Hellopeter
Share Your Experience
KJ
Karen J

1 reviews | Active since Nov 2010

21 Jan 2026, 14:15

INSURANCE CLAIM NOT TO BE PAID

INSURANCE CLAIM NOT TO BE PAID Response to Recent Claim Assessment – Property at 974 Wolfaardt Street, Da****rt Estate, Pretoria

I am writing in response to the recent claim assessment regarding the property at 974 Wolfaardt Street, Da****rt Estate, Pretoria. I would like to address several concerns:

With the severe hailstorm that struck Pretoria in the early hours of 1 December, causing extensive damage to homes and properties. Several roofs collapsed, and numerous windows were shattered as the storm swept through the area.

It was said by John De Jager that maintenance was allegedly not performed on the roofs of the house and flatlet. This statement is incorrect. Regular upkeep has been carried out to ensure the integrity of the roofing structures. Specifically, waterproofing was completed in December 2024, and again in January and August 2025.

I am concerned about how the assessor, John De Jager concluded that maintenance was not done, given that this was his first visit to the premises and he did not do inspections on the roofs, just walked around and taking pictures of the carport on the ground, the whole inspection was about 5min. Furthermore, we received no feedback after his inspection. When we attempted to contact him for clarification, we were informed that he is currently on leave.

The assessor indicated that the building plans should reflect the carports. Unfortunately, there are no existing plans available for the property. This is due to a major fire that occurred at the municipal offices in Pretoria, which destroyed the west wing of the Munitoria building on March 3, 1997, where all archived house plans were stored. As a result, it is not possible to produce the original plans.

Due to ongoing heavy rains, additional damage has occurred, and the cost of repairs continues to escalate. This situation requires urgent attention to prevent further deterioration and financial impact.

Please note that the household claim is also being held back due to this inconvenience, which is causing additional strain and delays in addressing the overall damage.

Please advise on the next steps and confirm whether this explanation will be accepted so that we can move forward promptly. I am committed to resolving this matter and providing any additional information you may require.

I am paying the insures every month, via debit order or EFT. We don’t claim for small unnecessary issues. We are covered in the Police schedule for storm/wind/water/hail and snow.

NOW after this you tell us you are not going to pay the claim, i am very disapointed in John De Jager as the assesor and IntegriSure as well

0
Replies (16)
IntegriSure
IntegriSure's reply21 Jan 2026, 14:28
Official
Hi Karen, 

Thank you for reaching out and providing us with feedback. We are concerned to hear this and will  investigate the matter. Please rest assured that one of our advisors will be in contact with you. 

The IntegriSure Team. 
KJ
Karen J's update21 Jan 2026, 14:42
Reviewer Update
Dear Sir / Madam,
I am writing in response to the recent claim assessment regarding the property at 974 Wolfaardt Street, Da****rt Estate, Pretoria, and would like to formally raise several concerns regarding the assessment outcome and process.
In the early hours of 1 December, a severe hailstorm struck Pretoria, causing widespread damage to homes and properties in the area. Several roofs collapsed, and numerous windows were shattered as the storm swept through the neighbourhood. My property was also affected by this extreme weather event.
It was stated by the assessor, John De Jager, that maintenance was allegedly not performed on the roofs of the house and flatlet. This conclusion is incorrect. Regular maintenance has been carried out to ensure the integrity of the roofing structures. Specifically, waterproofing was completed in December 2024, and again in January and August 2025.
I am concerned about how the assessor concluded that maintenance had not been performed, given that this was his first visit to the premises, and no roof inspection was conducted. The inspection lasted approximately five minutes, during which the assessor only walked around the property and took photographs of the carport from ground level. No feedback was provided after the inspection, and when we attempted to contact him for clarification, we were informed that he is currently on leave.
The assessor further indicated that the building plans should reflect the carports. Unfortunately, no municipal plans are available for this property. This is due to a major fire that occurred at the Pretoria municipal offices on 3 March 1997, which destroyed the west wing of the Munitoria building where all archived house plans were stored. As a result, it is not possible to provide the original plans.
Due to ongoing heavy rainfall, additional damage has occurred, and the cost of repairs continues to escalate. This situation requires urgent attention to prevent further deterioration and financial loss.
Please note that the household claim is also being delayed as a result of this matter, causing further inconvenience and strain in addressing the overall damage.
I am a loyal policyholder and pay my premiums monthly via debit order or EFT. We do not submit claims for minor or unnecessary issues. The policy schedule clearly confirms that we are insured for storm, wind, water, hail, and snow damage.
I have attached a video of the storm that occurred on 1 December for your reference.
I hereby formally request that this claim be reassessed as a matter of urgency. Should this matter not be resolved promptly and fairly, I will have no alternative but to escalate it to the Ombud Scheme for Short-Term Insurance for assistance.
Please advise on the next steps and confirm whether this explanation will be accepted so that we may move forward without further delay. I remain willing to provide any additional information required.
Thank you for your attention to this matter.
Kind regards,
IntegriSure
IntegriSure's reply21 Jan 2026, 15:50
Official
Hi Karen, 

Thank you for bringing this to our attention, we are concerned to hear this. We have already escalated the matter and ensure you that one of our advisors will be in contact with you. 

The IntegriSure Team. 



KJ
Karen J's update22 Jan 2026, 10:56
Reviewer Update
IntegriSure

I have send an mail to *** date: 21 Jan 2026, 14:34 and no responds

I have send an mail to *** and *** requesting the report and photos taken by the assessor, John De Jager and yet no responds


IntegriSure
IntegriSure's reply22 Jan 2026, 10:58
Official
Hi Karen, 

Please rest assured that we will follow up on this matter with the respective department, and ensure feedback is provided to you as soon as possible. 

The IntegriSure Team. 
KJ
Karen J's update22 Jan 2026, 14:13
Reviewer Update
IntegriSure
I am writing to express my concern following your phone call informing me that, of all the damage to my property caused by the severe hailstorm, the insurer will only cover the replacement of three windows that were broken by the hail.

As a loyal client who consistently pays my premiums and does not submit claims for minor or unnecessary issues, I am deeply disappointed by this outcome. The damage in question was caused by an extreme weather event, not by neglect, and I believe it deserves proper consideration.

I kindly request that this decision be reviewed and reassessed, taking into account the severity of the hailstorm.
KJ
Karen J's update22 Jan 2026, 14:23
Reviewer Update
so this is the BULL**** assessor, John De Jager wrote whith his 5min inspection, I believe this man must be a super natural
image.png 254.36 KBimage.png 233.21 KB
KJ
Karen J's update22 Jan 2026, 14:28
Reviewer Update
Mr. De Jager did not access the roof, did not use a ladder. Instead, photographs were taken from outside the gate, including images of my entertainment area roof, which was not affected by the hailstorm and was not mentioned in the claim.
It is difficult to understand how such limited observations could result in a definitive conclusion regarding the condition, maintenance, or extent of hail damage to the property. A proper roof inspection would reasonably require physical access and close examination, which did not take place.
Given the severity of the hailstorm and the damage sustained, I strongly believe the assessment was inadequate and does not fairly reflect the true extent of the loss. I therefore request that this claim be reviewed
IntegriSure
IntegriSure's reply22 Jan 2026, 14:50
Official
Hi Karen, 

We completely understand your concern, and we will escalate your request to reassess to the respective department. 

The IntegriSure Team. 
KJ
Karen J's update23 Jan 2026, 08:08
Reviewer Update
IntegriSure
So Yesterday i received the report that was written, i requested the photos that was taken by assessor, John De Jager and yet i have not received them
KJ
Karen J's update26 Jan 2026, 09:09
Reviewer Update
Dear Integrisure Team,

I hope you are well.
I am writing to follow up on my request dated 23 January 2026 regarding the photos taken by your assessor, John De Jager. To date, I have not received any response or further communication on this matter.
These photos are required to proceed with the Ombud Scheme for Short‑Term Insurance, and I kindly request that you provide them as soon as possible, or alternatively, update me on the status of my request.

Your prompt attention to this matter would be greatly appreciated.
Thank you,
IntegriSure
IntegriSure's reply26 Jan 2026, 09:14
Official
Hi Karen, 

Please note that we have sent through your request. 

The IntegriSure Team. 
KJ
Karen J's update30 Jan 2026, 12:35
Reviewer Update
I refer to your letter dated 30 January 2026 regarding the partial rejection of my building claim (Claim No. IS***CLM) for the storm and hail event of 30 November 2025.
After reviewing the reasons for the rejection, I must express my disagreement with the findings and hereby formally appeal the decision for the following reasons:


1. Incorrect attribution of water damage to “wear and tear” and “lack of maintenance”

Your letter states that the internal water damage was caused by:
However, this water damage occurred immediately after hail broke multiple windows during the storm, followed by continuous rain for several days. The only reason water entered the property was because of the sudden, insured event — not pre‑existing deterioration.
The policy clearly states that I am covered for:
"Storm, wind, water, hail or flood."
[IS***C...WJ Johnson | PDF]
The water entered because hail broke the windows — an event you have already accepted and approved for coverage. Therefore, the resultant water damage is directly connected to an insured event, not maintenance failure.


2. Delayed assessment contributed to further deterioration

Your assessor only attended the premises after the heavy rains had persisted, long after the hail event. It is not reasonable to expect that “no water marks, no ceiling marks, and no furniture damage” would exist after continuous rainfall before assessment could be done.
Had the assessment been conducted promptly, the extent and cause of the damage would have been clearer.


3. Structural defect findings are not relevant to the claimed areas

Your letter mentions:
This was not the source of the internal water damage we claimed for. The internal damage occurred inside the main building where the windows were broken by hail. Linking this to unrelated structural comments is incorrect.


4. Long‑standing customer of more than 15 years

Given that I have been a loyal client for over 15 years, I am extremely disappointed that the insurer has chosen to deny coverage for damage so clearly resulting from a sudden and insured event.


5. Request for reconsideration

I hereby request the following:
  1. A full reconsideration of the claim, including all internal water‑related damages caused by the open windows during the storm.
  2. A review by the Internal Arbitrator if necessary.
  3. Written confirmation that this appeal has been logged within the 90‑day appeal window.
I am willing to provide additional photographs, timelines, and any further documentation required.

I have escalate it to the National Financial Ombud Scheme South Africa as referenced in your letter
KJ
Karen J's update30 Jan 2026, 12:44
Reviewer Update
I am disapointed to say the least regarding this matter
KJ
Karen J's update10 Feb 2026, 12:57
Reviewer Update
So, we started taking off the ceilings this weekend… and this is what we found: hail holes in the roof. There are no leaks or damage anywhere else, and definitely not on the timber beams. The paint on the walls is damaged due to the water running down from the roof.
But the inspector and assessor did a great job in assessing the damage…
...NO MAINTANACE MY @#$%%
IMG_***.jpg 125.3 KBIMG_***.jpg 214.39 KBIMG_***.jpg 257.18 KBIMG_***.jpg 286.1 KBIMG_***.jpg 174.39 KBIMG_***.jpg 214.73 KBIMG_***.jpg 243.96 KBIMG_***.jpg 167.01 KBIMG_***.jpg 158.06 KB
KJ
Karen J's update10 Feb 2026, 13:09
Reviewer Update
So, we started taking off the ceilings this weekend… and this is what we found: hail holes in the roof. There are no leaks or damage anywhere else, and definitely not on the timber beams. The paint on the walls is damaged due to the water running down from the roof.
But the inspector and assessor did a great job in assessing the damage…
...NO MAINTANACE MY @#$%%
IMG_***.jpg 125.3 KBIMG_***.jpg 214.39 KBIMG_***.jpg 257.18 KBIMG_***.jpg 286.1 KBIMG_***.jpg 174.39 KBIMG_***.jpg 214.73 KBIMG_***.jpg 243.96 KBIMG_***.jpg 167.01 KBIMG_***.jpg 158.06 KB
Remove
IMG_***.jpg 158.06 KB