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Sunday, January 23, 2022

Former client wins a ’significant’ court victory against insurance company

Durban – The latest episode in the legal battle between a businessman and the insurance company that repudiated his more than R2 million disability claim of 2011, has gone the way of the client.

The main event, the trial, where Ravichandren Reggie Dhurgasamy will attempt to prove his permanent disability claim with Discovery Life Limited was a valid one, is next on the cards.

Recently, Discovery’s application to have Dhurgasamy’s disability claim dismissed because of its validity was overruled at the Durban High Court.

Judge Mahendra Chetty made the ruling, with legal costs also awarded in Dhurgasamy’s favour.

Dhurgasamy signed up for a Discovery policy in 2009.

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He then experienced continuous lower back trouble, had surgery, but ended with a permanent disability that prevented him from working.

Dhurgasamy lodged a claim according to the policy’s “Capital Disability” benefits in June 2011.

He anticipated a payout of more than R2m.

While Dhurgasamy revealed he had back surgery in 2001, when he signed the policy, Discovery contented that he failed to declare two consults with a general practitioner (2006 and 2007), who diagnosed spondylosis. Therefore, Discovery repudiated his claim.

Dhurgasamy challenged the decision at the office of the long-term insurance ombudsman and received a favourable ruling in 2012.

Discovery responded by categorising Dhurgasamy‘s condition to be a temporary disability and made payments totalling R130 050.

No further payouts were made because Dhurgasamy’s policy lapsed in April 2012. He claimed he was in a weakened financial state at the time.

Although he asked for a reassessment in August 2012, Discovery refused and were firm that Dhurgasamy was not disabled.

Dhurgasamy, again, approached the ombudsman.

After assessing evidence provided by both parties, the ombudsman office eventually stated in April 2016 that they were unable to rule conclusively in favour of either party.

In August 2017, Dhurgasamy served summons on Discovery, in respect of his claim.

That set in motion a series of legal salvos fired by both parties.

It included the issues of “exception” Discovery raised against Dhurgasamy’s claim.

A legal exception is raised when one party objects to a defect in the other’s pleadings.

He hit back at the exceptions and Discovery’s bid to have his disability claim dismissed, which turned the matter into a protracted legal battle.

Dhurgasamy accused Discovery of “doing everything to avoid accountability and liability because of a personal vendetta against him”.

He said his legal team comprising advocate Ryan Naidu and law firm Manoj Haripersad and Associates “vigorously opposed” all of Discovery’s legal actions.

“On April 20, the judge found no basis existed for the application made by Discovery, that I did not have a valid claim,” said Dhurgasamy.

He also stated that Discovery’s comment, in a previous article, that the court delays were exacerbated by him appointing new attorneys, who then challenged the exception raised by the company, was misleading.

Dhurgasamy said the latest court outcome was a significant result.

“I’m not deterred by taking on a financial giant like Discovery. I look forward to the trial,” he said.

Hein Human, Discovery Life’s head of legal matters, confirmed they would not be appealing the latest court decision, would abide by the ruling, but welcomed the opportunity for the matter to be heard in open court.

Human said they had indisputable evidence that Dhurgasamy had no valid claim.

He said Dhurgasamy’s claim was repudiated only because it did not meet the policy’s permanent disability criteria.

“It is unfortunate that Mr Dhurgasamy has sought to characterise the litigation process initiated by him as an indication of anything other than our zero-tolerance approach to fraud, our commitment to all our clients, and to prudent and responsible operations as a financial services provider.”

Human said they rejected all allegations that Discovery was trying to “frustrate” Dhurgasamy and deliberately delay proceedings in the matter.

He explained that exceptions were common in civil proceedings and that on March 19, 2020, Discovery received a notice of withdrawal of Mr Dhurgasamy’s attorneys of record, Manoj Haripersad and Associates.

“The same lawyer was reappointed shortly thereafter, but this directly resulted in the delay in the legal proceedings because it led to the court date being postponed. Discovery doesn’t have any interest in prolonging the matter and would like to see it resolved.”

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Sunday Tribune

Credit IOL

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