The Permanent Disability Benefit Explained

The Accident Permanent Disability benefit offers up to R250,000 cover for specific permanent disabilities incurred as a result of an accident. It pays out cash less medical expenses incurred.

The benefit is available once per policy lifetime. This means that the total amount available on your chosen benefit level can be used once and, when used up, does not reinstate.

Claims are usually paid from the Accident Hospitalisation benefit first, which makes sense as the events must be accident related. If the accident results in a permanent disability then the costs already covered are transferred to the Disability benefit. This is what is meant by "less medical expenses incurred".

You have up to 24 months after an accident event to claim.

The benefit includes cover for the permanent and total loss of :

• speech
  
• hearing in both ears
  
• sight in one or both eyes
  
• an arm at or above the wrist
  
• a leg at or above the ankle
  

as a result of an accident.

There is no waiting period for the Main Member of a policy. Your cover will be available immediately when your policy is active.

On Level 3, cover is extended to the Adult Dependant (spouse) of a policy. The spouse will have a 6 month waiting period applied.

To quote the policy wording:

• "A sudden, unforeseen, unusual and unexpected specific event" - an accident
  
• "which is unintended" - you didn't mean it to happen and it was not self-inflicted
• "arises from a source external to the insured" - it was something else that affected you, like a car or a spider
• "which is independent of illness, disease or other bodily malfunction" - illnesses are not accidents
• "occurs at an identifiable time and place" - you can pinpoint what it was and when it happened

The definition above helps because it is not only car accidents that apply but also falling, getting bitten by a dog, malaria or other accidental events. But getting cancer is not an accident, even though it was not intended.