OMBUDSMAN’S DETERMINATION: BENEFITICIARIES OF SOME DECEASED PUBLIC OFFICERS WHOSE DEATH CLAIMS WERE REPUDIATED BY ALLIANCE INSURANCE.

Last year 2014, the Office of the Ombudsman received complaints from people who were aggrieved that the death benefit claims of their relatives had allegedly been repudiated by the insurer (Alliance Insurance).

Upon receipt of these complaints the Ombudsman summoned the Director of the Teaching Service Department and the Principal Officer of the Pension Fund to come and explain why the claims were being repudiated.

The Principal Officer- Pension Fund explained that all members of the Fund including the deceased teachers and civil servants whose beneficiaries had lodged the complaints were insured and that in terms of the provisions of the contract with the insurer, claims for the death benefits ought to be submitted to the insurer within six months of the occurrence of death. He said that in the cases under investigations, the Teaching Service Department and some line Ministries and Government agencies had notified the Pension Fund about the deaths of the members in question after the prescribed period of six months had expired and that as a result the insurer (Alliance Insurance) had repudiated the claims.

The Director of the Teaching Service Department admitted that it was true that the TSD had delayed to notify the Fund about the deaths of some teachers who were members of the Fund. She said that the delay was caused by beneficiaries who took a long time to submit the required documents such as death certificates of the deceased for onwards transmission to the Pension Fund. The Principal Officer of the Pension Fund did however advise that what was urgently needed was simply to notify the Fund about the death of a member, so that funds for claim/s could be secured and set aside while required documents were awaited.

Following elaborate investigations into this matter, the investigator made the following findings: