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Thread: Water damage claims

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    Water damage claims

    I have got to a stage with insurance companies that i will no longer waste my money on brokers, what i need is an attorney, why because "anything you say can and will be used against you in a claim" Broker dont have the backbone when it comes to claims. Think about, my wife and i pay a broker around R3000 per month for insurance, i have never been paid out a claim, there is always a story, i didnt read my policy properly, something i said made the assessor reject the claim, etc.

    Surely if i pay an attorney like scorpion a monthly fee, lets say there is an advert for around R200 per month instead of paying a broker commission at least when i put in a claim the lawyer can handle the claim. The assessor can deal with the lawyer directly.

    I have been speaking to lots of people on my daily rounds who are fishting for claims, due to water, the insurance comany responses vary from.

    Sorry but we dont cover water which flows under your property, so the fact that your whole driveway has collapsed you are not covered.
    or the roof is not covered due to lack of maintenance,
    or we will pay out a "small percentage" of the claim because you did maintain the roof, but, will cover some of the water damage, but not all because you didnt put a cover over the roof when it began leaking.
    The best so far is my claim, because my driveway is only 3 mm thick and not 5 mm thick, i dont have a claim.

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    Diamond Member AndyD's Avatar
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    Lol, I just got paid for a claim I made over a year ago. To keep a long story short it was a policy we took out specifically to cover weather damage to a plant room whilst the roof had been removed by the main contractor. A temporary roof was fitted and our engineers plus the insurance companies engineer certified it. Three days later there was a massive storm, the new roof ended up 30 meters away and the damage to the plant controls ran into hundreds of thousands. We claimed and the insurance company offered to pay 1/7 th of the amount because they said the storm consisted of seven weather fronts in quick sucession (over a six hour period) and we weren't covered for six of them.

    We begged to differ on their interpretation of the policy. Needless to say we handed it to legal and eventually they've settled in full plus legal fees. The court case was due to be heard early next week so I suspect that may have swayed their decision to revisit their original decision.

    This isn't the first time, in fact more of our claims (which aren't that frequent) end up in legal disputes than not. Touch wood we've always been paid with expenses and usually before the court case but I wish it could be without the usual legal pantomime.

    I'm wondering if it's worth taking out separate insurance against your insurance company not paying your legitimate claims.
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    Diamond Member Blurock's Avatar
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    Quote Originally Posted by AndyD View Post
    the insurance company offered to pay 1/7 th of the amount because they said the storm consisted of seven weather fronts in quick sucession (over a six hour period) and we weren't covered for six of them.
    How ridiculous! This is the lamest excuse for not paying that I have ever heard.

    I'm wondering if it's worth taking out separate insurance against your insurance company not paying your legitimate claims.
    Name and shame Andy! Name and shame...
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    How many people who "dont" have some form of connection in the insurance industry have managed to get paid out in full for claims? You must not be a broker or have a family memebr or close friend in the industry. Clietel legal have an offer for R130 per month, only catch there are terms and conditions.

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    Platinum Member sterne.law@gmail.com's Avatar
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    I can believe these excuses.
    Scorpion and the like may not work because they are insurers so you may find in bed with the original protagonists.

    Andy: Interesting how the company has managed to apportion the damage equally. Even if the excuse of you only covered for one storm a day is genuine. How on earth can they ascertain the causation of the damage..
    Insurers make their money on repudiating claims, many being hogwash.
    And even though one can lodge a claim to the omboud, who will make a ruling, people often don't have the time to put their claim down and figure out the grounds and technicalities of why the claim should be paid out.
    Anthony Sterne

    www.acumenholdings.co.za
    DISCLAIMER The above is merely a comment in discussion form and an open public arena. It does not constitute a legal opinion or professional advice in any manner or form.

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    i have been around a long time to advise that one needs a long standing above medium size broker. Insurance companies do not generally mess around with brokers that pass a lot of business their way (am excluding Andy's case). & i would keep away from those "telephone brokers" who supposedly beat beat most quotes.

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    Platinum Member sterne.law@gmail.com's Avatar
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    I agree with flaker.
    I have a friend in JHB with a large brokerage and they fight for their clients to get paid if the claim is genuine.
    Anthony Sterne

    www.acumenholdings.co.za
    DISCLAIMER The above is merely a comment in discussion form and an open public arena. It does not constitute a legal opinion or professional advice in any manner or form.

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    Quote Originally Posted by ians View Post
    How many people who "dont" have some form of connection in the insurance industry have managed to get paid out in full for claims? You must not be a broker or have a family memebr or close friend in the industry. Clietel legal have an offer for R130 per month, only catch there are terms and conditions.
    I did with business outsurance last year September. Got broken in (think it was the Friday) was paid out in full about a week later.It was around 15 x monthly contributions, so not a huge amount but not small ether. They where also incredibly easy to deal with - could have been very petty if they wanted too, but didn't.

    BTW what is your driveway made of that it is only 3mm thick?

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    My broker is fighting the claim, but with little progress. I will be getting tar specialist in to do a report, then take it from there, however, my argument is when i purchased the property 4 years the driveway was still new and i have pics to prove it, if the tar company on put 3mm of tar down according to the insurance broker, then i would need to decide what to do.

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    Diamond Member Blurock's Avatar
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    Quote Originally Posted by ians View Post
    How many people who "dont" have some form of connection in the insurance industry have managed to get paid out in full for claims? You must not be a broker or have a family memebr or close friend in the industry. Clietel legal have an offer for R130 per month, only catch there are terms and conditions.
    So now you must take insurance to fight the insurance company who is not paying? I have often thought about the idea that the happiest man must be the man who has nothing to lose. Having nothing is uncomplicated. It is happiness. (NB. I may have been smoking my toe nails)

    I have stopped accumulating stuff long ago. The more you have, the more you must fight to keep it. (#1 law of the jungle) I now rather try to experience things and accumulate memories than trophies. Memories can not be stolen. (What? What was that again?)
    Excellence is not a skill; its an attitude...

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