When an insurer rejects a claim, they may be relying on not just the wording of the insurance policy in question, but how this wording is applied to the facts of the case. This can lead to unhappiness and frustration for consumers, especially when they believe that they have been treated unfairly.

When reviewing complaints here at the NFO, we look at not just strict contractual questions, but also the more elusive issue of fairness. For example, an insurer may be technically correct to reject a claim, but it is also vital that they explain exactly why they did so. This can be particularly important in cases where the loss did not result from immediate events, but from some underlying cause.

Visit our Newsroom page to read an FA News article on this topic: https://nfosa.co.za/newsroom/