Water damage claims

[AndyD]

How ridiculous! This is the lamest excuse for not paying that I have ever heard.

I've heard lamer, but I'm at the stage where I don't get emotional about it anymore, I have it down to a fine art.

Name and shame Andy! Name and shame...

I'd have to read the final settlement agreement carefully but think I agreed not to name them. I could however tell you they are very well established and are world renowned for their involvement in shipping insurance.

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..

I actually put it to them before I instructed lawyers that even if they could warp the wording of the policy to mean we were only covered for one 'weather front' and not the entire storm, I was only claiming for the front that originally damaged the equipment. We could establish exactly what time the damage occured because security reported the roof damage as it occurred and within a few minutes the entire building power went down because of the electrical fault. They just refused point blank to discuss the reasoning behind their decision.

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.

I agree, at that stage in the game they hold all the cards and they are happy to refuse genuine claims probably as some kind of numbers game. I'm sure they're aware that statistically a certain number of these victims won't see the legal process through for any number of reasons so they basically try their luck. If this is the case then they're no better than the low-life policy holders who make fraudulent claims.

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.

I'm not sure of the Rand value of your claim but if it's substantial enough I would get an independant report on the drive way and an independent legal opinion on the policy and the insurance companies liability. I would expect this to require a comitment of a couple of thousand Rands to figure out if you have a leg to stand on legally speaking. At that stage I'm sure if you read between the lines you would be able to decide if it's worth more time/money persuing the claim through the ombudsman or the courts.

[ians]

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?)

I agree 100%, the less kak you have the less stress in your life.

Why we go out and buy big houses which cost a fortune to buy, look after and then when you sell considering you pay double what you paid for it by the end of the bond is it really worth the hassle. The same goes for toys, you go out and buy a jetski for example, got lots of friends who are willing to pay to put petrol, but who pays for the insurance and maintenance costs, the regisiteration fees etc etc etc. You better off living in a small 2 bedroom simplex paying rent, something breaks, the wall falls down, the geyser packs up, the roof leaks, the elctrical require a total rewire, not your problem. Same with a motor vehicle, i paid cash R10 000 for my bakkie and didnt insure it for 10 years, had to replace the motor after 5 years, fitted an import at a cost of R4000, odd service here and there cost around R5000, new tyres cheapest on the market R370 each, changed 3 times lets say over a 10 years period it cost R30 000, what a saving compared to what it has cost me for my van, over R200 000 just for the van then an additional R48 000 for insurance, just the insurance cost more than the total cost of the bakkie over a 10 year period, makes you think. Between my wife and i we have paid out almost R150 000 in insurance over the past 5 years(by the way that is excluding life, education and endowment policies), and we are yet to be paid out for any claims. So someone is smiling and it sure as hell isnt me.

I paid out hundreds of thousands of rands to life insurance, education, endowment etc policies (not including motor vehicle and household thats another story) for my wife kids and i over a 16 year period, after having a motor vehicle accident was sent a letter with a cheque for R14 telling me that due to my years of experiences and qualification they dont need to pay me out for the claim because i can get a job as a supervisor so i dont need the use of my right arm. The scary part you will only find out if this would apply to you, if you actually have an accident and need to put in a claim( by the way that wasnt even part of the fine print) just the insurance companies policy, you must understand when it comes to your broker he has a job to do and the bigger the commision he makes out of your policy, the bigger his house and fancy his motor vehicle. The worse part of the whole claim, wasnt even the fact that i didnt get paid out, it was the fact that when i was on the street he never even offered me a plate of food.

I wonder how many millions of rands insurance companies save by bullying people out of paying up, by using their resouces knowing the man on the street doesnt stand a chance against them and their lawyers nor could we fight the case. The way i see it is you should be investing all that money over the years into owning your own lawyer firm rather than wasting it on insurances policies, insurance companies didnt get all the money to run millionare clubs and owning more than half or not all the commercial properties in the country by paying out claims.

[Blurock]

Well, if I should ever win the lotto (which I never play) I would give away my house and cars and just travel. Why do you have to stay in one place? No insurance hassles or traffic jams.

Imagine if you could just go where your whims take you and sleep over or move on if you wish! Niagra Falls on Monday, Venice or Santorini on Tuesday or even Thursday if the travelling gets too hectic. Summer in Cape Town, winter in Durban. Sundowners on a secluded island beach. Stay there for a month until the weather deteriorates and then move on....

[ians]

First part of the driway claim, rejected due to this clause, they are saying that the claim was rejected under this clause due to defective workmanship, i purchased the property and a short while after the purchase, we had some heavy rains and the driveway tar broke open, it was just a small hole at the time of the claim.


7. DEFECTIVE DESIGN OR LACK OF MAINTENANCE AND COST OF MAINTENANCE
This policy does not cover loss of or damage caused by or attributed to defective design, defective workmanship, defective
construction or defective material or lack of maintenance and the cost of maintenance of the insured property.





Second claim, got my official rejection notice, a part of the driveway about 20 metres further down, from the first claim, now here is my argument, if it was water flowing under the asphalt, why has the driveway no collapsed between the new hole and the old hole, considering we drive ove rit on a dialy basis, me with my bussines at home i must drive ove rthe driveway 10 times a day, ther eare no sign of any damage 9or even sagging for that matter, between the old and new claim. Well i am no tar specialist so time to call in the experts.

REJECTION
Dear Policyholder
We are acting on behalf of Compass Insurance Company Limited in the above matter and Insurers' rights
herein are reserved.
According to the information on hand, a pre-existing aperture on the driveway had expanded due to a
combination of the slope of the driveway and underground water from the garden bedding area. In addition
water flows underneath the asphalt area via existing potholes elsewhere at the rear of the property.
There is no cover for the claim submitted and we draw your attention to Specific Exception f) of Section A,
Property and General Exceptions 7 and 8 of the policy.
Unfortunately therefore this claim is rejected in its entirety and we make no admissions regarding the alleged
claim.
We trust that we can be of service in the future.
Yours faithfully