INSURANCE

[Phil Cooper]

Dian

I would like to know the full circumstances of your case.

In terms of various legislation Insurers may not rely on anything non-material to the claim to decline it, and any attempt to do so would (rightfully) be overturned by the Ombud.

[ians]

Phil, this story about loyalty is a lot of crap. I have been with Santam for more than 15 years for my house en vehicle insurance with only a few minor claims during that time. Also had life insurance with Sanlam. When I needed Santam for a major claim, they sent their assessor 4 times to my house to look for a reason not to pay, and they eventually found something not even vastly relevant to the claim and then refused to pay. Needless to say I stopped all insurance with them and want nothing to do with them. There is nothing they can say that I will trust them again. Insurance companies will gladly take your money but will always look for a way out not to pay.

I believe that most of us think that we take out insurance, because that day when something goes wrong we will be covered full stop...ie (this just being an example)you have a break in and loose lets say R10 000 worth of goods. So you put in a claim thinking no problem i have R2 million worth of cover, my stuff is only valued at R10 000, i should get a R10 000 payout less the excess, anything from R500 to what ever percentage you agree on, "NOT" because that day there was a power failure and the battery went flat, so the assessor finds out about it, if you read the clause in xyz paragraph it "clearly states that you are only covered if you have a "working" alarm system. So a word of advise, if the claim is big make sure you have your lawyer present, because everything you say will be held against you, they will make out like they are your best frined ask about the family how your kids are doing at school etc etc, and then every now and again ask a random question to try catch you out, for something no matter how small and insignificant.

One of the questions the assessors asked my wife, which at the time didnt seem relavant "when did you first see a hole in the driveway" would have saved the assessor taking pics and having to carry out further investigations. If the answer was something like 2 weeks ago, 2 months ago, the claim would have been rejected on those grounds, immediately.

I believe, if an insurance company sends and assessor, it means the insurance company either doesnt believe that the information on your claim form is correct, or they are trying to find a way to reduce the claim.

Sometimes if you are a loyal customer and your claim is small and you havent ever put in a claim, they might just pay you out without sending an assessor to keep your bussiness, like in my case with my camera, paid out no problem, why because i insure valuable items worth hundreds of thousands rands, to loose me as a customer because of a R2000 claim would just be silly, my premium per month is more than what they paid out, now that i think about it, was a stupid test.

What i am going to do is figue out a way to link all my insurance together, bussiness, household, motor vehicles,etc together. That way it would be in the insurance companies best interest to pay out, be it a driveway claim or a camera claim. I beleive this is the problem at the moment, i am insured with different underwritters.

[Phil Cooper]

Ian

A couple of Insurers DO offer a domestic and commercial package in one - but that is rare.

There is NO need to do them all together - you just need to ensure you are CORRECTLY covered. Often it is far more cost-effective to spread the covers around.

Assessors are sent - generally - on any claim over a certain size. It is NOT their job to GET OUT of paying, but it IS their job to ensure that (a) you are correctly insured, and (b) if that is the case that you get the correct payout for what you have lost.

Bluntly - the problem is that MOST people lie about a claim. They try to either (a) cover their excess by loading the claim, or (b) load their claim as "the Insurer is going to reduce it anyway".

[Citizen X]

Hi
Current reserves being carries at R130-m!

Good afternoon Phil,
So in practice: is it as simple as saying that premuim increases will compensate for this 130 M? In these cases the claims are all bona fide, the problem is that there are multiple claims! What I'm really trying to establish is that how possible is it that events such as these can totally destroy an insurance company??

[Darkangelyaya]

Hi, Chrismine
Beats me why Santam will not insure your wife's camera equipment. Is it a case it is used professionally, or is it pure domestic covers?

Darkangelyaya
I agree with you wholeheartedly! If you want a decent, professional job done with the right backup - use people like you! The trouble is, like Insurance, people do not look at the potential consequences. If you want to cut down a tree in the middle of the garden- with no buildings, walls, fences, etc. possibly in reach - well, if you want to take a chance, that is up you you (but just pray nobody gets injured in the process, as you, as owner of the property would be held legally liable (I do not meen one of the fellers)! (By the way - if you want to quote me to remove 21 blue gums on my property please contact me. Thanks!)

Ian
The Excess is not to reduce the Insurer's admin costs - it is to keep you "interested" in minimising the claim

I would chat to your Broker and ask him to approach the Insurer to see if they will reduce the excess. Many Insurers today are quoting 5% instead of 10%, and a number are also offering flat excesses of between R2,500 and R5,000 - that may be to your benefit. Some Insurers - albeit very few - are offering excess free covers. At least one is offering a Franchise instead of an excess: this means if your claim is equal or less than the franchise amount, you have NO claim, but once it exceeds that, your entire claim is paid from the ground up.

As to whether I would have written the comments: perhaps not in the manner which I did, specifically answering your exact questions. But I have posted a number of articles related to Insurance on here which I have regarded of interest.

And, if ANYBODY wants to post questions, I will be happy to answer as best as I can.

I will gladly quote, Phil - seems like you are getting my business anyway.

[ians]

Ian

A couple of Insurers DO offer a domestic and commercial package in one - but that is rare.

There is NO need to do them all together - you just need to ensure you are CORRECTLY covered. Often it is far more cost-effective to spread the covers around.

Assessors are sent - generally - on any claim over a certain size. It is NOT their job to GET OUT of paying, but it IS their job to ensure that (a) you are correctly insured, and (b) if that is the case that you get the correct payout for what you have lost.

Bluntly - the problem is that MOST people lie about a claim. They try to either (a) cover their excess by loading the claim, or (b) load their claim as "the Insurer is going to reduce it anyway".

I wonder why people would lie about their claims?

[Phil Cooper]

Vanash

It is VERY unlikely that an Insurer would be wiped out by an incident like this.

Most Insurers - if not all - buy "catastrophe reinsurance" - basically, if a loss from a single loss exceeds a certain figure, the excess claims over this amount are picked up by reinsurers.

So - a new insurer with minimal reserves may cap themselves at, say, R10-m, whereas a Company like Santam may make, say, R100-m their loss limit.

After that the reinsurers cover the losses.