OP-ED: Festive Accidents, Frozen Claims: Why Insurance Keeps Failing Consumers When It Matters Most

More car accidents, break-ins, losses and predictably, more insurance claims. Yet for many Batswana, the real shock comes after the incident — when claims stall, exclusions are suddenly “discovered”, and phones stop being answered.

Insurance, at its most critical moment, often disappears. Insurance was never meant to work like that.

Insurance Law was born from a simple moral idea; sharethe risk so that one person’s misfortune does not become catastrophic. That is why courts developed the principle of utmost good faith — not just for policyholders, but for insurers too. Many people only learn about insurance law when something goes wrong.  A car accident, a burglary, a rejected claim. By then, confusion replaces confidence.

This article explains the basic principles of insurance law every policyholder in Botswana should understand.

Insurance was meant to protect people, not outsmart them. Somewhere along the way, that balance has tilted.Insurance should bring peace of mind. Instead, many people only discover how it works after a claim is rejected. Understanding a few basic principles of insurance law can make the difference between being protected — and being disappointed.Here is insurance law, without the fine print.

1. Insurance Is a Contract — But Not an Ordinary One

An insurance policy is a contract, but it is governed by special rules called the Policy. Courts recognise that insurers draft the terms and control the language. For that reason, ambiguities are interpreted in favour of the policyholder, not the insurer.

If a clause is unclear, it cannot be used as a trap.

2. Utmost Good Faith Cuts Both Ways

Insurance law is built on the principle of utmost good faith. Most people are told this applies to policyholders — disclose everything, answer honestly.

What is less said is that insurers owe the same duty. They must assess claims fairly, investigate properly, avoid opportunistic repudiations, and communicate honestly and promptly. Good faith is not one-sided.

3. Exclusions Must Be Clear and Proven

Insurers may exclude certain risks. That is lawful. But exclusions must be clearly written, narrowly applied, and supported by evidence. A vague exclusion cannot defeat a genuine claim. Suspicion is not proof.

4. Delay Can Be Unfair

Investigating a claim is allowed. Dragging it out is not. Unreasonable delay can cause real harm — loss of income, transport, or shelter. Courts increasingly recognise that timing matters. Insurance that pays too late may still fail its purpose.

5. You Are Entitled to Reasons

If a claim is rejected (repudiation), the insurer must explain why, in writing.Silence, shifting explanations, or vague references to “policy terms” are not acceptable. A policyholder has the right to understand the decision being made.

6. Regulators Exist for a Reason

In Botswana, short-term insurers are regulated by the Non-Bank Financial Institutions Regulatory Authority (NBFIRA). If a dispute cannot be resolved, policyholders should escalate formally, document everything, and seek advice early.

Insurance law does not reward passivity.

7. Insurance Is About Protection, Not Perfection

Policyholders are not expected to be perfect. The law recognises ordinary human behaviour — travel, accidents, mistakes.Insurance exists to protect against risk, not to punish normal life.

Bottom Line

Insurance law was created to shield people from sudden loss. Knowing these basic principles shifts the balance of power back where it belongs — with the insured.

The fine print matters. But so does fairness.