Terrible Insurance

On the 02/03/2020 I suffered total loss to my vehicle after having been in an accident where I was rear ended by a speeding vehicle at a red robot and then forced into the rear of another vehicle infront of me.

I called my insurer, Oakhurst immediately who arranged recovery of the vehicle to their approved dealer, A1 Panel and Paint in Montague Gardens, Cape Town. I was hospitalised and discharged after being cleared.

I heared from Oakhurst about my claim on the 02/03/2020 in the late afternoon where they requested an Accident report and any pictures I had taken at the accident scene. This was sent to them. As my claim progressed, I contacted Oakhurst for updates but to no avail, I was promised call backs but always had to call in when this commitment was not met. On the 16/03/2020 I was informed that my vehicle has been written off and that Oakhurst required a settlement quote from my finance house, MFC a division of Nedbank. I had this documentation sent to Oakhurst on the same day. I was contacted the next day and was informed by Ziyanda in the salvage department that Oakhurst will be paying R160 010.00 of the R205 012.04 settlement amount due to MFC. Ziyanda explained that this is all that will be paid out as that is what the vehicle is worth at the moment due to depreciation. She assured me that the shortfall of R45 002.04 will be covered under the Credit Shortfall policy I hold with oakhurst. Ziyanda then submitted a claim for the shortfall amount and told me that I will hear from my claim handler, Winney Du Preez in the coming days. Needless to say, I did not. I followed up with Oakhurst everyday and got no update but promised callbacks. On the 20/03/2020, Benita in the claims team called me at 17h35pm to inform me that my claim was declined due to 'extras not covered at point of sale'. When I enquire on what that extras referred to, she could not explain. This made me very anxious. It was a Friday early evening right before the department closed for the weekend so there was nobody to escalate to. I recieved an email on the 21/03/2020 and called in immediately. I spoke to Katherrine in the claim department who agreed that the calculation was incorrect thus the claim should not have been rejected. She committed to redoing it herself and having Isaac Williams verify her calculation then call me back between 8am and 10am on Monday the 23/03/2020. Monday came, no callback. I called in at 10h35am and spoke to Benita. I escalated and spoke to Charlotte who also, like Katherine, agreed that the calculation was incorrect thus the claim should not have been rejected. She committed to redoing it herself aswell and calling me back after 2 hours. I got no callback that entire day.

I called in the following day and spoke with Yolandie Watson who understandably oversees the claim department. She assured me that she will look into everything from inception and call be back with a resolve. Yolandie called me back to inform me that Michael Tlou will be point of contact going forward and promised a callback that same day. No callback.

I called the following day and was told that McNiel Arries was handling my complaint but was working from home due to the national lockdown and therefore could not be contacted telephonically. Despite calling in and chasing up feedback, not Michael nor McNiel called me back. I then got an email on the 25/03/2020 advising that my claim was rejected AGAIN. I escalated as McNiel could not tell me why. Finally on 27/03/2020 McNiel called me to elaborate. He caused such anxiety that I handed the phone to my husband who is named on the account to speak with him. He dropped the phone on my husband within 1 min. I immediately requested a callback from Michael who is McNiel's superior. My argument was that my policy which was never explained to me upon inception reads ; ''Credit Shortfall covers the difference between the insured value of your vehicle and the settlement amount of your instalment agreement if your vehicle is written off or ****** (where a total loss happens), up to a maximum of R50 000.00 or 20% of the insured value of your vehicle, whichever is the lesser amount up to the limit in your schedule.'' However, the claim is rejected for no reason dictated within the policy exclusions which was also not explained to me ever before.

Michael advised that Oakhurst is not obligated to explaining the policy wording unless I verbalise confusion & referred me to the Ombudsman.