How a car insurance claim is handled and decided, step by step

After you claim, the insurer must record the claim, tell you how it will be handled, decide it within a reasonable time, and tell you the decision in writing within 10 days. If it refuses, it must give plain-language reasons and at least 90 days for you to respond. You can then go to an ombud.

What does the insurer have to tell me when I claim?

Rule 17.8.3 of the Policyholder Protection Rules (Short-term Insurance), 2017, lists what an insurer must disclose to a claimant. It covers:

• the type of information required from you;
• where, how and to whom the claim and related information must be submitted;
• any time limits on submitting claims;
• any excesses payable by you;
• details of any administrative fee for managing the claim; and
• any other relevant responsibilities you have.

All communication with you must be in plain language (Rule 17.8.2). The insurer's claims processes must be transparent and visible, and accessible through channels suited to its policyholders (Rule 17.8.1).

The time limits matter. Many policies expect you to report certain events within a set period. If your policy has such a limit, the insurer must tell you about it, and you should act on it at once.

What happens in the first days?

Three Rules shape the start of a claim.

Recording. Rule 17.8.7 says the insurer must record the claim "by no later than the first business day after" it receives it. It may not wait until you have supplied every document.

Acknowledgement. Within a reasonable time after receiving the claim, the insurer or its representative must acknowledge it, give you the contact details of the person or department processing it, and give you indicative timelines for finalising it (Rule 17.8.4). A claim is treated as received on the day the insurer, its representative, or an independent intermediary or other service provider it has mandated to manage claims receives notification of it.

Information requests. The insurer may only require information or documents from you that are "essential to the assessment of the claim" (Rule 17.8.5).

What must the insurer keep telling me?

Rule 17.8.6 says you must be kept adequately informed of the progress of your claim, the causes of any delay and the revised timelines, and the insurer's decision. If it needs more from you, it must say what is outstanding.

If you use a broker or another intermediary, that does not weaken your rights. Rule 17.4.4 says that giving part of the claims process to an intermediary or other person does not reduce the insurer's own responsibilities under the rule.

How long does the insurer have to decide?

Rule 17.6.1 says an insurer must accept, repudiate or dispute a claim, or dispute the amount of a claim, "within a reasonable period after receipt of a claim". The Rules do not fix a number of days for this decision. What is reasonable depends on the claim.

Once the insurer has made a decision, Rule 17.6.2 gives it 10 days to notify you of it in writing.

The Rules also say the insurer may not "deny a claim without performing a reasonable investigation" (Rule 17.11.1(b)). It may investigate, but the investigation has to be reasonable. It may not dissuade you from using an attorney or an adjustor (Rule 17.11.1(a)).

What if the insurer refuses the claim, or disputes the amount?

If the insurer repudiates the claim, or disputes the claim or its amount, Rule 17.6.3 requires a notice in plain language that tells you:

1. the reasons for the decision, in enough detail for you to dispute them if you choose;
2. that you may, within a period of not less than 90 days after the date you receive the notice, make representations to the insurer about its decision;
3. the details of the insurer's internal claim review and escalation process;
4. your right to complain to a relevant ombud, with the ombud's contact details, and other legal provisions about time limits for that complaint; and
5. if the policy has a time limit for starting legal action, that limit and what it means for you, or, if it has none, that the Prescription Act, 1969 applies.

If the insurer uses another person to send this notice, the notice must also give the insurer's name and contact details and say that any recourse or enquiry must go directly to the insurer (Rule 17.6.4).

What happens when I make representations?

If you write to the insurer after a refusal, Rule 17.6.5 gives it 45 days after receiving your representation to tell you in writing whether it accepts, repudiates or disputes the claim or the amount. If it confirms its earlier decision, it must again give reasons in enough detail for you to dispute them, with the facts that informed the decision, and the same ombud and time-limit information (Rule 17.6.6).

The Rules say the internal review process should be allocated to an impartial, senior functionary of the insurer or to a process appointed for that purpose (Rule 17.5.3(d)), and that its procedures should not be overly complicated or place unduly burdensome paperwork on claimants (Rule 17.5.2).

Is there a time limit for going to court?

A policy can contain a clause that sets a time limit for starting legal action. The Rules limit how it works. For a policy entered into on or after 1 January 2011, the clause may not count the 90-day representation period, and it must give you not less than 6 months after that period ends to start legal action (Rule 17.6.8). Even after a limit has passed, you may ask a court to condone non-compliance if it is satisfied, among other things, that there was good cause for the delay and that the clause is unfair to you (Rule 17.6.9).

This is a legal matter, and Olvian does not give legal advice. The notice you receive from the insurer must set out the limit that applies to your policy, so read it carefully.

What if the claim is paid?

When the insurer makes a final payment or offer of settlement, Rule 17.8.8 says it must explain what the payment or settlement is for and the basis on which it was calculated. If the amount seems wrong, ask for that explanation in writing, then use the dispute route described above.

If the claim involves a settlement that follows a total loss, your policy wording says how the insurer values the car, and the excess still applies as the schedule states. Car insurance excess explained covers what the Rules require the insurer to disclose about the excess.

How are claims on my own policy different from the Road Accident Fund?

A claim on your own motor policy is a contract claim against your insurer. A claim to the Road Accident Fund is a statutory claim by a person injured, or by dependants of a person killed, in an accident involving a motor vehicle. Section 17 of the Road Accident Fund Act frames the Fund's duty around loss from bodily injury or death. The two can sit side by side after an accident. Our guide on motorbike insurance and the Road Accident Fund explains the difference in more detail.

Where do I take an unresolved dispute?

Work upwards in this order.

1. Write to the insurer and ask it to reconsider, using the internal review process (Rule 17.5).
2. If you are still unhappy, lodge a complaint with the National Financial Ombud Scheme. Its website says it offers free dispute resolution to the complainant and that it can only look at a complaint after you have first lodged it with your insurer. Its phone line is 0860 800 900.
3. For concerns about how a financial institution has conducted itself, you can also approach the Financial Sector Conduct Authority, which supervises market conduct and says it assists clients with complaints about conduct and breaches of the laws that govern it.

For the rest of the complaints route, see motorbike insurance complaints and your rights, which applies to cars in the same way.

Sources

Checked on 31 October 2026. Olvian is not a financial services provider and this guide is information, not advice.

• Policyholder Protection Rules (Short-term Insurance), 2017, Government Notice 1433, Government Gazette 41329 of 15 December 2017: Rule 17 (claims management), in particular Rules 17.4.4, 17.5, 17.6, 17.8 and 17.11.
• Road Accident Fund Act 56 of 1996, section 17
• National Financial Ombud Scheme
• Financial Sector Conduct Authority