Trisha Goolab: Actuary
Petrie Marx: Actuary
Karen Bongers: Actuary
Sanlam is here to protect you despite COVID-19 and the challenges it’s brought. Sanlam will continue to deliver on its policy promises and provide you with peace of mind. Sanlam Life Cover policies will still pay out even if the cause of death is attributed to a COVID-19 infection.
Restricted forms of risk cover, such as accidental death plans, don’t extend to deaths caused by pandemics such as COVID-19. This is because these deaths don’t meet the criteria of ‘death as a result of an accident’, for which accidental death plans are intended.
Although COVID-19 is not listed as a separate claimable event under severe illness and disability policies, it is fully covered if it leads to any of the claimable events, for example, being unable to work under the disability policy.
So, what if you are unable to work due to lockdown or quarantine? Unfortunately, insurance is not in place to cover individuals if there’s a lockdown and everyone needs to stay at home. We look at the medical condition that requires you to stay at home. If you’re sick at home or in hospital for a sustained period and unable to work due to COVID-19, this is where a disability income or sickness benefit under your income protection policy could pay out.
Please consult with a financial planner before you take any action regarding your policies.
It’s possible to get reinfected with COVID-19. In the event that you are diagnosed with this illness again, you are covered by your policies in the same way that you were during the first infection, according to the benefits that you’re covered for. There are no new exclusions that would apply, and you would not get rejected by Sanlam if you got diagnosed with COVID-19 again. However, the same terms of those benefits would also apply. So if, for example, there were any waiting periods before cover could kick in, you’d have to wait for the agreed waiting period to be over before expecting any payouts.
This depends on whether you have recovered completely, or if you’re experiencing any further symptoms. If you have completely recovered, it’s likely that there will be no restrictions if you were to apply for new cover.
If you haven’t fully recovered there’s a possibility that you’re suffering from long COVID. Long COVID is where individuals display signs and symptoms during or after any infection, that is even after they’ve been cleared of the virus. You could be diagnosed with long COVID if certain signs and symptoms continue for more than 12 weeks and cannot be explained by an alternative diagnosis.
In this case, Sanlam may defer your application for insurance for one month, or longer for more serious cases. This is standard underwriting practice where symptoms are experienced for which the final outcome is still uncertain. Because of this, it is important to note that there is no standard exclusion or loading foreseen for COVID-19 survivors. In the future there may be some individuals with similar long-term health damage that should be rated accordingly, but it is too early to tell the extent of those cases.
Sanlam regards COVID-19 vaccinations as an effective solution to significantly slow down the spread of the coronavirus and the resulting pandemic. Adverse medical reactions as a result of vaccination are extremely rare. However, if after vaccination you experience an adverse medical reaction that meets the contractual requirements of your Sanlam policy, we will consider the claim.
We have no specific vaccine exclusion and our clients will therefore continue to benefit from the cover they need during these times. There are also no new requirements for claimable events in this regard. We know that it is exactly for times like these that you have insurance; and our goal is and always has been to serve our clients in their time of need.
You can take out severe illness cover for yourself or your spouse. Sanlam also has a Child Illness and Injury benefit that you can take for your child. For people who are not members of your nuclear family or adult children, you can be the premium payer. For example, if your mother or adult daughter needs severe illness cover but they cannot afford the premium themselves, they can apply for a benefit and make you the premium payer. Any claim will then be payable to them, but you can help to pay the premiums.
A severe illness benefit pays out if you are diagnosed with one of the illnesses covered by the benefit. Remember to check your policy contract or chat to your financial planner about applicable survival periods. It’s good to know that a death benefit pays out if you pass away, and you can add more than one benefit to the same policy, for example a death benefit as well as a severe illness benefit.
You have the option to choose between a Cancer-only benefit and a Comprehensive Severe Illness benefit that will cover you for a myriad of diseases, including cancer. You can also consider taking both, so that you are covered for a broad range of diseases but have additional cancer cover if cancer is your main concern. It’s best to speak to a financial planner to understand which option makes the best sense for you, depending on your individual needs and concerns.
As part of the application, you will need to answer questions about your health, finances, occupation and lifestyle. This will help us determine whether we can accept your cover, how much cover is offered to you, the premium amount and the terms that apply. All questions are to be answered honestly and truthfully. Failure to do so may result in claim payouts being reduced or claims being declined.
Being sick does not necessarily exclude you from cover. During the application process we will ask you questions about your health, and based on your answers determine whether the cover can be accepted and whether, due to existing medical conditions, there is a need for any exclusions and/or medical loadings to be placed.
We’ve worked with our service providers and the relevant safety precautions and methods to safely reintroduce medical testing where possible, while also giving you four options to consider when applying for cover:
Risk cover becomes more expensive as you grow older, so the earlier you take out cover, the cheaper it will generally be. There is also a risk that if you wait too long and become sick before you take out cover, you are not able to get cover or need to pay much more for it.
Medical aid is important and severe illness cover does not replace it. It however complements it, as it can be used to pay for various other expenses associated with becoming ill, like travelling expenses to treatment facilities, employing additional help with childcare and delaying return to work in favour of a speedier recovery.
Serious illnesses, like cancer, heart attacks, or multiple sclerosis usually strike without warning. At times like these the extra cash will be needed to adjust your lifestyle and pay for the costs associated with becoming ill.
Many of us think it won’t happen to us, but the reality is that cancer affects 25% of South Africans. If not to you, it could happen to someone you know. Protect yourself against the financial strain of cancer.
Sadly, no one is safe or exempt from the risk of serious illness or injury – not even children. Cover your child against life’s unexpected events.