By Yulanda Paterson
Consumers buy insurance to protect their assets so that if something unforeseeable happens to them, they would not need to worry about the financial implications or cost of replacing the assets.
But in a turn of events, the rejection of a claim or cancellation of a policy by an insurer may lead to further financial strain and frustration.
The insured needs to be aware of circumstances that may result in an insurer declining to pay out on a claim.
Insurers also can validate a claim based on independent witnesses, expert evidence, vehicle tracking data, bank statements, cell phone records, medical records, police reports and call recordings.
Remember that the insurer is only liable to pay you if the claim falls within the scope of the cover provided in the policy wording.
Here are five common reasons a claim can be rejected:
- Insurer finds out that the insured was driving recklessly or driving whilst under the influence of alcohol or without a valid driver’s license at the time of the motor accident.
- You withholding or misrepresenting information when taking out the policy or when you lodge a claim. The Office of the Ombudsman for Short-Term Insurance (OSTI) reports that it usually receives many complaints where - policyholders have misrepresented the ‘regular driver’ so as to pay a cheaper premium or a lower excess.
- Failing to provide complete and accurate information to insurers for them to underwrite the appropriately.
- Providing insurers with incorrect or inconsistent versions of the events leading up to or during an incident, such as inflating claims or refusing to give insurers access to information that could have a material effect on the outcome of the claim.
- The insured’s breach of a contractual duty of care, for example, failing to maintain or replace the worn-out tyres. The clause requires that the insured must use all reasonable care and take reasonable precautions to prevent or minimise loss, damage, death, injury, or liability.
Consumers must review their policies regularly to familiarize themselves with the terms and conditions of the policies.
You need to check your policies to ensure you have the correct cover in place.
Consumers must also update their details and inform their brokers or insurers of any changes in their circumstances that may have occurred since they have taken out the policy.
This initiative-taking approach will help consumers to be aware of what is covered and what to do if they need to submit a claim.
Infiniti Insurance offers an online platform that was developed to provide clients with a secure tool to manage their personal and business insurance requirements entirely online.
The entire onboarding process is completed online – from choosing the appropriate cover to managing monthly debits and claims. Any change to the policy can be made by the client or by the client’s appointed broker.
The Infiniti Online platform is user-friendly and easy to navigate, and everything is clearly explained in plain language that is easily understood. Together with itemized costing, this makes the application and securing of insurance policies, simple and completely transparent.
Yulanda Paterson is the Head of Specialist Division and Online at Infiniti Insurance.
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