A Pretoria business consultant was shocked when his insurance rejected his claim and instead slapped him with a R15,000 storage and car hire bill after his Land Rover caught fire.
Leon Mbangwa, 59, of Kammeldrift East, is taking iWYZE to court in a bid to recoup the money he has lost as their client of just over a year. The Ombudsman for Short-term Insurance (OSTI) has recommended the matter be heard in court as Mbangwa argues that the investigation was not done so properly and that the insurer prejudiced him.
Mbangwas’s problems started in April when he, his son and nephew were driving on Moloto Road from a graduation ceremony in KwaMhlanga, Mpumalanga. His son was driving the vehicle when other motorists flagged them about flames coming underneath the car.
His son stopped the vehicle immediately and they tried to put out the fire, which had spread to the engine. A truck driver stopped and used his fire extinguisher to eliminate the blaze but it was too late as most of the engine was burnt. The insurance towed the vehicle to a garage in Silverton, Tshwane and then moved it to another in Bronkorspruit.
The incident happened on a Saturday night and Mbangwa submitted the insurance claim on Monday, April 25. The insurer rejected the claim on the grounds of “mechanical breakdown/failure, wear, tear and breakdown (policy exclusions) and due care and precaution”.
It further said the driver should have stopped the vehicle immediately when the warning lights came off from the dashboard.
“It is also the insurer’s view after considering all relevant circumstances, facts and compared the incident driver’s behaviour to a reasonable person’s behaviour that the driver failed to take due care and/or precaution to prevent the loss sustained in this incident,” read the letter from the insurance.
Mbangwa said it took the company 50 days to inform him of the outcome of his claim.
“In the first 30 days I was accorded a car hire, which is a benefit I paid for in the policy agreement. Upon expiry of the benefit on May 26, I returned the hired car and hired one at my expense. Surprisingly, I have been informed by the insurance after the rejection of my claim that I owe them R14,574 I must pay to Auction Nation for car hire costs, towing and car storage,” said Mbangwa.
He said he found this unfair as he was not involved in any discussions pertaining to the rates of the hired car, appointment of the towing truck and determination of the garage the car had to be stored in. He paid the bill nonetheless but his problems were far from over.
The report from the insurance declared the vehicle as “beyond repair” and the fire specialist report said the fire was a mechanical fault, which the specialist blamed on lack of regular service, said Mbangwa.
“I was not given a copy of the report and was never privileged to access and comment on it before adoption by the insurer on such a major decision which affects our relationship. I was not accorded an opportunity to appoint my own independent specialist accredited by Land Rover.
“The specialist credentials, tools and Land Rover accreditation are not known to me. My vehicle was serviced religiously at Land Rover. Land Rover’s involvement in substantiating the cause of the incident could have been convincing,” said Mbangwa.
“First, it took over 35 days for the insurer to appoint a fire expert. During all this period the vehicle was moved three times over an average of 30km on each occasion. I was never told that or informed that I should also come with my own independent fire forensic specialist,” he argued further.
After the impasse with the insurance company, Mbangwa lodged a formal complaint with the Omsbudsman’s office, whose outcome he received last month.
It said iWYZE was at liberty to choose any service provider to validate the claim and it also noted Mbangwa’s dissatisfaction at not being told on time to appoint his own fire specialist immediately after the claim was made.
“Having considered the submissions made by both parties and the expert report, we find that the expert’s opinion regarding the warning signals on the insured vehicle is unsubstantiated, therefore, the insurer’s decision to reject the claim on the grounds of due care and prevention of loss is not justified,” said the ombudsman’s office in its ruling.
“We wish to point out that the issues raised by the insured are service related, and as such, they fall outside the jurisdiction of our office. Furthermore, we are of the view that the insured’s contention regarding the findings of the insurer’s expert and his credibility and/or his credentials can only be ventilated in a court of law, by means of cross examining the expert to address the issues in doubt in his report. OSTI has a limited adjudicative function and does not have the power to hold a formal hearing,” said OSTI.
Mbangwa warned motorists that comprehensive insurance is not a guarantee that the insurer will honour their end of the deal.
“Insurance companies should also not hide the process of evaluating a claim. It must be an open process,” he said.
iWYZE Response:
We can confirm that we recently closed a claim regarding the insured’s vehicle catching fire. The matter was also taken to the Ombudsman for Short-term Insurance (OSTI) and iWYZE’s decision was upheld by the OSTI. The file was closed on the 31st of October 2022. We appointed an independent forensic specialist to investigate, who found that the fire was caused by a mechanical breakdown and/or a wear and tear. A defective pipe leaked diesel on the exhaust, which ignited the fire.
The customer’s policy excluded cover for incidents caused by these events. The unfortunate reality is that regular car services do not completely mitigate against these risks.
In addition, the customer’s policy terms are such that for non-valid claims the customer will be liable for towing and storage fees. The customer had a car hire benefit and after its expiry, this cost was for the customer’s account. This was confirmed in the claim outcome letter.
Key extracts of the specialist report were shared with the customer.
consumer@sowetan.co.za
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