Insurer’s unfair play
Funeral insurers must treat you fairly, even if the fine print disqualifies your claim.
A funeral insurer declined to pay out when a woman claimed on two policies after her niece was killed in a house robbery. The insurer said the niece had died during the waiting period – a period where the policy only pays for accidental deaths.
The insurer said murder was not accidental. The Ombud argued that the essence of a waiting period was to prevent the life assured or the beneficiaries of the policy from benefiting unfairly and that murder, while not specifically accidental, was unnatural. The Ombud said the aunt, as the beneficiary of the policy, cannot be seen to have benefited unfairly from the policy. She was paid out R80 000.