Motshabi Nomvethe: Head Technical Marketing
Insurance is vital to financial security, providing a safety net for unforeseen circumstances. But it is not until a claim event arises that the true value of insurance is felt. The peace of mind that comes with knowing you will be looked after is priceless. That is where PPS, a company that embraces the ethos of mutuality and is committed to providing the finest cover for professional persons, steps in.
Since its inception in 1941, PPS has been dedicated to paying valid claims and assisting its members in times of need. This commitment to our mission statement has earned PPS the trust of its members and made it a leader in the insurance industry. In 2022 alone, PPS paid more than R3.35 billion in claims, with R957 million going towards death claims.
For PPS, insurance is not just about protecting against risk but about providing peace of mind. It is about knowing that in the event of a claim, members can trust that we will be there for them.
Sickness benefit
In 2022, PPS paid more than R1 billion in sickness claims, accounting for just over 39% of the total claims paid. These claims are for members who are unable to perform their professional duties due to illness or injury, and the claim criteria are met. The top three conditions claimed were infectious and parasitic diseases, musculoskeletal and connective tissue diseases, and respiratory system diseases.
One of the most remarkable aspects of PPS’s coverage is its breadth. The youngest member to receive a claim was just 23, while the oldest was 83. This demonstrates that PPS covers members from their fourth academic year of study through retirement and beyond. In fact, many of our members continue working beyond the normal retirement age.
Most Sickness benefit claimants were 51 to 60 years old, with medical doctors and paramedical professionals making up 52% of claimants. However, from the previous year, we have seen a 50% increase in claims for the age groups of 21-30 and 31-40 years. This again indicates the need for coverage even for those in the earlier stages of their careers.
Permanent Incapacity benefit
For members who have been receiving the Sickness benefit for 728 days and are still unable to perform their usual professional duties, PPS offers case management and consideration for a Permanent Incapacity benefit. This benefit is payable until the member can return to work or reaches retirement age.
In 2022 alone, PPS paid more than R749 million to members receiving the Permanent Incapacity benefit. Most of the illnesses were caused by diseases of the musculoskeletal system and connective tissue, followed by mental disorders and neurological conditions.
Interestingly, despite the challenges brought on by the COVID-19 pandemic, PPS noticed a slight decrease in claims for mental and behavioural disorders compared to 2021.
Death claims
The loss of a loved one is never easy, and the financial burden that comes with it can often make things even more challenging. We understand this and remain committed to helping our members and their beneficiaries during these difficult times. In 2022, we paid R956 million for death claims, ensuring our members’ families or estates received the financial support they needed.
The causes of death varied, with injury, poisoning and certain consequences of external causes being the leading factors, especially for younger members. However, cancer remained the top cause of death, accounting for 19% of all claims. The 51-60 age group members were also heavily impacted, with 35% of all claims paid to their beneficiaries or estates.
In addition to the Life Cover amount, we also paid R131 million in PPS Profit-Share Account™ benefits to our deceased members’ nominated beneficiaries or estate. This additional benefit is paid free of early access charges and is calculated based on a member’s PPS Profit-Share Account™* balance at the time of death. It provides extra cash to beneficiaries, tax-free, to help them settle outstanding debts and expenses.
Critical Illness claims
PPS members faced significant challenges in 2022, including critical illnesses affecting the health and well-being of members of all ages. In 2022, we paid R416 million for Critical Illness claims.
Cancer remains a leading cause of critical illness claims, with breast and prostate cancer being the most common. The increase in critical illness claims among younger age groups highlights the importance of being proactive about health and well-being, regardless of age.
Our Critical Illness Cover provides a tax-free* lump sum payment to help cover medical expenses, treatment or other financial obligations that may arise during a member's illness.
Lump-sum Disability
We understand that disabilities can happen to anyone at any time, which is why we offer a lump-sum Disability benefit to our members. The impact of such an event on a member’s life and that of their family can be overwhelming. Our goal is to provide our members with the financial support they need to help them through these difficult times, so they can focus on their recovery and adapting to their new life of living with a disability.
In 2022, we paid out a total of R186 million for lump-sum Disability claims. The top causes of claims were cancer, diseases of the musculoskeletal system and connective tissue, and neurological diseases. It is important to note that disabilities can happen to anyone, regardless of age, and the youngest member to receive a disability claim was only 34 years old.
COVID-19 claims
As we slowly emerge from the pandemic era in 2022, one thing remains clear: COVID-19 has profoundly impacted our lives, personally and financially.
Despite the progress we have made, the numbers are staggering. In the past year alone, we paid R263 million in COVID-19-related claims, with R213 million going towards sickness claims and R39 million for death claims. While this is less than what we saw in 2021, it is still significant.
But it is not just the financial impact that is concerning. We have also seen our first COVID-19 critical illness claim, which may hint at the long-term effects of this virus.
Since the beginning of the pandemic in 2020, we have paid out more than R2.05 billion in COVID-19-related sickness and death claims, processing more than 23 000 claims in total.
As we move forward, it is clear that the impact of COVID-19 will be felt for years to come. At PPS, we are committed to being there for our members, providing the support and assistance they need during these challenging times.
When it comes to financial security, having insurance can be a lifesaver. And for PPS, paying out claims is more than just a business transaction. It is a promise to our members that we will provide the financial safety net that they deserve.
* Members holding qualifying life-risk products share in the profit and the loss of PPS through the notional PPS Profit-Share AccountTM and past performance is not necessarily indicative of future performance. The PPS Profit-Share AccountTM is a notional account and vests on retirement from age 60.
Profit-Share allocations are taxed in the policy, therefore, the payment after vesting is made free of any additional tax.
PPS is a licensed insurer conducting life insurance business, a licensed controlling company and an authorised FSP.
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