Miway Insurance - i learned a lesson today!

[scotty]

Indeed, a broker usually places a lot of business with an insurer and has a lot more "pull" when it comes to sorting out issues than an individual. They also have a lot more experience in understanding and explaining the fine print to folk like me who never read it, so Yeah, I agree, use a broker and stick with the Blue Chip companies, M&F, Zurich, Santam etc they are usually a bit more expensive than direct insurers but as in anything you get what you pay for.

 

Remember that M&F Slogan........If you want to know how good your insurer is...Claim!" - never a truer word has been said.

Plus 1 for M&F when i was insured through them for building insurance i had no hassles with them when i claimed.

 

I'm now with Outsurance and 3 out of 3 claims have gone bad.

[Eugene]

I am with Indwe Brokers and my policy is with Santam. I have yet to find a cheaper insurance and I have not had an inch of trouble with them. There are no payment delays and they have never quibbled over anything and there have been a number of claims.

 

A car t-boned me on my 6mnth old bike, snapping the frame in 2. Other than the saddle, not much else was damaged. The bike cost and was insured for R18 500. To replace the frame and saddle (and the build costs) was R15 500. Within a day of lodging the claim, I received a call from a claims consultant who told me that they had contacted the bike shop and because the damage costs was so close to a new bike, they would be replacing the whole bike. R18 500 was paid into my account that same day. They also paid separately for my helmet and the clothes that were torn in the accident.

[ricochet_rabbit]

Anyway, lets have a bit of fun......I happen to know of a number of cases that have seen the insurance ombudsman's attention so I picked two. Have a read and tell me (or all of us) how you think the ombudsman rules and why. I will give you the ombudsman's ruling in a day or so......have a shot its just a bit of fun.

 

Case 1

 

A car enthusiast buys an old car with a view to restoring it and using it daily. After the restoration he do's all the necessary, like taking it through the road worthy etc and its a fully legal and licensed vehicle on the road, he also insures the car comprehensively.

 

Some time later the insured experiences a brake problem, he tries to fix it himself but cant, and takes it to a professional workshop for repairs. The job is done and the brakes work fine for two weeks, then, one morning they fail completely and the insured is involved in a major accident and both cars are written off.

 

The insurance company refuses the claim on the basis of their terms and conditions which say "all vehicles must be maintained in a safe and reliable mechanical condition and must be roadworthy at all times" - the insured takes the claim to the ombudsman, how do's he rule.?

 

Case 2.

 

A client moves into a house and is resident there for about 8 months. He insures his house as usual with the bank who holds the bond.

 

One day the geyser bursts, there is extensive damage to the roof structure and the ceiling. The geyser was also over the lounge and the leather lounge suite is destroyed by water as well as carpets, curtains etc.

 

The insurer repudiates the claim on the basis that (a)there was no catch tray beneath the geyser as required by law and which would have prevented major damage and (2)the geyser was found to be in poor condition with extensive rust, there was also extensive rusting found on the inlet and outlet pipes as well as other pipes in the roof which meant, that the insured had not adhered to their terms and conditions which state "the geyser must have a catch tray,...... the geyser and all pipes must be regularly inspected and maintained in good condition" that they were not liable for the claim.

 

The insured takes the claim to the ombudsman on the basis that the house was inspected by the banks appointed inspector prior to the bond been granted, and he made no mention of the poor condition of the pipes or geyser or the fact there was no catch tray, hence, the insured claims he was unaware of the issue and requested the ruling be overturned.

 

How did the ombudsman rule.?

 

Okay lets hear.!

 

car- favour of client: on the basis the brakes were repaired by a professional.

geyser - favour of Insurer on the basis it is up to the insured to ensure they comply. their agent just checked the existence of the property and that it was fair value for the bond value.

 

how did I do ?

[orbeaorca]

I am with Indwe Brokers and my policy is with Santam. I have yet to find a cheaper insurance and I have not had an inch of trouble with them. There are no payment delays and they have never quibbled over anything and there have been a number of claims.

 

A car t-boned me on my 6mnth old bike, snapping the frame in 2. Other than the saddle, not much else was damaged. The bike cost and was insured for R18 500. To replace the frame and saddle (and the build costs) was R15 500. Within a day of lodging the claim, I received a call from a claims consultant who told me that they had contacted the bike shop and because the damage costs was so close to a new bike, they would be replacing the whole bike. R18 500 was paid into my account that same day. They also paid separately for my helmet and the clothes that were torn in the accident.

 

I must second this. i have only had good service from them and the premiums are good.

['Dale]

Plus 1 for M&F when i was insured through them for building insurance i had no hassles with them when i claimed.

 

I'm now with Outsurance and 3 out of 3 claims have gone bad.

3/3 gone bad...

 

Incredible!

[GrumpyOldGuy]

car- favour of client: on the basis the brakes were repaired by a professional.

geyser - favour of Insurer on the basis it is up to the insured to ensure they comply. their agent just checked the existence of the property and that it was fair value for the bond value.

 

how did I do ?

 

Spot on bud......you been reading the ombudsman cases.

 

 

Indeed, case one the ombudsman found the insured showed due diligence by taking the car to a professional for repairs when he realized the severity of the issue, he could not have foreseen that the brakes would fail again.

 

Case 2 to the insurer on the basis that 8 months was sufficient time for the insured to inspect his property and repair any defects in accordance with the insurers requirements. The bankers agents do not inspect for insurance risks.

[manbearpig]

Mutual & Federal. Go through a broker and don't have hassles. You pay a bit more but it is worth it when you need to claim. I have been extremely impressed. For car crash related issues go ask a panel beater who you should insure with.

[Slowbee]

Spot on bud......you been reading the ombudsman cases.

 

 

Indeed, case one the ombudsman found the insured showed due diligence by taking the car to a professional for repairs when he realized the severity of the issue, he could not have foreseen that the brakes would fail again.

 

Case 2 to the insurer on the basis that 8 months was sufficient time for the insured to inspect his property and repair any defects in accordance with the insurers requirements. The bankers agents do not inspect for insurance risks.

 

regarding Case 2. Considering the implications. You need to check all your plumping and electrcity within a reasonable time frame? Obiously less than 8 months.

 

Who gets into the roof to inspect the geyser plumping ?

 

And surely, the responsibility is on the previous owner, who broke the law by selling the house knowing certain things were illegal ?

 

 

However, do you not get a certificate upon transfer ?

[Sharkie 2]

I have also heard of a couple of people of late struggling with claims at various places, I work through a broker, been with them for years and have never had any issues when claiming. They are underwritten by Santam/Sanlam and although I pay about 5% more than what I can get at insurers directly they give excellent service

[Minion]

Spot on bud......you been reading the ombudsman cases.

 

 

Indeed, case one the ombudsman found the insured showed due diligence by taking the car to a professional for repairs when he realized the severity of the issue, he could not have foreseen that the brakes would fail again.

 

Case 2 to the insurer on the basis that 8 months was sufficient time for the insured to inspect his property and repair any defects in accordance with the insurers requirements. The bankers agents do not inspect for insurance risks.

Where did you get those rulings? I had a browse through the OSTI website, but couldn't find those two. I was surprised to see they've only made (or listed) 17 formal rulings.

[GrumpyOldGuy]

Where did you get those rulings? I had a browse through the OSTI website, but couldn't find those two. I was surprised to see they've only made (or listed) 17 formal rulings.

 

They come from a legal magazine discussing ombudsman rulings. I think those are just exceptional rulings, or examples, or they have seriously fallen behind on their updating of the site, they have ruled on a lot more than that.

Edited December 12, 2011 by GrumpyOldGuy

[GrumpyOldGuy]

regarding Case 2. Considering the implications. You need to check all your plumping and electrcity within a reasonable time frame? Obiously less than 8 months.

 

Who gets into the roof to inspect the geyser plumping ?

And surely, the responsibility is on the previous owner, who broke the law by selling the house knowing certain things were illegal ?

 

 

However, do you not get a certificate upon transfer ?

 

Yeah, hardly anybody I agree, but insurers maintain that like any working item geysers and piping need to be inspected and maintained to a reasonable standard.

 

The previous owner only broke the law IF he was aware of the issue, however the damage could also have happened in the 8 months I guess.

As far as I know only an electrical certificate of compliance is required for transfer, plumbing is not required to be inspected.

[andydude]

As far as I know only an electrical certificate of compliance is required for transfer, plumbing is not required to be inspected.

 

I think the Western Cape recently added a plumbing compliance certificate as a condition of transfer, althought that is more to stop leaking pipes and wasting of water.

[Slowbee]

I think the Western Cape recently added a plumbing compliance certificate as a condition of transfer, althought that is more to stop leaking pipes and wasting of water.

 

[CatGirl]

My Outsurance policy says that will only cover loose items if they are enclosed in a concealed storage area, such as a boot or cubby hole and there are visible signs of forced entry. The agent said that the concealment requirement does not apply to bicycles that are locked in a car or bike rack. Just to be sure, I got them to specifically state that in my cover document.

 

is this what you are talking about?

 

 

"THE REQUIREMENT REGARDING THE CONCEALING OF ITEMS INSIDE THE VEHICLE DOES

NOT APPLY TO PEDAL CYCLES. THERE MUST HOWEVER BE VISIBLE SIGNS THAT THERE

WAS A BREAK IN. PEDAL CYCLES LOCKED TO SPECIFICALLY DESIGNED ROOF OR BICYCLE

RACKS WHEN TRANSPORTED WILL ALSO BE COVERED.

-

IT IS A CONDITION OF COVER THAT ANY ITEMS LEFT IN ANY VEHICLE MUST BE

CONCEALED IN THE ENCLOSED STORAGE AREAS SUCH AS THE CUBBY HOLE, BOOT OR

UNDER RETRACTABLE OR REMOVABLE BOOT COVERS. THIS DOES NOT APPLY TO BABY OR

TODDLER SEATS.

ITEMS CONCEALED ON THE BACK OF AN LDV (BAKKIE) UNDER

SPECIALLY DESIGNED DURABLE LOCKABLE LOAD COVERS ARE ALSO COVERED. ITEMS

CONCEALED UNDER CANVAS COVERS ARE HOWEVER NOT COVERED. ITEMS CONCEALED

IN THE LOADING AREA OF AN LDV (BAKKIE) WITH A CANOPY OF WHICH ALL THE WINDOWS

OF THE CANOPY HAVE "SMASH-AND-GRAB" SAFETY FILM OF AT LEAST 100 MICRON AND

WITH VISIBILITY OF 35% OR LESS ARE ALSO COVERED. THERE IS HOWEVER NO COVER AT

ALL IF ANY OF THE FOLLOWING ITEMS ARE LEFT IN THE LOADING AREA: CELL PHONES,

COMPUTER EQUIPMENT, AUDIO/VIDEO EQUIPMENT, PHOTOGRAPHIC EQUIPMENT AND

INDIVIDUAL ITEMS WORTH MORE THAN R 100,000. THERE MUST BE VISIBLE SIGNS THAT

THERE WAS A BREAK IN. GOODS LEFT IN THE OPEN ARE NOT COVERED"

 

 

which brings me to another thing: what happens if someone steals something through your bedroom window which has got burglar bars, and he can reach through the window?

Edited December 12, 2011 by helloise

[Minion]

is this what you are talking about?

That's the one.