As you are all aware, the final regulations related to the demarcation of health insurance products were passed and published in the Government Gazette No. 40515 on the 23rd of December 2016.

Please ensure that this information letter reaches all of your intermediaries to which this pertains to.

THE IMPORTANT INFORMATION is available by clicking here

... is that all of TRA’s gap cover products are compliant with the type of medical shortfall products that have been approved in terms of the regulations.

... of the new regulations is 1 April 2017 for all new policies. Fortunately, all existing policyholders will retain their current benefits and will only be subject to the new regulations from 1 January 2018.

Annual limit
All medical shortfall policies will be limited to an aggregate annual amount, per insured person, of R150 000. This includes the gap cover, co-payment cover, sub-limit cover, casualty cover and oncology cover that form part of our packages, where applicable.

It is worth noting that the highest single claim we have processed to date has been around R137 000 and we do not anticipate that policyholders will be affected to a great degree. In fact, the reduced risk will not have a material effect on premiums and they remain as is.

Accidental Death Cover and the Policy Extender Cover are not affected. Our general exclusions and waiting periods are also unchanged. Also in line with the regulations, there is no entry age limit onto any of the Gap Cover products.

Ancillary Products
Our Femme Cover, Funeral Cover and Premium Waiver products are unaffected by these regulations. However, we have added two new funeral plans to our benefits, with our highest plan now offering up to R30 000 of cover.

... payable for medical shortfall products are governed by Regulation 5.3.1 which allows 20% commission to be paid for premiums under R300 per month. All of the current TRA products fall into this category.

... relating to “compliant” products will have to meet certain minimum standards and we have already embarked on changing those and submitting them to the various regulatory offices for approval.

... to the demarcation regulations is well documented and included negative and positive comment. We suggest having a look at the following Fin24 article which accurately summarises the situation.

We would encourage all of our intermediaries to study the gazetted regulation and advise accordingly and help us to spread the “truth” regarding our products.

Once again a huge thank you for your continued support of our range of compliant, value for money and well-administered products.

Head of Marketing and Distribution

Total Risk Administrators Pty (Ltd)

an authorized Financial Service Provider
Reg No 1999/024507/07. FSP No 40815

16 Jersey Drive, Longmeadow Business Estate East, Longmeadow, 1609
P.O. Box 1181, Parklands, 2121

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