GM
Gift M

1 reviews | Active since Dec 2015

24 Oct 2017, 18:13

claim still not paid after 11 moths

On 14-Nov-16, during heavy storms in JHB ,a claim was submitted with broker First Equity Brokers underwritten by Santam. They appointed an assessor from Kruger and associates who came to do an assessment at my mom's house questioning her how she managed to build such a house whereas she is a widowed pensioner which has nothing to do with the claim I wonder if they are insinuating that a black old women cannot afford to own such a house. My mom being a pensioner and no knowledge of how insurance works, requested that I assist her to follow up on the progress of her claim. On numerous occasions we asked for feedback only to find out that an incorrect assessment was submitted to the insurers. The only correct quote was from Top carpets for the Laminate flooring and no building contractor was ever sent to quote on the building related damages but yet a quote from an unknown contractor was sent to the insurance who also happens to be the assessor himself (misconduct & conflict of interest right there) something was fishy and up to date the brokers has refused to give us the copy of the assessment report & pictures after questioning them why is the assessor and the contractor the same person. After receiving no joy from the broker we lodged a complaint directly with Santam 22-March-17. In April they gave us feedback that the assessor advised the bedroom ceiling and walls just needs painting and no mention of the lounge walls. When I questioned how can knotty pine ceilings be painted, no one could answer. There are clear signs of water damages on that knotty pine ceiling in the main bedroom & lounge which cannot be painted but needs to be sanded and varnished and the wooden cornices will have to be stripped and replaced as they are pulling away from the wall. The bedroom walls must be washed and painted with 1st coat and double velvet paint app****. The lounge walls has Gamma-zenith app**** and cannot be painted, it needs to be s****ped off and the special decorative mould to be re-app****. When the assessor was asked about the Gamma-zenith walls he still responded to say the walls can just be painted, I don’t know how many times we have advised you cannot just paint over Gamma-zenith walls, it’s a mould that is app**** over the walls. The assessor also said there is no cover for the kitchen cupboard but There is clear signs of water that ran down the walls damaging the backboard of the kitchen cupboard. No breakdown of removal of the damaged backboard and installing of new back board. When I sent pictures of that kitchen cupboard, he then responded to say it’s gradually deteriorated. What does he expect as these damages are from Nov 2016 but pictures taken immediately after the incident was sent when the water stains was still fresh. In May 2017 I requested Santam's portfolio manager( Lesley Singh) and the complaints manger (Rudi Snell) to appoint their own independent assessor which was only done on the 7th month after having lodged a complaint to the Ombudsman and only then Santam appointed as I was not happy with the assessment from the assessor sent by the brokers. Ken Mann Loss adjustors came out and did a detailed assessment & value at risk on 02-July-17. up to date I have asked for a copy of this assessment report but nothing has been furnished yet they advertise transparency and treating clients fairly. today I get an AOL from the brokers & Santam, with no assessment report or break down with proper estimates, my mom must just accept the amount & sign. This claim has been ***********ly handled with no urgency to respond unless I call to follow up and lack of decisiveness . I have never experienced such appalling treatment and brash disregard for client service or is it because my mom is black to just accept a settlement where other damages is not included but yet are part of the claim, where is the fairness in that .She paid premiums for a service which she never even received after 11 months from the date of incident.

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Replies (1)
Santam
Santam's reply25 Oct 2017, 08:26
Official

Good day

Thank you for your post.

We note this matter is being handled by the office of the Ombudsman for Short-Term Insurance, reference M1425/17X.

We are therefore unable to assist you on this platform.

We trust the above is in order.

Thank you and kind regards

Kurt Koopman

Client Care Manager