OS
Oupa S

1 reviews | Active since Nov 2023

04 Nov 2023, 19:36

Rejected insurance claim

Pls help me here. I was in a accident where a police officer was off duty, driving a state vehicle caused an accident, fled the scene leaving the state vehicle behind. The insurance rejected my claim stating I was speeding, driving 95 at a 60 zone but with no speed signs & very late at night.

LETTER OF REJECTION 25 October 2023 Quintin Sibanda 1633 Polo Street Blue Hills Halfway house 1685 Dear Mr Q. Sibanda Policy number: *** Claim number: *** 1. We refer to your claim under policy number *** in respect of an incident which occurred on 12 August 2023. 2. As discussed telephonically with our assessor Ivan Fourie on 12 October 2023, we confirm that we have elected to reject your claim due to the following reason(s): Materially exceeding the speed limit Misrepresentation of fact 3. In this regard, we wish to refer you to the policy terms and conditions which states: 13. WHAT VEHICLE COVER EXCLUDES 13.1. The Insurer does not compensate under this Policy Section for claims for any of the below: u) loss of or damage while materially exceeding the national and local speed limits, this includes the approach speed leading to an accident that impacts on the reaction time of the driver of the insured Vehicle; Materially exceeding the speed limit and speeding 4. The accident occurred while the incident driver exceeded the speed limit by 76.67% in a section of road regulated at 60km/h. The data collected confirmed that the speed travelled prior to the incident was the cause of the incident. 17. WHAT IS NOT COVERED UNDER YOUR POLICY *****, DISHONESTY AND MISREPRESENTATION 17.1 We do not compensate you for claims based on *****, dishonesty, or misrepresentation (giving misleading or incorrect information), including exaggerated claims. The entire claim will be rejected, and your policy cancelled retrospectively from the actual incident date if you or anyone acting on your behalf submits a claim, or any information or documentation relating to any claim that is in any way *****ulent, dishonest, inflated or exaggerated Misrepresentation of facts 5. At claim submission you stated that your brother Oupa with Id number *** was the incident driver at the time of the accident. 6. During validation of the claim, it was established that your brother was not the incident driver. 7. In consideration of the above, we confirm our decision to reject your claim. 8. The vehicle is currently standing at Auction Nation. They are located 94 Sarel Baard Cres, Rooihuiskraal, Centurion, 0044 and their contact number is ***. We will assist to move the vehicle to your residential address however you may be liable for certain fees payable. 9. Kindly note that you have 72 hours from the date of this letter to make the necessary arrangements with the supplier to have the vehicle released after which you will be held liable for any additional daily storage costs. 10. Take note that you have a period of 90 days from the date of this letter to object to the rejection in writing and to make representations. Objections can be emailed to *** and should include the detailed reasons why you are objecting our decision. Please include ‘Objection’ and your claim number in the subject line of your email. 11. Once you have informed us about your objection and should the outcome not be satisfactory, you may address it with the Short-term Insurance Ombudsman (www.osti.co.za). For any compliance/non-compliance matters relating to FAIS or the Policy Holder Protection Rules, you may address these with the FAIS Ombud (www.faisombud.co.za). 12. You have a period of 6 months after the expiry of the 90 days to institute legal proceedings. Should you not institute legal proceedings within this 6-month period, iWYZE shall have no further liability in respect of the claim. 13. Please note that the above-mentioned reason for rejection may not necessarily be exhaustive. Regards Faizel Erentzen Team Manager

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