Business Brief

A family is one of the most important and powerful relationships that exist. Ever wonder what you will do if a family member suffers an injury in a car accident? Or if your child is diagnosed with a terminal illness? Have you ever stopped to think about how the illness of a loved one can adversely affect your family? A PPS member’s family is not only very important to them, but also to PPS.

The PPS Family Responsibility Rider benefit can be added to the Sickness and Permanent Incapacity benefit with no medical underwriting.

When the PPS Family Responsibility Rider benefit is added, the money that pays out could allow a member to take time off work when one of their family members is hospitalised or it can be used to cover any additional expenses.

PPS will pay the member a benefit if their spouse or child is hospitalised for three (or more) consecutive days. The benefit is then payable retrospectively from day one*.

A sub-category under the PPS Family Responsibility Rider benefit is the Child Terminal Illness benefit. PPS will pay the member a Child Terminal Illness benefit (upfront lump-sum benefit equal to up to 12 months’ benefit) if a child is diagnosed with a terminal illness and likely to die within 12 months. This will remove the necessity to submit ongoing claims, allowing the member to focus on supporting their family.

A second sub-category under the PPS Family Responsibility Rider benefit is the Child Death benefit. With this benefit, a member can cover any funeral costs and support the family during this sad time. If no Child Terminal Illness benefit was payable and a child passes away, PPS will pay up to one month’s benefit. 

The PPS Family Responsibility Rider benefit covers children between the ages of four months and 21 years and spouses until they are 70 years.

Some facts to remember about the PPS Family Responsibility Rider benefit:

• No need to specify the spouse or children. They are not medically underwritten upfront. (proof of the relationship is required at claims stage);
• No PPS Family Responsibility Rider benefit will be payable for 12 months from the start date of the benefit for any condition that existed prior to the child or spouse becoming eligible for this benefit, unless the member had a similar product before purchasing the PPS Family Responsibility Rider benefit and had completed the condition-specific waiting period on such product;
• PPS will waive the waiting period if hospitalisation is due to an accident;
• PPS covers biological, legally adopted and/or stepchild(ren) and spouses.

The three examples below show that PPS also cares about the families of its members. Members interested in this rider benefit must request a quotation and complete the PPS Family Responsibility Rider benefit application form. The application will be processed accordingly and added to the Sickness and Permanent Incapacity benefit. Members also receive direct Profit-Share allocations*** for this rider benefit.

Some real Family Responsibility claims paid by PPS:

Financial consultant (age 57)

• Family member claimed for: wife
• Medical condition: COVID-19 pneumonia
• Wife was hospitalised from 8 July 2021 to 26 July 2021 (19 days)
• Amount paid by PPS for the family member: R42 112.00**

Dentist (age 31)

• Family member claimed for: husband
• Medical condition: Osteomyelitis
• Husband was hospitalised from 19 April 2022 to 27 April 2022 (nine days)
• Amount paid by PPS for the family member: R31 918.92**

Medical doctor (age 46)

• Family member claimed for: husband
• Medical condition: COVID-19 pneumonia
• Husband was hospitalised from 2 August 2020 to 28 August 2020 (27 days)
• Amount paid by PPS for the family member: R78 565.45**

By Monique Drotsky, Technical Marketing Specialist

* The PPS Family Responsibility Rider benefit is not a medical scheme and the cover is not the same as that of a medical scheme. This benefit is not a substitute for medical scheme membership.

** Claim amount is determined using the member’s Sickness and Permanent Incapacity sum-assured amount and the number of days the family member was hospitalised.

*** Members holding qualifying products share in the operating profit or loss of PPS and past performance is not necessarily indicative of future performance.

PPS is a licensed insurer conducting life insurance business, a licensed controlling company and an authorised FSP.