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THE FINANCIAL SERVICES TRIBUNAL

 

Case No. PFA11/2023

 

 

In the matter between:

 

SIMON ST CLAIR VENTER                                     APPLICANT

 

and

 

SANLAM LIFE INSURANCE LIMITED                   FIRST RESPONDENT

 

CENTRAL RETIREMENT ANNUITY FUND            SECOND RESPONDENT

 

THE PENSION FUNDS ADJUDICATOR                 THIRD RESPONDENT

 

Summary: Reconsideration of a decision of the Pension Funds Adjudicator (30M) in terms of Section 230 of the Financial Sector Regulation Act 9 of 2017 ("the FSRA").

 

 

DECISION

 

 

INTRODUCTION

 

1.          The Applicant is Simon St Clair Venter, a former South African Policeman.

 

The Applicant was a Central Retirement Annuity Fund member.

 

2.          The First Respondent is Sanlam Life Insurance Limited ("the Administrator"). The First Respondent provides administration services to the Second Respondent.

 

3.          The Second Respondent is the Central Retirement Annuity Fund ("the Fund"). The Fund is registered and approved and is subject to the provisions of the Pension Funds Act 24 of 1956 ("the PFA")

 

4.          The Third Respondent is the Pension Funds Adjudicator ("the Adjudicator"), the statutory ombud as defined in section 1(1) of the FSRA and is established in terms of the PFA.

 

5.          This is an application in terms of Section 230 of the Financial Sector Regulation Act 9 of 2017 against the decision taken by the Adjudicator in terms of Section 30M of the PFA.

 

6.          The parties have waived their right to a formal hearing, and this is the decision of the Tribunal.

 

7.          Section 230 of the Financial Sector Regulation Act 9 of 2017 ("the FSR Act") provides the basis for an appropriate Applicant to lodge an application for reconsideration and seek appropriate relief.

 

THE FACTS

 

8.          This is an application for the reconsideration of the Adjudicator's decision relating to the Fund's alleged non-payment of a medical advancement benefit.

 

9.          The Applicant was admitted to membership of the Fund in 1996. A policy was issued under policy number 16024398X6 ('the Retirement Policy"). The Retirement Policy commenced on 1 November 1996 and had a contractual retirement date of 1 November 2024. The Applicant also held a life policy under Policy Number 16740706x3 ("the Life Policy").

 

10.       As of 28 January 2021, the Retirement Policy had a value of R30,924.36. This Retirement Policy was a pure savings product and contained no disability cover.

 

11.       The Applicant failed to make the required payments in respect of premiums, and the Retirement Policy was made paid up in January 2001. The Retirement Policy was reinstated in October 2010, but again, due to non-payment of premiums was made paid up in May 2011.

 

12.       In 2000, the Applicant claimed a disability benefit under the Life Policy, but the claim was repudiated based on a non-disclosure of material information. The repudiation was referred to the Ombudsman at the time, and the repudiation was upheld. The Applicant took no further steps at the time, and accordingly any claim related to the Life Policy has prescribed.

 

13.       The gravamen of the Applicant's current complaint is that when he applied for his early retirement benefit in January 2021, he discovered that he was entitled to a medical advancement benefit from the Fund. He now seeks this benefit.

 

14.       As indicated above, when the Applicant applied for an early retirement benefit, the value of the Retirement Policy was R 30,924.36, but due to the Applicant's outstanding tax obligations, this amount was paid in its entirety to the South African Revenue Services ("SARS").

 

15.       Although the Fund indicated that the Applicant would not have been entitled to the medical advancement benefit, it makes the point that this would only ever have been the value of the Retirement Policy, in any event. This amount has now been paid to the SARS on the Applicant's behalf. Put differently, the Applicant has received all he would ever have been entitled to, even on his own version.

 

LEGAL PRINCIPLES AND APPLICATION TO THE FACTS

 

16.       It is trite that the Fund's Rules are its constitution and that the Fund can only act in accordance with its rules. The Fund found that the medical information received from the Applicant to indicate a disability and entitlement to the medical advancement benefit was insufficient. Furthermore, even if it had been sufficient, this benefit would have been equal to the value of the Retirement Policy and this the Applicant has received, albeit that it was paid to SARS.

 

17.       Section 37D(1)(a) of the PFA permits the Fund to settle any member's tax obligations before payment of the balance to the member. In the Applicant's case, the total amount was paid to SARS.

 

CONCLUSION

 

18.       The Applicant has failed to make out a case for interfering with the Adjudicator's determination.

 

ORDER

 

(a)          The application is dismissed.

 

 

Signed on behalf of the Tribunal on 29 August 2023.

 

 

PJ Veldhuizen

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