OUTsurance forced to settle R65K claim after initially rejecting it

schumi

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#1
Johannesburg - Consumers' struggles with insurance pay-outs were highlighted after OUTsurance received a R65 000 bloody nose from clients who fought and beat the company.

Vuyisile Ntshangase and her husband Sifiso - both of whom are lawyers - took on OUTsurance.

This was after the company in December refused to pay a lodged claim, despite expert mechanics from Mercedes-Benz Bedfordview - an accredited workshop - saying their car’s problematic steering rack was damage caused by entering a pothole, which the insurer covers.

In October, Sifiso was driving the family’s Mercedes-Benz GLE coupe when he noticed that the car pulled to the left due to a faulty steering rack.

Upon taking it for a service at Mercedes-Benz Bedfordview, where the couple were billed R70 950.10, Andries van Wyk from the workshop wrote in November: “The steering rack is bent due to the sequential damage caused by a pothole.”

However, OUTsurance disputed this expert assessment - according to communication seen by The Star - and said it rejected the Ntshangases' claim as the insurer’s assessors had come to a different conclusion.
More at : https://www.iol.co.za/the-star/news...k-claim-after-initially-rejecting-it-19117698
 

Gordon_R

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#2
Key paragraph at the very end of the report:

Natasha Kawulesar, OUTsurance’s head of client relations, said the company had assessed the damages initially and found no visible evidence to components supporting the steering rack.

Kawulesar added that the claim was thus rejected, where their clients were advised to claim “under the warranty of the vehicle”.

She said OUTsurance had attempted on numerous occasions to contact its clients to find out whether they had received the company’s assessment report, to no avail, adding that the high court application was unnecessary.

“Upon further engagement with our client’s service provider we were advised that our client had previously replaced a tyre.

“This is a component supporting the steering rack. Replacement of the tyre is an indication of pothole damage and thus a valid claim,” Kawulesar said.
 

yebocan

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#5
Key paragraph at the very end of the report:

Kawulesar added that the claim was thus rejected, where their clients were advised to claim “under the warranty of the vehicle”.

I don't get it, pothole caused damage --- insurance, wants client to claim under manufacture's warranty? for what ,defective part...? shifting the blame/claim?
 

TrueETO

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#7
They have being pulling the same stunt on alot of people in the past few years (me being one of them)
 

Gordon_R

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#8
Kawulesar added that the claim was thus rejected, where their clients were advised to claim “under the warranty of the vehicle”.

I don't get it, pothole caused damage --- insurance, wants client to claim under manufacture's warranty? for what ,defective part...? shifting the blame/claim?
The whole article and claim/counter-claim is written backwards IMO:

Natasha Kawulesar, OUTsurance’s head of client relations, said the company had assessed the damages initially and found no visible evidence to components supporting the steering rack.
They hit a pothole, then replaced the wheel, then found the steering was out, then took it to the dealer...
 

Shi

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#9
How can anyone say (for sure) that the damage was caused by a pothole given these circumstances?
 

Gordon_R

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#10
How can anyone say (for sure) that the damage was caused by a pothole given these circumstances?
They must have an invoice for the wheel/tyre that was replaced, and probably cellphone camera photos.

Anyway OUTsurance have settled, so most of this story is 'fake-outrage'...
 

access

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#11
moerse pothole. heavy car too i guess.

the manufacturer covers mechanical failure, not damage. they have stated it was damaged, or are the manufacturers not accredited by insurers.. lol
 

supersunbird

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#13
Repeated calls to get the OUTsurance assessor’s report, according to the Ntshangases, proved unsuccessful, which led to the couple filing a legal challenge on January 21 in the South Gauteng High Court to gain access to the report the company had relied on to repudiate the claim.
She said OUTsurance had attempted on numerous occasions to contact its clients to find out whether they had received the company’s assessment report, to no avail, adding that the high court application was unnecessary.
Maybe Outsurance should get the slackers who can't make these 2 things meet up, and re-educate them.
 

moklet

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#15
I once took on a battle with the insurance of an other party. They tried every single avenue not to pay even after the other party admitted he was at fault (The guy basically reversed out of his parking lot while I was standing behind him for a while, because I couldn't move because of other cars). It took me 2 years before they finally admitted defeat. Their excuse was accidents in a parking lot is both parties fault.

Was it worth the effort probably not, I could have easily claimed from my own insurance, but they wouldn't have fought till the end and I still would have to pay my excess.

But it still gave me great satisfaction that I fought of a big insurance company with no legal assistance just my pure determination for fighting which was right.
 
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Gordon_R

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#17
Wouldn't the rim also have shown damage in a case like that?
The article is not clear if the rim or only the tyre was replaced (or both). You do not have to go to a dealer to get a new wheel, and the amount involved may be too small to bother notifying insurance. My understanding is that there was probably a delay, and a long sequence of investigations before a claim was lodged.
 

ponder

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#18
How can anyone say (for sure) that the damage was caused by a pothole given these circumstances?
Would be a hard call imho but the article does not really go into much detail wrt what's wrong with the steering rack.
 

Gordon_R

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#19
Would be a hard call imho but the article does not really go into much detail wrt what's wrong with the steering rack.
With modern power assisted steering (electric on recent models) you might not get much feedback on how hard the wheels are being banged around, and unaware of the forces on the steering rack. No mention of the speed at which the vehicle was traveling?
 

ponder

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#20
With modern power assisted steering (electric on recent models) you might not get much feedback on how hard the wheels are being banged around, and unaware of the forces on the steering rack. No mention of the speed at which the vehicle was traveling?
From personal experience I would say the faster you go the safer you are. Years ago I almost got swallowed by this crater driving in to Flagstaff at about 60km/h, never in my life felt anything like that before, the rim got bent and the suspension geometry got thrown completely out of whack on the left hand front side.

PS If anybody in the dbn area needs someone that knows suspension go see Sam Edgar, it's not a fancy shop but they know their schit and have a good rep. I sspect the old man might have passed on but his son is a knock off the old block.
 
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