Benefits
From 1 times up to 5 times annual salary but subject to a maximum of US$1 500 000.
Definition of disability
The Member is considered disabled if he has the continuous total and permanent inability to perform the material and substantial duties of his own occupation or any occupation with his current employer or in the open labour market, due to an injury, disease or illness, from the date of disability.
It also includes the member suffering from the loss of use of or the severance at or above the wrists or ankles of both hands or feet or one of each, or the permanent loss of sight in both eyes. The member will, however, only be considered to suffer from a permanent disability, if the disability results in a loss of earned income, and Global Alliance Life are satisfied that the disability will remain continuous, total and permanent, and such disability can not be removed by any form of treatment that the member can reasonably be expected to undergo.
Accelerated Benefit
As an accelerated benefit, it is reliant on the Member having at least the same sum assured for the Group Life Benefit. If the member claims the Permanent Disability Benefit, the amount paid will reduce the Group Life Benefit, i.e. if the member receives US$10 000 benefit under the Permanent Disability Benefit, the Group Life Benefit will be reduced by US$10 000.
Waiting period:
Benefits are not payable during a 6-month waiting period.
Reduction in the benefit
A reduction of 20% per annum applies in the 5-year period before retirement.
Payment of benefits
All benefits are payable directly to the claimant.
Eligibility
The maximum age for a Member to join the group scheme is 64.
A group scheme Member is allowed to enjoy Permanent Disability Benefits up to a maximum age of 64.
Exclusions
Exclusions applicable are:
Participation in war, riot and civil commotion, terrorism,
all claims related to atomic, biological and chemical warfare, or terrorism,
the commission of a crime, attempted suicide or self inflicted injury and deliberate exposure to exceptional danger,
non-compliance with recommended medical treatment,
a condition the member suffered in the 12-month period before joining the scheme and for which the member claims in the first year of membership.
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Conversion Option
The option allows a Member to convert his Group benefits to an Individual life Policy, underwritten by Global Alliance Life, at individual life rates subject to medical underwriting. The Conversion Option is only available if the member also exercises the Conversion Option in respect of their Group Life Benefit.
If the Member resigns from the Employer’s service, before age 60, he is eligible for this option, but needs to apply to Global Alliance Life within 30 days of resignation.
The Employer can only select group scheme Conversion Option benefits at the commencement date.
Requirements:
HIV/Aids test.
Cotinine test.
If a member dies during the 30 day period, after becoming eligible to exercise the Conversion Option, he will automatically qualify for the full benefit that he would have been eligible to convert, subject to meeting the group scheme Policy terms and conditions.
Claims Process
Notification period
Within 1 month from the date of the incident giving rise to a disability claim.
Submission of claim documents
6 months from the date of disability. Any additional documentation must be submitted within 60 days of the request by Global Alliance Life.
Claim documents to be submitted
A completed notification of a potential disability claim form,
Section A:
Part 1 - Claimant's personal statement,
Part 2 - Employer’s statement,
Section B:
- Confidential medical report,
- all available clinical evidence relevant to the claim,
- an original certified copy of member’s identity document,
- an original certified copy of the member’s payslip for the last completed month of employment,
- any other documentation as requested by Global Alliance Life.
Who pays for disability claim evidence?
Initial - Member or employer.
Further - Global Alliance Life.
Independent - Global Alliance Life.
Appeal evidence - Member or proposer. If the claim is found to be valid, Global Alliance Life will pay for the evidence.
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