Insurance not always a cure-all to damages, loss

Many South Africans believe that having an insurance is the panacea to future losses or damages. Unfortunately, this is not always the case.

The ombudsman for short-term insurance was established to assist consumers who feel their insurers have dealt them a bad hand.

The office deals with personal lines short-term insurance disputes including those relating to motor insurance, homeowners’ insurance, household insurance, cellphone insurance, travel insurance, disability insurance and credit protection insurance. The services of the office are free of charge.

The case of Mrs N and the stolen cellphone Mrs N claimed for a cellphone that was stolen from her bag while she was playing netball.

The insurer relied on the following provision in the policy to reject her claim:

“7.3 prevention of loss. 7.3.1 – the insured shall take all reasonable steps and precautions to safeguard the equipment, including but not limited to, ensuring that the equipment is: – not left exposed in a public place, place of recreation, mall or social occasion where it is vulnerable to easy removal or damage.”

“The insurer argued that the cellphone was not safeguarded and that it had been left in a vulnerable situation where easy access could be gained to Mrs N’s bag. The office of the ombudsman said the grammatical meaning of the word “exposed” is not “covered or hidden; visible”.

Since the phone was in Mrs N’s bag, it was not exposed and it would be unreasonable to expect her to safeguard her bag all the time. The office of the ombudsman recommended the insurer settle the claim, and it agreed to do as recommended.

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