Table of Benefits: Event & Sum Insured

Premiums = R52 per month

Accidental Death Cover

In the unfortunate event of the accidental death of an employee, benefits payable will assist in covering outstanding debts the employee may have with their employer or any other third party debts as well as finance children’s education or provide financial peace of mind for those left behind.

  • Death occurring within 12 months of the date of an accident: a lump sum payable to the employer or the insured person’s estate.

Accidental Disability Cover

The financial consequences of a permanent disability can have a devastating effect on the employee and family resulting in considerable lifestyle adaptations to cater for the disability and potentially the diminished earning ability of the employee.

The Accidental Disability Cover is designed to address more severe disabilities and provides the employee with a lump-sum benefit.

  • Disability occurring within 12 months of the date of the accident: a lump sum payable to the employer or employee based on a scale of defined disabilities.
  • Benefit is payable in accordance with the relative severity of the disability.

Scale of Disabling Injuries

Insured Event The % of the Sum Insured payable

Permanent and Total Disability = 100%

Loss of Hearing in one Ear = 35%

Loss of Hearing in both Ears = 100%

Loss of one Limb = 100%

Loss of Intellectual Capacity = 100%

Loss of more than one Limb = 100%

Loss of Sight in one Eye = 100%

Loss of Sight in both Eyes = 100%

Loss of Speech = 100%

Disability Definitions

1. Permanent and Total Disability 

The above scale of disabling injuries does not take the employee’s occupation into consideration, which means that irrespective of whether the employee can continue their employment, the benefit will still be payable.

2. Loss of Hearing

Total and irreversible loss of hearing of all sound, relying on audiometric and sound-threshold tests.

3. Loss of Intellectual Capacity

Diagnosed as permanently and incurably insane according to the usual and customary standards of the registered medical profession.

4. Loss of Limb

  • in respect of an arm: permanent physical severance of the four fingers at or above where the fingers join the palm of the hand; or the permanent total loss of use of an entire hand or arm;
  • in respect of a leg: physical severance or total loss of use above the level of the ankle; or the permanent total loss of use of an entire foot or leg.

5. Loss of Sight

Total and irreversible loss of sight without expectation of recovery.

6. Loss of Speech

Total and permanent loss of the ability to make a comprehensible word or an understandable verbal language.

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Temporary Total Disability Cover

Often, when an employee suffers an accident and is unable to continue in their occupation for an extended period, they may no longer be entitled to receive an income from their employer or their income may be reduced until the employee is in a position to return to work. (*)

The loss of income or reduced income due to the employee’s inability to continue in their occupation due to a temporary disability, coupled with the additional expenses associated during the employee’s time of recovery can leave the employee with the inability to settle their current debt obligations.

(*) This is dependent on whether the employer has an employee benefits program in place for their employees.

The Temporary Total Disability Cover provides the employee with a monthly income in the event of their temporary disability resulting in the person being unable to work.

Accidental Casualty Cover

An unexpected trip to the casualty ward (sometimes known as the emergency, out-patient or trauma ward) after being involved in an accident, more often than not results in an unexpected expense that most of us don’t cater for in our monthly budgets and often cannot afford.

The Accidental Casualty Cover benefit provides a cash lump sum payable to the employee for the immediate emergency costs incurred.

Accidental Daily In-Hospital Cash Cover

Daily In-Hospital Cash Cover provides employees with a daily cash benefit for every 24 hour period that the employee is hospitalized as an in-patient. This benefit is payable separately from any existing medical insurance benefits. The benefit will assist with any unexpected expenses – it can be used for any costs the employee chooses, from paying an expense such as their monthly cellular subscription to treating themselves to a day at a spa as part of their recovery process or covering medical expenses incurred during their stay in hospital.

Accidental Casualty Cover

The 24 hour Trauma Cover benefit will cater for the expenses incurred for trauma counselling following a traumatic event.

Incidents such assault, robbery, hijacking and the like, requiring counselling are regarded as traumatic events.

We’ve extended this benefit to the immediate family members and/or work colleagues of the employee, who have been subjected to the same incident, occurrence of violence or traumatic accident as the employee.

HIV Prevention Program

The HIV Prevention Program ensures immediate help and preventative treatment to the employee who has come into contact with HIV through any accidental exposure, occupational exposure, needle-stick injuries, motor vehicle accidents, rape, assault and other types of exposure.

In the event of an incident, the employee will receive rapid private treatment following a simple call to the 24-hour, 365-day operational Care Centre.

The employee will be directed to the nearest private healthcare facility (anywhere in South Africa).

The HIV Exposure Plan includes:

  • 24-hour, 365-day-a-year toll-free telephone counselling,
  • Three-day starter pack (AZT & 3TC),
  • Morning-after pill & STD prevention medication if required (as in the case of rape),
  • 25-day triple-combination antiretroviral therapy, with home delivery service.

This is not an “access only” programme. The costs for medication, counselling and access to the programme are covered in the above plan, so there are no costs to the employee or their employer.