Insurer cannot rely on policy terms after adviser’s misrepresentation
A policyholder’s godfather was recorded as her father despite the adviser knowing the true relationship, leading to a ruling that the insurer must pay the claim.
Misrepresentation
Court raises bar for repudiation based on misrepresentation or non-compliance
Non-life insurers may repudiate claims for alleged misrepresentation or regulatory breaches only when they can produce clear, consistent, and reliable evidence.
High Court upholds Discovery Life’s decision to void policy
The policyholder inflated her earnings and failed to disclose a simultaneous application with another insurer, materially affecting the risk assessment.
Court ruling highlights discovery dispute in R16-million insurance claim
The High Court has dismissed challenges by a policyholder accused of defrauding Discovery Life of more than R16m in disability and income protection claims.
FSCA to exempt non-life brokers from clawbacks when a policy is voided because of non-disclosure
The FSCA has proposed amending the Short-term Insurance Act regulations to exempt independent intermediaries from commission clawbacks when a policy is voided because of material misrepresentation or non-disclosure by the policyholder. Regulation 5.4 […]
Ubuntu, fairness and equity in financial services
The matter of social justice was one of the considerations in the high-profile business interruption cases that were considered over the last year. A prime example of how this can be approached is […]
Ubuntu, fairness and equity in financial services
The matter of social justice was one of the considerations in the high-profile business interruption cases that were considered over the last year. A prime example of how this can be approached is […]
Material misrepresentation leads to rejected claim
In a recent Short-term insurance case study, the Ombudsman for Short Term Insurance (OSTI) emphasised that short-term insurance contracts are entered into in good faith. “Under common law, a policyholder when requesting cover […]
Material misrepresentation leads to rejected claim
In a recent Short-term insurance case study, the Ombudsman for Short Term Insurance (OSTI) emphasised that short-term insurance contracts are entered into in good faith. “Under common law, a policyholder when requesting cover […]
Material misrepresentation and material non-disclosure at sales stage
In more than two thirds of the Ombudsman for Short-term Insurance’s (OSTI) finalised complaints in 2018, consumers were dissatisfied with the insurer’s decision on a claim. In its Annual Report the Ombud reported […]
