Nurse’s R10m Momentum dispute turns on what her policy covers
DURBAN — A KwaZulu-Natal nurse born without a left kidney has approached the High Court to challenge an ombud appeal decision supporting Momentum’s rejection of her insurance claims. The dispute includes a functional impairment policy with a R10 million benefit, according to IOL.
Momentum accepts the diagnosis but argues that her functioning remaining kidney does not satisfy the policy’s specified renal conditions. The nurse disputes that interpretation, saying the assessment should consider the absent organ and the policy’s impairment provisions.
Her application also challenges the handling of respiratory evidence and alleged medical non-disclosure. She argues that information arising after her applications should not be treated as something withheld when she applied.
The ombud appeal tribunal refused leave to appeal. Momentum said the ombud had considered the matter twice and ruled in its favour. It declined further comment on the merits, citing the pending proceedings and confidentiality.
The report describes a review application, not a High Court judgment awarding or refusing payment. The policy wording, medical evidence and disputed disclosure history remain central to the challenge.
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