Icon

Directory

IconAccounting & Tax
IconActuaries
IconAdministrators
IconAppraisers & Valuers
IconArbitration Services
IconASIB
IconAssessors & Loss Adjusters
IconAssist and Lifestyle Benefits
IconAssociations & Institutes
IconAuditors
IconBBBEE Consulting and Verification Agencies
IconBroker Acquisition Financing
IconBrokers for Brokers
IconBusiness Process Management
IconBusiness Process Outsourcing
IconCall Centre Outsourcing & Sales
IconCompany Secretarial Services
IconCompliance
IconConsumer Protection
IconCorporate Governance
IconCredit Bureaus
IconDebit Order Collection Facilities
IconDefensive Driver Training
IconEducation and Training
IconEmergency Medical Rescue
IconFAIS
IconFire, Storm, Flood Damage Specialists
IconHuman Resources
IconIndustrial Cleaners
IconInformation Technology and Software Partners
IconInsurance Companies
IconLegal
IconLightning Damage & Surge Protection Specialists
IconNiche Insurance Products
IconOmbud
IconOutbound Sales
IconOutsourcing Companies
IconPolicy Administration
IconPremium Financing
IconPublic Loss Adjustors
IconPublications
IconRating Agencies
IconReference Books & Material
IconRegulatory Authorities
IconRisk Finance
IconRisk Management
IconRisk Surveyors
IconSalvage Operators
IconSpecialized Claims Investigations & Assessing
IconSurveys and Research
IconTraining Courses & Workshops
IconUnderwriting Managers
IconVehicle Accident Management
IconVehicle and Household Risk Inspection Services
IconVehicle Tracking
IconWellness Programs
IconWholesale Brokers
IconZZZZZZ
Image
  Subscribe To »

Pick the right Ombud

Published

2017

Fri

11

Aug

 

This case reminds me of a Dennis the Menace cartoon where he walks up to his dad and says: “Pick a card – any card.” Dad picks a card and Dennis says: “No, not that card.”

It is amazing how two Ombuds can have such divergent views on the same matter.

We have often in the past expressed concern with the Ombud’s 20/20 vision in hindsight, particularly when it comes to disclosure of material terms. In most instances where it was the word of the client against that of the adviser, the benefit of the doubt went the way of the client, despite documentary proof to the contrary.

This same issue arose in a case mentioned in the latest Short-term Ombud’s annual report.

Background

This was a classic case of a seller being swindled out of his vehicle by means of false proofs of payment and intimidation, the end result of which was the handing over of the vehicle and the registration documentation. The true facts were only discovered the next day.

In his complaint to the Ombud, the insured, Mr. G, submitted that he did not receive the policy wording from the insurer and that he was unaware of the relevant terms and conditions. Further, he argued that his broker did not do enough to ensure that he was aware of the policy terms and conditions.

The insurer asserted that Mr. G’s broker had indicated that the policy wording was furnished to Mr. G via registered post at the inception of the policy. The insurer also attached a welcome letter where it was stated that cover provided was subject to certain exclusions which should be perused by the insured. Proof that the documents had been sent by registered post was provided to this office by the insurer. A record of advice was also furnished from the insurer indicating that Mr. G was informed of important information contained in the policy including the policy exclusions.

The Ombud found that as the policy excludes theft under false pretences, there was no cover for this loss. The Ombud also found that there was sufficient evidence to prove that the policy wording was provided to Mr. G’s broker and that Mr. G’s broker advised that the policy terms and conditions were explained to Mr. G.

Consequently, the Ombudsman found that the insurer’s rejection of the claim could not be faulted and the rejection was upheld.

To misquote Dennis the Menace: “Pick an Ombud, any Ombud. No, not that Ombud.”

 
Source: Paul Kruger: Moonstone Compliance (Pty) Ltd
 
« Back to previous page Print this page » |
 

Breaking News »

Headline Risks: Seeing the big picture

By Dale Cooper/The Risk Doctor Partnership Risk assessments are often undertaken in detail, or several assessments are conducted in different parts of an organisation, project or program. Detail may be appropriate ...
Read More »

  

Hong Kong: Concerns Despite Robust Growth

By Coface, the international trade credit insurance company GDP figures show that Hong Kong’s economy expanded by 3. 8% Y-o-Y in Q2 (1. Rising asset prices and strong consumer spending, backed ...
Read More »

  

What compliance needs to know about data privacy

James George, Compliance Manager, Compli-Serve SA You don’t have to be a tech-savvy computer boffin to address the basics of data privacy. Like many areas compliance departments oversee, asking the right ...
Read More »

  

Catastrophes cause global total economic losses of USD 44 billion

Zurich: According to preliminary Swiss Re sigma estimates, global total economic losses from natural catastrophes and man-made disasters in the first half of 2017 were USD 44 billion. That was well below the first ...
Read More »

 

More News »

Image

Healthcare »

Image

Investment »

Image

Life »

Image

Retirement »

Image
Image
Image
Image
Image
Image
Image
Image
Image
Image
Image
Advertise Here

From The Glossary »

Icon

Asset Backed Securities:

Securities issued on the basis that the value of the security is backed by the value of an underlying asset.
More Definitions »

 
 
By using this website you agree to the Terms of Use.
Copyright © Stoker Risk & ICT (Pty) Ltd 2004 - 2017.
All Rights Reserved.
Icon

Advertise

  Icon

eZine

  Icon

Contact IG

Icon

Media Pack

  Icon

RSS Feeds