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:
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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
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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
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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
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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.
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LUMP SUM EARNING ABILITY COVER
more info…
Clear definitions and language
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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.
- I ntentional 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.
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Choice of full or tapered cover to age 65 next birthday
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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
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OMMS 06.2010 T1266
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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
60
100%
100%
100%
61
80%
80%
100%
62
60%
64%
100%
63
40%
51%
100%
64
20%
41%
100%
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:
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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.
this is how
how…
GREENLIGHT sees it
GREENLIGHT Comprehensive Disability
(Own) Benefit
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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.
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.
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.
GREENLIGHT Comprehensive Disability
Benefit
■■
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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.
more info…
Top of the range all-in-one earning ability
protection
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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.
COMPREHENSIVE LUMP SUM COVER
more info…
Clear definitions and language
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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:
- V
iolation of criminal law by the Life Covered has been simplified and made as specific as
possible.
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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
60
100%
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
■■
OMMS 06.2010 T1266
■■
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
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:
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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
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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
■■
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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.
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A choice of waiting periods – tailored to suit
need and affordability.
LONG TERM INCOME COVER
more info…
Generous cover that meets real needs
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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
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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
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The GREENLIGHT Premium Protection (Disability) Benefit is automatically built into these income
benefits.
Wide range of occupations covered
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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
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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
OMMS 06.2010 T1266
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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.
TEMPORARY INCOME COVER
OCCUPATIONAL DISABILITY TEMPORARY INCOME BENEFIT
BUSINESS OVERHEADS REPLACER BENEFIT
why?
Occupational Disability Temporary Income Cover
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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
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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
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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
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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.
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TEMPORARY INCOME COVER
more info…
100% protection
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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
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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
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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
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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
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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
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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
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OMMS 06.2010 T1266
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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.
3-IN-1 ACCIDENTAL COVER
ACCIDENTAL DISABILITY AND/OR DEATH BENEFIT
why?
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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
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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.
An Occupational Disability Benefit will not be
payable if the Life Covered is retired or begins a
disallowed occupation.
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.
3-IN-1 ACCIDENTAL COVER
more info…
Comprehensive 3-in-1 accident protection
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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
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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
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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
OMMS 06.2010 T1266
Motor vehicle accident Crime and violence
Shot
Other
Drowning
Gassed
Accidental poisoning
Machinery accident
Railway accident
72.9%
13.6%
3.2%
8.5%
1.0%
0.2%
0.2%
0.2%
0.2%