By Brian Harris, GM Operations at Turnberry Management Risk Solutions
The insurance industry is undergoing a significant transformation, particularly in addressing coverage gaps. One critical element in this paradigm shift is the role played by gap cover. The quest for comprehensive coverage within the confines of affordability has led to the development of diverse medical aid options. However, to keep premiums reasonable, insurers often pass on a significant portion of risk to policyholders. This includes co-payments, penalties for non-Designated Service Providers (DSPs), and reduced coverage for specialist fees. Enter gap cover – a cost-effective solution designed to provide ultimate peace of mind to policyholders.
Technological advancements and their impact on medical cover
Technological advancements are shaping the design and delivery of gap cover solutions in the insurance industry, and South Africa boasts world-class facilities and specialists who leverage cutting-edge technology to provide patients with the best possible outcomes. From robotic surgery to advanced scanning technology and specialised cancer formularies, these innovations come at a considerable cost, and insurance providers need to stay abreast of these technological advancements to ensure that their clients receive the ultimate level of cover.
Strategic financial planning: unveiling the role of gap cover
The incorporation of gap cover contributes to a more comprehensive and effective risk management strategy, and understanding one’s true financial exposure to unforeseen medical events is crucial. While medical aids typically cover 100%-200% of the medical aid tariff, specialists often charge in excess of 400%. Coupled with co-payments and penalties for non-DSPs, this could result in shortfalls running into tens of thousands of Rands. Gap cover acts as a vital safety net, mitigating the financial risks associated with potential shortfalls.
As various industries emphasise hyper-personalisation, insurers are tailoring their gap cover offerings to meet the unique needs of individual clients. In a landscape where members can choose from over 100 different medical aid plans in South Africa, gap cover ensures that every member has an option best suited to their specific scheme and life stage. Policies range from individual coverage to encompassing all dependents, with rates tailored to the policyholder’s age and associated exposure.
Innovations driving success: recent trends in gap cover products
Recent product innovations in gap cover have proven successful, aligning with current trends in the insurance and financial planning sectors. Beyond addressing immediate medical needs, gap cover now extends its benefits to include contributions toward dependents’ medical aid for six months and full gap cover for 12 months after the policyholder’s passing. Proactive measures such as cover for prophylactic mastectomy, robotic surgery, and innovative cancer drugs have significantly improved the lives of policyholders.
THINK BACK.THINK AHEAD.
Now Rethink Insurance.
For all insurance solutions related to the commercial, agricultural, engineering and sectional title sector contact your broker or call Western:
Western Cape +27 21 914 0290, Gauteng +27 12 523 0900 or visit www.westnat.com
Western National Insurance Company Ltd, affiliates of PSG Financial Services Ltd, a licensed controlling company, are authorised financial services providers. (FAIS: Juristic Reps under FSP 9465)
Considering the dynamic nature of the insurance and financial planning spaces, staying ahead of the curve involves selecting a gap cover provider with a proven track record. The provider should offer long-term quality service, tailor-made products aligned with offerings, and a robust digital solution for easy access to essential cover. Regulatory considerations, such as the Demarcation Regulations, play a role in setting boundaries between medical aids and supplementary medical insurance. Compliance with underwriting requirements and benefit limitations ensures a balanced and regulated approach to gap cover.
Financial advisors can leverage behavioural coaching trends to enhance their clients’ understanding and adoption of gap cover. The journey begins with awareness, as far too often, individuals only recognise the financial shortfalls associated with medical expenses when an event occurs. Real-life examples with actual costs, rather than hypothetical cases, allow clients to ask crucial “what if” questions and gain a clear understanding of their exposure and available cover.
About Turnberry Management Risk Solutions
Founded in 2001, Turnberry is a registered financial services provider (FSP no. 36571) that specialises in Accident and Health Insurance, Travel Insurance, and Funeral Cover.
With extensive experience across healthcare and insurance industries in South Africa, Turnberry offers unsurpassed service to Brokers and clients. Turnberry’s gap cover products are available to clients on all medical aid schemes, as they are independently provided and are therefore transferable in the event of a change in the client’s medical aid scheme.
Turnberry is well represented nationally, with its Head Office based in Bedfordview, Johannesburg with Business Development Managers in Cape Town and Durban. The Turnberry Team’s focus on outstanding client service comes from having extensive knowledge and experience in the financial services sector and is underwritten by Lombard Insurance Company Limited. Lombard Insurance Company Limited is an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.