HIV disability cover
AllLife offers optional permanent disability cover as an additional benefit on our Advantage Life Insurance policies. We define permanent disability in terms of the life insured’s ability to perform Activities of Daily Work (ADW) as defined in AllLife’s terms and conditions.
Whole Life or Term Disability Insurance
Disability cover is available as an option on all of the Advantage Life products offered.
Disability benefits are 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.
As an illustration, for a policyholder with R1 Million of life insurance and linked disability cover on a whole life level cover basis, the benefit payable in the event of a successful disability claim would be R750 000. In the event that the policy is a loan protector policy, the benefit payable would be equal to the scheduled outstanding balance on a loan of the same term as the policy.
Definitions of disability
Activities of Daily Work (ADW) definitions, or in terms of AllLife’s defined HIV-specific disabling conditions.
AllLife considers the life insured to be disabled where this disability is due to an injury or illness that is regarded as permanent and continuous, and where the claimant has reached maximum medical improvement despite reasonable medical treatment by appropriate specialists (at the life insured’s own cost). There is a waiting period of 6 months on a permanent total disability claim.
A disability claim will not be admitted should this claim arise directly or indirectly from any back or spinal disorder or condition, unless such a back condition or disorder is due to paraplegia, quadriplegia, a malignant condition of the vertebrae or spine, fractures of the spine or failed back syndrome after more than two previous back surgeries.
No benefits are payable in the instance where the life insured fails to undergo reasonable medical treatment by appropriate specialists – including taking appropriate medication for their condition. Due allowance will be given for the risk and prognosis of such treatment.
Activities of daily work
The Activities of Daily Work (ADW) definitions are based on the basic activities needed to perform work. The life insured is considered permanently and totally disabled if they achieve a predetermined minimum points score on the defined ADW scale, as assessed by AllLife or a suitably qualified agent of our choosing.
AllLife’s disability definitions are included in our policy documentation and in our published terms and conditions or are available on request. The Activities of Daily Work methodology is widely used within the Life Insurance industry to provide an objective methodology for assessing claims.
AllLife’s Advantage disability product pays out a lump sum in the event of the permanent total disability of the life insured (as defined in AllLife’ published terms and conditions) during the term of the policy. (Initially, there is a six-month waiting period and only after this period, can a claim be lodged.) This benefit is an acceleration of the death benefit, which means that once a permanent disability claim has been paid, no further benefits will be payable under the policy, including the death benefit.
The increase in premium for this additional disability benefit is small and well worth the extra cost.
Disability benefits cease on the 65th birthday of the life insured, although the death benefit may continue beyond the age of 65.
The policy includes a waiver of the premium during the waiting period in the event of a disability claim. This benefit is limited to a maximum of 12 monthly premium payments over the term of the policy (i.e. multiple claims are allowed as long no more than 12 months are claimed in total), at the discretion of AllLife.
HIV specific disability
AllLife defines a set of HIV-specific disabling conditions, based on the WHO Stage 4 AIDS-defining conditions, as set out in the bulleted list 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 to treatment.
- HIV wasting syndrome.
- Pneumocystis Carinii Pneumonia.
- Toxoplasmosis of the brain.
- Cryptosporidiosis with diarrhoea.
- Isosporiasis with diarrhoea.
- Extrapulmonary cryptococcosis.
- Cytomegaloviral disease of an organ other than the liver, spleen, or lymph node.
- Herpes simplex virus infection (Chronic or visceral).
- PML (progressive multifocal leukoencephalopathy).
- Any disseminated endemic mycosis.
- Candidiasis of the oesophagus, trachea, bronchi, or lungs.
- Atypical mycobacteriosis.
- Non-typhoid Salmonella septicaemia.
- Extrapulmonary TB.
- Kaposi’s sarcoma.
- HIV encephalopathy.