Insurance

Insurer ordered to honour mental illness claim

By Martin Hesse | Published Sep 29, 2023

Mental illness cases are often difficult to assess, and insurers may sometimes be too hasty in deciding on their validity. A recent determination by the Ombudsman for Long-term Insurance found that an insurer incorrectly declined a disability claim for mental illness because it failed to take a holistic approach and disregarded the totality of the evidence.

Subsidised medical scheme membership declines

By Staff Reporter | Published Sep 28, 2023

The escalating costs of healthcare are challenging the traditional employer-sponsored medical scheme membership model. For many, the long-running hyperinflationary increases in the costs of comprehensive medical scheme membership, with its expensive Prescribed Minimum Benefits (PMB) model, places it well out of reach for a huge section of South Africa’s working population. Even with subsidisation by employers, many employees can no longer afford their contributions - more so as other household expenses like high food, fuel and electricity costs and high interest-bearing debt repayments on house and car loans eat into an even greater chunk of their income than ever before.