eL
ella L
1 reviews | Active since Aug 2019
20 Nov 2025, 08:52
Misleading customers to take out insurance and then refuse to cover!!!
My husband took out a contents cover with Outsurance beginning of the year and the sales consultant who sold him the policy advised that everything loose we own is covered by Outsurance. Now we have a problem with accidental damage to our couch and automatically its not covered yet we requested the call recording and it clearly stipulates by the consultant that our sofas are also covered for any damage!!! This is just a terrible insurance company.
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Replies (3)eL
ella L's updateReviewer Update
20 Nov 2025, 09:17Claim number: ***
I would like to highlight an important point: during the sales call, my husband presented the consultant with several different scenarios and in every instance he confirmed that such damage would be covered. This was clearly communicated and formed a material part of my decision to accept the policy.
Given this, I request that the entire call recording be reviewed again, with specific attention to the portions where these scenarios were discussed and cover was confirmed (from 14 minutes onwards) which we also have the call recording of.
I would like to highlight an important point: during the sales call, my husband presented the consultant with several different scenarios and in every instance he confirmed that such damage would be covered. This was clearly communicated and formed a material part of my decision to accept the policy.
Given this, I request that the entire call recording be reviewed again, with specific attention to the portions where these scenarios were discussed and cover was confirmed (from 14 minutes onwards) which we also have the call recording of.
eL
ella L's update20 Nov 2025, 09:17
Reviewer Update
Claim number: ***
I would like to highlight an important point: during the sales call, my husband presented the consultant with several different scenarios and in every instance he confirmed that such damage would be covered. This was clearly communicated and formed a material part of my decision to accept the policy.
Given this, I request that the entire call recording be reviewed again, with specific attention to the portions where these scenarios were discussed and cover was confirmed (from 14 minutes onwards) which we also have the call recording of.
I would like to highlight an important point: during the sales call, my husband presented the consultant with several different scenarios and in every instance he confirmed that such damage would be covered. This was clearly communicated and formed a material part of my decision to accept the policy.
Given this, I request that the entire call recording be reviewed again, with specific attention to the portions where these scenarios were discussed and cover was confirmed (from 14 minutes onwards) which we also have the call recording of.
OUTsurance's replyOfficial
24 Nov 2025, 14:18Hello Ella
Further to our initial response to your review. we received feedback from our claims manager.
It was confirmed that our sales advisor provided you with incorrect information. Based on this, we are proceeding with your claim. Arrangements were made with our service provider to assess the damage to the couch. Upon receipt of the report, we will then finalise your claim.
You have our sincere apologies for the poor service experience! The service concerns are being addressed internally.
Regards
The OUTsurance Team
Further to our initial response to your review. we received feedback from our claims manager.
It was confirmed that our sales advisor provided you with incorrect information. Based on this, we are proceeding with your claim. Arrangements were made with our service provider to assess the damage to the couch. Upon receipt of the report, we will then finalise your claim.
You have our sincere apologies for the poor service experience! The service concerns are being addressed internally.
Regards
The OUTsurance Team
OUTsurance's reply24 Nov 2025, 14:18
Official
Hello Ella
Further to our initial response to your review. we received feedback from our claims manager.
It was confirmed that our sales advisor provided you with incorrect information. Based on this, we are proceeding with your claim. Arrangements were made with our service provider to assess the damage to the couch. Upon receipt of the report, we will then finalise your claim.
You have our sincere apologies for the poor service experience! The service concerns are being addressed internally.
Regards
The OUTsurance Team
Further to our initial response to your review. we received feedback from our claims manager.
It was confirmed that our sales advisor provided you with incorrect information. Based on this, we are proceeding with your claim. Arrangements were made with our service provider to assess the damage to the couch. Upon receipt of the report, we will then finalise your claim.
You have our sincere apologies for the poor service experience! The service concerns are being addressed internally.
Regards
The OUTsurance Team
eL
ella L's updateReviewer Update
01 Dec 2025, 23:25Dear Outsurance Claims Department,
I am writing in connection with the above-referenced claim for accidental damage to my leather two-seater couch. As previously communicated, the consultant who assisted me at the time of taking out this policy confirmed that this item was covered. Based on that representation, I proceeded with the policy. The inspection for the claim has already been completed.
I have now received a request for “previous insurance claim history” from a prior insurer as a condition for finalising my current claim. I must formally raise my concern regarding the legitimacy and relevance of this request.
1. Request for Legal and Contractual Basis
Kindly provide, in writing:
The specific clause in my policy wording or underwriting record that obliges me to provide historical claims information from a previous insurer as a precondition for a valid claim.
Confirmation that this requirement was clearly disclosed to me during the initial underwriting process.
Your explanation as to why such information is “material” to the assessment of the present claim, as required under South African insurance law.
At no point during the application process was I requested to supply prior claims history, nor was I advised that the approval of future claims would be dependent on such information.
2. Good Faith and Legal Principles
Under the principles of uberrima fides (good faith) applicable to short-term insurance, both parties are required to act fairly and transparently. I have comp**** with all obligations of disclosure based on the questions put to me at underwriting.
I also draw your attention to Jerrier v Outsurance Insurance Company Limited (2015), in which the Court held that an insurer may not repudiate or prejudice a claim on the basis of alleged non-disclosure where:
The insurer did not clearly request the specific information during application;
The policy design or wording was ambiguous;
The information withheld was not clearly proven to be material to the claim.
This precedent is directly relevant where an insurer seeks to rely on historical incidents or prior insurance behaviour which were neither expressly requested nor clearly relevant at inception.
3. Consultant Representation
It is also important to note that Outsurance’s consultant expressly advised me that my leather couch was covered, which formed the basis of my acceptance of the policy. Outsurance has since acknowledged this and agreed to proceed with the claim based on that initial representation.
Introducing new conditions after the claim has been lodged — particularly ones not disclosed or contractually required at inception — may amount to an unfair and unreasonable claims practice.
4. Request for Immediate Progression of the Claim
Given the above, I request:
That the claim proceed without further delay;
That your request for prior-insurer claims history be withdrawn unless you can substantively justify it with reference to the policy wording and the law;
Written confirmation of the next steps and timelines for settlement.
5. Notice of Potential Escalation
Should this issue remain unresolved, or should further delays occur without clear legal justification, I will have no choice but to refer the matter to the Ombudsman for Short-Term Insurance (OSTI) for adjudication, and will supply all correspondence — including evidence of the initial consultant’s representations.
I trust that Outsurance will act in good faith and in line with its legal obligations. Kindly provide the written justification requested above and confirm continuation of the claim process.
I look forward to your urgent response.
I am writing in connection with the above-referenced claim for accidental damage to my leather two-seater couch. As previously communicated, the consultant who assisted me at the time of taking out this policy confirmed that this item was covered. Based on that representation, I proceeded with the policy. The inspection for the claim has already been completed.
I have now received a request for “previous insurance claim history” from a prior insurer as a condition for finalising my current claim. I must formally raise my concern regarding the legitimacy and relevance of this request.
1. Request for Legal and Contractual Basis
Kindly provide, in writing:
The specific clause in my policy wording or underwriting record that obliges me to provide historical claims information from a previous insurer as a precondition for a valid claim.
Confirmation that this requirement was clearly disclosed to me during the initial underwriting process.
Your explanation as to why such information is “material” to the assessment of the present claim, as required under South African insurance law.
At no point during the application process was I requested to supply prior claims history, nor was I advised that the approval of future claims would be dependent on such information.
2. Good Faith and Legal Principles
Under the principles of uberrima fides (good faith) applicable to short-term insurance, both parties are required to act fairly and transparently. I have comp**** with all obligations of disclosure based on the questions put to me at underwriting.
I also draw your attention to Jerrier v Outsurance Insurance Company Limited (2015), in which the Court held that an insurer may not repudiate or prejudice a claim on the basis of alleged non-disclosure where:
The insurer did not clearly request the specific information during application;
The policy design or wording was ambiguous;
The information withheld was not clearly proven to be material to the claim.
This precedent is directly relevant where an insurer seeks to rely on historical incidents or prior insurance behaviour which were neither expressly requested nor clearly relevant at inception.
3. Consultant Representation
It is also important to note that Outsurance’s consultant expressly advised me that my leather couch was covered, which formed the basis of my acceptance of the policy. Outsurance has since acknowledged this and agreed to proceed with the claim based on that initial representation.
Introducing new conditions after the claim has been lodged — particularly ones not disclosed or contractually required at inception — may amount to an unfair and unreasonable claims practice.
4. Request for Immediate Progression of the Claim
Given the above, I request:
That the claim proceed without further delay;
That your request for prior-insurer claims history be withdrawn unless you can substantively justify it with reference to the policy wording and the law;
Written confirmation of the next steps and timelines for settlement.
5. Notice of Potential Escalation
Should this issue remain unresolved, or should further delays occur without clear legal justification, I will have no choice but to refer the matter to the Ombudsman for Short-Term Insurance (OSTI) for adjudication, and will supply all correspondence — including evidence of the initial consultant’s representations.
I trust that Outsurance will act in good faith and in line with its legal obligations. Kindly provide the written justification requested above and confirm continuation of the claim process.
I look forward to your urgent response.
eL
ella L's update01 Dec 2025, 23:25
Reviewer Update
Dear Outsurance Claims Department,
I am writing in connection with the above-referenced claim for accidental damage to my leather two-seater couch. As previously communicated, the consultant who assisted me at the time of taking out this policy confirmed that this item was covered. Based on that representation, I proceeded with the policy. The inspection for the claim has already been completed.
I have now received a request for “previous insurance claim history” from a prior insurer as a condition for finalising my current claim. I must formally raise my concern regarding the legitimacy and relevance of this request.
1. Request for Legal and Contractual Basis
Kindly provide, in writing:
The specific clause in my policy wording or underwriting record that obliges me to provide historical claims information from a previous insurer as a precondition for a valid claim.
Confirmation that this requirement was clearly disclosed to me during the initial underwriting process.
Your explanation as to why such information is “material” to the assessment of the present claim, as required under South African insurance law.
At no point during the application process was I requested to supply prior claims history, nor was I advised that the approval of future claims would be dependent on such information.
2. Good Faith and Legal Principles
Under the principles of uberrima fides (good faith) applicable to short-term insurance, both parties are required to act fairly and transparently. I have comp**** with all obligations of disclosure based on the questions put to me at underwriting.
I also draw your attention to Jerrier v Outsurance Insurance Company Limited (2015), in which the Court held that an insurer may not repudiate or prejudice a claim on the basis of alleged non-disclosure where:
The insurer did not clearly request the specific information during application;
The policy design or wording was ambiguous;
The information withheld was not clearly proven to be material to the claim.
This precedent is directly relevant where an insurer seeks to rely on historical incidents or prior insurance behaviour which were neither expressly requested nor clearly relevant at inception.
3. Consultant Representation
It is also important to note that Outsurance’s consultant expressly advised me that my leather couch was covered, which formed the basis of my acceptance of the policy. Outsurance has since acknowledged this and agreed to proceed with the claim based on that initial representation.
Introducing new conditions after the claim has been lodged — particularly ones not disclosed or contractually required at inception — may amount to an unfair and unreasonable claims practice.
4. Request for Immediate Progression of the Claim
Given the above, I request:
That the claim proceed without further delay;
That your request for prior-insurer claims history be withdrawn unless you can substantively justify it with reference to the policy wording and the law;
Written confirmation of the next steps and timelines for settlement.
5. Notice of Potential Escalation
Should this issue remain unresolved, or should further delays occur without clear legal justification, I will have no choice but to refer the matter to the Ombudsman for Short-Term Insurance (OSTI) for adjudication, and will supply all correspondence — including evidence of the initial consultant’s representations.
I trust that Outsurance will act in good faith and in line with its legal obligations. Kindly provide the written justification requested above and confirm continuation of the claim process.
I look forward to your urgent response.
I am writing in connection with the above-referenced claim for accidental damage to my leather two-seater couch. As previously communicated, the consultant who assisted me at the time of taking out this policy confirmed that this item was covered. Based on that representation, I proceeded with the policy. The inspection for the claim has already been completed.
I have now received a request for “previous insurance claim history” from a prior insurer as a condition for finalising my current claim. I must formally raise my concern regarding the legitimacy and relevance of this request.
1. Request for Legal and Contractual Basis
Kindly provide, in writing:
The specific clause in my policy wording or underwriting record that obliges me to provide historical claims information from a previous insurer as a precondition for a valid claim.
Confirmation that this requirement was clearly disclosed to me during the initial underwriting process.
Your explanation as to why such information is “material” to the assessment of the present claim, as required under South African insurance law.
At no point during the application process was I requested to supply prior claims history, nor was I advised that the approval of future claims would be dependent on such information.
2. Good Faith and Legal Principles
Under the principles of uberrima fides (good faith) applicable to short-term insurance, both parties are required to act fairly and transparently. I have comp**** with all obligations of disclosure based on the questions put to me at underwriting.
I also draw your attention to Jerrier v Outsurance Insurance Company Limited (2015), in which the Court held that an insurer may not repudiate or prejudice a claim on the basis of alleged non-disclosure where:
The insurer did not clearly request the specific information during application;
The policy design or wording was ambiguous;
The information withheld was not clearly proven to be material to the claim.
This precedent is directly relevant where an insurer seeks to rely on historical incidents or prior insurance behaviour which were neither expressly requested nor clearly relevant at inception.
3. Consultant Representation
It is also important to note that Outsurance’s consultant expressly advised me that my leather couch was covered, which formed the basis of my acceptance of the policy. Outsurance has since acknowledged this and agreed to proceed with the claim based on that initial representation.
Introducing new conditions after the claim has been lodged — particularly ones not disclosed or contractually required at inception — may amount to an unfair and unreasonable claims practice.
4. Request for Immediate Progression of the Claim
Given the above, I request:
That the claim proceed without further delay;
That your request for prior-insurer claims history be withdrawn unless you can substantively justify it with reference to the policy wording and the law;
Written confirmation of the next steps and timelines for settlement.
5. Notice of Potential Escalation
Should this issue remain unresolved, or should further delays occur without clear legal justification, I will have no choice but to refer the matter to the Ombudsman for Short-Term Insurance (OSTI) for adjudication, and will supply all correspondence — including evidence of the initial consultant’s representations.
I trust that Outsurance will act in good faith and in line with its legal obligations. Kindly provide the written justification requested above and confirm continuation of the claim process.
I look forward to your urgent response.