Insurer under fire for delayed payments

DIRECTIVE: Pension Funds Adjucicator Charles Pillai. Pic. Esa Alexander. 16/04/2010. © Sunday Times.
DIRECTIVE: Pension Funds Adjucicator Charles Pillai. Pic. Esa Alexander. 16/04/2010. © Sunday Times.

INSURER Liberty Life has been taken to task by Pension Funds Adjudicator Charles Pillai for causing undue delay in the processing of an ill-health early retirement benefit and the lower than expected amount that was paid out.

INSURER Liberty Life has been taken to task by Pension Funds Adjudicator Charles Pillai for causing undue delay in the processing of an ill-health early retirement benefit and the lower than expected amount that was paid out.

"It is not expected of an insurer or administrator of a retirement annuity fund to take more than six months to submit a claim form from its Benoni branch to its head office in Johannesburg.

"This delay can only be attributed to the negligence of the insurer's employees who displayed a singular lack of care and diligence in this matter," Pillai said in his determination.

The complainant, Lalitha Nayager, was a member of the Lifestyle Retirement Annuity Fund (first respondent) which was underwritten and administered by Liberty Life (second respondent).

She applied for an ill-health early retirement benefit on January 30 2008 at Liberty's branch office in Benoni.

However, despite numerous enquiries at the branch, the application was not processed.

The initial application form was only forwarded to head office in July 2008 and Nayager was asked to complete another application in September 2008.

The disability claim was assessed and admitted, and she was paid on October 31 2008.

Pillai reviewed the submissions from the parties and found that the insurer was responsible for the delay in ensuring that the claim form was timeously transferred from its Benoni branch to its head office for assessment.

Liberty Life sent reminder letters advising Nayager of the unpaid contributions, but no further monthly contributions were received.

Liberty Life made the contract paid-up on April 1 2008.

The complainant's fund value immediately before the paid-up event was R64704, 82. A paid-up causal event charge of R1512,77 was levied by the second respondent, reducing the complainant's fund value on April 1 2008 to R63192,05.

"As a result of some issues in the branch during 2008, the claim was only submitted to the head office claims department in July 2008. The assessment process was delayed further by the assessors requiring declarations from the former employer and medical reports from attending specialist. These are standard requirements for the assessment of any disability benefit," Pillai said.

Liberty Life was ordered to pay the complainant an amount of R25571,67, less any deductions in terms of sections 37A and 37D of the Pension Funds Act, plus interest thereon at the rate of 15,5 percent a year computed from October 23 2008 to the date of payment.

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