other than:
    1. premises (or the contents thereof) temporarily occupied by the Insured for work therein, or other property temporarily in the Insured’s possession for work thereon (but no indemnity is granted for damage to that part of the property on which the Insured is working and which arises out of such work);
    2. employees’ and visitors’ clothing and personal effects;
    3. premises tenanted by the Insured, but only to the extent that the Insured would be held liable in the absence of any specific agreement;
  16. For claims or complaints arising out of any dishonest, criminal or malicious act or omission, or any act or omission in violation of any law or ordinance, committed by or on behalf of the
    Insured, save where such criminal or illegal conduct is negligent and not reckless or intentional.
  17. For claims or complaints arising out of any loss, damage, cost or expense directly or indirectly arising out of, contributed to by, or resulting from any infectious epidemic/pandemic.

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