The importance of policy wording was underlined again in the UK’s comprehensive High Court analysis of 21 samples in coverage extensions for business-interruption COVID-19 related losses recently. At times the hearing sounded more a semantics class than a court case. Policy wording in terms and conditions have in many other cases also been a bone of […]
The importance of evaluating and reassessing a client’s risk, including changes in insurance risks under the COVID-19 lockdown period was one of the topics discussed at the OSTI’s virtual Consumer Webinar. “Elements and circumstances of risks change throughout one’s life. Depending on the stage of your life and the circumstances, there might be times when […]
As intermediaries, we have a very important role to play when a dispute arises between a client and the insurer. Understanding the roles of the various parties can help us retain clients by arriving at an amicable settlement. “OSTI remains an independent organisation. It continues to deliver fair and just outcomes,” the chairman of OSTI’s […]
In a case study shared in the recently published OSTI annual report, the issue to be determined was whether the insurer’s offer of settlement amounted to indemnification on the part of the insurer. “Short-term insurance contracts are contracts of indemnity which means that the insurer’s obligation is to place the insured back in the same […]
“Consequential loss” has always been a grey area in the short-term insurance industry. The South African Insurance Association (SAIA) defines “consequential loss” as “a loss not directly caused by the insured event, but an indirect result of the event. “ An example is when a person’s geyser bursts and their ceiling and carpets are damaged. […]
Is it a case of “innocent until proven guilty” or “guilty until proven innocent”? Although witnesses shared their views and not one piece of evidence was overlooked, a recent Ombudsman case study indicated that insufficient evidence can lead to a favourable ruling for the client. What lead to the claim? The claimant, Mr M, was […]
In a recent media release, the Office of the Ombudsman for Short-Term Insurance (OSTI) highlights some of the things consumers do which might result in the insurer cancelling cover or refusing to pay out on a claim. These things also link with the requirements placed on an adviser during the application as well as servicing […]
When it comes to insurance, the payment of claims is top of mind for most clients. Ultimately risk cover is there to protect a policyholder when the unexpected happens. It is therefore concerning to note that the second highest cause for complaints, based on the Ombudsman for Short-Term Insurance (OSTI)’s annual report for 2017, was […]
