Critical illness benefit claim
The critical illness cover benefits provide financial protection against illnesses like a heart attack, cancer, stroke, Alzheimer's and Parkinson's disease. You’re also covered for injuries from accidents such as paraplegia, major burns and brain damage.
If a valid claim is admitted, the claim amount will be paid to the following people in the following order:
- The cessionary (if any).
- The policyholder.
Critical illness benefit claim requirements
- The critical illness claim form (cardiac and arterial system, cancer and nervous system)) (CLAIM008)open_in_new completed and signed by the policyholder or authorised representative of the policyholder (available on request).
Or
- The critical illness claim form (general) (CLAIM015) open_in_new completed and signed by the policyholder or authorised representative of the policy holder (available on request.
- The POPIA Consent Formopen_in_new completed and signed by the claimant or duly authorised representative of the claimant.
- A copy of the insured life’s identity document.
- Copies of all the relevant diagnostic tests/reports .
- An up-to-date confidential medical report from the treating specialist, which must include the full diagnosis, prognosis, treatment plan and response to treatment. Regrettably, a report from a general practitioner will not be accepted.
- Proof of banking details, in the name of the claimant (natural person, minor, deceased estate, legal entity), not older than 3 months on a bank letterhead or that has a bank stamp on it.
- Curator bonis appointment if the claimant is not able to handle his/her own financial affairs (if applicable).
And the following additional requirements (whichever is applicable):
If the claimant is a cessionary
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- Verification documents - authorised representative (Green bar-coded, smart ID card, valid driver's licence or valid passport)
- A written instruction from the cessionary confirming the bank account to use for the claim payment as well as proof thereof in the form of a bank statement not older than three months on a bank letterhead or that has a bank stamp on it
- Payment to a bank or cessionary claim form (CLAIM029E)open_in_new
If the claimant is a trust
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- Verification documents - trust beneficiary (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Verification documents - all active trustees (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Verification documents - founder of the trust (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Trust deed or founding document
- A letter from the Master's Office confirming registration of the trust
If the claimant is a private company
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- Verification documents of managers (Chief Executive Officer/Managing Director), (green bar-coded, smart ID cart, valid driver's licence or valid passport)
- Verification documents of all directors and all shareholders with at least 25% interest (green bar-coded, smart ID cart, valid driver's licence or valid passport)
- Copy of the certificate of incorporation (private company documents)
- A copy of the shareholder's register or a certified copy of the organisational structure and explanation of ownership
If the claimant is a closed corporation
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- Verification documents of all active members (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Copy of the certificate of incorporation (CK documents)
- A copy of the shareholder's register or a certified copy of the organisational structure and explanation of ownership
If the claimant is a partnership
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- Verification of identity of all partners in the partnership (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Verification documents of persons who exercise executive control over partnership (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Copy of the partnership agreement
If the claimant is a foreign company
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- IDs of managers for its affairs in RSA (Chief Executive Officer/Managing Director)(valid passport, United Nations certified travel document/passport, valid travel document, refugee document (valid for 2 years only)) OR (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Verification documents of all directors and shareholders with at least 25% interest (valid passport, United Nations certified travel document/passport, valid travel document, refugee document (valid for 2 years only)) OR (green bar-coded, smart ID card, valid driver's licence or valid passport)
- Copy of the certificate of incorporation (foreign company documents)
- A copy of the shareholder's register or a certified copy of the organisational structure and explanation of ownership
If the claimant is a foreign national
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- Verification documents (United Nations certified travel document/passport, valid passport, valid travel document, refugee document (valid for 2 years only))
- A copy of the claimant's naturalisation certificate, if born in South Africa
- Written confirmation if the claimant never lived in South Africa and was not a South African resident
- Form MP336 (b) (an application to the South African Reserve Bank for foreign capital allowance) completed in full and signed by the claimant who has emigrated (CLAIM013Eopen_in_new)
- Indemnity form completed by the foreign claimant (CLAIM025Eopen_in_new)
- The name of the bank and branch where the claimant banked in South Africa before departure
We may require additional information for medical requirements and legal entities.
Contact details to submit a critical illness benefit claim
[email protected]
Fax: +27 12 675 3947