Clientele Life Assurance's funeral policy, the lasting dignity plan, tells prospective consumers that no medical report is required.
Clientele Life Assurance's funeral policy, the lasting dignity plan, tells prospective consumers that no medical report is required.
But don't be fooled, they do need it when the policyholder dies.
Consumer Line discovered this while trying to assist Richard Mlotshwa, who complained that the company had repudiated his claim.
He said it referred him to an exclusionary clause in the policy, which says certain illnesses and conditions are not covered.
His wife had died from an illness that was not covered. Clientele had assessed the information from his wife's medical report from Chris Hani-Baragwanath Hospital.
Mlotshwa said clients were being misled and that it was incorrect for Clientele to "go behind a client's back or after a death to get medical reports".
But his misery will soon end because the ProBono organisation has agreed to consider the matter.
Every Tuesday the organisation runs an HIV-Aids legal clinic for people who are unfairly discriminated against by employers and insurance companies that decline claims.
Mlotshwa's wife died in 2006 after a short illness. Clientele did not pay the claim within 48 hours as they had agreed to when he took out the policy.
He said he took out the policy in 2000 and paid his premiums promptly.
Clientele declined the claim because the death fell within exclusions that include suicide or suicide attempts within the first two years, mental or physical illness that existed before the policy commenced and HIV-Aids-related deaths.
"Even if my wife died of Aids, the life insurance industry was in 2006 stopped from denying death and disability benefit claims to people who die from Aids," Mlotshwa said.
When the discriminatory clauses were outlawed, Life Office Association's chief executive, Gerhard Joubert, said the HIV and Aids exclusion clauses would be waived for all types of life and disability cover that pay lump-sum benefits, including group life, credit life and funeral cover.
This decision was made after the Aids Law Clinic had fought for beneficiaries who lost their benefits because the policyholder died after contracting the virus, though he or she was HIV negative when the policy was taken out.
Mlotshwa said this is what happened to him.
To explain why Clientele had repudiated his claim, Mlotshwa was referred to a doctor who had never treated his wife.
"I was shocked when the doctor the company referred me to said he could not give me any records about the cause of my wife's death because he only delivered babies," Mlotswa said.
Shirley Motae, Clientele's client communications manager, confirmed they had declined the claim on the basis of Mlotshwa's wife falling within the exclusions of the policy.
"The clinical notes we received confirmed the exact cause of death and these conditions form part of the exclusion of the plan," said Motae.
Odettte Geldenhuis of Pro Bono said the organisation runs an HIV-Aids legal clinic for people whose rights have been violated.
She said people who are HIV positive often have to cope with more than the illness.
"Because of their status there is discrimination at work and also in housing and insurance," Geldenhuis said.
She said people living with HIV suffer the most discrimination and are also the ones who have the least access to legal resources.
"In addition, the cost of legal services is generally beyond their reach," she said.
"It is for this reason that ProBono, a nonprofit clearing house that increases access to justice via pro bono legal services, provides a weekly legal clinic where HIV-positive people can access free legal advice and services."
Geldehuis said their attorneys try as far as possible to resolve any problem.
"Where it is not possible the client becomes a client of the relevant firm, which will finalise the matter on a pro bono basis.
lThe clinic is open every Tuesdays at 8.30am to noon;
lClients are assisted by experienced attorneys from top law firms on appointment or on a first come first served basis;
lThe attorneys assist with advice, opinion, non-litigious intervention, alternative dispute resolution and or litigation.
Their offices are on the 9th floor of Schreiner Chambers in the south wing on 94 Pritchard Street, Johannesburg
Phone 011-336-9510 to make an appointment.
No Dignity in this plan
Clientele Life Assurance's funeral policy, the lasting dignity plan, tells prospective consumers that no medical report is required.
Clientele Life Assurance's funeral policy, the lasting dignity plan, tells prospective consumers that no medical report is required.
But don't be fooled, they do need it when the policyholder dies.
Consumer Line discovered this while trying to assist Richard Mlotshwa, who complained that the company had repudiated his claim.
He said it referred him to an exclusionary clause in the policy, which says certain illnesses and conditions are not covered.
His wife had died from an illness that was not covered. Clientele had assessed the information from his wife's medical report from Chris Hani-Baragwanath Hospital.
Mlotshwa said clients were being misled and that it was incorrect for Clientele to "go behind a client's back or after a death to get medical reports".
But his misery will soon end because the ProBono organisation has agreed to consider the matter.
Every Tuesday the organisation runs an HIV-Aids legal clinic for people who are unfairly discriminated against by employers and insurance companies that decline claims.
Mlotshwa's wife died in 2006 after a short illness. Clientele did not pay the claim within 48 hours as they had agreed to when he took out the policy.
He said he took out the policy in 2000 and paid his premiums promptly.
Clientele declined the claim because the death fell within exclusions that include suicide or suicide attempts within the first two years, mental or physical illness that existed before the policy commenced and HIV-Aids-related deaths.
"Even if my wife died of Aids, the life insurance industry was in 2006 stopped from denying death and disability benefit claims to people who die from Aids," Mlotshwa said.
When the discriminatory clauses were outlawed, Life Office Association's chief executive, Gerhard Joubert, said the HIV and Aids exclusion clauses would be waived for all types of life and disability cover that pay lump-sum benefits, including group life, credit life and funeral cover.
This decision was made after the Aids Law Clinic had fought for beneficiaries who lost their benefits because the policyholder died after contracting the virus, though he or she was HIV negative when the policy was taken out.
Mlotshwa said this is what happened to him.
To explain why Clientele had repudiated his claim, Mlotshwa was referred to a doctor who had never treated his wife.
"I was shocked when the doctor the company referred me to said he could not give me any records about the cause of my wife's death because he only delivered babies," Mlotswa said.
Shirley Motae, Clientele's client communications manager, confirmed they had declined the claim on the basis of Mlotshwa's wife falling within the exclusions of the policy.
"The clinical notes we received confirmed the exact cause of death and these conditions form part of the exclusion of the plan," said Motae.
Odettte Geldenhuis of Pro Bono said the organisation runs an HIV-Aids legal clinic for people whose rights have been violated.
She said people who are HIV positive often have to cope with more than the illness.
"Because of their status there is discrimination at work and also in housing and insurance," Geldenhuis said.
She said people living with HIV suffer the most discrimination and are also the ones who have the least access to legal resources.
"In addition, the cost of legal services is generally beyond their reach," she said.
"It is for this reason that ProBono, a nonprofit clearing house that increases access to justice via pro bono legal services, provides a weekly legal clinic where HIV-positive people can access free legal advice and services."
Geldehuis said their attorneys try as far as possible to resolve any problem.
"Where it is not possible the client becomes a client of the relevant firm, which will finalise the matter on a pro bono basis.
lThe clinic is open every Tuesdays at 8.30am to noon;
lClients are assisted by experienced attorneys from top law firms on appointment or on a first come first served basis;
lThe attorneys assist with advice, opinion, non-litigious intervention, alternative dispute resolution and or litigation.
Their offices are on the 9th floor of Schreiner Chambers in the south wing on 94 Pritchard Street, Johannesburg
Phone 011-336-9510 to make an appointment.
Would you like to comment on this article?
Register (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.
Trending
Latest Videos