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Vehicle inspection as part of the car insurance claims process

What you need to know about car insurance claims

Car insurance claims are critical to the insurance process, ensuring you receive financial protection in times of need. However, navigating these claims can often be a complex and frustrating experience. One primary reason for this complexity is the inherent differences among insurers, each with unique claim processes and policies. Understanding these differences is essential for every car owner seeking to secure timely and fair treatment in the event of an incident.

While insurance aims to provide timely financial support, you may need help processing claims, leading to frustration and uncertainty. These delays can disrupt business operations, cause inconvenience, and erode trust in the insurance system. Insurers’ varied approaches to claim processing contribute significantly to these challenges.

Insurers have specific duties in processing claims rooted in the principle of good faith. They must promptly investigate and assess claims and communicate decisions transparently to the insured. However, the nature, complexity, and value of claims may lead to variations in the time to finalise them. Despite this, insurers must uphold their responsibilities to ensure fair treatment for their clients.

Similarly, as an insured individuals, you bear responsibilities in the claims process. It’s in your best interest to cooperate with insurers, providing the necessary documents and information without obstructing investigations. However, you do also have the right to challenge unreasonable requests from insurers, ensuring your rights are protected under good faith.

In cases where insurers fail to fulfil their duties promptly, insured individuals have legal recourse. You can seek the assistance of the ombud or court intervention to compel insurers to expedite claim decisions and hold them accountable for undue delays. Legal representation can be instrumental in navigating these processes and ensuring that you receive the timely and fair treatment you deserve.

Every insurer operates differently with its policies and procedures, so car owners must know these nuances when dealing with insurance claims. By understanding the intricacies of your insurer’s claim processes, you can better navigate the claims journey and secure the support you need in times of adversity. This article aims to provide valuable insights into car insurance claims, so you can make informed decisions and safeguard your interests effectively.

Challenges of delayed insurance claims

Many motorists often feel frustrated by unexplained delays in their insurance claims. This waiting period can be exasperating, as it may lead to loss of business, inconvenience, and uncertainty about when the claim will be resolved. Such delays seem contradictory to the primary purpose of insurance, which is to provide timely financial protection in times of need. Understandably, insured individuals may feel compelled to seek legal advice only after their claims are rejected, often due to a lack of awareness or financial constraints hindering them from pursuing legal avenues promptly. ¹

Duties of insurers in claims processing

The duties of insurers play a crucial role in the claims process. While insurers are not obligated to finalise claims immediately due to variations in nature, complexity, and value, they must promptly investigate claims. This duty is rooted in the principle of good faith, which underpins all insurance matters. Insurers must also assess claims promptly, make decisions (approve or reject), and communicate these decisions to the insured. Transparency and timely updates are essential when facing delays and complications in the claims process. ¹

Responsibilities of insured individuals

Similarly, insured individuals have duties under the principle of good faith. They must refrain from obstructing claim investigations, promptly provide necessary documents and information, and cooperate with reasonable insurer requests. However, you have the right to challenge unreasonable requests from insurers, as such actions may be deemed bad faith. ¹

Legal recourse for undue delays

Legal recourse is available in cases of unreasonable delays by insurers. Insurers acting in bad faith or breaching their duty to treat clients fairly may face legal or regulatory consequences. You can seek the intervention on an ombudsman or court intervention to compel insurers to make decisions within a specified time. Depending on policy terms, insured individuals may also claim special damages for financial losses resulting from delays. In court proceedings, insured individuals may request punitive costs to hold insurers accountable for undue delays.¹

Ensuring timely and fair treatment

So now you know that while insurers are expected to wait to finalise claims, they must investigate claims promptly and communicate decisions transparently. You should cooperate with insurers while still challenging unreasonable demands. Legal recourse is available for insured individuals facing undue delays, and seeking legal representation can expedite the resolution of delayed claims. By holding insurers accountable, you can ensure timely and fair treatment in the claims process. ¹

Disclaimer

The article aims to provide South African motorists with what they need about car insurance claims.

Are you thinking of buying a new or used car? You will need comprehensive car insurance to finance your future vehicle purchase. Get a quote for affordable car insurance with PMD, with fixed premiums*, reducing excess*, and excellent service today. T’s and C’s apply.

Please get professional financial advice from a certified financial advisor to ensure you select the appropriate financial services product.

Sources

  1. https://www.adams.africa/mtho-maphumulo/what-is-the-legal-position-regarding-insurance-claims-that-take-long-to-finalise

Internal links

  1. https://prime.co.za/news/peace-of-mind-with-cheap-car-insurance/
  2. https://prime.co.za/terms-of-use/
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