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 EOH Views

The Main Purpose of an Insurer

The main purpose of an Insurer is to settle all valid claims fairly, accurately and as quickly as possible. Unfortunately it is a reality that there are opportunists and blatant fraudsters who will try to submit fraudulent and dishonest claims. We are obliged to protect the interests of all our clients and shareholders. Accordingly, since its launch in 2010 EOH is involved in several crime fighting initiatives aligned with the endeavours of the wider insurance industry, the South African Insurance Crime Bureau, the International Association of Arson Investigators, the International Association of Auto Theft Investigators as well as the Association of Certified Fraud Examiners.

Unfortunately, through making it difficult for unscrupulous fraudsters, swindlers, arsonists and opportunists to financially gain with illegal Insurance claims, several tactics are often used by individuals, agents and/or groups to move underwriters to settle false and/or inflated claims through amongst others, threats of media exposure and even misdirected publications in the media. Fortunately we subscribe to a strict adherence to agreed processes, codes of conduct, regulatory requirements and the South African law. All clients have rights to action any grievances or unhappiness with EOH senior management, their underwriters, regulatory bodies, and the Ombudsmen.

We see absolutely no benefit in defending our endeavours with anyone in the media especially relating to serious unfounded allegations about our processes, services, conduct and methodology. It is imperative to know that neither EOH nor its employees have the authority or power of attorney from any of our clients to determine claims outcomes, we report on factual findings and the insurer determines the outcome of all claims considering the principles of insurance and contract laws, the approach to claims by the industry, the expectations of the industry regulators as well as the broker and the client community.

 

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