Pick the right Ombud
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.
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.”
Paul Kruger: Moonstone Compliance (Pty) Ltd
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