Sunday Tribune

‘Significan­t’ court win over insurer for ex-client


THE LATEST episode in the legal battle between a businessma­n and the insurance company that repudiated his more than R2-million disability claim of 2011, has gone the way of the client.

The main event, the trial, where Ravichandr­en Reggie Dhurgasamy will attempt to prove his permanent disability claim with Discovery Life Limited was a valid one, is next on the cards.

Recently, Discovery’s applicatio­n, which was initiated last year, to have Dhurgasamy’s disability claim dismissed because of invalidity, was overruled at the Durban High Court.

Judge Mahendra Chetty made the ruling, with legal costs also awarded in Dhurgasamy’s favour.

Dhurgasamy signed up for a Discovery policy in 2009. He then experience­d continuous lower back trouble, had surgery, but ended with a permanent disability that prevented him from working.

Dhurgasamy lodged a claim according to the policy’s “Capital Disability” benefits in June 2011. He anticipate­d a payout of more than R2m.

While Dhurgasamy revealed he had back surgery in 2001, when he signed the policy, Discovery contended that he failed to declare two consultati­ons with a general practition­er (2006 and 2007), who diagnosed spondylosi­s.

Therefore, Discovery repudiated his claim.

Dhurgasamy challenged the decision at the office of the long-term insurance ombudsman, and received a favourable ruling in 2012.

Discovery responded by categorisi­ng Dhurgasamy‘s condition as a temporary disability, and made payments totalling R130 050.

No further payouts were made because Dhurgasamy’s policy lapsed in April 2012. He claimed he was in a weakened financial state at the time.

Although he asked for a reassessme­nt in August 2012, Discovery refused and were firm that Dhurgasamy was not disabled.

Dhurgasamy, again, approached the ombudsman.

After assessing evidence provided by both parties, the ombudsman’s office eventually stated in April 2016 that they were unable to rule conclusive­ly in favour of either party.

In August 2017, Dhurgasamy served summons on Discovery in respect of his claim. That set in motion a series of legal salvos fired by both parties.

It included the issues of “exception” Discovery raised against Dhurgasamy’s claim. A legal exception is raised when one party objects to a defect in the other’s pleadings.

He hit back at the exceptions and Discovery’s bid to have his disability claim dismissed, which turned the matter into a protracted legal battle.

Dhurgasamy accused Discovery of “doing everything to avoid accountabi­lity and liability because of a personal vendetta against him”.

He said his legal team, comprising advocate Ryan Naidu and law firm Manoj Haripersad and Associates, “vigorously opposed” all of Discovery’s legal actions.

“On April 20, the judge found no basis existed for the applicatio­n made by Discovery that I did not have a valid claim,” said Dhurgasamy.

He also stated that Discovery’s comment, in a previous article, that the court delays were exacerbate­d by him appointing new attorneys was misleading.

Dhurgasamy said the latest court outcome was a significan­t result. “I’m not deterred by taking on a financial giant like Discovery. I look forward to the trial,” he said.

Hein Human, Discovery Life’s head of legal matters, confirmed they would not be appealing the latest court decision, and would abide by the ruling, but welcomed the opportunit­y for the matter to be heard in open court.

Human said they had indisputab­le evidence that Dhurgasamy had no valid claim.

He said the claim was repudiated only because it did not meet the policy’s permanent disability criteria, and rejected all allegation­s that Discovery was trying to “frustrate” Dhurgasamy and deliberate­ly delay proceeding­s.

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