Africa-Press – South-Africa. The lawyer representing a man challenging Discovery Life’s failure to pay out a claim wants the company to “do the right thing and pay my client”.
Marco Martini was commenting after the Gauteng High Court on Monday dismissed Discovery Life’s application for leave to appeal against its earlier order to pay more than R25 million to a man deemed unable to work as a stockbroker.
Martini said he had expected the court to dismiss the company’s application for leave to appeal.
The man, identified in the court papers as PR, is fighting for a payout for his “Capital Disability Benefit” policy, which covers him in the event of permanent disability.
His policy expired on 30 November 2015. In court papers, he claimed he could not carry out his work duties between 28 December 2014 and that date.
He suffered from health issues, including “a combination of post-traumatic stress disorder and bipolar mood disorder” following the death of his girlfriend during their holiday in Mauritius in December 2014.
In January 2015, he was arrested and charged with her murder and detained, pending trial.
He subsequently fell ill.
The company rejected his claim because it said it had no evidence that PR had been disabled when the policy expired.
However, Judge Stuart Wilson ruled that Discovery had no right to reject PR’s claim, saying the company should have investigated whether he had become permanently disabled before 30 November 2015.
After the High Court made its initial order last month for Discovery to pay, the company said: “The implication of this is that insurers are liable to pay insurance claims when claimants only qualify for the conditions covered under the policy a significant amount of time after the policy has lapsed.
“This could impact premiums for disability and severe illness cover, as well as the insurability of certain conditions across the industry.”
Wilson said the company’s argument that his judgment would affect the insurance industry did not hold because it pertained to Discovery and PR.
He added that because the matter had no prospects of success, he could not ask the Supreme Court of Appeal to entertain it.
He continued:
Discovery Life said it was considering its options.
“Discovery Life respects and is studying the judgment that was handed down today (Monday), and we are considering the options available to us.”
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