RaetsMarine insures, but does not pay

Dutch insurance company "RaetsMarine" and its Russian partner, Falcon P&I Ltd company – do not want to pay disability compensation to the seafarer, motivating their decision by that person still can be cured completely and he will return to work at sea. However, the seafarer is ashore throughout two year by now, without having any slightest possibility to work at sea ever again. Yet, the insurers persistently do not wish to recognize this fact.

Two years ago the chief engineer got a femoral neck fracture during his work on board. The seafarer was operated in a Greek clinic and the implant was inserted. Then he was repatriated to continue his treatment at home. Ashore the seafarer has received medical treatment, but, unfortunately, has not recovered completely, and the third group of disability had been established.

Thus, an epopee which lasts to this day has started. After finding of the seafarer unfit for the further work at the sea the question about compensation payment for disability and the payment of basic wages for period of his sickness arose. But the insurance company had stated that chances to get the payment are virtually a zero. Representatives Falcon P&I Ltd which represent the RaetsMarine Co. at first had alleged that the payment can not be made due to not receiving a sick-leave certificate, which the seafarer couldn’t get legally since he worked onboard vessel under a Flag of convenience, and according to the Russian legislation, a sick-leave certificate may be issued for the companies domiciled in the Russian Federation only. The representatives of the Falcon Co. should have been aware of this, but they have preferred to misinform their Dutch partners.

Further, without wishing to part with the considerable amount of money, the insurers began to allege that the seafarer violated the prescribed treatment regimen, in spite of the fact that the Falcon company even never worried to organize a such treatment for the seafarer. He had to undergo the medical treatment using his Policy of Obligatory medical insurance (OMS).

As a result, the representatives of the Falcon P&I Ltd. having exhausted all their explanations (ridiculous anyway) had decided to send the seafarer to St.Petersburg for medical examination by the doctors appointed by the insurers. Why? Did they mistrust to the conclusions of two previous medical commissions? Or did they wish to recognize the seafarer as fit for work at the sea by all means? But again, the appointed commission has confirmed that the chief engineer cannot work at the sea after having a femoral hip prosthetic implanted, and that he can even walk only by using a cane.

But even the conclusion of “own” experts did not impress the insurers! The affair came to the point of absurdity: a complete medical examination had also shown that the seafarer had gallstones, and insurers had once again refused to pay the compensation under this new pretext! They seemed to forget the fact that the disability was assigned as a result of an injury on board.

However, it is for the second year by now already second that the man is declared as having the third group of disability. Insurers from the Falcon P&I Ltd. try to grasp at a straw, alleging that this (the gallstones) is why they cannot pay compensation to the seafarer.

They claim that according to the Russian legislation, to be exact - according to the Russian Federation Governmental Decree No.247 of 7 April 2008, “On amending the Rules of establishing disability”, the disability is established without indicating its period not later than two years after initial finding a person having diseases, defects, or irreversible morphologic changes (according to the approved list) as a disabled one, and not later than four years after initial recognition of a person as a disabled one when it is found that the disability caused by lasting irreversible morphologic changes, or defects, or dysfunction of body systems or organs.

The representatives of the Falcon P&I Ltd. are trying to use the law as a cover and don't want to look up the seafarer’s employment contract terns and conditions, whereas the latter stipulate that in case a worker loses 50% or more of his ability to work, he is entitled to 100% of the full disability compensation, and according to the doctors’ opinion, the trauma of the chief engineer is one that falls under clause of 50% and more rate of disability.

The Seafarers Union of Russia, seeing that no arguments can persuade the company, turned to English lawyers on behalf of the seafarer. They initiated a lawsuit against the owner of the vessel in an English court since according to the seafarer’s employment contract, all disputes shall be solved under the English laws. The Employment contract where compensatory payments are stipulated, was concluded between the seafarer and the shipping company, thus the worker had no agreements or direct relations with the insurers. The representatives of the SUR and the ITF submitted all necessary documents to their foreign colleagues and monitor the situation.

In spite of the fact that case is going to be dealt with by an English court, the representatives of the Falcon P&I Ltd. continue to enact a farce. After the claim against them was filed, they started to act again: according to our information, they are doing their best to have the findings of all previous medical expertise confuted, and to get a new decision on the seafarer’s condition.

For all these years, the seafarer has to visit various clinics to be examined by medical commissions, to collect medical certificates and to prove his entitlement to the insurance payment, instead of just receiving due medical treatment. The lack of money does not allow him to get an expensive treatment to minimize or to eliminate the post-surgery stress-shielding syndrome (a.k.a. osteopenia) accompanied by severe pains in a place of fracture.

Despite all misfortunes and prolonged resistance of insurers, there is a good chance that justice will triumph, as the seafarer is a member of the SUR, so he is backed not only by this trade union, but also by such a strong and influential organization as the International Transport Workers Federation. The hopes for a long-awaited victory are also supported by the fact that the SUR has already dealt with the same companies – the RaetsMarine and the Falcon P&I Ltd., and won.

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In 2011, in the port of Dubai, a second Engineer died during watchkeeping, at the age of 45. Before the voyage the man has signed his employment contract, but failed to include his wife’s name as his next of kin and a heir. The lapse of the seafarer gave to the RaetsMarine Co. a formal pretext for not paying the death compensation to the widow. The company alleged that the seafarer hadn’t expressed his will, and the formal marriage did not grant to the widow entitlement to death compensation. And again, the interests of the RaetsMarine Co. in Russia were represented by the Falcon P&I Ltd.; the latter maintained that the formal marriage certificate was not enough. It was suggested to widow to bring witnesses who could confirm that the seafarer did love his wife and really was officially and lawfully married to her. It was said that it would be better if she could brung more than one such witness. But two labour Unions (German Ver.di and the SUR, both affiliated to the ITF) stood up for the family of the diseased seafarer. The case was heard in a German court which made athe definitive judgemet on this case, having obliged the shipowner to pay to the widow not only the death compensation, but also to compensate her moral losses – as the lawsuit lasted for two years.