About Disability Cover.

How is disability defined?

There are two types of disability cover that AllLife can offer you; this will depend on your work status, work type, income and education (amongst others).

1. Occupational disability (OCC)

Occupational disability (OCC) is better suited to professionals who may need to perform a specific task as part of their job where the ability to perform these tasks is not covered by the ADW disability definition.

The definition that we use when defining Occupational disability:

The Life Insured is considered to be permanently and totally disabled if the Life Insured is unable to perform the important duties of any reasonable gainful occupation due directly to injury or sickness.

A reasonable occupation is an occupation which the insured:

  • is reasonably qualified OR could reasonably be expected to become qualified , based on his/her education, training, or experience; AND
  • could reasonably expect to earn an annual income equal to or greater than 75% of the annual income of the insured at the time of the claim event.

Note: For a claim to be admissible, the insured must have received the appropriate care and attendance of a licensed physician AND the disability must be permanent for 6 months.

2. Activities of daily work Disability(ADW)

A benefit may be paid where the applicant is unable to successfully complete a defined set of tests.

Definitions of Activities of daily work:

Bending - the ability to bend or kneel to pick up something from the floor and straighten up again.

Climbing - the ability to walk up and down a flight of 12 stairs without holding on or resting.

Communicating - the ability to answer the telephone and take a message for someone.

General health - the ability to independently arrange to see a doctor and take routine prescribed medication.

Lifting - the ability to lift, carry or otherwise move everyday objects using either hand. Everyday objects would include a kettle of water, bags of shopping, an overnight bag or briefcase.

Manual dexterity - the ability to use hands and fingers with precision, including the ability to pick up and manipulate small objects such as pens or cutlery.

Reading - the ability to read ordinary newsprint, with spectacles or contact lenses if necessary, or to pass the standard eye test for driving. This activity would be regarded as failed if the relevant life assured is certified blind or partially sighted by an ophthalmologist.

Walking - the ability to walk a distance of more than 200m on flat ground without stopping or without severe discomfort.

Which disability cover is right for me?

This will depend on your health condition. We have cover for HIV+ individuals, and we have a separate cover for Diabetic individuals.

1. Disability Cover for Diabetic Individuals

What benefits does Optimum Disability Cover for Diabetics offer me?

  • Disability cover can be added to the life cover or taken separately Clients may select a higher or lower cover amount than the life cover (if selected)
  • Because the Life cover and Disability cover are independent, there can be a pay-out for disability as well as for life
  • Disability due to accidents and illnesses is covered

What if I am only temporarily disabled?

  • There is no payment of cover for temporary disablement.
  • Your cover can still stay active for up to 12 months – because AllLife will pay the premiums on your behalf.
  • You need to apply to have this additional benefit activated.

What disability conditions do you cover under the optimum life cover?

  • We cover disability as a result of major diabetic concerns such as amputations, blindness, stroke, etc.
  • We also cover other standard disablements, such as becoming paralysed in a car accident or disabled as a result of crime.

What happens if I miss a premium payment?

  • AllLife have a product called the Policy Protector Benefit, which allows you to miss up to five consecutive Monthly Contributions and still keep the some cover.

If I don't have the policy protector benefit and miss a premium payment, what happens?

  • Should any Monthly Contribution(s) not have been paid during the six month period immediately preceding a Claim (or whatever period has elapsed since the Commencement Date, where this is less than six months), the Benefit claimable will be in proportion to the number of Monthly Contribution(s) received during this period;
  • Where a debit order is returned unpaid, the Benefit will be temporarily reduced.

Can I make up a missed premium payment?

  • If you want to maintain full Benefits, you may choose to make up this missed payment.

What exclusions are there for the optimum disability benefit?

Claims will not be admitted if death / disability is a result of:

  1. An injury which is self inflicted or in any way deliberately caused by the Life Insured (suicide);
  2. Negligence, recklessness or any participation by the Life Insured in any criminal act;
  3. The Life Insured being under the influence of alcohol, inhalation of fumes, consumption of poisons, drugs, narcotics or medication, except as prescribed by a qualified medical practitioner and used as prescribed;
  4. Participation in any form of aviation, other than as a passenger travelling on a scheduled flight in an aircraft flown by a duly licensed pilot;
  5. Participation in mountaineering, pace making or any speed contest and trials;
  6. The Life Insured failing to disclose required information prior to the commencement of the benefit;
  7. War, hostilities or warlike operations (whether war be declared or not), and a hostile act of invasion;
  8. Act of an enemy foreign to the nationality of the Life Insured or the country in, or over, which the act occurs;
  9. Civil war, Insurrection, Revolution, Overthrow of the legally constituted government;
  10. Civil commotion assuming the proportion of, or amounting to, an uprising, Military or usurped power;
  11. The use of nuclear, biological or chemical weapons, or any radioactive contamination;
  12. Attacks on or sabotage of facilities (including, but not limited to, nuclear power plants, processing plants, final repository sites and research reactors) and storage depots, which lead to the release of radioactivity or nuclear, biological or chemical warfare agents, irrespective of whether any of the aforesaid has been performed with the specific use of information technology;
  13. Any pre-existing conditions where the policy has not yet been underwritten;
  14. Disabilities due to Non-specific Back Pain.

2. Disability Cover for HIV+ Individuals

What benefits does Advantage Disability Cover for HIV+ individuals offer me?

  • Disability cover can be added to the life cover or taken separately Clients may select a higher or lower cover amount than the life cover (if selected)
  • Because the Life cover and Disability cover are independent, there can be a pay-out for disability as well as for life
  • Disability due to accidents and illnesses is covered

How does the cover work?

  • Disability cover is provided over the same term and at 75% of the death benefit value when linked to an Advantage Term Life or an Advantage Whole Life product. When linked to an -Advantage Loan Protector product, the disability benefit is 100% of the (declining) death benefit value.

What if I am only temporarily disabled?

  • There is no payment of cover for temporary disablement.
  • Your cover can still stay active for up to 12 months – because AllLife will pay the premiums on your behalf.
  • You need to apply to have this additional benefit activated.

How will you pay me out if I am disabled?

  • We will pay you a lump-sum in the event of permanent total disability (as defined in AllLife’s published terms and conditions).
  • There is a 6-month minimum waiting period after the date of disability before a disability claim can be paid out.

What happens to my life cover if I claim for disability?

  • Advantage Life Disability products accelerate the death benefit in the event of a disability claim.
  • This means that if you become permanently disabled, then the policy will cease and no further benefits will be payable.

What disability conditions do you cover under the Advantage Life Disability Cover?

AllLife’s disability products provide cover should the life insured be diagnosed with any of a range of AIDS-defining conditions. AllLife defines a set of HIV-specific disabling conditions, based on the following WHO Stage 4 AIDS defining conditions, as set out below. The life insured is considered permanently and totally disabled if they are diagnosed with one or more of these conditions, and where they are no longer responding despite optimal treatment.

  • HIV wasting syndrome
  • Pneumocystis Carinii Pneumonia
  • Toxoplasmosis of the brain
  • Cryptosporidiosis with diarrhoea
  • Isosporosis with diarrhoea
  • Extrapulmonary cryptococcosis
  • Cytomegaloviral disease of an organ other than liver, spleen, or lymph node
  • Herpes simplex virus infection (Chronic or visceral)
  • PML (progressive multifocal leukoencephalopathy)
  • Any disseminated endemic mycosis
  • Candidiasis of the esophagus, trachea, bronchi, or lungs
  • Atypical mycobacteriosis
  • Non-typhoid Salmonella septicaemia
  • Extrapulmonary TB
  • Lymphoma
  • Kaposi’s sarcoma
  • HIV encephalopathy

All available treatment options must have been exhausted at the time of the claim.

What happens if I miss a premium payment?

AllLife have a product called the Policy Protector Benefit, which allows you to miss up to five consecutive Monthly Contributions and still keep the some cover.

If I don't have the Policy Protector benefit and miss a premium payment, what happens?

Should any Monthly Contribution(s) not have been paid during the six month period immediately preceding a Claim (or whatever period has elapsed since the Commencement Date, where this is less than six months), the Benefit claimable will be in proportion to the number of Monthly Contribution(s) received during this period;
Where a debit order is returned unpaid, the Benefit will be temporarily reduced.

Can I make up a missed premium payment?

If you want to maintain full Benefits, you may choose to make up this missed payment.

What exclusions are there for the Advantage Disability benefit?

Claims will not be admitted if death / disability is a result of:

  1. An injury which is self inflicted or in any way deliberately caused by the Life Insured (suicide);
  2. Negligence, recklessness or any participation by the Life Insured in any criminal act;
  3. The Life Insured being under the influence of alcohol, inhalation of fumes, consumption of poisons, drugs, narcotics or medication, except as prescribed by a qualified medical practitioner and used as prescribed;
  4. Participation in any form of aviation, other than as a passenger travelling on a scheduled flight in an aircraft flown by a duly licensed pilot;
  5. Participation in mountaineering, pace making or any speed contest and trials;
  6. The Life Insured failing to disclose required information prior to the commencement of the benefit;
  7. War, hostilities or warlike operations (whether war be declared or not), and a hostile act of invasion;
  8. Act of an enemy foreign to the nationality of the Life Insured or the country in, or over, which the act occurs;
  9. Civil war, Insurrection, Revolution, Overthrow of the legally constituted government;
  10. Civil commotion assuming the proportion of, or amounting to, an uprising, Military or usurped power;
  11. The use of nuclear, biological or chemical weapons, or any radioactive contamination;
  12. Attacks on or sabotage of facilities (including, but not limited to, nuclear power plants, processing plants, final repository sites and research reactors) and storage depots, which lead to the release of radioactivity or nuclear, biological or chemical warfare agents, irrespective of whether any of the aforesaid has been performed with the specific use of information technology;
  13. Any pre-existing conditions where the policy has not yet been underwritten;

Disability Cover is an option – Cover is for illness or accidents

Our cover is designed to cover conditions which diabetics should be worried about:

  • We cover disability as a result of major diabetic concerns such as amputations, blindness, stroke, etc.
  • We also cover the normal concerns such as becoming paralysed in a car accident or as a result of crime

Permanent Disability benefit:

  • Disability cover can be added to the life cover or taken separately (if taken together, we will waive one diabetes control fee of the combined price)
  • Clients may select a higher or lower cover amount than the life over (if selected)
  • Because the Life cover and Disability cover are independent, there can be a pay-out for disability as well as for life
  • Disability due to accidents and illnesses is covered

Temporary Disability benefit:

  • If the Client is temporarily disabled, there is no payment of cover
  • Cover can stay active for up to 12 months – because AllLife will pay the premiums on their behalf
  • The client must apply to have this benefit activated

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