How we’re protecting you & your group insurance benefits during COVID-19

Last updated on 22nd June, 2021 at 09:52 am

The COVID-19 pandemic has heightened awareness of the life risks we collectively face. Find out how Sanlam Group Risk is protecting you and those on the frontline so you can use your group insurance benefits safely.

Medical underwriting to qualify for risk cover

One of the most significant features of group insurance is that the cover is granted up to a certain monetary amount, called the medical proof free limit (MPFL) of the group scheme. This applies to all qualifying members of a group scheme. When you, as a new member, exceed the MPFL, or receive a salary increase that results in your full potential group cover exceeding the MPFL (for the first time), you’ll be required to provide medical evidence of good health for the total amount in excess of the group scheme’s MPFL.

Since lockdown measures have begun to ease, Sanlam has reintroduced more options for you to complete medical requirements, if necessary. These include:

1. Accessing your own GP, who would be able to conduct the necessary medical tests
Plenty of GPs have remained open, and, as a group risk scheme, we are also not prescriptive in terms of whether you, as the member, have received a telephone consultation.

2. Access to pathology laboratories
The preferred labs include:
• PathCare
• Lancet
• Vermaak & Partners
• Toga
• Ampath
• Global

3. Requesting a medical testing nurse to visit you at your home or office
Additional guidelines were put in place for instances where a Sanlam Group Risk scheme member wishes to make use of our travelling-nurse service, in order to protect you as the member, and the nurses. These include telephonic screenings when setting up the meeting with the nurse; conducting the necessary screening of both yourself and the nurse (i.e. symptom and temperature screen); sharing the information at entry of your home or workplace; and wearing a separate pair of gloves for any paper transaction, and medical interventions.

Income disability insurance claims

Income disability insurance pays a monthly income when you, as a member, suffer from total occupational disability, due to illness or injury, preventing you from working for a prolonged period of time, and experience a loss of income.

Although contracting the virus will not automatically constitute an income disability insurance claim, some complications may result in temporary or permanent disability. The nature of the potential disability is assessed against the disability definition contained in your fund or employer’s policy contract.

To evaluate an income disability claim, your insurer requires medical reports, sick leave records, etc. All diagnostic and other test results must be submitted when submitting a claim.

To help potential disability claimants during the lockdown period, the Sanlam assessment team is engaging in telephonic discussions with claimants and employers (where applicable and required). To further assist, we have incorporated the services of external occupational therapists, who are able to do telephonic consultations.

With regard to the review of existing disability claimants, we did not merely suspend claimants’ monthly payments, but instead provided an extension during the first few months of lockdown. This was owing to the fact that doctors’ consultations and access to public healthcare would most likely have been a challenge. However, with the easing of restrictions, normal requirements to continue the payment of the monthly benefit have resumed.

Because we are deemed an essential service as a group risk insurance cover provider, our medical underwriting and claims teams are equipped to function at full capacity from remote locations. We will therefore continue to operate and support Sanlam Group Risk members who depend on us during this global challenge, and strive to minimise any service disruptions.

Sanlam Life Insurance Limited is a Licensed Financial Services Provider.

As a Reality Access for Sanlam Group Risk member, you enjoy free benefits, including 24-hour expert legal help and trauma assistance on the phone, monthly discount coupons to make your money go further and 24/7 emergency medical support. Find more about your benefits here.