Cash back of 10x daily benefit amount.

Details

  • This is a solution designed to assist clients with filling income gaps created by long stays in hospital.
  • It pays out a daily cash benefit on hospitalisation of the covered member.
  • No restriction on anyone who qualifies.
  • Minimum age at entry - 18.
  • Maximum age at entry - 62.
  • Termination age - 65.

Features

  • Minimum total premium of P80.
  • Minimum term = One Year.
  • Maximum term = Number of years remaining to age 65.
  • Plan covers spouse and up to six nominated children between the ages 1 - 21 years.
  • Children in full education, at a recognized institution are covered to the age of 25years.
  • Hospital income.
  • Mentally retarded as well as permanently disabled children can be covered under this plan irrespective of their age.
  • Policy term is determined by the client.
  • There are 4 different Solution options (bronze, silver, gold, and platinum) with differing levels of premiums and cover.
  • Not Taken-up Cancellations/ Free Look period: 3 months.

Benefits

  • Ideal whether you have medical aid or not.
  • Daily Benefit Amount paid every day (24 hours) of Hospitalization.
  • Loyalty bonus (cash back) payable every 3 years equal to 10 times the daily benefit amount.
  • No-claims bonus payable every 3 years equal to 10 times the daily benefit amount.
  • Hospitalisation is not limited to Botswana.
  • Hospitalisation as a result of an accident will qualify for benefits from the first day.
  • The waiting period and pre-authorization requirement are waived for emergency procedures.
  • Benefits will double if one is in ICU.
  • The benefit is paid directly to the policyholder or his/her legal representative and is paid in addition to any other insurance or aid benefit the policyholder may have.
  • Optional Death Premium waiver @ 5% of the monthly premium amount. If the client elects for this premium waiver, his/her premiums would be increased by 5%. This means that the policyholder's family will continue to be covered with no further premiums being due if the policyholder passes away before termination of the policy.

Limitations

  • Waiting period of 3 months before a policyholder and dependant are able to claim non accidental related benefits.
  • 12 month waiting period for maternity related procedures.
  • Hospitalisation arising from illness will have a waiting period 1 day and then qualify for benefits from the first day.
  • Hospitalisation for the same condition, not separated by at least 366 days, is regarded as continuous.
  • Satisfactory proof of hospitalisation has to be submitted.
  • There is a 90-day cooling off period. The full premium will be refunded provided no benefits have been claimed.

Exclusions

  • All procedures which are purely for cosmetic surgery.
  • Pregnancy or confinement within one year of commencement.
  • Any illness of injury sustained while the person assured is resident overseas for longer than three consecutive months.
  • Illness or injury sustained during participation in a wilful and material violation of the law.
  • Illness of injury sustained during a wilful participation in war, terrorist activity, civil commotion, rebellion or insurrection.
  • Any medical condition for which treatment was received or recommended by a medical practitioner within the last 12 months or for which the nominated person assured was aware of during the last 12 months prior to the issue date of the policy.

Premium Rates & Cover Levels

BWP
MEMBER ONLY MEMBER & SPOUSE MEMBER & CHILDREN MEMBER,CHILDREN & SPOUSE BENEFIT/DAY Loyalty/no claims bonus
80 95 100 120 50 500
133 140 147 153 100 1000
163 173 185 195 150 1500
190 200 220 230 200 2000

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