ST INSURANCE
BROKERS TRUST

Claims Procedure

As a valued client, we at ST Insurance Brokers Trust are committed to providing the best claims service to you. In order for us to be effective in this area, we need to establish a specific claims procedure to ensure that your claims are handled efficiently and timeously.

Firstly, it is of the utmost importance that you understand the policy that has been issued on your behalf. Note the relevant covers in place and ensure that you have acquainted yourself with the policy terms and conditions. Most sections of the policy carry a first amount payable or an excess for which you are responsible. In the case of Motor claims where you were not the guilty party, the excess or first amount payable remains your portion of the claim. Your policy schedule should be read in conjunction with the policy wording. If you no longer have a copy of the wording, you may request another from us and we will provide you with same.

Secondly, when reviewing your policy, you should ensure that the values or sums insured represent full replacement value. The Insurers will apply average in the event of a claim should you prove to be under-insured. Average is not applicable where cover has been arranged on a first loss basis. Please note that Glass cover is also subject to the average clause and it is important that the cover in place is sufficient.

We must also point out that where buildings are insured on the policy, such buildings must be maintained at all times. Claims can be repudiated due to poor maintenance. Remember that no policy will cover you for any structural damage not caused by an insured peril. Subsidence and Landslip cover is not automatically included. Should you require this cover, most Insurers will insist on an Engineers Report or a Geological Survey before granting cover. If cover is granted, then a specific excess will be applied and you need to ensure that you are aware of the excess for this cover. Roofs and gutters should be checked on a regular basis. Further, electronic gates and motors, electric fencing, signage and awnings are not automatically included in the cover unless your Insurers have been advised that these items are included in the sum insured. Please revert to us should these items need to be included on the policy, if not already included. With the exception of Houseowners insurance on a personal policy, geysers are not included automatically under a Commercial policy – Fire or Building Combined sections. If you want to include cover for geysers you need to advise us of the number of geysers and a value for each. If you do not advise us, there is NO COVER.

Where items have been more specifically insured under the All Risks section, it is important to note that these are usually high valued items and in most cases, the Insurers will require proof of purchase or valuation certificates. Where available, serial numbers should also be provided. Items such as cell phones, firearms, bicycles, expensive sunglasses, sporting equipment and jewelry items should be specified on the policy. Computers must be separately noted on the policy, as they are regarded as high risk items and attract a higher premium. Please advise us if you have a computer which should be included on your domestic policy.

Laptops and mobile phones are high risk items and these must always be specified on the policy in order to enjoy any cover. Business computers should be insured under the business electronic policy. When adding computers or any electronic equipment, models and serial numbers must be provided. Please note that there is no cover for wear and tear, electrical or electronic breakdown on electronic equipment. Further it is a condition on the policy, that items in a vehicle need to be stored out of sight, preferably in a locked boot. There must be forcible entry into the vehicle, otherwise Insurers will reject the claim. “Jamming”devices that miscreants use to gain entrance to vehicles are not considered by the Insurers as a valid reason for entrance – due care must be taken to ensure the vehicle is secure.

Accidental damage cover is also not automatically included on any policy. Please advise us should you require this cover. Most policies give no or include very limited cover and we suggest that if you have items of high value that can be accidentally damaged, you consider including this cover, especially on domestic policies.

Should theft cover be applicable on the policy, it is important that the Insurers conditions are met. If a burglar alarm is a requirement, it remains your responsibility to ensure that the alarm is in working order at all times. Regularly check with your service provider that a signal is being sent through. We suggest that you check the system at least every two months. If there has been lightning in the area, we also advise that you ensure that the alarm is still working. A maintenance contract should also be in place if an alarm system has been installed. Insurers will require proof of activation should a burglary occur whilst the premises are un-occupied.

Where vehicle insurance is applicable, it is important to note that all vehicles insured should be in a roadworthy condition. After an accident the assessor will normally check things such as tyre tread and brake efficacy. Such vehicle should also be licensed in accordance with the Road Ordinance Act. All drivers of vehicles should also be licensed to drive such vehicle. In general, vehicles with a value in excess of R200 000.00 should be fitted with an approved tracking device. Such device should also be tested annually by the service provider, to ensure that a signal is being received. In the event of an accident or service repairs, it is also recommended that the device be tested. Vehicles with a value in excess of R50 000.00 should be fitted with an approved VESA gearlock or an approved immobiliser/alarm. Tracking and Gearlock certificates must be forwarded to your Insurers and we suggest that if this has not yet been attended to, you do so immediately to prevent any possible disputes in the event of a claim. Should you be unsure of the security requirements currently applicable on your policy, please contact our offices and we will be happy to advise you of same. Please also remember that the Insurers can apply betterment on a claim i.e. if the tyres were worn and now need to be replaced, the Insurers will deduct proportionately an amount for the used tread. They will not replace a used tyre with a brand new tyre.

Please also be advised that if you are involved in an accident, you ensure that the vehicle is still drivable before leaving the scene of the accident. Insurers will not cover mechanical damage which resulted after the accident, as it is your responsibility to prevent any further losses. It is therefore important that you check for example that there are no water/ oil leaks that could lead to engine damage and so forth. If you are not sure, rather have the vehicle towed away.

All possible claims should be reported to our offices immediately in order that we may advise your Insurers. Claims must be reported within 30 days of an incident. A claim form should be completed in full and signed for onward transmission to your Insurers. Should you have difficulty in completing the claim form, we will be happy to assist you. In most cases the Insurers will not attend to a claim until they are in possession of the claims documentation, so it is imperative that you attend to this immediately to prevent any possible delay. Documentation can be faxed or e-mailed through, however, in some instances the original documentation will be  required before the claim will be settled. We cannot complete the claim form on your behalf.

We also draw your attention to the fact that all motor claims, burglary and related losses should be reported to the S A Police within 24 hours of the occurrence. We will require full details in this regard, including the case number and the police station the incident was reported to. Storm damage and windscreen claims do not have to be reported to the police.

All motor and windscreen claims must be accompanied by copies of the drivers identity document and drivers licence. At least two quotations are required on motor claim repairs, unless the vehicle cannot be driven. Assessment of vehicles can only take place at a Panelbeater and we ask that you advise us as to when and where the vehicle will be available for assessment. Please note that some Insurers have a panel of repairers which are approved by them and they will then insist that the repairs be carried out by their panel. Should you however decide on your own panelbeater, the Insurers will not accept any liability for poor workmanship and will in fact require that you release them of any responsibility regarding repairs.

Should an accident not be your fault, the Insurers will attempt to recover the damages from the other party, including the excess you might have paid. This however is not a given and if damage to your vehicle is not significant the Insurers may not proceed against the other party, given the cost of litigation.  If the accident is your fault, NEVER ADMIT LIABILITY, simply give the other party your insurance details. In the event that the Insurers find that blame can be apportioned to both parties then they will not refund the excess.

Where a vehicle is stolen and recovered later, even if the Insurers have paid your claim it remains your responsibility to assist the S A Police in identifying the vehicle as yours. This might require you to travel a distance, however, most Insurers will cover the cost of travel and accommodation if necessary. Their approval must however first be obtained.

Commercial/ Corporate Business must especially be aware that with the passing of the Consumer Act through Parliament, it becomes extremely important to review the Liability covers in place and to consider either increasing the Liability covers or obtaining additional covers as the need may be. Insurers have developed a number of Broad Form Liabilities which can be included on your policy. Consumers will become more aware of their rights going forward and it is therefore important that you review the risk you are exposed to and try to limit the risks accordingly with the various Liability covers available. If you are unsure of the cover you require, please contact us and we can investigate what covers are required for the type of business you are in. We also advise that Disclaimers do not always reduce the risk of exposure to a Liability claim. Most Liability quotes will require the completion of a questionnaire before being submitted.

Fire, lightning, storm/ water damage, burglary claims including money losses, electronic equipment and business all risks claims must be submitted with a property loss claim form, together with quotations for replacement/ repair of stolen/ damaged items. In all instances, the proof of a claim remains your responsibility, which may be in the form of purchase invoices, till slips, copies of cash book entries, copies of driveway slips, instruction manuals etc. Claims in excess of about R10 000.00 will usually be investigated by an assessor, who will normally reach an agreement with yourself regarding the settlement. His report will then be forwarded to the Insurers for final decision and payment of same.

All glass and windscreen claim forms must be submitted with a glass claim form. An original invoice will be required for settlement. You may in both instances replace the glass/ windscreen at your own cost and then submit the claim to us for settlement. Should you use P G Glass or Glasfit, they will normally obtain authorization directly from the Insurers and will then only levy the excess due on such claim. They will also complete the necessary documentation with you.

We trust that the above information assists you with regards to claims submissions. Please be assured that we are more than happy to support you with regard to any claims submitted. As your Broker, we believe that in the event of a claim the value of our service becomes apparent and therefore, even in a dispute on a claim we will attempt to assist and support you where necessary. Obviously, insurance cover cannot be purchased for every type of loss which could occur and it is therefore very important that if you have recognized a possible risk that you advise us of same in order for us to establish whether there is cover in the market for such a loss. Whilst we try to understand the type of business you run, we cannot always identify the risks with which you are faced and therefore will always require your input in this regard. It remains your responsibility to check the covers on your policy and to contact us should you have any queries regarding the cover arranged on your behalf.

Please also remember that if the risk changes in any way that you advise us immediately as this could have an impact on the cover provided – e.g extensive renovations or the property being unoccupied for more than 30 days. Insurers could decide to restrict covers or place additional excesses on the policy. Failure to advise us of any change in the material risk will be regarded as non-disclosure. Also remember that if you change your physical address, you advise us immediately. Your cover and premium is based on the address we have on file and if you do not advise us that you have moved, you will not enjoy any cover at your new address.                                                                                                     

On the anniversary date of the policy, you will be presented with a summary of insurance. At this time it is important to review existing cover and if necessary add additional covers. It might be that affordability was paramount when initially obtaining insurance and certain covers were either not required or affordable at the time. As the business grows it might be necessary to obtain additional cover as the exposure to certain risks might increase or new risks might become apparent. If at anytime you are unsure of cover in place, please contact us and we will advise you accordingly. Further, renewal also presents an opportunity to adjust the vehicle values where applicable.

Please note that the most Insurers will pay out in the event of a claim is the current retail value at the time of the loss. It is therefore in your interests to adjust vehicle values at least once every year. When adjusting the values you should consider the condition of the vehicle, the mileage travelled and any extras fitted to the vehicle that are not standard. We cannot adjust the vehicle values automatically as we may not have all the information required to do so, however, the issue will be raised at each renewal and your feedback in this regard will be required, as well as your confirmation that the values can be adjusted.  We take no responsibility should your vehicle be over or underinsured if you have not instructed or confirmed that we may adjust the value. The value we use is based on the limited information we have on your vehicle, using the Mead & McGrouther Dealers Digests. You will always be given a Renewal Authority, which you should sign and return to us. Should you not submit this signed document to us, we will assume that you have and that you are in agreement with the renewal documentation presented to you.

Please note that as the Insured, you must at all times remain aware of the risks that you are exposed to and to take the necessary precautions/ due care in the safe-keeping of your insured assets. Further, your policies will be monitored from a claims point of view and you could be penalized should your claims statistic be considered unfavorable. Premiums and excesses can be increased and in some instances, the Insurers might find the risk un-acceptable and will cancel the cover/ policy.

Please also remember that all instructions to us be communicated in writing. We cannot amend your policy in anyway if we have not been instructed to do so, in writing, by you.

All claims forms are available in our offices and these can be posted, faxed or e-mailed to you.

Should a dispute arise regarding a claim and you wish to persue the matter on a higher level, you may contact the Insurance Industry Ombudsman. Detail as follows :

Tel : 011 -726 8900 or 0860 726 890

Fax: 011 – 726 5501

E-Mail : info@osti.co.za

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