Insurance plays a vital role in shielding South African businesses and individuals from unexpected financial setbacks. However, one of the policyholders’ most common frustrations is navigating complex and often slow claims processes.
Delays, unclear terms, and disputes over exclusions can negatively impact cash flow, cause stress, and undermine trust in the insurer. This article unpacks the most frequent challenges in claims processing—and offers actionable advice to help policyholders better prepare and protect themselves.
The State of the Insurance Market in South Africa
While South Africa’s insurance industry remains resilient, the market is shaped by economic challenges:
- In the first half of 2024, insurers paid out a substantial R298 billion in claims and benefits.
- However, rising costs and financial strain led to the cancellation of over 4.3 million policies during the same period.
As consumers and businesses continue to face economic pressure, optimising claims processes becomes critical to ensuring effective risk protection.
Challenges in the Claims Process
Many South Africans face unnecessary obstacles when filing claims. The most common issues include:
Lengthy Processes
Excessive paperwork and slow turnaround times often delay critical payouts, affecting operational stability and household finances.
Disputes Over Interpretation
Claims may be denied due to:
- Misunderstandings around exclusions
- Non-disclosure of key details at policy inception
- Ambiguity in policy wording
Inadequate Cover
Due to rising premiums, some policyholders opt for cheaper, limited policies—only to find they’re underinsured when the time comes to claim.
Tips for Navigating Insurance Claims More Effectively
To avoid delays and improve the likelihood of a successful claim:
1. Understand Your Policy
Carefully review your policy to understand coverage limits, exclusions, waiting periods, and excess amounts.
2. Be Transparent
Disclose all relevant information at the time of signing and updating your policy. Inaccurate details are a leading cause of claims being rejected.
3. Keep Documentation in Order
Have key documents ready when submitting a claim, including:
- Proof of ownership or value
- Photos of damage (where relevant)
- Incident reports or police affidavits (if applicable)
4. Work with a Trusted Broker
Brokers like RBS Insurance Brokers advocate on your behalf. We:
- Clarify unclear policy terms
- Help compile supporting documentation
- Liaise directly with insurers to expedite your claim
Emerging Trends Reshaping the Claims Experience
As we move deeper into 2025, insurers are shifting toward faster, more transparent claims handling:
Digital Transformation
More insurers are introducing online claims portals, AI-driven risk assessments, and automated document checks—speeding up approvals and reducing human error.
“Promise to Help,” Not Just “Promise to Pay”
Some insurers are evolving beyond simply paying claims. They now offer value-added services like:
- Emergency response coordination
- Temporary accommodation
- Access to repairs and recovery service providers
Closing the Protection Gap
Insurers are introducing more flexible, modular products to cater to underinsured markets—especially small business owners and asset-light clients.
Be Prepared, Stay Protected
The best way to protect yourself in a complex insurance environment is to know your policy, stay organised, and work with experts who understand how to navigate claims efficiently.
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About RBS
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 B-BBEE 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, as represented by its board membership with WING (Worldwide Insurance Network Group).