King price motor warranty dept has ****med me again

I hereby lodge a formal complaint regarding the handling of my motor warranty claim under my policy with King Price Insurance. This is the second occasion on which I have sought to exercise the benefits of the warranty, and in both cases my claims have been unreasonably limited or declined.

Background

My vehicle recently experienced a significant mechanical fault. As an automotive engineer, I immediately suspected timing kit failure. This was subsequently confirmed through diagnostic testing conducted by a qualified mechanic. The diagnostic report clearly indicates the requirement for replacement of the timing kit.

My policy expressly states that the timing kit is a covered component. Despite this, your representative, Ms. Eloise Monteiro, communicated the following:

“Please also note that while the timing chain kit was included in the quotation, we are unable to assist with this item as there is no evidence of mechanical failure. The component is not broken and has merely reached its replacement interval, which does not meet the criteria for claim approval.”

Grounds for Dispute

I reject this reasoning on the following grounds:

Policy Coverage – The timing kit is expressly included under the policy schedule. Attempting to exclude it on the basis of “replacement interval” is inconsistent with the contract.

Mechanical Failure – A component that has degraded to the point of requiring replacement to prevent engine damage constitutes failure. Limiting cover only to catastrophic breakage undermines the very purpose of a warranty.

Good Faith Obligation – In terms of South African insurance law and the principle of uberrima fides (utmost good faith), the insurer is required to act fairly and reasonably in the assessment of claims. Consistently interpreting terms in the insurer’s favour to avoid liability amounts to bad faith.

Pattern of Conduct – This is the second such instance with King Price, which demonstrates a pattern of denying or reducing claims contrary to reasonable policyholder expectations.

Requested Action

I hereby demand:

A full review of this claim decision;

Written reasons, with reference to specific policy wording and legal interpretation, for excluding the timing kit;

Payment in terms of the policy, failing which I will have no choice but to escalate the matter.

Escalation

Should this matter not be resolved within 7 working days, I will refer the complaint to the Ombudsman for Short-Term Insurance (OSTI) in accordance with FAIS and insurance regulatory provisions. I also reserve all rights to pursue further remedies available under South African law.