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Your life cover policy schedule – what you need to know

Posted  March 7, 2017

Understanding your policy schedule will ensure that claims are paid out in full and without delay.

Insurance is a legal contract between an insurance company and a person who wishes to cover some future risk. The client pays a monthly premium, and the insurer pays out a fixed amount on valid death, dread disease or disability claims of the Life Assured, as stipulated in the contract.

The proposal form that you fill in when you take out insurance is the basis of the contract, so it is vital that all the information you give is correct. You also need to check the details from time to time and update as required.

The policy schedule outlines all the important information about your specific policy. Understanding your policy schedule, and ensuring that all the information is correct, will ensure that any claim is paid out without delay. Here’s what is in your policy schedule, and what you need to look out for.

Policyholder detailsThis section lists the contact details and ID number of the policyholder. The policyholder is the person that purchases and owns the insurance policy or contract. In most cases the policyholder is the person who is insured by the contract (the life assured) but this is not always the case. For example, a spouse might choose to insure the life of his or her partner.

Top tip: The policyholder is the only person who can make changes to a policy, for example change the names of the policy beneficiaries or increase the cover amount. As the policyholder, you are obliged to ensure that premiums are paid monthly as well as inform 1Life of any changes relevant to the policy.

Life assured detailsThe life assured is the person who is insured for life, dread disease or disability. This section lists their personal and contact details, including their monthly income, occupation, height & weight. It is important that these details are correct as any errors or omission might result in reduced or rejected claims.

Top tip: Make sure you know your BMI details (height and weight) as this has an impact on your premium.

Payment detailsYour schedule contains the following details: premium amount, date of payment and your bank details. Your payment of the premium listed in the policy is what keeps you covered. If you miss a regular payment, your policy will be suspended. If you continue to miss premium payments, the contract you have with your insurer, will be terminated.

It is strongly recommended that you set up a debit order. This will ensure that you never miss a payment date, even if you are incapacitated and therefore unable to personally ensure payment is made.

Top tip: If your monthly premium debit order has bounced, you can simply pay it at retail stores, using a Pay@ reference number which will be supplied to you by 1Life via either email or SMS.

Don’t forget to inform your insurer if your bank details change.

Policy benefit & additional benefit tableDetailed here are the cover amounts you agreed to take out, in line with what products you chose as well as the benefits that are associated with the relevant cover you have chosen, such as a 3-month deferment period from date of disability, which is applicable had you taken out Occupation-based Disability cover. It is important to familiarise yourself with waiting periods and any premium escalations. You can also find your premium listed as well as the administration fee applicable.

Top tip: Under the additional benefits table it is important to note the additional benefits that are included in your policy, such as a R50 000 pay now funeral benefit. It is also important to note that you are required to go for your HIV test within the specified time frame to ensure your family’s future financial security.

General exclusions

It’s important to know what you’re covered for, but just as important to know what you’re not covered for.

It’s important to know what you are covered for, but it’s just as important to know what you are not covered for. Familiarise yourself with the general exclusions listed in the 1Life Policy Book.

In addition to general exclusions, the questions you answer relating to your lifestyle and medical history will determine any other risks the insurer will exclude here. For instance, if you have a heart condition then that risk will be excluded but you may still be covered for everything else.

Note: If you have a life cover policy and it only covers accidental death, then all other types of death are effectively excluded. It is very important that you - and your beneficiaries – are aware of the limited cover and know what you are not covered for.

Beneficiary details (1Life Pure Life Cover Only)The beneficiary is the person who will be paid the benefit in the event of your death. It is essential that the beneficiary is correctly and clearly identified; otherwise your benefit will go into your estate and be administered by the state, potentially delaying pay-out to your beneficiary.

Check your beneficiary’s name and contact details are correct, and update them if necessary. Review your beneficiaries from time to time, particularly if circumstances have changed, for instance you get divorced, or a family member passes on.

Underwriting declarationThis section lists the answers you have given to questions about your or the life assured’s health, family history and insurance history. It is vital that all underwriting questions have been answered correctly, because that information will be closely examined at the time of claim.

The bottom lineThe policy schedule contains all the important details about your contract. It is essential that they are correct. Understanding the contract and its conditions will ensure that you are covered as you intended, and that you or your beneficiaries are paid out without delay in the event of a claim.

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