Express Cover: Sanquote process

Transcription

1 Flashfact March 2016 Express Cover: Sanquote process The issuing of a risk plan currently involves various types of underwriting, i.e. medical, occupational, part-time activity, financial, overseas and foreigner underwriting. All these types of underwriting increase the time it takes to write and issue a risk plan. Express cover, however, involves a simplified underwriting process which streamlines the sales process for the intermediary, as well as the client. Process The Sanquote process involves a Sanquote quote plus an electronic or paper application form. Application forms A separate, shortened application form is available for Express cover applications. Payments Accepted mode of payment is via debit order or stop order. Roles There must be at least 1 underwritten life insured on the plan. (An underwritten life is a life with at least 1 underwritten benefit). Accidental benefits are also seen as underwritten benefits, although there is no medical underwriting for these benefits. The allowable insurable interests for underwritten lives are: own life, or spouse The Funeral (FSC2) benefit is not available for own life. Express cover also allows you to add funeral lives. The allowable insurable interests for the Funeral benefit on Express cover are the same as for this benefit on the Classic and Premier product options.

2 Available products, benefits and features Express Cover: Sanquote process Products & benefits Matrix Express Topcover: Death benefit Funeral and other immediate expenses benefit Funeral benefit Disability for regular occupation benefit Disability for regular occupation and functional impairment benefit Physical impairment benefit Core dread disease benefit Accidental death benefit Accidental disability benefit Accidental injury benefit Matrix Express Income Protector: Death income benefit Total and permanent disability income benefit Rules with regard to Funeral benefits: The normal rule on Matrix which requires a life insured with the Funeral and other immediate expenses benefit to also have an underwritten benefit with cover of at least 4 times as much as this benefit, does not apply to Express cover plans. The Funeral and other immediate expenses benefit is available only to the underwritten lives insured, while only the Funeral benefit is available to the other lives. The Funeral (FSC2) benefit is not available for own life. An Express cover plan with only the Funeral benefit or Funeral and other immediate expenses benefit (with or without Cashback benefit) is not allowed. Payment patterns Cover growth options Guaranteed term Optional Cashback benefit * Reality integration Level Fixed compulsory 5% Age-related 0% 3.5% 5% CPI 5 years Available Not available *Details on the working of Cashback benefit in the Cashback benefit flashfact. 2

3 Cover limits per life insured Benefit Amount Death R Death income Funeral and other immediate expenses Funeral R p.m. R R before a life insured s 6th birthday R on or after a life insured s 6th birthday, but before that life insured s 14th birthday R on or after a life insured s 14th birthday Disability for regular occupation R Functional impairment plus Disability for regular occupation Total and permanent disability income R R p.m.* Physical impairment R Core dread disease R Accidental death R Accidental injury R Accidental disability R *Also limited to the lower of the sliding scale and 75% of gross income. Maximum The following maximum also applies: Disability for regular occupation Functional impairment plus Disability for regular occupation R Limits apply per life insured and are subject to financial underwriting. Minimum cover amounts for these benefits are the normal New Business minimums for these benefits. 3

4 Entry age Minimum 19 anb for underwritten lives, 2 anb for other lives taking only the Funeral benefit Maximum New Business maximums as for other product options Underwriting For Express cover there are 2 different underwriting levels, depending on the amount of cover being applied for - per underwritten life and per plan: Underwriting level Large Small When applicable The underwriting level determines: At least 1 of the lump sum benefits for that life insured on that plan is greater than R , OR At least 1 of the income benefits for that life insured on that plan is greater than R p.m. Other (cases not qualifying for the Large level of underwriting) the number of health questions asked during medical underwriting whether random cotinine tests and/or BMI verification apply whether medical loadings can be placed or not whether a life must provide information on cover with other insurers. 4

5 Medical underwriting LEVEL Medical questions Small 7 questions Tele-underwriting is available for Rate Group 2 and up More detail will be required for a Yes answer Large 12 questions Tele-underwriting is available for Rate Group 2 and up More detail will be required for a Yes answer Blood tests No blood tests Random cotinine tests may be required for non-smokers Can be done by either the Nurses on Wheels (min. premium of R300 p.m.), or a client s own doctor or clinic If a positive test is received, the application for that life insured will be declined and he or she will not be able to apply again for Express cover for a 1-year period BMI Other medical requirements (e.g. scans, ECGs, medical examinations, medical reports, etc.) Medical loadings and exclusion clauses Height and weight will not be asked None No medical loadings will be placed. Medical exclusions can be placed and will be pre-approved by the client on the application form. A letter will be provided with the contract which will refer to any exclusion clauses placed. There is therefore, no need to return to the client for purposes of signing off an exclusion clause. Height and weight will be asked Random verification of BMI may be required BMI may be used as a rating factor on death benefits, as well as to place medical loadings (normal process) BMI verification can either be done by Nurses on Wheels (min. premium = R300 p.m.) or at the client s own doctor or clinic. None Medical loadings can be placed (normal rules/practice) Medical exclusions can be placed. (Normal rules/practice i.e. clients can pre-approve existing exclusions on the application form, but must give their consent for new exclusion clauses). 5

6 Pricing Plan fee = R20 No stop order fee applies. Rate groups Rate groups are determined according to the life insured s income and highest qualification. Rate groups 1 to 5 are available as for the other product options. Rate group 5 For Express cover the following occupations qualify for Rate group 5, subject to the life also having a 4-year degree or equivalent qualification: Actuary Architect Chartered accountant Chemist Dentist Dietician Engineer Financial planner Information technology (IT) Lawyer or attorney Lecturer, professor or rector Medical doctor or specialist Nurse Occupational therapist Optometrist Pharmacist Physiotherapist Scientist Speech therapist Veterinarian Disability classes No occupation needs to be entered on Sanquote for Express cover. Sanquote will ask a number of questions and will then determine the disability and accident classes based on the answers to these questions. These answers will also print on the quote output and will, therefore, form part of the plan document. Financial underwriting Cover with other companies will only be requested for applications with a Large level of underwriting. For lives who have only the Funeral benefit, cover with other companies will be taken into account for lives < 15 anb only and that is for legislative reasons. Cover will then be limited so that the total death cover per child will not exceed the amounts specified by legislation. Occupational underwriting Express cover is not available to insured lives with the following occupations or occupational duties: Working underground for more than 10 hours per week Working at heights of more than 15 metres Working with voltages of more than V Working on an oil rig, or with asbestos or with explosives Cash in transit, debt-collecting (excluding per telephone) or micro-lending Security guard, body guard, escort, bouncer or private investigator Driving a taxi Helicopter-flying, flying at low altitudes or flying fighter aeroplanes Diving, stuntwork or hunting big game Professional sportsman or -woman Unemployed (excluding students, housewives and pensioners). 6

7 Part-time activities underwriting No part-time activity questions are asked, but the following list of hazardous activities is contractually excluded (whether done part-time or as part of occupation): Cliff-diving; Free-diving at depths greater than 25m; Scuba-diving at depths greater than 40m; Unaccompanied scuba-diving; Cave-diving, commercial diving, or the exploration of underwater wrecks for financial gain; Expedition-style mountaineering; Solo-climbing mountaineering; Expedition caving; Hazardous aviation activities with a fixed-wing aeroplane (including student pilots and acrobatic flights); Microlight, helicopter or gyrocopter flying; Recurrent hang-gliding, paragliding, sky-diving, parachuting or sky-surfing; BASE jumping; Motorised racing or speed contests; Drag powerboat-racing, competitive jet-skiing or competitive water-skiing; Professional boxing, professional kick-boxing, or professional wrestling, martial arts or combat sports. These exclusions apply to all Express cover benefits (also the Death benefit), except the Funeral (FSC2) benefit. The following (shortened) list of general exclusions also applies. They apply to all Express cover benefits except the Death, Funeral, Funeral and other immediate expenses and Death income benefits: We will not admit a claim if it resulted directly or indirectly from any of the following, whereby the life insured: participates in riot, insurrection, civil commotion, military or hostile action, or an act of terrorism; commits or attempts to commit a crime of murder, assault, housebreaking, theft, robbery, kidnapping, a crime involving a sexual act, or a crime of a similar nature to any of the aforesaid crimes; deliberately inflicts an injury on himself or herself; takes drugs or medicine not in accordance with medical prescription, or drives any form of motorised vehicle on a public road whilst his or her blood alcohol level exceeds the legal limit; is exposed to a nuclear explosion or radio-activity. 7

8 Overseas underwriting The application process for Express cover does not involve any questions regarding living or travelling overseas. The following clauses, however, apply: Claim events in the following list of countries are contractually excluded: Afghanistan, Angola: Cabinda Province, Burundi, Djibouti, Egypt, Eritrea, Ethiopia, Iran, Iraq, Lebanon, Nigeria: Niger Delta, North Korea, Pakistan, Somalia, Sudan and the Syrian Arab Republic. If we admit a claim in the following list of countries, the cover amount will be limited to 70%: Albania, Algeria, Angola excluding Cabinda Province, Antarctica, Azerbaijan, Belarus, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Gambia, Gough Island, Guinea, Guinea-Bissau, Haiti, Ivory Coast, Kazakhstan, Kosovo, Liberia, Libya (Libyan Arab Jamahiriya), Mali, Marion Island, Mauritania, Morocco, Mozambique, Niger, Nigeria excluding Niger Delta, Republic of the Congo, Russian Federation, Rwanda, Senegal, Sierra Leone, Sri Lanka, Taiwan, Tajikistan, Tonga, Tunisia, Turkey, Uganda, Ukraine, Uzbekistan and Zimbabwe. Foreigner underwriting The application process for Express cover does not involve any questions for foreigners. A standard clause prints in the contract explaining that foreigners (excluding Lesotho and Namibia) only have cover inside the RSA. Claims philosophy V /2016 Despite the manner in which the underwriting for Express cover has been simplified, our claims philosophy for Express cover is the same as for our other product options. Express cover clients can, therefore, enjoy the same peace of mind as under our other product options. Sanlam is a Licensed Financial Services Provider