Not responding to a consumer's emails and calls can cost you money, as Liberty found out when the ombudsman for long-term insurance, Judge Ron McLaren, ordered it to pay R15,000 as compensation for poor service in the handling of a woman's claim for income disability after a second mastectomy.
She said Liberty was making ridiculous requests while she was homebound after major surgery. The insurer's occupational therapist also recommended that she stay home for six months, but Liberty only granted her disability leave of three months. In addition, the insurer required detailed oncologist and psychologist reports although neither were involved in her surgery.
"Liberty has continuously acted as if I am exaggerating the situation and been booked off excessively. They have made me feel like a hypochondriac. If you are on chemotherapy, you have a compromised immune system and Covid-19 would be a death sentence.
"They are treating me badly at an extremely difficult period of my life. This is causing extreme stress, headaches, worry and emotional damage," she said. After the ombudsman started to investigate her complaint, Liberty admitted to poor handling of the case and offered her R2,500, which she rejected.
According to the ombudsman's office, the adjudicator meeting noted that R2,500 falls far short of what should be paid.
"At a time when the consumer was stressed and ill, Liberty's poor handling of her claim and complaint added to her distress. The often nonsensical and contradictory answers that Liberty gave to questions and requests added to Ms W's frustration."
After the matter was referred to a compensation committee, a provisional determination was made for an award of R15,000. Liberty offered R10,000, but the consumer did not accept it. She said her cancer treatment, especially chemotherapy, was difficult and severely compromised her immune system.
In his final determination, the ombudsman said Liberty had not stated why it did not want to pay R15,000 as compensation.
"The lack of reason by Liberty for its non-adherence to the provisional determination is further evidence of the perfunctory handling of this complaint."
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