Understanding Winter Insurance Claims: What’s Covered and What’s Not?

As South Africans, we’re all too familiar with the harsh realities of our environment. This past month has been a stark reminder, as at least two tornadoes were recorded in the north of Durban, hail in Umhlanga, snow in the Northern Cape, and heavy rains and strong winds in the Western and Eastern Cape as reported by the Daily Maverick. With such extreme weather conditions becoming increasingly common, understanding winter insurance claims is crucial for protecting both personal and commercial properties.

Common Winter Claims for Personal and Commercial Properties
Water damage

Water damage is one of the most common issues during the winter months. Persistent rain can seep through roofs, walls, and foundations, causing extensive damage. 

  • Covered: sudden pipe bursts and rainwater entering through a damaged roof. 
  • Not covered: gradual leaks due to lack of maintenance and mould and mildew resulting from prolonged moisture exposure are typically not covered.
Winter storms

South Africa’s winter storms can be particularly ferocious, bringing strong winds that can topple trees and damage roofs and windows. Such events can cause significant structural damage to properties and even disrupt business operations. 

  • Covered: Insurance policies generally cover damage caused by falling trees or branches and wind damage to roofs, windows, and external structures. 
  • Not covered: Damage from trees that were dead or diseased before the storm or pre-existing structural issues exacerbated by the storm.
Car Accidents 

Heavy rain, hail, and poor visibility can lead to collisions, requiring prompt insurance claims to cover repairs and medical expenses. 

  • Covered: Damage to your vehicle from collisions due to wet road conditions and liability for damage to other vehicles or property.
  • Not covered: Accidents resulting from reckless driving or negligence and wear and tear unrelated to the accident.
Navigating the Claims Process

Filing an insurance claim can be daunting, especially in the aftermath of a stressful event. However, understanding the process can make it smoother and more efficient.

  1. Immediate Action: As soon as the incident occurs, ensure everyone’s safety and prevent further damage (e.g., by covering a leaking roof or moving vehicles away from falling trees).
  2. Documentation: Take clear, detailed photographs of the damage. For property claims, include images of both the exterior and interior. For car accidents, photograph the scene, the vehicles involved, and any relevant road conditions.
  3. Notify Your Insurer: Contact your insurance provider as soon as possible to report the incident. Provide all necessary information, including the photos and a detailed account of what happened.
  4. Assessment: Your insurer will likely send an assessor to evaluate the damage and determine the extent of your coverage.
  5. Repair Estimates: Obtain quotes from reputable contractors or mechanics for the repair work needed. Submit these to your insurer for approval.
  6. Follow-Up: Keep in regular contact with your insurer to monitor the progress of your claim and address any additional information they may require.

By understanding what is covered and what isn’t and following these steps for documentation and claims processing, you can navigate the challenges of winter insurance claims with greater ease and confidence. The recent severe weather events in Durban, Umhlanga, the Northern Cape, and the coastal regions remind us of the importance of being prepared. Stay safe and prepared this winter, South Africa!

About RBS 2024

Risk Benefit Solutions, better known as RBS, originated as an entrepreneurial-focused services business in 1998 and today is one of the largest fully-fledged black-owned insurance brokers in South Africa and a Level One BBBEE contributor. Celebrating 25 years in business this year, our growth has contributed to offering clients a unique approach to risk management by positioning our skilled resources as an extension of our client’s risk management team. Our company covers various services, including Insurance Broking, Risk Management, Commercial and Corporate Risk Advisors, and Corporate Vehicle Hire Services. With its head office in Cape Town, RBS has offices in Gauteng, the Eastern Cape and globally, represented through its board membership with WING (Worldwide Insurance Network Group).