Ombudsman

Ombudsman

The Ombudsman is not one person, but an independent office of well qualified people employed to assist the consumer and insurer in the event of a conflict arising from an insurance claim! Established in August 1989, The Office of the Ombudsman for Short-Term Insurance provides consumers with a free, efficient and fair dispute resolution mechanism. It offers consumers with a “no risk” mechanism to resolve disputes with insurers.

The Ombudsman’s Office is governed by a Board of Directors, comprising of four consumer representatives, three insurer representatives, one representative from the South African Insurance Association (a trade association, which represents all short-term insurance companies in South Africa) and one representative from the Financial Services Board.

The current Chairman is Moses Moeletsi and the Deputy Chairman is Gail Walters.

The Office can assist consumers with the following personal lines short-term insurance:

  • Motor
  • Houseowners (Buildings)
  • Householders (Contents)
  • Cell phone
  • Travel
  • Disability
  • Credit protection insurance

Commercial Insurance on a Limited basis, i.e. claimants such as small businesses, including a sole proprietor or trader, a juristic person, partnership or trust that has a turnover in the last financial year of less than R8 million. Claim disputes, which the Office can assist with, include fire and allied perils (if there is an involvement of loss of profits/interruption, the entire claim will not be dealt with by the Ombudsman’s Office), glass, theft, motor, travel, sickness and accident and SASRIA claims (affiliated to the aforesaid covers).

But will the insurer listen to the decision by the Ombudsman?
The Office of the Ombudsman for Short-Term Insurance has been granted recognition in terms of the provisions of the Financial Services Ombud Schemes Act. All personal lines short-term insurers have agreed to abide by the Ombudsman’s decision.

The Ombudsman’s task is to act as a “mediator” or informal arbitrator and he/she does not represent either of the parties to the dispute.

The consumer needs to be aware of the following aspects:

  • The consumer must complain to his /her insurance company first and only if unable to resolve the dispute with your insurer, then he/she can refer the matter to the Ombudsman’s Office
  • The Ombudsman’s decisions are binding on the insurance company but not on the consumer – it does not take away the other legal remedies available to the consumer.
  • The Ombudsman’s Office is an independent office
  • The Ombudsman’s decisions can be based on either law or equity The Ombudsman’s Office does not give legal advice
  • The service is free to insured consumers

On the Car Insurance and Road Safety Blog we will provide commentary on some of the decisions by the Ombudsman and the lessons learn from these decisions.

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18 thoughts on “Who is the Ombudsman and can he help with my car insurance?

  1. Jan

    Hi i was in a accident a month ago .I have a 1984 Charade,a lady on a cell phone skipped a stop street did not even give me a meter to do anything i was in a straight road,i hit her bakkie on the front wheel ,she said she did not see me .The owner of the bakkie got a dent about 10cm and can`t even see any damage ,In that 1-2meter time line i wanted to try a drive out of the way while braking and picking up my hand break.The damage to my car is the left panel ,my bonnet ,my left flicker light ,bumper,left headlight,and body a little bend,and my radiator had a hole in it ,that is as far as i could see the damage extends to .From the accident my neck was stiff but better now ,but i get memory loss sometimes since the accident .

    This car was our income and only daily transport.

    They don`t want to pay ,What can i do ?The other party has insurence but my car is to old to be fixed.The amount roughly to fix it ,would be R5000,my car value is R3000,But i spent about R10 000 to fix every little vault it had

    The other

  2. Doreen Neo Moeng

    I have a dipute with my car insurance Budget.I was involved in the accident last year 2011 July the 19th.My car was sent to their repaires but,to my shock the colour of my car was changed without my approval.I escalated the quiry with them since last year.They took my car when I indicated to them that I cannon wait any longer I go external my car is with their repairer and they gave me a car hire which is not even similar to my car.I am paying for my car installment and insurance for the car that I do not have.I need assistance in this regard.

  3. Bob Simpson

    My Toyota Fortuner was stolen from my workplace on 12 October. The car was in a secure parking with a securtiy guard present.
    I purchased this car end of July. The insurance company required a tracker to be installed. I was still in the process of doing inquiries regards different tracking companies when it was stolen. The insurance company has intimated that I have no claim. Please Advise. Tank you Bob Simpson

  4. Tracy Mains

    When my husband came out of work, we sold one of our vehicles , he took over my van, and when we went to get the insurance for it, Budget told us to just change driver details over on my policy. My husband would be policy owner & I would be 2nd driver. Now I thought my no claims bonus would be on hold for me when I was able to afford another car. I had 9 yrs NCB & when I phoned them about it, they said I couldnt have it because Id transferred it to my husband. My husband has a letter off them thanking him for proof of his NCB which was 6 yrs. He’s just cancelled his insurance & his proof of NCB is 8 yrs. If he’d of had mine, it would of been 11 yrs NCB. How do I get my NCB back? Ive just had to start again with No NCB

  5. Hugh Rolph

    Hello, I wonder if you can help me, I took out Fully Comp, Car Insurance with the Post Office in August and was contacted by The M.I.D. on 21/11/2012 to say that my car was not registered as insured. I rang the Post Office Insurance the next day (22nd) and was told not to worry i was insured, they would however register it straight away. Since then i have made 3 other calls to them and also rang M.I.D. twice, and it is still not registered.
    On the last call to the M.I.D. they said i would be getting a fine for this, I was horrified and rang the Post Office Insurance yesterday about my concerns yet again. They said they would ring me back yesterday, but 24 hours later i still have had no call back. I go away on Jan 15th 2013 to Devon until March 15th 2013 and would really like this sorted before i go, also i do not wish to receive a fine and possilby points on my license becuase of their incompetence, in over 44 years of driving i have never encountered such problems, I have retired early from H.G.V. driver to look after my sick wife, i also hold an advanced driver certificate. Please could you advise me?
    My Policy number is: 120487454-01
    Customer Services Phone number : 0845 0731002
    Many Thanks Hugh Rolph

  6. Mrs S Pather

    Please I ask this question with no disrespect to the ombudsman’s office. Can you advise me on the following:
    ;without prejudice’
    If you have a case which is more than 365 days old with the ombudsman and if it was first handled by an assistant ombudsman and then a senior ombudsman and still a decision is not arrived at but was advised to accept the offer given with a prejudiced amount, are we at liberty to seek the review of our case by the chief ombudsman, Mr Dennis Jooste, himself with regard to the prejudiced amount.If this is possible, please advise how do we obtain the email address of the chief ombudsman. As pensioners, we cannot afford the legal and am therefore trying to solve our case to the best of our ability. Thank you most kindly in advance, for your comment.

  7. Mr William Nel

    To Whom it concerns,
    Good Day! I currently have my Household & Vehicle Insurance with Dial Direct Insurance Co. I have been a member of this Company for approx 4 Yrs plus – No claims. My current claim was made 03 February 2013 for a vehicle accident I was involved in. The Assessors have completed their estimates on the damage 08 February 2013. The vehicle is lying dormant this week as a result of my normal monthly Debit order been ONLY visible on their database wef 15th of each month. This monthly premium has never been missed, however I was informed as a result of Dial Direct not seen a payment as yet (February) I will have to wait until it is on the system before any further processing and approval on my repair work is reached. I feel this is just unacceptable for such a reputable company like Dial Direct to approve and agree to such unfairness on a client. My details are as follows: Policy No: 828243863 ID: 5111305084089. Thanking You.

  8. Grace Xaba

    Dear Sir/Madam,

    I would like to my rights regarding a case that involves Wesbank (First National Bank) where my late son took a credit life insurance when he purchased a car through WesBank. My late son Ntuweleni Innocent Xaba, bought a car (BMW 323i – E90)on 26/10/2011 and has been paying the installments through debit order until his death on 26/02/2012. According to Wesbank documents agreement signed during the conception of the purchase, “part C” of the total cost, the interest rate and credit life insurance is mentioned and when I approached Wesbank, they demanded that I pay the remaining amount if I decide to keep his car, as the parent of the deceased. (see attached agreement for your kind attention)

    I wanted to know and be advised on the credit life insurance that he took, was it not supposed to have covered the remaining amount in the event of his death? and if that is the case why are they not settling his debt as the person who was insured? All documents related to his death were submitted to them and I have settled the car because they refused to honour this matter.

    Kindly advise and would appreciate if you could respond to my inquiry before a formal complaint is lodged. What are my rights in this case, I need your help?

    Thank you

  9. Joy Mojapelo

    MY NAME IS JOY MOJAPELO FROM SOWETO, MY VEHICLE WAS DAMAGED BY NOMTHANDAZO MOKOENA ALSO FROM SOWETO DRIVING ON A WRONG LANE AND COLIDED WITH ME AND NOW HER INSURANCE WHICH IS BROLINK REQUESTED ME TO DO THREE QOUTATION AND FORWARD THEM TO MADELAINE VAN NIEKERK OF BRONLINK WHICH I DID. AFTER DOING ALL THE TAKING THE UNDRIVEBLE VIHECLE TO DIFFERENT PANEL BEATERS I WAS TOLD THAT THEIR CLIENT WAS NOT WRONG AND THEREFORE THE ARE NOT PAYING FOR THE DAMAGES.PLEASE KINDLY HELP ME I AM NOW WITHOUT A VEHICLE ITS BEEN THREE MONTHS NOW.

    BELOW WERE THE RESPONDS OF BROLINK :
    Good day
    Our client where insured through Prime Meridian before she took out insurance through us. She initially referred this claim to the wrong insurance, and that is why they rejected the claim. We are the correct insurance and are not linked to Prime Meridian.

    We await your witness statement.

    Kind regards

    Madelaine van Niekerk
    Third Party Liabilities
    Brolink (Pty) Ltd

    Good day

    Kindly take note that we confirmed the merits of this matter with our client. We are not liable for the damages to your vehicle unless you can provide us with an independent witness statement that can proof your version

  10. kashief Adams

    I have been involved in a accident which was partially my fault and so was the other vehicle too now I have to pay for all the damages. I did not even get a chance to defend myself. Could you please help me

  11. tsholanang nkau

    I wonder if you can help me with the problem im having with MH motors,my wife bought a polo classic last year somewhere in March, we than complain to them that the car is locking the front wheels,they tried fixing the problem until we decide to give them the car back after many attempts of trying to solve that mechanical issue.
    We agree with them that they will take a car back and give us another one but in my name, I than fill all documents and they give us Honda Accord,the second day i complain to them about the sound in the front left wheel, worn out tyres and that the car dint have a spare even today I didnt recieve a spare wheel from them also the sound is still there and I went to them again of which they said there is nothing they can do because im driving the car and they will tell me when must I come pick a spare wheel,the only thing they assisted me of was just one wheel of which tue other one was bought by me, please advice me what to do or help please.
    Regards
    Tsholanang Nkau

  12. Thamsanqa Leonard Mkhize

    Comment my car insurance is king price. I made a claim with them to fix my car windscreen with glassfit. but I failed to have money for excess. but now I do have money but my insurance says my claim has expired . when I claim again they declined my claim. please help I need my windscreen to be fix

  13. thulile

    Commentwas involved in an accident 02/04/2015 till today durban panelbeaters are telling lies they told me the car was gonna be ready last week friday the next day I sent my brother to go check if it was ready he was told that the car was ready bt the person who was to release it eas off sick today they are telling me that the car is nt ready I wonder why they are lying about everything nw

  14. Rudi Van Der Walt

    Good day
    I am desperately in need of assistance in the following matter, hoping you can advise.
    On the 6th May 2015 I was in a motorbike accident. A driver of a company vehicle(Fidelty security services) bumped into me.
    A witness to the accident called the netcare ambulance service to take me to hospital. The other driver gave his contact details to my step daughter who arrived on the accident scene and the driver left the scene saying he was going to the police station to report the incident. I was taken to hospital by netcare ambulance service. Luckily I was not seriously injured but my bike was damaged. The next day I went to report the incident by the police station and got a case number. I was told that the driver of the motor vehicle had not reported the incident. Luckily my step daughter had arrived at the scene of the accident and got his details, The Saturday after the accident I went to the drivers house and he admitted that he did not see me as I was in his blind spot. He gave me his companies details, I contacted the company who then told me the driver had not reported the accident to them. I was then told different stories but the one was that he had passed a polygraph test and denied that he had hit me at all. The witness to the accident also made a afidavid at the police station on my behalf as she had seen the accident. . I was then told by the company to contact head office were I had to give them my description of the accident and get quotes for the bike repairs and sent them the netcare ambulance bill and hospital bill. I also had to send a letter saying I did not have insurance. From then I have just been messed around and they keep having excuses or not replying to my emails. They have told me the driver did report the incident but after numerous request from me to get the case number , I still have not received it.They also said the case was under further investigations but have not even contacted witnesses regarding the accident They then said they were waiting for polygraph test result(again), finally they said he had passed it, but could not get it as the lady who took it resigned without giving it to them, then the story changed to he had a voice detector test and they wanted a proper polygraph test. They do not want to pay me for any damages but will not give me any proof of the polygraph test or the case number the driver apparently had. I now have to pay the hospital bill, bike repairs and ambulance bill. Please could you assist in this matter and advice to where to go and what to do from here. I am desperate and the company now does not even answer my emails
    Kind regards
    Rudi Van Der Walt

  15. surge

    hi Please can i have contact details for me to log a complain about a panel shop that took my money but did not complete my repair ontrack panel beaters

  16. Obakeng Kabelo Mokgwamme

    Hi There

    My Name is Obakeng Mokgwamme.

    I was insured with King Price Insurance with no joy.

    I logged a claim and had to run around doing their administrative duties looking for paperwork that they required and was told told that it was a favour if they had to find it for me by Anri Quick working for king price.

    I then returned to my previous insurers and get that information which I did within an hour taking Anri Quick a full four days with no success, then the claim was approved.

    Taking a breather, I receive a call from a certain Bryce also employed by King Price and I quote ‘Mr Mokgwamme we made a mistake by insuring you under private use when you clearly stated that you want insurance for business use of your vehicle, so we’ll have to increase your premium by R200+’

    I refuses and told them it’s not my fault but the call center agent imprudently said there was nothing he could do the system will deduct that obviously thinking that I am somewhat stupid, so they went on and increased the premium. I don’t have money lying around to pay for the mistakes that King Price employees make.

    Please advice

    My Policy number is KP2070551
    My ID 8303105385082
    My Names Obakeng Kabelo Mokgwamme

    Many Thanks

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