Santam

I write this experience because I am sure there are other customers with the same experience. I lodge a complain with Santam for my bedroom aircon not working. Santam give me the opportunity to get my own service provider to come and see what is the problem. The service provider gave me feedback and send me a report that states what is the problem which I forward to Santam. Santam phone me and said that this report does not say what wrong with the aircon ( whiich is wrong) and then Santam send there own service provider out to do another assessment on the aircon because the 1st service provider did not say what they want to hear. the 2nd service provider did his assessment and here is my correspondence to them. Good day, Thank you for providing your detailed submissions and allowing us the opportunity to investigate the matter. After a thorough review of the details and consultation with the claims branch, we regret to inform you that our decision to reject the claim remains unchanged. Following our consultations with the claims division, our offices have been advised as follows: Cause of the Damage to AC Unit: As you mentioned, you had been dissatisfied with the rejection of your claim being wear and tear and subsequently advised that the damage had not been noted as wear and tear from the assessors. Our offices have since had sight of the various assessor’s reports. The report from Lienkies Cooling Assessment confirmed that the outdoor condenser fan motor windings had been burnt, however no clear indication as to the cause of burnout to the fan in this regard. With regards to the unit, the technician who had been on sight confirmed that it had not been possible to cut open the compressor to the unit as it is a sealed motor, therefore further diagnostics into the system fault had been limited. The alternative report from DAS confirmed that the PCB board had been faulty, however due to the age of this unit, no replacements would be possible. The cause of the fault to the PCB board had been due to its general age and gradual deterioration over the years. It was confirmed that the system had been fairly maintained, however, due to gradual deterioration which requires replacement parts and this no longer being possible for this aged unit, this does not constitute as an insured peril. A genuine attempt had been done to rectify the damage to the A/C Unit, however due to the PCB board being faulty, the issue would continue to persist. It must thus be noted that the proximate cause of damage to the A/C unit is not as a result of an insured event. The policy wording stipulates that the damage must be sudden, unforeseen and as a result of an insured event. In this case, the unit became faulty over a period of time and subsequently required replacement parts due to the wear and tear of the current parts therein. Our offices note your submissions concerning the questions posed by the assessor however have confirmed that this is due to the internal processes to ensure that all possible factors have been taken into account which may be considered an insured peril as gradual deterioration and wear and tear to the parts of the A/C unit is not covered in terms of your policy contract. The faulty PCB Board is attributed to normal wear and tear due to component failure. Further to the above, the incident is not classified as “unforeseen” or ‘unexpected” as with cases of gradual deterioration, it is a slow, progressive decline in the performance or condition of a device over time due to normal wear and tear. This is an expected outcome due to the nature and lifespan of devices. You are hereby referred to page 38 and 45 of your policy which states as follows: “GEBOUE - OMSKRYWINGS Versekerde gebeurtenis beteken diefstal of poging tot diefstal, brand, ontploffing, weerlig, donder****, water, sneeu, vloed, seedeining, storm, wind, hael, aardbewing, oopbars van waterpype of watertenks, oopbars van warmwatersilinders, botsing, inbraak, ineenstorting of breek van antennestelsels of satellietskottels, lekkasie van olie uit olieverwarmers, kwaadwillige beskadiging, insakking of grondverskuiwing, sowel as toevallige skade aan spieëls en sekere glas. Hierdie polis sal aandui teen watter van die versekerde gebeurtenisse jou geboue soos in jou polisopsomming genoem, gedek is. HIERDIE AFDELING DEK NIE DIE VOLGENDE NIE Geen van die volgende is gedek nie, tensy dit spesifiek in jou polisopsomming genoem word: b) Verlies of skade wat veroorsaak is deur of bestaan uit: - slytasie of ander oorsake wat geleidelik inwerk” Given that the damage to your A/C unit was due to wear and tear and normal operational use overtime, and not due to an insured peril, we confirm that the claim has been handled correctly according to the terms of your policy. The onus remains with the insured to prove that the damage falls within the ambit of the policy prior to and pursuant to being shown otherwise by the insurer. Please be advised that the underwriting consultants have further confirmed that contact shall be made with yourself to discuss your premiums going forward. While we empathize with your situation, the decision to reject your claim is consistent with the policy requirements. Regrettably, our office cannot assist further in this matter.

My wife then write a complaint to Santam. Good day We were claiming our aircon that did not work in our bedroom. It was definitely difficult for the Santam guy that spoke to us to understand what was said in the technician report as he was questioning my husband on a few calls of what happened to the aircon. You need to listen to these calls please. He was asking about lightning in Bellville like really in Dec/Jan a few times. He was questioning the technician as he thought the report was not right, like he was the expert of being an aircon technician. We got an aircon technician out and he said it was not wear and tear on his report and that the mother board went. We paid the guy as he fixed our living room aircon but because of the mother board that went on the bedroom aircon he could not fix that one. If the technician could have fix the bedroom aircon we obviously would not have claimed. The Santam guy got another technician out to come to our house. That technician said exactly the same then the 1st technician that the mother board went. He was very nice and said if we need his assistants after the claim we must call him. The Santam guy phoned my husband and said it was wear and tear. That was not even on the report how can it be wear and tear if the mother board went? We are with Santam for many years but this claim was not handled professional and not by the sharpest pencil in the pencil case. The last time we had wear and tear on the geyser I phoned in and said I want to pay more to make sure I have this on my policy you can go and listen to calls. I even paying more not to have extra cost with my vehicles as when I want to claim I don’t want this unprofessional client service or pay more on a claim or not have my claim paid out. So it does not matter what you claim and something broke, Santam will say it is wear and tear which means we can not claim white stuff anymore. What is the purpose of having insurance to cover that? We already paying R2000 in on all white stuff because of the loadshedding email. Now loadshedding is done but we still paying in R2000. That was not amended after loadshedding. I always thought I will be with Santam because Santam is the Merc of the short term insurance but with this type of feedback I am thinking of getting other quotes from other insurance companies. I have everything on this policy, house hold, structure of house and all vehicles. This guys went out of his way to make sure we cannot get this claim with all his questions about technicians and lightning and even got a 2nd technician in which said the same. Looking forward to hear from you guys as we are extremely disappointed in Santam. And then i wrote also a email to Santam Dear Santam Hope my email finds you well. I am very disappointed in Santam. And from now on please don’t use my surname when you send any correspondence to me or my wife its very clear to me that me and my wife is only a number to Santam. I am not 10 years with Santam I am longer than that .So please use my policy number I giving you authority to do so. This will make it easier to accept when you say again to me we don’t cover you. I just want to bring the following under you attention. 1. The 1st Service provider I used Lienkies Cooling you didnt want to accepted their damage assessment report, because they didn’t say what you want to hear. Santam decided then to used their own service provider, to do a 2nd damage report and here is when things start to be interesting. This word WEAR AND TEAR Santam is using for white house hold stuff is a way to not to pay for something, like fridges and AC. I believed that all moving parts is bearings and motors, this are moving parts of a machine. How can a PC board be a moving part please explain to me.? How Wear and Tear can occur on a PC board. You talk about due to the age of the Ac you will not pay out, make that sense to you. If I had a AC for 1YEAR and you must pay out I will understand because the amount of premiums I pay in is not enough and you are losing money, but this AC I had long enough for you to cover the AC with the premiums. This AC took long to broke down due to that I look good after it and you must congratulated me not penalize me for looking after my stuff. You said the damaged must be sudden, this AC didn’t make any noise or indicated to me that Its going to break, nothing like that, it broke just sudden. Due to faulty PC board. This is the 1st time I hear that moving parts is the cause of the PC board being faulty. If I know that you going to penalize me for looking after my stuff I would never insured this items and I am going to make a point to take it off my policy. Why must I pay for something I knew the day when it comes to put in an claim the insurer is going to look not for paying out and for my that leaves a bad taste in my mouth. Over a year back my pressure valve was faulty and the same thing happened your consultant inform me that the pressure valve is not part of the Geyser just imagine take away the pressure valve what will happened, you have a blerrie bom and that time I should have not let it go, I should report that person, but I didn’t. Please check my claim record and you will see I do not misuse Santam. Please understand why I going so far to write to again and ask to review you decision to appositive outcome. I believe I pay every month my premiums and for me it’s a lot of money and I just don’t want to feel what I am paying for I don’t received service. Please assist me in this matter.

And here is the response from Santam

Good day,

Please take note that should you wish to remove an item from your policy contract that contact be made with the underwriting department at ***or at ***.

If I must used the words, I have a perfect claim record with Santam, but this leave me speechless.