G and S Insurance Consultants

SHORT TERM INSURANCE – REASONS FOR REJECTED CLAIMS

More and more insurance companies surface with different covers and products. As an insured, we accept the cover, but we still wonder if what was covered for will be rejected when claimed for.

Being a broker and meeting with clients every day and to hear the reason why claims were rejected is shocking. We want to take this with us as a broker to make sure that when our clients claim that they will not receive a letter of rejection.

To bring you, as the client, to a clear understanding of your contract we would like to explain the reasons why claims are rejected:House contents

  1. Security incorrected noted on a policy at your home address. Example – Should you wish to have full cover on your garage for tools, make sure that should your policy read burglar bars and security gates, that this will apply to the garage as well. In the case of an alarm being noted, this means that the alarm must be extended to the garage. If the garage is interleading with the house, there must be a security gate at the door. Noting an alarm at your home it is your responsibility as a client to make sure that each sensor is in a working condition. This section sum insured must be replacement cost and correct as average will apply.
  2. Sum insured must be calculated on replacement value; therefore, you will not be under insured. Try your best to do an annual inventory on your contents and don’t forget to include outbuildings such as a garage. This means that you can be underinsured, and not paid out what you expected or lost.
  3. Change of address is very important, as a client this is your responsibility to change your address. Remember to always inform and make 100% sure that you apply to the security requirements.

Buildings

  1. Maintain the structure, this is your responsibility as a client.
  2. The sum insured will also be calculated on replacement value, NOT resell of municipality value.
  3. This section is average complaint (can be underinsured).
  4. Only sudden and unforeseen damages will be covered and not gradual and over time damage.

All risk

  1. Unspecified all risk – this will cover all items taken with you from your risk address. However, you will need to specify the following items to enjoy cover: cellphones, laptops, iPads, surfboards, reading glasses, electronic games and data carrying equipment. Should these items not be specified the claim may be rejected.
  2. Specified items, means that you will enjoy cover on an all risk base. The cover includes theft, water damage, accidental damage etc.

Motors

This section makes up 90% of the reason why clients change insurers. Here are why claims are being rejected:

  1. The regular driver is very important. Clients are under the impression that should they not note their children as the regular driver that the premium will be sky-high and rather take the risk of not to note them as the driver. Should any insurer decide to investigate a claim (and they have the full right to do so) and discover the real facts the claim will be rejected. Noting your children on the policy will only be a benefit to them should they be financially able to do their own insurance.
  2. The risk address at night is very important. Should your son/daughter be studying at the university and stay on campus, the address must be noted as such as well as the overnight security at the address.
  3. If there is a tracker noted in the vehicle it is your responsibility as a client to make sure it is in a working order. Test the unit at least every six months.
  4. Should your brother/sister/family member/friend borrow your car, make sure to note this on your policy.

General

As a client, you should read your policy wording and policy contract. Make sure your details are correct. Remember the above only covers a fraction of the existing reasons why customer claims can be rejected. Therefore, ensure that you understand everything from your policy.

Alternatively, you can contact us for any assistance on your short-term insurance.

083 407 7045 | 011 907 2412 | adelev@gsinsurance.co.za