Terms and Conditions:
“Agreement” – The agreement concluded between the Client and Claims Specialist in respect of the Product and/or Service outlined in the Contract and any additions to such contract, which agreement will be exclusively governed by these terms and conditions and the specific terms and features applicable to the relevant Product or Service (as contained in Claims Specialist’s Product brochures), read together with the contract and any appendices attached. “Business Day” – Any day other than a Saturday, Sunday or official public holiday in South Africa. “Claims Specialist” – Claims Specialist (Pty) Ltd and any entities appointed by Claims Specialist to perform the Service and shall include references to the employees, agents, sub-contractors, service providers, suppliers and any independent contractors of Claims Specialist or such appointed entities. “Client” – The Party whose details appear on the Contract and who has signed after being requested to read these terms and conditions which will govern the relationship between the Parties. “Confidential Information”- Information that is identified (orally or in writing) as confidential or of such a nature that a reasonable person would understand such information to be confidential. “Day; Week; Month” – Calendar Day, week or month, respectively. “Direct Marketing” – means where the Client has been approached by Claims Specialist in an unsolicited manner as defined in the Consumer Protection Act No 68 of 2008. “Fee” – The collective fees for providing the Service, either as a minimum term option or as a standard option specified on the Contract and payable monthly in advance or Upfront by the Client to Claims Specialist, together with any other bank or administrative charges incurred by Claims Specialist under this Agreement. “Product” – Each case and/or the value-added services selected by the Client on the Contract and any additional Products selected and/or added from time-time. “The Parties/Party” – Claims Specialist and the Client; either Claims Specialist or the Client. “Price Table” – An indicative price list, available to the Client on request, setting out the ruling retail price for the Service, the Minimum term option amounts, the Products and ancillary charges which may be updated from time to time. “Service” – Means the provision by Claims Specialist to the Client of Administration of repudiated claims from Rejection to Ombudsman dependent on the stage of the claim on the Contract. “The contract” – The face of this Agreement and any appendices attached. “Term” – Where the Client has selected to enter into the agreement, from and including the date that the contract was signed up to and including the last day of the contract; where the Client has the minimum term option period shall be deemed to be 12 (thirty-six) months from signing the contract.
This Agreement shall continue for the Term
The Client (if the Client is a natural person) may cancel this Agreement in writing or in another recorded manner: Upon the conclusion of the case, the Client will be liable to Claims Specialist for any amounts owed in terms of the Agreement up to the date of termination; or at any other time, by giving Claims specialist notice of 20 (twenty) Business Days, subject to the Client remaining liable to Claims Specialist for any amounts owed in terms of the contract up to the date of cancellation and subject to clause stipulated herein. The Client (if the Client is a juristic person) may cancel this Agreement in writing or in another recorded manner: By giving Claims Specialist notice of 1 (one) month upon expiry of the Term, subject to the Client remaining liable to Claims Specialist for any amounts owed in terms of the contract Claims Specialist will impose a reasonable cancellation fee, should the cancellation be before the end of the Term. In this regard, if the Client is a Consumer, as defined by Section 1 of the Consumer Protection Act No 68 of 2008, then the cancellation fee shall be determined by taking into account the cost incurred by Claims Specialist in the acquisition of the Client, which costs may vary from time to time. Should the Client not fall within the definition of a Consumer, then the cancellation fee shall be equal to the value of the remainder of the Client’s contract. Claims Specialist may cancel this Agreement 20 (twenty) Business Days after giving written notice to the Client of a material failure (i.e. non-payment or failure to comply with the obligations in terms of this contract) by the Client unless the Client has rectified the failure within that time, should the client fail to pay their first premium the services of Claims Specialist will cease, should the second premium be missed, the Claims Specialist contract will terminate and the client will be liable for the remainder of the fees payable for the term of the contract.
Fees:
The Price Table, as contained in the Contract and updated from time to time, will be made available to the Client upon the Client’s request. The Client shall pay Claims Specialist the Fee for the Service as set out in the Contract as revised from time to time as per this contract, monthly in advance by debit order from the Client’s bank account. Claims Specialist reserves the right to debit on the Client’s salary date and/or their preferred debit date, as provided by the Client. In the event that either payment date does not fall on a Business Day, the Client hereby agrees that Claims Specialist may debit the Client’s bank account on the preceding Business Day. In the event that the Client’s debit order is returned for any reason whatsoever, Claims Specialist reserves the right to change the date on which debit orders are processed.
The Client agrees such costs reflected on an invoice received from Claims Specialist shall be considered a true reflection of the costs incurred by the Client and the Client shall not withhold payment for any reason whatsoever. All amounts outstanding in terms of this Agreement shall bear interest from the due date until payment at the maximum rate permitted by law.
Furnishing of Information:
The Client confirms the completeness and accuracy of all the information on the Contract or otherwise furnished by or on behalf of the Client to Claims Specialist. The Client shall immediately, or as soon as it’s practically possible notify Claims Specialist in writing of any changes to the information on the Contract, any material changes relating to the case at hand, including, inter alia, insurance details, or other information furnished to Claims Specialist. From time to time, by written notice to admin@claimsspecialist.co.za or by calling 033 940 1791. The information will be updated within 7 (seven) days of receipt by Claims Specialist. The Client has selected the address referred to on the Contract as its selected legal address where all communications from Claims Specialist and any legally required notices will be delivered for all purposes arising out of this Agreement, provided that the Client shall be entitled to change such legal service address, by written notice to admin@claimsspecialist.co.za or by calling 033 940 1791. The information will be updated within 7 (seven) days of receipt by Claims Specialist. The Client consents to Claims Specialist supplying third parties with its personal information to create value propositions for the benefit of the Client, including, but not limited to the Client’s name and contact number, or other information as is reasonably required. The Client may revoke this consent at any time on written request.
Disclaimers
Claims Specialist makes no warranty that the Service will resolve all cases in the client favour, that any specific result or outcome will be achieved by utilising the Service, or that the use of the Service by the Client will comply with all applicable laws.
General
Claims Specialist will make every reasonable effort to carry out its obligations under this Contract, using commercially reasonable efforts conforming to generally accepted industry standards. Where Claims Specialist is directly or indirectly prevented or restricted from carrying out all or any of its obligations under this contract by a cause beyond its control, then Claims Specialist cannot be held responsible for delay or failure in performance in meeting its obligations.
By entering into this agreement, the client consents to Claims Specialist processing its personal information. For the duration of this Agreement and at all times after its termination, each Party and its employees and agents agree not to disclose any Confidential Information obtained from the other Party to any other person or entity.
Any other services or value-added products included in the Client’s package are subject to these terms and conditions, as read together with the terms and conditions of the applicable product. It is the responsibility of the Client to ensure that they familiarise themselves with the relevant terms and conditions from time to time.
The Client may not alter the terms of this Agreement without the written consent of Claims Specialist. Claims Specialist reserves the right to amend these Terms and Conditions from time to time. Any new version of the Terms and Conditions will be displayed on the Claims Specialist’s website (www.claimsspecialist.co.za) together with the date on which it will become effective, which will never be less than 30 (thirty) days after the date on which it is first published. It is the Client’s obligation to visit the Claims Specialist website on a regular basis in order to determine whether any amendments have been made and the effective date thereof.
Where any number of days or other period is given in this Agreement for the carrying out of the Service or obligations, the days will be calculated excluding the first day and including the last day.
In the event of Claims Specialist taking legal action against the Client for breach of payment under this contract, the Client shall be responsible for all costs (on a client and own attorney scale) allowable by the courts if an award is made in Claims Specialist’s favour.
The nature and amount of any indebtedness of the Client to Claim Specialist at any time shall be determined and proved by a document signed by a manager of Claims Specialist, whose capacity or authority it shall not be necessary to prove. Such certificate shall, upon the mere production thereof, be binding on the Client as prima facie proof that the amount stated therein is due and payable, and will prima facie be valid as a liquid document against the Client in any competent court. If the Client wishes to dispute such certificate or the effects thereof, the burden of proof rests on the Client.
Neither Party may cede or delegate the rights or obligations in terms of this Agreement without the prior written consent of the other Party, which consent shall not unreasonably be withheld.
The Laws of the Republic of South Africa will apply to this agreement and the parties hereof consent to the jurisdiction of the magistrate’s court in terms of Section 45 read with Section 28 of the Magistrate’s Court Act of 1994 as amended. This agreement shall further be governed in terms of the law of the Republic of South Africa will apply to this Agreement and the relevant courts of the republic of South Africa will have exclusive jurisdiction in relation to the agreement.
The client undertakes to provide Claims Specialist with 30 (thirty) day written notice in the event that the client no longer wishes to receive correspondence regarding new products and value-added services.
Your Go To Professionals.
Why Choose Claims Specialist?
Making an insurance claim is a very personal matter. It can also be incredibly stressful and time consuming. Claims Specialist shall take the time to help you at the repudiation stage.
Pietermaritzburg Address:
Block A, Town Bush Office Park, 460 Town Bush Road, Montrose, Pietermaritzburg, 3201
Durban Address:
15 Fairways avenue, Mount Edgecombe Country estate 2, Mount Edgecombe
Cape Town Address:
The Pavilion, Esplanade Road, Central Park, Century City, Cape Town, 7441
