Mr Goshai submitted a claim to IUM on 9 March 2022 following a single-vehicle accident which occurred on 6 March 2022. Following the notification, IUM on the same day appointed an assessor to investigate the loss, who confirmed the following in his report:
CCTV footage obtained from the accident scene intersection confirmed that Mr Goshai, on the day of the incident, was stationary at a red traffic light in the right-hand turning lane on Marine Road at the intersection of Marine and Blaauwberg Road.
When the traffic light turned green for vehicles to proceedstraight in both directions, Mr Goshai accelerated harshly while turning right in order to cross the intersection before the on-coming traffic.
Mr Goshai then lost control of his vehicle and collided with a street pole resulting in the single-vehicle accident. The CCTV video footage evidences that Mr Goshai acted recklessly by cutting in front of on-coming traffic when he was not entitled to do so.
Further, investigation revealed that Mr Goshai, on his own version, had consumed alcohol during the course of the day and witness statements obtained by the assessor confirm that Mr Goshai appeared intoxicated after the Incident.
IUM, as a consequence of the investigation, validly rejected Mr Goshai’s claim on 12 April 2022, one month and three days after notification, on the basis that Mr Goshai failed to comply with his duty of care, in accordance with his policy wording.
Put differently, an Insured is expected to take all reasonable care to prevent or minimize loss, damage, and liability. Considering the facts, Mr Goshai did not take reasonable care to prevent or minimize the loss, damage, or liability, did not keep a proper look-out, did not drive the vehicle at a reasonable speed given the circumstances, did not observe the rules of the road, and did not allow for the right of way of the on-coming traffic.
Mr Goshai then proceeded to institute a complaint at the Ombudsman for Short-Term Insurance (“the OSTI”) on 25 August 2022 – over four (4) months after receiving his rejection letter. Following the OSTI’s objective assessment of the merits, the OSTI then upheld IUM’s rejection and confirmed that Mr Goshai’s conduct was not in accordance with his duty of care.
IUM has considered the contents of the article and it is littered with falsities made by Mr Goshai. To that extent, any delay occasioned in finalisation of this matter was borne by Mr Goshai as IUM handled the claim expeditiously.
Further, Mr Goshai was insured with IUM for a period of five months on the day of the accident and not for a period of 10 (ten) years, as he suggested.
IUM prides itself in providing exceptional customer service. Every claim that is registered is handled professionally and objectively. To that end, Mr Goshai’s claim was correctly investigated and based on the findings, was validly rejected.
IUM, www.ium.co.za
Source: IOL