In­surer’s un­fair play

Sowetan - - Your Money -

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.

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