When it comes to placing a claim, the last thing you would expect is to have it denied. Exclusions can cause your claim to be denied, however, knowing what these exclusions are beforehand can make the claim process smoother. Here is what you need to know.
Guilty of non-disclosure
Applying for life insurance with false information is known as non-disclosure. Should your insurer find that you have submitted any false information, a claim can be denied. It is always better to answer any questions you are asked truthfully to help your loved ones avoid unnecessary stress.
Claim event arising abroad
Most insurers will cover you for a claim that has occurred outside the borders of South Africa. However, there are a list of countries that insurers will not cover due to the danger they pose to your life. Should the policyholder decide to go to one of these countries, and pass away while there, your insurer could deny the claim.
Participating in riots
If the main policy holder dies due to participating in riots, insurrection, civil commotion, military or hostile action their insurer can deny the claim. Participating in any activity where you knowingly put yourself in harm or increases your chances of dying can cause an insurer to deny a claim.
Housebreaking and crime
Should a policy holder commit a crime such as breaking into a house, murder, assault, robbery, kidnapping, or a crime involving sexual acts their claim will be denied.
Taking drugs
Taking drugs that have not been prescribed by a medical professional and puts your health at risk will not be covered by an insurer. It is crucial to disclose all medical information with your insurer when applying for life insurance. Always remember to update your insurer of medical or health changes that can affect your life.
Participating in risky lifestyle choices
Doing things such as excessive drinking or activities such as drifting can cause insurers to deny a claim.
Participating in dangerous hobbies
Participating in any activity that can result in you sustaining bodily harm or increase your chances of dying are also reasons to have your claim denied.
Suicide exclusions
Most life insurers have a waiting period for deaths caused by suicide. The waiting period is usually 24 months. Should the policy holder die within this period, their claim can be denied.
These exclusions are usually explained to the policyholder when they are about to take out a policy. You will also receive a document that lists the terms and conditions that come with a policy to ensure that you understand what you are taking out.
