Unreasonable claim rejection

The ceiling of my main bedroom fell on the 30th of October 2020 and overnight there was a storm which caused branches of a tree to fall on the roof of my house. I logged a claim which was a very painful exercise that ended up being a trip to the insurers HO in Steyn City. After 2 weeks of making alternative sleeping arrangements as my bedroom was inhabitable, they rejected my claim and gave me this reason:” The above claim has been rejected on the basis that the brandering is too far apart (480mm) & the support nails for the ceiling were spaced too far apart (250mm).” And then they went on to further insult me with their so called courtesy: “Further to our discussion, we have made a business decision on the basis of your tenure with us, as well as reasons mentioned above, to settle the claim on an Ex Gratia basis for the amount of R6 000.00.” The reason their offer felt like an insult is that the amount is less than the sum of 2 months premium and it doesn’t even come close to the cost of repairing my ceiling.

I refused their offer and disputed their rejection and this was their advise for next steps: “ As per your request, the next point of escalation would be to speak to management & to this end, I have copied my manager on this email as well as have requested that he contact you by close of business tomorrow.” I did eventually speak to the manager and expressed my displeasure and to date I haven’t heard anything further instead they increased my premium by 30% without giving me any reason for that and they continue to debit my account for a house they clearly don’t cover because of “faulty design or poor workmanship”

I now fully understand why most people say they insurance is designed to exploit people. I feel ****** and bul**** if a big company like A&G with means to evaluate and check for issues they identified agree to take premiums and when it’s convenient for them they hide behind clauses in contracts that don’t make any sense. If they can return all my premiums I will be able to fix my house and possibly find an hones insure it such exists