A clear case of an ambiguous policy wording?
The policy’s terms and conditions, read together with the schedule, did not make it clear that a tracking device was a requirement for theft/hijacking cover.
Ombudsman for Short-Term Insurance
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Failure to have a vehicle inspected does not necessarily mean an insurer can reject a claim
The insurer could not revert to the pre-inception sales discussion when subsequent developments had clearly overtaken that fact, ombud finds.
Why policyholders complained to the short-term ombudsman in 2022
Annual report notes a steady increase in disputes related to power surge claims.
Short-term insurers with the most and the least complaints in 2022
The important statistic is the proportion of personal lines complaints relative to an insurer’s share of the total personal lines claims.
Single Financial Ombudsman scheme set to go live in 2024
The amalgamated scheme will later include the FAIS Ombud and the JSE Ombud.
When is it too late to submit a complaint to the Osti?
Ombudsman can only condone non-compliance with a policy’s time-barring provisions if the insured shows good cause.
Ombud uses logical inferences to conclude that driver was reckless
The insurer must prove on a balance of probabilities that the insured recognised the danger and proceeded with his course of action.
Unfair for insurer to decline claim purely because it was reported late – Osti
The insured submitted a third-party liability claim two months after the incident.
‘Progressive’ and ‘reformist’ retired judge is new insurance ombudsman
Margie Victor says the offices she oversees will strive to improve insurance services.
Store consultant’s relationship to the insurer proves decisive in ombud’s ruling
Claim was rejected because the phone was not used with the SIM card encoded with the number listed on the policy schedule.
Golfer lands in the rough with hole-in-one insurance claim
The insured submitted that, in terms of the policy, he was entitled to the maximum indemnity.
The importance of timely notification of a potential claim
The first case, on which I will not dwell, concerns a claim for business interruption following water damage to a sound system, televisions, camera system, a computer system and a point of sale. […]
Complaints data for short-term insurers
This link will open the complaints data from the Ombudsman for Short-term Insurance’s 2021 annual report. The insurers are sorted by number of complaints per thousand claims (column 5). As the Osti points […]
Business interruption-related complaints account for nearly half of Osti settlements
Only 259 of the new complaints registered by the Ombudsman for Short-term Insurance (Osti) last year were related to Covid-19. But settlements in Covid-related business interruption (BI) complaints accounted for 49.5% of the […]
Osti flags increase in disputes due to ‘reasonable precaution’ clause
The Ombudsman for Short-term Insurance (Osti) has once again flagged the increase in the number of complaints from consumers whose claims are rejected because insurers allege the driver failed to exercise reasonable precaution […]
Expert’s findings unreliable in dispute over damaged pump
The Ombudsman for Short-term Insurance (Osti) ruled that an expert’s findings on which the insurer relied to reject a claim were unreliable. The policyholder submitted a claim for storm damage to his jacuzzi’s […]
Policyholder triumphs over insurer’s tyre expert in tussle over vehicle claim
The Ombudsman for Short-term Insurance (Osti) found that the conclusions drawn by a tyre specialist could not be relied on to decline a policyholder’s claim. The insurer used the specialist’s findings to support […]
