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What to Do if Your Car Insurance Claim Gets Rejected

Ever had your car insurance claim get rejected? Don’t despair! Here are steps you can take in this challenging situation.

You love your car, and most of the time it gives you great driving and enjoyable trips. Then the unforeseen happens, and you need to claim from your insurance for damage, loss, or theft. Most of the time, valid claims are accepted and paid out.

But what if your claim gets rejected? Is there anything you can do to change things? We take a look at steps to follow to get justice or a fair outcome for rejected insurance claims. You can use these 7 steps to make sure your claim was processed fairly.

6 Steps to Take If Your Car Insurance Claim Gets Rejected

According to the Short-Term Insurance Ombudsman of South Africa, car insurance claims are the most common claims they end up dealing with. Sometimes it’s a simple misunderstanding on your or your insurer’s part. There is rarely corruption or fraud involved, but if you suspect your claim was unfairly processed, you can take these steps:

1. Check Your Policy Documents.

Sometimes we claim for things that aren’t actually covered by our policy. It’s easy to assume every cost related to your car will be covered by your insurance. Unfortunately, they do not cover everything. Check your policy documents for exclusions, waiting periods, and the details about what is and isn’t covered.

Sometimes, you can only claim after 6 months of having the policy. If you have an accident in month 4, your claim will be rejected. If you have a third-party only car insurance policy, your insurance company won’t pay out for damages to your vehicle due to an accident. They will only pay for the damages to the other person’s car.

Some insurers require that you stick to certain parameters in order to get cover. For example, they may require you to park your car in a locked garage at night. If the garage door wasn’t locked and it gets stolen, the insurer may reject your claim. Or maybe your car is only covered when you are the driver. If your mom drives the car and is in an accident, they may consider your claim invalid. Finally, if you drive under the influence of alcohol and an accident occurs, your claim can be scrapped.

2. Give Your Insurance Provider a Call.

Once you’ve had a look at your policy, you can call your insurance company. Tell them that you are not happy with the results of your claim if you found nothing in the policy indicating that the event wasn’t covered. A good insurance company will listen carefully to your complaint and answer your questions honestly. Most insurers have a complaints procedure. We recommend cooperating fully by following the complaints process and remaining calm and reasonable.

3. Stay Objective About the Facts.

Sometimes the complaints process can feel frustrating. You may feel misunderstood or even feel that you can’t trust your insurance provider. Even so, it is important to stay calm in the situation. You are more likely to be listened to and it will be easier to accurately convey all the facts about the claim.

It’s also a great idea to write down all the facts in logical or chronological order so that you can convey them accurately when the time comes. Remember to include all relevant details, like the date and time of the insured event, your claim number, and your policy details. This list can also come in handy if you end up getting legal advice or contacting the ombudsman.

4. Request an Independent Assessment.

Your insurer should be able to give you the specific reason why your claim was rejected. When you have this reason, you can request an independent assessment. You can contact an independent loss adjuster, who will look at the damage, loss, or theft objectively and send a report to your insurance company.

Hiring an independent loss adjuster comes out of your own pocket, but it can pay off well if you get a favourable outcome. This option also only works for short-term cover like vehicle insurance and won’t help for life insurance claims, for example.

5. Contact the Ombudsman for Short-Term Insurance.

What happens if you follow these steps, and still the insurance provider won’t pay out? Provided that your claim is valid, you can take it to the short-term ombudsman of South Africa.

Who is the Short-Term Insurance Ombudsman of South Africa?

The Ombudsman for Short-Term Insurance is a South Africa organisation that provides fair and efficient dispute resolution for consumers who believe their claims have been unfairly rejected by their insurance provider for free.

It is a nonprofit independent organisation that can deal with disputes relating to car insurance, home insurance, cell phone cover, travel cover, disability insurance, and even credit protection cover. By applying the law and principles of equity and fairness, the ombudsman can act as a means of dispute resolution in matters relating to car insurance, home insurance, cell phone insurance, disability insurance, and more.

6. Get Legal Advice.

The Ombudsman isn’t a court of law, and they can also not give you legal advice. While they will base their decisions on law, you also have the option of taking the insurer to court. If you want to take this route, you can start by getting legal advice from an attorney. They can help assess the merits of your case and even give you advice on what can and can’t legally be achieved in your matter.

DISCLAIMER: Information provided in this article is meant for informational purposes only and should not be construed as legal, medical, or financial advice. Facts stated in this article are correct at the time it was published.

Sources: Hollard;

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