Claim complaint

I am writing to lodge a formal complaint regarding the handling of my two claims submitted three weeks ago.

1. Delays and Poor Communication Despite submitting the claims promptly, no action was taken until I called your office last week. Only after my follow-up did you send an assessor to inspect the damage. This delay is unacceptable.

2. Contradictory Communication Following the assessor’s inspection, I received an SMS in black and white confirming that the claim had been approved, with an applicable excess of R1250. This communication was clear and official. However, when I contacted your office today, I was informed by Siyamo—who displayed an extremely unprofessional and dismissive attitude—that both claims had been rejected. He claimed the approval SMS was “system generated.” I do not accept this explanation. A system does not generate an approval without human intervention, and once confirmation is issued in writing, it must be honored.

3. Unjust Decline of Claim The stated reason for rejection was “wear and tear.” This reasoning is not valid in our case. We have consistently maintained and serviced our roof over the years. The roof has never leaked nor presented issues prior to this winter. The current damage is clearly the result of the severe Cape Town weather conditions, not neglect or deterioration. To reject a legitimate weather-related claim under the guise of “wear and tear” is unjust and unreasonable.

4. Unacceptable Service Experience The combination of the excessive delays, contradictory approvals and rejections, and the unprofessional conduct of your staff member has caused immense frustration and inconvenience.

I therefore demand:

A full review of my claim with immediate reconsideration based on the evidence provided.

Written confirmation as to why an approval SMS was issued and then later disregarded.

Assurance that your staff will conduct themselves in a professional manner when dealing with customers.

If this matter is not resolved urgently, I will have no choice but to escalate it to the relevant ombudsman and regulatory authorities.

I trust that you will treat this complaint with the seriousness it deserves and revert with a positive response.