• Editor

Needs-matched certainty in a changing world - What makes our group risk cover unique

The last year saw everyone having to deal with a lot of uncertainty considering the COVID-19 pandemic. Many people were unsure about whether their businesses and employers would remain open, how their income would be affected, and how their health and the health of those they love would be impacted. For many members, group risk benefits are the only financial product they own. During these uncertain times, it helps to have financial products that provide certainty when they or their loved ones need it most – at claim stage.

When we launched our needs-matched group risk cover in 2018, we set out to deliver change for good to employee benefits. By making use of technology never applied in group risk products to date, we deliver more efficient, more flexible products while also improving certainty for members at claim stage. We offer a wide spectrum of cover, including temporary expense needs cover, permanent expense needs cover, additional expense needs cover, funeral cover, and death cover.

An industry-first – combining sickness benefits, clinical definitions and occupational criteria into one claims process

BrightRock is the only insurer that combines all three of these elements into the assessment of claims under our cover for temporary and permanent expense needs (known in the market as Permanent Health Insurance or Income Protection Benefits).

This approach allows us to provide members (and employers) with more certainty as the claims criteria is made know upfront. In the majority of cases, it also allows for a more efficient claims payment process with quicker turn-around times, as the assessment is against a doctor’s sick note or a list of clinical conditions and it is far quicker than an occupational assessment process – the default approach of the industry.

It is, however, the interaction or the combination of the three assessment elements – sickness, clinical and occupational criteria – that creates an environment for each claim to receive the fairest possible treatment in the quickest possible time.

A practical example of how our unique features would work

The example below shows how our needs-matched product would work in this scenario – this isn’t a real client.

A member of a BrightRock scheme, aged 25, works as a machinist, earning a gross annual income of R125 000 (R10 416 per month). The scheme he is a member of has temporary and permanent expense needs cover of 75% of gross monthly income. They opted for a three-month waiting period and selected ‘own or similar occupational criteria, with own employer’ during the initial period of 24 months.

On 17 January 2020, the member is diagnosed with Stage 4 osteosarcoma, a type of bone cancer. The cancer originated in the femur of his left leg, just above the knee. Given that the cancer had spread to his lungs, his doctors decide to surgically remove his leg (where the cancer originated from). He also undergoes chemotherapy to treat the cancer that had spread to his lungs. After the three-month waiting period, the member receives his monthly pay-out from BrightRock – this amount would be payable until the earliest of his retirement or death.

The member goes into remission and in January 2021, he returns to work in the workshop as the supervisor of a team of machinists, albeit in a limited capacity.

Based on the diagnosis of Stage 4 cancer, the member would be deemed permanently disabled by BrightRock, irrespective of his ability to perform his own or a similar occupation at his employer (initial period) or any employer (extended period).

BrightRock group risk members have the certainty of knowing that we’ll never reassess their condition after we’ve approved their claim under their permanent expense needs cover – even if they were to recover or partially recover and even go back to work. Importantly, we wouldn’t reduce their claim pay-out by any active income they receive from work they do – with some other group risk providers in the market, clients’ pay-outs would be reduced by any active income they earn while in a claim.

By introducing needs-matched group risk cover to the market, BrightRock has brought much-needed certainty to employee benefits. This is particularly important in these uncertain times, as clients look for products that truly live up to their promise when it matters most.