TAX INSURANCE

**Rafael** · 24-Jan-13, 03:02 PM

The question on the application is
"Have you ever taken any recreational drugs including cannabis (dagga), cocaine, ecstacy, anabolic steriods, etc"

Further down it asks
"whats the average alcohol consumption per week"

and there are many other questions.
The best thing for the client to do is disclose it, I submit to the insurer and they will come back with an answer if he is accepted or not.
If he is accepted, then there will be a payout.

Every one has their opinion about insurance and I'm not here to change anyone's minds. I've seen the good it in, while others have seen the bad.
All I'm saying is Companies will payout if you honest and you covered correctly.

**Mike C** · 24-Jan-13, 03:16 PM

I once took out Hospital Insurance for me and my family and the questionnaire asked if anyone had suffered from Asthma. As it happened, my one daughter had suffered from asthma as a child, but had not had an asthma attack for about 10 years.

I was honest and disclosed it, and when it came back, the insurance would not cover any asthma related claim for her.

The message that was sent to me that day is that "we are happy to cover you when you are hale and hearty and there is very little chance of you needing to claim".

I know that the insurer has to take all kinds of things into consideration so that he comes out ahead, but for me - at that time - it was like a slap in the face.

So - to get to the previous posting and the matter that adrianh asked ... if the application asks "Have you EVER taken recreational drugs ... " it kind of leaves it open doesn't it. Shouldn't it rather ask - "Have you taken any recreational drugs in the last 5 years, and if so how often?" Something like that would make more sense.

**adrianh** · 24-Jan-13, 03:16 PM

All I'm saying is Companies will payout if you honest and you covered correctly.

Maybe, but the statement is nothing more than opinion considering that the words "honest" and "correctly" are very open ended.

Insurance salesmen and economists have a lot in common, they sell a vague idea and refine the idea once reality proves itself one way or another.

I want insurance salesmen to take personal responsibility if the insurance company fails to pay. What should happen is that if a claim is repudiated then the insurance salesman should return all his commission to the client. You should be able to put your money where your mouth is.

All I'm saying is Companies will payout if you honest and you covered correctly.

Ok so, will you stake your commission on this statement, I gamble, so should you!

**Phil Cooper** · 24-Jan-13, 03:46 PM

Adrian

Tell someone whose house has just been burnt to the ground, and whose insurance has re-built it, replaced the contents, and paid his and his family's temporary residence costs for a year whilst the house was being rebuilt that his insurance was a rip off.

Tell someone whose R375,000 car was hijacked, and been replaced, that insurance is a ripoff.

HOWEVER - deal with a "cheap" insurer, expect the same cover as with a reputable insurer, do NOT expect to get the same benefits when you claim. BUT - if you read and compare your wording to the other Insurer (which NOBODY will do) - you will KNOW the shortfalls and take an informed decision as to the covers you buy.

If you came to me, a Broker, to buy Insurance, I am EXPECTED (by Law) to do a needs analysis for you, and offer you options to cover your needs.

BUT - the Direct Insurers are NOT obliged to do a needs analysis. All they are there for is to sell you their product. Whether it fits your needs or not is immaterial. As long as they sell you their products, they are happy stop

Adrian, generally I find that people who are so anti-insurance as you have had a bad experience, often by buying from a cheap insurer or by taking shortcuts, and have this jaundiced idea that insurers are out to get them. I can tell you categorically, after more than 40 years in the industry, that the majority of reputable insurers go out of their way to pay your claim to the maximum that you are entitled, and only try to avoid claims when there is a very genuine reason.

You're being pedantic above. The reason for repudiation has to be material to the repudiation before it can be applied: for example, if your house burns down and your car is destroyed in the garage during the fire, the insurers could not repudiate your claim because the car was unroadworthy and all the tyres were smooth. It has no bearing on the claim.

**Rafael** · 24-Jan-13, 03:49 PM

Originally Posted by Mike C

I once took out Hospital Insurance for me and my family and the questionnaire asked if anyone had suffered from Asthma. As it happened, my one daughter had suffered from asthma as a child, but had not had an asthma attack for about 10 years.

I was honest and disclosed it, and when it came back, the insurance would not cover any asthma related claim for her.

They could of put a three month waiting period on asthma, at the extreme 12 month. I would of fought the decision.
Today I removed a clients waiting period of 3 months on her medical aid, by querying why there was a waiting period and what was needed to remove it. They just needed her membership certificate from her previous medical aid.

Originally Posted by adrianh

What should happen is that if a claim is repudiated then the insurance salesman should return all his commission to the client. You should be able to put your money where your mouth is.

Ok so, will you stake your commission on this statement, I gamble, so should you!

I completely agree with you, it would encourage honest business from the Advisers side, but what if the claim is repudiated because the client lied to have cover in place.

Look I could of overstepped when i said "Companies" but who I represent does payout if everything is done correctly and with my clients I would stake my commission because the right job has been done even though I don't gamble

**Phil Cooper** · 24-Jan-13, 03:52 PM

Adrian

You say "I want insurance salesmen to take personal responsibility if the insurance company fails to pay. What should happen is that if a claim is repudiated then the insurance salesman should return all his commission to the client. You should be able to put your money where your mouth is. "

So, I ask you have you ever had your drivers licence endorsed. You answer "no", but it was endorsed for drunken driving six months ago. Now you have a claim, and the claim is declined because of your mis-statement.why must I return my commission to you because you have lied and tried to cheat an insurance company?

Likewise,The policy states that you must set your burglar alarm and have armed response in your house. you tell them you comply. You then go away for a day, leaving your house unlocked, and without the alarm set. You have not carried out your terms of the policy, of which I as a broker have advised you, because you are bluntly too lazy or careless. The insurers justifiably decline your claim. Why must I suffer because of your negligence or failure to comply with policy conditions or terms?

There are times where insurers can justifiably repudiate claims. I am saying that a reputable insurer will go out of their way to pay a legitimate claim to the maximum benefit possible.

**adrianh** · 24-Jan-13, 04:01 PM

Phil - Yes, I agree that if the client didn't do what he was supposed to then the broker is ok, but what about the times when the broker doesn't properly explain all the terms and conditions or under insures or insures incorrecly.

**Mike C** · 24-Jan-13, 04:11 PM

They could of put a three month waiting period on asthma, at the extreme 12 month.

That would have made complete sense to me, and I would have gone with such a suggestion quite happily. As it was - we decided to scrap the idea of that insurance and took our chances. Luckily for me, we had no major upsets, so it worked in our favour. I am only too aware of what awful things could have happened.

I like your style Rafael. And when you are prepared to say

I would stake my commission because the right job has been done even though I don't gamble

it tells me that you are a person who is really interested in benefitting his client rather than just making a sale. Well done.