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One of the most important policy terms and conditions is that you pay your premium every month. If you miss a payment and your debit order doesn’t go off, any claim may be delayed, reduced or declined. We take a look at your options when your debit order bounces and what to do to make sure your claim is paid quickly.
If premiums are paid every month, valid claims will be paid
Pay your premiums every month on the due date and your policy remains in force and you can claim for specified events. 1Life aims to pay all valid claims as quickly as possible. For valid funeral cover claims, we aim to pay within 48 business hours, once all the documentation is received.
How do claims work when premiums are not paid?
A valid claim is when all the policy terms and conditions have been met. If there is an outstanding premium, the policy conditions have not been met. Does this mean the claim will be automatically declined? No, there are options depending on the circumstances:
The pay-out might be delayed
As the circumstances need to be investigated and premium payment information confirmed, a claim for a policy where premiums have been missed might be delayed.
The claim pay-out might be reduced
If there is a premium outstanding, a claim may be paid, but the pay-out may be reduced.
If a debit order is returned unpaid, remains unpaid and a claim is submitted, the likely outcome is that the claim pay-out will be reduced by the amount outstanding and any admin charges.
The claim might be declined
If more than one premium is outstanding, the policy may lapse or benefits may be suspended. Lapsed policies have no benefits, so you cannot claim on them. This is the same for suspended policies. It’s a tough situation to be in. However, we are unable to pay claims where premiums are not up to date.
There is a grace period of 31 days during which you can make up unpaid premiums. This blog has more details on how to make up missed premium payments. If payments have been made within the grace period, valid claims will be paid, and the outstanding premiums deducted.
Top tip: If more than one premium payment is missed and your policy lapses, you may have an option to reinstate your policy. Our 1Life consultants can assist you with any reinstatement queries and requests.
Can you dispute a reduced or declined claim?
Yes. 1Life Insurance has an approved claims dispute process.
You can lodge a dispute within 90 days from the decision on the claim with 1Life Insurance (tell us you are unhappy and why). You can email us on [email protected]. We will respond to you within 10 days of receiving the dispute. If you are unhappy with our response, you can lodge a query with the National Financial Ombud Scheme South Africa within 6 months of our response to your dispute.
How to prevent unpaid premiums
You can avoid unpaid premiums and declined or delayed claims if you:
- Make sure you have sufficient funds in your account for the debit order.
- Select a convenient debit order date, such as the day your salary is paid or the day after.
- Check that we have the correct banking details for your premium payment and update these if they change.
- DebiCheck your debit order. DebiCheck is a secure process that specifies the amount and the date your bank account will be debited, in this case by 1Life Insurance as part of your agreement or contract with us. DebiCheck debit orders are less likely to be returned as they are given priority and deducted from bank accounts before unverified debit orders. You can contact a skilled 1Life Insurance consultant for assistance with DebiCheck.
- Speak to us if you are struggling to pay your premiums. One of our consultants can explore options to keep some cover at an affordable monthly premium. Your financial adviser can also assist. Be sure to let us know as soon as you can that you are struggling to pay premiums. Wait too long and your policy may lapse and all benefits may be cancelled.
Pay premiums and valid claims will be paid
The financial stability and security of you and your loved ones depend on making premium payments. To make sure that a policy pay-out can change their lives, keep paying premiums when due.