How long do I have to claim from an insurance company?

You have three separate clocks to watch when you claim from an insurance company. The first is the notification period in your policy, which says how soon after the event you must tell the insurer. The second is the period you get after a rejection to argue your case, which the Policyholder Protection Rules fix at a minimum of 90 days. The third is the deadline for going to court, which is set by the time-bar clause in your policy and by the three-year prescription period under the Prescription Act 68 of 1969. Miss any one of them and a claim that should have been paid can be lost for good.

None of these periods is the same for every policy. The only reliable source for your notification period and your time-bar period is your own policy wording. If you do not have it, ask the insurer or your broker for a copy today. They must give it to you.

The three clocks explained

Clock one: notification. Almost every short-term policy, whether for a car, a house, a phone or a business, requires you to report an insured event within a stated period. Some policies say "immediately" or "as soon as reasonably possible" and then add a hard outer limit. Others state a number of days. Life and funeral policies also have notification and claim periods, which are usually longer but still finite. The Policyholder Protection Rules, issued under the Short-term Insurance Act and the Long-term Insurance Act, require insurers to state these periods clearly and to draw your attention to them.

Clock two: the 90 days after a rejection. When an insurer rejects your claim, or pays less than you claimed, the Rules require it to tell you in writing why, to tell you that you have at least 90 days to make representations (which simply means to write back and argue your case), and to tell you about your right to complain to the ombud. A rejection letter that does not mention these things is itself a breach of the Rules, and that is worth pointing out in your complaint.

Clock three: the time-bar and prescription. If the insurer still refuses after your representations, you must issue a summons within the time-bar period in the policy. The Rules require that period to give you a reasonable window after the 90 days has run out, and in most policies it is measured in months rather than years. Separately, the Prescription Act gives a debt, including a claim under an insurance contract, a life of three years from the date it became due. Whichever of these two dates comes first is your real deadline.

How the process works step by step

1. Report the event. Phone the insurer's claims line and follow up by email so that you have a dated record. Get a claim number. If the event involves a crime, such as theft or hijacking, report it to the police first and give the insurer the case number.
2. Submit what is asked for. Quotes, photographs, proof of ownership, an affidavit if requested. Keep copies of everything you send and note the date you sent it.
3. Wait for the decision. Insurers generally undertake to decide within a set period once they have all the documents. Chase in writing if they exceed it.
4. If rejected, make representations within 90 days. This is your chance to answer the reason given. Attach any new evidence.
5. If still rejected, complain to the ombud. The National Financial Ombud Scheme handles short-term and long-term insurance complaints free of charge. Read How to complain to the ombudsman for short-term insurance for the detail.
6. If the ombud cannot resolve it, consider a summons. Do this before the time-bar period or the prescription period expires, whichever is sooner.

Our prescription checker works through the dates with you if you are unsure where you stand.

A worked example

Naledi owns a townhouse insured under a standard household policy. A geyser bursts in March and floods two rooms. She is overseas at the time and her tenant does not tell her until she returns six weeks later. Her policy requires notification within 30 days of the event. She reports the claim on day 44.

The figures below are illustrative only, made up to show how the clocks interact. They are not a prediction of any outcome.

• The claim: repair quotes come to R38 000 for the ceiling, flooring and geyser replacement.
• The rejection: the insurer rejects the claim for late notification. The letter states the reason, tells her she has 90 days to make representations, and gives the ombud's details, as the Rules require.
• Representations: within the 90 days, Naledi writes back. She explains why she could not report sooner, attaches her flight tickets and her tenant's statement, and points out that the insurer's assessor was still able to inspect the damage and that nothing about the delay made the loss worse or harder to investigate.
• The ombud: the insurer maintains its rejection. Naledi lodges a free complaint with the National Financial Ombud Scheme. The time-bar clock in her policy is paused while the ombud considers the complaint.
• The outcome: the ombud's view often turns on whether the late notification actually prejudiced the insurer. If it did not, insurers are frequently expected to consider the claim on its merits. Nobody can promise Naledi that result, but she has protected every one of her deadlines and lost nothing by trying.

Had Naledi ignored the rejection letter for four months, she would have missed the 90 days, and the time-bar period would have started running against her without any complaint to pause it.

What to do this week

• Find your policy wording and highlight the notification period, the time-bar clause and the complaints section.
• If the event has just happened, report it today, in writing, and get a claim number.
• If you have a rejection letter, write the date you received it in your diary and count forward 90 days. That is your representations deadline.
• Write your representations now rather than at the end of the 90 days. The sooner the insurer receives them, the sooner the next step can begin.
• Start a single folder, paper or digital, for every email, letter, photograph and quote.

Evidence to gather

• your full policy wording and schedule, not just the summary
• proof of when the event happened and when you reported it (emails, call logs, the police case number)
• photographs and videos of the damage or loss, taken as early as possible
• quotes, invoices and proof of ownership for anything you are claiming
• the rejection letter and every later letter from the insurer
• statements from anyone who saw the event or can explain any delay

Realistic timeline

• Reporting and assessment: days to a few weeks for a simple claim, longer if an assessor or investigator is appointed.
• Rejection and representations: up to 90 days for you to respond, then a few weeks for the insurer to reconsider.
• The ombud: several months is common. Complex or disputed complaints take longer.
• Court: if it goes that far, a year or more. Most disputes are resolved well before that.

Common mistakes and what they cost

• Reporting late because you were waiting for quotes. Report first and send quotes afterwards. A late report gives the insurer a reason to reject that has nothing to do with the merits.
• Ignoring the rejection letter. The 90 days runs whether you act or not. Silence is treated as acceptance.
• Going to the ombud after the time-bar has already expired. The ombud can pause a clock that is still running. It cannot restart one that has stopped.
• Assuming the ombud complaint pauses prescription as well. It pauses the policy time-bar. Do not assume the three-year prescription period is also paused. Keep your eye on that date and issue summons before it if the matter is unresolved.
• Accepting a reduced payment without reading what you are signing. A full and final settlement usually ends the claim.
• Letting a broker handle everything without checking. The deadlines are yours, not the broker's.

Your rights and the insurer's rights

You have the right to: a copy of your policy; written reasons for a rejection; at least 90 days to make representations; a free complaint to the ombud; and to issue summons within the time-bar period. If an insurer wants to rely on late notification, it generally has to show that the delay actually prejudiced it, and its own compliance with the Rules will be examined.

The insurer has the right to: be told of the event within the policy period; investigate before paying; ask for documents and cooperation; reject a claim that falls outside the cover or breaches a condition that matters; and enforce a lawful time-bar clause that complies with the Rules.

If you cannot afford an attorney

You do not need an attorney for any of the first five steps above. Representations and an ombud complaint cost nothing but time. The National Financial Ombud Scheme is free for consumers and it is the route most insurance disputes take.

If the matter must go to court and you are a natural person claiming a modest amount, the Small Claims Court hears claims up to its monetary limit without attorneys. Check the current limit and whether your claim fits with our small claims court calculator, and see court fees for what a summons costs. Legal Aid South Africa can be reached on 0800 110 110, though civil insurance disputes are not always within its priorities. For a larger claim, some attorneys take insurance disputes on a contingency basis under the Contingency Fees Act 66 of 1997, which requires a written agreement and caps the success fee. What does claims and compensation cost? explains the usual fee models.

Frequently asked questions

People often ask whether a late report automatically kills a claim. It does not. The insurer must usually show that the delay caused it real prejudice, and the ombud looks at that closely. People also ask whether the 90 days starts from the date on the rejection letter or the date they received it. Treat it as running from the date on the letter, and act well inside it, so that the question never matters. Finally, many people ask whether they can go to the ombud and to court at the same time. In practice the ombud will not consider a matter that is already before a court, so choose the free route first, unless a deadline forces your hand.

If your claim has already been rejected, read My insurance claim was rejected. What can I do? next.