Discovery Life, an insurance company, has initiated legal action to recover R16 million paid to a man who claimed he was permanently unable to work due to depression.
Sunil Pranpath, a KwaZulu-Natal accountant, held multiple insurance policies with Discovery Life, including disability and income protection coverage. In June 2023, Pranpath filed a claim for both policies, citing orthopedic injuries sustained after being hit by a car while walking. His claim was approved and the insurance company paid the benefits.
However, in February 2015, Pranpath filed another claim under the same policies, asserting that he was suffering from major depression and chronic pain that rendered him unable to work. This claim was also approved, and Pranpath received payment in December 2016.
As part of the ongoing process, Discovery Life regularly reviews such claims to ensure that the insured person continues to meet the necessary conditions, including proving a continued loss of income. These reviews are mandatory, as there is always the possibility that a claimant might recover and return to work, thus losing entitlement to further disability payments.
Pranpath completed three claim review forms over the next few years, in June 2018, August 2019, and August 2020, consistently stating that he was unable to work as an accountant and did not foresee returning to his job. He also confirmed his inability to work in a quality of life questionnaire completed in September 2019.
However, Discovery Life later discovered that Pranpath had, in fact, continued to work as an accountant between August 2019 and August 2020. Surveillance conducted by the insurer in October 2019 showed Pranpath at his workplace during regular working hours, earning an income.
In addition to these findings, Pranpath refused to provide his income tax assessments and bank statements for the period between 2012 and 2017, despite contractual obligations to do so. Discovery Life sought legal action in the KwaZulu-Natal High Court to compel Pranpath to disclose his financial records, including tax returns, bank statements, and documents related to his businesses.
Pranpath responded by arguing that it would be too expensive to obtain the documents and claimed that many of the requested records either no longer existed or were irrelevant. He also contended that some documents had already been provided under subpoena.
However, the court was not convinced by Pranpath’s arguments. Acting Judge Anna Annandale ruled that the requested documents were necessary for Discovery Life to make an informed decision regarding the validity of the claim. She emphasized that even if some documents were ultimately deemed irrelevant, the application itself was not improper.
The court ordered Pranpath to provide Discovery Life with the required documents within 10 days.
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