Momentum been under fire for the last few days after it refused to pay a policy worth R2.4 million to the family of Nathan Ganas who was shot and killed during a hijacking in his driveway last year. Momentum claimed Ganas failed to declare that he had been diagnosed with high blood sugar levels. This led to heavy criticism from the South African public and the insurer has changed its stance.
“It is clear from market reaction over the last two days that under certain circumstances, current industry practice creates the impression that insurers are looking for reasons not to pay a claim,” Momentum says in a statement.
“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.”
Momentum adds that these key points should be noted:
This payout will be fully funded from Momentum’s profits and not from our 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;
The payout is not in addition to the normal death benefit. It only applies in circumstances when the death benefit will not be payable or has been reduced;
Momentum reserves the right to reject any fraudulent claims.
“The guarantee will apply immediately to all our life cover clients, and will be applied retrospectively. We are identifying clients who were impacted in this way and we will contact their families to arrange payment. This includes Mrs Ganas.”
“The importance of full and honest disclosure at application stage cannot be overemphasised,” the company says.
“The only time your health status matters, is when you apply for cover. This is when you need to share all your medical and health information. If your health deteriorates after commencement of the policy, there is no need for you to inform Momentum – your claim will be completely valid if the information provided at the start of the policy was accurate.
“With exception of the new guarantee, full disclosure remains non-negotiable to ensure peace of mind.
We care for our clients and always strive to solve for their needs. We hope that this solution illustrates that.”