PPS offers guidance on what members need to know about COVID-19 and their insurance cover

As COVID-19 infections increase across South Africa, we want to assure you that PPS will provide the required cover and support to members during this pandemic.

Working with our intermediary community, we will be sharing information that will be pertinent to you, our members. Because the situation is evolving, we must be adaptive. We will therefore evaluate information regularly and respond accordingly as the pandemic matures in South Africa.

Life Insurance

It goes without saying that we are committed to supporting you in times of need and we would like to ensure that you are well-informed regarding your PPS insurance cover or products, and how to handle claims during the time of this pandemic.

The PPS Sickness and Permanent Incapacity Benefit has no exclusion on pandemics, and we encourage our members to continue to submit all valid claims.

The most important information to know is the following:

  • Members who have the Sickness and Permanent Incapacity Benefit are fully covered should they be diagnosed with COVID-19 and be unable to work for a period of time.
  • If members are asymptomatic (not sick), they would need to have been hospital quarantined by a South African government authority such as the Department of Health following confirmed or probable exposure to COVID-19, in order to be able to claim.
  • Members who do not have COVID-19 and are not hospital quarantined, but are displaying influenza-like symptoms, and have been diagnosed and treated by a medical practitioner can submit a claim as they would for any other medical condition. Please note that all claims will be subject to the terms of the PPS Provider Policy.
  • Members are not required to prove there was a loss of income in order for a sickness claim to be paid.

Other PPS Life Insurance policies

Should the impact of COVID-19 be so severe that it leads to a critical illness, disability or even death, the resulting claim will be assessed based on those specific policies’ claim definitions.

Short-Term Insurance

Should your business experience a mandatory shutdown during this period, your Business Insurance cover will be best suited to respond to this risk through Business Interruption cover. However, this cover is ONLY available if you elected to add an optional extension called Miscellaneous Risk on your PPS Short-Term Business Insurance.

Investments

Current events have resulted in much uncertainty and volatility in the markets.  Lessons we have learnt from past crises show that markets eventually recover, so investors should not let the recent events lead to any rash or reactive decisions. Speak to your adviser about any concerns you have around your investments, to ensure you make sound and informed decisions.

Profmed medical aid claims

Many PPS members also belong to the Profmed Medical Aid Scheme, and you can be assured of support during this time. Profmed will cover all costs related to confirmed cases of COVID-19 irrespective of which option you are on. Any member and all their dependants qualify for benefits for confirmed cases of COVID-19, whether adult or children. New members who are in the 3-month general waiting period will be reviewed on a case-by-case basis.

You may need to pay upfront for out-of-hospital tests or consultations and if your tests are positive, Profmed will retrospectively refund your expenses. It is your responsibility to inform the Scheme if you have contracted COVID-19 so we can help take care of you and pay any claims. The benefits will come from insured funds, therefore any claims relating to COVID-19 will not come from your day-to-day benefits.

Walk-in service

In order to flatten the exponential curve of infections, we all need to practice social distancing and avoid face-to-face interactions as much as possible. Therefore, walk-ins are strongly discouraged at any of our centres; however, PPS will be available to support you and provide service to you through our telephonic and virtual channels.

Should a face-to-face meeting be unavoidable, all visitors to PPS offices will be required to complete a travel declaration form, to assess possible exposure to COVID-19. Even if you have not travelled but you know you are unwell or have potentially been exposed to a person who has tested positive for COVID-19, we request that you declare this information so we can assess our risk adequately.

Profit-Share

PPS operates under the ethos of mutuality, which means members with qualifying products get to share in the profits of the PPS Group through their unique Profit-Share Accounts. It is important to note that your claims have no impact on your Profit-Share Account allocation.

Useful information

During this time, it is especially important not to panic, to focus on the facts, and avoid fake news and fear mongering. PPS has set up a page that will be continuously updated, with specific details on how we are handling claims as well as reliable sources to refer to.

https://www.pps.co.za/covid-19-coronavirus

You can be assured that we’re here for you and have capacity to assist you. Should you have any queries, please contact your PPS-Accredited adviser. You can also contact PPS Member Services via email at membersevices@pps.co.za or by telephone on
0860 123 777.

 

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