The National Financial Ombud Scheme (NFO) dismissed a homeowner's insurance claim for a collapsed boundary wall, attributing the damage to wear and tear rather than extreme weather. The case highlights policyholders' duty to maintain their properties despite disclosing pre-existing issues to insurers.
A case handled by South Africa's National Financial Ombud Scheme (NFO) this year involved a homeowner who claimed his boundary wall collapsed due to extreme weather. An insurer's assessment found the damage was old, with the wall leaning for some time and no evidence of storm impact. Instead, it concluded the issue stemmed from wear and tear and gradual deterioration. The homeowner noted he had informed the insurer of cracks before the policy started, and the insurer accepted without a property inspection. He provided Google Street View photos and assessor images, but NFO observed the cracks had worsened over time. It ruled that, on balance of probabilities, the damage did not result from a single sudden unforeseen event. Disclosing the cracks did not excuse the homeowner from repair responsibilities. Mamiki Khunou, NFO non-life insurance adjudicator, explained: “The purpose of a short-term insurance policy is to provide cover for damage caused by a single, sudden, and unforeseen event.” She added that policyholders must familiarise themselves with terms and conditions. Wynand van Vuuren of King Price Insurance noted exclusions for gradual damage from poor maintenance, urging routine checks like clearing gutters and repairing cracks. Ryno de Kock of PSG Insure emphasised that policies require taking precautions to prevent losses, with terms varying by risk factors like location.
