The complainant approached our office for assistance following the rejection of his motor vehicle claim. The participant rejected the claim on the basis of lack of due care or recklessness on the part of the driver, being the complainant. The participant relied on the following policy provisions to reject the complainant’s claim.
Case Study 1 – Final Ruling Where Funeral Claim was Wrongly Declined
The case concerned a funeral policy with Liberty Life (“the insurer”). The complainant was the beneficiary and premium payer. Ms R was both the policyholder and the life assured. Ms R (“the deceased”) died some 12 months after the policy was issued whereupon the complainant lodged a claim.
Thousands of Financial Service Complaints Come from Rural Areas
Assisting consumers with their complaints and giving the right advice at the right time to rural and vulnerable people can significantly reduce the complaints arising from financial products and services in these communities.
NFO Recovers a Staggering R328 Million for Disgruntled Financial Consumers
Since its establishment a year ago, the National Financial Ombud Scheme South Africa (NFO) placed a staggering R328,5 million in the hands of aggrieved consumers who had complained about financial institutions.
Medical Report is No Guarantee for Disability Insurance Payout
A medical report does not automatically qualify an employee for disability insurance. While medical reports are crucial evidence, the employer’s medical boarding policy could well differ from the criteria used by the insurer for determining eligibility for disability benefits.
The High Cost of Unpaid Insurance Premiums
In this tough economic climate, policyholders may be forced to sacrifice their short-term or non-life insurance premiums cover to save money…
Freedom Month: NFO champions Justice and Fairness for Credit Consumers
The National Financial Ombud (NFO) has reaffirmed its commitment to protect credit consumers from exploitation and unfair treatment – including reckless lending – as it endorses Freedom Month when the right to dignity and equality is celebrated…
When You cannot Bank on Your Bank, The NFO Can Assist
Bank customers have every right to expect good service and for complaints to be taken seriously, says Nerosha Maseti, the Lead Ombud of the Banking Division at the National Financial Ombud Scheme (NFO).
Making a Significant Difference in the Lives of South Africans
The amalgamation of the Ombudsman for Banking Services (OBS), the Credit Ombud (CO), the Ombudsman for Long-Term Insurance (OLTI), and the Ombudsman for Short-Term Insurance (OSTI) into the National Financial Ombud Scheme (NFO)…
Breach of Policy Condition not Material to The Loss
Having a professional driving permit (PrDP) would not have prevented the driver of a truck with goods from being hijacked at gunpoint, the Non-life Insurance Division of the National Financial Ombud Scheme South Africa (NFO) has ruled.