Urgent Complaint Regarding Rejected Funeral Claim – Policyholder

I am writing to lodge a formal complaint regarding the rejection of my funeral policy claim following the passing of my mother on 2 June 2025. I have been paying premiums for her funeral cover through Capitec, and after her passing, I submitted all required documentation including original proof of our biological relationship and hospital bills I personally paid when medical aid failed to cover certain costs. Despite this, I was told that my claim was rejected on the basis that we are not related. This decision contradicts the documentation I submitted and has caused me significant emotional distress. What’s worse, I have received no proper explanation for this rejection, nor have I been refunded the premiums I was assured would be returned to me. My follow-ups via email have gone unanswered, and when I visited the branch in person, I received no assistance. As a paying customer, I expect fair treatment and accountability. I therefore invoke the following legal rights and protections: Rule 2A of the Policyholder Protection Rules (Long-Term Insurance Act): I have the right to be treated fairly and to receive outcomes aligned with the purpose of the funeral policy I purchased. Insurance Act 18 of 2017 (Funeral Class): This policy falls under funeral cover provisions, and I am legally entitled to claim benefits if I’ve paid the premiums and provided the necessary documentation. Consumer Protection Act (CPA): I have the right to honest, transparent communication and fair redress when services are not delivered as promised. Capitec’s lack of response and unjustified denial of my claim may violate these provisions. I demand the following: A full and transparent written explanation for the rejection of my claim. An immediate refund of all premiums paid to date, as promised. A thorough review of my claim with consideration of all documents submitted. Please treat this matter with the urgency it deserves. I expect a formal response within 7 working days. Failure to respond will leave me no choice but to escalate the matter to the Ombudsman for Banking Services and/or the Ombudsman for Long-Term Insurance. Sincerely, Khayelihle Msimango