Ombudsman For Long Term Insurance
Claim rejected in contradiction to policy

I was declared medically unfit in June 2012 and was no longer able to work and pay for my Retirement Policy 696680004054496. In the Benefit Detail Document section "What and when we pay" it states clearly that when "you become disabled to a degree that you leave the Group and can no longer pay your contributions, we will pay your Maturity Value in cash to you. You must supply us with a medical certificate proving your disability to our satisfaction." The claim was submitted but it was rejected as they say that the net value is paid not the maturity value. It was pointed out to me by Lilian that I should use common sense and not expect full payment when the maturity date has not been reached, I found this comment extremely unprofessional and insensitive. I pointed out in the disabled clause next to the words Maturity Value put Net Value in brackets not on the top, in order to avoid confusion. If this also applies in the event of my death which is also under this section then this policy is very deceptive. I am asking for your assistance as I am still forced to pay even though I depend fully on my husband with no earnings of my own. Any help is much appreciated. Thank you.

Company: Ombudsman For Long Term Insurance
Country: South Africa
City: Johannesburg

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