Beware of OUTsurance

To Whom It May Concern,

I am compelled to place on record my profound dissatisfaction with the manner in which my insurance claim has been assessed, finalised, and ultimately repudiated. The handling of my matter reflects not only a disregard for the contractual obligations owed to me as a policyholder but also a deeply concerning reliance on pre-scripted and generic justifications designed to nullify legitimate claims.

I have been a loyal client for over eleven (11) years and, during this period, have made a mere three claims — a clear indication that I have never abused my cover and have consistently honoured my obligations by paying premiums timeously. Despite this loyalty, the treatment I have received is nothing short of dismissive and unjust.

Two of my claims under the building cover were rejected on the grounds that the alleged damages were “maintenance issues.” One such example is particularly egregious: a garage door which was less than four (4) months old, brand new, and for which I have invoices proving its recent installation. To classify this as a “maintenance” issue is wholly unreasonable, arbitrary, and without factual or legal foundation.

Most recently, following a severe storm, I lodged a claim for significant property damage, including a cracking boundary wall, a cracked concrete slab, and consequential leaning of my thatch lapa. An assessor and a thatch specialist attended the premises, yet the claim was again repudiated. The justification offered was that the wall was “too high” and that the damage was “gradual” rather than storm-related. This position is untenable. The property was purchased in its existing condition, and it is patently unreasonable to penalise me for construction predating my ownership, while at the same time ignoring the proximate cause — the storm itself.

When I sought clarity from the assessor regarding the imminent risk of collapse, I was informed that, should the wall fall, the claim would once again be denied on the grounds of “lack of maintenance.” This circular reasoning ensures that, no matter the circumstances, the insurer is shielded from liability, leaving the insured entirely unprotected despite having comprehensive cover.

What is most alarming is that every major component specifically listed under my comprehensive building cover — namely the boundary wall, the thatch lapa, and the swimming pool — has been systematically denied. This amounts to a complete failure to honour the core provisions of my policy and renders the so-called “comprehensive” cover effectively worthless.

The consequences of this approach are dire. Should the boundary wall collapse, it will inevitably cause the lapa to collapse, leading to further damage to the swimming pool. I hold a comprehensive building policy explicitly covering these three items, yet when an event of damage occurs, I am presented with nothing more than contrived, pre-formulated excuses to evade responsibility.

This conduct undermines the very essence of an insurance contract — the promise of indemnity when the risk materialises. It is both legally and ethically indefensible. As a paying client, I cannot accept such treatment, and I reserve all rights to escalate this matter, including but not limited to lodging a formal complaint with the relevant ombudsman, pursuing legal recourse, and recovering any damages occasioned by this breach of contract and bad faith conduct.

Yours faithfully, Sarfaraaz