
DUI exclusions drive increase in motor claim disputes
Motor, homeowners’, and commercial policies again generated the most complaints to the Non-life Division, with exclusions and claim rejections driving many disputes.

Motor, homeowners’, and commercial policies again generated the most complaints to the Non-life Division, with exclusions and claim rejections driving many disputes.

The division recorded more formal investigations in 2025, but improved turnaround times and secured almost R300 million for complainants.

Higher critical illness and disability payouts reflect a risk environment increasingly defined by prolonged recovery, income loss, and ongoing care costs.

The mutual insurer reports R5.56bn in investment returns compared with R1.32bn in operating profit, while higher claims put pressure on underwriting performance.

The state-owned insurer says it is on track to reach R30bn in reserves by 2029 – but emerging risks could still put its resilience to the test.

Disciplined underwriting, improved claims experience, and robust investment income helped non-life insurers to navigate structural headwinds.

KPMG’s survey shows broad improvement across major life insurers, driven by moderate premium growth, stronger investment returns, and efficiency gains.

Recurring-premium risk policies grew modestly, while the number of endowment policies and retirement annuities declined, ASISA statistics show.

The interim board says the Fund will prioritise claims older than 180 days, estimated at more than R20 billion.

The decline in KeyCare Plus membership reflects a reduction in employer subsidies and fewer mandates for medical scheme membership, DHMS says.

Santam says clients are opting for core covers only, part-insuring assets, increasing excesses, and taking risk-mitigation measures to reduce premiums.

The ‘big four’ illnesses made up 73% of severe illness claims; cancer alone accounted for 68%, driven by breast and prostate cancers.

Theft under property covers remains the leading driver of crime-related claims, even as overall crime claims dipped in 2024, Santam reports.

Lead Ombud Edite Teixeira-Mckinon warns against drawing hasty conclusions about complaints stats without factoring in claims volumes and policy counts.

Most complaints to the NFO went to the Non-life Division, whose interventions yielded R107m in quantifiable benefits for policyholders.

Complaints about life-benefit payouts climbed to 36% of the Division’s cases, from 34% in 2023.

The High Court, endorsing the minority judgment’s view, rules the Fund must pay the medical expenses covered by Discovery Health.