What could possibly go wrong? A lot it seems when it comes to insurance...

I am sure I'm not the only one who has a healthy suspicion when it comes to insurance policies and companies.

That is not to say that I don't have insurance. I do. In fact, when I looked at my budget recently, I realised that almost 20% of my total budget goes to insurance premiums.

Yet, my kids won't inherit a fortune from life insurance when I die. I have only one life policy to cover my mortgage. In addition, I have medical insurance, gap cover, car and house insurance.

So nothing fancy – only the necessary.

Yet, it seems that every time I have a claim I end up paying. Years ago when I had a break-in, the same person who came to value my belongings, told me that I was 30% under-insured and thus they could only pay out two-thirds of my small claim.

Two years ago, someone drove through a stop street and crashed into me. I was on a three-lane freeway and she hit me straight from the side – so there was no alternative explanation possible for the accident. The driver also never denied that she was at fault. Yet, OUTsurance (her insurer) insisted that I prove it. No amount of affidavits etc. convinced them, and I was left with a very substantial excess to pay.

(As a sign of protest, I now change channel every time the seemingly endless OUTsurance ads come on TV.)

My medical insurance experience has not been much better. I have a (very expensive) hospital plan. A while ago, I had to go to the emergency department – for well, a medical emergency on a weekend. My medical insurance paid for everything except… wait for it… the doctor. Now I ask you: If the assumption is that you didn't need to see a doctor, why would you go to the emergency department?

They quoted some rule in very small writing and like most people I gave up fighting with them.

Which reminds me: "Discovery, can someone please pay the claim for my dad’s three-hour hospital admission on the day he died? You are causing my already mourning mother a huge amount of anxiety. How many letters and phone calls do you need before you do the right thing?"

Over the last few weeks, I have been reading reports that some of the big insurance companies in South Africa insist they are unable to honour business interruption insurance claims to the tourism industry linked to the Covid-19 pandemic.

Apparently many business interruption insurance policies' cover also include cover for interruptions caused by infectious or contagious notifiable diseases. As we all know, Covid 19 is highly infectious and the-health-minister-reports-on-it-daily notifiable. So, to quote one of these insurers' advertisements: "What could possibly go wrong ?"

A lot apparently.

According to many insurers, the hospitality industry's businesses were interrupted, not because of Covid-19, but because of the government's regulations to prevent the spread of Covid-19 and thus they don't have to payout.

(To be fair to OUTsurance, apparently they are honouring claims, which is great, but I'm still boycotting their ads.)

Thabo Mabaso, head of corporate communications at Santam, explained:

"It is a requirement in terms of the policy that the business is directly affected by a case of Covid-19. For example, if a policyholder ran a hotel and one of their workers or guests became infected with Covid-19, forcing them to close their operations, then they would have a claim for as long as it took them to clean their premises and return to operations."

So at least now we know of one industry that was delighted that the government had a hard lockdown – because otherwise, they would have had to pay out claim after claim as establishments would have had to repeatedly close as people got infected.

The industry claims that paying these claims could ruin them. I'm no expert, but it seems to me that is a problem for their risk people. They can't now "punish" the policy holders because they failed to anticipate such an event.

In the meantime, most owners of these tourism establishments, many of whom are small businesses and certainly don't have plush offices and boardrooms, are facing ruin on a personal and professional level.

To make matters worse, they are now forced to take these giant insurers to court.

I'm sure it is of very little comfort to them that according to Santam's chief risk officer Asher Grevler:

We (at Santam) have agonised, and we have really struggled over this.

There are very few industries that have not been affected by this terrible pandemic. On an individual level, the stories of suffering and sacrifice have been heartbreaking.

Imagine how much goodwill the insurance industry could have won if they had "done what they promised to do when you claim", to quote yet another of their ads.

Instead they are hiding behind rules and insurance "principles".

This is no surprise, yet it remains shameful.