Durban - The former chief executive officer of the Life Offices’ Association (LOA), Gerhard Joubert, has raised questions about a database of personal information used as a shared resource by more than 20 insurance companies, which the insurance industry says is vital to prevent fraud.
The LOA was the forerunner of the Association for Savings and Investment SA (Asisa).
Joubert said he had followed the story of Denise Ganas, whose late husband Nathan’s life policy claim was declined by insurance giant Momentum after he was gunned down in an attempted hijacking.
Momentum said Nathan Ganas’s medical records of “raised blood sugar levels” had not been disclosed in his policy and declined to make the payment on those grounds.
Social media users vented their outrage at the apparent injustice of linking the medical condition with the cause of death, even though Momentum was legally justified to do so.
Under public pressure Momentum made an about-turn and agreed to pay R2.4 million to Denise Ganas.
This week, Joubert said applications for life insurance generally included a clause that read “the applicant gives consent that personal information may be stored, processed and shared”, or had similar wording.
This was often included in the terms and conditions of a policy or on a separate consent form. Once an application was signed, this allowed an insurance company to place the information on the Life & Claims Register, which could be accessed by 22 insurance companies.
Joubert said: “We know little about the extent of the sharing of medical data between life insurance companies. All the major life companies who are Asisa members participate in the Life & Claims Register, which provides ‘red flags’ to...insurers, who can then contact each other to find out the exact details of your medical condition.
“One does not know exactly what is disclosed in the database or in such discussions, but it will be about your medical information for underwriting and claims purposes - and an assessment of your likelihood to claim.”
He said light needed to be shed on the database, because “concern about the right to privacy is an international one, especially where medical data of people is made available to such a large group of companies and people”.
“I would urge the public not to sign these consents and insist that any personal data about you is made available to you, directly at request.”
But Asisa hit back, with its senior policy adviser, Anna Rosenberg, saying insurance advisers were “encouraged to clearly disclose to customers why certain information is needed and what it will be used for and that, in order to reduce underwriting costs and combat fraud, this information may be exchanged with other insurers through a shared life and claims database”.
She said this information was generally included in the policy application form.
She said the database is managed by Astute Financial Services Exchange and it is important to note that the database is divided into “life” and “claims” sections and that data of individuals who were healthy would not be captured on the register.
The life section shares information about people applying for cover or who have had insurance under existing policies, who had notifiable impairments relevant to risk or claim assessment. The claims section shares information about people who have policies and who have made notifiable claims that will be relevant to the assessment of future claims.
Rosenberg said Asisa “plays no more than a facilitation role between the insurers and Astute” and did not have access to the information stored on the database. She said access to either the life or claims database was strictly controlled and limited to senior personnel at insurance companies.
While Astute Financial Services Exchange said it could respond to a media query only next week, its website says insurance companies “must clearly disclose to the client why the information is needed and what it will be used for”.
To check on which insurance companies participate in the Life and Claims Register, go to www.astutefse.com