Medical cover is an integral part of a client's insurance portfolio. Unfortunately many people still opt for the incorrect option, due to a lack of knowledge and understanding.
In light of this, Liberty Life Medical Scheme asked Hereford Financial Services CEO Michael Dundulakis and colleague Andrew Penney to reveal the key factors that help to create a win-win situation for both financial adviser and client when it comes to the purchase of a medical cover:
* The most important issue to be tackled upfront is a client's lack of understanding of how medical aids are structured and which benefits are paid from a particular plan. Consultants must therefore take the time to help a client understand how their plan operates.
* Use the statutory disclosures and FAIS paperwork to establish exactly what a client expects from the consultant. This will establish the client's financial position and budget, which will help in selecting a plan further on down the line.
* What is the client's current situation regarding medical aid? Do they have a plan? Are they happy with it? If not, what are the problems causing them to be dissatisfied? Does their employer subsidise their premiums? If they have medical aid, establish which provider its with and the name of the clients current plan.
* When making comparisons the consultant should establish whether the client wants a new generation structure (Hospital plus savings account) or a more traditional plan (pooled risk plan with no individual savings accounts). Also check what kind of a structure the client is currently on.
* What role does a clients employer currently play? Before suggestions to the client are made, check with the HR department as to what the companys policy is regarding medical aid schemes and plan choice. Going forward, this may help the consultant to get business from the group as a whole.
* Important areas to consider are the level of cover in-hospital (i.e. medical aid rates vs. private rates); limits in and out of hospital; which procedures are covered in a day clinic setting; which chronic conditions are covered; will the plans premiums change in the event of claiming for chronic medication; are there co-payments for procedures; what levels of savings does the plan have for day-to-day expenses; how often are claims paid; how are claims submitted?
Penney adds: "I have also come to understand that many people are disgruntled with the current range of healthcare offerings and this means they are looking closely at more cost-effective options, which also offer increased benefits."
"Fortunately, the Liberty Medical Scheme fits the bill on both accounts since it offers benefits that are easy to understand, as well as a host of innovative features such as a Trauma benefit - currently the only one of its kind in the country."