Baseless rejection of a claim and no response from the independent investigator within the 30 working days from Old Mutual insure

The claim relates to Bettersure which is part of Old Mutual insure.

This claim has been on going since November 2023, including listing 3 hellopeter complaints and multiple phone calls. Subsequent to all of this, I only received the rejection outcome on the 29 February 2023.

Once I received the rejection outcome, I was not satisfied with the reasoning. As per the rejection letter, if an independent investigation is requested, you would need to email ***********. This email does not exist and the email came back undeliverable. Subsequent to this, I then phoned bettersure twice and it was indicated that a claims handler will return my call. To date, no call has been received.

Nevertheless, below are my the reasons why I am not in agreement with the rejection.

I vehemently disagree with the conclusion as per the rejection letter and would hereby wish to lodge an objection.

Below are my arguments in response to the above rejection:

The rejection refers to the property being vacant since it was purchased, therefore the claim is rejected. Based on the clauses per the policy, the property must have been vacant for 60 consecutive days.

The title deed indicates that the transfer went through on the 18 October 2023. The police statement and the case was opened on the 26 November 2023. The property was therefore not vacant for more than 60 days (less than 60 days), therefore this argument is unfounded and invalid. The night after the breakin was discovered, I arranged for someone to occupy the property. In terms of the second point of the rejection, it was stated that there was no evidence of forcible and violent entry. On the night of the break-in theft, I have taken multiple pictures of the damage, which is clearly evident of the forcible and violent entry. You will note that the latches have been taken off the window frame and the glass on the french door was broken which is clearly a sign of forced entry. At the time when the assessor came, renovations had commenced and the damage was remedied. I had no choice but to start with the renovations immediately after the breakin, in order to prevent further theft and damage to my property.

Based on the above, it is hereby requested that this rejection needs to be reconsidered as in my view, the grounds for the rejection are totally flawed and is a mere attempt by the insurance company to not pay for valid damages which occured at the property.

This is extremely poor service from bettersure and extremely frustrating. I would not recommend anyone to sign up with bettersure/Old Mutual insure.

On 22 March 2024, I logged a request for an independent investigation with ***. As per the auto response, I was set to receive feedback within 25-30 working days. It’s currently 35 working days and no feedback has been received. Multiple follow up emails were sent and it was indicated by Sandisiwe Mzindle, that a claims handler will contact me however no claims handler has contacted me.

The reference number is *** Claim number is BSH***

I am extremely helpless dealing with pathetic customer service from this insurance company