Dishonesty Has Consequences: Pretoria Man Ordered to Pay Over R1.5 Million to Discovery Insure for Fraudulent Claim

Background

Tshamunwe Masindi, a resident of Pretoria, took out a policy with Discovery Insure to cover specified insured risks, including damage or total loss of his household contents due to particular risks. The policy stated that if such events occurred, rendering his residence unfit for human habitation, Discovery would compensate him for the damage to the building and household contents, as well as reimburse any emergency accommodation expenses.

Masindi submitted a claim for storm damage to his residence, comprising repairs to the residence, damaged household contents, and emergency accommodation expenses. Discovery paid him a total of R1,594,980.12 in settlement for both components of the claim.

Discovery’s Investigation

Discovery launched an investigation into Masindi’s claim and found that it was partially fraudulent. They notified Masindi that he had to repay the full amount disbursed, but he failed to do so, leading Discovery to cancel his policy.

Legal Action

Discovery initiated legal action against Masindi for failure to repay the amount owed, resulting in a recent ruling by the Supreme Court of Appeal. The court has ordered Masindi to pay Discovery Insure R1,594,980.12, plus an interest of 10.25% per annum from June 8, 2017, until the final payment date.

Importance of Honesty and Disclosure

This case underscores the significance of honesty and full disclosure when dealing with insurance companies. Fraudulent claims not only lead to legal battles and financial consequences for the claimant but also contribute to higher premiums for honest policyholders.

Discovery Insure’s Innovative Approach

Discovery Insure is an insurance company that offers a range of products and services catering to the diverse needs of its clients. The company has launched a prepaid healthcare voucher scheme, providing flexible and affordable healthcare options for South Africans. Additionally, Discovery has implemented an electronic vaccination data system to streamline the COVID vaccine registration process and has warned of higher premiums for unvaccinated clients.

The case of Tshamunwe Masindi serves as a cautionary tale about the repercussions of fraudulent actions in the insurance sector. It emphasizes that honesty and transparency are essential when dealing with insurance claims.