KHAYA SITHOLE: Illogical reasoning is at the heart of insurance disputes
The legalese of contracts is much better understood by insurers than by clients
Over 10 years ago, my Friday morning ritual consisted of a 6am drive to the headquarters of Outsurance for the weekly “claims meeting”.
The meeting was designed to enable claims advisers to table “grey-area” claims for deliberation. These claims would ordinarily have been rejected based on the static reading of the insurance contract. A person who claimed to be living in a gated estate when they lived in something rather different would — based on the reading of the contract — see their claim rejected with no recourse...