Common ways South Africans lose out on insurance claims

Being unfamiliar with the contents of insurance cover, failing to provide the information required, or altering the information required often sees dedicated insurance premium payers lose out on the benefits of cover.

This shows that there is definitely a right and wrong way to go about making a successful insurance claim, says Christelle Colman, insurance expert at Old Mutual Insure.

“Since you pay a premium, it is essential that you make the effort to understand and complete the claims process accurately and in full to ensure your right to a fair settlement,” she said.

“Policyholders should do their homework upfront. Understanding exactly what is covered in your policy is essential. Don’t wait until you have an accident before you read your policy and find out “that you have submitted the wrong information or claimed unnecessarily for things that you are not covered for,” she said.

Colman said that claims should also be logged quickly, as and when the damage or loss occurs, not days later. She said that policyholders should also not admit liability even if, in their opinion, they are liable.

This is because liability is something that only an insurance or a legal process can decide. Individuals should not take it upon themselves to apportion liability after a car accident for instance.

“Liability is not something laymen are equipped to decide no matter how cut and dried it may appear to them,” she said . Policyholders will be left in a difficult position legally if they have admitted liability and it turns out, after an insurance or legal process, that they are in fact not liable.

“Instead, policyholders should merely record all the details of the accident or loss, let concerned parties know that they have cover where relevant, and then leave it to the insurance companies involved to assess the loss, apportion liability and settle costs for damages where applicable.”

Move fast 

In cases of burglary or robbery household contents policyholders should let the police know and get a valid case number.

Despite popular opinion on police performance, goods are often recovered and items, especially cars, do often get found, said Colman.

“Having a case number can, in the long run, “save policyholders a lot of money by adding to the accuracy, validity and efficiency of the claims and recovery process,” she said

“It is important to get as much of the right information at the time and scene of the accident. Colman understands that after an accident, burglary or robbery people are very stressed, often forgetting things, failing to write down information like registration, licence or identity numbers.”

This is where new technology can make a difference, said Colman.

“These days it makes much more sense to simply take a picture on a cell phone of the cars and registration numbers involved, as well as the required license cards and the identity numbers.

“This only takes a few seconds and even if you are shaken up and forget things, you’ll always have the photographs to refer to on your phone,”

Honesty is the best policy

Regardless of how you collect and report the information required for the claims process, honesty is essential, said Colman.

“Never lie, flee from the scene of an accident if you think you are over the alcohol or speed limit, switch drivers, or add extra items to the list of contents stolen in a burglary.

“Lies, inconsistencies, different drivers, differing versions of the same incident, items not mentioned in the policy but claimed, are very easy to spot and lead to a number of claims being repudiated.”

Colman also warned that it is fraud to lie during an insurance claim. “

“Criminal proceedings can be instituted against you by an insurer where there is sufficient evidence of dishonesty,” she said.


Read: South African insurers will begin using drones to check claims

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Common ways South Africans lose out on insurance claims