Co-Payments
The excess payable upfront to the hospital before treatment or a procedure.

• MRI Scans: A CT scan is best suited for viewing bone injuries, diagnosing lung and chest problems, and detecting cancers. An MRI is suited for examining soft tissue in ligament and tendon injuries, spinal cord injuries, and tumours. CT scans are widely used in emergency rooms because the scan takes less than 5 minutes. An MRI, on the other hand, can take up to 30 minutes.
• Oncology: Oncology is a branch of medicine that deals with cancers and tumours.

Accidental Casualty Benefit
The Casualty Benefit will pay for the facility fee and consultation associated with admissions into the emergency room or casualty ward of a private hospital.

Hospital Cash Benefit
A cash payment you receive for every day you spend in hospital due to an accident or premature birth (more than 41 days before the originally expected natural birth date of 40 weeks).

If you’re a Sanlam Reality member, please refer to the Sanlam Reality section for more information on your Hospital Cash Benefit.

Family Booster
The natural or surgically assisted birth of 1 or more infants that occurs more than 41 days before the originally expected natural birth date of 40 weeks as verified by the clinical records of the mothers attending physician.

Family Protector
The lump sum benefit is payable upon the death or permanent disability of an insured party due to accidental harm.

Medical Scheme and the Sanlam Gap Policy Contribution Waiver
The benefit payable is equal to the monthly medical scheme and Gap contribution applicable after the qualifying event, multiply by 6 and subject to an overall annual limit. This benefit is limited to one event over the policy lifetime.

Dental Reconstruction
The lump sum Benefit will only be paid in the event of Dental Reconstruction Surgery being required as a direct result of Accidental Harm or from Oncology Treatment that occurred after the Inception of this Policy.

Road Accident Fund Claims (RAF)