I hope and trust you are doing well.
I have lodged an complaint with the Ombudsman in regard to partial rejection of insurance claim from Oakhurst Insurance Company (Dotsure). As I am aware that Ombudsman can take incredibly long I am seeking personal legal advice and assistance. I have already been without my car for two months and very dependent on my car. I cannot afford to wait other 3 months to a year as I have been advised the Ombudsman can take to help resolve the problem.
Herewith please find the following info.
I was unfortunate to be in a car accident on 05 June 2017. The claim was lodged with Dotsure on 06 June 2017. All requirements from Dotsure claim department were handled swiftly from my side and I tried to assist wherever possible to speed up the process. After delaying the initial estimate date I would have received my car back by two weeks, the vehicle was released on Thursday 24 August 2017 by the Panelbeaters. On the release of the car to my husband the Panelbeaters advised that the cars motor seems to have taken a knock.
I contacted Dotsure on Friday, 25 August 2017 advising them that there was something is wrong with my car. Late Friday afternoon my car broke down and had to be towed. The consultant had my car towed to Hyundai on Saturday morning, where in turn it was returned to the Panelbeaters.
The Panelbeaters took parts of the vehicle’s motor apart and took photo’s which they sent to the assessor Mr Jaco Greeff for assessment.
Mr Greeff phoned me on Thursday, 31 August 2017 to advise that they will not be covering the damage to the motor of the car as they found sluggish oil in parts of the motor which they feel blocked the oil flow and caused the damage to the car. I have requested an official written report from Rosalie Claasen as well as Shamiso Malvas, (Dotsure consultants that were working with my claim) to date I am still awaiting the requested report.
I feel that the rejection of the claim unjust as there were no issues with my car prior to the accident.
This year saw the anniversary of seven years with my employer. I took ownership of the car in June 2017 as part of my employment contract was that the car that I have been driving for the past five years becomes mine after a stipulated time period. In order to have the cars ownership change and licence renewal done the car had to go through road worthy first. I took the car to A+ Testing station where they initially rejected the road worthiness test due a spot light not working, rear tyres being worn and the wheel alignment. All faults were corrected and the car was taken back to the testing station. The car passed its roadworthy and documents of same was sent to Dotsure.
The car was inspected and passed roadworthy less than a month prior to the accident. Surely this constitutes as evidence that the vehicle was indeed in a good working condition prior to the accident.
In light of the above I requested that further investigation into the cause of the incident be made by Dotsure as there was nothing wrong with the car prior to the accident. The request was denied.
DOTSURE CLAIM DENIED:
Mr Jaco Greeff (Assessor) advised that the claim was denied due to old oil built up in the cars sump as well as the oil filtering system. Mr Greeff advised that the company felt the reason for the motor to seize was not accident related and will thus not be covering the engine.
REASON FOR DISPUTE OF REJECTION OF CLAIM:
Prior to the accident on 05 June 2017 there was nothing wrong with my car. The car was in good working order and it was in daily use.
As the car is no longer under Hyundai’s warranty and the fact that I only took ownership of the vehicle in June 2017, I have no record of the previous service the car went for as requested by Mr Jaco Greeff (Assessor) . Only documentary proof I have of the state of the vehicle is the road worthy it had to pass before the change of ownership could be done in June 2017.
When the car was released to us by the Panelbeaters they advised that there was a knock to the motor and added that they were Panelbeaters and not mechanics and is not allowed to touch the motor of the car.
I advised Rosalie Claasen (claim consultant) on what they advised my husband, yet the car was still returned to the Panelbeaters after the breakdown.
Frontal collisions often result in damage to mechanical components. The cars cradle needed to be replaced after the accident. As the cradle holds everything in the car in place such as the engine and transmission including the lower control arms, torsion bar, end links, struts and steering gear are attached to the sub frame. This should have been an indication that the engine might have sustained further damage that are unseen to the eye due to the knock it took.
Both the radiator and radiator bottle needed replacement after the accident. This is an indication that further damage to the motor is highly possible. All engine car parts are closely packed, so when the engine’s temperature increases, other components around the motor including electrical wiring, fuel pump and other sensors could have been damaged.
After the car broke down on 25 August 2017 I further established:
The insurance company neglected to check the cars motor after the accident. No diagnostic tests were done to determine if any components on the engine got damaged that were not clear for the eye to see. When the Panelbeater took the car for alignment the first time after the repairs to the car was done the engine light came on. They checked the oil. Less than a pint was missing, yet they filled up the car with oil and the light went off. After the car was returned to the Panelbeater after it broke down (the motor seized) the complete motor and other components of the car was once again not checked. The Panelbeaters only took certain parts apart which spesifically was the sump and oil filtering system. A crucial part of the vehicles repairs were overlooked during the repair process. An overall check-up of your vehicle. A full work up could have caught whatever caused the engine to seize and could have prevented further damage to the car.From the time we collected my
vehicle from the Panelbeaters (24 August 2017) to when the cars engine seized (25 August 2017) neither the car’s engine light nor oil gage came on as warning that the engine was not getting any oil. I had no issues with my car prior to the accident. I am thus not convinced with the findings of the assessor. There are several possibilities as to why the cars motor seized, without a detailed check on all parts of the car one cannot come to the conclusion that was given by the Assessor. The problem now lies that even further damage has now been made to the motor and pinpointing the origin could be challenging.Please be so kind and look into this matter of urgency as I have been struggling for over two months now without my car.Looking forward to your early reply.Yours faithfully,
[Source] Click here to view the answer to this question