The 42-year-old father, Nathan Ganas was shot dead during a botched hijacking in the driveway of his home, south of Durban after his wife came under attack last year.
Years before that, he had taken out life insurance with Momentum. After his death, the family’s claim of R2.4-million was rejected by the company.
It said it was because Ganas, who had high blood sugar levels, failed to disclose this when he took out the policy.
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Social media users have lambasted the company saying it should pay out because that is not what caused his death.
But Momentum has replied saying before a policy is taken out, a client completes a medical questionnaire, which determines whether there are any pre-existing conditions that could lead to a decision not to extend cover.
Consumerwatch’s Wendy Knowler explains that not disclosing a particular condition may jeopardise one’s chances for a claim.
“If you fail to disclose a condition to an insurer, it means they have based the entire policy on a risk that is not true. If it’s the case that the existing condition would have meant that they wouldn’t have taken out the policy for you in the first place, they are within their right to say – now that you are claiming for this – they will repudiate the whole policy.”
The long-term insurance ombud also found that Momentum had made the right decision. Knowler has more advice.
“Never fail to disclose anything no matter how minor it may seem because it doesn’t matter even if you forgotten or intend to withhold – that’s immaterial. If you did withhold and failed to disclose something, they can repudiate the policy,” Knowler said.
Read Momentum’s full statement here
Source: ECR, eNCA Twitter