Unfair declined of Funeral Policy Claim

itec Bank

I write this letter with great disappointment and concern regarding the decline of the funeral claim submitted for my late cousin, who was covered under my Capitec Funeral Policy.

I hereby formally lodge a complaint and dispute the decision to decline this claim, as I believe the handling of the policy and the assessment of the claim were unfair, unclear, and not adequately justified.

The funeral policy documentation and the extended family definitions provided by Capitec do not explicitly state that cousins are excluded from being regarded as immediate or eligible family members. Furthermore, when adding beneficiaries or covered individuals under the Capitec Funeral Cover, the system does not allow the policyholder to clearly select or specify the exact relationship of the covered person. There is an option to select “sibling,” but no comprehensive list of family relationships is provided, nor is there a clear warning that cousins are excluded.

I have faithfully paid premiums on this policy for over three years. At no point during the policy term was I informed—either verbally or in writing—that cousins do not qualify for cover. Had this been clearly communicated at inception or during the policy term, I would have made an informed decision regarding my cover.

The decline letter issued does not provide sufficient evidence or a clear contractual clause to substantiate the rejection of the claim. The reasoning provided is vague and does not convincingly demonstrate how the claim contravenes the policy terms.

In light of the above, I respectfully request that this claim be reconsidered . Given the lack of clear disclosure and the long-standing payment of premiums, I strongly believe that this claim should be honoured.

I trust that this matter will receive urgent attention and be resolved fairly. Should this dispute not be satisfactorily addressed, I reserve the right to escalate the matter to the relevant regulatory bodies.

I look forward to your prompt response.