header image

Making a claim

Our customers are at the very heart of the claims handling process.

We recognize that the claims experience is a moment of truth for our customers and their employees, and this gives us the opportunity to deliver on our promise at what is often a difficult time. We do this by treating everyone with utmost empathy and using our expertise to deliver on our promises. ‘Simply Care’ centres around being responsive, proactive and communicating clearly with our customers, in a way that gives them confidence in our abilities to fully meet their needs.
 

 

approach to claims2x

Approach to claims

Our dedicated team of senior claims examiners – with over 20 years of experience – utilize their direct access to medical professionals to ensure the best outcome for the employee and secure rehabilitation (where available) when needed.  

Each benefit claim is assessed on an individual basis. By default, claims are payable to you as the employer. Following our decision on a claim, the payment is immediately ordered and will usually reach the employer account within one week. 

Claims process

To start the claims process you can use the contact us section below.

claims process 12x

We receive your claim and request the documentation we need.

claims process 22x

Your case is assigned to a dedicated claims examiner – your new point of contact.

claims process 32x

Once all the required information is received, it is assessed and you’ll be informed of the decision.

claims process 42x

Payment is initiated and notified with a formal letter to the employer.

percentage

We are proud to have admitted and paid 97.6% of claims over the last 3 years (2021 – 2023)

Of the claims notified in 2023, only 3 were declined; due to non-disclosure or not meeting the eligibility criteria.

Percentage img

 

Group life cover provides employees with the reassurance that they will be taken care of, should the worst happen.

cancerarrowdown2x

Cancer

 

2023 38%
2019 (38%)
deathheartdownarrow

Heart disease

 

 2023 26%
 2019 (17)%
deathaccidentarrowdown2x

Accident

 

 2023 5%
 2019 (26)%

Contact us

Any questions, doubts or suggestions? Leave us your comments and we will contact you as soon as possible.

Contact