Insurance interrogated me

Napalm2880 said:
Had a similar thing with Outsurance. Assessor came and questioned me for 45 minutes for a stolen vehicle. It was mostly straightforward questions - and I entertained it - but then he tells me I need to register for e-tolls so he can see my e-toll record to prove I wasn't lying about where I was on the day the vehicle was stolen. Told him to get stuffed.

Thankfully vehicle was recovered 3 days later so I didn't have to deal with the assessor any further - and the rest of the experience with Outsurance was beyond amazing. In retrospect I wouldn't give the guy half the time. They can look at the police report and if they have questions outside that, they can send them via e-mail.

Btw. Did you know it's standard process to search your social media profiles to see if there's anything that can be used to invalidate your claim.
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They aint even gonna find me on there...
 
On a side note, I am with a Broker and when I had the fortunate experience of hitting a rabbit on my way to work one morning, I also had to with an assessor who met me at the scene of the accident and I had to re-tell my story to him again. Didn't mind, as I wasn't in the wrong, but because of the time of the accident, I had to prove that my story was true. I think they think I was drunk driving...

Alas, they did pay for the repairs, which was quite costly, but yeah, interrogation happens from brokers as well.
 
S.Claus said:
I was in a accident about two weeks ago at a red light with the other party being at fault .Did the whole circus act of phoning my insurance company figuring they would help me repair the damage to my car at least (considering the other party didn't have insurance or a valid license for that matter) . After having the car towed in and filling all the necessary paper work (quotes,statements , police report and photos) .

Yesterday I got a phone call from them saying they want to set up a meeting and to discuss what happened (keep in mind I gave my statement to them and the police twice) . He kept hammering on about some insurance policy and that the conversation is being recorded saying that if I lied I would be black listed and that no insurance company would cover me.What I don't get is when did I turn into a criminal here ?

He turned the conversation into a interrogation stating that he knows that I am the primary not the secondary driver and that he could prove it ,he wanted friends and family members numbers who could vouch my driving abilities ( point being what does that have to do with the accident ?) .After which he conveniently pulled out a document stating we would drop the claim (so he in turn would drop the whole primary/secondary driver case)

So I am curious if this happened to anybody else before ? Seems like you need a full time lawyer when talking to these guys
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Who is this pathetic company?
 
S.Claus said:
I was in a accident about two weeks ago at a red light with the other party being at fault .Did the whole circus act of phoning my insurance company figuring they would help me repair the damage to my car at least (considering the other party didn't have insurance or a valid license for that matter) . After having the car towed in and filling all the necessary paper work (quotes,statements , police report and photos) .

Yesterday I got a phone call from them saying they want to set up a meeting and to discuss what happened (keep in mind I gave my statement to them and the police twice) . He kept hammering on about some insurance policy and that the conversation is being recorded saying that if I lied I would be black listed and that no insurance company would cover me.What I don't get is when did I turn into a criminal here ?

He turned the conversation into a interrogation stating that he knows that I am the primary not the secondary driver and that he could prove it ,he wanted friends and family members numbers who could vouch my driving abilities ( point being what does that have to do with the accident ?) .After which he conveniently pulled out a document stating we would drop the claim (so he in turn would drop the whole primary/secondary driver case)

So I am curious if this happened to anybody else before ? Seems like you need a full time lawyer when talking to these guys
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Sounds like Outsurance :D
 
Freddl said:
It is clear that you chose the wrong company to do business with. Some insurance companies in South Africa use the American model of insurance where they actively try to repudiate all claims. This is clearly one of those and I would advise you to drop that company as soon as you can and go to a more reputable insurance company such as Santam or Mutual and Federal.

Insurance companies sell trust and if you cannot rely on them to find every way possible to pay your claim, you should dump them as soon as you can.
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Considering i work for an american insurance company, which ones try to refute all claims?

Whats this model that you speak of?
 
crackersa said:
Considering i work for an american insurance company, which ones try to refute all claims?

Whats this model that you speak of?
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Go to your claims department and ask them how they handle a claim. The model works as follows:

1. Repudiate all claims
OR in some cases carefully go through everything trying to find a reason to repudiate the claim. The reason can also be imaginary.
2. Try to threaten the client and get him afraid enough to withdraw the claim
3. Ignore all correspondence from the client
4. Operate a call centre that stays vague about reasons for the repudiation. Never allow the client to speak to the claims clerk.
5. Only pay the claim after legal action has been taken.

If your company does that, you are working for one that follows the model.
 
Someone drove into me while I was stopped at a robot. Insurance assessor guy was super pleasant to deal with. Santam/broker.
 
Freddl said:
Go to your claims department and ask them how they handle a claim. The model works as follows:

1. Repudiate all claims
OR in some cases carefully go through everything trying to find a reason to repudiate the claim. The reason can also be imaginary.
2. Try to threaten the client and get him afraid enough to withdraw the claim
3. Ignore all correspondence from the client
4. Operate a call centre that stays vague about reasons for the repudiation. Never allow the client to speak to the claims clerk.
5. Only pay the claim after legal action has been taken.

If your company does that, you are working for one that follows the model.
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All state, geico, aflac and my company doesnt do this. Even though they all look for shady stories.

Which ones actively look to refute all claims?
 
crackersa said:
All state, geico, aflac and my company doesnt do this. Even though they all look for shady stories.

Which ones actively look to refute all claims?
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All of them cos Murica!

I thought you would know this dude.. :p
 
Freddl said:
Go to your claims department and ask them how they handle a claim. The model works as follows:

1. Repudiate all claims
OR in some cases carefully go through everything trying to find a reason to repudiate the claim. The reason can also be imaginary.
2. Try to threaten the client and get him afraid enough to withdraw the claim
3. Ignore all correspondence from the client
4. Operate a call centre that stays vague about reasons for the repudiation. Never allow the client to speak to the claims clerk.
5. Only pay the claim after legal action has been taken.

If your company does that, you are working for one that follows the model.
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No I'm sorry, but you are completely wrong.

The principle of insurance being in good faith is what is tested at claims stage. If you have a valid claim you will be settled. If however you tried to work the system you will not get your claim paid. The problem is how farm some insurance companies will go to try and repudiate a claim. There is nothing wrong with checking factual data given when you took the policy. Like verifying who the regular driver is, was the person drinking before the accident happened if it happened 2am on a Saturday morning and no third party involved and so on. Insurance get's their money from admin fees and so on. The premium you pay goes into a book that needs to cover all insured people on that book. If your book has a positive balance it just means your premiums can be more competitive going forward and so on. Having a healthy book is the aim here. Repudiating a claim doesn't miraculously make an insurance company more money. It does make the book's loss ratio better meaning more benefits to those in the book.
 
crackersa said:
All state, geico, aflac and my company doesnt do this. Even though they all look for shady stories.

Which ones actively look to refute all claims?
Click to expand...

I am not an American but I quote the Amerrican Association for Justice: 'All State , AIG, and State Farm among others have denied valid claims in an attempt to boost their bottom lines. These companies have rewarded employees who successfully denied claims, replaced employees who would not, and when all else failed, engaged in outright fraud to avoid paying claims.'

If the Association is right, you have a few names to play with.
 
Freddl said:
I am not an American but I quote the Amerrican Association for Justice: 'All State , AIG, and State Farm among others have denied valid claims in an attempt to boost their bottom lines. These companies have rewarded employees who successfully denied claims, replaced employees who would not, and when all else failed, engaged in outright fraud to avoid paying claims.'

If the Association is right, you have a few names to play with.
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But ofc people should be rewarded for preventing claims that was not valid to begin with :confused:
 
Freddl said:
I am not an American but I quote the Amerrican Association for Justice: 'All State , AIG, and State Farm among others have denied valid claims in an attempt to boost their bottom lines. These companies have rewarded employees who successfully denied claims, replaced employees who would not, and when all else failed, engaged in outright fraud to avoid paying claims.'

If the Association is right, you have a few names to play with.
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That doesn't even BEGIN to state that their SOP is to deny all claims, merely that they have denied valid claims...
 
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