Sun. May 19th, 2019

Momentum: Violent crimes benefit sees four families paid out for rejected claims

Momentum say they are looking to do not just what is legal but what South African society feels is right with their violent crimes benefit.

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Insurance provider Momentum claim to have seen the error of their ways thanks to the scandal surrounding their initial refusal to pay out the life policy of Nathan Ganas.

Ganas was gunned down in 2016 leaving his widow Denise to engage in a prolonged battle to get the insurer to pay out his R2.4m life policy taken out in 2014.

Legally Momentum were within their rights to reject the claim because of a failure to disclose a medical condition, but when Denise went public with the story it did not sit well with South Africa.

Facing a public relations storm that made the company look increasingly cold and heartless, Momentum relented an paid out the R2.4m in November 2018.

The company say that they have learned from the experience and have instituted a violent crimes benefit, and ad-hoc policy that will see the insurer pay an amount equal to the death benefit, limited to a maximum of R3m, in the case of deaths resulting from violent crime, regardless of previous medical history, and even when non-disclosure has impacted the legitimacy of the contract. 

“We have learnt a great deal,” Momentum told Timeslive this week. “The more we tried to explain how right we were from a legal and contractual perspective, the more people were telling us how wrong it felt.

“To date we have paid out five claims to the value of R7.3m – including the Ganas claim,” Momentum said.

“We conducted an internal audit to proactively establish which other families qualified to receive payouts under the violent crimes benefit.

“But shortly after announcing this new benefit, the impacted families contacted us and we were ready to pay their claims.”

The four additional claims had all previously been rejected for payout by Momentum, the oldest of those were for a death that occurred in 2005, another was from 2006 while the remaining two took place in 2017.

Momentum feel that the scandal has taught them that they have an obligation to ensure the general public remain informed of insurance industry norms and standards.

“We repudiate only four out of every 1,000 claims,” Momentum said, “better than the industry standard.”

“So we really took the criticism [about the Ganas case] to heart.

“We have learnt that as an industry, there is much more we can do to bridge the gap between what clients understand and expect from insurers, and what the industry delivers and communicates.

“In general, there is a lack of awareness and understanding around industry principles, such as non-disclosure, and it is our duty to bridge this gap.

“Because of this realisation, we are doing research to understand what the gaps are and to develop targeted communication to address these shortfalls.”

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