Insurance Law Services For Policyholders

POLICY INTERPRETATION AND COVERAGE ADVICE

We provide clear, practical advice on policy wording, cover, exclusions, policy conditions, disclosure obligations, and policyholder rights and obligations.

CLAIMS ADVISORY AND CLAIMS SUPPORT

We assist policyholders throughout the claims process by:

• Assessing the merits of claims;
• Advising on policy requirements and supporting evidence;
• Assisting with the preparation and presentation of claims;
• Engaging with insurers and loss adjusters; and
• Advising on quantum and indemnification issues.

REPUDIATED AND DISPUTED INSURANCE CLAIMS

Where a claim has been declined, reduced, delayed, or disputed, we provide legal advice and representation in relation to:

• Non-disclosure and alleged misrepresentation;
• Breach of policy terms or conditions;
• Causation disputes;
• Late notification allegations;
• Average clause disputes;
• Underinsurance disputes;
• Underpayment of claims;
• Policy interpretation disputes; and
• Unreasonable delays in claims processing.

NATIONAL FINANCIAL OMBUD SCHEME SOUTH AFRICA (NFO) COMPLAINTS

We assist policyholders with preparing, lodging, and managing complaints before the NFO in matters involving:

• Non-life insurance disputes;
• Life insurance disputes;
• Claims repudiations; and
• Unfair claims handling practices.

FAIS OMBUD COMPLAINTS

We advise and represent clients in complaints against financial services providers, brokers, and intermediaries concerning:

• Inappropriate or unsuitable advice;
• Mis-selling of insurance products;
• Disclosure failures;
• Negligent advice;
• Administrative errors; and
• Intermediary misconduct.