Senario: Client dies shortly after suffering a brain aneurysm – two claim pay-outs despite no death cover…
A Brightrock client, a 31-year old female, suffered a brain aneurysm and stroke and was rushed to hospital. She had surgery to insert a shunt but unfortunately went into a coma and died four days after the aneurysm. She only had permanent disability and critical illness cover, without death cover.
Below grid compares the amount of cover she could have bought for a similar premium with other insurers as well as the payout upon the event.
Why did Brightrock pay the claim?
- They paid the full amount because the health event did not have a survival period clause.
- The health event qualified as a permanent disability as well as a critical illness claim, thus her death had no bearing on the claim.
- If she had death cover, her beneficiaries would have received the death benefit as well.
- The Brightrock benefits are all stand-alone thus a claim on the one benefit does reduce the cover on another benefit.
Why did Brightrock pay out so much:
- Due to Brightrock not having restrictive waiting periods on their benefit payout outs, her condition qualified for an immediate payout for both disability and critical illness.
- The reason for the higher disability cover is that Brightrock bases its cover on a monthly income but offers the client the option to take an equivalent lump sum.
Conclusion:
The grid indicated that a number of Brightrock competitors would not have paid this claim on one or both of their benefits as they still have survival periods on either their disability or their critical illness cover, or both. None of them would have paid out as much as BrightRock under lump-sum disability cover. One competitor would not allow disability cover without having death cover in place.
For peace of mind contact Innov8ions on 0114761016 or natasha@innov8fs.co.za for obligation free review of your current cover.