Direct Answer
If a funeral insurer refuses to pay out your policy, you can complain to the Ombudsman for Long-Term Insurance (OLTI) — for free. Common disputes include disputed waiting periods, claims on suicide (where the policy doesn't exclude it), and disputes over covered members.
What the Law Says
Your Legal Foundation
Long-term Insurance Act 52 of 1998
Various
“Long-term insurers (including funeral insurers) must act in good faith, disclose exclusions clearly, and handle claims within a reasonable time.”
Consumer Protection Act 68 of 2008
Section 49
“Unusual or restrictive terms in a consumer contract must be drawn to the consumer's attention in a prominent and clear manner.”
Common Questions
Frequently Asked Questions
Can a funeral insurer refuse a claim for suicide in South Africa?
Only if the policy explicitly excludes suicide. If the exclusion was not clearly drawn to the policyholder's attention, the exclusion may be unenforceable under the CPA.
What is a waiting period on a funeral policy?
A period (typically 6 months from inception) during which no claims are paid for natural deaths. Accidental deaths are usually covered from day one. An insurer must disclose waiting periods clearly.
How quickly must a funeral insurer pay a valid claim?
Typically within 48–72 hours of receiving all required documents. Delays beyond 30 days are unreasonable and subject to OLTI complaint.
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