Durban - INSURANCE giant Momentum did an about turn when it announced that Shallcross widow Denise Ganas would be paid out the R2.4 million on late husband’s life insurance policy.
An emotional Ganas said that while she had not been officially informed about the pay-out, it was a huge relief to know that the future of her minor children would be secured.
“My family and I have been suffering for a year and 8 months - emotionally and financially. My children can finally have the life their father would have wanted for them.”
She said that with the financial pressure now being eased, she could finally grieve for her husband.
In statement, Momentum said the market reaction in the past two days created the impression that insurers were looking for reasons not to pay a claim.
“Momentum is in the business of paying claims and we have, therefore, taken the criticism to heart. We have created a solution that will pay an amount equal to the death benefit (limited to a maximum of R3 million) in the case of violent crime, regardless of previous medical history. This will apply to all existing as well as future life cover clients,” it read.
It further stated that such payouts, including that to Ganas, would be funded from its profits and not from clients’ premiums.
The guarantee will pay out when the death was a direct result of violent crime, even when material medical non-disclosure impacts the legitimacy of the contract. It added the payout was not in addition to the normal death benefit, which only applied in circumstances when the death benefit was not payable or had been reduced.
Momentum said they were in the process of identifying clients who were impacted in this way and we would contact their families to arrange payment.
Earlier yesterday, the EFF in KwaZulu-Natal lent its support to Ganas and cautioned Momentum to pay the R2.4-million claim or “pay a heavy price”.
The provincial party leader, Vusi Khoza labelled Momentum’s actions “criminal” after it declined an application for the life insurance payout for Ganas’s husband, Nathan, 41, who was killed while trying to protect her during a hijacking in the driveway of their home last March.
The claim was declined on the grounds that Nathan had not disclosed he had been diagnosed with raised blood-sugar levels, which may have occurred before he completed his application for the policy in 2014.
The insurer had said that it would open a can of worms and prejudice existing clients were it to pay the claim.
Before Momentum’s announcement, Ganas said she was prepared to put up a fight to safeguard the financial future of her children, and said she owed money on her house and needed to put her children through school.
Ganas, a sales co-ordinator for a home textile company, said that it had been tough trying to pick up the pieces after her husband’s death.
“I am the breadwinner - the provider for my children. It has been tough since Nathan’s death,” she said.
She said that she and her children, aged 12 and 15, still lived in the home where her spouse had been killed.
“It has been a daily struggle to make ends meet. There are things my children need that I sometimes am unable to provide. This breaks my heart. My burden has now been eased.”
When Momentum declined to pay out the claim, Ganas turned to the insurance ombudsman. It ruled in Momentum’s favour, saying they believed Nathan was aware of his raised blood-glucose test results.
The insurer also asked Ganas to pay back a R50000 cash benefit she had received when Nathan died - money that was used for his funeral.
On Monday, after immense social media pressure, Momentum said Ganas did not have to pay back the money and it would also return the insurance premiums paid since 2014.
The premium was R2653 a month and included an education policy for their children. A total of R76510 was deposited into her bank account on Monday.
In an earlier statement when Momentum stressed it would not pay out the claim, Johann le Roux, chief executive of Momentum Life, said it only became aware of Nathan’s “non-disclosure of his pre-existing medical condition” after his death, when they conducted a standard claims process of verifying medical information provided at application stage.
“From reliable information, it is clear that the late Mr Ganas was tested multiple times for blood-sugar levels, with the last time as recent as two weeks prior to his application for Momentum cover.”
He said the results of these tests consistently indicated abnormally high blood-sugar levels: “Had we been aware of these elevated blood-sugar levels, we would not have offered cover.”