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File Image: IOL

10 things to keep in check to ensure that your short-term insurance claim gets approved

By Vernon Pillay Time of article published Sep 8, 2021

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Getting insurance cover for one’s assets is commonly seen by many as a grudge purchase, and as much as some customers might not enjoy paying their monthly premiums, the good news is that they’re assured that their assets are well covered (within the limits of the policy wording) to face the worst of unforeseen circumstances.

Very few people read through the fine print in their insurance contracts, which differs significantly between policies and insurers. In some instances, it’s only when they need to submit a claim, that they learn about a missed clause that they have not adhered to or an exclusion, resulting in a possible rejected claim.

Elizabeth Mountjoy, Private Wealth Manager for FNB Insurance Brokers says, “Claim rejections happen and often leave the customer feeling dissatisfied and cheated. As a customer you have the right to request the reasons for rejection from the insurer and either approach the insurer’s internal arbitrator or take it further by approaching the Ombudsman for Short Term Insurance to counter the rejection. Often, claims are rejected for valid reasons, and it is unfortunate that in some cases, the customer has misinterpreted the cover and exclusions or failed to comply with the terms and conditions. Where you feel the rejection is not warranted, obtain a second opinion to validate your claim and present this evidence to your insurer.”

Below are 10 things customers need to keep in order, to ensure that their claims are approved:

  • Wear and Tear
  • Maintenance
  • Defective workmanship/ materials used
  • No cover
  • Non-Disclosure
  • Late notification
  • No insurable interest
  • Unpaid premiums
  • Misrepresentation, dishonest or criminal behaviour
  • Avoidance of cover -

In order to avoid a situation where your claim could be rejected, it is important to familiarise yourself with the above-mentioned reasons, but also make sure that the terms and conditions are reviewed regularly. Following the claims procedures, complying with the time limitations and taking the necessary steps to avoid a loss are some of the important steps you can follow if you want your claim to be settled.

“It is extremely important to understand your insurance contract and claim parameters. Every policy sets out your obligations in the event of a claim. This includes the time period within which a claim must be reported to the police and your insurer, what information you must provide to your insurer, as well as the time frame within which to dispute the outcome of a claim,” concludes Mountjoy.


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