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CR329 Late submission of claims Claim delayed by police taking possession of documents for criminal investigation. A group scheme funeral policy, of which a funeral parlour was the beneficiary, stipulated that a claim would not be payable if not submitted within 6 months of death. The main member, her partner and her minor child were […]Read More
Late submission of claims CR307 Group scheme – claim under group disability scheme repudiated on grounds of late submission – late submission policy provision in principle enforceable, unless considerations of equity demand otherwise – equity ruling not fair to insurer in the particular circumstances. Background 1. The complainant, a general labourer, worked for a construction […]Read More
CR285 Late submission of claims Death and disability claims in terms of mortgage protection policies
CR285 Late submission of claims Death and disability claims in terms of mortgage protection policies – individual policyholders, members of their employer’s housing scheme, having been granted mortgage bond by their employer, ceding their policies to their employer – can the insurer be held liable where the employer fails to notify it of the claims […]Read More
CR284 Late submission of claims Equity – unique circumstances. Background The life assured, who was murdered, held a policy which provided that: The claim must be submitted within 12 months from the date of death. The complainant, his wife, was the named beneficiary, and she lodged a death claim some 21 months after the murder. […]Read More
CR226 Late submission of claim /Interpretation of contract Background The complainant approached our office when two separate claims under two separate policies were declined by the insurer due to late submission. The policies commenced in October 2002 and August 2003 respectively and made provision for Permanent Total Disablement benefits due to accident. In November 2004 […]Read More
CR225 Late submission Background The life insured died on 24 October 2005. The policy provided for a notification period of six months. A death claim was lodged on 3 March 2006, well within the submission period. The complainant submitted the required documentation with the claim. The only difficulty was that the copy of the death […]Read More