Medical Premium Waiver

What is Medical Premium Waiver?

The Medical Premium Waiver Policy ensures you and your family enjoy uninterrupted and ongoing medical cover in the event of death or disability.

In the event of a claim your medical scheme contributions will be paid directly to your medical scheme by the policy benefit. This policy will also cover your monthly Zestlife Gap Cover contributions. This will take place monthly for a period of either 2 or 5 years depending on the benefit period chosen. The benefit payments will keep pace with annual medical increases to ensure your contributions are covered and your medical benefits are ensured.

Why do I need Medical Premium Waiver?

Medical Premium Waiver is a special purpose life cover that caters specifically for the immediate and ongoing cost of your family’s healthcare. It offers the security that irrespective of how long it may take for other life insurance to pay out for a death or disability claim, you and your family will receive uninterrupted medical cover. Importantly, it also offer peace of mind knowing the policy benefit will only ever be used to fund the on-going provision of medical scheme cover and gap cover and cannot be diverted for any other purpose.

Cover

Premium

Actual medical scheme and gap cover contribution up to R6 500 payable monthly for 2 years on death or permanent disability

R165

Actual medical scheme and gap cover contribution up to R6 500 payable monthly for 5 years on death or permanent disability

R289

Frequently Asked Questions

The policy is underwritten by Guardrisk Life Limited.

The benefit is paid directly to your medical aid for the amount of your medical aid contribution up to the maximum of R6 500 for a period of 24 or 60 months.

This is the continuous, total and permanent inability of the insured, due to injury, disease or illness to perform the material and substantial duties of any occupation for which he/she is qualified.

There are no medicals required when applying for this policy.

The only eligibility requirements relate to the need to being a member of a medical scheme, having not reached 60 years of age and answering in the negative to the single underwriting question: Have you ever tested positive or been treated for HIV/Aids?

This policy needs to be taken out prior to the principal member reaching 60 years old.

There is a pre-existing condition exclusion that excludes claims that occur within 12 months of the policy being taken out that are related directly or indirectly to physical defect, medical condition or injury which manifested symptoms to the insured within 12 months prior to the commencement of the policy.

Furthermore there is a list of general exclusions such as sickness or injury that is caused from nuclear weapons or material, suicide, injury from an accident while over the legal alcohol limit, active participation in war, police duty, civil commotion.

There are no general waiting periods on this policy however if the policyholder has a pre existing condition, claims related to this condition will not qualify for a period of 12 months from the commencement of the policy.

The first premium will be debited on a day of your choice.

The premium amount will be reviewed on 1 February each year and you will be notified of any premium increase on 1 (one) months notice.

Within 6 months of a hospital admission giving rise to a claim you need to submit a claim. This can be done by contacting Zestlife who will advise you of the documents that will have to be completed in submitting a claim.

You may also be interested in:

Medical Gap Cover – Cover the shortfalls of your medical aid payouts.