desputing repudiation of claim

DISPUTE Policy NO: ********** 49

I am writing to dispute the outcome of my claim on the above mentioned policy.

Based on the repudiation letter sent to us on Wednesday, 09 May 2018 @ 12:37PM, It is very difficult for us to accept this rejection letter and the reasons thereof.

Yes the premiums for March and April were missed that I do understand, however there was an SMS sent that clearly states that we need to pay our defaulted premiums by the 03/05/18 or our chance to keep the policy active will expire.

My brother in-law died in an accident on the 29/04/2018

My husband called in on Monday the 30/04/2018 and he was told policy is active and was immediately transferred to claims department, where he was dealing with a lady by the name of Rozzane who is well aware of the SMS sent to us about paying before the 03/05/2018 and my husband went to checkers to pay and unfortunately the PAY @ was off line he went to PEP stores and it was also off line, he then called Rozanne to let her know that the system was off line he was told she is busy on a call and was put through to a guy buy the name of Simphiwe who confirmed the pay @ was off line and my husband requested the he made note of this on the system, called in the next day Rozzane this was now the 03/05 which was the last day for us to pay this outstanding amount, Rozzane advised he doesn’t need to pay anymore as the file was now with the assessor.

On the 04/05 we called in again frustrated as it was now Friday and we were now travelling to KZN where the funeral service was going to be held, we spoke to Rozanne again a million times and the only thing that was holding our claim was the fact that we sent incomplete documents as she had also requested we send the accident report which we still have no access to, at some point we spoke to Sunette was an assessor to this claim, who told us she needed to listen to voice recordings of my mother in-law calling in to change banking details and she called again but the network was terrible and when we tried to call again she was nowhere to be found and had made a note that she would call us again on Monday.

We called again for Sunette and we were put through to Simangele who I assume is in claims or is one of the assessors, she explained to us that the reason why our claim is on a stand still is because of the documents sent which weren’t certified nor did we send the BI663 form which was a requirement, she sent a list of documents to be sent on Monday for the claims to be finalized via an SMS as well.

And yes she did touch on the subject of missed payments and I explained the SMS received and the pay @ off line issue (explained above).

On Monday we spoke to Sunette who told us she is waiting for recordings and will advise once she is done of the outcome. We requested the same recordings she was supposed to be listening to as well as the recordings from 30/04/18 -04/05/18 that we were told policy is active and documents were requested from us.

Please understand that our brother’s sudden passing has left an emotional void that we cannot even begin to describe. He was one my mother in law called on when in need. With this claim rejection we found ourselves having to take up loans to ensure he’s send off was a dignified one. We have accumulated debt that we cannot manage.

Due to these reasons we have decided to dispute this repudiation.

Please provide us with voice recordings from the date of claim notification 30-05-2018 to date. We have found that whilst dealing with all the mentioned consultants, there have been inconsistencies with their statements. We have the SMS at hand, should you require this. Please help us understand how a policy is kept active the whole week only to be rejected because a claim has been launched? Sunette advised the policy lapsed in April, but we have an SMS that says the contrary.