Please select an appropriate category from the list below or search for topics and cases using the search tool. Please type in the "CR" prefix when searching by case codes.
The Ombudsman for Long–term Insurance has a vacancy for an Assistant Ombudsman. If you are interested in a career in alternative dispute resolution, dedicated to service delivery, able to work under pressure and you have the necessary qualifications, you are invited to submit a covering letter and your CV. The Role Investigate and analyse complaints. […]Read More
Premiums CR315 Collected after cover ceasing – funeral cover ceasing at age 65 – member’s premiums continuing, however, until her death at age 67 – death claim repudiated – complaint settled on basis that half claim paid, plus refund of premiums after age 65. Background 1. The complaint in this case was lodged by attorneys […]Read More
CR161 A cancer claim rejected Background The contract featured a specified ‘cancer benefit’ catering for female cancers (cervical cancer, genito-urinary cancer or breast cancer) and male cancers (prostate and testicular cancer). “Cancer” was defined as “…a disease that is manifested by the presence of a malignant tumour, characterised by the uncontrolled growth and spread of […]Read More
CR119 Afkoop van polis – datum vir berekening van die waarde daarvan. Agtergrond Mnr A was ‘n aandeelhouer en direkteur van maatskappy B. ‘n Polis op sy lewe is deur die maatskappy by versekeraar X uitgeneem en deur A, as polishouer, aan maatskappy B gesedeer om te verseker teen die geval dat A te sterwe […]Read More