Dad Nathan Ganas, 42, was shot dead trying to protect his wife Denise during a hijacking in the driveway of their Durban home in March.
Back then, the widow never dreamed she would have to fight the insurer, who has now refused to pay out a R2.4 million life insurance policy on the grounds that Nathan had high-blood sugar levels.
The insurer, Momentum, said the claim had been declined because of non-disclosure by Nathan, who was diagnosed with raised blood sugar levels which may have occurred before he comple- ted his application for the policy in 2014.
Momentum has also asked Denise to pay back the R50 000 instant cash benefit from the policy, which the family used to pay for Nathan’s funeral.
Following a backlash on social media, Momentum on Monday stuck to their guns over the rejected claim despite the pre-existing condition not being related to Nathan’s cause of death.
In some countries, life insurance claims are settled if cause of death is unrelated to a non-disclosure breach, but not in South Africa.
Momentum said it would open a big can of worms and prejudice existing clients if it were to pay the claim.
Nathan’s 10-year-old daughter, Carmen, now 12, was also injured in the attack.
Denise said she was shocked by the rejection.
She said as far as she was aware, her husband was never on chronic diabetes medication before the application for the policy.
“The post-mortem report states he had died of gunshot wounds and not diabetes,” Denise told the Independent.
“I feel a grave injustice has been done to my kids and myself in our time of bereavement.
“Due to my financial situation, I may have to rethink my living arrangements.”
In a statement, Momentum said it was truly sorry for Nathan’s tragic death and also had sympathy for the views that the cause of death was not related to the non-disclosure.
But the insurer said paying the claim would result in an increase in claims which would ultimately increase the premiums for other clients just because “a client has not acted in good faith”.
“The rejection of the claim was referred to the Ombudsman for Long-Term Insurance, who ruled Momentum’s decision was correct under the circumstances.
“In this instance, had the information been known to us, no cover would have been issued in the first place, and no claim would have been paid, regardless of the cause of death,” Momentum said.
The CEO of Momentum Life, Johann le Roux, told PowerFM on Monday the company will refund the premiums paid by the Ganas family since the start of the policy.
But Denise says she hasn’t been contacted yet.