Every member of the Scheme is covered for permanent disability.

A tax-free benefit, calculated according to the option selected will, depending on the medical condition of a member, either be paid out as a single lump sum or be paid over a period in monthly installments.

Total or permanent disability is when, because of illness or injury, a person is unable to work in their own or any other suitable occupation for which they are suited through training, education, or experience.

First and foremost, a member must be totally and permanently disabled for a claim to be successful! A claim will only be approved by the insurer if the definition of total or permanent disability is met.

It is the member’s responsibility to prove his/her disability by providing the insurer with the relevant specialist medical proof of disability.

All disability or potential disability claims must be reported to the Scheme, whose competent staff will assist the claimant with the claims process.

WHEN MUST A CLAIM BE SUBMITTED?

Claims must be submitted with the Scheme within 12 months from date of termination of service for it to be considered.

Do not wait till the last day of employment. If you as a member is booked of work for more than a month due to a serious illness and/or injury, contact the Scheme in order to report a potential disability claim to the insurer.

This is actually the responsibility of the Employer. Remember, you as the employee could be unable to report a potential claim to the scheme due to illness or injury and is it thus the responsibility of your direct supervisor or HR Officer to report the claim on behalf of you and the Employer.

A possible disability should be reported as soon as,
1.
An employee is off from work due to illness of injury for a period exceeding 30 days.
2.
An employee is, because of his/her illness or injury no longer doing or able to do the actual work that the employee was appointed to do.
3.
it becomes a possibility of an employee losing his/her job due to a disability or illness.

Important to take note that claims submitted to the Scheme after 12 months will be declined.

WHAT DOCUMENTS TO BRING

The Scheme will need the following documents in order to successfully process a disability claim:

• Insurer’s claim form (pages 5-7 must be completed by the Supervisor/HR/any other person who is familiar with the member’s condition/abilities in the workplace. Page 8-12 must be completed by the member)
• Leave records for 3 years.
• Specialist’s medical reports
• X-rays and scans (if applicable)
• Prescriptions
• Member’s identity document and bank details
• Any other medical proof that will assist in confirming your disability

ADVICE

When you are filing for permanent disability with the Employer you must contact the Scheme immediately. In order to ensure timely submission of claims and pay-outs, do not wait until the last day of employment.

A member’s discharge from the Employer’s service must be recommended by a medical specialist. A normal GP’s (general practitioner’s) or doctor’s note will not be enough to lodge a successful claim with the insurer.