News

LATEST NEWS

Quote of the Month: Challenging the Rejection of an Insurance Claim

Apr 28, 2022 | Quote of the Month, Short Term Insurance

Mtho Maphumulo at Adams & Adams:

‘Insurance policies are generally worded in a complex manner and consist of various legal terminology and principles. This is unsurprising given the fact that these policies are drafted by lawyers.

‘Rejection of claims may be based on various factors e.g., the claim falling within one or more of the exceptions as per the policy wording, the claim not being timeously submitted in accordance with the provisions of the policy, etc.

‘Insurance policies play a crucial role in assisting with the loss, and in addition, the insured pays premiums for protection. It is for these reasons that repudiated claims should be seriously considered and challenged where the insured is unsatisfied with the reasons for repudiation. Over the years, our courts and other alternative dispute resolution forums have come to the rescue of many insureds whose claims were rejected.

‘Our courts take the view that insurance claims should not be repudiated on trivial and insignificant grounds. Also, they want to give effect to the primary purpose of the insurance contract i.e., to compensate the insured in the event of the insured peril materialising. In cases such as the ongoing rains, the element of sympathy is likely to also play a role in favour of the insureds. Of course, where there are just and legal grounds for the repudiation, the courts will approve of that repudiation.’

Disclaimer: The information provided herein should not be used or relied on as professional advice. No liability can be accepted for any errors or omissions nor for any loss or damage arising from reliance upon any information herein. Always contact your professional adviser for specific and detailed advice.

© FinDotNews