Cedric Stephens Why the secrecy and delay in the Taneka Gardner life claim?
Many thoughts raced through my mind as I read last Sunday’s article about the non-payment of a life insurance claim following the killing of Taneka Gardner at a Montego Bay church on October 17 last year.
They ranged from what appears to me to be a lack of respect and empathy on the part of the insurance company to the deceased’s family members – who may or may not be the beneficiaries – and the absence of any discussion about the contractual, ethical, or regulatory duties of the parts of the insurer and the deceased’s former employer.
Sections 97 to 99 of the Insurance Act 2001 were not mentioned in the article. They detail how beneficiaries or legal personal representatives of life policies are to be named. Ms Gardner’s relatives are, no doubt, still traumatised by the brutal manner of her passing. The dealings between them and the insurers appeared to have been what St Paul called, in the Epistle to Titus (1:11), all about the ‘filthy lucre’, that is, money.
Risk adviser Serena West – https://riskinfo.com.au/news/2022/08/ – writes that “when something very personal and difficult happens to a client and they (or family) member(s) enter the life insurance claims process, service providers must offer accountability, professionalism, and knowledge to deliver the best possible client experience”. This statement is also true for non-life insurance.
A motorist recently told me that she decided to end her 10-year association with an insurer. The reason: the person who oversaw her claim was cold and unsympathetic. The move was planned to occur after the total loss claim was paid. That took place without any hassle or undue delay. Insurance company employees who manage death or health claims have a difficult job and must be professionally trained.
Poor communication was another feature of the Gardner family-insurer interactions. Another real-life example illustrates the point. The Bank of Jamaica’s full-page advertisements in The Gleaner contain messaging errors that financial institutions often make. The ads are meant to explain how it regulates commercial banks and other deposit-taking entities. They are meant to respond to sustained public criticisms about poor banking services for which the regulator has oversight responsibility.
Last Wednesday’s BOJ ad tried to say why it is so difficult for customers to move their accounts from one bank to another. The BOJ folks, probably an economist and an attorney, wrote: “the central bank is undertaking research on mechanisms to facilitate the transfer of information between commercial banks and account portability”. It continued like this for another 55 words.
Insurers use similar mumbo-jumbo. I recently translated the phrase ‘claims experience letter’ for a motorist. She had no clue what those three words meant.
Naming of beneficiaries
Section 97(2) of the Insurance Act provides information about how an insured person may name their “legal personal representative, trustee, or beneficiary as the person to receive the proceeds of the insurance policy at the time of making a contract of insurance or by declaration at any time after the making of the contract”.
Subsection (3) sets out the rules for the naming of beneficiaries:
o The beneficiary shall be stated in a form and effected in the manner specified in the contract of insurance;
o The form shall be deposited with the insurer;
o The naming of a beneficiary shall not affect the insured person’s right to assign, exercise rights under or in respect of surrender or otherwise deal with the contract …; and
o The insured person may alter or revoke (a beneficiary) by declaration (as per rules previously cited).
Section 97(1) describes the features of the declaration. The instrument must be signed by the insured person and witnessed by a Justice of the Peace or a Notary Public.
In making a life insurance claim, the following documents should be submitted to the insurer, according to the information posted on the website of a local insurer: death certificate; evidence of age in the form of a birth certificate or national ID; completed claim form; a doctor’s statement; the contract of insurance; and the letter of probate or administration.
The listed information does not meet the minimum standards set out on Pages 9 to 11 in Section 11.0 of the badly drafted Financial Services Commission’s February 2019 Market Conduct Guidelines. Some standards discuss, among other things, transparency about the claims procedures; the avoidance of settlement delays; and insurer-claimant communication. There are no rules in the Insurance Act and regulations about not speaking with grieving family members, who may or may not have an interest in the claim proceeds of the policy.
Moral duty
The insurance company has a moral duty to say something to the late Ms Gardner’s family.
The Life Insurance Council represents the interests of insurers transacting business in India. This is what it says about the settlement of life insurance claims. “Insurers are required under Rule 14(2)(i) of the 2017 Regulations enacted by IRDAI (the insurance regulator) to settle a claim within 30 days of receipt of all documents including clarification sought by the insurer. However, the insurance company can set a practice of settling the claim even earlier. If the claim requires further investigation, the insurer must complete its procedures expeditiously, in any case not later than 90 days from the date of receipt of claim intimation and the claim shall be settled within 30 days thereafter.”
Ms Gardner’s death did take place in the privacy of her home surrounded by members of her family. She was murdered in a public space in a bloody ritual presided over by a man who was allegedly named the policy beneficiary. That man is now also dead.
Either Ms Gardner complied with Section 97 of the Insurance Act in naming this person as her beneficiary in place of family members or she did not. Why the secrecy and delay in the settlement of the group life claim? Also, it is not in the company’s interest to delay payment. They will have to pay interest on the sum insured when the claim is paid.
Cedric E. Stephens provides independent information and advice about the management of risks and insurance. For free information or counsel, write to: aegis@flowja.com or business@gleanerjm.com.