TABLE OF CONTENTS

Introduction

This answers some Frequently Asked Questions related to the Transfer of Cover Underwriting for new business and additional dependant application forms received.  


What is Transfer of cover?

The Transfer of Cover Underwriting refers to policy holders and dependants who belong to a Gap provider for a certain duration of time and elect to join Sirago. From the point of terminating their cover with the previous gap provider to joining Sirago, there must not be a break in cover (ie. Uninterrupted cover) in order for the transfer of cover concession to be applied.   


What are the documents needed to in order to apply transfer of cover underwriting on a policy?

  1. A fully completed Application or Transfer of Cover Form is expected from new members or an Additional Dependant Application form for dependants to be registered to an existing policy. 
  2. Relevant supporting previous proof of cover documentation from the previous Gap provider
    1. A recent copy, not older than 30 days of the previous gap provider’s master policy schedule, to prove continuous creditable cover; or
    2. A recent copy, not older than 30 days of the previous gap cancellation certificate to prove continuous creditable cover


What details must the previous provider’s master policy schedule or cancellation reflect?

  1. The original inception date;
  2. The product option name;
  3. The effective date that the master policy schedule or cancellation certificate was generated;
  4. The policy holder’s details (ie. ID number, Full Name/s);
  5. The eligible dependant’s details. In the event that the dependant’s details are not reflected, the master policy schedule must indicate that the policy covers the policy holder and all their registered dependents on their medical aid.

Please note that for point 5, Sirago will still apply the family size rules and may from time to time call upon a certificate of membership from the medical aid.



What information do we look at when applying Transfer of Cover Underwriting?

    Is the client transferring from to Sirago where the policies have been on cover for 12 (twelve) months or longer;

    Is the client transferring from to Sirago where the policies have been on cover for 12 (twelve) months or less;

    Which product option they belonged to on the previous Gap provider.

    Which Sirago Gap product option they have elected to join.

    Is the previous providers product option and the elected Sirago product option a like-for-like transfer (ie. Benefit A to A)  or a none like-for-like transfer (ie. Benefit A to B).

    Who are the eligible policy holders and eligible dependants covered on the previous policy.



Will transfer of cover underwriting apply is the relevant supporting documentation is not provided?

Standard full underwriting will be applied in the event that the relevant supporting documentation has not been provided. In order to assist with reviewing the underwriting, the supporting documentation must be provided within 30 days from when the policy is activated.


What is the difference between the transfer of cover underwriting terms applied for transfers of 12 months or more and for less than 12 months?

    In the event that the beneficiaries have been on cover for more than 12 months no 3 (three) month general waiting periods or waiting periods on pre-existing conditions apply however General policy terms, conditions & exclusions will apply.

    In the event that the beneficiaries have been on cover for less than 12 months and these policies are currently serving waiting periods, the balance of the unexpired waiting periods will be applicable, no 3 (three) month general waiting periods however General policy terms, conditions & exclusions will apply.



How are the monthly premiums determined?

Premiums would be determined by the policy holder’s entry age at inception of the previous gap provider. All transferring policyholders with an entry age of under 64 and 65 + years will pay premiums as determined by the relevant age category premium table and duration of uninterrupted cover from the previous Gap provider.


If the principal was under the age of 64 years at inception of their policy (ie. their entry age with the previous provider is under 64 years) they will qualify to pay under 64 rates on their Sirago gap cover policy


The implementation and preservation of the above relies on the accurate and full completion of the policy holder and their dependant's details as well as the supporting proof of continuous cover.