Getting documentation right from the start is the single biggest factor in a claim being paid quickly: a SAPS case number for any theft, time-stamped photos before anything is moved, and notification to your insurer as soon as reasonably practicable. If the insurer rejects the claim and its internal complaints process gets you nowhere, the dispute route is the National Financial Ombud Scheme (NFO), which replaced the old short-term insurance ombud (OSTI) from 1 March 2024 and is free to use.
Before you phone the insurer
Gather these for a typical construction or vehicle claim:
- Policy schedule and wording, so you know your cover, excess and notification period.
- SAPS case number. Mandatory for theft, hijacking, malicious damage and vandalism claims.
- Photos and video of the damage, time-stamped, taken before anything is moved.
- Site diary or incident report: date, time, witnesses, what happened.
- Inventory or asset register proving what was on site and what it was worth.
- Purchase invoices and receipts substantiating the value claimed.
- Contracts and bill of quantities, which establish the contract value for CAR claims.
- Medical reports where anyone was injured.
- Repair or replacement quotes from an approved supplier.
Why SA insurers reject claims
The rejection grounds are predictable. Knowing them in advance is most of the defence:
- Non-disclosure at inception. A previous claim, conviction or risk factor you did not mention can void the whole policy.
- Policy lapse. Premium unpaid. SA law requires a minimum 15-day grace period, but once it expires, cover is gone.
- An exclusion applies. Riot damage on standard CAR without SASRIA, defective workmanship, design error.
- Security conditions not met. You declared an alarm and tracker but they were faulty, unmonitored or not fitted.
- Commercial use on a personal policy. A bakkie carrying workers or materials on private motor cover.
- Underinsurance. Works insured at R400,000 that were really worth R600,000: the average clause reduces every claim proportionally.
- Late notification, unauthorised repairs, or an unlicensed driver. Tell the insurer fast, do not fix anything before the assessor sees it (emergency safety measures aside), and check licences.
CAR claim or public liability claim?
This boundary confuses many contractors. Section 1 of a CAR policy (material damage) pays for damage to your contract works, materials and site property. Section 2 (public liability) pays for damage to someone else's property or injury to someone who is not your employee. Damage the homeowner's existing fence while excavating and that is a Section 2 claim; your own half-built wall flattened in a storm is Section 1. The two sections usually carry separate excesses, so claim under the right one.
The NFO: your free dispute route
The National Financial Ombud Scheme South Africa took over from the Ombudsman for Short-Term Insurance (OSTI) on 1 March 2024, merging four previous ombud schemes. Its non-life division handles contractor policy disputes. The service is free to complainants, and a ruling is binding on the insurer but not on you, so you keep your right to go to court.
Its monetary jurisdiction for short-term insurance: general complaints up to R3.5 million, buildings cover complaints up to R6.5 million, and commercial complainants must have an annual turnover of R35 million or less, which covers almost every small contractor.
How to use it:
- Exhaust the insurer's internal complaints process first and get the final response in writing.
- Submit your complaint to the NFO online, by email, by phone or in person.
- The NFO investigates, applies insurance law and fairness, and issues a ruling.
Contact details as published at 2024/25: nfosa.co.za, call centre 0860 800 900, WhatsApp 066 473 0157, email info@nfosa.co.za, with offices in Houghton (Johannesburg) and Claremont (Cape Town). Confirm current details on the NFO site before you submit; contact details and jurisdiction limits change.
A worked example
Themba's bakkie is stolen from site. He reports it to SAPS the same morning, gets a case number, notifies his insurer within 24 hours and sends the case number, registration and policy schedule. An assessor is appointed and the claim is approved. Two months later his employee drops a concrete block through the homeowner's glass conservatory roof; Themba claims under Section 2 (public liability) of his CAR and the insurer pays the glazier.
Scenario B: the insurer rejects the bakkie claim because the tracker subscription had lapsed. Internal escalation fails. Themba submits to the NFO, which finds the policy wording did not clearly state that a lapsed subscription (as opposed to no tracker at all) voids cover, and rules in his favour. Free, and binding on the insurer.
Common mistakes
- No SAPS case number. Theft claims are rejected outright without one.
- Cleaning up before the assessor arrives. Photograph everything first and get approval for repairs.
- Sitting on the notification. "As soon as reasonably practicable" means days, not weeks.
- Accepting the first rejection letter. Many rejections do not survive an internal escalation, let alone the NFO.
- Skipping the internal complaints step. The NFO expects the insurer's final written response first.
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