OM INSURE - ********* Standards on the part of the Insurer

Being a client of almost 30 years with OM insure (Previously Mutual & Federal), I had lodged a claim on the 02nd March 2021 for our rear wall that was affected after a recent storm since inception of our home in May 2017. We have been awaiting OM Insure to remediate the damages since the 02nd March 2021 to date being the 05th May-21 (with OM Insure dragging their feet with regard to committing to remediation, with a clear lack of urgency). OM Insure reasons: OM Insure: The boundary wall was found not to be in compliance with Park K of the SANS10400 National Building Regulations. • Does every home buyer apply the above SANS Regulation to every detail of the built structure upon purchase of a new home? • Should OM insure not have facilitated their own inspection prior to inception and proportionately insuring me for cover on the respective property? OM Insure: Moreover, we observed that the wall retains soil and the insured’s policy categorically excluded storm related damages to these type of walls. • Being a client with OM Insure for more than 30 years, having both my short and long term insurance needs covered by Old Mutual, I would have understood and would at the same time have expected that my insurance needs be covered in its entirety, after all this is what’s expected from an Insurance company? Not to be informed after an incident arises, that the respective technicalities do not form part of the claim, I find this a means of OM Insure wavering responsibility to remediating the resulting damages. • Yet again I must stress the fact that upon inception of the home, the construction of the wall appeared to be well constructed and has been since (almost 4 years later) until this recent occurrence. OM Insure: The lack of weep holes and lateral pressure from the higher ground level would have also contributed to the wall leaning outwards. • Upon purchase of the house, the wall was in good stead and understood it to have an underground drainage system. • Point being it’s only after 4 years since inception to the property that the problem has arisen, considering we’ve had previous rains and inclement weather as well. OM Insure: We also refer to claim *** form the 13th of June 2020 were the wall was reported to have cracked and was not dealt with then. Thus this portion of the claim will not be covered. • The above point is inadmissible as discussed on site and shown to the Assessor (Mr.Lerato Molema) upon the physical inspection, this was for a tree that fell in the yard and required the services of a Tree Feller, it does not form part of the wall construction , and yet another reason for OM Insure to waiver themselves from committing to loyal client. Is this the service that a client would expect from their insurer (OM Insure) after 30 years, is this the way an Insurer would treat a loyal client after all these years, when things are well, It is fine for OM Insure to accept the clients premiums, but when a claim is lodged and more so a valid claim that OM Insure looks at reasons and technicalities to waiver themselves from committing to remediation of damage, to even go as far as reverting to a client with new reasons for not being able to settle the claim or remediate the damages. Is OM insure transparent, honest and open to changing the goal post when they are faced with facts, rather than opinion, so much so that Mr. Lerato Molema representing OM Insure constantly changes his reasoning, so one day it’s a set of reasons and another day a different set of reason. Is this ethical for an insurer to incur this type of behavior on their client and is this normal business practice for OM Insure? My Broker Farouk Khan and Associates that I’ve been with for 30 years have supported and stood by me, so much so that they have reverted to the Mr. Lerato Molema that his constant change in reasons to refute the claim is unacceptable, and does not conform to Insurer Ethics and general business practice. We have since sought legal engagement. Our next step is follow protocol (via. the Insurers Internal Arbitrator, then the External Ombudsman) to ensure that the respective party/s that has falsified reasons / to constantly changing them on the part of OM Insure, will be brought to question, this conforms to ********* behavior on the part of OM Insure's Representative and that of the Insurer respectively.