Do you know what you are covered for / Cyclesure?

[ewep]

I get the feeling that the issue lies with Fred and his team at Cyclesure.

[rouxtjie]

 

 

Nice response, Hollard.

 

So, to clarify, the claim hasn't been rejected?

 

One of the issues that seems to have cropped up in this thread, though, is the way that policy terms and conditions are updated. Is there any way to make it clear to the client which parts of the policy have been updated and how they differ from the old wording? Also, if the update has been sent by email can an active response from the client be required?

Also he manner in which these new terms and conditions are delivered. A call to said client is the bare minimum, where these changes are gone through one by one by a trained employee.

[Hollard]

Nice response, Hollard.

 

So, to clarify, the claim hasn't been rejected?

 

One of the issues that seems to have cropped up in this thread, though, is the way that policy terms and conditions are updated. Is there any way to make it clear to the client which parts of the policy have been updated and how they differ from the old wording? Also, if the update has been sent by email can an active response from the client be required?

 

Hi Rata.

 

No, the claim was never rejected. A final decision had not yet been made when this thread was posted. As with all short term claims, any claim that might be rejected as per the policy wording is put through a process in which ALL of the merits of the claim are assessed to ensure we're treating our customers fairly.

 

Thanks for your comments on the way policy terms are updated. This thread has shown us that we need to look at how this is done. As it stands now, if we don't get a response within an allocated amount of time (will have to check with our legal department but I think it's 30 days) then we assume that the customer has no objections.

[Rata Del Spruit]

It seems the claim was initially rejected and subsequently having regard to independent communications (the HUB!!), the claim was review and now looks like a positive ending for the client. The power of the Hub can never be underestimated. Insurance people - eish!!!!

 

We've had calls from CycleSure and Hollard now and the way that it has been explained to me is thus:

 

CycleSure assesses a claim and takes notes. They warn the client that the claim can be rejected if it breaks any of the clauses in the policy. They don't, however, reject the claim. They will then forward the claim to Hollard with a report that also explains XYZ reasons why the claim can be rejected, if at all. Hollard then decides on the merits of the case and makes a decision then, taking into account lots of factors, not just the isolated incident.

 

Hollard naturally didn't want to give us any details that would compromise client confidentiality but they did explain that this is the stage of the process that they are at and they are hoping for a positive outcome from all of this, especially with regard to tailoring their cycle cover to meet the needs of cyclists.

 

This is a good opportunity for us to turn this into something positive and provide feedback on what we would like to see in our cycling specific cover and what wording doesn't make sense (take the debate on whether or not we have to ask our muggers to assault us, for example).

[mazambaan]

The method of notification fits my theory. You sign the sucker on one set of healthy terms then shoot off a 100 pages of changes effectively reneging on key obligations to his last known address. Interesting to know what how a test case would pan out on this.

[Hollard]

It seems the claim was initially rejected and subsequently having regard to independent communications (the HUB!!), the claim was review and now looks like a positive ending for the client. The power of the Hub can never be underestimated. Insurance people - eish!!!!

 

Hi.

 

While we respect the power of the Hub , that was not the case here. A final decision had definitely not been made. A broker has the mandate to pay any claim, but when it comes to repudiating one it must first go through a process in which ALL of the merits are assessed to ensure we're treating our customers fairly, and this claim was still being assessed when this thread was posted.

 

As stated above, we would like to stress that there really are some powerful avenues for any insured to pursue in cases where they feel that an insurer has treated them unfairly. These include lodging a formal complaint with the insurer and then, if no satisfaction is obtained, contacting the Ombudsman for Short-term Insurance (www.osti.co.za).

[shaper]

Hi Rata.

 

No, the claim was never rejected. A final decision had not yet been made when this thread was posted. As with all short term claims, any claim that might be rejected as per the policy wording is put through a process in which ALL of the merits of the claim are assessed to ensure we're treating our customers fairly.

 

Thanks for your comments on the way policy terms are updated. This thread has shown us that we need to look at how this is done. As it stands now, if we don't get a response within an allocated amount of time (will have to check with our legal department but I think it's 30 days) then we assume that the customer has no objections.

This is where you and cell phone providers are incorrect in your assumptions... correct me if am wrong, but under the consumer protection act you now have to opt in to accept these terms and not be automatically opted in by the service provider if you do not respond.

[Hollard]

We've had calls from CycleSure and Hollard now and the way that it has been explained to me is thus:

 

CycleSure assesses a claim and takes notes. They warn the client that the claim can be rejected if it breaks any of the clauses in the policy. They don't, however, reject the claim. They will then forward the claim to Hollard with a report that also explains XYZ reasons why the claim can be rejected, if at all. Hollard then decides on the merits of the case and makes a decision then, taking into account lots of factors, not just the isolated incident.

 

Hollard naturally didn't want to give us any details that would compromise client confidentiality but they did explain that this is the stage of the process that they are at and they are hoping for a positive outcome from all of this, especially with regard to tailoring their cycle cover to meet the needs of cyclists.

 

This is a good opportunity for us to turn this into something positive and provide feedback on what we would like to see in our cycling specific cover and what wording doesn't make sense (take the debate on whether or not we have to ask our muggers to assault us, for example).

 

This.

[Vangar]

Hi.

 

While we respect the power of the Hub , that was not the case here. A final decision had definitely not been made. A broker has the mandate to pay any claim, but when it comes to repudiating one it must first go through a process in which ALL of the merits are assessed to ensure we're treating our customers fairly, and this claim was still being assessed when this thread was posted.

 

As stated above, we would like to stress that there really are some powerful avenues for any insured to pursue in cases where they feel that an insurer has treated them unfairly. These include lodging a formal complaint with the insurer and then, if no satisfaction is obtained, contacting the Ombudsman for Short-term Insurance (www.osti.co.za).

 

While I still think there's a fair amount of spin in the statements from Hollards side. Thanks for taking the oppurtunity and the response. While I would still not use cyclesure because of complete disagreement with regards to their policy wording, I would like to effectively use Hollard in future through Standard Bank insurance who are the broker on my vehicle and home insurance. Is there any chance we could get a document with the requirements and exclusions from Hollard?

 

Insurance should be simple and reasonable. If I see a list of exclusions and conditions as long as my arm for ANYTHING, I'm gone in a flash, can't be bothered to worry if I am breaking any.

[rouxtjie]

 

 

Hi.

 

While we respect the power of the Hub , that was not the case here. A final decision had definitely not been made. A broker has the mandate to pay any claim, but when it comes to repudiating one it must first go through a process in which ALL of the merits are assessed to ensure we're treating our customers fairly, and this claim was still being assessed when this thread was posted.

 

As stated above, we would like to stress that there really are some powerful avenues for any insured to pursue in cases where they feel that an insurer has treated them unfairly. These include lodging a formal complaint with the insurer and then, if no satisfaction is obtained, contacting the Ombudsman for Short-term Insurance (www.osti.co.za).

@Hollard

 

Why did carpet then feel her claim was rejected?

Why did she feel desperate enough to rope her father in to fight on her behalf?

Why was her expectations not met, why was she surprised that her claim was rejected?

 

Surely this speaks about communication in your company. One aspect of treating a client fairly is managing their expectations ito the product you offer, the other is making it easy for a client to claim. Do you think you have delivered this

[Hollard]

This is where you and cell phone providers are incorrect in your assumptions... correct me if am wrong, but under the consumer protection act you now have to opt in to accept these terms and not be automatically opted in by the service provider if you do not respond.

 

Hi Shaper.

 

Thanks for your comments. Please allow us some time to get back to you on this specific question as it pertains to policy wording updates.

[Bloukrans]

Hi.

 

While we respect the power of the Hub , that was not the case here. A final decision had definitely not been made. A broker has the mandate to pay any claim, but when it comes to repudiating one it must first go through a process in which ALL of the merits are assessed to ensure we're treating our customers fairly, and this claim was still being assessed when this thread was posted.

 

As stated above, we would like to stress that there really are some powerful avenues for any insured to pursue in cases where they feel that an insurer has treated them unfairly. These include lodging a formal complaint with the insurer and then, if no satisfaction is obtained, contacting the Ombudsman for Short-term Insurance (www.osti.co.za).

Thanks for the reply. On a reading of the OP's post, it was stated that she was informed that her claim was turned down. My understanding of that statements is that the claim was assessed and repudiated. Did the broker / agent inform the OP that the rejection / repudiation/ turning down of the claim is provisional and subject to another process? In any event, I hope everything works out for the OP

[Hollard]

While I still think there's a fair amount of spin in the statements from Hollards side. Thanks for taking the oppurtunity and the response. While I would still not use cyclesure because of complete disagreement with regards to their policy wording, I would like to effectively use Hollard in future through Standard Bank insurance who are the broker on my vehicle and home insurance. Is there any chance we could get a document with the requirements and exclusions from Hollard?

 

Insurance should be simple and reasonable. If I see a list of exclusions and conditions as long as my arm for ANYTHING, I'm gone in a flash, can't be bothered to worry if I am breaking any.

 

Hi Vangar.

 

Please mail us on ask@hollard.co.za with this request and we'll get right on it ASAP.

[Hollard]

Hi again all.

 

Going to have to sign off now but we'll be back at 9ish tomorrow morning to answer any more questions and take your suggestions. You can also mail us on ask@hollard.co.za.

 

Please remember, and this is to respect our customers privacy, that we are generally not able to comment on specific claims.

 

Thanks all. Stay safe.

[shaper]

@Hollard

 

Why did carpet then feel her claim was rejected?

Why did she feel desperate enough to rope her father in to fight on her behalf?

Why was her expectations not met, why was she surprised that her claim was rejected?

 

Surely this speaks about communication in your company. One aspect of treating a client fairly is managing their expectations ito the product you offer, the other is making it easy for a client to claim. Do you think you have delivered this

The wording in the original post is clear "Today I get informed that my claim was turned down."

​There is no ambiguity that this is being reviewed by the underwriter... so the back tracking here is now customer damage limitation, nothing more...

[marko35s]

 

Hi Shaper.

 

Thanks for your comments. Please allow us some time to get back to you on this specific question as it pertains to policy wording updates.

It still equates to the same thing as inertia marketing. Asking a client to 'opt out' or disagree to changes (that they quite possibly have not received or understood) on an agreed schedule is done purely for the convenience of the insurer. Surely to treat the customer fairly any changes should be explained to them in order that they understand the ramifications?

Could this be done on a legal document such as a will? No. Any changes or amendments would have to be acknowledged and signed for, why is this any different?