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Ombudsman Instates Appeal System

 

A long overdue appeal system has been instated by the ombudsman for short-term insurance. Now any ruling by the ombudsman can be appealed by either the insured party or the insurer. This brings an extra modicum of control to a very self-regulated industry.

The Ombudsman for Short-Term Insuranceombudsman_short_term_insurance

The Ombudsman for Short-Term Insurance, or OSTI, was established in 1989 to provide a fair dispute resolution mechanism in the short-term insurance industry. The Ombudsman generally acts as a mediator or informal arbitrator in a dispute between an insured party and the insurer and does not represent either of the parties.

The Ombudsman is not there for legal advice and they will not give it to you. You have to complain to your insurance company first and only to the Ombudsman if no satisfactory decision had been reached between you and your insurer.

The Ombudsman can assist as a mediator or arbitrator in the following lines of short-term insurance:

  • Motor
  • Household (buildings and content)
  • Cell Phone
  • Disability
  • Credit Protection Insurance
  • Commercial Insurance (on a limited basis).

Their arbitration services are totally free.

Appeals

Until recently, any decision made by the Ombudsman was binding and could not be taken further.

Recently, however, the Ombudsman has instated an appeal mechanism to provide the means for either the insurer or the insured party to lodge an appeal against a final ruling by the Ombudsman. Provided, however, that the Ombudsman grants leave for the appeal to be lodged at its own discretion.

An application for an appeal will have to be lodged within 30 days of the Ombudsman’s final ruling.

Costs

Though the Ombudsman’s services are usually 100% free of charge, the fees for an appeal are two-fold:

  1. The party who lodges the appeal will have to pay an appeal deposit, which is refundable should the appeal be successful. Should the appeal not be successful, the deposit is forfeit. However, it should be noted that no cost awards may be made against the unsuccessful party.
  2. Any legal representation that either party wishes to have present at the appeal hearing will be at their own costs. The Ombudsman does not represent either party.

 

Who Will Be on the Appeal Tribunal?

The Appeal Tribunal will consist of the following highly skilled members:

  • The Chairman: The Honourable Mr Justice Sandile Ngcobo (former Chief Justice);
  • The Honourable Mr Justice PM Nienaber (former judge of the Supreme Court of Appeal)
  • The Honourable Mr Justice TD Cloete (former judge of the Supreme Court of Appeal).

More Information

The appeals process is subject to rules, regulations and additional processes that have to be complied with.

A PDF document with the Appeal Mechanism has been uploaded to the Ombudsman’s website, www.osti.co.za.

The Ombudsman can also be contacted telephonically on 011 726 5501 or by email at info@osti.co.za.

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