Don’t ignore messages from your insurance company, especially if it is about something as important as funeral cover.
This is the hard lesson that Esme April learnt to her cost.
“I am two years away from retirement and I applied to Clientele for funeral cover so I can add up to 13 relatives on one policy. My father, who turned 80 in December last year, died on May 18 this year. A few days after the funeral I phoned Clientele to submit a claim. They told me I can’t claim because I missed one payment in April. My response was that in April it was level 5 lockdown and we had to stay at home as we couldn’t work. They told me it’s not their problem but I couldn’t claim. I have had this policy since 2018 and haven’t skipped a payment. This was the first time due to Covid-19.
“I’m very disappointed in Clientele for treating me this way. My instalment is R1 700 a month. I missed the payment in April as we had to stay indoors and couldn’t go to work so there was no income,” said Ms April.
This is one of the many unintended consequences of the lockdown imposed by the National Coronavirus Command Council.
Perhaps Ms April should ask one of them to pay the premiums.
Clientele said they would look in to it. But there was a ryder.
“We will investigate but because this query relates to a matter of a confidential nature, a power of attorney allowing the company to respond to this query must be provided by the policy owner.”
I told Clientele that it has nothing to do with client confidentiality: the questions were of a general nature.
Which is when they said it was required by the Protection of Personal Information Act (POPIA). Popia became law on July 1 this year and it has been a work in progress since 2005 (natlawreview.com).
They did answer but I don’t know if they asked Ms April for her consent.
However, expert property lawyer, Marlon Shevelew of Marlon Shevelew and Associates in the CBD, who routinely deals with Popia, believes the insurance giant interpreted it incorrectly.
Clientele said the claim was lodged on the “passing of Ivin Kistern on May 18 2020”, but it was declined because the April premium wasn’t paid. The last premium was paid on March 25.
“On May 4, we sent an SMS to Ms April advising that the premium has not been paid and that cover would only resume once it was paid. The company’s systems show that Ms April has not paid any premiums for three months and we advised her that policies automatically lapse after three consecutive unpaid premiums.
“In Ms April’s case this was for the months of April, May and June.
She did receive an SMS on July 10 notifying her of this. No refund is due to her but if she can provide a bank statement showing otherwise we can investigate this further.
However, the systems show that no premium was collected in June from Ms April,” Clientele said.
Mr Shevelew said Popia provides that everyone has the right to privacy; which includes a right to protection against the unlawful collection, retention, dissemination and use of personal information by public and private bodies that will infringe on a person’s right to privacy. The entire Popia is now law, except sections 110 and 114(4), which only come into effect on June 30 next year.
Normally, where an insurance company collects information, it may only be processed again in line with the purpose for which it was collected. Therefore any random request for personal information will in most instances be prohibited because to accede to such a request would be to process the information in a manner incompatible with the purpose for which it was collected.
“In this case, the woman agreed to the distribution of her information, and as such the insurance company was not prevented by Popia from sharing it.
“The objection which was initially raised that a power of attorney needed to be provided is also not correct. Consent is defined in Section 1 as any voluntary, specific and informed expression of will in terms of which permission is given for the processing of personal information. An email would be proof enough of consent,” Mr Shevelew said.
Like all legal documents, Popia is full of jargon. “But,” said Mr Shevelew, “Once stripped of its wordiness, it all makes sense. Information may only be collected for certain purposes and may not be distributed or further processed.
One exception is when the person whose information it is, agrees to share the details,” the lawyer said.
The problems of wordiness are not unique to Popia and the uncertainty surrounding the application of some of the provisions can lead to difficulty in obtaining information which should legitimately be provided.
“This is an unfortunate, yet inevitable consequence of legislation such as Popia. As society grapples to come to grips with the prescripts of the act, some will interpret it incorrectly, and some will use it as a shield to avoid complying with legitimate requests.
“Therefore when, in response to a legitimate request, a response like the one that was advanced by the insurance company, should not be taken at face value.
The underlying reasoning needs to be interrogated, and if it is found wanting, then it must be challenged. This is the only way to ensure that the purpose of Popia is realised, and that it is not abused by some corners of society,” Mr Shevelew said.
Email info@marlonshevelew.co.za or call 021 425 7069 for help.
