A wise old man once told me to “look after the facts…and the law will look after itself.” I discovered the truth and value of this statement when assisting a friend who had his legitimate short term insurance claim declined. Having approached the Ombud for Short Term Insurance with a very detailed complaint, the insurer [after letters from the Ombudsman] decided not to wait for the formal decision and made the payment as required under the policy.
The detailed written correspondence to the Ombudsman would not have been possible without the neat and precise filing of documentation by the insured party. For such correspondence it is required to have all the facts, and these facts include the written disclosures by the broker/ insurer as is required under the FAIS act, eg
- Details of the policy, what it covers, and what you will be paid out
- The contact details of the insurance company
- The monthly premium payable
- Whether the premium will increase annually or not
- Special conditions, including exclusions or things you are not covered for and excess (the first amount you will be responsible for)
- Exactly what you must do when you have to claim
- That you are allowed a 15-day grace period for late payment of premiums
Other documents to be kept in a file with the above disclosures are all updates, letters from the insurer, changes in premium or added insured items and documents pertaining to their value.
In this specific instance documentation on the side of the insured client that proved to be important included documentation on:
- Payment to the security company for the monthly security & alarm services
- Inventory of assets and receipts indicating the value of computers and other equipment purchased
- Photographs of the premises
- Contract of employment and UIF payments as proof that an employee who lived at the promises was in fact an employee…
I have learnt an important lesson – the lesson not to leave anything to chance – a lesson that everything is better in black and white and it is better to keep this safe and available. I would advise all insurance clients to keep all documents, including policy documents, records of payments, etc in a safe place!
If you have not done so yet, or believe you may have misplaced or lost the documentation – it is not too late. Your insurer is obliged to keep the policy documentation on file and to provide you with access to this. Have copies delivered to you – and if uncertain whether you are insured for something, ask the insurer to provide confirmation in writing!