An issue at call centres is the way agents use business jargon when communicating with clients.
Maybe they’ve been taught that “bullshit baffles brains”. If they used plain English it would make things easier all round.
Marine scientist Neil van den Heever, of Noordhoek, couldn’t understand the reply he got from Hollard’s call centre when he lodged a third party claim after he had a motorbike crash.
Mr Van den Heever was involved in a collision when the motorist changed lanes suddenly, reportedly without signalling.
The bike was a write-off. But he wasn’t happy when the insurance giant offered to pay him
R73 941, which was 70% of his claim, because he could not have avoided the crash. It was not his fault that he landed up in hospital and was without transport for six months,“Not to mention the stress, the crash caused”.
“Hollard claims I am responsible to an extent for the accident – at first it was 40%, now it is 30%. I was on a motorcycle and I am fully aware that after 53 years of daily riding I will be the one injured in a collision and do my utmost to avoid it. I had no chance as the client abruptly changed lanes without ensuring it was safe to do so. I was next to him in the left lane of a dual carriageway and the client was in the right lane and I had nowhere else to go,” Mr Van den Heever told Hollard.
The offer included R11 931.50 for the loss of helmet and jacket.
The agent told Mr Van den Heever: “We have looked into your matter and wish to state the (70%-30%) given is our final offer. There is no contract between yourself and Hollard and as such subrogation cannot take place…”
The agent said Mr Van den Heever “was welcome to litigate on this”.
What does subrogation mean?
Well, if you were in the insurance business you would know. Or maybe not. Subrogation happens when the insurance company steps into the shoes of the insured – to sue the other party for the loss suffered by the insured.
Hollard spokesperson Warwick Bloom said they sympathise with Mr Van den Heever.
“However, our team’s handling of the third party claim was aligned with best practice in the industry, and also with legal precedent. Which suggests that the assignment of 100% blame to any party in a collision is virtually impossible. The courts have held that no driver has an absolute right of way and every driver should be vigilant and keep a proper look out. The courts have held that lane change collisions warrant an apportionment as both parties share contributory negligence.
“While Mr Van den Heever feels very strongly that there was nothing he could do, it would be very difficult to argue in a court of law that it was physically impossible for him to have behaved any differently, which is what would be required. Our client claims he indicated before changing lanes – for example, it is probably impossible for us to say that, given his skill and experience, Mr Van Den Heever had no chance of noticing this before the lane change,” Mr Bloom said.
Accidents of this nature attract a 60%/40%, 70%/30% or in isolated cases an 80%/20% apportionment of fault.
“While our initial review of this matter suggested that a 60/40 apportionment would apply, a thorough investigation resulted in a 70/30 apportionment. If we had simply applied this, we would have paid Mr Van Den Heever 70% of his damages and he would have been liable for 30% of the damages incurred by our insured.
“However, to simplify matters, we ignored the 30% of the damages to our insured’s vehicle and offered to pay Mr Van den Heever 70% of the assessed value of the damages to his bike,” said Mr Bloom who explained that Hollard is legally not entitled to use the salvage as there is no contract between Hollard and Mr Van den Heever.
Hollard subtracted the salvage value from the damages claimed to make their calculations.
“Our policy does not allow for anything more than payment of the market value as per industry guides.
“However, any modifications would enhance the scrap value, and result in a greater payment to Mr Van den Heever than our assessment. The helmet and jacket valued at R17 045 were included in the assessment, but because of the apportionment of blame, we offered R11 931.50,” explained Mr Bloom, who added that Mr Van den Heever was not obliged to accept their offer, and he was entitled to take legal action which they would defend.
Mr Van den Heever said that he was grateful for Mr Bloom’s explanation and he now understands the third party concept.
“I appreciate all your effort but still feel I have lost much: the aftermarket items on the bike would not enhance the scrap value as that too is damaged beyond repair. I do not want to drag this out any longer.
“Mr Bloom was the first person at Hollard to treat me as a person instead of a claim number.”