As long as monthly premiums continue to be paid, as a member of a fund/scheme policy, you will remain covered for the benefits provided for in the policy/ies.
Depending on the specific benefits provided for in the fund or employer policy contract, Sanlam will cover members for any illness, impairment or disability where these conditions are caused as a result of complications linked to infection by any bacteria or virus, as long as the claim meets the contractual requirements. The virus can be COVID-19 or another virus.
Sanlam will honour claims arising from the illness provided it meets the standard claims criteria, as set out in the fund specific or scheme specific policy contract.
In terms of a severe illness or critical illness insurance policy contract, the illness itself will not be covered as such due to its absolute uncertainty – in the same way that Ebola and other infectious diseases are not covered. However, some of the complications of the disease might lead to a claim, for example end stage lung disease, renal failure, loss of vision, etc. In these instances a claim may be valid depending on the specific policy contract and the nature of the benefits selected and, in particular, whether the policy contract provides for a Core or Comprehensive option.
With regards to disability insurance policy contracts, contracting the virus may also not automatically constitute a claim, but some complications may result in temporary or permanent disability. The nature of the potential disability will be assessed against the disability definition in the client-specific policy contract, which in turn will depend on the type of disability product, waiting period, etc.
Sanlam pays all death claims in line with its normal requirements, regardless of what caused the death.
For funeral claims Sanlam will, wherever applicable, take into account the waiting period for natural causes which applies to a fund specific or scheme specific policy contract.
Members should contact their employer or HR representative to assist with the necessary forms and requirements.
For any further information, please contact your Client Solutions representative at Sanlam Corporate.