Insurance complainants get back R386m in payouts

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Policyholders unhappy about rejected funeral and life policy claims.

Motor vehicle insurance attracted the highest number of complaints from South African short-term insurance policyholders in 2023.

Most of the exclusions resulted from speeding, followed by misrepresentation or non-disclosure at the time of taking out the policy, during its term, or when the claim was submitted.The second-highest number of complaints emanated from homeowner claims that had also been rejected due to exclusions. Under this category, the highest number of complaints came from claims related to acts of nature, at 44.7%. In 2022, these complaints were 45.1%.

In this instance, a complainant approached the office for assistance after the insurer declined a claim for his collapsed boundary wall. The aggrieved policyholder contended that the wall had collapsed due to extreme winds during April 2023. After considering evidence and input from both the insurer and the policyholder, the Osti ruled that the “proximate cause” of the wall’s collapse could not be a single, sudden event. The evidence showed that the wind was, in fact, the “final straw that broke the camel’s back.”Facts and figures ADVERTISEMENT: CONTINUE READING BELOW The short-term ombud ended 2023 with 12 188 registered complaints – up 5.6% from 2022.

Of these, 6 714 complaints were within its jurisdiction – 5.8% lower than the previous year, which indicates that the number of complaints has returned to pre-Covid-19 levels.

 

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