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Know your life policy: accidental death vs elevated cover

Posted  February 9, 2019

Your 1Life life policy offers great benefits and will make sure your family is provided for if you are no longer around. Do accidental death benefit policies offer the same cover? We take a look.

Your 1Life life cover policy means that you can provide for your loved ones when you are no longer around. Life cover pays out the sum assured (the amount you are insured for) to the beneficiaries if the life assured (the person who is insured) dies in an accident or from natural causes.

Most of our clients qualify for life cover, and 1Life has paid out millions in claims to policy beneficiaries. However, there are two circumstances when you may not qualify for life cover and will be offered accidental death benefit cover instead. This is similar to life cover in that it pays a claim on the death of the life assured, but different because it will only pay a claim if the cause of death is an accident. This is why life cover is sometimes called elevated life cover – it pays out in more circumstances than accidental death cover.

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Now that we know the difference between the two – when does 1Life offer only accidental death benefit? There are two reasons:

1. The HIV test is not completed in the first three months of the policyA requirement of all our life cover policies is that the life assured take an HIV test in the first three months of taking up the policy. There are many places where you can take this test and it is easy and quick. If you don’t take an HIV test, we unfortunately cannot offer elevated life cover and the policy will change to an accidental death benefit policy. The premium is cheaper, but you are not covered as comprehensively as life cover, so it really is important to take your HIV test when you take out your policy.

2. You don’t qualify for elevated life coverIt may happen that a person applying for life cover is seriously ill. Their life cover premiums would therefore be unaffordable so we may offer accidental death benefits instead and adjust the premiums accordingly. Accidental death cover might not offer your family as much protection as life cover, but it does offer some benefits and as the saying goes - some cover is better than none.

In the table below, we show some of the causes of death and whether or not they are covered by accidental death benefit policies. Keep in mind that these are general answers and that we assess each claim individually to make sure we pay every valid claim.

Cause of death

Death claim covered by accidental death benefit

Death claim covered by life cover

Traffic accident

Yes

Yes

Violence such as gunshot or stabbing

Yes

Yes

Pneumonia or other respiratory illness such as the flu

No

Yes

Tuberculosis

No

Yes

Heart attack, diabetes, or other chronic illness

No

Yes

Cancer or other terminal illness

No

Yes

Alzheimers or other dementia illness

No

Yes

Suicide

No

Yes, if policy has been in force for more than two years

Complications in surgery while under anaesthesia

Yes

Yes

Terminal illness benefit – the policy pays out the sum assured if the life assured is diagnosed with a terminal illness and has less than 12 months to live

No

Yes


Note:
Some policies include certain exclusions. An exclusion on a policy means that if something happens as a result of an excluded event a claim won't be paid. For example, you may have life cover with an exclusion for heart attacks, which would mean that if death was caused by a heart attack the claim would not be paid. Your policy schedule will have details of any exclusions and special conditions.

If you took out a life policy and haven’t taken your HIV test you may only have cover for accidental death. You can call us on 0860 67 06 70 or email hivtests@1life.co.za to check this and we’ll let you know where to go for your test so you can qualify for elevated life cover. It is really important to go for your HIV test so your family can have as much protection as possible – so take your test as soon as you can.

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