Last Expense Claim Victory: Waumini Insurance Forced to Pay Full Settlement

Case Summary

Introduction

We are proud to report another breakthrough for insurance consumers! After initially rejecting a valid Last Expense claim, Waumini Insurance Brokers and their underwriter Prudential Assurance have been forced to settle in full — following relentless advocacy and legal pressure.

Case Background

• PM took out a last expense cover on the life of her father. Premium was paid on 14 October 2021, and her father sadly passed away on 12 January 2022 — the 91st day after inception.
• Waumini repudiated the claim, arguing that death occurred "within the 3-month waiting period."

But here's the catch:

• - The Policyholder's waiting period was defined in days (30 days)
• - The Dependent's waiting period was stated vaguely as "3 months"
• - There is no constant definition of a month in days. As shown below, "3 months" can mean 89 to 92 days depending on the start date. January to April = 91 days.

Month Days Calculation

Legal Principle

✨ In law, ambiguities in insurance contracts are interpreted against the insurer. PM's father died on the 91st day — and the insurer's vague wording backfired.

Outcome

• ✅ The underwriter eventually agreed to settle in full.
• ✅ It was NOT ex-gratia.
• ✅ This was a legal obligation.