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Momentum reviewing 3 years of rejected claims after death benefit about-turn

Nov 22 2018 06:45
Sibongile Khumalo, Fin24

Momentum has reviewed claims on life policies dating back to 2016 so far, which it rejected under circumstances similar to the death of slain policy holder Nathan Ganas.

The financial services and insurance group on Tuesday backtracked on its earlier decision not to pay a R2.4m life insurance claim to the Ganas family, due to Ganas's failure to disclose that he suffered from elevated blood sugar levels.

The company initially cited non-disclosure of his health condition as grounds for rejecting the death benefit, although it was not the cause of his death. According to Momentum, they became aware of his condition when they requested his health records after receiving the claim - a standard industry procedure, according to the company.

The legal wrangle between Momentum and Ganas's widow over the claim drew public outrage, prompting the group's sudden turnaround. On Tuesday it announced it had created a policy to pay out an amount equal to the death benefit, limited to a maximum of R3m, in the cases where violent crime caused a client's death. These would be paid out regardless of previous medical history.

"Other than Mrs Ganas, we have identified other cases which we are currently reviewing. We have reviewed records up to and including 2016," said Momentum CEO Johann le Roux on Wednesday. "We are only reviewing claims declined due to non-disclosure where the cause of death was violent."

Ganas was killed in a shooting accident in March 2017, and his wife denied knowing that he suffered from high blood sugar levels.

Le Roux said the payout of reviewed claim solution "is capped at the client’s sum assured up to a maximum of R3m".

The company could not say how much the process would cost the company, only stating the total cost will depend on the number of clients identified. 

Momentum’s decision not to pay the claim was supported by a ruling from the Ombudsman for Long Term Insurance; however, the decision drew public anger, with clients taking to social media with threats to cancel their policies.

According to the company, less than 50 policy holders had cancelled their contracts since the Ganas saga dominated media from last week.

"To date … we can confirm that less than 50 policies have been cancelled. However, a number of our clients have taken up this opportunity to advise us of information they have not previously shared," said Le Roux.

"We are interacting with these clients on a case by case basis."

Treasury's deputy director general Ismail Momoniat has welcomed the Momentum decision, stating that government would continue to work with the Financial Sector Conduct Authority to engage with industry to review whether current standards are going "far enough" to treat customers fairly.

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