Extended Disability Income. Fixed cease age. Extended Disability Income. Whole Life UP TO 24 MONTHS. Pre-retirement.
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1 For intermediaries Sanlam Risk Cover January 2015 Temporary Disability Income benefit (OIT3) Primary Income Protector benefits Waiting period Sickness Temporary Disability Income Including fixed payment for defined list of claim events Overhead Expenses protector Extended Disability Income Fixed cease age OR Extended Disability Income Whole Life Post-retirement Impairment Income Payment on basis of permanent impairment no waiting period UP TO 24 MONTHS CHOSEN CEASE AGE OR MIN (RETIREMENT, 70) DEATH Optional rider benefits Spouse Protector Child Protector Optional rider benefits available with Sicknessand Temporary Disability Income benefits Pre-retirement Impairment Income Payment on basis of permanent impairment no waiting period Optional rider benefit available with Extended Disability Income-benefit Additional Income Protector benefits Total and Permanent Disability Income Payment on basis of permanent disability no waiting period Death Income CHOSEN CEASE AGE Sanlam is a licensed financial services provider
2 Claim Pay-out limits We will limit the income payment to the cover amount. If the disability does not result in a total loss of income, we will further limit the income payment in proportion to the loss of income. If the disability results directly or indirectly from any of the conditions listed below, we will further limit the amount of the income payment to ensure that this amount, plus any income that the life insured might receive from the plan and from other individual or group disability income type plans, does not exceed 100% of the average monthly income after tax that the life insured earned directly before the disability. depression or dysthymia, whether as an episode or disorder, or as part of the symptom complex of another psychiatric diagnosis; post-traumatic stress disorder; fibromyalgia; chronic fatigue syndrome and its synonyms; a back condition, unless it is one of the following: paraplegia; quadriplegia; malignant tumours of the spinal cord and vertebral column; or failed back syndrome after multiple spinal surgery, provided the extent of the functional impairment arising from the failed back syndrome is verified by a specialist that we will nominate; Claim event The Temporary Disability Income benefit provides cover for when the life insured becomes disabled to the extent that he or she is continuously unable to fulfil a substantial and material part of the duties of the regular occupation he or she practised for income immediately before the disability, resulting in a loss of some or all of such income. If a waiting period of 7 days or 1 month has been chosen for this benefit, a benefit may also be claimed if the life insured suffers certain defined claim events as indicated in the plan contract, irrespective of whether the life insured is disabled as described above or not, and irrespective of whether the life insured has a loss of income or not. any orthopaedic condition where the disability is based mainly on pain, discomfort, loss of sensation, loss of range of motion, or any combination thereof; any decline in cognitive functioning irrespective of the cause thereof; an injury or illness that directly or indirectly resulted from, or is traceable to, any of the above causes; a complication that directly or indirectly is attributable to any of the above causes, or to such an injury or illness; a side-effect of treatment for any of the above causes, or for such an injury or illness, or for such a complication. We will pay a claim if the amount is equal to or more than the smaller of: 10% of the cover amount; and the minimum cover amount for New Business. 2
3 Fixed payment for defined list of claim events If the life insured suffers any of the defined claim events indicated in the table below, and we admit a claim, we will make income payments as if the life insured is continuously disabled for the number of weeks indicated in the table below. We will assume that the disability starts on the date that the defined claim event occurred, and that the life insured has a total loss of income during this period. A benefit may be claimed if the chosen waiting period for this benefit is 7 days or 1 month only. We will not make any ssumed disability during the waiting period This means that if the number of weeks indicated in the claim event table is shorter than or equal to the chosen waiting period, we will not admit a claim. Also: the waiting period will be deducted from the period of assumed disability to determine the period for which we will pay. An exception to this is when the chosen waiting period for this benefit is 7 days and the defined claim event meets the criteria of one of the conditions listed in the contract for which we will pay a claim from the date on which the claim event occurred instead of from the end of the waiting period. Period of assumed disability in weeks for disability class* Defined claim event A B and C D and E Surgical replacements Surgical replacement of a shoulder joint Surgical replacement of an elbow joint Surgical replacement of a wrist joint Surgical replacement of a hip joint Surgical replacement of a knee joint Surgical replacement of an ankle joint Fractures Fracture of a collar bone with subsequent surgery Fracture of the bone of an upper arm Fracture of a bone in a forearm Fracture of a bone in a hand with subsequent surgery, fingers excluded Fracture of the bone in an upper leg Fracture of the shin bone of a lower leg Fracture of the calf bone of a lower leg Fracture of a heel bone Skull fracture requiring reconstruction
4 Period of assumed disability in weeks for disability class* Defined claim event A B and C D and E Fracture of the facial bones requiring reconstructive surgery Multiple rib fractures with unstable ribcage Stable pelvis fracture Unstable pelvis fractures Fracture of the body of a spinal vertebra Fracture of the bony elements of a spinal vertebra, other than the body Ligament repairs Surgical repair of rotator cuff syndrome of the shoulder Complete rotator cuff rupture Knee cruciate ligament reconstruction Knee medial or lateral ligament repair Complete achilles tendon rupture Other defined claim events Abdominal injury with liver rupture, spleen rupture or kidney damage requiring emergency surgical repair Acute disc lesion of the spine Amputation of a hand Amputation of a foot Coma Loss of an eye due to injury Major burns Paraplegia Quadriplegia Penetrating gun shot wound into the chest, abdomen or neck Penetrating stab wound into the chest, abdomen or neck Removal of the neck or lower back intervertebral discs, or fusion of the neck or lower back vertebrae *The disability class of the life insured is indicated in the quotation that forms part of the contract documents for the plan. If we admit a claim, we will use the disability class indicated in the most recent quotation that forms part of the contract documents for the plan. 4
5 Benefit features Stand-alone benefit available on the Income Protector product Guaranteed term 5 years, possible increase after expiry of guaranteed period is capped at 20% Waiting period options 7 days 1 month 3 months 6 months 12 months Benefit payment period There is no choice of payment period. The maximum number of monthly income payments we will make for a specific cause of the claim event for disability depends on the chosen waiting period for the benefit: 24 waiting period of 7 days; Claims waiting period of 1 month; waiting period of 3 months; waiting period of 6 months; waiting period of 12 months. We will waive the payments of the plan for as long as we make an income payment. If we admit a claim, benefit and payment growth, if any, will continue to take place as before the claim. Inception ages Minimum: 18 Maximum: 5 years before chosen cease age 5
6 Benefit features (continued) Benefit cease age options Minimum and maximum cover limits Minimum: R3 000 per life insured per month Maximum: R per life insured per month (to a maximum of a percentage of Income according to the sliding scale below) Income (I) Up to and including 55 Older than 55 I R % 77% R < I R % 72% R < I R % 68% R < I R % 64% R < I R % 60% R < I R % 55% R < I 60% 51% Available growth patterns Level with optional growth No growth Non-specified payment growth /5% cover growth Non-specified payment growth /CPI cover growth (max 15%) Compulsory growth Fixed compulsory growth 5% payment growth /0% cover growth 12% payment growth /5% cover growth Age-related* compulsory growth 0% cover growth 5% cover growth * In order to have an age-related pattern that is more sustainable for income protection benefits, the premium increases on this pattern start reducing at older ages. See Risk Technical Guide for the full details of this payment pattern. Optional rider benefits available with the Temporary Disability Income benefit Spouse protector* Child protector* *Technical details available in the FlashFact for Income Protector: Optional rider benefits. 6 i /2015
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