Car insurance ? Guilty as charged !

[Patchelicious]

Again another thread where it's automatically the insurance company's fault.................. until full story comes out.

 

Guys guys guys..... I say this over and over, I promise it is more expensive for the insurers to NOT pay a valid claim than it is to just settle it.

 

Those that say insurers go out of their way to repudiate claims are simply being ignorant.

(Direct insurers are another story though)

 

edit: As for the outbonus, it is there to incentives you to be more risk averse, NOT to act as a savings account.

Edited June 25, 2014 by ArchedBackChinOut

[Falco]

Be very careful with Outsurance in doing this (repairing damage out of your own pocket to save the Outbonus). Here is a documented case where a client with a high value vehicle did this - he repaired the vehicle twice at his own expense - then the vehicle was written off and Outsurance started to investigate - they found out about the previous "losses" and repudiated the claim - their argument: the client's loss history would have influenced his risk profile and they would have adjusted his rates accordingly - therefor they didn't get their correct premium. The case went Outsurance's way.

You can check out the full detail here: http://www.moonstone...-vs-outsurance/

This makes perfect sense. Premiums are calculated according to risk profile and accident history, not according to who repaired the car after undisclosed accidents.

 

If a driver has two accidents, his premium will increase. In this case, it didn't. So his risk profile was higher, but the premium stayed the same.

 

He deserved to have his claim denied.

[Starvin' Marvin]

Tromp I hope you get sorted out.

[rouxtjie]

Maybe I can just put in a rave for santam

 

Story: My maid broke her arm whilst cleaning the house(tripped over a carpet and had one hell of a fall). We rushed her to the doctor which took xrays and referred us to ortho, now she isn't on medical aid. Luckily there was no operation required cause bones didnt shift so a brace would do just fine. Of course we now need a temp maid whilst she is on sick leave. Inquired with Santam about personal liability in my house and I am covered for R5000.00 wrt this.

 

We did tell the doctors and ortho about our situation and they came to the party wrt a special rate. Santam paid out the amount as well as covered some of the new maid's salary.

 

Whats the old saying...you only know how good your insurer is when it comes to claim time.

[Eugene]

This doesn't sound right. If he jumped the stop street, he is guilty. It is not your responsibility to make sure that someone obeys the laws of the road! There is no "partial blame" in an accident. Are you insured? If so, claim from your insurance and let them sort it out. If not, I suggest you get some legal advice.

 

A work colleague was in a similar situation. A guy jumped a stop street and hit her. Her matter ended up in court. The magistrate ruled that she did not take the correct evasive action and apportioned the blame 60/40. Fortunately her insurance sorted the issue out (including the 40% liability to his car).

 

So yes, there is such a thing as partial blame

[Skubarra]

This makes perfect sense. Premiums are calculated according to risk profile and accident history, not according to who repaired the car after undisclosed accidents.

 

If a driver has two accidents, his premium will increase. In this case, it didn't. So his risk profile was higher, but the premium stayed the same.

 

He deserved to have his claim denied.

 

Agree, the one accident was actually R200K so it's not as if he didn't reported minor scratches.

[Spez_Boy]

Here's a tip........... Take R 500.00 a month and put it into a unit trust..... Then claim your own out bonus every 5 years....

 

 

Use your insurance, it's not a saving plan......

 

Great comment!

[Mets]

Again another thread where it's automatically the insurance company's fault.................. until full story comes out.

 

Guys guys guys..... I say this over and over, I promise it is more expensive for the insurers to NOT pay a valid claim than it is to just settle it.

 

Those that say insurers go out of their way to repudiate claims are simply being ignorant.

(Direct insurers are another story though)

 

edit: As for the outbonus, it is there to incentives you to be more risk averse, NOT to act as a savings account.

I am a broker myself - so BIG like for this comment - You really have to be clued up and knowledgeable on insurance if you want to insure with a direct insurer and be confident that your claims will be paid.

There is a saying assume - makes an @ss of u and me - and with most direct insurance companies - assume your always covered at your own peril .

[JGR]

Again another thread where it's automatically the insurance company's fault.................. until full story comes out.

 

Guys guys guys..... I say this over and over, I promise it is more expensive for the insurers to NOT pay a valid claim than it is to just settle it.

 

Those that say insurers go out of their way to repudiate claims are simply being ignorant.

(Direct insurers are another story though)

 

edit: As for the outbonus, it is there to incentives you to be more risk averse, NOT to act as a savings account.

That is not entirely true as ST insurers need to achieve a certain rate for their claims

[droo]

Maybe I can just put in a rave for santam

 

Story: My maid broke her arm whilst cleaning the house(tripped over a carpet and had one hell of a fall). We rushed her to the doctor which took xrays and referred us to ortho, now she isn't on medical aid. Luckily there was no operation required cause bones didnt shift so a brace would do just fine. Of course we now need a temp maid whilst she is on sick leave. Inquired with Santam about personal liability in my house and I am covered for R5000.00 wrt this.

 

We did tell the doctors and ortho about our situation and they came to the party wrt a special rate. Santam paid out the amount as well as covered some of the new maid's salary.

 

Whats the old saying...you only know how good your insurer is when it comes to claim time.

 

+ 1 million.

 

Been with them through a broker for years. Was with A&G before, and they made an absolute pig's ear of two claims before I kicked them to touch.

 

The broker got me a 30% better premium through Santam (with zero excess), and I have only once had to fill in a form - which was because I got my broker to handle a 3rd party claim because the 3rd party's insurer was making me jump through hoops.

 

They've always paid out, and all I need to do is email them the SAPS case number.

[Patchelicious]

@JGR

 

The correct term is loss ratio.

There are many more productive ways to get to the target loss ratios. These ratios are monitored by industry boards like the FSB and SAIA by the way and if an insurer is not within thresholds it is addressed by them.

 

The majority of them are also re-insured.

 

Insurers will not manage these loss ratios by targeted repudiation targets, thats not only damaging to their business but illegal. They would much rather try and minimize claims number through risk management, such as Santams "small mind set changes makes you more careful" drive or Discovery's "pay how you drive" initiative on personal polices. Commercial policies are a bit easier to underwrite more accurately as a Clients Needs Analyses needs to be done to ensure the clients much larger sum insured is covered correctly.

 

The other way they will manage their loss ratios is to either simply increase premiums on high risk items, to bring he premium vs claims ratio back in line, or they simply sell a badly performing portfolio of business to someone who is better at that specific line of insurance.

 

Point is there are many many less risky ways for short term companies to manage it than for them to just repudiate claims.

Edited June 25, 2014 by ArchedBackChinOut

[JGR]

@JGR

 

The correct term is loss ratio.

There are many more productive ways to get to the target loss ratios. These ratios are monitored by industry boards like the FSB and SAIA by the way and if an insurer is not within thresholds it is addressed by them.

 

The majority of them are also re-insured.

 

Insurers will not manage these loss ratios by targeted repudiation targets, thats not only damaging to their business but illegal. They would much rather try and minimize claims number through risk management, such as Santams "small mind set changes makes you more careful" drive or Discovery's "pay how you drive" initiative on personal polices. Commercial policies are a bit easier to underwrite more accurately as a Clients Needs Analyses needs to be done to ensure the clients much larger sum insured is covered correctly.

 

The other way they will manage their loss ratios is to either simply increase premiums on high risk items, to bring he premium vs claims ratio back in line, or they simply sell a badly performing portfolio of business to someone who is better at that specific line of insurance.

 

Point is there are many many less risky ways for short term companies to manage it than for them to just repudiate claims.

In theory perhaps but I have recently interviewed a person(Claims managers) who is trying to change jobs because of the unethical behavior of the loss ratios and being forced to dismiss claims where he felt the claimant was due his money. The loss ratio you mentioned is lets say 80% (as an example) - if 8 claims are accepted than means the next 2 can be dismissed without the FSB being alerted to anything regardless of the validity. Obviously not the norm but from the horses mouth .... I make use of a broker, not only for the expertise but also the network he has when processing claims. I would not touch a b2c insurer

Edited June 25, 2014 by JGR

[Patchelicious]

It is not a theory it is fact. An isolated case is not grounds to declare a trend. Loss Ratio Percentage is Rand based not number of claims. = Claims paid - R / Premiums Collected - R

 

Sounds like your posts are directed at Direct Insurers (you say the manager was dealing with a claimant as well as having the directive to manage payouts).... I have a saying to my friends that insure direct, you might know it, as jy dom is moet jy ......

 

I have zero sympathy for people who try and save a quick buck by going direct and then crying when they try and claim.

 

General: Stop being cheapskate and a get a broker! It is their job to represent you to the insurers.

Edited June 25, 2014 by ArchedBackChinOut

[Paul Ruinaard]

Be very careful with Outsurance in doing this (repairing damage out of your own pocket to save the Outbonus). Here is a documented case where a client with a high value vehicle did this - he repaired the vehicle twice at his own expense - then the vehicle was written off and Outsurance started to investigate - they found out about the previous "losses" and repudiated the claim - their argument: the client's loss history would have influenced his risk profile and they would have adjusted his rates accordingly - therefor they didn't get their correct premium. The case went Outsurance's way.

You can check out the full detail here: http://www.moonstone...-vs-outsurance/

This was the case i mentioned.

[JGR]

It is not a theory it is fact. An isolated case is not grounds to declare a trend. Loss Ratio Percentage is Rand based not number of claims. = Claims paid - R / Premiums Collected - R

 

Sounds like your posts are directed at Direct Insurers (you say the manager was dealing with a claimant as well as having the directive to manage payouts).... I have a saying to my friends that insure direct, you might know it, as jy dom is moet jy ......

 

I have zero sympathy for people who try and save a quick buck by going direct and then crying when they try and claim.

 

General: Stop being cheapskate and a get a broker! It is their job to represent you to the insurers.

calm down ... re-read. I have a broker and mentioned I would not use b2c (business to consumer) direct broker et al. I said in theory which is different to a theory. Neither did I claim it was a trend, in fact I confirmed it was a case. He was from a big ST insurer btw ... so in this case your assumptions are wrong.

[Hairy]

This Pr#ck jumped the stop street. I collide with said Pr#ck. His insurer says I am 40 % guilty for " not being more observant " . Will only pay 60 % of my loss based on current values. Car total loss. Sitting with a piece of irreparable scrap and some pocket money. I am just letting off some steam with this post.

I had one jump a stop street this morning and very nearly killed me ...... I managed to swerve out to my right.

 

What would the case be if I am on my bicycle (as per this morning) and my bike get written of by said pick... would his/her insurance payout or will they just say "sorry"?