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The current opinion poll contains snippets that were taken from the South African Ombudsman for Short Term Insurance Website. It relates to the general image and sentiment that the public has when interacting with Insurance in general. Insurance Policies currently exist that cover all sorts of things: from Cars, Homes, Household Goods and our Health all the way through to the wellbeing of Pets, and our Hips & Buttocks (for celebrities). There seems to be a plethora of possibilities available for the Insurance industry, and due to the fact that most of us require a financial loan to purchase any kind of substantial asset, it is a predetermined requirement that we obtain insurance in order to secure a loan. Combined with the perception, whether it be correct or not, of the level of crime in the country it seems reasonable to say that each and every individual gets some form of insurance at some point in their life. Now read about the following incident:
"It was not a happy Friday 13th for the insured, a chef at a hotel in Saxonwold. At 20:00 he was on his way home along Jan Smuts Avenue, Johannesburg, and on one of the many turns he noticed a group of pedestrians crossing the road. While avoiding them, he overcorrected and collided with a light pole. He lost consciousness and woke up the following day in the Milpark Hospital. He was discharged on Saturday at 15:30 and his wife took him home, gave him medication and put him to bed. He spent the whole of the Sunday in bed, and although still shaky and in a lot of pain, reported the accident to the Randburg Police Station on Monday. He lodged a claim for the repairs of his car with the insurer, which repudiated the claim on the ground that he had failed to report the collision to the SA Police within 24 hours. (continued later) - Source: Ombudsman Newsletter : 04/03
The snippet above is a case study publicly displayed on the Ombudsman's website, and impacts upon the image of insurance companies. Accidents, though unfortunate, are a common occurrence in our lives. One of the primary expectations from people who have insurance is that, if they ever meet with an accident, they could at least have their damaged assets reasonably replaced - Whats the point of taking out an insurance policy if you cant claim from it when things go awry? The argument put forward by Insurance companies against this is that if the insured person, deliberately or through negligence, causes the accident then the Insurance Company does not have to pay out. That seems logical enough but interesting situations arise when assessors subjectively decide on the degree of responsibility of the insurance policy holder... sometimes it seems even downright unfair when you are held responsible for an accident that happened when you were obeying all the rules of the road. To complicate things even more, after the accident takes place you have duties to perform within a specific period in order for a claim to be successful otherwise it will simply be rejected. The image of the insurance industry certainly suffers by what could be described as the "dirty tricks" employed when it boils down to Insurance companies upholding their side of the contract. Do you feel that Insurance Companies employ "dirty tricks" to best serve their own interests?
To further complicate matters, rumours are perpetuated that seem to serve the Insurance Company more than they serve the Insurance Industry. Things such as: "If you claim from the Road Accident Fund for the injury you sustained however many years previously, then in the future, you'll have difficulty obtaining life insurance because you now have a permanent record as having sustained previous injuries, and your policy will be loaded accordingly or even refused." Have you heard any such stories? How do these statements make you feel about Insurance in general?
On the other hand, there really are individuals who attempt to defraud the system by claiming on things that they genuinely are not entitled to, or who con the system and/or exaggerate the claims due to their own inherent opportunism. I'm sure there exists examples where people smash their own car windows and remove their own car radios for the sole purpose of selling it and claiming back from the insurance as though a genuine theft had taken place. I'm also sure that Insurance Companies are prone to fraud in countless other examples. Can you cite a few? How do you feel about people who defraud the Insurance Industry? And what of the consequences that Insurance Fraud has on the rest of us?
"The insurer alleged that it was not given the opportunity to verify and confirm the incident with the Police and there was also no blood test conducted to confirm the possible use of alcohol. As a result of the Ombudsman's intervention, the insurer admitted the claim and paid out to the insured R44 095.17, being the pre-accident value of his vehicle. - Source: Ombudsman Newsletter : 04/03
This person had enough determination to approach the Ombudsman and fight for his/her case. In the end it looks like they were successful and were adequately compensated. Honestly, what would you have (or what have you) done if/when your claim was rejected? Do you think that this would be the response of the majority of people who have insurance?
Comments Received about the Confidence in the South African Insurance Industry poll
Insurance Companies are unscrupulous but this also stems from the fact that in the same way they try & catch us, we inturn make bogus claims.
Anon - Stellenbosch