A homeowner was offered a “bitter sweet” financial settlement following mediation after he complained to the Office of the Ombud for Financial Services Providers (FAIS ombud) that an insurer had rejected his claim after his house burnt down.
The FAIS ombud said in a statement that in all instances when it receives complaints, it strives to resolve them in a “procedurally fair, informal, economical and expeditious manner”. This means the office explores all avenues before proceeding to formally resolve a complaint by means of a determination.
Even in instances when a dispute is solved through conciliation, the ombud’s office highlights the pertinent points that led to the dispute, or dereliction of duty on the part of the service provider.
In the case of the homeowner, the issue was that the insurer did not disclose material conditions and, in this case, exclusions to cover, prior to the policy being taken out. The homeowner accordingly claimed not to have been aware that he should have notified the insurer of additions built onto his home.
Despite the insurer making an offer, the ombud pointed out that because the offer was R800,000 — the office’s jurisdictional limit — the result was “bitter sweet” as the damages initially claimed totaled R1,495,040.