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Accident / Illness / Death Cover

Does The Unlimited cover HIV/Aids?

Yes, we cover HIV/AIDS under Death Cover and under Hospital Cash Cover.

For Death Cover:

Any claim that is approved where HIV/AIDS or a related illness is the cause of death will need to meet the following criteria:

  1. HIV/AIDS must have been contracted after the start date of the policy, and
  2. A waiting period of  12 months needs to have been met. This is equal to a period where you have made 12 successful consecutive monthly payments.

For Hospital Cash Cover (hospitalisation due to illness):

  1. If HIV/AIDS is contracted after the start date of the policy a waiting period of 3 months applies, or
  2. If HIV/AIDS is a pre-existing condition, meaning that it was contracted before taking out the policy and was declared as a pre-existing condition, then a 12-month waiting period applies.
How might my claim be affected by a pre-existing condition or a waiting period?

Please click here to read the FAQ on “Policy terms and conditions” for answers to these questions.

How do I submit a Death Cover claim in the event of a death?

1. Call 0861 990 000 and we will guide you through the process.

2. We will check that you have met the policy terms, specifically, the waiting periods and the terms around a pre-existing condition. The person you are claiming for must have been included on your policy.

3. You will then need to provide:

  • A completed claim form.
  • A certified copy of the deceased’s ID.
  • A certified copy of the death certificate.
  • A copy of the notification of death form completed by a doctor (this known as a DHA-1663/DHA-1680 form).
  • A letter of executorship/authority when the benefit is payable to an estate.
  • If applicable, copies of the police, motor vehicle accident reports, or hospital records.

4. In addition to the documents mentioned above, if a claim is submitted by your spouse, we will need:

  • A copy of your spouse’s ID.
  • A copy of the marriage certificate.

5. When there is no spouse, we will need:

  • A copy of the ID of the person claiming.
  • Letters of executorship; and/ or
  • An affidavit by the person who is claiming confirming they are the sole dependent of the deceased. In circumstances where they are not the sole dependent, there must be an additional supporting affidavit by another member of the deceased’s family confirming that the claimant is authorised.

6. We reserve the right to request additional supporting documents should we be unable to validate the claim with all the information requested above.

7. If we approve a claim, you will need to provide a copy of your bank statement. The statement must clearly show the name of the account holder, the account details, and the bank’s date stamp.

8. All costs incurred in submitting a claim are for your account.

9. Your claim documents can send to us by any of the below methods:

Email Address: claimsdocs@theunlimited.co.za

Fax Number: 086 206 4069

Postal Address: Private Bag X7028, Hillcrest, 3650

Physical Address: 1 Lucas Drive, Hillcrest 3650

(Please note that post may take longer)

10. Your claim might be rejected if you fail to comply with our reasonable requests, if there is non-cooperation in the investigation of claims, if you do not complete or send in the correct documents, or if the documents are not valid.

11. In all cases, we will do our best to help you through this process so that your claim can be fulfilled.

I have been admitted to hospital. How do I submit a claim?

If you are admitted to hospital for more than  24 consecutive hours (one day) for an injury caused by an accident (the event), you can claim under your Accident Cash benefit. It is best to claim after you are discharged and can claim for all the time you were in hospital for that event.

The completed claim form together with all supporting documentation must be submitted to one of the following addresses:

Email: claimsdocs@theunlimited.co.za

Fax: 086 206 4069

Post: The Claims Department The Unlimited, Private Bag X7028 Hillcrest, 3650

(Please note that post may take longer)

Will I have to pay for this documentation?

Yes. You are liable for any cost incurred for the documentation needed for your claim.

Will The Unlimited pay the hospital directly?

No. Once your claim is approved,  we will pay the proceeds of the claim directly into your bank account, i.e. the account from which your premiums are paid. Only in the event of the death of the policy holder will we pay an approved claim to another bank account, i.e. your spouse, appointed administrator or executor.

How long does it take to process a claim?

Once we have received all the required documents and your completed claim forms, your claim will be assessed. We will let you know about the decision regarding your claim within 72 hours.

How long does it take to pay out a claim?

Once the claim is approved, it will be processed and paid within 24 hours.

How long does a refund take to be processed?

Once we receive your request, and you have sent us all supporting documentation (this is usually a bank statement), you can expect feedback within 24 to 48 hours.

How does the Accident Cash benefit work?

When you, or a member of your family that you have included on the policy, are injured as a direct result of an accident and it is serious enough that you are admitted to hospital for a full day (24 hours consecutively) or longer, you have a daily amount of cover that you get for each day you are admitted up to the maximum cover limit of your policy.

When can I call for support?

Monday to Friday: 08:00 to 17:00.

Saturdays and Public Holidays: 08:00 to 13:00.


NAVIGATION

AUTHORISED FSP

The Unlimited is an Authorised Financial Services Provider (FSP No. 21473). Address : 1 Lucas Drive, Hillcrest, Durban, South Africa.

The Unlimited abides strictly by the Financial Advisory and Intermediary Services (FAIS) Act of 2002

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