Taking the pain out of medicals

TSA Administration | Medical underwriting
Medical underwriting can be a terminology minefield, and keeping up-to-date with all of the changes can feel like you’re navigating this minefield with a blindfold on…

Sanlam has recently made changes to the manner in which they ‘forward underwrite’, so we thought this would be a great opportunity to explain how each insurer currently approaches the task of medical underwriting…

Old Mutual

Old Mutual underwrites with forward underwriting to double the potential cover at the time of underwriting. Medicals are only required again when the member exceeds this amount, or after five years – whichever comes first. Old Mutual does not impose loadings. If a member is not accepted, they will be restricted to the proof free limit, or declined cover where none exists. They may also add exclusions.

Hollard

Hollard also underwrites with forward underwriting to double the potential cover at the time of underwriting. Medicals are required again when the member exceeds this amount, after five years, or if a member’s salary increases by more than 20% in any one year – whichever comes first. Hollard does not impose loadings. If a member is not accepted, they will be restricted to the proof free limit, or declined cover where none exists. They may also add exclusions.

Capital Alliance

Capital Alliance underwrites with forward underwriting to double the potential cover at the time of underwriting. Medicals are only required again when the member exceeds this amount, or after five years – whichever comes first. Capital Alliance does not impose loadings. If a member is not accepted, they will be restricted to the proof free limit, or declined cover where none exists. They may also add exclusions.

Sanlam

Sanlam underwrites with forward underwriting to double the potential cover at the time of underwriting with minimum and maximum amounts of R3m and R24m for GLA, and a minimum of R17,000 and maximum of R130,000 per month of PHI, including waiver amounts. Medicals are only required again when the member exceeds this amount, or after five years (extended to the age of 40 if the member is younger than 35 at the time of underwriting) – whichever comes first. Sanlam does still impose loadings, so if a member is not accepted, they will be loaded, restricted to the proof free limit, or declined cover where none exists. They may also add exclusions.

Sanlam members already accepted before 01/08/2008:

Will have forward underwriting up to R36 million for GLA with no time period attached, up to R100,000 per month for PHI with no time period attached. That is if the current cover including the waiver is less than R90,000 and up to R130,000 per month, or a five year period from 1 May 2011 if the current cover including the waiver is more than R90,000.

Sanlam members already accepted after 01/08/2008:

Will have forward underwriting up to R24 million for GLA with no time period attached, and up to R130,000 per month for PHI, or a five year period from 1 May 2011 – for those with cover of less than R100,000 per month, and a five year period from the time of underwriting for those with cover of more than R100,000 per month.

TSA team at your service

Don’t worry if this is a mouthful to you – the medicals team (Santrica, Meena and Vinolia) will gladly assist, and your consultant, or Shanalie and Greg, is always on hand to help you and your clients through the world of medical underwriting.

Medical underwriting remains one of the most labour-intensive parts of group risk cover. Working through TSA however, ensures that you have a team dedicated to proactively following up with your clients to gently request and remind members until they have completed their medicals and received an underwriting decision for their insurer and beyond.

From acceptances and exclusions to loadings – TSA’s medicals team will be there to process a case up until the client is satisfied.

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