I had an unpleasant referral to the Ombud for Short term insurance involving my vehicle being written off when involved in an accident.

From the onset one could pick up that the claims handler was leaning more towards repudiation than actually resolving my claim.

This was confirmed after them appointing a so called accident reconstruction expert.

All information was made available from to onset by the insured but the insurer found all excuses.

This was my reality when an Assistant ombud made a ruling in favor of the insurer quoting case law not related to the event or even close to the event. All what the case law pointed out was that the onus was on the complainant to prove the case.

The same information was then used to escalate the matter and the escalation committee without prosecutoral powers made a ruling in there review recommendation in favor of the insured.

Again giving the insurer a chance to dispute sequence of events and even provide more information that they claim was not used or introduced on an earlier occasion.

The Ombud then accept that evidence and use it to support the insurer’s version of events.

That was despite the insured pointing out that the information was just recycled and did not bear or has any impact on the claim in question.

The insurer even responded on their letterhead with dates before the actual review report was released and the Ombud agreed with them even though they are in a professional corporate environment.

Now the question is what is the rationale of sharing and making information available to the Ombud if they already decided on the outcome?
Will the public even be protected or assisted by the ombud.
Do they even review all evidence and just rely on the version of the insured.

Big business knows that litigation would and could be a very expensive exercise and with the help or lack of it from the Ombud they can circumvent such a process knowing full well that the Ombud will make a ruling in their favor, frustrating the complainant.

One would not always expect a positive ruling but one would want to look at a thorough process where all documents are inspected and all evidence evaluated.

Would you get such help from an instution that’s supposed to be an alternative form of dispute resolution?

Will the Ombud really be there for the complainant?

I can bet my bottom dollar, you won’t get such an assistance.

Would appeal help – definitely not as one would not want to be seen overruling ones own.

SO many questions… SO little answers…