Many South Africans believe
that having an insurance is the panacea to future losses or damages.
Unfortunately, this is not always the case.
The ombudsman for
short-term insurance was established to assist consumers who feel their
insurers have dealt them a bad hand.
The office deals with
personal lines short-term insurance disputes including those relating to motor
insurance, homeowners’ insurance, household insurance, cellphone insurance,
travel insurance, disability insurance and credit protection insurance. The
services of the office are free of charge.
The case of Mrs N and the
stolen cellphone Mrs N claimed for a cellphone that was stolen from her bag
while she was playing netball.
The insurer relied on the
following provision in the policy to reject her claim:
This particular Insurer had the following terms and conditions in their policy
wording:
“7.3 prevention of loss.
7.3.1 – the insured shall take all reasonable steps and precautions to
safeguard the equipment, including but not limited to, ensuring that the
equipment is:
7.3.1.2 – not left exposed
in a public place, place of recreation, mall or social occasion where it is
vulnerable to easy removal or damage.”
“The insurer argued that
the cellphone was not safeguarded and that it had been left in a vulnerable
situation where easy access could be gained to Mrs N’s bag.
The office of the ombudsman said the grammatical meaning of the word “exposed”
is not “covered or hidden; visible”.
Since the phone was in Mrs
N’s bag, it was not exposed and it would be unreasonable to expect her to
safeguard her bag all the time.
The office of the ombudsman recommended the insurer settle the claim, and it
agreed to do as recommended.
Conclusion:
In the event of a claim rejection, clients have the option of approaching the
offices of the FAIS Ombud to resolve short-term insurance complaints fairly,
efficiently and impartially.
The Ombudsman’s services is free to consumers and policy holders can approach them
directly on their website. www.osti.co.za
For any assistance with
your car, home, building or business insurance ES Brokers is here to assist
you.
Phone our offices on 031-5021922 or visit our website www.esbrokers.co.za
Article featured in
Sunday World, by Kabelo Khumalo