Every single day, insurance companies in South Africa pay out millions in claims for car accidents, stolen cars, house break-ins, and building damage. You name the disaster and you can bet that there’s an insurer dealing with the claim. Unfortunately, ‘dealing’ with a claim isn’t the same as approving and paying out a claim.
There are situations where your claim could be rejected. You’ve probably heard of a thousand horror stories because there are a variety of reasons why your claim could be denied. It could be that you’re insured with a dodgy company who has created and uses loopholes to avoid paying out if their clients put in a claim. That does happen. But a lot of the time, claims are rejected because of exclusions.
What are exclusions?
Exclusions are pretty straightforward to understand and are usually stated in your policy docs. Exclusions are exceptions to your cover, which is a short way of describing the circumstances under which you won’t be insured. Which translates to circumstances under which your claim will be rejected.
You should know that it doesn’t matter how comprehensive your cover is or how long you’ve been insured for. If it’s an exclusion that’s in your policy, then it’s not covered.
Examples, examples, examples
A common exclusion for car insurance is when your claim is denied because you’ve been involved in an accident, while under the influence of alcohol or drugs. It’s not just that you won’t be covered, actually. You could very well go to prison, because these are pretty hectic crimes.
A common exclusion for home insurance is putting in a claim for loss or damage to your home if you’re using your place as a boarding house or commune. Communal living is generally not covered, either.
But how would you know any of this if you don’t know what your exclusions are?
Your insurer should be upfront
Yes, the responsibility is yours to know what your exclusions are. You need to read the terms and conditions of your insurance policy to make doubley sure that you know about the instances when you won’t be able to claim.
But while that’s your duty, it’s also your insurer’s responsibility to make it as easy as possible for you to understand your cover. Unfortunately, the truth is that not all insurance companies make this info super clear. Some persistently stick to the same archaic language, stuffed with complicated sentences and words. Thankfully, there are some who have decided to take a different route. Check out these policy documents to see how simple insurance can be when an insurer uses plain South African English, complete with examples.
Sure, it’s still terms and conditions… But you can understand what’s being said. You can see exactly where the exclusions are. There’s no confusing jargon. And it’s not the worst thing to read, to be honest.
If you’re keen to get on board with an insurance company who believes in being transparent, then click here to get commitment-free quote, or call 0860 50 50 50 to get in touch and chat about your needs