[imagesource:freemalaysiatoday]

In a twist of irony, Discovery Life is going after a KwaZulu-Natal accountant who managed to claim a whopping R16 million by pretending he couldn’t work due to depression – despite being spotted working while allegedly ‘incapacitated.’

Sunil Pranpath, who had multiple policies with the insurer – including disability and income protection cover in the event that he became totally and permanently unable to perform his duties as an accountant – initially filed a claim after a car knocked him down in 2013, citing physical injuries, according to the court documents.

The insurer accepted the claim, no questions asked. Then, in 2015, Pranpath upped the ante, claiming mental health issues – major depression and chronic pain – made him permanently unable to work. Discovery approved this too, paying out the claim in December 2016.

But the plot thickens. Discovery Life regularly reviews claims to ensure people aren’t getting paid out for something they’ve ‘recovered’ from. Discovery Life conducts those reviews by requiring the insured person to complete claim review forms and questionnaires periodically.

Subsequent to the initial benefits being paid, Pranpath completed three continuous claim forms starting from June 2018, August 2019, and August 2020.

In all of the reviews, Pranpath represented that he was totally unable to work as an accountant, was not working as an accountant, and did not foresee that he would return to work at any specified date or time.

He indicated the same in a quality of life questionnaire which he completed in September 2019.

But despite Pranpath’s repeated claims that he was still totally unable to work a big surprise came through surveillance footage revealing him working as an accountant during those very years.

To top it off, Pranpath refused to hand over his income tax documents and other financial records as per his policy’s terms. Discovery Life, not backing down, dragged him to court to demand full financial disclosure, including business and tax records dating back to 2012.

Pranpath, in his defence, claimed it would be too costly to produce the documents and some were “irrelevant.” The court wasn’t buying it.

Acting Judge Anna Annandale ruled in favour of Discovery Life, ordering Pranpath to cough up all the requested documents within 10 days.

Talk about a serious blow to his ‘sick leave’ story.

[source:iol&saflii]