CR248 Mistake Mistake by insurer when furnishing maturity values

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CR248

Mistake

Mistake by insurer when furnishing maturity values – insured attempting to take advantage of obvious error.

Background

At regular intervals, but also on request, the insurance company provided the policyholder with detailed policy information schedules which featured, inter alia, estimated maturity values (EMV). These were values that the schedules stated were neither guaranteed nor promised, but were mere forecasts of future growth. For a short period of time, just a few weeks, incorrect estimated maturity value figures were quoted. Instead of an EMV of R200 000 the policyholder was told that the EMV was R1 200 000. The complainant sought to hold the insurance company to the incorrect figure. The insurance company stated that the error arose as a result of a malfunction of the data processing system.

Discussion

The office accepted that data processing systems do occasionally go wrong; insurance companies are not infallible and errors do occur from time to time. In this instance the incorrect figures quoted, which in any event were only estimates, were of such magnitude that they were obviously inconsistent with figures quoted both previously and subsequently. Any reasonable reader would have recognised that the figures were unrealistic and that a mistake had been made.

Result

We took the view that the complainant was seeking to take advantage of the error. The complaint itself was not upheld but an award was made of R2500 to compensate for inconvenience suffered.

Postscript

Two years after the ruling was made the complainant again raised the issue with the insurance company. An extract of his letter read:

“I would, however, consider a settlement of R20 000 as full and final payment on the above matter. If a settlement cannot be reached in this instance I will have no further option but to expose this whole issue to the financial press.”

The insurance company did not accede to the complainant’s request.

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