Insurance Law

A recent decision by the Financial Services Tribunal (“Tribunal”) has revisited an old but recurring question under the Pension Funds Act (“the Act”): can an employer rely on Section 37D(1)(b)(ii)(bb) to recover losses from an employee’s pension benefit where the employee’s conduct was grossly negligent, but not dishonest? The case arose from an incident at […]

The JHB High Court recently delivered a significant case pertaining to virtual commissioning. This case presented a significant legal question regarding the validity of affidavits commissioned virtually, particularly when the deponent is located outside the Republic of South Africa (RSA) and the Commissioner of Oaths is within the RSA. The central issue was whether such […]

A recent decision of the Financial Services Tribunal underscores a crucial distinction in pension law — the jurisdictional boundary between approved and unapproved benefits. The ruling confirms that the Pension Funds Adjudicator (PFA) has no authority to investigate complaints arising from employer-held, unapproved disability policies, even when such benefits are linked to a registered fund. […]

Facts In 2022, the Plaintiff sought to invest in a Sharetea franchise in Alberta. The Defendant was the master franchisee for Sharetea in Alberta, operated and controlled by an individual. The Defendant provided the Plaintiff with promotional materials and revenue figures for existing Sharetea locations, leading to a Memorandum of Understanding (MOU) in September 2022. […]

In ISMIE Mutual Insurance Co. v. Pergament, an Illinois appellate court reaffirmed a core principle of professional liability insurance: indemnity is not triggered unless the insured becomes legally obligated to pay damages. The court held that where a doctor assigned his policy rights to a claimant but was expressly relieved of any payment obligation, the […]

Introduction In a widely shared judgment delivered on August 27, 2025, the Punjab and Haryana High Court, in India, addressed a critical yet often overlooked issue in the Indian healthcare system—doctors’ handwriting. Justice Jasgurpreet Singh Puri, while presiding over a bail hearing in a criminal case involving allegations of rape, cheating, and forgery, encountered a […]

A recent U.S. federal court decision underscores the power of exclusion clauses in commercial general liability policies—particularly those involving firearms. Facts of the case: Two patrons of a Georgia-based lounge brought lawsuits after suffering injuries during a violent incident at the establishment. One patron was shot, while the other was trampled in the ensuing panic. […]

Introduction A recent judgment from the Mpumalanga Division of the High Court provides a critical interpretation of Section 35(1) of the Compensation for Occupational Injuries and Diseases Act (COIDA). It explores the limits of employer immunity under COIDA when tragic incidents occur in the course of employment—but not necessarily arising from it. Facts of the […]

A recent decision from the United States District Court for the Southern District of California, in the matter between Del Mar Woods v. Philadelphia Indemnity Insurance Co., 2025 WL 1798300 (S.D. Cal. June 27, 2025), provides guidance on the interpretation of “Claim” under claims-made insurance policies and highlights the limits of what may constitute a […]

When contributions to a provident fund are not paid, it is the beneficiaries who suffer the most. A reconsideration application before the Financial Services Tribunal (“the Tribunal”) confirmed that employers remain bound to honour their obligations, regardless of probationary status of employees or business transfers. The application arose from contributions that were not paid on […]

A recent decision of the Financial Services Tribunal underscores the fundamental importance of the “fit and proper” requirements in the financial services sector, particularly the qualities of honesty and integrity. The ruling confirms that these standards are not aspirational ideals but binding regulatory thresholds. Where a representative’s conduct falls short, debarment is both warranted and […]

Brief background The insured applied for a claims-made professional liability policy and answered “No” to a question asking whether it was aware of any circumstances that might result in a claim. Prior to the application, the insured had received multiple complaints from a customer regarding defective equipment and had internally acknowledged the issues. The insurer […]

A recent High Court judgment highlights the critical importance of strict compliance with binder agreements and licensing conditions in the insurance sector. The court confirmed that where an underwriting manager exceeds its mandate or disregards regulatory limits, an insurer is entitled to enforce its contractual rights — including urgent access to underwriting data. Background Underwriting […]

A recent decision from the Appellate Court of Illinois, in the matter between Monroy-Perez v. Sentry Select Insurance Co., 2025 IL App (1st) 241711, serves as a stark warning to insurers regarding the consequences of withholding policy information from insureds. The court held that an insurer may be estopped from raising coverage defences, including limitations […]

A recent decision from the United States Court of Appeals for the Seventh Circuit, in the matter between Hammond Power Solutions Inc. v. National Union Fire Insurance Co. (2025), provides important guidance on the interpretation of exclusions in commercial general liability (CGL) policies—particularly those relating to radiation. The ruling confirms that a broadly worded exclusion […]

The recent decision in Gideon Pieter van Zyl v Kobie Spangenberg en Genote (Pty) Ltd by the Financial Services Tribunal (“the Tribunal”) highlights the critical importance of compliance with the procedural safeguards under section 14 of the Financial Advisory and Intermediary Services Act 37 of 2002 (“FAIS Act”) when effecting a debarment. The case underscores […]

On 8 August 2025, the Constitutional Court handed down its unanimous judgment in Mutsila v Municipal Gratuity Fund and Others, a case that brought into sharp focus the obligations of pension and retirement funds when allocating death benefits under Section 37C of the Pension Funds Act (“the Act”). At its heart was a dispute over […]

Directors’ and officers’ liability (D&O) insurance is a critical risk management tool for companies and their leadership, providing protection against claims arising from alleged wrongful acts in the management of the company. However, the scope of coverage under such policies is often the subject of dispute, particularly when regulatory investigations are involved. A recent decision […]

Factual Background The High Court of South Africa, KwaZulu-Natal Local Division, Durban, recently delivered judgment in a dispute concerning the supply of liquid petroleum gas (LPG). The Plaintiff, a supplier of LPG, had provided the product to the First Defendant over several years. Following a breakdown in the business relationship, the Plaintiff instituted action to […]

Facts of the Case The plaintiff, an account manager, brought a claim against the first defendant (a veterinary clinic) and the second defendant (a veterinarian employed by the clinic) following injuries sustained by his dog, Triesie, during a surgical procedure to repair a torn cruciate ligament. The plaintiff had a strong emotional attachment to the […]

Introduction The Financial Services Tribunal’s decision in Sehlabaka v The Pension Funds Adjudicator & Others delivers a stern reminder: the three-year time limit for filing complaints with the Pension Funds Adjudicator (“the Adjudicator”) is not a flexible rule, but it is a strict legal requirement. If a complaint is brought after that period, the Adjudicator […]

Brief Facts In a landmark case before the Gauteng Division of the High Court, the Financial Sector Conduct Authority (FSCA) sought to enforce an administrative penalty against several foreign individuals and a foreign partnership. The matter stemmed from the publication of a report that was widely distributed in South Africa, resulting in a dramatic drop […]

In a recent decision that underscores the enduring significance of full and accurate disclosure in insurance applications, the United States District Court for the Central District of California granted summary judgment in favour of an insurer seeking to rescind multiple liability policies on the basis of material misrepresentations. The case, Mt. Vernon Fire Insurance Company […]

A recent judgement by the United States District Court for the District of Connecticut offers important guidance for both policyholders and insurers on the significance of adhering to post-loss obligations under an insurance policy. Factual Background In this matter, the insured acquired a residential property and arranged property insurance. Shortly after the policy commenced, the […]

Introduction In a recent high value judgment granted in favour of the Standard Bank of South Africa Limited (“SBSA”), the Johannesburg High Court provided important clarity on the post-rescue enforceability of guarantees and suretyships, and demonstrated the importance of a well-drafted security package. The dispute at a glance Action proceedings were instituted by SBSA against […]

A Georgia-based contractor specialising in cooling system installations was sued after a maintenance worker died from exposure to leaking refrigerant gas at a facility where the contractor had installed the cooling system. The worker’s family pursued a wrongful death claim against the contractor, who in turn sought indemnity from its liability insurers. The insurers refused […]

Brief Facts of the Case The matter arose from a contractual dispute between a motor vehicle dealership (the Plaintiff) and a retired police officer (the Defendant). The Defendant entered into a written agreement to purchase a pre-owned vehicle from the Plaintiff, trading in his own vehicle as part of the transaction. The Defendant represented, both […]

The United States District Court for the Eastern District of Pennsylvania has recently held that a letter notifying the insured of the sender’s intent to institute a third-party joinder against it constituted a Claim under the insured’s claims-made professional liability insurance policy. Factual Background and Policy Context The insured healthcare staffing agency provided staff to […]

A recent decision from the Southern District of New York offers valuable perspective on the procedures and obligations that arise when an insurer defends a claim under a reservation of rights. Background The case involved a professional negligence action against an attorney, following an alleged failure to sue all responsible parties in a prior medical […]

Introduction The matter concerns a claim for damages arising from an incident in which the Plaintiff fell into an open manhole while walking along a pavement in Soweto. The Plaintiff, a resident of the area, was returning home from a shopping trip and chose to walk along Chris Hani Road to catch a taxi. While […]

A recent High Court judgement in London has sent a strong message to insurance brokers about the consequences of failing to provide comprehensive advice, while also offering new guidance on how overlapping insurance policies interact. The case, involving a leading insurance broker and a community housing trust (“the trust”), is likely to have a lasting […]

The recent decision in PRSS Solution (Pty) Ltd v M G Marara and Others by the Financial Services Tribunal (the Tribunal) underscores the crucial responsibility of employers to comply with their obligations under the Pension Funds Act (the Act). In particular, this includes registering employees with a pension fund and notifying the fund upon their […]

Introduction The recent judgment in the matter between the National Credit Regulator (NCR) and the credit lender company (the respondent) marks a significant development in the regulation of credit insurance practices in South Africa. The case scrutinised the legality and fairness of bundled credit insurance products sold to vulnerable consumers, including pensioners and disabled persons, […]

Car insurance policies are often assumed to provide blanket protection for any incident involving the insured vehicle. Many policyholders overlook how their insurer defines who else may legally and validly drive the insured vehicle. These definitions — and their often-overlooked nuances — can have major consequences when a claim arises. The recent US case of […]

In the recent decision of NN and OB Transport CC and Others v Transport Sector Retirement Fund and Others, the Financial Services Tribunal dismissed the employer’s application for reconsideration of a Pension Funds Adjudicator’s determination. At the heart of the dismissal was not only a lack of merit in the underlying dispute, but a critical […]

Background and Facts Just over a year ago and leading to the national elections, on 15 May 2024, the President of South Africa assented to and signed the National Health Insurance (NHI) Bill into law, a move that was met with significant opposition from various stakeholders, including the Board of Healthcare Funders of Southern Africa […]

Facts and Issues In a recent judgment delivered by the Gauteng Division of the High Court, the Plaintiff, a major financial institution, sought a monetary judgment against the Defendants, who had bound themselves as sureties for a company that had defaulted on several loan and facility agreements. The company, for which the Defendants stood surety, […]

Introduction A recent judgment from the Supreme Court of Appeal has provided important clarification on the application of prescription in the context of misappropriation of funds within a close corporation. The case revolved around whether a debt owed to a close corporation had prescribed, particularly in circumstances where one member was alleged to have misappropriated […]

Introduction The recent High Court judgement in Cadac Pension Fund and Others v Nash and Others (Gauteng Division, Johannesburg, 16 April 2025) offers important guidance on the role of interim interdicts in pension fund disputes — particularly where issues of curatorship, member entitlements, and alleged fund mismanagement are concerned. The case deals with a pension […]

Introduction In legal proceedings, the joinder of a third party can be a critical aspect, especially in cases where multiple parties may share liability. This article delves into the intricacies of a recent judgement concerning the joinder of a third party in a slip and fall case. The focus is on the legal principles and […]

In a decision handed down by the Eastern Cape Division of the High Court in Blue Crane Route Municipality v Municipal Workers Retirement Fund and Another, the Court affirmed that the in duplum rule applies equally to statutory interest owed under the Pension Funds Act (“PFA”). The judgment reinforces the principle that the accumulation of […]

Facts of the Case On 12 April 2021, the policyholder, Mr Mavela, was involved in a motor vehicle collision on the R26 road between Hobhouse and Wepener in the Free State Province. His Toyota Fortuner was damaged beyond economical repair. The policyholder, who was comprehensively insured by the insurer, filed a claim for compensation. The […]

Facts: On 10 February 2021, the Plaintiff was injured by a falling glass window while walking on the pavement in front of the Defendant’s premises, in Johannesburg. The glass window fell from the Defendant’s building, causing a significant cut on the Plaintiff’s left forearm, necessitating immediate medical treatment. The Plaintiff did not initially report the […]

Introduction South Africa boasts a vibrant running culture, with a wide array of organised races held throughout the year. The organisation of these events varies significantly; some races ensure that runners are shielded from spectators and the public, while others allow for potential interaction between runners and the public. The recent Supreme Court of Appeal […]

On 25 March 2025, the Financial Services Tribunal handed down a crucial decision in Auto Workers Provident Fund v Thulani Nyalungu & Others, providing essential guidance on the extent of the Pension Funds Adjudicator’s (“PFA”) authority when handling member complaints concerning pension fund transfers. The ruling emphasises the importance of adhering to pension fund rules […]

Introduction In the realm of delictual claims, the concept of foreseeability of damages is both fundamental and frequently underestimated. Plaintiffs often focus on the harm suffered and the apparent negligence of the defendant, but delictual liability requires a more nuanced assessment—particularly of whether the harm was reasonably foreseeable. Foreseeability plays a pivotal role in evaluating […]

In the construction industry, it is common to encounter a principal building contract between the employer and the main contractor, alongside a subcontract between the main contractor and its subcontractor. A pertinent question arises: does the employer have any recourse against the subcontractor if the employer is held liable for the actions of the subcontractor, […]

The recognition of factual dependency plays a crucial role in pension fund law, particularly in the allocation of death benefits under Section 37C of the Pension Funds Act (“the PFA”). The decision of the Financial Services Tribunal (“the Tribunal”) in Semenya and Others v Old Mutual Superfund Pension Fund and Others (“the Semenya case”) provides […]

South Africa has become a highly litigious country, as evidenced by the growing court rolls across the nation. This increase in litigation can be attributed to various factors, including greater public awareness of legal rights and recourse, the availability of litigation funders, and increased resources to pursue justice. In recent years, it has become common […]

Introduction In a recent court case, the Johannesburg High Court delivered a judgment on 8 January 2025 pertaining to disclaimers. The case revolved around a delictual claim for damages by the plaintiff who sustained injuries after slipping on a wet floor at the defendant’s premises. The court ultimately found in favour of the defendant, citing […]

7 March 2025 – Leading African law firm Adams & Adams is pleased to announce the appointment of Mtho Maphumulo to partner in its Insurance and Financial Sector Practice. Maphumulo’s appointment reflects the firm’s strategic focus on bolstering its dispute resolution capacity, specifically in the insurance and financial sectors. “Mtho’s commitment to learning and service […]

Introduction: The recent judgment in Neumann v Edelstein Farber Grobler Inc. has shed light on the intricate dynamics of commission entitlements and the responsibilities of employers in the real estate sector. This case, adjudicated in the High Court of South Africa, Gauteng Division, Pretoria, delves into the claim for damages by Mr. Neumann against his […]

Claims-made policies often require that policyholders notify their insurer promptly or as soon as practicably possible after an incident that may give rise to a claim. This requirement exists primarily to allow insurers to investigate potential claims while evidence is still fresh. Prompt notice helps ensure that key details and documentation are secured, which is […]

Introduction:  On 31 January 2025, the Pretoria High Court delivered a judgement in a motor insurance case in which the insurer rejected the policyholder’s claim following the theft of their vehicle. According to the insurer’s rejection letter, the claim was denied because the policyholder failed to prove that, at the time of the theft, the […]

The devastating wildfires that have swept through Los Angeles and other parts of California have highlighted the growing risks associated with climate change. These fires, intensified by prolonged droughts and extreme heat, have led to billions of dollars in damages, forcing the insurance industry to adapt rapidly. While the direct impact of these fires is […]

The primary purpose of building insurance is to protect property owners from financial losses due to damage to their buildings.  Buildings can be damaged from a variety of events, including fires, storms, floods, and earthquakes, each posing unique risks and challenges.  Exclusions and Their Impacts  Policyholders and brokers acting on their behalf must apprise themselves […]

The recent judgment of Municipal Workers’ Retirement Fund v Mafube Local Municipality and Others highlights the severe consequences of failing to meet statutory obligations under the Pension Funds Act 24 of 1956 (“the PFA”). Delivered by Opperman J, the judgment emphasises the importance of compliance with section 13A of the Act. At the heart of […]

The interpretation of what constitutes a claim under a claims-made policy is often a contentious issue. Ambiguities in policy wording frequently lead to disagreements between policyholders and insurers over whether specific events or circumstances trigger coverage. Frequently, policyholders fail to understand what qualifies as a claim under their policy. This misunderstanding often results in insurers […]

Claims-made policies in professional indemnity insurance often include prior exclusion clauses, which serve to limit the insurer’s liability for claims arising from circumstances that occurred or were known before the policy’s inception date. Insurers should exercise care in drafting prior exclusion clauses to ensure clarity and precision. Ambiguities in these clauses can lead to disputes […]

Can a professional services firm rely on a client’s assurance that they will not pursue legal action to avoid notifying its claims-made professional liability insurer of a potential claim arising from an alleged omission? This question is particularly significant in the context of claims-made professional liability insurance, where the insured’s duty to disclose any potential […]

Introduction On 29 November 2024, the Johannesburg High Court delivered judgment in a delictual case where the Plaintiff, a lessee on the Defendant’s premises, sued the Defendant after a gate fell on her. The significance of this judgment is highlighted below. Brief Facts The Plaintiff sustained injuries in August 2020 when a malfunctioning gate fell […]

Introduction The Western Cape High Court recently delivered judgment in yet another cybercrime incident. These cases have been growing rapidly, signalling a surge in cybercriminal activities. One might have expected a decline in such incidents, given the legal precedents addressing them, but this has not been the case. Facts The parties involved in the case […]

Like in many countries, during the festive season in South Africa, most activities come to a near standstill, including the operations of the courts. The Rules of Court recognise dies non (days on which the courts do not sit). Although the exact dates may vary each year, dies non typically extends from the 16th of […]

Introduction Recently, the Johannesburg High Court dismissed a personal injury case against an institution, finding no evidence of negligence or wrongdoing on its part. In recent years, South Africa has witnessed a growing trend of litigation, with an increasing number of lawsuits being filed—even in cases where the objective facts do not justify legal action. […]

Introduction: Once a party has been effectively served with summons, they must act promptly and follow the procedures set out in the Uniform Rules of Court (“the Rules of Court”). Failure to do so can lead to undesirable and costly consequences. The judgment delivered on 13 November 2024 by the North-West High Court serves as […]

In a matter of weeks, the festive season will be in full swing. This period usually comes with numerous lifestyle adjustments, including traveling, acquiring new items, and upgrading or improving homes, vehicles, and other belongings. These changes often affect the value of such items, making them more attractive targets for theft and exposes them more […]

On 16 October 2024, the Pretoria High Court delivered a judgment in an insurance case where the insurer had repudiated the policyholder’s claim on three grounds: The policyholder drove at an excessive speed, showing reckless behaviour; The policyholder allegedly misrepresented facts in his claim by stating he was avoiding a dog when he lost control […]

Disputes often arise between insurers and policyholders regarding the value of insured property. Some of these disputes are resolved with little difficulty, as the value can be relatively easily established. For example, in cases where a storm causes partial damage to a home and its contents, the insured property remains assessable. However, other disputes are […]

Directors and Officers (D&O) insurance policies often exclude claims arising from actual or alleged contractual liability. These exclusions typically prevent coverage when the company or an insured person is sued for breaching a contract or failing to fulfil contractual obligations. This is because D&O policies are designed to cover wrongful acts related to executive actions […]

The snowfall last week, which impacted much of KwaZulu-Natal and parts of the Free State, serves as yet another reminder of South Africa’s increasingly unpredictable weather patterns. In 2023, Johannesburg also experienced a light snowfall, though it was far less severe than last week’s event. Even then, such occurrences were considered unusual in the South […]

Introduction: South Africans are among the most highly indebted people in the world. With the unemployment rate showing no signs of improvement, there is no end in sight for this crisis. Persistent socio-economic issues are also exacerbating the situation. The widespread indebtedness of the majority has been recognized by the government for some time, leading […]

Introduction: When employees are dismissed or abscond following suspected theft or misappropriation of funds, ex-employers often attempt to recover the lost funds from the ex-employee’s pension benefits. In such cases, time is of the essence, as ex-employees may try to withdraw their pension benefits quickly. To have a chance of recovering the lost monies, an […]

The High Court of South Africa, Gauteng Division, Pretoria, was recently called upon to decide on a claim based on interim payment certificates from a building contract between the applicant, a construction company, and the respondent, a shopping centre. Under the building contract, the applicant was contracted to build a shopping centre in Montana, Pretoria. […]

When a liability insurance policyholder is being sued, they refer that legal case to their insurer. If a claim in question falls within the four corners of a policy, the insurer handles the claim on behalf of the policyholder. If the matter goes to court, the court papers cite the policyholder (not the insurer) as […]

Dishonest conduct by representatives of financial service providers (“FSPs”) continues to plague the sector. This is evident from an analysis of the most recent rulings of the Financial Services Tribunal, where a substantial proportion of the rulings pertain to reconsideration applications, challenging FSPs’ decisions to debar their former representatives. Are these simply the actions of […]

In today’s fast-paced digital world, legislation often struggles to keep up with the rapid advancements in technology. An example of such legislation is the Justices of the Peace and Commissioners of Oaths Act, 16 of 1963 (“the Act”). The Act requires that oaths be administered in the presence of a commissioner of oaths. Is this […]

A judgment from the High Court of South Africa, Eastern Cape Division, Mthatha, serves as a timely reminder that a lien (right of retention) can be defeated by providing adequate security for the debt alleged to be due. On 7 March 2023, the insured was involved in a collision on the road between Port St […]

Introduction The Johannesburg High Court (“the court”) has handed down a judgment on a matter that brought, once again, the prescription intricacies to the fore. There are many cases pertaining to prescription, from different courts, and, with each case, there are unique variables that make each case intricate. Facts Briefly, the Plaintiff sued his erstwhile […]

President Ramaphosa has promulgated the National Health Insurance (“NHI”) Act (“the Act”). The NHI, in its bill form, has been controversial since its introduction and has attracted significant critique from various stakeholders. It is therefore likely that the Act will be the subject of fierce litigation, sooner or later. Some of the institutions/groups which have […]

A judgment from the High Court of South Africa, Eastern Cape Division, Bisho, serves as a timely reminder for legal practitioners to diligently consult the rules of court before instituting proceedings to avoid the pitfalls that may arise from failing to follow a rule correctly. The applicant sued the first and second respondents, seeking damages […]

Restraint of trade agreements safeguard businesses by legally preventing employees from joining competitors, thus protecting businesses’ proprietary information and maintaining their competitive advantage. In an urgent application seeking to enforce a restraint of trade agreement, recently before the Labour Court of South Africa, Johannesburg, an insurance brokerage firm made the fatal error of failing to […]

A judgment stemming from the High Court of South Africa, Limpopo Division, Polokwane serves as a timely reminder that a “without prejudice” offer, if not drafted or approached properly, can interrupt the prescription of a claim. Facts of the case The plaintiff instituted action against the defendant for the injuries she suffered from a helicopter […]

Attorneys representing plaintiffs should take note of a judgement recently handed down in the High Court of South Africa, Gauteng Division, Johannesburg. Two unemployed plaintiffs instituted action against the Minister of Police, Minister of Justice and Correctional Services, and the National Director of Public Prosecutions, each claiming R5,000,000.00 for their alleged unlawful arrest and malicious […]

Policyholders and insurers alike should take note of a judgement recently handed down in the High Court of South Africa, Gauteng Division, Johannesburg. The case concerned a claim for specific performance in terms of a life insurance policy. The policyholder lodged a claim with his insurer through its authorised agent on or about 27 September […]

An appeal serving before a full bench in the High Court of South Africa, Gauteng Division, Pretoria has recently shed light on whether a midstream review of proceedings conducted at an investigative stage is permissible. The appeal stemmed from a ruling by a single judge in the same division that an investigation conducted at the […]

INTRODUCTION: The law draws a distinction between “negligent conduct” and “grossly negligent conduct”. Grossly negligent conduct is synonymous with reckless conduct. The distinction is of great legal significance. If a conduct is deemed to be “negligent”, an insurance policy is bound to respond to a claim. If, however, it is found to be “grossly negligent”, […]

It is that period where there are many pressing things which preoccupy people’s minds, such as school/university fees, finalising the last errands before heading back to work, etc. Against this backdrop, it is perhaps understandable why this is a period where most insureds are likely to miss sight of critical aspects of their insurance policies. […]

Large parts of Johannesburg and Mpumalanga were hit by a severe hailstorm on Monday, 13 November 2023. Since then, various media platforms have been abuzz with videos and pictures depicting the damage caused by the said hailstorm. Many cars, roads, buildings, infrastructure, establishments, etc. were damaged in the process. Naturally, the first thing that the […]

Insurance claims can be repudiated for many varying reasons – from the most obvious to the least expected reasons. One of the best ways of trying to avoid an insurance repudiation is to understand your contractual duties stemming from your policy. Although this does not guarantee a payout, it does, nonetheless, enhance one’s chances of […]

The news that dominated the headlines this past weekend, 15 – 17 September 2023, was the storm surge incidents that swept across three coastal provinces – the Western Cape, Eastern Cape, and KwaZulu-Natal. Mainstream media and social media alike were abuzz with the news. Since then, videos depicting the storm surges have been circulating across […]

During the course of last year, 2022, there were various media reports that there has been a significant rise in home insurance claims. Complimenting these reports was the announcement by the Short-term Ombudsman’s Office that there had been a rise in disputes relating to home insurance claims. There were many reasons attributed to this rise, […]

On 5 September 2023, a noteworthy legal judgement emerged from the Gauteng Division of the High Court of South Africa, situated in Johannesburg. The case centered around an individual sanctioned by the Johannesburg Stock Exchange (“JSE”) for transgressing various provisions of the JSE’s Listing Requirements. Aggrieved by the sanction imposed, the individual applied, under section […]

Introduction: It is not uncommon for financial services representatives (“the representatives”) who are debarred to run out of time to file their reconsideration applications. There have been, over the years, various reasons submitted to the Financial Services Tribunal (‘the Tribunal”) trying to condone the late filing of such applications. Some of the reasons are meritorious […]

Road accidents involving food delivery drivers are far more common than you can imagine, with most cases reported to have resulted in serious injuries and death. Following the COVID-19 pandemic, with most people choosing to stay indoors, the food delivery industry expanded and presented more opportunities for players in the industry. It also created job […]

Introduction: It is often said that South Africa’s financial sector is one of the most highly regulated in the world. This is certainly true if one has regard to the several ‘financial sector laws’ (see Schedule 1 of the Financial Sector Regulation Act) that regulate the financial sector. There are several statutory duties imposed on […]

There have been reports regarding the rise of non-indemnity claims stemming from unnatural deaths. This is certainly worrying for life insurers. This is particularly concerning because life insurers have had to entertain several claims in the past couple of years due to Covid-19 related deaths, and subsequently, the July 2021 unrest and the 2022 Durban […]

The past few weeks have been engulfed with flames of truck arson attacks in South Africa. Over 20 trucks have been torched in various provinces including Mpumalanga, Limpopo, Kwa-Zulu Natal, etc. While the sudden rise in these incidents is undoubtedly worrisome, one must bear in mind that truck attacks are not a novel phenomenon in […]

INTRODUCTION The North Gauteng High Court recently handed down a judgment which will undoubtedly gain support from many policyholders. Whilst the matter specifically relates to a car insurance claim, the principles laid down in this case will certainly find application in other insurance cases. The case is significant for both the insurers and the insureds […]

Introduction It is almost impossible to think of an insurance policy that does not have any conditions and/or warranties. Most insurance policies, if not all, have various conditions and warranties which, if they are not adhered to, may lead to a lawful rejection of one’s claim. The conditions and warranties perform extremely important functions in […]

The global business community is undergoing a transition towards a green economy driven by a shared recognition of the urgent need to address climate change, protect natural resources, and promote sustainable development. As businesses in South Africa and elsewhere adopt sustainable practices and environmentally conscious strategies, they can expect to encounter two categories of risks […]

For the past few days, the international news has been dominated by the missing Titanic submarine. Social media platforms have also been abuzz with the missing submarine. One of the interesting questions that seemed to be prominent was the question of whether insurance claims could be submitted if the passengers of the submarine were not […]

Insurance contracts are sometimes referred to as reciprocal contracts because they usually involve both the insured (paying a premium and getting peace of mind) and the insurer (bearing the risk whilst getting premiums) – both parties bear some obligations and (potential) benefits. There are, however, instances where the lines may be blurred. This is due […]

A few years ago, several well-known short-term insurance companies took legal action against an intermediary company due to the damages they incurred as a result of the intermediary’s collapse. The intermediary, presently in liquidation, was responsible for the collecting and accounting of premiums owed to the insurers. Surprisingly or some might even contend strangely, the […]

Insurance policies often contain a standard clause requiring policyholders to comply with the laws of the country where the policy is issued. The intention behind the clause is to ensure that policyholders act in a lawful manner. Failure to comply may lead to policy exclusions or the denial of claims. With the current energy crisis […]

The parties to an insurance contract all have a legal duty to disclose. All the material information must be disclosed. This sounds simple enough, however, this is not so in real life. This is evidenced by the fact that there is plethora of court cases that relate to the issue of non-disclosure. The substance of […]

It is not unusual to have insurance claims approved but payouts being underwhelmingly low and/or slow. This was mostly seen during COVID-19 in relation to business interruption claims. Whilst most claims were approved by the insurers, the payouts left the insureds with great dissatisfaction. Despite COVID-19, many other major events led to this kind of […]

Many policyholders are underinsured, whether it be deliberately or ignorantly so. Either way, it may just come back to bite them at the claims stage. Principle of average Underinsurance arises when the amount for which an object is insured is less than the actual value thereof. When this happens, it gives rise to the principle […]

The National Shutdown of 20 March 2023 saw many businesses and institutions close down in fear of violence and destruction to their properties. To the contrary (credit being due to the protestors and overwhelming visibility of law enforcement) this was not the case. Whilst the anticipated damage was less than expected, it is nonetheless apt […]

Litigation in South Africa has risen tremendously over the years with more and more individuals and organizations seeking redress through our courts. The increase in litigation can largely be ascribed to: Improved access to justice through initiatives, such as the Small Claims Court, Legal Aid South Africa, and the various industry Ombuds. Consumer friendly legislation, […]

Most short-term insurance policies have a standard “precautionary clause” that requires the insureds to “take all reasonable precautions to prevent loss, damage, accidents…”. This clause ordinarily forms part of the general terms and conditions of the policy. It is not uncommon for insurers to rely on this clause to reject claims – sometimes rightly so, […]

Non-disclosures by policyholders are rife within the long-term insurance industry. A non-disclosure can be committed fraudulently, innocently, or negligently. In any respect, the non-disclosure needs to have been material and must have induced an insurer into entering a contract of insurance to warrant the contract being avoided (cancelled). The test for materiality is an objective […]

It is not unusual for many insureds to complain about unexplained delays in their insurance claims. More often than not, insureds undergo a very frustrating period whilst waiting for the outcome of their insurance claims. There are many applaudable reasons why insureds may become frustrated when there are delays in the claiming process – an […]

Insurance policies often contain clauses requiring policyholders to take reasonable steps to maintain an insured object. The reason therefore is quite simple – the purpose of insurance is to protect policyholders against unforeseen events, not to compensate them for wear, and tear. A policyholder’s failure to maintain an insured object may result in any claim […]

Introduction: South Africa has been experiencing a heavy downfall for a couple of weeks now, which has resulted in heavy flooding in most provinces. It is for this reason that the President of the country has declared a National State of Disaster. The ongoing flooding has caused serious damage to people’s properties, cars, house contents, […]

The Ombudsman for Short Term insurance has ruled that an adventure resort’s insurer is liable to indemnify it against a claim brought by one of its patrons. On 19 January 2019, a patron sustained severe burns when hot oil from one of the resort’s quad bikes spilled onto the patron’s legs. The patron immediately demanded […]

South Africa is suffering from the worst loadshedding ever implemented. This is causing significant headaches for the insurance industry, particularly the short-term insurance companies. The energy crisis comes on the back of the major calamities of recent years, such as Covid-19, the July 2021 unrest, and the Durban floods of April 2022. As a result, […]

During May 2015, a fire broke out on farm owned by Normandien Farms (Pty) Ltd (“Normandien”), causing extensive damage to a plantation which was insured by Safire Crop Protection Co-operative Limited (“Safire”). Normandien subsequently lodged a claim with Safire who in turn rejected the claim. The reason for their rejection was twofold; firstly, Safire believed […]

Within the first month of the new year, there have been 2 (TWO) tigers reported to have escaped from captivity and found to be roaming around freely on the streets. The first one was found and euthanised. By the time it was located, it had already seriously injured at least one resident. There have been […]

Our client, a successful medical practitioner, suffered a cardiac arrest (“the event”) following a routine procedure to remove a mass from his kidney. Pursuant to the event, our client was placed on a ventilator for months, resulting in him not being able to speak post being weaned off the ventilator. In addition, our client suffered […]

Many insured consumers may be in for a nasty surprise for wrongly believing that they enjoy blanket cover from their insurer. The reality is however that their cover is limited to that specifically agreed with their insurer. The cover usually relates only to physical damage sustained to an insured object, meaning that, unless otherwise agreed, […]

For most households, the first few months of the year are the most financially demanding and, as a result, people struggle to make ends meet. It is, as such, not surprising that most people relook at their budgets to identify non-essential expenses. It often happens that insurance policies are one of the few items that […]

A large insurance company’s application to rescind a court order, granted by default, was dismissed with costs in the High Court of South Africa, Gauteng Division, Pretoria. The insurer, in exchange for monthly premiums to be paid by the insured, agreed to indemnify the insured for loss or damage. The insured’s motor vehicle was subsequently […]

A few media houses have recently reported that Mr. Erlo Goshai, a Cape Town motorist, has warned motorists to “read the fine print when entering into contracts with their insurance company to make sure they are adequately covered”. According to the reports, Goshai was driving along Marine Drive and was in the process of turning […]

Consumers procure insurance for many reasons. One of the reasons is to protect themselves from their own actions. Negligence v recklessness Some actions enjoy cover under insurance policies whilst others don’t. For example, negligent actions are usually covered whilst reckless actions are usually not. Negligence can colloquially be defined as failing to act reasonably which […]

The festive season is upon us, and everyone is eagerly looking forward to their much-needed break. It is the “crazy season,” with lots of buying, travelling, partaking in various adventurous activities, etc. An unfortunate reality is that during the festive season, there are lots of insurance related perils that tend to occur – which do […]

The Supreme Court of Appeal (“the SCA” hereinafter) recently delivered a judgement in a matter involving Zurich Insurance Company South Africa LTD (“the insurer”) and the Gauteng Provincial Government (“the insured”), bringing to an end litigation that commenced early 2015. This insurance repudiation matter involving highly technical legal and civil engineering components is crucial for […]

Thousands of consumers make use of the services of a broker, to procure insurance from an insurance company. In such instances, two separate agreements come into existence.[1]The first is between the consumer and the broker and the second is between the consumer and the insurance company (represented by the broker). While both agreements involve the […]

South Africa’s energy crisis seems to be getting worse by the day, and there is no end in sight. Eskom, the only public energy supplier who has in the past received massive financial injections from the government, seems to be helpless at this point. There are many reasons that have been advanced for this crisis […]

Introduction: The major events of recent years, particularly in South Africa, including the 2021 July civil unrest and 2022 Durban floods, have brought forth an issue that is not often entertained due to the rarity of such events, and that is whether it is possible to claim under a life policy where the deceased’s body […]

PRICE TO PAY IN THE KING PRICE CASE: FAILURE TO COMPLY WITH YOUR INSURER’S REQUESTS!! INTRODUCTION On 9 May 2022, the South Gauteng High Court division delivered a judgment in the matter between Zandisiwe Musa (“Musa” hereinafter) and King Price Insurance Company (“King Price” hereinafter). This judgment is significant in many respects, as it highlights […]

As if there have not been enough fires in the country for 2022, there is an expected rise in wildfires as the winter season is in full swing. With strong and harsh winds that naturally come in the month of July, wildfires are to be expected and businesses and individuals alike will need to be […]

Insurance provides cover for losses arising from insured events which may happen in the future. Against an agreed premium, the risk of an insured event arising is transferred from the insured to the insurer. Insurance is, therefore, a critical risk mitigation component to both businesses and individuals alike. In practice, insured events triggering insurers policies […]

Weather conditions of any sort have direct effect on the insurance industry. The severity thereof is, however, of particular significance for the industry, as the possibility of insured risk materialising heightens. At this point in time, this is particularly relevant in South Africa given the ongoing heavy and persistent rains. There have been reports, images […]

Insurance provides cover for losses arising from insured events which may happen in the future. Against an agreed premium, the risk of an insured event arising is transferred from the insured to the insurer. In practice, insured events triggering insurance policies to respond are not always clear-cut. This is largely due to the complex wording […]

The past few years have tested the resilience and strength of insurers to the greatest magnitude. This has been the case worldwide and, more so, here in South Africa. Many insurance-triggering events occurred, requiring insurers to respond. Although most of these occurrences were relevant mainly to short-term insurers, some were relevant to long-term insurers. After […]

Introduction When concluding an insurance contract, it is important in the pre-contractual stage, to disclose all material facts which would be relevant to the assessment of the risk, the premium to be determined and decision to be made by the parties to conclude the agreement. A statement of fact which is false or misleading, amounts […]

It is fast becoming a normality to wake up to the reports of fire break outs in South Africa. Since the July 2021 civil unrest, there has been further major fire break outs. This year alone, 2022, there has been at least 4 (FOUR) major fire break outs reported. During the July 2021 civil unrest, […]

The ongoing persistence of loadshedding is causing havoc for households and businesses alike. As if Covid-19 and civil unrest and looting experienced mid-year were not devastating enough for businesses, they now have to put up with the current ongoing loadshedding. Whilst most big businesses may have insurance cover and mitigating equipment in place to deal […]

INTRODUCTION Businesses always strive to have sufficient insurance cover for all and any possible perils. For this, they are willing to spend a lot of money. It is for this reason that when an insured peril occurs, they realistically and reasonably expect their insurers to pay out and/or repair the damage. Unfortunately, this is not […]

The events of the past two years, from the COVID-19 pandemic to the recent riots, have underlined the critical importance of business insurance. Unfortunately, there are no guarantees that your business insurance claim will be settled and not repudiated. Although an insurer has the right to protect its interests when handling your insurance claim, your […]