KHAYA SITHOLE: Illogical reasoning is at the heart of insurance disputes
The legalese of contracts is much better understood by insurers than by clients
08 July 2020 - 15:36
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...
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