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CR141 Fraud – quite probable – but claim paid

CR141 Fraud – quite probable – but claim paid Background Medical evidence which was featureless, and which included a negative HIV test, was supplied at the time the application for life cover was submitted. The proposer was accepted at tabular rates and the contract was effected. Eight months after the commencement date the life assured […]

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CR139 Funeral Insurance

CR139 Funeral Insurance – increase of the rate of premiums alternatively the reduction of benefits at the discretion of the insurer. Facts The policyholder, a domestic worker, complained to us with the help of her employer that the premiums under her funeral policy were being increased year by year to a point where she could […]

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CR138 Funeral policy – Section 53 of the Long-term Insurance Act No 52 of 1998

CR138 Funeral policy – Section 53 of the Long-term Insurance Act No 52 of 1998 Facts The main member under a funeral policy submitted a claim under her policy on the death of an extended family member. She complained to the office that the insurer paid a claim amount of R950 instead of R2 500. […]

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