A multimillion-rand litigation battle between insurer Discovery Life and a Limpopo gynaecologist, is headed to court on Friday, reports News24. The gynaecologist, Dr Patrick Tigere, is counter-suing for about R30 million.
At the heart of Tigere's dispute with Discovery are the insurer's claims that he misrepresented himself when he applied for his policies and again after he submitted a claim, write Penelope Mashego and Londiwe Buthelezi in the article published by News24 on 19 October 2020.
Discovery rejected a disability claim that Tigere made in 2018 and wants him to pay back the R2 million that the insurer paid out before discovering the alleged misrepresentation and material non-disclosure.
However Tigere, who has a private practice in Louis Trichardt in Limpopo, is denying any wrongdoing. He says Discovery is trying to paint him as a fraudster.
‘Material misrepresentation’
Tigere's relationship with Discovery began in January 2015 when he took up several life insurance policies. He paid a monthly premium of R90,000.
Problems began in 2018 when Tigere dislocated his left shoulder, resulting in surgery, News24 reports. Discovery paid the doctor temporary disability benefits between April and September that year, as part of his income continuation benefit. The insurer also paid the overhead expenses benefit.
However, three months later, Discovery stopped the payments after a check-up revealed that Tigere was permanently disabled and could no longer work as a gynaecologist. Among other things, Discovery also repudiated his claims because he allegedly continued to work and generated an income from his practice while Discovery was paying for temporary disability.
Discovery told News24 that upon investigation, it became clear that the relationship between the two parties was problematic from the start. It argues that “material misrepresentations were so severe that it entitled Discovery Life to void the entire contract. The legal remedy for a mis- or nondisclosure is voiding of the contract from inception.”
The insurer has since taken Tigere to court, filing a claim with the Limpopo High Court to recover back the R2 million it had already paid out.
Client is counter-suing Discovery
News24 writes that Tigere's legal team denies any instance of misrepresentation, including of medical history. Tigere denies Discovery's allegations that he continued working as a gynaecologist after he was declared disabled. Instead, he said his reason for going to his office was to refer patients to other doctors.
The doctor, who has continued to pay his premiums throughout the battle with Discovery, said that because he has been unable to work, he was forced to sell some of his properties and to cash in investments.
Tigere's lawyer, Benedict Phiri, said he was initially fighting for Discovery to reinstate his client's cover, but that has changed. The claim now includes a lump sum of R8.8 million for Tigere's disability claim and about R300,000 the doctor is meant to receive from Discovery for overhead expenses and the income continuation benefit until he is 65, bringing the total claimed to about R30 million. Phiri is due to file the claim at the Limpopo High Court on Friday, News24 writes.
[link url="https://www.news24.com/fin24/companies/financial-services/discovery-and-clients-multimillion-rand-counter-sue-battle-headed-to-court-20201019"]Discovery and client's multimillion rand counter-sue battle headed to court. News24 article (subscriber only)[/link]