Watch out for the con­di­tions in your in­sur­ance pol­icy

The Star Early Edition - - NEWS - – Pa­tri­cia Nku­mane

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.

Newspapers in English

Newspapers from South Africa

© PressReader. All rights reserved.