- Understand Your Coverage: Know what's covered and what's not by reading your policy carefully, just like you would a manual for a new gadget.
- File Claims Quickly: Contact your insurer and file your claim as soon as possible—don't delay, or you might miss important deadlines.
- Excess & Costs: The excess is your share of the bill, like splitting dinner costs. Higher excess means lower premiums but more out-of-pocket if you claim.
- Claims Process & Impact: After filing, your insurer will investigate. Be aware that filing a claim can raise your premiums, so drive safely!
- When to Seek Help: If your claim is rejected, you can dispute it, or if things get tricky, consider getting legal advice.
You asked. We answered. Explore Pineapple’s comprehensive guide as we answer the most frequently asked questions about insurance claims, providing clarity and expert insights for policyholders.
Welcome to the world of insurance claims, where questions are plentiful, and clarity is key.
As a motorist, you might dread the day to make a claim, but being prepared is essential. Understanding the claims process can save you from out-of-pocket expenses, whether a minor scratch or a major smash.
To guide you through this journey, Pineapple has compiled a list of twelve common insurance claims questions.
These include queries about excess payments, even in no-fault accidents, the detailed information required when registering a claim, and understanding coverage in various scenarios.
We also explore the reasons behind claim processing times and the specifics of choosing service providers.
This concise guide is designed to demystify the insurance claims process, equipping you with the knowledge to handle any situation confidently and efficiently.
Why must I pay an excess if the accident wasn’t my fault?
Pineapple says, “You've had an accident, and it wasn't your fault, but you still have to pay the excess stipulated? That can feel unfair, but there's a method to the madness.
Insurance providers don’t use blame as a criterion to determine whether you must pay an excess.
The idea behind an excess is to share the risk between you and your insurance company. It's a way to keep things balanced and ensure your policy remains affordable at the renewal stage. Having to pay a bit when you submit a claim discourages people from claiming for every tiny scratch.
In the case of the other party being at fault, we will try to recover the excess from the guilty party on your behalf. It’s not always guaranteed that we’ll be able to recover the funds successfully.
However, you can rest assured that we will try all means possible.
Remember that this could be a lengthy process, which can be prolonged further if the other driver is uninsured.”
Why are there so many questions asked when I register a claim?
Pineapple says, “Insurance providers often ask a laundry list of questions when you submit a claim. It can feel like you're being grilled in an interrogation.
However, there's a reason for that.
The process is simple, every client’s claim has to undergo a validation process; this is to ensure that all the information is factually correct.
This information is then used to validate the incident that occurred.
Insurance providers also have to follow certain laws and regulations. This means we must gather enough information to comply with these rules and ensure everything's above board.
Furthermore, insurers need to know exactly what happened to fully understand the claim. The more they know, the better they can assess the situation.
Plus, all these questions help curb insurance fraud.
Some people try to cheat the system with false or exaggerated claims. So, an insurer has to ask many questions to ensure everything adds up. It's the only way to double-check the incident to protect both the client (a.k.a honest customers like you) and the company from fraudsters.
Lastly, it may sound counterintuitive, but more questions upfront can actually speed things up.
By getting all the information right from the start, insurers can avoid back-and-forth later on; if the validation process is not done right at the beginning of the claim submission, it can slow down the claim process.”
Am I covered if an accident was my fault?
Pineapple says, “The beauty of comprehensive car insurance is that we'll pay you out even if you're at fault in an accident—you’ll just have to take care of the excess amount.
There could be instances where an insurer may reject a claim; a few examples include if you tread into illegal territory, like driving drunk, having an endorsed or invalid driver's license, or cruising around in an unroadworthy car, to name a few.
So, in a nutshell, yes, you can be covered even if the accident was your fault, but the extent of that coverage and the financial implications depend on your specific insurance policy and its terms.
So, remember that policy document you’ve been avoiding? It’s time to start reading it now!”
Why are there so many additional excesses?
Pineapple says, “Additional excesses are often applied to specific scenarios or high-risk factors, like young drivers. These excesses reflect the increased risk and potential cost associated with these factors.
They're a way for insurers to balance risk while offering coverage to a broader range of customers.
A Basic Excess fee of R6 200 will be applicable.
Then, the following additional excesses may also apply if:
1. You claim within 6 months of the policy’s inception date.
2. The Regular Driver is under 25.
3. The Regular Driver has been licensed for less than 3 years.
4. The driver at the time of the incident was not the registered Regular Driver.
5. The incident occurred between 22h00 – 06h00.
6. The incident happened outside of South Africa’s borders.
7. It’s a single vehicle incident.
However, if more than one incident is true (for instance, a driver is under 25, their license is not older than 3 years, and they were driving between 22h00 to 06h00), a maximum of only THREE incidents will be considered.
This means the excess amount will be (Your basic excess) x (the Standard Additional Excess of R6 200 x 3).”
What information do you need from me (when I claim)?
Pineapple says, “When submitting a claim, you'll typically need to provide details about the incident (e.g., date, time, location, validation documentation).
Your insurance provider will likely also ask for a description of what happened, information about any other parties involved, and any relevant police reports or witness statements.
But rest assured, your Pineapple claims advisor will take you on a step-by-step journey as to what will be required of you to validate your claims.”
Who can submit the claim (policyholder vs. proxy)?
Pineapple says, “Generally, only the policyholder can file the claim with their insurance provider.
Insurance providers explicitly require the policyholder's direct involvement to ensure accurate and authentic communication and validation information. This is to curb fraud, misunderstandings, or misrepresentations of the incident.
However, in certain situations, a designated proxy, like a family member or legal representative, can submit a claim on behalf of the policyholder, especially if the policyholder cannot do so themselves.
In cases where a proxy is allowed to submit a claim, they may need to provide evidence of their authorisation to act on behalf of the policyholder, such as a power of attorney or other legal documentation.
This ensures they have the legal right and the policyholder's consent to handle the claim.”
How do I register a claim?
Pineapple says, “To register a claim, it is advisable that you register the claim as soon as possible via our mobile app or online.
Provide all necessary details and follow your insurer's guidance on the next steps, including submitting specific forms or documentation.
With Pineapple, we follow this process:
1. Log onto the Pineapple app (If your phone has been stolen, you can submit a claim through the webpage).
2. Navigate to the claims flow.
3. Confirm that you will be honest in all your questions.
4. Select the date on which the incident occurred
5. Select items that were affected.
6. Select if the incident was a theft or a damage event.
7. Submit a voice note explaining what happened.
8. Use our Google Maps integration to show us where the event occurred.
9. Upload as much supporting documentation as possible or take pictures of evidence.
10. If you have a case number, please provide us with it.
Finally, review your information and hit submit.”
When should I inform my insurer?
Pineapple says, “There’s no time like the present. Inform your insurer immediately or as soon as practically possible after an incident, ideally within 24 to 48 hours.
Most policies have a stipulated time frame within which you must report an incident. Delaying beyond this period could violate your policy terms, potentially leading to a denial of your claim.
Plus, the sooner you report an incident, the quicker your insurer can process your claim.
This also means an insurer can address any necessary repairs, replacements, or other forms of compensation quicker.”
How long will the repairs take?
Pineapple says, “The duration of repairs after an insurance claim can vary significantly based on several factors:
- Extent of damage
- Availability of parts
- Insurance process
- Capacity of the repair shop
- Quality assurance
The important thing to remember is to have realistic expectations regarding repair times. While everyone involved aims for a swift resolution, ensuring the repairs are thorough and meet safety standards is paramount.”
Is car hire automatically included?
Pineapple says, “Comprehensive car insurance is the alpha and omega of car insurance policies, but even it has limits. Car hire or rental car coverage isn’t automatically included in your policy and varies depending on your insurance policy and provider.
If your current policy doesn’t include car hire coverage, you can add it for an additional fee. It's worth considering, especially if you rely heavily on your vehicle for daily activities.”
Do I have to give you a specific service provider/can I choose?
Pineapple says, “Like many insurance companies, we have our own network of approved service providers or panel beaters.
These approved service providers often have benefits, such as streamlined billing processes, where we, as the insurer, directly settle the bill with the service provider. Also, the insurer usually guarantees workmanship done by approved providers for quality and timeliness.
However, the best bet is to check your insurance policy's terms and conditions regarding repairs.
At Pineapple, here’s how it works:
We do not compensate for claims where the Policyholder has not obtained our approval for repairs/replacement of your insured items.
So, if your car is damaged in an accident and you decide to have it repaired at repairer of your own choice without obtaining approval from us, we will not compensate the Policyholder for the cost of the repairs.
So, it’s always better to stick to using our service providers.”
Conclusion
The next time you find yourself in the thick of an insurance claim, remember this trusty guide.
Whether it's about choosing your repairer or figuring out car hire options, you're now equipped with the knowledge to tackle your next claim with ease.
From understanding excess payments in no-fault accidents to the intricacies of repair times, we've shed light on the essentials. So, navigating insurance claims doesn't have to be a maze of confusion, not with Pineapple by your side.
With these key questions answered, you're all set to steer through the world of insurance claims with a bit more savvy and much less stress.
Happy claiming! Don't have insurance yet? Get a quote!
Pineapple (FSP 48650) is underwritten by Old Mutual Alternative Risk Transfer Insure Limited, a licensed Non-Life Insurer and authorised FSP. T&Cs apply. Premium is risk profile dependent.
Please Note: The information provided above is for informational purposes only; you should not construe any such information as legal or financial advice.
Team Pineapple
Team Pineapple comprises our company’s top talents, who are dedicated to creating clear, high-quality content on essential vehicle insurance topics. This diverse group, including actuaries, accountants, data scientists, and insurance professionals across South Africa, collaborates to produce enlightening and empowering articles.
Each piece is thoroughly researched, factually accurate, and rigorously reviewed to ensure quality.
*We say they’re the finest because we want them to keep writing for us!
