ENGINEERING NON-COMPLIANCE, DEFECTIVE REPAIRS, OUTSTANDING WORK, CLAIMS HANDLING CONCERNS & OMBUD DEADLOCK

Policy Number:

Dear Sir/Madam,

I refer to the above matter and the final determination issued by the National Financial Ombud Scheme South Africa.

I place on record that the outcome issued by the National Financial Ombud Scheme does not constitute a finding that the repairs undertaken on behalf of Absa Insurance are technically compliant, nor does it amount to a determination in favour of Absa Insurance on the merits of the engineering dispute.

Rather, the Ombud expressly acknowledged the existence of a material dispute of fact between competing expert opinions and concluded that the matter could not be appropriately resolved on paper. The Ombud further indicated that the dispute is more suitably determined in a forum where expert evidence can be properly tested.

Importantly, my complaint was not dismissed on its merits. The central engineering concerns remain unresolved and have now been further substantiated by independent expert evidence.

In addition to the engineering concerns, I wish to formally record my concerns regarding the handling of this claim and the conduct of Absa Insurance's internal assessor assigned to the matter.

Throughout the claims process, I repeatedly raised concerns regarding the quality of the reinstatement works, the conduct of the appointed service provider, and the failure to adequately address numerous defects, omissions, and outstanding items. These concerns were raised over an extended period and were supported by ongoing evidence of unresolved workmanship defects and recurring complaints.

Given the prolonged nature of the dispute and the repeated failure to achieve resolution, I specifically requested that Absa Insurance conduct an investigation into both the conduct of the appointed service provider and the actions of the internal assessor responsible for overseeing the matter.

Rather than my concerns being independently investigated, I experienced what appeared to be a dismissive approach toward legitimate complaints, with concerns repeatedly disregarded, minimized, or attributed to causes inconsistent with the available evidence. This has created a reasonable perception of bias, procedural unfairness, and victimisation for having persistently sought accountability and remedial action regarding defective and incomplete works.

The failure to meaningfully investigate these concerns has further eroded confidence in the objectivity of the claims handling process and has contributed significantly to the breakdown in trust between the parties.

I therefore request confirmation as to whether any independent review was ever conducted into the conduct of the internal assessor and the appointed contractor following my complaints and, if so, that the findings of such review be disclosed to me.

For completeness, I further note that whilst I am the policyholder in this matter, I am also a Professional Certificated Engineer (Pr.CertEng) registered with the Engineering Council of South Africa (ECSA), with approximately twenty years of experience in engineering, including exposure to mechanical, structural, and infrastructure-related environments.

Accordingly, the concerns I raised throughout the claims process were not based solely on dissatisfaction with the outcome of the repairs, but arose from a professional appreciation of engineering principles, material suitability, structural performance, workmanship standards, durability considerations, risk management, and regulatory compliance.

It is therefore particularly concerning that many of the technical concerns repeatedly raised by me during the course of this claim were not subjected to meaningful independent investigation and were frequently dismissed or attributed to alternative causes without adequate technical substantiation.

The fact that concerns raised by an ECSA-registered engineering professional during the progression of the claim were not independently evaluated, but were instead repeatedly disputed, raises further questions regarding the adequacy of the technical assessment and decision-making process adopted in this matter.

Importantly, the purpose of including this information is not to substitute my own views for independent expert evidence. Rather, it demonstrates that the concerns raised throughout the claims process were grounded in technical reasoning and professional experience. Significantly, many of these same concerns have now been independently corroborated by a qualified ECSA-registered professional engineer, lending objective support to issues that were previously disregarded or insufficiently investigated.

This is particularly concerning given that the technical concerns raised were not merely those of a layperson, but were repeatedly identified and articulated by an ECSA-registered engineering professional and subsequently corroborated by an independent engineering assessment which I obtained from another qualified professional engineering company registered with the Engineering Council of South Africa (ECSA), post ombud ruling. The findings are significant and raise concerns extending beyond a conventional insurance dispute.

The independent engineering report concludes, inter alia, that:

• The replacement awning and carport do not constitute a like-for-like reinstatement as contemplated by accepted insurance reinstatement principles;

• Inferior and thinner materials were installed when compared to the original structure, resulting in reduced structural capacity and performance;

• Additional structural members were introduced as compensatory measures, indicating that the installed sheeting is incapable of achieving the required performance characteristics on its own;

• Multiple workmanship defects exist, including missing fasteners, over-tightened fixings, improper installation practices, and poor attention to detail;

• Structural members have been unnecessarily drilled and modified, creating potential durability, corrosion, and long-term structural integrity concerns;

• No structural stability certification, design certification, or compliance certification has been provided for the altered structure; and

• The installation fails to satisfy the requirements and intent of applicable South African building and structural standards, including SANS 10400-B and SANS 10160.

I attach the independent engineering report for ease of reference. Absa Insurance is hereby formally placed on notice of the findings contained therein, including the concerns relating to structural adequacy, compliance, workmanship, durability, and safety.

These findings indicate that the repairs performed by Absa's appointed contractor have not restored the property to its pre-loss condition and do not comply with accepted engineering, construction, and reinstatement standards.

Consequently, this matter creates significant risk exposure for Absa Insurance, including but not limited to:

• Potential liability arising from defective, unsafe, or non-compliant structures;

• Failure to fulfil contractual obligations relating to proper reinstatement of insured property;

• Potential scrutiny under applicable Treating Customers Fairly (TCF) principles and regulatory obligations;

• Ongoing prejudice to the policyholder;

• The consequences arising from the failure to adequately investigate repeated complaints regarding the appointed contractor and claims management process;

• Potential governance concerns arising from the handling of technically substantiated complaints; and

• Reputational harm should the matter require determination through litigation or other formal proceedings.

In light of the Ombud's confirmation that the dispute remains unresolved, I am providing Absa Insurance with a final opportunity to resolve this matter amicably and without the need for formal legal proceedings.

Accordingly, I request the following:

1. A comprehensive reassessment of all post-loss repair works by an independent structural engineer jointly agreed upon by the parties;

2. Written confirmation that all reinstatement works will comply fully with applicable engineering, construction, and SANS requirements;

3. Appropriate remedial measures to restore the installation to a safe, compliant, durable, and genuine like-for-like condition;

4. A reassessment of all outstanding and incomplete insured repairs;

5. Consideration of a cash-in-lieu settlement in respect of the outstanding works, in lieu of any further involvement by Absa's previously appointed service provider, given the documented history of disputes, loss of confidence, repeated unresolved complaints, and concerns regarding the quality of workmanship and oversight;

6. Written confirmation as to whether any investigation was conducted into the conduct of the internal assessor and appointed contractor, together with disclosure of the outcome thereof; and

7. Written confirmation of Absa Insurance's position within ten (10) business days of receipt of this correspondence.

Given the history of unresolved complaints, the concerns regarding the handling of the claim, the apparent lack of independent oversight, and the serious engineering findings now available, I respectfully submit that this matter warrants review at a senior executive, governance, risk-management, and legal level within Absa Insurance to ensure that the principles of fairness, transparency, accountability, and proper customer treatment have been upheld throughout the claims process.

I trust that Absa Insurance will afford this matter the seriousness it warrants and take the necessary steps to achieve a fair, technically sound, and commercially reasonable resolution.

Failing such resolution, I reserve all rights available to me in law, including the right to pursue appropriate relief through a court of competent jurisdiction, where the competing expert evidence can be properly tested and determined.

I remain willing to engage constructively in an effort to resolve the matter without litigation. However, after approximately 23 months of unresolved complaints, disputed technical findings, and continuing prejudice, it is imperative that meaningful steps now be taken to bring this matter to a proper conclusion.

Yours faithfully,