Insurance case tells big lesson

THE Port Elizabeth High Court has once again warned consumers to read the fine print of insurance policies and make sure they were entitled to amounts paid into their bank accounts – ordering a consumer to pay back R650 000 that was paid to him in error.

This followed a five-year legal battle by Riaan Wolmarans against Momentum Insurance.

On Christmas day in 2007, Momentum Insurance paid R650 000 into Wolmarans’ account. Wolmarans thought it was a payout of a disability benefit. It turned out that it was a mistake. Wolmarans had taken out a new policy when he moved his bank accounts over to FNB in 2007. He already had insurance with Momentum that covered him for disability and also provided life insurance.

His new insurance policy was only for life insurance and his monthly premium was R557.73. No disability or inability cover was ever included in this policy.

Wolmarans said he did not know that. He claimed the insurance broker assured him the benefits would be the same.

He told the court that because he could not afford both policies, he surrendered the earlier policy.

On 24 August 2007, Wolmarans was admitted to hospital for an emergency coronary bypass operation and submitted a claim for “inability benefits” on October 26 2007.

His claim was paid out in error as Momentum had explained they had moved over to a new system and the assessor did not have all the information at her dispo- sal. After the payment was done, Momentum then phoned Wolmarans to explain to him the money was paid in error and he only had life cover and no disability cover in terms of his policy.

Wolmarans refused to pay back the money. Momentum then sued him for it.

In her judgment, Judge Elna Revelas said Wolmarans could not rely on his own confusion about the policy as a defence.

“It was his responsibility to ensure his new policy provided for those benefits.

“He should have ensured the documents constituting the insurance contract he signed made provision for disability and inability benefits. His signature appears twice on the relevant documents.

“This was also not the first time Wolmarans concluded an insurance contract, if one has regard to his bank statements.

“Wolmarans was either negligent in not ascertaining exactly what insurance product he was buying or there was a misunderstanding.

“In either case, Momentum cannot be held responsible for the fact Wolmarans was not covered to the extent he wanted to be. [He] was advised more than once the amount was paid in error, but persisted he was entitled thereto,” Revelas said.