Ombudsman

Ombudsman

We have in an earlier blog post written about “Who is the Ombudsman and can he help with my car insurance?” It is important to be aware of the process that a customer / client has to follow when he is not happy with the way that his claim has been handled / processed. It would simply cause chaos if everyone ran to the Ombud for Short Term Insurance at the first moment they are a little bit aggrieved at the initial correspondence from their insurer.

The Ombudsman advises all short term insurance clients to follow a few basic steps:

  • You must complain to the Insurance Company first, before the Ombudsman can look at your complaint.

When complaining to your Insurance Company, it would be helpful if you do so with efficiency and to keep the following in mind:

Complaining to the Insurance Company:

  • It is usually best to complain in writing. But if you phone, ask for the name of the person you speak to. Keep a note of this information, with details such as, the date and time of your call and what was said. This may be required at a later stage.
  • Remain calm and polite, however emotional, angry or upset you may be. You are more likely to explain your complaint clearly and effectively if you can stay calm.
  • Initially attempt contacting the person you originally dealt with. If they cannot help, indicate that the matter will be taken further. Seek details of the name or job title of the person who will be handling your complaint and for details of the Insurer’s complaints procedure.
  • Attempt taking up the matter with a Senior Official at the Insurer.
  • When you write a letter of complaint, set out the facts as clearly as possible.
  • Write down the facts in a logical order and stick to what is relevant. Include important details like your claim number or your policy number.
  • Keep a copy of any letters between you and the Insurer.

What to do next:
If you are not happy with the Insurer’s decision you may:

  • Issue a summons out of the Small Claims Court (there is a small cost involved ) on the Insurance Company. The maximum amount that can be claimed in the Small Claims Court is R 7,000.00.
  • Consult with an Attorney to pursue the matter by means of further legal action.
  • The Ombudsman for Short Term Insurance may be able to help. You will need to fill in our complaint form and send it to the Ombudsman.
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20 thoughts on “How do I complain about my car insurance claim?

  1. Robert Walser

    Hi.

    Does anybody know why Santam Insurance would want to penalise drivers that hold a more advanced driving license (C, C1, EC, EC1 & EB), by having them pay an additional insurance excess of 5% of the claim or R2000 minimum in case of accident, in addition to the normal excess?

    I find this extremely unfair, unreasonable and offensive to say the least.

    Except for the Ombudsman, where can one formally complain?

    I think driver’s with more advanced driving licenses must stand together to have Santam and any company that may be foolish enough to follow their example, review and reverse this unfair decision.

  2. Paul

    I have found a bit of a gap in the market and dont know how to fill it. If the other party in the accident was at fault and you try and claim as an individual against their insurer (in this case a Delivery Vehicle insured by HCV Insurance), then there seems to be no recourse against them as the Ombudsman can only support you against your own insurance company. They told me all I can do is sue them with the high court, because of the amount and there is no public protectorate for the general public in these cases. Can anyone advise me otherwise.

  3. I am unhappy with the way my claim is being handled by my Insurance company. How do I contact the Insurance Ombudsman?

  4. I have sent email to ombudsman short term insurance many times,I also submitted my application form for investigations.I received no response from them.
    please email me the email address,this email (info@osti.co.za) no response.
    thank you
    sharon

  5. Arun Kumar Bhatter

    Dear Sir,

    Re: Car No. WB02V7776- Ford Fiesta

    Sub: Insurance Claim

    Policy No. 100300/31/12/6100000676

    My Car met with an accident on 19.11.2012. I informed this to NIC Ltd. on 23.11.2012.

    After that an inspection was carried out and I was asked to carry the repair work. I completed my work and submitted a claim of Rs.20280/- for the damaged portion exclusively including the spare parts.
    The composition of The Bill was as under:

    Labour Charges for Damage portion and denting and Printing Charges. Rs. 10200.00
    Cost of Spares Rs.10080.00
    Total Rs.20280.00

    After some time we received a claim of Rs.7515/- the details of which is enclosed I have two important submission to make.

    a) Out of Rs.10200/- why depreciation of painting & denting is to be deducted.

    b) Why are amount of Rs.3500/- needs to be deducted is a question mark to me where as never I have been told about this by the Insurance Co, nor the agent,
    Thanking You,

    Yours truly

    # 9831151444

  6. Palm Goodman

    My name is Palm Goodman and ID number (7704035183086) and telephone number is 0839965049 & is very dissatisfied with the service I am getting from my way. I was in an accident and my car is not driveable they don’t seem to bother about my whereabouts can someone please assist in this regard. I was given a consultant by te name of Sandile Gwebu who does not show any seriousness about my claim

  7. Thandeka Moosa

    Hi, my name is Thandeka. i met with an accident in November, i have subimtted my claim through my insurance but i am very disatisfied. repair quotation was R35000.00 including labour cost. the insurance have approved the claim but will only pay R25000.00. on top of that they are charging me R20000.00 excess,. break down of this excess, Licence less than 7 years, R5000.00, C1 Licence R5000.00, Non recoverable R5000.00 And basic excess R5000.00.

    please assist hwo can help me with this issue cause clearly i am repairing my own vehicle but cliam that i have an insurance.

    Thanks and Regards

  8. Sizakele Lingani

    Hi my name is Sizakele, i had an accident on the 1 Nov 2013, submitted my claim through my insurance. I was very dissastified with the outcome because the inspector who went to inspect my car only conctrated on the bonet part only, when i got the accident the car was undrivable which means the suspection was bronken). i complain to my insurance who said the bronken syspection is part of my previous accident( can i drive a car with a bronken suspection), which i never been involved in an accident, furture said they wont replace unless i do another claim which resulted to double access fee. Question is why do i need to do another claim if i already have a claim number. please help.

  9. Cliff

    Good Day
    I was involved in an accident in April involved was myself and a taxi.
    I claimed against the taxi driver, CTU insurance done there investigation found that it is my fault.and refuse to fix my car. Ive though i witness testified it was the taxi fault.
    Taxi Driver made an ilegal U turn i tried to avoid but collide with the taxi.
    Part of email sent to me from CTU insurance.
    “It has been found that it was your vehicle that failed to keep a proper lookout and also speed contributed towards the accident.”
    Please assist

  10. craig chetty

    Please can you contact me regarding my insurance claim whicj im nt happy about . 0848455710

  11. I recently had an accident where it was the other persons fault. I am claiming 3rd party from Santam. Santam have come with a huge list of documentation they need which I have gladly supplied, even though it took me 2 weeks to get as I have a day job too. They have come back now stating that it will take another 2 weeks to be processed as they need to do their own assessment. Why could they not have done their assessment in the meantime. Now it is going to be more than a month since my car was damaged until it will be fixed. I’m so glad I am with Miway, at least they look after their customers. Typical Santam, stamping on the little guy. Thank you Santam, for nothing!

  12. I had an accident on the 20th August 2014 where a car swerved to the right in thto the side road in front of me without indicating causing the accident, upon approaching Anderson Insurance they send me from pillar to post knowing that I had no means of transport, I evetually managed to foward all relevant documentation including my bank statement proving that the premium went off. After which they never contacted me I would call and they would promised to call back which never happen, they reverted after 7 working days (at the time I told them about my complaint to the ombudsman) to inform me that the car was a write-off, I requested a courtesy car as it forms part of my cover, and they only responded after 3 days to tell me that i can collect the vehicle, after collecting the vehicle I was informed to returned the courtesy car as they never received 1 months premium. Thank you Anderson for being the worst Insurance company to deal with, I basically paid you to assign me to do your job!

  13. I had an accident on the 20th August 2014 where a car swerved to the right into the side road in front of me without indicating causing the accident, upon approaching Anderson Insurance they send me from pillar to post knowing that I had no means of transport, I evetually managed to foward all relevant documentation including my bank statement proving that the premium went off. After which they never contacted me I would call and they would promised to call back which never happen, they reverted after 7 working days (at the time I told them about my complaint to the ombudsman) to inform me that the car was a write-off, I requested a courtesy car as it forms part of my cover, and they only responded after 3 days to tell me that i can collect the vehicle, after collecting the vehicle I was informed to returned the courtesy car as they never received 1 months premium. Thank you Anderson for being the worst Insurance company to deal with, I basically paid you to assign me to do your job!

  14. sanjay singh bamel

    I m frustrated to have a policy of royal sundaram .my car swift dezire got accident on nov 15 2014 but r.sundarm asked me for total loss but after 2 month they decided to repire the vehicle n now they r not allowed some parts of the vehicle which is purely damaged .now maruti is not able to repire the vehicle because insurance company is not giving such part .i me dealing with such a worst n fake insurance company .royal sundram also not interested to talk with me…. To my view nobody should insure your vehicle to royal sundarm i request u to help me.in this matter

  15. zama zwane

    Comment I was involved in accident, Anderson send someone 2binspect my car and they write my car off, they say I must pay 22 thousands so that I will get a new car, now the dealership phone me and said I must choose a car of 175 thousands, and my car coast 220 thousands, I’m angry and confused y they don’t give me back my car.

  16. Zola

    My car heated up, I phoned Anderson road assist emergency no.,they told me they don’t do road assistance,towing or cannot give me a courtesy car as my car was not involved in an accident,even if I was paying for it.They don’t cover mechanical and electric breakdowns

  17. Nozipho Buthelezi

    Can I be assisted. I was involved in a car accident on the 04th of April. There was a log lying in the lane I was driving in & there was the oncoming traffic and I had to deam. By the time we’re about to pass each other I saw this log which was so close.

    I try not to drive on it because it was so thick but the car lost control and it was raining. My car hits the electricity pole and enters into the gumtree bush. It was in the undriveable condition . I reported the accident to the insurance but they declined saying my insurance is new because I changed the insurance & they confirmed my cover on the 16th of March.

    They even sent policy document after giving me the car inspection report that they said I must do with Glasfit. The accident occurred on the 04th of April then they started talking of the first premium that wasn’t debited. They never even sent the assessor. It’s almost four months now but nothing is happening.

    What worries me most is that Im paying the instalment & the premium of an undriveable car since April. I want to know for which car are they debiting as they’re not fixing my car. It is also charging storage fee with the scrapyard as it is kept there.

    My claim was processed by Danny in Durban. The insurance name is First 4 Women and the policy number is 95 115 9805. I may be contacted on 0630515882 or 0729130913 for further explanation.

    Please intervene in the situation. It is really difficult to pay for something that you don’t have even for the insurance of the very same undriveable car. Why are they further debiting then? I think this is corruption that some Insurance companies are doing to us as their clients.

    Thank you.

  18. I was in car accident on April and I did the claim with my insurance*Aukhurst* and my car was written off of which i was not happy with that cause they did that without my permission, in May they contacted me and the lady told me that the car will debit at the end of the month but they still arranging with 3rd party insurance of how are they going to pay but she promised me that before end of June they will advise me with what they agreed with and if there is a more money they will refund me but even now they stll never get back to me and now we are in the middle of August, and evertime if i contact them they always tell me that they will get back to me. I even called the 3rd party insurance and they told me to contact aukhurst, please assist if you can my phone number is 0847536709/0732123988 aukhurst policy no is ELIA 1013975 AND CLAIM NO MZOLOM0001000-ACCO

  19. My insurance is liquidated (ANDERSON INSURENCE ) and my claim is still hanging and I don’t know what is happening. I am still paying for the car and the car is in the scrapyard in Carletonville, please help me.

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