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Covid-19 hospital cash plan will pay for your stay

The first confirmed case of Covid-19 in South Africa left many scared and unsure about what was coming, this fear included the finances associated with long hospital stays. To ease the pockets of those who have tested positive, Sirago has launched a new insurance policy that will pay out if you are hospitalised for Covid-19.

Pandemic Shield has a three-week waiting period after which it will pay you out if you are hospitalised for more than 48 hours after testing positive for the virus. The policy also offers cover for hospitalisation as a result of any future disease that the World Health Organisation declares a pandemic as it has declared the coronavirus.

The policy has two levels of cover, for R99 a month you can get a benefit of R25,000 if you are hospitalised, but the more expensive option for R199 a month offers you a lump sum of R50,000 if you are hospitalised and R500 a day for each day you are in the hospital up to 14 days.

Martin Rimmer, the CEO of Sirago, said “The policy is designed to cover any kind of expense you might incur if you are hospitalised and is suitable for both medical scheme and non-medical scheme members”.

Medical scheme Bonitas recently reported that among those who are infected with Covid-19, only 20% will be hospitalised and of those only 5% will be treated in ICU. Among the 80% who get the virus but do need to go to the hospital, 20% will be asymptomatic and 60% will need treatment at home.

Rimmer highlighted that the policy will not cover you if you need treatment or to be quarantined at home, the cover is only for those who are admitted to hospital for more than 72 hours after testing positive for the virus.

The Pandemic Shield policy benefit can be used for any expenses you incur, for example, child care, but Rimmer also notes that it was not designed to replace your income should you be hospitalised. There is a 21-day waiting period that also applies after each claim but there is no other underwriting nor exclusions. You cannot take it out if you are over the age of 60.

What happens if you already have a hospital cash plan?

Rimmer said short-term insurance products generally have standard exclusions that could mean hospital cash plans would not pay out for pandemics. However, Clientele Life, Metropolitan and Hollard said they will not exclude claims for admissions to hospital from the coronavirus from cover as long as you have a valid claim and the waiting period has passed.

Ayanda Mazwi, senior assistant ombudsman at the Ombudsman for Short-Term Insurance confirmed that so far, no complaints have been registered with it regarding rejected claims for hospitalisation as a result of Covid-19.

Kedibone Dikokwe, Divisional Executive for conduct of business supervision at the Financial Sector Conduct Authority, said it is also not aware of any insurers denying hospital plan claims. “If insurers make changes to their insurance policies, they would need to comply with the applicable insurance legislation, the terms of the policy on changes and the Treating Customers Fairly Principles,” said Dikokwe.

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