The Professional Edition 3 July 2021 | Page 17

In 2020 , PPS paid the following in COVID-19-related claims :

R156 million paid in sickness benefits

R234 million

paid in death benefits ( excludes Profit-Share payments )
Claims by COVID-19 protocol :

80 %

COVID-19 positive

14 %

quarantine medical

4 % quarantine government / NICD 2 % person under investigation ( PUI )

In 2020 , we paid 96 % of all claims submitted across all benefits :
95 %
of sickness claims
Reasons for claims not paid : 1 . Claim period less than the waiting period . 2 . Does not have the benefit . 3 . Did not consult a doctor .
100 %
Life cover
critical illness claims : lump-sum disability claims :
65 % Reasons for claims not paid : 72 %
1 . Does not meet criteria . 2 . Already paid for a related condition . 3 . Condition excluded .
Reasons for claims not paid : 1 . Does not meet claim requirements . 2 . Already paid for a related condition . 3 . Still performing occupational duties .
TOTAL CLAIMS * PAID IN THE LAST 10 YEARS .
12.1
15.3
0.7
1.6
2.6
3.7
4.9
6.3
8.1
10.0
BILLION ZAR

R15.3bn **

TOTAL CLAIMS PAID
** all health and life risk claims ( excluding short-term insurance and Profit-Share payouts )
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
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