NA
Nazmeera A
1 reviews | Active since Aug 2020
22 Mar 2023, 07:19
LIFE INSURANCE CLAIM - NO PROFFESSIONALISM OR ETHICS EXERCISED
My husband passed away on the 1st of November 2022, I have followed up countless times on my claim only to be told today and tomorrow, the latest was that I was told everything will be sorted by the end of March, I called them requested a letter to state this so I can provide same to my daughter's school however there is absolutely no response.
I emailed the claims manager informing him I am heading the ombudsman way and there has still not been any response.
before approaching the ombudsman today I would like to know by email when will this claim be paid.
Please respond to me in writing only.
Thank you
Helpful (0)
Replies (3)0
Replies (3)
Different Life's replyOfficial
22 Mar 2023, 07:44Good Day Mehmood,
We apologise for the experience you have had. We will follow up about your case with our claims team and they will be in contact with you via email today.
We apologise for the experience you have had. We will follow up about your case with our claims team and they will be in contact with you via email today.
Different Life's reply22 Mar 2023, 07:44
Official
Good Day Mehmood,
We apologise for the experience you have had. We will follow up about your case with our claims team and they will be in contact with you via email today.
We apologise for the experience you have had. We will follow up about your case with our claims team and they will be in contact with you via email today.
Different Life's replyOfficial
22 Mar 2023, 09:57Thank you for your details.
Different Life's reply22 Mar 2023, 09:57
Official
Thank you for your details.
Different Life's replyOfficial
27 Mar 2023, 14:19Good day, Mrs Abbas,
Thank you for contacting us regarding the above-mentioned complaint.
The policy contract requires that the answers to the medical and lifestyle questions asked during the policy application process form the basis of the policy contract. The claim assessment aims to establish that the answers given at the application stage were accurate and complete.
The claims department requests reports from medical practitioners as well as medical aid statements showing historical claims related to the applicant. The claims team ask the policyholder’s medical practitioner/s for personal medical attendant (PMA) questionnaires to be completed, and request copies of medical files.
This questionnaire requires details relating to the medical history of the policyholder prior to the policy being issued up until the claim incident. Based on the information noted in the PMAs, additional information may be required from other medical professionals or institutions identified in these records. Questionnaires will then be sent to these newly identified medical professionals to obtain any relevant information required for the accurate assessment of the claim. During the collection of the medical history, the claimant may be called upon to assist with the authorisation of the release of information pertaining to the medical history of the policyholder. Unfortunately, the collection of medical history can take time, as well as change timelines if new information is uncovered, as this is dependent on external parties. The claims team follow up regularly to finalise these documents so that a claims assessment result can be made.
As previously discussed telephonically, we have requested medical tracing for your claim due to gaps in the medical history verification. We can only make a decision once this information is fully verified.
We assure you that Different Life is not pulling out of the claim, the claim is still being assessed and our team is focused on finalising the claim as quickly as possible.
Thank you for contacting us regarding the above-mentioned complaint.
The policy contract requires that the answers to the medical and lifestyle questions asked during the policy application process form the basis of the policy contract. The claim assessment aims to establish that the answers given at the application stage were accurate and complete.
The claims department requests reports from medical practitioners as well as medical aid statements showing historical claims related to the applicant. The claims team ask the policyholder’s medical practitioner/s for personal medical attendant (PMA) questionnaires to be completed, and request copies of medical files.
This questionnaire requires details relating to the medical history of the policyholder prior to the policy being issued up until the claim incident. Based on the information noted in the PMAs, additional information may be required from other medical professionals or institutions identified in these records. Questionnaires will then be sent to these newly identified medical professionals to obtain any relevant information required for the accurate assessment of the claim. During the collection of the medical history, the claimant may be called upon to assist with the authorisation of the release of information pertaining to the medical history of the policyholder. Unfortunately, the collection of medical history can take time, as well as change timelines if new information is uncovered, as this is dependent on external parties. The claims team follow up regularly to finalise these documents so that a claims assessment result can be made.
As previously discussed telephonically, we have requested medical tracing for your claim due to gaps in the medical history verification. We can only make a decision once this information is fully verified.
We assure you that Different Life is not pulling out of the claim, the claim is still being assessed and our team is focused on finalising the claim as quickly as possible.
Different Life's reply27 Mar 2023, 14:19
Official
Good day, Mrs Abbas,
Thank you for contacting us regarding the above-mentioned complaint.
The policy contract requires that the answers to the medical and lifestyle questions asked during the policy application process form the basis of the policy contract. The claim assessment aims to establish that the answers given at the application stage were accurate and complete.
The claims department requests reports from medical practitioners as well as medical aid statements showing historical claims related to the applicant. The claims team ask the policyholder’s medical practitioner/s for personal medical attendant (PMA) questionnaires to be completed, and request copies of medical files.
This questionnaire requires details relating to the medical history of the policyholder prior to the policy being issued up until the claim incident. Based on the information noted in the PMAs, additional information may be required from other medical professionals or institutions identified in these records. Questionnaires will then be sent to these newly identified medical professionals to obtain any relevant information required for the accurate assessment of the claim. During the collection of the medical history, the claimant may be called upon to assist with the authorisation of the release of information pertaining to the medical history of the policyholder. Unfortunately, the collection of medical history can take time, as well as change timelines if new information is uncovered, as this is dependent on external parties. The claims team follow up regularly to finalise these documents so that a claims assessment result can be made.
As previously discussed telephonically, we have requested medical tracing for your claim due to gaps in the medical history verification. We can only make a decision once this information is fully verified.
We assure you that Different Life is not pulling out of the claim, the claim is still being assessed and our team is focused on finalising the claim as quickly as possible.
Thank you for contacting us regarding the above-mentioned complaint.
The policy contract requires that the answers to the medical and lifestyle questions asked during the policy application process form the basis of the policy contract. The claim assessment aims to establish that the answers given at the application stage were accurate and complete.
The claims department requests reports from medical practitioners as well as medical aid statements showing historical claims related to the applicant. The claims team ask the policyholder’s medical practitioner/s for personal medical attendant (PMA) questionnaires to be completed, and request copies of medical files.
This questionnaire requires details relating to the medical history of the policyholder prior to the policy being issued up until the claim incident. Based on the information noted in the PMAs, additional information may be required from other medical professionals or institutions identified in these records. Questionnaires will then be sent to these newly identified medical professionals to obtain any relevant information required for the accurate assessment of the claim. During the collection of the medical history, the claimant may be called upon to assist with the authorisation of the release of information pertaining to the medical history of the policyholder. Unfortunately, the collection of medical history can take time, as well as change timelines if new information is uncovered, as this is dependent on external parties. The claims team follow up regularly to finalise these documents so that a claims assessment result can be made.
As previously discussed telephonically, we have requested medical tracing for your claim due to gaps in the medical history verification. We can only make a decision once this information is fully verified.
We assure you that Different Life is not pulling out of the claim, the claim is still being assessed and our team is focused on finalising the claim as quickly as possible.