RC
Rama C

1 reviews | Active since Aug 2023

22 Aug 2023, 23:32

Outsurance refuses to pay claim after me being a client for 25 years.

<div>At 2am a few weeks ago, we were awoken by the sound of water running from somewhere inside the house only to find water running through my kitchen cupboards along two walls. On the other side of the wall is the bathroom and it looked like a leak from the shower somewhere. My family and I were mopping up the water which looked like flooding at that time of the morning. I tried to have it fixed but the kitchen cupboards were already swollen and damaged. I called Outsurance, they sent some contractors out last week. They didnt say anything but that they will submit a report to Outsurance. My claims advisor, Lizelle Goes then called to say that they will not be paying because the pipe was not a pressurized pipe. Logically, all pipes are pressurized because it is supp**** by the municipality, this is my understanding. I have no idea what that means but she was insistent that they do not cover this. What then, do I do about the damage to the kitchen cupboards. I then get a call from a Tshepi Mabele today who refused to let me speak, was very rude and condescending and refused to listen to anything I said. I was told that in no uncertain terms will Outsurance will not pay for any of the damage. They want to close the claim. I am 74 years old and a Pensioner, I took building insurance from Outsurance in 1998, 25 years ago and have claimed maybe thrice, once for the geyser. I was not told about any of the exclusions and Lizelle Goes stated that it is in my policy, to have a look. My policy states that Outsurance does not cover sewer pipes. Thats it. I want Outsurce to go back and listen to my sales call as non of this is specified. Outsurance's famous statement when trying to sell you building insurance is 'Imagine if you turned your house upside down, anything that falls to the floor will not be covered by building, anything that has not fallen will be covered,' So in other words Outsurance is saying that fixed kitchen cupboards will fall to the floor because they wont pay for it, the leak that is coming from somewhere in the wall in the bathroom is not covered because it fall to the floor. They have sent one contractor out to assess, the feedback focuses on a pressurized pipe. They are trying everything to not pay out. I cannot keep wasting my airtime to beg someone to help me, I am on a fixed income. I am going to open a case with the Ombudsman and have already asked for quotes from several other companies. After paying for 25 years, I expected Outsurance to be fair and actually assist but no they are rude and just want to shut me down to close the claim. When I told the lady that I am now looking to change my Insurance company, she said don't move, you need your geyser to be covered, so this is what I have been paying for for all these years under the assumption of the actual building being insured, its just my geyser that I've paid all this money for and in the future am only covering my geyser. It also sounds to me like because I am a pensioner and older, that there is some bias and that they can be dismissive, is that customer service? Outsurance is more worried about taking a clients money than actually them in their time of need, I see that they not really concerned about being reported to the Insurance Ombudsman either. Your logo should be "NO HELP @ OUT" and "HOW CAN WE NOT HELP YOU"</div>

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Replies (1)
OUTsurance
OUTsurance's reply30 Aug 2023, 14:01
Official
Good day Rama,

Thank you for raising your concerns with us.

Further to our private response, we can confirm that our claims manager, Xini, contacted your daughter to discuss the claim rejection in detail. A leak detection test was carried out and it was identified that the cause of the loss or damage to the item for which you submitted a claim is not covered in terms of the facility. Xini discussed the ambit of cover in detail with your daughter and she emailed the information to your daughter as requested. 

We do apologise for the disappointing outcome of your claim.

Regards, 

The OUTsurance Team