CR284
Late submission of claims

Equity – unique circumstances.

Background

The life assured, who was murdered, held a policy which provided that:
The claim must be submitted within 12 months from the date of death.

The complainant, his wife, was the named beneficiary, and she lodged a death claim some 21 months after the murder. The insurer declined the claim on the basis of late submission.

The complainant contended that the reason for the delay was beyond her control. She and another had been formally accused of having murdered the life assured. She had been continuously detained from shortly after the life assured’s death and after a lengthy trial she was acquitted and released, while her co-accused was convicted of the murder.

She lodged the claim with the insurer promptly after the trial was concluded.

Consideration

In the light of the unique circumstances surrounding the delay in lodging the claim, as outlined above, we invited the insurer to reconsider its decision.

Result

In response thereto the insurer’s Claims Committee decided to waive the defence of late submission and assessed the claim on its merits. It met the claim in full.

TS
October 2009