Disregard by Santam of valid arguments icw. major damage claim to holiday home.

My Homeowners insurance is currently with Santam. The insured is BM Hoogenhout Trust/ Policy No. ***. My complaint is in respect of a claim (***) that has been repudiated at my holiday house in Jongensfontein. This house has had extensive damage caused to the structure, sagging walls, due to rainwater damage stemming from the above property. This water came from a broken 110mm pipe carrying rainwater that discharged all the water on one spot in the sand on my border above a wall. As the house is situated on a steep sandy slope, the water flowed by means of gravitation, underneath the paving, through the sand, and this water was deposited under my house causing subsiding and and subsequent major structural damage to the building! This was discovered during a visit September/October 2020. During the summer holidays of that year NO damage was visible in- or outside the house except for cracks in the wall caused by a burst supply pipe in the wall which happened in 2018. The extensive damage happened during the State of Disaster with lockdown when heavy rains occurred. Some rainfall figures are: August 85,2mm, September 60,6mm and October 68mm . My son-in-law and his wife (our daughter) discovered the bottom section of the house under water and the damage caused by the huge water stream coming in and below and through the house. This was on 30 Sept./1 Oct. 2020. We obviously could not access the house earlier during lockdown in 2020.

With the assistance of an assessor and a Structural Engineer, Santam repudiated my claim saying the damages are due to “gradual deterioration” which is excluded by the policy. Shockingly the Engineer ignored proof (invoice) that the house was fully repainted with minor repairs done in 2014! The Santam Structural Engineer repeatedly and incorrectly referred to the damage (cracks) caused by a burst pipe in 2018 (fully settled claim ***) stating that it was due to “gradual deterioration” !

The Structural Engineer further ignored my explanation that the water must have come from the above property/properties and did not investigate properly! If he had done so, he would have noticed the broken pipe from where the strong flow of water had originated. Furthermore I again queried the Structural Engineer ( from George) as to investigate the source of the water which he again conveniently ignored. Making matters even worse, the Structural Engineer referred to a Building regulation (Regulation R1 from part R). Maintaining that the paving ,which had sagged, saying this regulation was not adhered to due to incorrect building practices ! This sagged section of paving was caused by water damage due to the infiltration of water from the broken 110mm rainwater pipe from the neighbour’s property above my house.

The onus rests on the Insured to prove the opposite and refute the so-called findings of Santam! This is an extremely costly and prohibitive exercise, bringing in other expert advice and possibly ending up in court. Theoretically it appears Santam aims for zero-compensation for damages incurred, of which it appears that Santam has virtually perfected the art, giving me the most disappointing experience ever in short term insurance, as far as I am concerned, if possible, I would rate Santam in a “negative star rating” ! Is this attitude ethical, therefore making insurance of your property, vehicles, valuables etc. questionable?

My broker had contacted the Ombudsman (Short-term Insurance) and app**** for assistance and furthermore furnished an independent Engineers Report to the Ombudsman.

After consideration of my complaint, the Ombudsman informed me on 20th December 2021 that they had made their decision on the side of the insurer as it appeared to be in line with the policy terms! The contrasting reports by the different Engineers was obvious, as well as an alleged dispute of the broken 110mm rainwater pipe not investigated by the Insurers Engineer! The Ombudsman stated I have the right to take further legal action.

I am utterly disappointed by this decision of the Ombudsman in favour of Santam, of which I believe was strongly affected by Santam’s Structural Engineer’s “biased” and in certain ways, incorrect report.

The fact of the matter is that, personally, I have spent plus minus R 50 000 (a minor part of the damage) on some repairs to the house and paving as this purposely drawn out claim has not been resolved, this cost does not include the independent Engineers work done. The problem being that further damage would obviously occur if the maintenance was neglected even longer, due to Santam’s attitude and non-compliance!