STEPHEN CRANSTON: Momentum learns lessons from policy payout disputes
The R2.4m death claim following the murder of Nathan Ganas featured at the life insurer's claim statistics briefing
Momentum, one of the big five life insurers, courted controversy in November 2018 when it refused to pay a R2.4m death claim following the murder of Nathan Ganas in Durban. The reason for repudiation was undisclosed high blood sugar level. This was well within its rights under normal underwriting conventions, life insurers can repudiate a claim on the grounds of nondisclosure. Even the long-term insurance ombudsman took Momentum’s side. In fact, it took Momentum’s side in all 121 cases sent its way involving the Momentum Myriad risk product range. But if the “treating customers fairly” regime means anything, it applies in this case. The client was quite clearly treated unfairly. The right thing to do would have been to bring in a double indemnity (double payout) clause for these violent deaths. The discussion at Thursday’s Momentum claim statistics briefing centred on this case. The life office eventually agreed to pay, and found another five cases similar to Ganas’s over the past ...
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