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Nkululeko R

1 reviews | Active since Aug 2018

06 Aug 2018, 16:05

BEWARE OF OUTSURANCE

On the 21st of July around past 10pm I was travelling home when I had an accident. I smashed into another vehicle at the 4way stop. It was at night I did not see the stop sign I only saw it after the accident and when the other driver made me aware that it is a stop sign and that I was supposed to stop. I then apologised to the driver and told him that I can see that it was my mistake, cause his car was damaged I then told him that I have an insurance and will lodge a claim with my insurance cause I was the one at fault. I then lodged a claim with my insurance OUTSURANCE my claim was approved, but the 3rd party claim was declined. The lady that was assisting me regarding the claim was Sinethemba from claims legal department I asked her why the claim was declined she said if the road signs/markings were not visible I'm not at fault the 3rd party must then claim from the municipality. I asked her why must the 3rd party claim from the municipality if I have admitted already to the 3rd party that I'm the one who was wrong by crossing the stop sign and that I’m paying monthly premiums without fail. She told me that I'm not supposed to admit that I'm wrong cause the 3rd party might be wrong as well. I then spoke to the manager Lebogang Sene who was very arrogant and rude he was not willing to assist me instead he was urging with me he said if the 3rd party takes me to court it's fine they will handle that. My Question to them was • If I’m wrong it means that I must lie for them not to pay for 3rd party • Why do I have comprehensive insurance that covers the 3rd party up to 5million rand if OUTSURANCE will decline my claim? • My life is at risk cause the 3rd party wants his vehicle fixed and will not claim from the municipality cause this was not his fault. • I told them that I was not fami**** with the place • Claim was declined based on what they think happened • The question I had for Lebogang Sene is that it means that their claims are based on lies • Now I will have to fix the 3rd party’s car • How do I go back to the 3rd party and change my story cause that’s what OUTSURANCE wants me to do.

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Replies (2)
OUTsurance
OUTsurance's reply13 Aug 2018, 13:43
Official

Hello ***

Firstly, please accept our apologies for a very belated response. This was followed after our liability claims manager, Riaan contacted you and discussed the reason we refuted liability and our revised decision now to settle the 3rd party claim.

Riaan also audited the call you had with Lebogang and we confirm at no stage did we indicate you should change your version of how the accident happened.

Thank you for accepting our apologies and allowing us the opportunity to discuss the merits and how we apply same.

Regards

Dinky

NR
Nkululeko R's update15 Aug 2018, 12:02
Reviewer Update
Hi Dinky I was told that the claim for the third party was not approved,I immediately contacted my lawyer for some advice.She then promised to get in touch with insurance of which she did and she spoke to the guy by the name of Lebogang Senne,on their conversation she was stunt the statement that was made by the manager she was told that I was not supposed acknowledge to the third party even if I'm the one who's wrong or I'm the one who caused the accident I must just deny or lie in order for the insurance not to pay the claim of the third party that's the policy of outsurance according to Lebogang Sene.,i was told that I must not worry even if the third party can take me to court they will defend me in court for free..If you look at the claim form that they sent to the third party it states clearly there,if our clients was negligent e.g.Crossing the stop sign without stopping they will pay the claim fully to the third party of which that's exactly what happened in my case.But now they don't want to pay the claim they say I was not negligent by crossing the stop sign and bumped into someone's car because I said to them I was not fami**** with the area.Please listen to the conversation that took place between Lebogang Senne and my attorney on the 26/07/18.