1 reviews | Active since Nov 2016
Do not take Income Care with Sanlam
<p>Good day</p> <p> </p> <p>To anyone who may be considering Income Care with Sanlam, please re-think it over. You will be promised compensation in the event of temporary or permanent disability. I have been on temporary disability from August. In mid August I app**** for Income Care. I was not bothered about being medically boarded off with a rather high-risk pregnancy because I knew my Income Care would kick in. I mean that's what I've been paying for every month right? WRONG! 2 months later, on 11 October I was notified that my application was rejected due to lack of supporting medical evidence. From then I've been going crazy submitting motivation, evidence, blood results, motivation from both my Gynaecologist and Rheumatologist specifically stating that my pregnancy is high-risk due to my Lupus, specifically stating that this patient should be on complete bedrest for the duration of the pregnancy. One would think that such motivation from a SPECIALIST should be enough to qualify for for temporary disability. It's not. They now require further clinical reports explaining God knows what. Then they would take another 2 months to review that which pushes the application to Jan. But I won't need compensation in Jan because I will already be on maternity leave as my baby arrives in Jan. So basically I've been on unpaid leave so far and get this..there will be no back payment should your application be successful so all these months of not getting paid, no one gives a ****. And that my dears..is how Sanlam will get away from paying me my Income Care..a benefit that I've been contributing towards for the past year and a half. I'm embarrassed to say that I belong to such an organisation. It's an absolute disgrace!!!</p>
Good day
We acknowledge receipt of your complaint and will arrange for investigation .
Kind Regards
Client relations
Good day
We acknowledge receipt of your complaint and will arrange for investigation .
Kind Regards
Client relations
Dear Ms Naicker
We have been informed that our Sanlam Employee benefits department made contact with you. They confirmed that they informed you that a confidential medical report from your treating specialist that complies with the “Guidelines Medical Report on Functional Impairment” is required for the assessment of your claim. The medical reports which you submitted did not meet the basic medical report requirements. Sanlam Group Risk is prepared to re-assess your disability claim on receipt of a clinical medical report from your rheumatologist and a medical report from your gynaecologist. Sanlam will request the reports directly from your doctors upon receipt of confirmation of the appointments. Sanlam will pay for the appointments and medical reports.It is also important to note that a waiting period of 3 months applies in respect of the payment of the disability benefit. The 3 months waiting started on your last working day at your employer. In terms of the policy the Managed Income Disability Insurance will only become payable the end of November 2016.
After receiving the medical reports as requested, the claim will be re-assessed.
Kind regards
Client Relations
Dear Ms Naicker
We have been informed that our Sanlam Employee benefits department made contact with you. They confirmed that they informed you that a confidential medical report from your treating specialist that complies with the “Guidelines Medical Report on Functional Impairment” is required for the assessment of your claim. The medical reports which you submitted did not meet the basic medical report requirements. Sanlam Group Risk is prepared to re-assess your disability claim on receipt of a clinical medical report from your rheumatologist and a medical report from your gynaecologist. Sanlam will request the reports directly from your doctors upon receipt of confirmation of the appointments. Sanlam will pay for the appointments and medical reports.It is also important to note that a waiting period of 3 months applies in respect of the payment of the disability benefit. The 3 months waiting started on your last working day at your employer. In terms of the policy the Managed Income Disability Insurance will only become payable the end of November 2016.
After receiving the medical reports as requested, the claim will be re-assessed.
Kind regards
Client Relations
Thank you for your response.
Note that on my rejection, I was offered 90 days to dispute provided that I send medical reports. Is there a template for such reports that the client can submit to his/practitioner? What should medical reports contain? The documents provided by my specialists pointed out that 1. I do have Symphysis Pubis Dysfuntion (SPD) 2. I do have Lupus 3. I should be on complete bedrest for the duration of the pregnancy. I've even submitted blood results. If there was a specific form that I could send through to my specialists, it would have made everything much easier but you cannot just request a medical report and assume that the client knows exactly what it should contain. Such lack of clarity causes such delays. Then I'm asked for a 'clinical medical report'. I don't even know what that is. Would it not have made much more sense if, on my first application, some attempt was made by Group Risk to contact my specialists specifying exactly what was required? I am an Accountant by profession. It should not be assumed that clients understand what medical reports are required and the difference between a 'medical report' (requested on rejection of my application)and 'clinical medical report' (now requested).If there is no template or specific points on what information is required, it makes it difficult to provide such information.
Kind regards
Thank you for your response.
Note that on my rejection, I was offered 90 days to dispute provided that I send medical reports. Is there a template for such reports that the client can submit to his/practitioner? What should medical reports contain? The documents provided by my specialists pointed out that 1. I do have Symphysis Pubis Dysfuntion (SPD) 2. I do have Lupus 3. I should be on complete bedrest for the duration of the pregnancy. I've even submitted blood results. If there was a specific form that I could send through to my specialists, it would have made everything much easier but you cannot just request a medical report and assume that the client knows exactly what it should contain. Such lack of clarity causes such delays. Then I'm asked for a 'clinical medical report'. I don't even know what that is. Would it not have made much more sense if, on my first application, some attempt was made by Group Risk to contact my specialists specifying exactly what was required? I am an Accountant by profession. It should not be assumed that clients understand what medical reports are required and the difference between a 'medical report' (requested on rejection of my application)and 'clinical medical report' (now requested).If there is no template or specific points on what information is required, it makes it difficult to provide such information.
Kind regards
Good day
Thank you for your post i will arrange for someone from our Employee Benefits Department to respond to your concerns raised.
Kind Regards
Client Relations
Good day
Thank you for your post i will arrange for someone from our Employee Benefits Department to respond to your concerns raised.
Kind Regards
Client Relations
Dear Mrs Naicker
We have been informed that our Sanlam Employee Benefits department made contact with you. They confirmed that they explained to you the disability claims process and requirements when your employer submitted a disability claim on your behalf. They also informed you that based on the claim documents in Sanlam’s possession you do not conform to the definition of disability as stipulated in terms of the policy arrangement. Sanlam is however, prepared to re-assess the disability claim on receipt of a clinical report for your rheumatologist and gynaecologist.
You confirmed that you will set up the appointments with your rheumatologist and gynaecologist and will provide Sanlam with the appointment details. On confirmation of the appointments, Sanlam will request the medical reports directly from the doctors. Sanlam will pay for the appointments and medical reports.
On receipt of the medical reports, Sanlam will re-asses your claim for disability benefits.
Kind Regards
Client Relations
Dear Mrs Naicker
We have been informed that our Sanlam Employee Benefits department made contact with you. They confirmed that they explained to you the disability claims process and requirements when your employer submitted a disability claim on your behalf. They also informed you that based on the claim documents in Sanlam’s possession you do not conform to the definition of disability as stipulated in terms of the policy arrangement. Sanlam is however, prepared to re-assess the disability claim on receipt of a clinical report for your rheumatologist and gynaecologist.
You confirmed that you will set up the appointments with your rheumatologist and gynaecologist and will provide Sanlam with the appointment details. On confirmation of the appointments, Sanlam will request the medical reports directly from the doctors. Sanlam will pay for the appointments and medical reports.
On receipt of the medical reports, Sanlam will re-asses your claim for disability benefits.
Kind Regards
Client Relations