JS
Jessica S

1 reviews | Active since Feb 2018

20 Jun 2018, 10:16

Old Mutual stalling severe illness payment

I would like express my disgust with the service received from Old Mutual regarding a severe illness claim

Old Mutual Greenlight reference guide (15 September 2014) Greenlight severe illness (Page 153) 8.1 Understanding severe illness benefits * Severe illness cover is designed to make a client’s recovery process easier without having to worry about the financial burden a severe illness or injury can bring. Recovering from a severe illness is expensive. The tax free lump sum payout can help for rehabilitation costs, settling debt and other lifestyle adjustments needed, to give them the best chance at recovery • Severe illness benefits provide cover for specified severe illness by paying a tax free lump sum in the event of the diagnosis or occurance of such illnesses as defined in the specific severe illness benefits terms and conditions and events description for severe illness benefit guide (version 01.2004) • Severe illness cover is not meant to replace long term income loses. Disability cover should be used for this need. In most instances clients may be able to work during and after their recovery. • It is Greenlights philosophy to provide funds to make the necessary lifestyle adjustments needed to recover from or live with a severe illness Old Mutual has not paid out the severe illness benefit as they say the condition needs to be permanent, yet here is their reference guide which does not mention anything about the severe illness being permanent yet the above is explained which client qualifies for so what is the hold up. This money needs to be paid to client immediately or else Old Mutual will be in breach of contract with the client According to my contract with Old Mutual : Contract number: ********** 92 I have the Elite Severe illness PLUS benefit which covers the following: It is the Greenlights flagship stand alone severe illness solution which pays a tax free lump sum and covers the most illnesses in our severe illness benefit range 14 day survival period has been met even though it is not required in this case P223 requirements of severe illness % payout in terms of lifestyle / daily events: • All the requirements have been met P224 says Old Mutuals Chief Officer must confirm that: • The life covered has undergone reasonable treatment and has reached the adequate level of functioning that can reasonably be expected of a person suffering from the illness, condition or event Sufficient medical records have been submitted to Old Mutual

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Replies (2)
Old Mutual
Old Mutual's reply20 Jun 2018, 11:07
Official

Dear Jessica

I acknowledge receipt of your complaint and refer to our earlier conversation.

This matter is being investigated and I'll be in contact with you.

Kind regards

Carol Olckers

Complaints Management

Old Mutual
Old Mutual's reply20 Jun 2018, 15:33
Official

Dear Jessica

I refer to my email.

You will need to deal directly with the Ombudsman's office in this regard.

Regards

Carol Olckers

Complaints Management