My uncle took out a life insurance with Sanlam Sky Solutions in June 2016 he unfortunately passed away September 2017. We logged a claim with Sanlam Sky Solutions they told us that they will get back to us, they did not mention a time frame of when they’ll get back to us. After several months we decided to contact them to ask them how far they are with the claim. They told us that they need the medical history of my uncle from the the employer and GP. We had no problem with giving them the consent to get the records. Our only problem was they wanted us to pay an amount of R2394 for these medical records. We could not pay this amount so Sanlam eventually paid to get these medical records and they told us again that they’ll get back to us.
They dragged the case again we decided to contact the ombudsman with our case. Sanlam Sky contacted us after to tell we had filled in the wrong forms and they attached the correct forms on the email. A few days later, we got an email from them telling us that my uncle did not disclose a certain illness meaning that they will not pay out the life cover.
Sanlam Sky then refunded the monthly premiums my uncle was paying they even subtracted the amount they wanted for the medical records. The life cover claim amount was not even disclosed.
We asked Sanlam Sky to show us the insurance form my uncle filled out so that we can see that he did not disclose the illness. They sent us a blurry looking scan that was one page. We couldn’t see anything properly including my uncle’s signature and details.
The ombudsmen finally responded they told us that there is no case and that they agree with Sanlam Sky.
Sanlam Sky did not ask my uncle to get a medical test before taking out their insurance, the cover had no disclaimer of what sicknesses they cover or do not cover. Through these months out family went through hardships, my uncle did not get a funeral he deserved. The ombudsmen failed us.
Please help us.