The Dread Disease Benefit Explained

Life cover for critical illnesses


Extra Cover for Critical Illnesses

Upgrade your Illness Hospitalisation benefit with additional Life Cover for specified Dread Diseases (Critical Illnesses).

The Illness benefit does pay for hospital expenses but a dread disease (like cancer) is a major medical event that will have major medical costs.

The Dread Disease benefit offers up to R371,000 to cover medical expenses for specific critical illnesses and is available once per member per policy lifetime.

The benefit is optional. You do not have to include it on your Hospital Plan but if you do you will need to include the Illness Hospitalisation benefit first.

12 Month Waiting Period
3 Benefit Level Choices
Optional Benefit
Requires Illness Hospitalisation

Choose Your Level of Cover

Flexible levels of cover mean you get to build your plan to suit your needs and budget.

Level 1

Up to R196,100 available

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Level 2

Up to R265,000 available

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Level 3

Up to R371,000 available

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How Does It Work?

Find answers to the most common questions about this benefit. Browse our Help pages and Blog posts for more information.

What is covered?

The Dread Disease benefit is designed to offer extra cover for major critical illnesses that can't adequately be covered by the Illness Hospitalisation Benefit alone.

It offers stated amounts to cover medical expenses for specific critical illnesses. It is available once per member per policy lifetime. This means that the chosen limits are available once per member and do not reinstate each year.

Standardised Critical Illness Definitions (SCIDEP) staging will apply and is explained below.

How does SCIDEP Staging apply?

SCIDEP staging applies to certain critical illnesses and defines the severity of the illness. The benefit then covers treatment according to that stage:

  • Stage 4 (most severe): 100% of the available benefit
  • Stage 2: 75% of the available benefit
  • Stage 2: 50% of the available benefit
  • Stage 1 (lease severe): 25% of the available benefit

For example, if a member is diagnosed with Stage 2 cancer, then 50% of the available benefit can be used for treatment leaving the remaining 50% to cover future events for that member.

Which Critical Illnesses are covered?

The Dread Disease benefit includes cover for the 8 most common critical illnesses:

  • Heart Attacks
  • Chronic Coronary Heart Disease (CCHD)
  • Strokes
  • Cancer
  • Kidney Failure
  • Major organ transplants for kidney, heart, lung, liver, pancreas or bone marrow
  • Paraplegia in both arms or both legs (owing to illness not accident)
  • Total Blindness (owing to illness not accident)

What is the waiting period?

There is a 12 month waiting period before any new member on a policy can claim under this benefit.

Is authorisation required?

Yes. In general, all hospital related claims need to be authorised first.

Authorisation is a simple procedure where the administrator and the hospital determine:

  • if the procedure you need is covered by your policy
  • if you have available amounts left over after previous claims

The authorisation procedure is described on the Claims page.

What Health Plan are you going to build?

Get a quote and find out. Talk to us or build your own.


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