Page 14 - Claims Binders Mandates and Guidelines

General Procedures
claimant be dissatisfied with the outcome/rejection of the claim. The Hollard Insure complaint process and contact details are contained in the policy disclosure notice. In the rejection letter, the Hollard Insure complaints contact details, the internal adjudicator details, as well as the details for the Ombudsman for Short-term Insurance should be noted. The claimant should be encouraged to first engage with Hollard Insure.
8.5 The binder holder needs to keep evidence on record.
8.6 The binder holder notifies other interested parties, for example, a contractor and panel beater.
8.6.1 If the vehicle is salvage/burnt-out or stolen, the relevant registers are to be updated.
8.6.2 If the vehicle is with a repairer or salvage contractor, the claimant and/or the finance house must be advised to collect the vehicle. The towing and storage costs will be for the account of the claimant, and the contractor must be advised of this urgently in writing by email.
You, as the binder holder, may remove the estimates once the claim is rejected. The claim may be finalised after the prescriptive period. For personal lines business, and business subjected to PPR, the minimum period prescribed under the PPR for representation to the insurer is 90 (ninety) days after the decision has been made. The 90 (ninety) days may not be included in any time-barring period contained in the policy for institution of legal action. The claimant can make representation to, or lodge a complaint with the insurer within 90 (ninety) days. Where the dispute remains unresolved, the policyholder then needs to institute legal action within the time period stipulated in the policy wording. This is usually a period of 180 (one hundred and eighty) days. Most policies therefore have a time bar period of 270 (two hundred and seventy) days in total.
If the commercial policy is governed by the PPR (this is where the claimant company has a turnover of less than R2 000 000 (two million) per year) then the time bar will be the same as personal lines policies which is the 270 (two hundred and seventy) days.
If it is not governed by PPR it will be governed by the time bar clause in the relevant policy wording. This differs from policy to policy and is normally 6 (six) to 12 (twelve) months, but each wording would need to be checked.
8.7 Ombudsman procedure
The Office of the Ombudsman for Short-term Insurance provides consumers with a free, efficient, and fair dispute resolution mechanism. It offers consumers a “no risk” mechanism to resolve disputes with insurers.
The Ombudsman's office assists consumers with the following personal lines short-term insurance:
8.7.1 Motor
8.7.2 Buildings
8.7.3 Householders (Contents) including All Risks
8.7.4 Cell phone
8.7.5 Travel
8.7.6 Disability
8.7.7 Credit protection insurance.
8.8 There is no limit in terms of annual turnover relating to jurisdiction on complaints received by the ombudsman.
8.9 When a claim has been rejected, and the claimant has approached the ombudsman:
8.9.1 Hollard Insure's Customer and Broker Experience team will be notified of the Ombudsman
complaint via the Ombudsman’s office.
8.9.2 Should further information be required by Hollard Insure's Customer and Broker Experience team in order to formulate the response to the Ombudsman, contact will be made with the binder holder’s office.
8.9.3 The merits of the claim and the rejection will be discussed between the Customer and Broker Experience team and the Ombudsman.
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Claims Binder Holders Mandates and Guidelines – V6: 2022