TG
Thergan G
1 reviews | Active since May 2020
22 May 2020, 11:08
Unproffessional and inefficient services from the OSTI
It took the Ombudsman (short term) seven months to apply the "prima facie" law ruling, yet the insurers electrical contractor provided false information in the form of a report, non of the facts that i provided were taken into consideration, apparently an expert is needed to distinguish between a plug socket and an isolation switch, not sure why common sense and logic isn't taken into consideration these days. It seems like the chosen electrical contractor is allowed to produce false information, it also seems like certain parties work together hand in hand. After seven months i was told that the Office of the Ombudsman lacks jurisdiction dealing with my case (CLC: G283/19) Not sure why such an organization exists, i was advised to go to court, it does not make financial sense to go to court for a damaged asset that costs R11000.
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Replies (4)
Ombudsman for Short Term Insurance's replyOfficial
25 May 2020, 17:37Dear Thergan Govender
I have reviewed the recommendation made by the Assistant Ombudsman to whom your complaint was allocated, as well as the contents of your file.
I do not agree that the information you submitted was not considered. It was addressed in the recommendation letter. There is no evidence to substantiate your allegation that the insurer's expert report was 'false', as you stated. While you contested the insurer’s position on the claim and also challenged the findings of its expert, you did not provide any expert evidence of your own disproving the insurer’s case or proving that you had a valid claim.
In the circumstances, there was no basis on which this office could rule in favour of the claim.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
I have reviewed the recommendation made by the Assistant Ombudsman to whom your complaint was allocated, as well as the contents of your file.
I do not agree that the information you submitted was not considered. It was addressed in the recommendation letter. There is no evidence to substantiate your allegation that the insurer's expert report was 'false', as you stated. While you contested the insurer’s position on the claim and also challenged the findings of its expert, you did not provide any expert evidence of your own disproving the insurer’s case or proving that you had a valid claim.
In the circumstances, there was no basis on which this office could rule in favour of the claim.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
Ombudsman for Short Term Insurance's reply25 May 2020, 17:37
Official
Dear Thergan Govender
I have reviewed the recommendation made by the Assistant Ombudsman to whom your complaint was allocated, as well as the contents of your file.
I do not agree that the information you submitted was not considered. It was addressed in the recommendation letter. There is no evidence to substantiate your allegation that the insurer's expert report was 'false', as you stated. While you contested the insurer’s position on the claim and also challenged the findings of its expert, you did not provide any expert evidence of your own disproving the insurer’s case or proving that you had a valid claim.
In the circumstances, there was no basis on which this office could rule in favour of the claim.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
I have reviewed the recommendation made by the Assistant Ombudsman to whom your complaint was allocated, as well as the contents of your file.
I do not agree that the information you submitted was not considered. It was addressed in the recommendation letter. There is no evidence to substantiate your allegation that the insurer's expert report was 'false', as you stated. While you contested the insurer’s position on the claim and also challenged the findings of its expert, you did not provide any expert evidence of your own disproving the insurer’s case or proving that you had a valid claim.
In the circumstances, there was no basis on which this office could rule in favour of the claim.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
TG
Thergan G's updateReviewer Update
26 May 2020, 09:16Hello Ayanda, thank you for such a prompt response. The reason why i claimed the report was false was due to the inaccurate information on it, i was unaware that i needed to get an "expert" to distinguish which electrical switch my stove was connected to, the contractors report clearly displayed false information as my stove was not connected in the way they had suggested on their report, the blown fuse was for the power socket, my stove was connected directly to the isolation switch, the blown fuse had nothing to do with the stove. There are other inaccuracies which i brought to the ombudsman's attention, they are date stamped with tech information as well as pictures.
If i get a report from an "expert" would there be a possibility of re-opening this file?
Regards
Thergan Govender
If i get a report from an "expert" would there be a possibility of re-opening this file?
Regards
Thergan Govender
TG
Thergan G's update26 May 2020, 09:16
Reviewer Update
Hello Ayanda, thank you for such a prompt response. The reason why i claimed the report was false was due to the inaccurate information on it, i was unaware that i needed to get an "expert" to distinguish which electrical switch my stove was connected to, the contractors report clearly displayed false information as my stove was not connected in the way they had suggested on their report, the blown fuse was for the power socket, my stove was connected directly to the isolation switch, the blown fuse had nothing to do with the stove. There are other inaccuracies which i brought to the ombudsman's attention, they are date stamped with tech information as well as pictures.
If i get a report from an "expert" would there be a possibility of re-opening this file?
Regards
Thergan Govender
If i get a report from an "expert" would there be a possibility of re-opening this file?
Regards
Thergan Govender
Ombudsman for Short Term Insurance's replyOfficial
26 May 2020, 11:52Good afternoon Thergan Govender
If you wish to challenge the validity of the insurer's expert findings on a substantive basis, you may furnish our office with a report from an independent expert on the cause of the damage. We will consider your report, and should the findings and evidence provided in your report take the matter further, that is, tilt the balance of probabilities in your favour, this office will have no issue reopening the file and reviewing its decision based on the additional evidence.
If you wish to challenge the validity of the insurer's expert findings on a substantive basis, you may furnish our office with a report from an independent expert on the cause of the damage. We will consider your report, and should the findings and evidence provided in your report take the matter further, that is, tilt the balance of probabilities in your favour, this office will have no issue reopening the file and reviewing its decision based on the additional evidence.
We must, however, caution that your case will only be successful if your report contains sufficient evidence to rebut the insurer’s findings. If your report merely presents a factual dispute, then it must be resolved in a court of law (as the Assistant Ombudsman indicated in her determination). This is where the conclusions reached by the experts contradict each other in material terms, whilst being equally probable or persuasive.
When a matter being investigated by this office reaches a stage where a factual dispute must be resolved, and the validity of the complaint depends on whose version of the facts are correct, the Ombudsman no longer has the jurisdiction to continue. A factual dispute needs to be resolved in a Court of Law, where a formal hearing may be held. The Ombudsman has a limited adjudicative function and can therefore not hold a formal hearing allowing the experts to be examined and cross-examined. Where there are such disputes, testing the opposing experts in this way the only way to arrive at a proper conclusion.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
Ombudsman for Short Term Insurance's reply26 May 2020, 11:52
Official
Good afternoon Thergan Govender
If you wish to challenge the validity of the insurer's expert findings on a substantive basis, you may furnish our office with a report from an independent expert on the cause of the damage. We will consider your report, and should the findings and evidence provided in your report take the matter further, that is, tilt the balance of probabilities in your favour, this office will have no issue reopening the file and reviewing its decision based on the additional evidence.
If you wish to challenge the validity of the insurer's expert findings on a substantive basis, you may furnish our office with a report from an independent expert on the cause of the damage. We will consider your report, and should the findings and evidence provided in your report take the matter further, that is, tilt the balance of probabilities in your favour, this office will have no issue reopening the file and reviewing its decision based on the additional evidence.
We must, however, caution that your case will only be successful if your report contains sufficient evidence to rebut the insurer’s findings. If your report merely presents a factual dispute, then it must be resolved in a court of law (as the Assistant Ombudsman indicated in her determination). This is where the conclusions reached by the experts contradict each other in material terms, whilst being equally probable or persuasive.
When a matter being investigated by this office reaches a stage where a factual dispute must be resolved, and the validity of the complaint depends on whose version of the facts are correct, the Ombudsman no longer has the jurisdiction to continue. A factual dispute needs to be resolved in a Court of Law, where a formal hearing may be held. The Ombudsman has a limited adjudicative function and can therefore not hold a formal hearing allowing the experts to be examined and cross-examined. Where there are such disputes, testing the opposing experts in this way the only way to arrive at a proper conclusion.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
Yours faithfully,
Ayanda Mazwi
Senior Assistant Ombudsman.
TG
Thergan G's updateReviewer Update
27 May 2020, 10:24Thank you Ayanda, i will get a qualified electrician to view the report and advise accordingly, however i strongly believe it is not necessary because any individual who owns a stove should be aware of where the electrical power source is, this expert can compare the report with the actual findings, thanks again for allowing me to reopen the case, appreciate it.
Regards
Thergan Govender
Regards
Thergan Govender
TG
Thergan G's update27 May 2020, 10:24
Reviewer Update
Thank you Ayanda, i will get a qualified electrician to view the report and advise accordingly, however i strongly believe it is not necessary because any individual who owns a stove should be aware of where the electrical power source is, this expert can compare the report with the actual findings, thanks again for allowing me to reopen the case, appreciate it.
Regards
Thergan Govender
Regards
Thergan Govender