While medical and, possibly, gap cover can make provision for medical expenses, these insurance products are very unlikely to cover any gaps when it comes to the additional expenses like lifestyle changes that result from life-altering illnesses or injuries. For example, for a condition like paraplegia, a critical illness policy will help cover the expenses involving alterations to a home to be wheelchair-friendly.
Many medical schemes may exclude certain treatments or not cover them in full, or you might have reached your annual limit. In these instances, critical illness cover may just come to the rescue.
But there are many critical illness policies that have not kept up with the times – especially when it comes to covering the treatment and/or recovery periods following some of the latest medical treatments in the market. If you already have critical illness cover, or are “shopping” for a policy, it is important to go through the fine print to see if they factor in the latest medical advances, and to see if they adjusted the range of conditions they provide cover for to keep up with the latest medical research and survival rates.
How many conditions are covered?
Start by obtaining the list of conditions covered by the critical illness policy, because the number of conditions covered vary from company to company. There are life insurance providers that provide cover for over 300 conditions, while some assurers cover fewer than 100 conditions. Some life cover providers also take into account the treatment, clinical impact and effect of an illness, which ensures protection for as yet undiagnosed conditions – this is the kind of cover you should be signing up for.
If my injury or illness is so severe that I could die soon after meeting the definition, will I always be paid?
If you were to meet the requirements for a claim, but pass away shortly after, you still may not qualify for a pay-out with some products. A 14 day general survival period would mean your pay-out would be refused, even though you have met the criteria, and incurred additional costs.
How do the payouts work if I have to claim?
You should also consider the pay-out structure and/or –options of your critical illness policy. There are policies with pay-out options that are helpful for conditions that involve large expenses initially, followed by smaller amounts over a number of months. Importantly, you should be allowed to make certain choices about how your cover should pay out at claim stage, when you know what your physical and financial needs are.
What about smaller events, like accidents?
Forward thinking life cover providers have also identified a need for financial protection in instances where you might have less critical, but still traumatic illnesses or injuries and spent little or no time in hospital.
Just think about the myriad of costs involving corrective procedures, medical aid co-pays, hospital costs, rehabilitation, assistive devices, physiotherapy, wound care, nursing and surgery costs resulting from a traumatic accident. These expenses can all have a financial impact that may not fully be provided for by you existing insurance policies.
And, the most important question
We’re living in a time where innovative services and products are designed to exactly match your individual needs, and your insurance policies should be no exception. So before signing up for a new, critical illness policy, ask yourself: Is my critical illness policy a needs-matched policy that will really make a positive difference in my life, when I need it most?
Schalk Malan is the CEO of BrightRock, provider of needs-matched life insurance.