Discover essential tips for ensuring a smooth insurance claims process, from understanding your policy to maintaining accurate personal information. Learn how to avoid common pitfalls and ensure your claims are processed efficiently.
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Insurance exists because accidents, and unexpected loss and damage can (and unfortunately often do) happen. And when they do, all people really want is for the claims process to be as smooth and straightforward as possible.
Most often, claims challenges arise when policy conditions haven’t been met, info is missing, or policyholders are unaware of certain requirements.
The Ombud for Short-Term Insurance (OSTI) reports that complaints related to car insurance accounted for 35.4% of all the complaints resolved during 2025, with the primary reason for these complaints being claims rejected due to an exclusion in the policy.
Insurance is a contract, which means both the insurer and the policyholder have rights and responsibilities: The good news is that many of the issues that can complicate a claim are preventable if you understand your cover and keep your info up to date.
Here are some of the most common reasons for claims glitches:
Personal info
The details you provide when taking out insurance form the foundation of your cover. This includes details about your risk profile, claims history, and other personal info, as well as everything about the things you’re insuring. The ‘regular driver’ of your car is a critical piece of info, this is the person who drives the car most often in any given month.
It’s up to you to ensure that all the info you provide when taking out cover is complete and accurate, and to let your insurer know if things change. If significant info is found to be incorrect, it could affect how a claim is assessed and may even impact the policy itself.
Exclusions
Many claims disputes arise simply because policyholders are unfamiliar with their cover. People often only read their policy documents when they need to claim. But, taking the time upfront to understand the terms, conditions, the exclusions that explain what is and isn’t covered, and what obligations need to be met, can help avoid surprises later.
Underinsurance
Insuring your buildings, home contents, and portable possessions insurance for less than their current replacement value could result in a claim being settled proportionately rather than in full. When it comes to portable possessions, it’s also critical to ensure that they’re correctly specified.
Maintenance
Insurance is designed to protect against sudden and unforeseen events, not gradual deterioration.
According to the 2025 OSTI Report, poor maintenance and wear and tear were the most common reason for complaints relating to buildings and home contents claims; the number of complaints here increased by 17.5% from the previous year.
The same principle applies to cars. Worn tyres, neglected brakes, and other maintenance-related issues could become relevant if they contributed to an accident.
Conditions of cover
Some policies include specific conditions that must be met for cover to apply. For homes, this may include alarms, burglar bars, or armed response services. For cars, insurers may require self-inspections or the installation of approved tracking devices.
The claims process
What you do after an incident can also influence how smoothly a claim progresses. The first step is to notify your insurer as soon as possible – most insurers require incidents to be reported within 30 days – and to produce any additional info they ask for, like SAPS case numbers or accident reports.
If your car needs to be towed, use an insurer-approved provider. Likewise, avoid repairing, replacing, or disposing of damaged items before receiving guidance from your insurer.
And, finally, remember that insurance cover depends on premiums being paid and the policy remaining active.
Insurance works best when both parties understand their responsibilities. A little preparation, regular policy reviews, and open communication with your insurer can go a long way towards helping make the claims process as smooth as possible.
* Ntuli is a spokesperson at King Price Insurance.
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