ARTICLE
3 February 2023

Case Update: Medical Practitioner Receives Disability Payment Worth Millions Despite Falling Behind On Insurance Premiums.

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Adams & Adams

Contributor

Adams & Adams is an internationally recognised and leading African law firm that specialises in providing intellectual property and commercial services.
Our client, a successful medical practitioner, suffered a cardiac arrest ("the event") following a routine procedure to remove a mass from his kidney. Pursuant to the event...
South Africa Insurance
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Our client, a successful medical practitioner, suffered a cardiac arrest ("the event") following a routine procedure to remove a mass from his kidney. Pursuant to the event, our client was placed on a ventilator for months, resulting in him not being able to speak post being weaned off the ventilator. In addition, our client suffered from severe short term memory loss which negatively affected his ability to function normally.

At the time of the event, our client enjoyed income protection and disability cover through a large insurer. Our client immediately lodged a claim for loss of income but was informed that his disability claim could only be entertained at a date in the future when the permanency of his disability had been determined.

Whilst awaiting clarity on the permanency of his disability, our client fell behind on his insurance premiums after forgetting to make his monthly payments. Our client's failure to keep his premiums up to date resulted in the cancellation of his insurance policy.

Against this backdrop, it pleases us to report that we have assisted our client in successfully lodging an internal appeal against the cancellation of his insurance policy, which has culminated in our client receiving a disability pay-out worth millions of rands.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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