why? this is how GREENLIGHT sees it
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1 EARNING ABILITY LUMP SUM EARNING ABILITY COVER OCCUPATIONAL DISABILITY (OWN) BENEFIT OCCUPATIONAL DISABILITY BENEFIT DAILY TASKS BENEFIT why? When clients become disabled and can no longer work, they need: Cover that will provide a lump sum for initial adjustments in lifestyle and also be managed by the client to replace lost future income. how GREENLIGHT Occupational Disability (Own) Benefit Provides cover against the Life Covered becoming disabled such that he is permanently unable to carry out the material and substantial duties of his own occupation. GREENLIGHT Occupational Disability Benefit Provides cover against the Life Covered becoming disabled such that he is permanently unable to carry out an occupation that he can reasonably be expected to follow. The reasonability of an occupation will be influenced by the Life Covered s education, training, experience and employment history. GREENLIGHT Daily Tasks Benefit This benefit provides the Life Covered with cover should he be permanently unable to perform normal daily activities as measured in our Daily Tasks Test. A benefit payout will be made to the Life Covered if he permanently scores 6 points or more on the Daily Tasks Test. this is how GREENLIGHT sees it As soon as your contract has been issued, you are covered and will be paid 100% when you claim, no matter how severe the condition. Cover is provided to a wide range of occupations, and if you do not qualify for Occupational Disability Cover (e.g. students, home executives and professional sportspeople) you can be covered under the Daily Tasks Benefit. Some great features offered are: Clear definitions and language. Providing certainty the simplest and least number of exclusions in the market! A choice of full or tapered cover to age 65 next birthday. A generous tapering method leaves 41% cover at age 64 next birthday. A proven claims payout record.
2 LUMP SUM EARNING ABILITY COVER Clear definitions and language At Old Mutual, what we call our benefits is the protection our clients can expect from the GREENLIGHT benefits. For example, all benefits in the Earning Ability Cover category are aggregated at claims stage. Because Physical Impairment Benefits are not defined by occupation, they will not be aggregated and do not form part of the Earning Ability Cover category. Our own occupation definition is clear. Our Daily Tasks Test is explicit and transparent, thereby increasing certainty of the event for which cover will be paid out. The tests are a SIMPLE measure of functional impairment. While these tests are not illness or impairment related, a physical impairment could lead to an inability to perform these tasks as well hence these benefits do indirectly protect the Life Covered against some physical impairments as well. Providing certainty the simplest and least number of exclusions in the market! Do insurers use exclusions as a means to decline claims? Old Mutual does NOT. See our proven disability claims payouts for back and psychiatric conditions, accounting for more than 50% of Old Mutual s disability payouts: Exclusions NOT applying to GREENLIGHT as standard practice: - Back and psychiatric conditions. - Intentional intake of alcohol, drugs, or inhalation of fumes. - Any undisclosed risky activities. Note that the wording of the exclusion relating to violation of criminal law by the Life Covered has been simplified and made as specific as possible. Choice of full or tapered cover to age 65 next birthday Choose to have cover remain in place in full to cease age, or choose to have it reduce from age 60 next birthday as future earnings reduces. Generous tapering method leaves 41% cover at age 64 next birthday Full cover is given to clients younger than age 60 next birthday. At ages close to retirement, the potential for clients to be over-insured increases as their earning ability time span shortens. From age 61 next birthday, when GREENLIGHT will start applying tapering, GREENLIGHT DOES NOT use the ORIGINAL Cover Amount to taper, BUT the amount of cover remaining after each tapering event is used hence there is more cover remaining throughout the period to retirement Age next birthday Competitor tapering GREENLIGHT tapering GREENLIGHT full cover % 100% 100% 61 80% 80% 100% 62 60% 64% 100% 63 40% 51% 100% 64 20% 41% 100% OMMS T1266
3 COMPREHENSIVE LUMP SUM COVER COMPREHENSIVE DISABILITY (OWN) BENEFIT COMPREHENSIVE DISABILITY BENEFIT why? When clients become disabled or impaired and can no longer work, they need: Cover that will provide a lump sum that will pay for initial adjustments in lifestyle and also be managed by the client to replace lost future income. Cover that will comprehensively protect the client against functional and occupational disability. how GREENLIGHT Comprehensive Disability (Own) Benefit This benefit combines the Daily Tasks Benefit with the Occupational Disability (Own) Benefit. The Occupational Disability (Own) Benefit provides cover against the Life Covered becoming disabled such that he is permanently unable to carry out the material and substantial duties of his own occupation AND provides the Life Covered with cover should he be permanently unable to perform normal daily activities as measured in our Daily Tasks Test. GREENLIGHT Comprehensive Disability Benefit This benefit combines the Daily Tasks Benefit with the Occupational Disability Benefit. Provides cover against the Life Covered becoming disabled such that he is permanently unable to carry out an occupation that he can reasonably be expected to do AND provides the Life Covered with cover should he be permanently unable to perform normal daily activities as measured in our Daily Tasks Test. The reasonability of an occupation will be influenced by the Life Covered s education, training experience and employment history. this is how GREENLIGHT sees it As soon as your contract has been issued, you are covered and will be paid 100% when you claim, no matter how severe the condition. Some of the other great features are: Top of the range all-in-one earning ability protection. Clear and simple definitions and language. Providing certainty the simplest and least number of exclusions in the market! A choice of full or tapered cover to age 65 next birthday. A generous tapering method leaves 41% cover at age 64 next birthday. A proven claims payout record. Top of the range all-in-one earning ability protection These benefits are a combination of the Occupational Disability Benefits and the Daily Tasks Benefit. This provides cover against being occupationally or functionally disabled. The Daily Tasks Benefit offers proxy cover against not being able to work. NOTE: Physical impairment could initially lead to an inability to perform these tasks as well hence these benefits do indirectly protect the Life Covered against some physical impairment as well. The claim subjectivity is lessened due to the explicit tests required under our Daily Tasks Test.
4 COMPREHENSIVE LUMP SUM COVER Clear definitions and language GREENLIGHT benefits are simply and clearly named; and our clients can expect the benefits to give them the protection that they describe. For example, all benefits in the Earning Ability Cover category are aggregated at claims stage. Because Physical Impairment Benefits are not defined by occupation, they will not be aggregated and do not form part of the Earning Ability Cover category. The occupational disability definitions are simple and clear. The Daily Tasks Test is explicit and transparent, thereby increasing certainty of when cover will be paid out. A benefit payout will be made to the Life Covered if he permanently scores 6 points or more on the Daily Tasks Test. The Daily Tasks Test is a SIMPLE measure of functional impairment. While this test may not be illness or impairment related, a physical impairment could lead to an inability to perform these tasks as well hence these benefits do indirectly protect the Life Covered against some physical impairments as well. Providing certainty the simplest and least number of exclusions in the market! Do insurers use exclusions as a means to decline claims? Old Mutual does NOT. See our proven disability claims payouts for back and psychiatric conditions, accounting for more than 50% of Old Mutual s disability payouts: Exclusions NOT applying to GREENLIGHT as standard practice: - Back and psychiatric conditions. - Intentional intake of alcohol, drugs, or inhalation of fumes. - Any undisclosed risky activities. The wording for the following exclusion has been CHANGED: - Violation of criminal law by the Life Covered has been simplified and made as specific as possible. Choice of full or tapered cover to age 65 next birthday Choose to have cover remain in place in full to cease age, or choose to have it reduce from age 60 next birthday as future earnings reduces. Age next birthday Competitor tapering GREENLIGHT tapering GREENLIGHT full cover % 100% 100% 61 80% 80% 100% 62 60% 64% 100% 63 40% 51% 100% 64 20% 41% 100% Generous tapering method leaves 41% cover at age 64 next birthday Full cover is given to clients younger than age 60 next birthday. At ages close to retirement, the potential for clients to be over-insured increases as their earning ability time span shortens. From age 61 next birthday, when GREENLIGHT will start applying tapering, GREENLIGHT DOES NOT use the ORIGINAL Cover Amount to taper, BUT the amount of cover remaining after each tapering event is used hence there is more cover remaining OMMS T1266
5 LONG TERM INCOME COVER OCCUPATIONAL DISABILITY (OWN) INCOME BENEFIT DAILY TASKS INCOME BENEFIT why? When clients become disabled and can no longer work, they need: Cover that can directly replace their lost income. True income protection covering full, partial, permanent and temporary income loss. how GREENLIGHT Occupational Disability (Own) Income Benefit This benefit pays out a monthly income if the Life Covered becomes totally or partially unable (due to illness or injury), to perform the material and substantial duties of his own occupation. GREENLIGHT Daily Tasks Income Benefit This benefit provides the Life Covered with cover should he be unable to perform normal daily activities as measured in our Daily Tasks Test. A benefit payout will be made to the Life Covered if he scores 6 points or more on the Daily Tasks Test. this is how GREENLIGHT sees it If you become partially disabled and lose for instance 50% of your income, you can fully replace the income that was lost. The benefit payment will cease on recovery of the disability or functional impairment, but the benefit will still continue. We will pay your premiums for the duration of your disability or functional impairment. Clear definitions make our Earning Ability benefits real easy to understand! Our Daily Tasks Test (as per insert) is transparent, and provide clarity on when you qualify for a claim. GREENLIGHT also allows the selfemployed, home executives and students cover under the Daily Tasks Benefit. Other great features are: Generous cover that meets real needs. Claims in payment keep up with purchasing power. Tax deductible premiums. A choice of waiting periods tailored to suit need and affordability.
6 LONG TERM INCOME COVER Generous cover that meets real needs The cover guidelines set out by Old Mutual are designed to prevent over-insurance, but at the same time to afford our clients the protection they really need. The GREENLIGHT definition of earnings is realistic: Gross annual income is defined as the regular salary or earnings derived from the Life Covered s occupation. It includes commission earnings and remuneration in the form of dividends, but excludes investment income. The cost of any other guaranteed benefits paid for by the Life Covered s Employer may also be included such as the employer s contribution to Retirement Funding and Insured Benefits, and the employer s contribution to Medical Aid Benefits. Aggregation applies to Earning Ability Benefits only. At new business stage we will consider a benefit relative to earnings of: - 90% up to age 30-85% up to age 35-75% over age 35 At claim stage we will not reduce cover unless a client is over 90% of pre-disability earnings. Additional amounts can be motivated at new business stage, and excluded from calculation at time of claim. Short-term disability products (max payment of 24 months) are not aggregated with lump sum benefits. Disclosure and regular review of a client s portfolio is the best way of avoiding benefit reduction at claim stage. Claims in payment keep up with purchasing power Cover on all income benefits can be increased each year using Scheduled Annual Cover Increases (SACI). The SACI rate at the time of disability will be applied while an income benefit is being paid. Adding SACI means that clients disability income payments increase each year at the SACI rate, helping clients keep pace with inflation. In addition, unscheduled cover increases are available on Occupational Disability (Own) Income Benefit. These additional unscheduled cover increases can be granted free of underwriting for a Life Covered whose salary increases at a rate higher than the maximum allowable SACI rates. Built-in waiver of premium The GREENLIGHT Premium Protection (Disability) Benefit is automatically built into these income benefits. Wide range of occupations covered The GREENLIGHT range of occupations covered under Occupational Disability (Own) Income Benefit is extensive. In addition, the self-employed, home executives and students can be covered under the Daily Tasks Income Benefit. Tax-deductible premiums Premiums are tax deductible under current revenue practice and the income received from the benefit is taxable. The tax deduction will only be available to those who have a taxable income against which to claim this deduction. Because the benefit payments are in the form of income, they are taxed in the beneficiary s hands at his marginal tax rate. Lump sum benefit payments are free of any tax i.e. the beneficiary will not have to pay any tax when he receives the lump sum payment. Choice of waiting periods tailored to suit need and affordability The Life Covered has a choice of waiting periods: 7 days, 1 month, 3 months, 6 months or 24 months, depending on the income benefit selected. OMMS T1266
7 TEMPORARY INCOME COVER OCCUPATIONAL DISABILITY TEMPORARY INCOME BENEFIT BUSINESS OVERHEADS REPLACER BENEFIT why? Occupational Disability Temporary Income Cover Whether clients are fully, partially, temporarily or permanently disabled, they want cover that will replace their income for a short period of time to fill the gap not covered by their long-term disability cover. Self-employed clients will need 100% of their income to be protected with as short a waiting period as possible. Employed clients will need top-up cover, which will result in up to 100% of their income being protected for a period of time. Business Overheads Replacer Cover If a key employee or the owner of a company cannot work, that company could suffer financial loss as business overhead expenses still accrue. As a result, clients want to be in a position where the business overheads are covered. how GREENLIGHT Occupational Disability Temporary Income Benefit This benefit pays out a monthly income if the Life Covered becomes totally or partially unable (due to illness or injury), to perform the material and substantial duties of his own occupation. GREENLIGHT Business Overheads Replacer Benefit This benefit will replace the allowable monthly business overheads when turnover is lost due to the Life Covered being unable (due to illness or injury) to perform the material and substantial duties of his own occupation. this is how GREENLIGHT sees it You can choose from a 6, 12 or 24 month Benefit Payment Set with the choice of a 7 day, 1 month or 3 month waiting period. Once you have exhausted the first Benefit Payment Set, you receive an Income Advance Payment with your your last month s payment of 1, 2 or 4 months worth of income for the 6, 12 and 24 month Benefit Payment Sets respectively. On top of all this... you receive a SECOND Benefit Payment Set! In this second set you can now claim for conditions unrelated to any condition that resulted in at least 6 months worth of payments in the FIRST Benefit Payment Set. Again, on your last month s payment from the SECOND Benefit Payment Set, you receive a SECOND Income Advance Payment. Only now the benefit will cease! Some great features offered are: 100% protection. A 7-day waiting period plus Day 1 payments on Business Overheads Replacer as well. These two income benefits are not aggregated with the lump sum disability benefits. Claims are paid for partial disability. There is a built-in waiver of premium. Premiums are tax-deductible. There are pay-per-day benefit calculations.
8 TEMPORARY INCOME COVER 100% protection At new business stage, the Cover Amount that the client takes out can be up to 100% of his monthly income (Occupational Disability Temporary Income Benefit) or 100% of the monthly contributions to business expenses (Business Overheads Replacer Benefit). Occupational Disability Temporary Income Benefit: At claim stage, the income payments should not exceed 100% of pre-disability earnings. Business Overheads Replacer Benefit: At claim stage, the income payments will be limited to 100% of the Life Covered s contribution to business overheads. 7-day waiting period plus Day 1 payments on Business Overheads Replacer Benefit as well Not only is the 7-day waiting period available for the Occupational Disability Temporary Income Benefit, but it is also available on the Business Overheads Replacer Benefit! This means that the business will be able to receive the much-needed funds within a month of the Life Covered having been disabled ensuring that all the allowable businesses expenses are met. Day 1 payments will apply for certain events involving hospitalisation of at least 24 hours except for back conditions, psychological disorders and complications during childbirth. These events must involve hospitalisation of at least 7 days in order to qualify a Day 1 payment. Not aggregated with lump sum benefits The Occupational Disability Temporary Income Benefit is not aggregated with the lump sum Earning Ability Benefits. As a result, this will help meet the gap that may exist while permanence is being established on the lump sum benefit. Claims are paid for partial disability A partial benefit is paid if the partial benefit is larger than 25% of the full Cover Amount or where the Life Covered was disabled for only a portion of a month. For example, if the Life Covered loses 50% of income, he can make a claim to replace the 50% of income that was lost and the remaining number of payments is reduced only by half a month s worth of income. Built-in waiver of premium While the Life Covered is disabled, any premiums that are due (and fall due after the waiting period has expired) will be waived automatically. Tax-deductible premiums Premiums are tax deductible under current Revenue practice and the income received from the benefit is taxable. The tax deduction will only be available to those who have a taxable income against which to claim this deduction. Because the benefit payments are in the form of income (including the Income Advance Payments), they are taxed in the hands of the beneficiary at his marginal tax rate. For personal cover, where the Contracting Party, Life Covered and Beneficiary are not the same person, this tax deductibility may be jeopardised. Pay-per-day benefit calculations The income benefit paid out while the Life Covered is disabled will be based on the actual number of days disabled. These payments will be made on the last day of the calendar month. OMMS T1266
9 3-IN-1 ACCIDENTAL COVER ACCIDENTAL DISABILITY AND/OR DEATH BENEFIT why? This type of cover is for clients who are medically uninsurable. It provides protection against disability, physical impairment or death resulting from accidents, crime and violence. It provides protection for clients who are at high risk of accidents e.g. where a lot of travelling is required. It can be used as top-up cover for extra protection. how GREENLIGHT Accidental Death and/or Disability Benefit It s a stand-alone lump sum benefit that pays out on events such as: Occupational disability, as defined per the Occupational Disability Benefit, due to an accident. Physical impairment, as defined per the Physical Impairment (Comprehensive) Benefit, due to an accident. Accidental death. An accident is an external, unexpected event that is not traceable, even indirectly, to the Life Covered s state of mental or physical health before the event. this is how GREENLIGHT sees it This unique benefit offers cover if you are medically uninsurable, since no medical or HIV testing is required. GREENLIGHT will pay what we promise irrespective of how much time has passed between your accident and death. It s comprehensive 3-in-1 accident protection. Some of the features are: Exclusions are clearly defined. Definition of accident is clear and simple to understand. GREENLIGHT pays what it promises. An Occupational Disability Benefit will not be payable if the Life Covered is retired or begins a disallowed occupation.
10 3-IN-1 ACCIDENTAL COVER Comprehensive 3-in-1 accident protection The Accidental Disability and/or Death Benefit meets more than one risk need by providing cover against: - occupational disability, - physical impairment and - death resulting from an accident. Exclusions are clearly defined In addition to the standard exclusions, the following activities are excluded from the Accidental Death Benefit: - Extreme climbing (soloing) - Ice climbing - Extreme altitude climbing above 6 000m - Cave diving - Internal exploration of wrecks - Diving at depths greater than 30m - Motorised racing (speed contests) - Boxing (including kick boxing) - Base jumping - Sky surfing - Aerobatic flying - Parasailing (land) - Employment as a mine-blaster Definition of accident is clear and simple to understand An accident is an external, unexpected event that is not traceable, even indirectly, to the Life Covered s state of mental or physical health before the event. 31% of GREENLIGHT s death claims are as a result of accidents, crime and violence. Causes of Accidental Death Claims Motor vehicle accident 72.9% Crime and violence 13.6% Shot 3.2% Other 8.5% Drowning 1.0% Gassed 0.2% Accidental poisoning 0.2% Machinery accident 0.2% Railway accident 0.2% OMMS T1266
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