Thanks to the short-term insurance act, South Africans are better protected and have more rights than they ever did before. What follows are some tips that explain your rights and how you can exercise them, but you should note that, as an insurance subscriber, you have responsibilities and duties as well.
An insurance policy is an agreement between the insurer and you that enables you to replace or repair an insured item if it is lost, damaged or stolen. The insurer must pay you fair value for that item when you file a claim, and you must agree to pay the required premium for the cover.
Premiums are based on the possibility that a loss will occur, and they are individually calculated as well. By estimating the risk of the item and the individual being insured, the insurer will arrive at a premium that applies in your case. Since you are a South African consumer and a policyholder, the law states that you should be treated fairly and respectfully, and your insurer must make every effort to serve you well.
With this in mind, the law also states that your insurance company should offer you products and financial advice that are customised to suit your particular needs. Because they must explain all the conditions and terms of your policy clearly, that gives you the right to ask questions. If your attempt to do this doesn’t go well, you can speak to their supervisor or another agent.
You are responsible for reading the policy, ensuring that the data you supply is correct, and informing your insurer when it needs to be updated. Also, by paying your premiums promptly, you will feel secure, knowing that the policy is in force. If you fail to pay your premium, your claims will not be paid and you will be viewed as a high insurance risk and a poor payer.
Do not lie to your insurance company under any circumstances, or tell them something that is only partially true. When this is discovered, your current claim will be denied, and you may even be charged with insurance fraud.
If you are dissatisfied with the way in which a claim was settled, begin by speaking to your insurer’s Head of Claims, and if the problem persists, contact the Head of Compliance. Your insurance company has a duty to handle the matter in a way that is mutually beneficial to you and to them.
If things still remain unresolved, you can speak to the Short-Term Insurance Ombudsman, an independent body that was established to settle such disputes. The Ombudsman, who functions as a facilitator, will consider both sides of the case and them make a ruling to settle it.
If you are so inclined, you can even make your problem a public issue by using Hellopeter.com or some other forum. You can also use these forums to research potential insurers and find out how they handle their policyholders. As your last resort, you can seek legal counsel and file a civil claim against your insurance company. However, because of the expense involved, you should only do this if you are certain that the ruling will be in your favour.
