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  • 员工福利
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  • ​人寿保险
    • 为什么要购买人寿保险
    • 人寿保险的妙用
    • 人寿保险常见问题回答
    • 购买人寿保险流程
    • 美元人寿保险
    • 意外险
    • 特殊寿险产品
    • 重大疾病险 >
      • 身体健康检查重要指标
      • 全球癌症病例激增
      • 细数癌症之最
    • Sanlam意外险
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  • 医疗保险
    • 南非的医疗保险介紹
    • 医疗保险Q&A 常见问题回答 >
      • Discovery COVID 疫苗注册
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      • 激活你的健活奖励
    • Bonitas医疗保险2023介绍
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    • 医疗附加险 >
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        • 医疗附加险法规改变
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    • 常见问题
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    • 南非2021财政预算及税法
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  • 关于我们
    • 我们如何与众不同
    • 我們如何帮助客户 - 保险篇
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    • 德博理财学院 >
      • 标准销售话术
Daberistic
  • I would like to
    • Covid-19 toolkit
    • Signup Newsletter
    • Schedule an appointment
    • Go to hospital
    • Deal with an accident
    • Make a Claim
    • Invest >
      • Investment needs analysis
      • Child education fund >
        • Top 100 schools in South Africa
      • For retirement
      • For income in retirement
      • For capital growth
      • For a new car
      • For a new house
      • Offshore funds
    • Apply for insurance >
      • Life Insurance
      • Medical Aid
      • Car and Household Insurance
      • Business Insurance
    • Appoint Daberistic as broker
    • Promotions >
      • 2022 Millionaire Investment Plan
      • 2022 Half-Millionaire Investment Plan
    • Update my policy >
      • Investment >
        • Allan Gray Debit Order
      • Life insurance
      • Arrear Premiums
      • Business insurance
    • Make a Will
    • Set up a business
    • Get an accountant.
    • Get business tax advice
    • Get personal tax advice
    • Preferred Suppliers >
      • Panelbeaters
      • Doctors and dentists
      • Attorneys, Notaries, Conveyancers
    • Product news
    • Cancel Daberistic Services
  • Invest
    • Our fund selection process
    • Retirement annuity
    • Tax-free Investment Plan >
      • Apply for Tax-free Investment Account
    • Unit Trusts
    • Guaranteed Investments >
      • Guaranteed Investments Q&A
    • Preservation funds
    • Offshore
    • Education plan
    • Endowment
    • Participation Bond
    • Deposits
    • Business investment accounts
    • Private investment accounts
    • Exchange Traded Funds
    • Share investing
    • Personalised share portfolio
    • Retirement income
  • Retirement Funds
    • Starting a Fund - What to Consider
    • Retirement Funds - Your Rights
    • What is Regulation 28?
  • Health
    • Our services
    • Discovery Health >
      • How to Select a Discovery Medical Plan
      • 2022 Update
      • 2023 Update
      • Discovery Health Products
      • International Travel Benefit
    • Discovery Vitality >
      • 2022 Update
      • 2023 Update
    • Momentum Health >
      • Momentum Health Products
      • 2022 Update
      • 2023 Update
    • Bonitas >
      • 2022 Update
      • 2023 Update
    • Gap cover >
      • Discovery gap
      • Sirago >
        • 2022 Update
        • 2023 Update
    • FAQ >
      • Discovery COVID Vaccine Process
  • Life
    • Life insurance >
      • Life insurance special offer
    • Accidental cover
    • Income protection
    • Lump sum disability
    • Business Assurance
    • Severe Illness
  • Insure
    • About Short Term
    • Service Charter
    • Business Insurance >
      • Goods in Transit Insurance
      • Professional Insurance
    • Car / House Insurance
    • SASRIA
    • Frequently Asked Questions
  • Financial Coach
    • Blog
    • Personal Financial Planning >
      • Pocket Guide To Money
      • Setting goals
      • Budgeting and cashflow management
      • Consumer Protection Act
    • Retirement planning >
      • Retirement Q&A
    • Risk planning >
      • Retirement funds
    • Tax planning
    • Investment planning >
      • What are unit trusts?
      • Active and passive investing
      • Chasing fund performance may be hazardous to your wealth
      • Understanding risk on and risk off
    • Family trusts
    • Wills and estate planning >
      • Make a will
      • Administering an estate / Duties of an Executor
      • What the executor must do once appointed
    • Business planning
    • Frequently asked questions
  • Accounting & Tax
    • About us >
      • DAA Proatia Manual
    • Accounting
    • Tax >
      • 2022 South Africa Budget and Tax Guide
      • 2020 South Africa Budget and Tax Guide
      • 2019 South Africa Budget and Tax Guide
      • 2017 South Africa Budget and Tax Guide
    • Business Plan
    • Company Registration & Secretarial Services
    • Audit/Review/Compilation report
    • Frequently asked questions >
      • Establishing a Business in South Africa
  • About us
    • Who we are
    • What sets Daberistic apart
    • How we help our clients
    • Our clients
    • Community involvement
    • Company Documents >
      • Privacy Policy
      • Complaints Resolution Policy
      • Conflict Of Interest Policy
      • PAIA Manual
    • Disclosures >
      • POPIA Consent
      • Email Confidentiality Notice And Disclosure
    • Company News >
      • Heritage Day 2015
      • Mandela Day 2016
    • Daberistic Academy >
      • Car insurance rating factors
      • Investment seminars
      • Personal finance seminars
      • Workplace skills >
        • Sales Scripts
        • Client Communication
        • Stress Management
        • Industrial Relations
        • Leadership
        • Employee Benefits
        • Company Values
        • Tax
        • Commercial Insurance
        • Gap cover
        • Excel
        • Retirement -
        • Retirement Annuity &Provident Fund
        • Marketing and Branding
        • Broker Appointment
        • Telephone etiquette
        • Client service etiquette
      • Mini MBA
    • Careers >
      • Positions >
        • Healthcare Consultant/Business Development Manager
      • Questionnaires >
        • Pre-interview Elementary Test
        • Chinese Client Consultant Pre-interview Questionnaire
        • Short-term Insurance Administrator Pre-interview Questionnaire
        • HR and Finance Administrator Pre-interview Questionnaire
    • Contact us >
      • Cancellation
  • 我想要
    • 德博理财专栏
    • 查看旧德博理财专栏
    • 促销活动 >
      • 百万富翁投资计划
      • 半百万富翁投资计划
      • Fedgroup飞达参与分红债券
    • 申请新保险 >
      • 员工团体保险
      • 寿险/意外险报价资料表
      • 国际学生医疗保险2023
      • 商业保险
      • 医疗保险需求评估
      • 医疗保险申请
      • 加入活力健康计划
      • 投资 >
        • 投资方案报价
        • 孩子教育基金. >
          • 非洲排名前100高中
          • 南非高校排行榜
        • 为年老时存钱.
        • 闲钱投资.
        • 月领退休金.
        • 免税投资账户.
        • 投资型保单.
        • 股票.
        • 基金
        • 海外基金
        • 房地产基金.
        • 投资
      • 汽车保险报价
      • 店面投保
    • 现有保单管理 >
      • 保费没扣到
      • 在线税务证明申请表格
      • 人寿险/意外险保单管理
      • 医疗保险客服 >
        • 新生儿加保申请表格
        • 家属退保申请表格
        • 国际旅游医疗福利
        • Discovery医保怀孕生产幼儿福利
        • 下载Discovery医疗保险证明
        • 下载Discovery医保税务证明
        • Sirago附加险索赔提交
      • 投资账户管理
      • 产物保险管理
      • 客服满意度问卷
    • 申请索赔 >
      • 申请车险索赔
    • 住院
    • 常用专科医生名称中英文对照
    • 出车祸处理
    • 设立遗嘱 >
      • 遗嘱的生效和不生效
      • 遗嘱的处分
      • 遺囑執行人被任命後
    • 聘德博为经纪人
    • 非居民在南非开银行账户
    • 投资移民
    • 唐人街商铺联系方式
  • 财富管理
    • 如何选择投资产品
    • 企业投资账户
    • 私人投资账户
    • 孩子教育基金
    • 为年老时存钱 >
      • 退休需要認真金錢
    • 闲钱投资
    • 海外投资 >
      • 如何投资海外资产
      • 南非外汇管制规定
      • Investors Trust外幣投資
    • 免税投资帐户 >
      • 免税投资账户问答集(Q&A)
    • 月领退休金
    • 投资型保单
    • 基金 >
      • 如何挑选基金
    • 稳赢固定利率保单
  • 员工福利
    • 公司团体医疗保险Q&A
    • 员工福利Q&A
    • 公积金Provident Fund说明
    • 中小企业员工福利完整套餐
  • ​人寿保险
    • 为什么要购买人寿保险
    • 人寿保险的妙用
    • 人寿保险常见问题回答
    • 购买人寿保险流程
    • 美元人寿保险
    • 意外险
    • 特殊寿险产品
    • 重大疾病险 >
      • 身体健康检查重要指标
      • 全球癌症病例激增
      • 细数癌症之最
    • Sanlam意外险
    • Old Mutual绿光关怀计划.
  • 医疗保险
    • 南非的医疗保险介紹
    • 医疗保险Q&A 常见问题回答 >
      • Discovery COVID 疫苗注册
      • Discovery 非洲医疗福利
    • 如何选择医疗保险
    • Discovery医疗保险 2022更新摘要 >
      • Discovery医疗保险 2022 - 如何选择医保选项
    • Discovery医疗保险 2023更新摘要 >
      • Discovery医疗保险 2023 - 如何选择医保选项
    • Discovery Vitality活力健康计划 2023 >
      • 激活你的健活奖励
    • Bonitas医疗保险2023介绍
    • Momentum 2023
    • 医疗附加险 >
      • Discovery 附加险
      • Sirago 医疗附加险 2023 >
        • 医疗附加险法规改变
    • 紧急意外险
  • 财产险
    • 雇主责任保险
    • 建筑工程一切险
    • 商业火险
    • 车险
    • 暴动险 Sasria
    • 常见问题
  • 会计师事务所
    • 南非2021财政预算及税法
    • 南非2020财政预算及税法
    • 南非2019财政预算及税法
    • 南非2018财政预算及税法
    • 南非2017财政预算及税法
    • 南非2016财政预算及税法
    • 南非2015财政预算及税法
    • 南非2008财政预算及税法
  • 关于我们
    • 我们如何与众不同
    • 我們如何帮助客户 - 保险篇
    • 我們如何帮助客户 - 投资理财篇
    • 德博理财学院 >
      • 标准销售话术

SEVERE ILLNESS

No-one knows what life has in store for them, and the sad fact is that severe illness could strike at any time. Being prepared is the only solution – prepared for the cost of being absent from work during recovery, being cared for at home while ill, potentially modifying your lifestyle and your home, and even perhaps taking early retirement due to ill health. As Severe Illness benefit can vary substantially from one life insurance company to the next, we use Discovery Life, our preferred provider's Severe Illness Benefit to illustrate available benefits, terms and conditions. Discovery provides  all the reassurance you need, should you become severely ill, paying out a lump sum and pays multiple claims for related and unrelated events regardless of the severity.


This page has the following sections:

1. How your claim is assessed
2. Benefits available in a Severe Illness Benefit
3. Real life examples of how clients have benefited from Severe Illness Benefit
4. Who should consider a Severe Illness Benefit
5. General terms and conditions of Severe Illness Benefi


How your claim is assessed

As a Severe Illness claim can be complex to assess, we first explain how your claim is assessed in the event of severe illness.

·         The life changing event must have occurred after the commencement of the                       benefit.

·         Symptoms and signs must be compatible with the diagnosis and the relevant                     special investigations (including blood tests, imaging, histology and other tests)                   must confirm the diagnosis.

·         Inability to perform Activities of Daily Living must be due to and compatible with               the diagnosis of the life changing event.

·         Psychiatric illness, chronic fatigue syndrome (and synonyms) and fibromyalgia (and           synonyms)     and related terms are not covered under the Severe Illness Benefit.

·         Major organ transplant claims include being on an official South African or                         international transplant waiting list for the relevant transplant.

·         Specialist reports are required to assess all claims. A specialist is a medical                         practitioner registered as a specialist with the Health Professions

·         Council of South Africa.

·         The claims definitions in the Discovery Severe Illness Benefit are compliant with                 the Standardised Critical Illness definitions Project (SCIDEP).

When can a claim be refused?

A claim may be declined  when:

·         Claim arising from any conditions or illnesses that the Claimant has ever suffered             from, was ever aware of, or has ever received medical treatment or advice for                      before commencement of this Benefit, are excluded from commencement or re-                in-statement of this Benefit.

·         The claim arose from participation in a pursuit deemed hazardous by Insurer

·         The Insurer is unable to get sufficient medical evidence from the claimant or                        treating medical practitioner to fulfil the criteria to make a Benefit payment.

·         The Qualifying Member or authorised person fails to provide medical evidence                   within 90 days.

·         The Principal Member’s  or approved medical scheme plan is in arrears or the                     Principal Member is not a member of Vitality if they on Discovery Health.

·         The refusal by the claimant to consent to Insurer obtaining medical                                        information about him or herself.

·         The severe-illness claim was a result of:

  1. Willful and deliberate breaking of any law or wilful involvement in any riot,            insurrection, usurpation of power, martial law or war.
  2. Intentional and negligent consumption of poisons, alcohol, drugs and narcotics     unless prescribed by a registered medical practitioner. (Neither the Principal       Member nor his or her dependents may perform the role of a registered medical practitioner in these circumstances.) 
  3. Excessive consumption of alcohol. 

·       Insurer shall not be liable for any claim  if the Qualifying Member commits any act             of dishonesty or fraud relating to any provisions contained in the Benefit

·         The claimant declines or neglects to undergo reasonable medical treatment when             there is a reasonable likelihood that the medical treatment would improve the                   medical impairment of the claimant. 

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Discovery explains how Severe Illness Benefit works in the video below.

Benefit options

Making Multiple claimsIncrease payout

Discovery who is our preferred supplier has structured the Severe Illness Benefit to cover all major body systems and to cover
you for multiple claims. On the Classic Life Plan you can receive multiple claim payments, regardless of whether the illnesses are the same, related or not related. It also doesn’t matter if the severity of

subsequent illnesses is the same or lower (except for progressive illnesses like cancer).  

the childbirth benefit 

Covers multiple births and congenital birth defects.

Waiting period

A waiting period is necessary on this benefit to distinguish severe illness claims from death claims. A 30-day waiting period applies providing the assured individual survives (without the use of life support) to receive the claim proceeds

The Severe Illness Benefit Booster and Spouse Severe Illness Benefit Booster:

Covers you and your spouse by giving you up to an additional 40% of cover at no extra cost, based on how your policy is structured.



Increase cover without underwriting

Increase your cover without underwriting every three years by 20%, subject to a negative HIV test, with the Guaranteed
Insurability Benefit. This is particularly valuable if you expect your income to grow faster than inflation.

Family trauma benefit

Covers each family member admitted to ICU with ventilation, as well as any reconstructive surgery needed as a result of a trauma event.

The female benefit

Covers cancers specific to women, as well as complications resulting from pregnancy and osteoporosis.

Severe illness extender benefit

Enhances your cover and boosts your payout for Severity A to D conditions by 25%.

global treatment benefit

Covers you for international healthcare procedures and gives you access to the best medical
practitioners and facilities in the world. 



How clients have benefited from an Income Continuation Benefit

Mrs Mitchell found a lump in her breast and consulted a medical specialist. A biopsy was done and confirmed that she had stage I breast cancer, which qualifies for a Severity D payout under Discovery’s Severe Illness Benefit. However, Discovery’s Life Time Severe Illness Benefit took the expected future lifestyle impact of her claim into account and upgraded the payout from 25% to 100% of the insured amount. On top of this, her Severe Illness Extender Benefit paid out an additional 25%, giving her an
overall total benefit payment of R7 421 300.

Further information on Income Protection policy

Tax consideration

Your income protection premiums are not tax deductible. In the event of a claim, the money you receive is tax free.

Regulatory protection

Life insurance companies in South Africa are regulated by the Financial Services Board. South Africa enjoys excellent financial services regulations and supervision, giving you the confidence that a life insurance company will pay according to the insurance contract you have signed up.

Medical underwriting

Underwriting is the process used by a life insurance company to assess your risk factors. When you apply for an Income Protection benefit, the life insurance company will do medical tests on you. If you are not healthy, the life insurance company may increase the premium it will charge you, decline certain benefits, or decline your application. 

General exclusions

Life insurance companies may not pay out the Severe Illness claim on most of the following reasons:


  • Participation in hazardous pursuits and/or risky activities Claim arising from any conditions or illnesses that the Claimant has ever suffered from, was ever aware of, or has ever received medical treatment or advice for before commencement of this Benefit, are excluded from commencement or re-in-statement of this Benefit. 
  • The claim arose from participation in a pursuit deemed hazardous by Insurer
  • The Insurer is unable to get sufficient medical evidence from the claimant or treating medical practitioner to fulfil the criteria to make a Benefit payment. 
  • The Qualifying Member or authorised person fails to provide medical evidence within 90 days. 
  • The Principal Member’s  or approved medical scheme plan is in arrears or the Principal Member is   not a member of Vitality if they on Discovery Health. 
  • The refusal by the claimant to consent to Insurer obtaining medical                                        information about him or herself. 
  • The severe-illness claim was a result of: 
  1. Willful and deliberate breaking of any law or wilful involvement in any riot,            insurrection, usurpation of power, martial law or war.
  2. Intentional and negligent consumption of poisons, alcohol, drugs and narcotics     unless prescribed by a registered medical practitioner. (Neither the Principal Member nor his or her dependents may perform the role of a registered medical practitioner in these circumstances.) 
  3. Excessive consumption of alcohol. 

  • Insurer shall not be liable for any claim  if the Qualifying Member commits any act of dishonesty or fraud relating to any provisions contained in the Benefit
  • The claimant declines or neglects to undergo reasonable medical treatment when there is a   reasonable likelihood that the medical treatment would improve the medical impairment of the  claimant. 
  1. Self-inflicted injuries
  2. War, civil commotion, riot, terrorist activity or rebellion
  3. Radioactivity or nuclear explosion
  4. Violation of criminal law by the life covered.


WhY should consider investing in a SEVERE ILLNESS BENEFIT?

The providers of severe illness policies all agree that medical scheme cover, disability or income protection cover and severe illness cover serve different needs. A medical scheme can cover you for the medical expenses associated with your illness, subject to certain rules and limitations, but your scheme may not meet all your medical needs. Severe illness cover can make up the shortfall.

Problems arise with long-term expenses, he says. For example, on basic plans, cover for chronic medication is often limited to a list of conditions – and even the more comprehensive medical scheme options do not cover everything. The costs associated with a critical illness can be significant. The lifetime costs of a severe stroke, for example, can amount to between R500 000 and R1 million, taking into account initial rehabilitation and chronic medication. 


Source: Personal Finance,Laura du Preez

What is the minimum premium?

The minimum premium is about R150 per month. So a Severe Illness benefit is affordable.

What if I don't pay my premium?

If you miss a premium payment, the life insurance company will try to debit your account again later in the month, or debit this month and next month's premiums next month. If you miss the premium payment again next month, the life insurance company will debit 3 months' premiums the following month. If the debit order is again unsuccessful, the life insurance company will have no choice but to terminate your policy.

After your policy is terminated, for a limited period of time, the life insurance company will allow you to reinstate your policy if you manually pay all the outstanding premiums into the insurance company's bank account, provide the proof of payment and complete a satisfactory declaration of health form.

Our product providers

As an independent financial planning practice, we have contracts with the following product providers in order to offer you a product that suits your needs:

Discovery, Hollard,  Momentum, Old Mutual

Our preferred providers

We have done the necessary due diligence in selecting the following preferred provider:

Discovery

Picture
We select Discovery Life as our preferred provider for the following reasons:
1. Reputable financial services group
2. Financially sound
3. Innovative product features
4. Immediate upgrade to 100% of your pre-disability income if you become permanently disabled
5. Uses 5 Underpins to assess claim, to find ways to pay the client in need
6. Meet upfront expenses with lump-sum disability payment
7. Extends cover on family members through Family Protector
8. Contribution waiver through Contribution Protector
9. Clever use of technology to provide excellent client service
10. Class leading travelling nurse service
11. Fast, fair claims

More info: Discovery Life Overview Brochure
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