Insurance Claims: 5 Inside Tips for a Successful Pay Out

We often have the perception that insurance quotes are declined for ‘no reason’. However, an insurance policy is a contract. The insurer agrees to cover you according to how much risk they think they take on and they set your monthly premium accordingly.

When the provisions aren’t met, the contract has effectively been broken and the insurer is exposed to more risk than ‘what your premium covers’ and ‘what was agreed to’.

They are then completely within their rights not to cover you – because the contract between you is no longer valid.  The best course of action is to take care to understand the wording of your policy or to sit down with your broker and ask him or her to explain exactly what you are, and aren’t covered for.

Below are five key examples to avoid…

The regular driver and owner of a vehicle differ on a policy

An example of where this happens is if a parent is the policyholder and a student child purchases a car that is insured under the parent’s policy.

Because the vehicle was purchased by your child, there is no insurable interest, as there will be no financial loss for you if anything happens to the vehicle. If your child claims, the claim will likely be rejected.

Tip: Clearly let your broker know the full details of any vehicle added to your policy, so that appropriate cover can be put in place. Don’t assume that simply adding a vehicle to a policy will mean it’s covered.

Vehicle extras aren’t specified

A case in point was when a client puts in a claim for a bulbar that was stolen from his bakkie. No extras were noted in his policy and the sum insured was only sufficient to cover the bakkie itself. The claim was therefore rejected.

Tip: Ensure that any fittings, such as bull bars and all accessories like a sound system or canopy are specified as extras, in addition to the sum insured value of your vehicle. Also keep in mind that you might need cover for mag rims on your tyres, so keep their replacement value in mind – anything you have changed or upgraded compared to the standard vehicle must be noted.

Security specifications weren’t discussed

All too common, this is an issue when claiming for a burglary. If your security features weren’t enabled at the time of the burglary, the claim will likely get rejected.

Tip: Make sure you ask about any elements of your cover that are your responsibility. If you are covered for having a locked security gate, an active electric fence or burglar bars on your windows, these features need to be in place and in good working order at all times. This will keep both your property and you safe.

You moved but didn’t say anything to your insurer

If you move house and don’t notify your insurer of your new address, any claims at the new premises will be rejected. This might seem like an obvious change to make to your policy but clients do forget.

Tip: Insurers usually require that you give written notice of your new permanent, physical address before you move. This is because your new address means your risk has changed and your monthly premium may also change.

Your replacement cellphone doesn’t match with what you thought was insured

Claiming for a stolen cellphone can be disappointing if your sum insured value is insufficient. All too often we have clients who are not able to buy a ‘top-of-the-range’ cellphone again when theirs is damaged or stolen.

Tip: Periodically adjust the sum insured cover on your cellphone in line with the market value of the same model.

* This article is provided for informational purposes only and should not be construed as legal or financial advice.