Motor insurance claim rejected? Here’s what you need to know

As a motorist, you’re probably paying car insurance premiums monthly, partly because the bank forces you to cover your loan terms and conditions against road dangers.

With car theft and road crashes on the rise in South Africa, you want to ensure that measures are in place to help you should you fall victim.

Unfortunately, just because you have a car warranty doesn’t necessarily mean you will get a payout when you submit a claim. Thousands of motorists in South Africa have car warranty coverage that are either partially or entirely rejected yearly.

A survey lists some reasons why your claim could be rejected and says, “the law is on your side should you sense as though you are treated unjustly by the Insurers.”

Six reasons why your car insurance claim could be rejected:

1. You have due premiums  

If you neglect or miss to pay your premiums on time, the insurance company will cancel your policy, leaving you without cover.

2. An unspecified or unlicensed driver is behind the motor.

Usually, the policy only covers the owner or regular driver of the vehicle. Moreover, your claim will be rejected if an unlicensed driver is driving your car and is involved in an accident.

3. Your car is not roadworthy.

Any mechanical issue, such as your indicators stopping working, could result in your claim being rejected if you’re in a crash. So be sure to have your car monitored regularly.

4. You were driving recklessly.

It is pervasive for insurance policies to incorporate the Failure to Take and Breach of Road Traffic Regulations section. The former means your insurance firm has the right to reject your claim if you were a hazard on the road. At the same time, the latter indicates that if you broke a road rule that resulted in an accident, i.e., driving or speeding under the influence, you would not be eligible for compensation from the insurance firm.

5. Write-off cover is not added to your insurance policy.

If your agreement doesn’t specify this, you won’t be entitled to an assert if you write your vehicle off.

6. tracking devices, general security measures, and alarms are not fitted.

Most insurance companies only pay out if these preventive devices are installed in your car. Also, if you have stated that your vehicle is parked in a secure space at night, but it comes to light that you park on the road, for example, you won’t receive a payout should it be broken into or stolen.

What if my claim was unfairly rejected?

If you know you’ve taken all the necessary precautions and your claim is still denied, you can proceed to the Ombudsman for Short Term Insurance for assistance. Still, there are specific steps you should follow before doing so.  

The car warranty industry is staggeringly regulated to protect purchasers’ rights. However, despite long terms and conditions, there are mechanisms for consumers to state their case should they feel the insurance companies aren’t sticking to their promises.”

It is advised to take these steps before approaching OSTI:

1. Ensure to raise your complaint with your insurer first. It’s best to do this in writing to have a clean record of all the facts leading up to this point.

2. While it may be tough to control your emotions, remain calm and friendly. It will help you communicate effectively.

3. Address the issue with the insurance company’s Senior Officials.  

4. Keep track of all facts and communications, and make copies of any correspondence.

If your claim is still refused after going through all those mentioned earlier, you can address your complaint to the Ombudsman. The Ombudsman functions as an arbitrator or partial mediator without representing the buyer or the insurance companies in South Africa.

No matter what you do, remember the appropriate time frames mentioned in your insurance policy. You usually have six months after your claim has been rejected to take the company to court and institute a civil suit. If you don’t, your lawsuit will lapse.” Buying a car warranty will cover all major wear and tear and breakdown included in your car warranty coverage.

 

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