PN
Phindile N

1 reviews | Active since Jul 2020

30 Dec 2024, 09:43

PRIME MERIDIAN (PMD) INSURANCE

Prime Meridian (PMD) insurance underwritten by Santam, declined my claim after my car was damaged, almost catching fire when our home unfortunately burnt, basically the car melted at the back it did not burn. When one takes up insurance it is to cover for unforeseen circumstances, my cover only covered natural fires, that was the reasoning for declining. This was the cover I accepted. Fires are rare and no one thinks they will be faced with such circumstances. I had a comprehensive cover which one would expect covers the everything. The was no malicious intent to damage the car, it was not through recklessness that it got damaged, there was even attempts to move car by breaking the windows but the windows wouldn’t break. In all of this no one even came to inspect the scene where this happened and even to send someone to assess the vehicle to see what the damages were on the car. I would have appreciated if PMD would have considered the circumstances and make decision on the merits of the case, not just tell me about exclusions, especially that THERE WAS NO MALICIOUS INTENT to damage vehicle, the damage was purely an accident. I was as very clear and honest when I submitted my claim. What was more disappointing was the response from the ombudsman which took 2 and half months to get the response where they came back to tell me about the very same exclusion. In my submission to ombudsman I did acknowledge that my cover excludes unnatural fire, my submission was to request them to review case based on the circumstances.

This exclusion is really not making sense, well I've never heard of a similar case like mine but even checking a few other insurances they don't have such exclusions.

i am truly disappointed with PMD that in these difficult times they chose to apply blanket approach and not consider circumstances. We get insurance cover because we don't have funds to cover such, if we had money we wouldn't need insurance.

0
Replies (2)
Prime South Africa
Prime South Africa's reply30 Dec 2024, 13:14
Official
 
Dear  Phindile  ,we regret to hear about your dissatisfaction and appreciate you letting us know. We will acknowledge your complaint in writing within 48 hours. Thank you for your patience. Kind regards, the Prime SA team. 

Prime South Africa
Prime South Africa's reply02 Jan 2025, 15:48
Official
Dear Phindile N,

Thank you for sharing your feedback. We are truly sorry to hear about how disappointing this experience has been for you.

We take great care to ensure that all our clients fully understand the scope of their cover before purchasing a policy. Your policy specifically covers naturally occurring fires, such as veld fires, and excludes unnatural fires.

While we empathise with the unfortunate circumstances surrounding your claim, the policy operated as agreed between us for the premium you paid. Providing cover outside of the agreed terms would be unfair to other clients who rely on us to honour valid claims within the scope of their policies.

We understand that the Ombudsman indicated that they may agree that this was the fair outcome, and we encourage you to engage with them should you be unhappy with their preliminary feedback. Please know that we remain committed to treating all our clients fairly and transparently.

You will be pleased to hear that we have a skilled Market Conduct Team that specialises in ensuring our clients' voices are heard.

Assuring you of our continued best endeavours.

Kind regards,
 PrimeSA