Rejected claim despite confirmed impact damage—here’s why I’m disputing it.

I am extremely dissatisfied with how my motor claim has been handled and ultimately rejected, and the matter has now been escalated to the National Financial Ombud Scheme South Africa.

After an insured incident in January 2025, my vehicle had to be recovered from a ditch. The vehicle does not have a tow bar, and the recovery process required lifting from underneath.

In April 2026, the gearbox failed.

Mazda’s official assessment confirmed: • The damage was caused by an external impact to the gearbox sump • The damage could originate at the time of impact and worsen over time • It may not have been immediately detectable or could have been missed during earlier repairs

The insurer’s appointed independent experts also confirmed that: • The damage was caused by an upward impact to the gearbox

However, despite both parties agreeing on the cause (an upward impact), the insurer rejected the claim, stating that: • The damage was likely caused by normal driving conditions or a later incident • The failure would have occurred immediately if it were related to the original accident

This reasoning is difficult to accept.

An impact strong enough to damage a gearbox sump is now being attributed to “normal driving,” while a very real and documented event — the recovery of the vehicle from a ditch — has not been meaningfully considered as a possible cause.

In addition, no evidence has been provided to support the suggestion that a separate incident occurred.

Instead, the conclusion appears to rely on assumption rather than conclusive proof.

The matter is now with the Ombudsman for independent review.

I am sharing this experience to highlight the importance of fair, evidence-based claim assessments and to hear from others who may have faced similar situations.

#Hellopeter #InsuranceClaim #ConsumerRights #SouthAfrica