Glossary
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A
Activities of Daily Living: The Activities of Daily Living (ADLs) is an internationally used scoring system that assesses the functional ability of a person in total. It takes into account the physical, social and interactive abilities of a person and includes activities such as bathing, preparing and eating meals, getting dressed, etc.
Aggregate limit: Refers to liability insurance and indicates the amount of cover the life assured has under the policy for the contract period.
Annuity: An agreement by an insurer to make periodic payments to a recipient for a specified period.
B
Benefit payment: Any amount of money paid to the policyholder (or as instructed by the policyholder) as a result of a policyholder claiming against their LIFE FUND for a life-changing event.
C
Capital Disability Benefit: Pays a lump sum amount if any assured lives are medically impaired the to the extent that their disability satisfies the criteria as set out in Appendix 2 of the LIFE PLAN Guide.
Case management: This is the coordination of medical services to treat a patient or claimant to improve care and reduce cost.
Case manager: A case manager is responsible for coordinating the delivery of medical services to patients or claimants and their families.
Child: A child is defined as an unmarried person who is financially dependent on the life assured/policyholder and is described as:
- a child under the age of 21 years, born of the policyholder/life assured
- a dependent stepchild of the policyholder/life assured, under the age of 21 years;
- a foster child of the policyholder/life assured, under the age of 21 years;
- a child under the age of 21 years, legally adopted by the policyholder/life assured;
- a stillborn child (death of the foetus after the 26th week of pregnancy) born to the policyholder/life assured.
- a grandchild being a child of the policyholder’s children, where both the child’s parents are deceased or the child is dependent on the policyholder/life assured.
Child Severe Illness Benefit: This benefit provides cover if the child of a policyholder/life assured contracts a severe illness.
Claim: This is the actual application for the benefit payout by the policyholder or beneficiary.
Commission: This is the fee paid to an intermediary or insurance salesperson as a percentage of the policy premium.
Contribution Protector™: Pays the policyholder’s contributions for the Individual LIFE PLAN, Discovery retirement Optimiser™, Discovery Health Plan, DiscoveryCard Protector, Health Plan Protector, and Vitality.
D
Dynamic Spend Protector™: Discounts at partner stores are provided to a policyholder that becomes permanently disabled.
E
Escalation in claim benefit: This benefit allows income payments to policyholders to increase annually in line with inflation.
Exclusions: Exclusions are conditions not covered by the insurance contract.
F
Financial adviser: A financial adviser is a professional who gives investment advice and financial planning services to individuals and businesses.
G
Global Education Protector: Provides cover for the education of a policyholder’s child or children in the event of his or her death, disability or severe illness.
Global Treatment Benefit: The policyholder will receive up to 180% of the severe illness benefit if he or she chooses to have treatment for his or her severe illness in one of the centres of excellence (in the USA) offered by Discovery Life.
H
Hazardous activity: A hazardous activity is generally excluded or the premium is increased on standard insurance policies. The activities include bungee jumping, scuba diving and sky diving among others.
Health Dividends™: This is an annual amount paid to the policyholder by the Health Plan Protector and is calculated on a percentage of his or her “unused” health contributions.
I
IMPAIRMENT FUND: If the Severe Illness Benefit is selected as a standalone benefit, the IMPAIRMENT FUND becomes the financial mechanism of the LIFE PLAN and is used to fund severe illness payouts.
Income Continuation Benefit: A regular income is paid if the policyholder experiences a loss of income upon injury or illness rendering him or her incapable of performing his or her nominated occupation.
Indemnity: This is the restoration of the policyholder to his or her financial position just before the life-changing event occurred.
L
Life assurance: An insurance policy that, in return for the payment of regular premiums, pays a lump sum on the death of the insured.
Life-changing event: This is could be death or a disability or severe illness that is severe enough to affect your lifestyle or your ability to earn an income and so lowers your standard of living.
Life Cover Benefit: This benefit pays out on the death of the policyholder.
LIFE FUND: The LIFE FUND is the financial foundation of the LIFE PLAN. The LIFE FUND is used to fund benefit payments for the benefits selected by the policyholder.
M
Medical Premium Waiver: This benefit ensures that our policyholders’ contribution towards their Discovery Health Plan continues if they suffer a life-changing event.
N
New life-changing event: A subsequent claim may occur which is not regarded as a progression of previous claims. In this case, the benefit payment for the subsequent claim will be treated independently of any previous claims. The benefit payment will be based on the full severity level of the subsequent claim.
P
Policy: This is the written contract of insurance. It includes all clauses, riders, endorsements and papers that make up the contract.
Premium: This is the monthly amount charged by the insurance company for the LIFE PLAN.
Progressive illnesses: At the time of the first claim, Discovery Life will evaluate the severity of the illness according to the severity rating scale. If the illness becomes more severe at a later date, Discovery Life will reassess the severity rating and pay the difference in severity level between the subsequent claim and the previous claim.
R
Risk class: This is a group of policyholders with a similar level of risk. For example, smokers may be grouped together. Age could also be used to separate out groups of policyholders.
S
Severe illness: An illness or disorder that significantly affects a person’s lifestyle.
Severe Illness Benefit: The Severe Illness Benefit provides a lump sum payment to the policyholder and covers all major physiological and anatomical systems.
Spouse: A spouse is defined as the person that the policyholder is legally married to and includes:
- a party to customary union according to Black law, or
- a union recognised as a marriage under the tenets of any Asiatic religion, or
- a person living with the policyholder in the manner of a spouse, living in a relationship of mutual dependence with the policyholder, and running or sharing a common household with the policyholder, or
- a person regarded by the policyholder as a common law spouse
U
Underwriting: This is the process of selecting risks for insurance and classifying them according to their degrees of insurability so that appropriate premium rates may be applied.
V
Vitality: Vitality is a wellness programme that empowers policyholders to improve their health by giving them the knowledge, tools and motivation to set and meet health goals.
W
Waiver of premium: Some insurance contracts have a provision in place which allows the insurance company to waiver the collection of premiums while keeping the policy in force if the policyholder becomes unable to work because of an accident or injury.
Waiting period: A certain period of time that passes after a life-changing event before a policyholder can receive insurance benefits.
100% Upgrade on permanent disability: If a policyholder meets Discovery Life’s Category A or D criteria for the Capital Disability Benefit, monthly payments will be increased from a maximum of 75% of income on temporary disability to 100% of income on permanent disability.
