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MN
Msiyana N

1 reviews | Active since Jan 2024

16 Apr 2024, 09:56

COMPLAINT AGAINST OLD MUTUAL WITH REGARDS TO NON PAYMENT OF THE LIFE COVER OF THE LATE MRS. GONYELA WITH POLICY NUMBER ***8

Old Mutual Life Cover with Policy number: ***8 for my late mother N Gonyela that was not paid by Old Mutual in March 2020.

I decided to take funeral and life cover for my late mother at old mutual. The funeral cover was paid and it was quick. However, the life cover was not paid by old mutual due to the reason that my mother never disclosed all her sicknesses at the time of application.

Surprisingly, is that I was with my mother the time of the life cover application and I took life cover also the same day, off which I later cancelled when I realized from the one off my mother that was not paid.

The process that we followed when we took the life cover at old mutual was: We made an appointment at old mutual and we were given a representative of old mutual whom we made an appointment with to visit us at home for application. The application for life cover is not complete without them sending you to their recommended Doctor for checking out all the illnesses even those you are not aware of. My mother was sent to the Doctor that was recommended by Old mutual prior the approval of the Life cover application.

later we were told that the application for life cover was approved and we were happy by that approval. I paid the life cover for my mother for years and when the time of the claim was told my mother **** of her illnesses, how is that possible if they took her to their Doctor for checking all her illnesses, and use that against the claimant. How did they approve the incomplete application in the first place.

Up until now I never received the claim for the life cover of my mother, I have exhausted all the offices where I needed to complain about this situation and that was the time of Covid 19 where we were not allowed to visit any offices so I dealt with my complaint via email. The last appeal I did it was to FAISOmbud off which they were in favour of old mutual so they working together if you have the complaint with old mutual you rather keep it. I am doing this since this happened directly to me so that people are aware of that. and take the right decisions. I lost a lot since I had to cancel all my policies with them and started elsewhere and I had to wait for 6 months to be covered again but since I started working I signed with old mutual until my mother **** about her illnesses, according to old mutual.

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Replies (5)
MN
Msiyana N's update17 Apr 2024, 16:31
Reviewer Update
Good day Msiyana

I refer to your review of 16 April 2024.

I am sorry to hear that your unhappy with the outcome of your complaint dealt with by the Fais Ombudsman in 2020.

I note from our records that a comprehensive investigation was done and feedback was provided to the Fais Ombudsman. We are unable to comment further on this matter. I will suggest that you refer the matter back to the Fais Ombudsman.

Kind regards
COLEEN AANHUIZENClient Relationship Manager I OML Customer Complaints
Mutualpark, Pinelands
T. +27 (0)21 *** I E. *** I R. --OCM***8--


Good Afternoon

The above response is not surprising at all to me.
This is not even closer to the complaint I had with Old Mutual. If you read my complaint, it is clearly stated that I consulted FAIS Ombudsman and they were also in favour of Old Mutual and you will find that in my last Paragraph and I am not willing to be told to lodge a complaint to them. People must just be aware.

As poor as I am, but you cannot with big name as Old Mutual took the money of any person and promising the policy, then only at the time you noticed that his was not a policy is when you claim towards it, where is the fairness in this, this in not easily understood as the customer although it can be easy on their side.

Kind regards
MN
Msiyana N's update17 Apr 2024, 17:05
Reviewer Update
Good day Siyabulela

Thank you for your e-mail.

The content of your complaint was noted.

The complaint was referred to the Fais Ombudsman, who referred the matter to the Office of the Internal Arbitrator at Old Mutual in 2020.

Old Mutual investigated this matter and provided the Fais Ombudsman with the all the information and supporting documents to review this complaint.

Complaints referred to a Ombudsman has priority over Hellopeter. If you dispute the outcome of the matter, you have to refer the matter back to the Fais Ombudsman.

Kind regards
COLEEN AANHUIZENClient Relationship Manager I OML Customer Complaints
Mutualpark, Pinelands
T. +27 (0)21 *** I E. *** I R. --OCM***8--


In one sentence. what made old Mutual to allow the application for life cover and knowing that there is invalid information in the application and continued to deduct the premiums?
MN
Msiyana N's update17 Apr 2024, 18:14
Reviewer Update
  • The truth is the Life Cover application was completed and approved by Old Mutual in 2018, then in 2020 the claim was rejected, whereas all the premiums were paid. Their reason for rejection including their Ombudsman was that: my mother failed to disclose other illnesses and that the application for the Life Cover was invalid although they approved the application and continued with the premiums.
  • The application was completed by an Old Mutual employee.
  • The application was branded Old Mutual and was submitted at Old Mutual Offices.
  • After completion of the Life Cover application you get an appointment to see Old Mutual doctor who will examine all the illnesses of the person about to take the Life Cover.
  • My failure to understand the above rejection reason is triggered with the above exercise that was done.
  • The notification that: Your application was approved and thank you for choosing Old Mutual was received from Old Mutual not anywhere else.
  • The premiums started to kick in from 2018 from the same Old Mutual.
  • The claim was done at the same Old Mutual and the Claim was rejected by the same Old Mutual.
  • It is now after three years but I everyday still think about this.
  • For all these years I didn't have the courage to talk about this since I was failed by their Ombudsman, and now if I am told to go back to Ombudsman what different will it hold.
  • Its high time people to open their eyes, when making their decision.
  • I am not frightened because I speak the experience that I had to go through with Old Mutual.

Old Mutual Client Relationship Manager recently told me via email that: Complaints referred to a Ombudsman has priority over Hello Peter, this has got nothing to do with the complaint and me referring it in this platform, as I am doing what I think is right for me as they also did what they thought it was right for them in rejecting the claim.

There is too many ways to stress out your unhappiness about the situation, as I just needed the answers and not interested in referrals, unless the referral is new not to where I was. Ombudsman.

Kind regards

MN
Msiyana N's update17 Apr 2024, 18:36
Reviewer Update
Good Evening

I need to stress this:
I strongly believe that no failure was done by taking the Life Cover at Old Mutual as all the due process when one is taking the policy was followed from application until approval, and when taking the policy you are unaware of the claim procedure as it is not transparent, and I was not employed by them to know what entails when you are about to take the policy and you only rely and trust the person who is doing the application on your behalf.

Then the failure of the person completed the application can never be our failure. I believe that the Client Relationship Manager is quick to respond without going through to the documents I am referring to and that I can easily picked up from his or her responses that are not constructive.
MN
Msiyana N's update17 Apr 2024, 18:46
Reviewer Update
Good Evening

Unless we are informed not to trust the representatives of them and the doctors they referring us to prior the Life Cover application, and they are not clued up on how to complete those applications for the people interested in taking the policy.

Kind regards