Watch out for the conditions in your insurance policy

I HAD a disability policy for 10 years and tried to claim after a water tank fell on my leg. I submitted a claim and my insurer, Old Mutual, declined on the basis that the policy was for a full-time working person.

They said it was because of their terms and conditions in their referral book.

I told them that they cannot use terms and conditions when I am claiming, they should have told me about them when I was applying for the policy.

I may lose R500 000 and be in pain for the rest of my life. What does Old Mutual have to lose?

Terry Samuel from Old Mutual’s complaints management department, responded: “Old Mutual declined the claim based on our terms and conditions in the contract which specified the importance of notifying (us) of any change in occupation, failing which the claim would be declined and the benefit would cease.

“The accident occurred on May 26, 2016, when the reader was not earning an income (her business was closed the previous year) and she was not covered under the comprehensive disability benefit because unemployed individuals do not qualify for such cover.”

It’s an important lesson – if your circumstances change, you must notify your insurer to avoid any potential claims being declined.