We chatted to Judge Galgut, the Ombudsman for Long-term insurance to find out what consumers need to know before they take out long-term insurance, and what to do if they have a complaint. Here is what he had to say:
- Broadly speaking long-term insurance is any insurance which includes life cover. More accurately, however, it includes not only a life policy, but also assistance policies (which includes funeral policies), disability policies, fund policies, health policies or sinking fund policies, or any policy comprising a combination of these.
- As a policyholder you have a 30-day cooling-off period during which the policy or an amendment to it can be cancelled.
- Complete your own written proposal as accurately as possible – insufficient or inaccurate information may result in the insurer being excused from liability and may justify the insurer in cancelling the policy contract at a later stage. In the case of doubt information should be disclosed.
- Always read the full document before signing it and also read through the policy contract upon its receipt to ensure that it conforms with your expectations or to what you understood the contract to be.
- You should always keep written proof of the correspondence between you and the insurer or the intermediary.
- If you do have a complaint, contact the insurer first, and give them the chance to resolve the problem or complaint.
- If you are not satisfied with the insurer’s response, then contact the office of the Ombudsman for Long-term Insurance, which you can do by post, fax, email or on the website at www.ombud.co.za. Remember to have the following details at hand:
- Your policy number
- The name of the insurer
- Your contact details
- A factual summary of your complaint
- Copies of all supporting documents relevant to your complaint, including correspondence with the insurer.
Click here to read a summary of Judge Galgut’s 2009 report.
