Excuses to Reject Claims
Claim was submitted waiting for approval , Service record book stamped was submitted , inspection sheet to waiver waiting period submitted , received email confirmation for all documents submitted . i was then asked for invoices for services rendered . Service Centre said that the stamp was proof enough that services were carried out . Auto and General after 3 weeks then calls to say that the claim is rejected because of the waiting period and when i then told the consultant that the waiting period was waivered, he then said that the claim was rejected because it was considered wear and tear. It is clear that Auto and General are looking for excuses to reject the claim in any angle. i have all email correspondence which i will post here or on their FB page so we the customers can see how we are getting **********. Mails were sent to '***' but obviously there was still no cause for concern and was given a deaf ear. Is this the Service we entitled To ?
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Replies (2)
Auto & General's replyOfficial
19 Jun 2024, 08:49Good day Mr. Garib,
We acknowledge your complaint, and our dispute resolution team will contact you to assist further.
Kind regards,
The Auto & General Team.
We acknowledge your complaint, and our dispute resolution team will contact you to assist further.
Kind regards,
The Auto & General Team.
Auto & General's reply19 Jun 2024, 08:49
Official
Good day Mr. Garib,
We acknowledge your complaint, and our dispute resolution team will contact you to assist further.
Kind regards,
The Auto & General Team.
We acknowledge your complaint, and our dispute resolution team will contact you to assist further.
Kind regards,
The Auto & General Team.
's updateReviewer Update
19 Jun 2024, 12:10Dear Mr A Garib
As discussed with you, an evaluation has been done on your claim/claims 1 under policy *** for claim registered on 23 May 2024.
After careful consideration of all contributing factors – the status of your policy, the cover available, terms and conditions, and details of the claim,
we have concluded that payment will not be made.
As your insurer, we always provide you with cover according to the policy you’ve chosen as well as the information made available to us at the time
you joined us, and at the time of your claim. We have processes in place to ensure that we accurately manage risk, while ensuring that our products
and the cover we provide you are sustainable.
The terms and conditions of your policy outline the product benefits, exclusions of cover, as well as the obligations of the parties. The rejection
reason provided above falls within those exclusions, and terms and conditions.
Please review the details as provided by you on your schedule to ensure that we have the most accurate details. Also refer to the terms and conditions
for full product benefits and disclosures.
Please be advised that, in accordance with the Policyholder Protection Rules, any complaints regarding the resolution of your claim must be
submitted to us within 90 days of the date of this letter. You can do this by contacting our Internal Dispute Resolution Department.
After this 90-day period, you have a further 6 months to serve us with a summons or to seek alternative recourse. Your right to contest our decision
on the claim will be lost if you fail to do so within this time frame.
To lodge a complaint, please get in touch with our Internal Dispute Resolution Department in one of the following ways:
This is the response i get with no proper reason for the rejection
As discussed with you, an evaluation has been done on your claim/claims 1 under policy *** for claim registered on 23 May 2024.
After careful consideration of all contributing factors – the status of your policy, the cover available, terms and conditions, and details of the claim,
we have concluded that payment will not be made.
As your insurer, we always provide you with cover according to the policy you’ve chosen as well as the information made available to us at the time
you joined us, and at the time of your claim. We have processes in place to ensure that we accurately manage risk, while ensuring that our products
and the cover we provide you are sustainable.
The terms and conditions of your policy outline the product benefits, exclusions of cover, as well as the obligations of the parties. The rejection
reason provided above falls within those exclusions, and terms and conditions.
Please review the details as provided by you on your schedule to ensure that we have the most accurate details. Also refer to the terms and conditions
for full product benefits and disclosures.
Please be advised that, in accordance with the Policyholder Protection Rules, any complaints regarding the resolution of your claim must be
submitted to us within 90 days of the date of this letter. You can do this by contacting our Internal Dispute Resolution Department.
After this 90-day period, you have a further 6 months to serve us with a summons or to seek alternative recourse. Your right to contest our decision
on the claim will be lost if you fail to do so within this time frame.
To lodge a complaint, please get in touch with our Internal Dispute Resolution Department in one of the following ways:
This is the response i get with no proper reason for the rejection
's update19 Jun 2024, 12:10
Reviewer Update
Dear Mr A Garib
As discussed with you, an evaluation has been done on your claim/claims 1 under policy *** for claim registered on 23 May 2024.
After careful consideration of all contributing factors – the status of your policy, the cover available, terms and conditions, and details of the claim,
we have concluded that payment will not be made.
As your insurer, we always provide you with cover according to the policy you’ve chosen as well as the information made available to us at the time
you joined us, and at the time of your claim. We have processes in place to ensure that we accurately manage risk, while ensuring that our products
and the cover we provide you are sustainable.
The terms and conditions of your policy outline the product benefits, exclusions of cover, as well as the obligations of the parties. The rejection
reason provided above falls within those exclusions, and terms and conditions.
Please review the details as provided by you on your schedule to ensure that we have the most accurate details. Also refer to the terms and conditions
for full product benefits and disclosures.
Please be advised that, in accordance with the Policyholder Protection Rules, any complaints regarding the resolution of your claim must be
submitted to us within 90 days of the date of this letter. You can do this by contacting our Internal Dispute Resolution Department.
After this 90-day period, you have a further 6 months to serve us with a summons or to seek alternative recourse. Your right to contest our decision
on the claim will be lost if you fail to do so within this time frame.
To lodge a complaint, please get in touch with our Internal Dispute Resolution Department in one of the following ways:
This is the response i get with no proper reason for the rejection
As discussed with you, an evaluation has been done on your claim/claims 1 under policy *** for claim registered on 23 May 2024.
After careful consideration of all contributing factors – the status of your policy, the cover available, terms and conditions, and details of the claim,
we have concluded that payment will not be made.
As your insurer, we always provide you with cover according to the policy you’ve chosen as well as the information made available to us at the time
you joined us, and at the time of your claim. We have processes in place to ensure that we accurately manage risk, while ensuring that our products
and the cover we provide you are sustainable.
The terms and conditions of your policy outline the product benefits, exclusions of cover, as well as the obligations of the parties. The rejection
reason provided above falls within those exclusions, and terms and conditions.
Please review the details as provided by you on your schedule to ensure that we have the most accurate details. Also refer to the terms and conditions
for full product benefits and disclosures.
Please be advised that, in accordance with the Policyholder Protection Rules, any complaints regarding the resolution of your claim must be
submitted to us within 90 days of the date of this letter. You can do this by contacting our Internal Dispute Resolution Department.
After this 90-day period, you have a further 6 months to serve us with a summons or to seek alternative recourse. Your right to contest our decision
on the claim will be lost if you fail to do so within this time frame.
To lodge a complaint, please get in touch with our Internal Dispute Resolution Department in one of the following ways:
This is the response i get with no proper reason for the rejection