Posts Tagged ‘Ombudsman’

Do not expect your car insurer to pay if you overload the vehicle!

Written on August 24th, 2009 by admin
Categories: Car Insurance Advice, Ombudsman
Severe Overloading

Severe Overloading

We often hear readers complain about their insurers and the non-payment of a claim. Before we criticise and take the matter to the Ombudsman we need to reflect on car insurance and the contents of the insurance policy. Car insurance is a contract between a client and his insurance company. The insurer agrees to provide cover on receipt of a monthly insurance premium for “normal” and “expected” risks to the insurable interest of the client.

The policy of insurance would also stipulate specific exclusions under which the insurer would not be obliged to make payment. These could include a certain event, person, peril, condition or situation that is not covered. This exclusion, or more than one exclusion, could be removed at the payment of an additional premium should the insurance company be in agreement to accept the additional risk. Typical exclusions from car insurance would be: overloading your car; using your car as a taxi service (earning income from it,) damage to your car from driving on gravel roads etc…

By overloading your vehicle you are creating an additional risk. The Arrive Alive road safety website described these risks:

  • The vehicle will be less stable, difficult to steer and take longer to stop. Vehicles react differently when the maximum weights which they are designed to carry are exceeded.
  • Overloaded vehicles can cause the tyres to overheat and wear rapidly which increases the chance of premature, dangerous and expensive failure or blow-outs.
  • The driver’s control and operating space in the overloaded vehicle is diminished, escalating the chances for an accident.
  • The overloaded vehicle cannot accelerate as normal – making it difficult to overtake.
  • At night, the headlights of an overloaded vehicle will tilt up, blinding oncoming drivers to possible debris or obstructions on the roadway.
  • Brakes have to work harder due to ‘the riding of brakes’ and because the vehicle is heavier due to overloading. Brakes overheat and lose their effectiveness to stop the car.
  • With overloading, seat belts are often not used as the aim is to pack in as many persons as possible into the vehicle.
  • The whole suspension system comes under stress and, over time, the weakest point can give way.
  • By overloading your vehicle you will incur higher maintenance costs to the vehicle – tyres, brakes, shock absorbers and higher fuel consumption.
  • Insurance cover on overloaded vehicles may be void as overloading is illegal.

Always remember that you would not only have to cope with poor handling and braking performance, you could also invalidate your insurance, and even incur a fine, if the car is overloaded.

Share and Enjoy:
  • Print this article!
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Mixx
  • Google Bookmarks
  • muti

When do I notify the insurer of an accident claim?

Written on July 28th, 2009 by admin
Categories: Car Insurance Claims, Ombudsman

The quick and easy answer would be – when does your policy document require you to provide such notification? It is important to remember that your insurance policy is the written agreement between you and your insurer. You pay a monthly insurance premium and the insurer agrees to provide compensation when a specific event occurs. The insurer will compensate for that damage after the accidental damage has occurred, and once you have complied with the complete and timely disclosures required in the policy!!
It is important to keep the policy documentation in mind in the event of an accident. Failure to follow the terms of the policy will amount to breach of contract and the insurer cannot then be held accountable for failure to provide compensation to the insured!
It is best to illustrate this with an actual example of a claim that was referred to the Ombud for Short Term Insurance:

Written notification of Car Insurance claim within 30 days

Facts:

The Insured’s motorbike was damaged in a collision on Thursday, 20th June 2002. The following day, i.e. on Friday, 21st June, he gave telephonic details of the collision to his Broker which telefaxed to him on Monday 24th June, claim forms. The motorbike was taken on a trailer to Linex Yamaha during that week, and he was only able to collect the quotation from Linex Yamaha the following Tuesday, i.e. 2nd July 2002. On Friday, 12th July 2002, his 79 year old father fell and was placed in Universitas Hospital, Centurion. The Insured being a single parent and between his responsibilities with his father, son and work, only managed to get to Linden Police Station on Tuesday, 23rd July 2002, to get them to stamp and sign off the motor accident claim form. On Thursday, 25th July 2002, he faxed the claim form together with the quotation to the Insurance Broker. The Insurer rejected liability because the claim was not reported in writing within thirty days of the event. The Insured was five days late within giving written advices to the Insurer of the claim.

Decision:

In view of the strict conditions of the Policy, requiring written notification of the claim within thirty days of the event, the Ombudsman could not make a ruling against the Insurer.
Source: Ombudsman Newsletter : 02/03

Advice:

We would like to advise all policyholders to keep their policy documents in a safe place – follow the steps taken as stipulated in this document and do not be the cause of unnecessary delays! Contact your insurer and always remember – there is nothing quite like enquiring!!

Share and Enjoy:
  • Print this article!
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Mixx
  • Google Bookmarks
  • muti

The truth, whole truth and nothing but the truth with car insurance!

Written on July 28th, 2009 by admin
Categories: Insurance Fraud, Ombudsman

It is important that the owner of a vehicle carefully considers the risks to his vehicle and how to protect himself from the financial risks threatening his ownership. Car Insurance is the best measure to have peace of mind that the financial interest in ownership is  – but then there must be total disclosure and honesty on the part of the insured!

I am one of those who dread reading insurance policies – yet, this is such an important part of being insured! Honesty is not only needed at the time of submitting a claim – but also at the time when the policy is discussed and acquired! It is at this time that the client discloses to the insurer all those factors that might be important to measure the risks and calculate the insurance premium to be paid…

I would like to explain through an actual example how the failure to disclose all these factors might be detrimental to the owner and his expectations to be compensated under the policy:

Example

When the Insured took out his Insurance Policy with the Insurer, he was noted as the regular driver of the insured vehicle. His vehicle was involved in a collision whilst his son was the driver of the vehicle.  The Insurer investigated the matter and discovered that the Insured’s son had been the regular driver of the vehicle for some time. Had the Insurer been informed of the change in the risk profile, the premium would have increased from R126.16 to R207.14 per month. The Insurer accordingly received only 60% of the correct premium.

Ombudsman’s response

In the light of the aforesaid factual scenario, the Ombudsman agreed with the Insurer that it was entitled to maintain its rejection of the claim.”
This is an important lesson to us all – we need to disclose all the facts to the insurer! Only through complete and honest disclosure will the correct premium be calculated and can we expect the insurer to provide compensation to meet our legitimate expectations!

Share and Enjoy:
  • Print this article!
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Mixx
  • Google Bookmarks
  • muti