Insurers Who Kick & Scream & Deny You Information

If you want to talk about insurance, there’s no better place to start than prudential, capitalised or not. You never know when something will go wrong, so being prudent is a good thing.

But sometimes, even insurance companies – not Prudential – don’t appreciate a householder’s prudence. Instead, they will resort to relentless kicking and shoving rather than a mutually agreeable settlement.

When a water geyser sprung a small hole – small as in a couple of drops every five minutes of so – in the middle of a Cape drought, it seemed the right thing to do to replace it as the hole couldn’t be repaired and would simply expand over time.

But then, the new geyser malfunctioned the first night it was installed, causing extensive water and hot steam damage to two adjacent rooms.

It took the insurers three months to settle the damage claim from the effects of the faulty geyser, creating huge stress and physical discomfort, even going against their own loss adjuster’s (assessor) proposal.

Insurance companies don’t seem to mind creating the impression during their first stab at resolving a claim that they assume the customer is a crook who has submitted dodgy facts. They will kick and slap you down, argue the toss, refer to clause XYZ of the agreement you signed which exculpates them of the obligation you think they have, blah blah blah.

My biggest challenge, however, was getting the insurance company to provide me with a copy of the assessors’ report into the damage claim. This was declined on the basis that the report was prepared for the insurance company and not for me. Fair enough, but it was based on information directly related to our household. Surely POPI (the Protection of Personal Information Act) applied?

Why did I want the report? Because in it, the assessor had given fair and favourable leeway in my favour in respect of what settlement offer the insurers should make to me.

The insurance company, Commercial and Industrial Acceptances or CIA, adamantly refused to provide the assessor’s report, with national claims manager, Wentzel van der Merwe, running to POPI as a reason why they could NOT release information – about me – to me. Even a request via the Promotion of Access to Information Act (PAIA) did not budge them.

He claimed that since I had “litigation in mind” (I had not), the loss adjuster report was a privileged document. He noted (with no sense of irony) that I would have to litigate if I wanted access to the report.

Despite his flawed interpretation, the corporate bully had me by a short thread: either I accepted his attitude or risked spending huge sums in going to court to force him to give me the report.

I chose not to accept the bully-boy tactics, and simply stood my ground, securing a reasonable settlement.

It took two months of backwards and forwards, and heated exchanges across a boardroom table with CIA’s Jimmie Louw, before the insurer agreed to settle, more or less in line with what the assessor had proposed.

Bizarrely, the industry body, the Institute of Loss Adjusters of Southern Africa, supported the view that assessor reports could not be released without permission of the insurance company. A clear case of knowing which side your bread is buttered.