Sanlam sky is ****

Dear Sanlam Sky Claims Department,

RE: Disputed Rejection of Triple Accident Benefit for the Late Ms Sbongile Lydia Dlamini (Policy No. DS***8)

I refer to your letter dated 05 June 2025, in which you state that the triple accident benefit cannot be considered under the above policy, on the grounds that the death of Ms Sbongile Lydia Dlamini was "due to natural causes."

With respect, I strongly dispute this conclusion and request an urgent reassessment of the claim, based on the following facts:


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1. Police Report Confirms Accidental Death

Attached is the official Sanlam police report (Case No. CAS447/04/2025), signed and stamped by D/CST Zuna SA and dated 14 May 2025. It clearly confirms that the deceased was:

> "Admitted for being sick where she was operated. Unfortunately she did not make it to life. She was declared dead on 2025/04/29."



This statement implies that the cause of death resulted from complications during or after an emergency operation, making it an accidental and procedural death, not a result of an underlying chronic condition.

Additionally:

Box B1 is marked “Yes” (Police investigation), and

The report includes the police officer's contact details and reference for verification.



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2. Inconsistency With Standard Industry Practice

You note that “factors therefore do not represent an accident.” However, other insurers have already settled similar claims from the same incident, based on the same documentation. This shows that your standard of evidence is inconsistent with industry practice.

If Sanlam Sky disputes the accidental nature of the death, I respectfully request that you engage directly with the police or hospital. As the claimant, it is neither my duty nor within my capacity to source additional medical information from government institutions.


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3. Request for Formal Reconsideration

In light of the police documentation provided — which you yourselves requested — and in the absence of a completed postmortem report, it is unjustifiable to default to a “natural cause” assumption. The deceased was operated on in a medical emergency, and died as a result. This sequence of events is consistent with accidental or procedural death, and should qualify under the accidental benefit clause, Holland paid out which is funeral cover, why sanlam sky procedure different from other funeral policies
4. Next Steps

Please consider this email a formal complaint under Step 1 of your outlined dispute procedure. I request that:

The claim be reassessed immediately, and the triple accident benefit be paid out without further delay, OR

Sanlam Sky engage directly with the investigating officer (D/CST Zuna SA) and the treating hospital to verify the circumstances of death.


Should this not be resolved satisfactorily, I will proceed to escalate this complaint to the Sanlam Arbitrator and the National Financial Ombud.


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Claimant Details:
Bhekani G. Malunga
ID: ***
Email: ***
Phone: ***

Thank you for your attention. I trust your office will act with fairness and urgency.

Sincerely,
Bhekani Malunga