Insurer reaches compromise

REJECTED CLAIM: MOMENTUM AGREES TO REPAY PREMIUMS, ALLOWS FAMILY TO KEEP CASH BENEFIT

Payout rejected for nondisclosure for family of man killed in hijacking.

Despite previously sticking to their guns over a rejected life cover insurance payout to a client who had not disclosed a pre-existing condition, even though it was not related to his death, life insurer Momentum appears to have been shamed into paying back Nathan Ganas’ premiums to his family in addition to letting them keep the R50 000 instant cash benefit they used to pay for Ganas’ funeral.

The company became a topic of discussion over the weekend after it was revealed that it had declined an application for a R2.4 million life insurance payout for a Durban resident, who was killed in a hail of bullets trying to protect his wife, Denise, during a hijacking in the driveway of their Shallcross home in March.

Ganas’ claim was declined by the insurer on the grounds he had not disclosed that he was diagnosed with raised blood sugar levels, which may have occurred before he completed his application for the policy in 2014.

This past weekend, social media users expressing their disappointment over the insurer’s rejection to pay the life cover.

In a lengthy statement, Momentum said it was truly sorry for Ganas’ tragic death and also had sympathy for the views that the cause of death was not related to the nondisclosure.

But the insurer said that paying the claim would result in an increase in claims which would increase the premiums for all other clients, just because “a client has not acted in good faith”.

“The rejection of the claim was referred to the ombudsman for long-term insurance, who determined that Momentum’s decision was the correct one under the circumstances.

“In this instance, had the information been known to us, no cover would have been issued in the first place and no claim would have been paid, regardless of the cause of death,” said Momentum.

Power FM host Iman Rappetti