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Five top tips for successful claims

Posted  May 4, 2018

Want to get your or your family’s claim paid quickly with as little fuss or delay as possible? Follow our five top tips for a successful claim.

1. Know your policyRead and understand the details of your policy so that there are no surprises – or delays - in store when you claim.

Type of cover
Familiarise yourself with the type of cover you have – life cover, funeral cover, dread disease, income protection or disability; and any additional benefits. Know what is covered by your policy and when a benefit can be claimed.

Waiting periods
Your policy may have a waiting period during which a claim will not be paid. Funeral policies have a 6-month waiting period for death due to natural causes and life policies have a 2-year waiting period on death due to suicide. Read your policy document to find out which waiting periods apply.

Policy conditions
Know when your policy does not offer cover and when a claim would be rejected. If you are injured while committing a criminal act for example, or have an accident while under the influence of alcohol, your claim would be rejected.

Claim time limits
Claims need to be submitted within certain time limits – 6 months for life claims and 3 months for dread disease and disability claims. Claims outside these time limits will not be paid.

For full policy terms and conditions, refer to the 1Life Pure Life Cover and 1Life Funeral Cover  policy books.

2. Pay premiums when they are dueOne of the most common reasons claims are rejected is because the policy has been cancelled due to unpaid premiums. You can avoid this by:

  • Paying the premium when it is due
  • Asking a responsible person to pay the premium if you are ill or in an accident and cannot make payment yourself

3. Keep your policy up to date

  • Update your personal details when a major life event happens: Let us know if you move, marry, divorce, or have children as these can affect your insurance needs and beneficiaries. We’ll also need your new contact details if these change.
  • Ensure continuity of cover: Changing jobs, leaving the country, smoking or starting a dangerous hobby can affect your cover and premium. Tell us when these happen, as we may need to reassess your risk. Not keeping us informed of changes such as a change of occupation can result in your policy becoming invalid or a claim being rejected or reduced.
  • Update your beneficiary details: Make sure we have the full name, ID number and contact details of your beneficiaries. If a beneficiary is a minor, include their guardian’s details with your policy.

Click here for more information on keeping your 1Life policy up to date.

4. Full disclosure at underwriting phase Say you have a long history of heart disease, knew about this and were on medication when you applied for insurance, but didn’t tell your insurer. If you have a heart attack and claim for it, your claim will be rejected.

Give us full details of any illnesses you have, medication you are taking and serious conditions that run in your family when you go through underwriting.

Deliberate or not, non-disclosure is a serious matter and will result in a claim being rejected.

5. Have an insurance hour with your family Keep your policy documents, Claims Instruction Sheets and will together in a safe place so that you and your beneficiaries can find your policies quickly in an emergency.

Once a year, have an insurance hour with your family and talk to them about your policies.

  • Tell them what policies you have and what they cover, for example death or disability.
  • Go through premium details – the premium amount, when payment is due and how you pay.
  • Talk them through the Claims Instruction Sheets so they know how to claim.

We want your claims experience to be a good one. If you are familiar with your cover, have given us all the necessary information and kept your policy and premiums up to date, your claim can be paid quickly and used for its intended purpose.

Important insurance contact details0860 10 51 96 - 1Life claims.
You can email us with complaints and compliments.
0860 103 236 - the Ombudsman for Long-Term Insurance who you can contact if you feel your claim was unfairly rejected.

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