Page 12 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

General Procedures
The Ombudsman's o ce assists consumers with the following Personal Lines short-term insurance:
8.5.1 Motor
8.5.2 Buildings
8.5.3 Householders (Contents)
8.5.4 Cell phone
8.5.5 Travel
8.5.6 Disability
8.5.7 Credit protec on insurance
8.5.8 Commercial Insurance on a Limited basis, i.e. claimants such as small businesses, including a sole proprietor or trader, a juris c person, partnership or trust that has had a turnover in the last nancial year of less than R25 million (twenty ve million Rand).
8.6 When a claim has been rejected, and the Insured has approached the Ombudsman
8.6.1 Hollard's legal division will be no ed of the Ombudsman complaint via the Ombudsman's o ce.
8.6.2 The complaint will be noted on the legal system.
8.6.3 Should further informa on be required by the legal team in order to formulate their response to the Ombudsman, contact will be made to the Broker's o ce.
8.6.4 The merits of the claim and the rejec on will be discussed between the legal team and the Ombudsman.
8.6.5 Should the Ombudsman rule in the Insured's favour and determine that the claim should be se led:
8.6.5.1 Hollard will advise you of the decision
8.6.5.2 se lement will be requested
8.6.5.3 proof of payment needs to be sent to Hollard in order to forward to the Ombudsman in order for them to close their le.
8.6.6 Should the Ombudsman rule in Hollard's favour, the le will be closed and prescrip on will con nue to run on the claim. The Insured needs to issue summons on Hollard before the prescrip on period ends.
9. CATASTROPHE CLAIMS
In the event of a major event giving rise to a large amount of claims being submi ed for the insured perils of Fire, Storm, Hail, Flood, etc., a register of the individual claims has to be completed for reinsurance purposes. A catastrophe claim, in terms of Hollard's current trea es, will normally include FST ac vi es over a period not exceeding 72 (seventy two) hours, and where it can be regarded as one weather pa ern.
Hollard will communicate iden ed catastrophes.
10. SASRIA CLAIMS AND PROCEDURES 10.1 General
10.1.1 All claim no ca ons and document submission must be done on the Customer Web Portal (CWP) for all companies on the CWP system otherwise by email to claims@sasria.co.za
10.1.2 Claims must be submi ed to Sasria SOC Limited (Sasria) by the Non-Mandatory Intermediary (NMI) or Broker and where the broker has submi ed a claim, the underlying insurer must be copied.
10.1.3 NMIs are to submit poten al Sasria claims within one month of being no ed of the claim. Late submission of claims may a ract penal es.
10.1.4 Minimal informa on may be u lised to no fy Sasria of a claim; however, all relevant claim documents are required in order for Sasria to make a decision on liability.
10.1.5 All claim documents required to proceed with a claim must be submi ed to Sasria without delay.
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Binder Claims Mandates and Guidelines – 2015/2016