Insurance group Momentum is sticking to its decision to reject a R2.4million life insurance payout for a Durban man due to non-disclosure of his health condition.
Although the man, who has been identified as Nathan Ganas, died from gunshot wounds, the insurance group rejected his policy claim after it was discovered he had high blood sugar levels.
The group said it would only refund the family all its premiums paid up to date, and would reverse its decision to recall the R50000 already paid to the Ganas, triggering a social media backlash.
Posting under the Twitter hashtag #MomentumMustFall, Annah Kudzai wrote: “So why did you continue taking his premiums? And he was murdered, he didn’t die of the high blood levels... just pay the family.”
@Flozzie79515123 weighed in when she tweeted: “So the high levels of his blood pressure made the hijackers pull the trigger? #Momentum I am so ashamed to be your customer!”
Palesa Madumo, executive director of strategy at Vuma Reputation Management, said while Momentum might have legally made the right decision in refusing to pay, its brand would suffer immensely.
“They are currently getting a lot of flak from everyday South Africans. They need to relook their stance,” Madumo said.
It has since emerged that non-disclosures of illnesses is one of the main reasons insurance companies reject claims in matters that end up before the Ombudsman for Long-Term Insurance.
Ombudsman stats for complaints settlement paint an ugly picture of only 29% cases settled in favour of the complainants.
Momentum is in the top four insurance companies with complaints sent to the Ombudsman of Long Term Insurers in terms of claims not paid because of non-disclosure.
Companies with the most complaints were Liberty with 40 cases; Old Mutual Life Assurance with 25; 1Life with 28, and MMI and Discovery Life with 23 cases each.
In a statement yesterday, Momentum said: “Based on the medical information that has become available to us after his death, it is clear that the client was aware of the pre-existing condition.
“The reality is that insurance has a strict requirement for full disclosure as a fundamental principle.
“Had this information been known at the point of application, we would not have entered into the contract.”