Water loss claim woes

[tRoN]

Hi Guys.

There was a leak on our common property of a complex of 6 units which was duly repaired by a registered plumber. .



He took all meter readings as he was unsure on whose meter it was leaking and ask us all to monitor the water account and to see who’s was in excess and report back to him.



There were delays with the Ethekwini accounts last year due to their system changeover and even the online portal was unavailable due to the website being hacked. This was widely reported in the media.

Thus many people got their accounts late.


When the account did finally arrive, I realized it was our unit that was affected by the leak and then I lodged the water loss claim to Westwood Insurance Brokers.

Allegedly the claim was sent just 5 days over their 60 day period to claim and they have rejected the claim due to this.

I appealed to the municipality but they rejected the processing of the claim. Westwood brokers referred me to the insurer New National Assurance company and they also rejected the claim using the 60 day rule as the reason.

No one is trying to understand the circumstances of why the claim was delayed.

But as you can see it was out of my control as it was impssible to have sent the claim earlier.

I also feel the 60 day period to claim is too short and unfair.

I have subsequently filed a complaint with the Ombudsman whose waiting period is around 3 months I believe.

In the interim I see the insurer offered an ex gratia payment of 50% (total claim around R3400)

What should I do?

Is the 60 day claim period CPA compliant?

[tRoN]

Eish. No one can offer advice?

[HavocXphere]

Eish that's a kark one.

I'd be inclined to accept their 50% because they're on pretty strong ground:
1) They're following their contract 100%
2) It's not their fault that the muni bill is late

So while it's unfair towards you I don't think you can make this their problem. A more plausible version is to go after the muni since they're the only ones that did anything wrong.

[reactor_sa]

Since the day I read the line, "Life is not fair, get used to it", not a week goes by that I do not have reflect on it.

[Hemi300c]

Almost aal policies never state a period for reporting a claim but rather state within a reasonable period.
Most insurers will not penalise for "late" notification unless they have been deprived in some way. In this case they probably weren't.
The Ombudsman, unless 60 days in your policy, will/should make the call on reasonable time.
They have made an offer without predgidous however this seems to show they are not correct.

The Ombudsman is renowned for sometimes making ludicrous decisions.

If your policy does state 60 days then it's from the time you were aware of the loss or possible claim.

[airborne]

So essentially you had no idea your unit would be the unit with water loss, finally got the bill only to discover it then, contacted the insurance promptly thereafter?

Clearly seems like the insurance is pulling a fast ones the 60 days should be from when you are made aware of the loss, ie when the bill arrived, how can you submit a claim for loss you have not yet incurred, the loss was only incurred when the bill was delivered?

[tRoN]

Almost aal policies never state a period for reporting a claim but rather state within a reasonable period.
Most insurers will not penalise for "late" notification unless they have been deprived in some way. In this case they probably weren't.
The Ombudsman, unless 60 days in your policy, will/should make the call on reasonable time.
They have made an offer without predgidous however this seems to show they are not correct.

The Ombudsman is renowned for sometimes making ludicrous decisions.

If your policy does state 60 days then it's from the time you were aware of the loss or possible claim.

So essentially you had no idea your unit would be the unit with water loss, finally got the bill only to discover it then, contacted the insurance promptly thereafter?

Clearly seems like the insurance is pulling a fast ones the 60 days should be from when you are made aware of the loss, ie when the bill arrived, how can you submit a claim for loss you have not yet incurred, the loss was only incurred when the bill was delivered?

The policy document which they sent me after I had the claim rejected (never saw it b4) stated within 60 days from repair. So repair happened before I discovered it was my unit. See excerpt below.

What does CPA give as a reasonable time to claim. Surely 60 days is short and shouldn't make the claim prescribe.

[cpu.]

The CPA does not apply here.

[ToxicBunny]

Westwood are a bunch of tits at the best of times... I had a water loss claim recently and somehow they just randomly decided to only Pay out 40% of the claim...

Ethekwini have also randomly decided to change my water meter number to a unit that doesn't exist so fscker if I know how to fix the whole.issue since the call centre are useless

[tRoN]

The CPA does not apply here.

Why not?

[tRoN]

Westwood are a bunch of tits at the best of times... I had a water loss claim recently and somehow they just randomly decided to only Pay out 40% of the claim...

Ethekwini have also randomly decided to change my water meter number to a unit that doesn't exist so fscker if I know how to fix the whole.issue since the call centre are useless

Yes. That's part of the problem. At some point the meter was changed to accommodate the restrictors

[Johnatan56]

Do you have the original contract one might read through? Just remove the signature pages.

[ToxicBunny]

Yes. That's part of the problem. At some point the meter was changed to accommodate the restrictors

Mine wasn't changed, just the meter number on my bill for some daft reason.

[tRoN]

Do you have the original contract one might read through? Just remove the signature pages.

Yes. Will upload. Didn't sign anything. The policy document was sent once in the account a long time ago but I guess they assume the premium you pay is acceptance?

[Johnatan56]

What date did you receive the bill?