GS
Geraldine S
1 reviews | Active since Nov 2019
17 Jun 2025, 15:49
Genric Insurance Company - Buyer Beware!
Despite the fact that I have an insurance claim that has been acknowledged as valid, it has been SIX MONTHS, and I still have no resolution or payment of my claim. They have literally tried every evasive technique in the books (that I know of and a couple of new ones) to avoid paying my claim - I REPEAT they have ACKNOWLEDGED THE LEGITIMACY OF MY CLAIM but keep on trying to reduce the amount that needs to be paid out! It has now reached a stage where I am going to lodge an official complaint against them with the Ombudsman.
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Replies (2)
GENRIC Insurance Company's replyOfficial
18 Jun 2025, 08:53 Dear Geraldine,
We acknowledge the frustration you have experienced, however, in order to ensure accurate processing and fair outcomes, we must adhere to the policy terms and conditions applicable to all claims.
As per Section 9.1: Baggage and Personal Belongings of your policy, there are specific sub-limits that apply to certain categories of items. In particular, the policy states that prescription spectacles, sunglasses, and contact lenses are limited to R1,500 per pair, regardless of their original purchase value. This limit is stated in your Schedule of Benefits and forms part of the terms accepted at inception of the cover. Additionally, proof of ownership is a standard requirement for high-value personal item claims. This documentation allows us to verify both the existence and replacement value of the claimed item. In the absence of proof of ownership for the sunglasses in question, we have app**** the applicable policy sub-limit.
We confirm that this assessment is consistent with both the terms of your policy and our internal claims handling protocols. The matter is currently under review by our Complaints team, and they will continue to engage with you directly.
Best regards,
The GENRIC Team
The GENRIC Team
GENRIC Insurance Company's reply18 Jun 2025, 08:53
Official
Dear Geraldine,
We acknowledge the frustration you have experienced, however, in order to ensure accurate processing and fair outcomes, we must adhere to the policy terms and conditions applicable to all claims.
As per Section 9.1: Baggage and Personal Belongings of your policy, there are specific sub-limits that apply to certain categories of items. In particular, the policy states that prescription spectacles, sunglasses, and contact lenses are limited to R1,500 per pair, regardless of their original purchase value. This limit is stated in your Schedule of Benefits and forms part of the terms accepted at inception of the cover. Additionally, proof of ownership is a standard requirement for high-value personal item claims. This documentation allows us to verify both the existence and replacement value of the claimed item. In the absence of proof of ownership for the sunglasses in question, we have app**** the applicable policy sub-limit.
We confirm that this assessment is consistent with both the terms of your policy and our internal claims handling protocols. The matter is currently under review by our Complaints team, and they will continue to engage with you directly.
Best regards,
The GENRIC Team
The GENRIC Team
GS
Geraldine S's updateReviewer Update
15 Jul 2025, 17:40Despite ongoing attempts to have this issue resolved, there is NO movement forward. The issue had been escalated to the internal Complaints Department on or before 29 May 2025 and it is now more than 6 weeks later without any resolution! Dear readers, note that the short-term ombudsman suggests that a 6-week period for a claim - from lodging to settlement - is a fair period. This claim was lodged in December 2024 and, therefore, more than 6 months ago!
it is interesting how disingenuous Genric's statement in response to my complaint is. It states that, according to its policy "prescription spectacles, sunglasses, and contact lenses are limited to R1,500 per pair". However, in the policy document itself, the wording is as follows:" Sub limits: Prescribed Sunglasses, Spectacles and Contact Lenses R1,500"
There is clearly a discrepancy between the Insurance Policy Certificate and the Insurance Policy Wording regarding the sub-limit for sunglasses. My ****** sunglasses were commercially bought and not "prescribed" (as per the Certificate) and were not "prescription sunglasses" (as per the Policy Wording).
it is interesting how disingenuous Genric's statement in response to my complaint is. It states that, according to its policy "prescription spectacles, sunglasses, and contact lenses are limited to R1,500 per pair". However, in the policy document itself, the wording is as follows:" Sub limits: Prescribed Sunglasses, Spectacles and Contact Lenses R1,500"
There is clearly a discrepancy between the Insurance Policy Certificate and the Insurance Policy Wording regarding the sub-limit for sunglasses. My ****** sunglasses were commercially bought and not "prescribed" (as per the Certificate) and were not "prescription sunglasses" (as per the Policy Wording).
Therefore, in terms of the contra proferentem rule, the wording most favorable to me (as the insured should apply). Therefore, the R1,500 sub-limit for "Prescribed Sunglasses" as per the Certificate, or "Prescription sunglasses" as per the Policy Wording, does not apply to commercially bought non-prescription sunglasses.
I expect full replacement value for this item, as per proof of purchase AND proof of ownership supp****. I am NOT going to go away quietly.
GS
Geraldine S's update15 Jul 2025, 17:40
Reviewer Update
Despite ongoing attempts to have this issue resolved, there is NO movement forward. The issue had been escalated to the internal Complaints Department on or before 29 May 2025 and it is now more than 6 weeks later without any resolution! Dear readers, note that the short-term ombudsman suggests that a 6-week period for a claim - from lodging to settlement - is a fair period. This claim was lodged in December 2024 and, therefore, more than 6 months ago!
it is interesting how disingenuous Genric's statement in response to my complaint is. It states that, according to its policy "prescription spectacles, sunglasses, and contact lenses are limited to R1,500 per pair". However, in the policy document itself, the wording is as follows:" Sub limits: Prescribed Sunglasses, Spectacles and Contact Lenses R1,500"
There is clearly a discrepancy between the Insurance Policy Certificate and the Insurance Policy Wording regarding the sub-limit for sunglasses. My ****** sunglasses were commercially bought and not "prescribed" (as per the Certificate) and were not "prescription sunglasses" (as per the Policy Wording).
it is interesting how disingenuous Genric's statement in response to my complaint is. It states that, according to its policy "prescription spectacles, sunglasses, and contact lenses are limited to R1,500 per pair". However, in the policy document itself, the wording is as follows:" Sub limits: Prescribed Sunglasses, Spectacles and Contact Lenses R1,500"
There is clearly a discrepancy between the Insurance Policy Certificate and the Insurance Policy Wording regarding the sub-limit for sunglasses. My ****** sunglasses were commercially bought and not "prescribed" (as per the Certificate) and were not "prescription sunglasses" (as per the Policy Wording).
Therefore, in terms of the contra proferentem rule, the wording most favorable to me (as the insured should apply). Therefore, the R1,500 sub-limit for "Prescribed Sunglasses" as per the Certificate, or "Prescription sunglasses" as per the Policy Wording, does not apply to commercially bought non-prescription sunglasses.
I expect full replacement value for this item, as per proof of purchase AND proof of ownership supp****. I am NOT going to go away quietly.