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CR366 Funeral benefit Claim declined on the basis that the parties were divorced prior to the conclusion of the contract.

CR366 Funeral benefit Claim declined on the basis that the parties were divorced prior to the conclusion of the contract. Background 1. The complainant took out a funeral plan covering her husband, two children and two extended family members. The policy commenced in July 1999. 2. The deceased passed away on 16 March 2015 as […]

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CR338 Funeral Insurance Funeral Plan required notification of a child’s birth for the child to be added to the policy

CR338 Funeral Insurance Funeral Plan required notification of a child’s birth for the child to be added to the policy – claim for a still-born child. The policyholder was a member of a group scheme that provided funeral cover for his family. In May 2012 he submitted a death claim for his still-born child and […]

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CR337 Policy-holder Funeral insurance – policy-holder

CR337 Policy-holder Funeral insurance – policy-holder – whether an individual who was not involved in any negotiations with the insurer may be the legal owner of a policy? Background It was not in issue that the complainant was the only person who at all times negotiated with the insurer for the conclusion of the policy […]

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CR336 Equity Funeral benefit claim rejected on grounds of late submission

CR336 Equity Funeral benefit claim rejected on grounds of late submission – equity – over much of this period at issue policyholder hospitalised and receiving medical attention. Background Mrs G had a funeral benefit policy containing a provision that any claim must be made within 12 months of the date of death of the deceased […]

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CR335 Funeral Insurance Funeral policy

CR335 Funeral Insurance Funeral policy – Insurer declining on basis of child not being registered as a full-time student at date of death and therefore over age in terms of the policy provisions Background 1. The policy-holder had a funeral policy which covered his son, the relevant policy rule stipulating that – “2.6 Membership will […]

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CR309 Funeral Insurance – Insurer “deeming” lives insured to be the policyholders

Funeral Insurance CR309 Insurer “deeming” lives insured to be the policyholders, and not the person who applied in her own name for the policy – this practice not justified. Background A “policyholder” is defined in section 1 of the Long term Insurance Act (no. 52 of 1998) as “…the person entitled to be provided with […]

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CR281 Funeral Insurance Funeral policy

CR281 Funeral Insurance Funeral policy – fund rule stipulating that a child over 22 years would only remain covered if he or she was a registered full-time student. Background The policyholder, a member of a fund, had a funeral policy covering her spouse’s life and that of their children. As to the children the relevant […]

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CR280 Funeral insurance Funeral benefit – no beneficiary nominated by the policyholder

CR280 Funeral insurance Funeral benefit – no beneficiary nominated by the policyholder – benefit paid to someone other than the executor of the deceased’s estate. Background In 1994 Mr M took out a funeral policy covering the lives of himself, his spouse and their children. He did not nominate a beneficiary. Mr M and his […]

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CR263 Funeral insurance policy – definition of a “common law spouse”

CR263 Funeral insurance policy – definition of a “common law spouse” – meaning of. BACKGROUND This was a case where, as sometimes happens, the insurer failed to take proper account of the terms of its own policy. In 1997 the complainant had become a policyholder in a scheme that provided inter alia funeral benefits in […]

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CR262 Funeral policy – covering “eligible children” as defined – interpretation

CR262 Funeral policy – covering “eligible children” as defined – interpretation – insurer liable, for interest as well. BACKGROUND The complainant was the holder of a funeral policy in respect of which benefits were payable in the event of the death inter alia of children named in the policy. One such named child was G, […]

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