Long Covid: How 3 SA Insurance Companies Handle Health, Disability Claims and Life Insurance

  • Millions of people who have had Covid-19 suffer from long-lasting symptoms known as Long Covid.
  • Returning to normal life is difficult for many, and some have had to give up their jobs.
  • Three SA insurance companies spoke to Health24 about how they handle long-distance driver policies and claims.

A growing number of people worldwide are reporting living with long-term Covid – a pervasive condition that persists after the acute stage of Covid-19 has passed.

Research has identified more than 100 million long-distance drivers and around 200 long-distance Covid symptoms, the weakest and most commonly reported being fatigue, breathing difficulties and cognitive impairment (which can cause brain fog and memory problems).

While scientists are still trying to understand the exact mechanisms of Long Covid, the phenomenon is real and clinicians and psychologists are trying their best to help these patients in their recovery.

READ | Living with long Covid: people are telling the stories of the debilitating symptoms left in their wake by the virus

In many cases, the disease has delayed long-distance drivers’ return to work or forced them to leave their jobs. Health24 last year interviewed Linda, who was on ventilators for 18 days after contracting Covid in December 2020. A few months later, the 46-year-old had to “retire from a career [she] thoroughly enjoyed”.

Many ventilated patients do not make it out of the hospital. But for those who survive, the real challenge begins as soon as they leave the hospital. They are likely to face ongoing health problems – from physical to mental and emotional, including post-traumatic stress disorder, breathing problems, depression, problems with daily activities, threatened organ damage and lost jobs.

Health24 spoke to three South African health insurance companies to find out how they deal with sickness and disability claims, as well as life insurance coverage for long-distance drivers whose lives have been turned upside down by the disease.

Sanlam

Sanlam began receiving long-term Covid-related claims that persisted after the first wave of Covid infections in SA, the company’s chief medical officer, Dr. Marion Morkel, to Health24.

From an insurance perspective, Sanlam Long considers Covid the same as any other disease. As accepted diagnostic criteria for the disease are not yet available, existing and new customers may not be able to make a claim specifically for long Covid but may still be able to make recourse.

Morkel explained, “There’s nothing on our sick pay or temporary income benefit, for example, that says we won’t consider new diagnoses, or anything that may not be conventional medicine and hasn’t been put into a diagnosis code.”

What they search

When applying for long Covid insurance, Sanlam will require detailed information from your doctor to assess the risk based on the product you are applying for.

“We will look at the combination of symptoms, clinical signs and the medical evidence of the level of impairment,” Morkel said, adding, “Based on the product that you have with us, this enables us, an illness or serious illness to pay benefit.”

Do you need proof of a positive Covid test?

No. Morkel said Sanlam will assess the level of impairment the condition has caused in the person, regardless of whether they have tested positive for Covid.

“In the event of a claim, we carefully consider the symptoms, clinical findings and impairments based on a claimant’s experience of Covid-19 complications. Then we measure and score these, as well as the response to treatment, against our definitions,” she said.

Other considerations

Morkel explained that existing or potential customers cannot obtain coverage without restrictions or risk categorization.

“That’s what we do, whether it’s long covid, diabetes, HIV etc. We categorize the risk of the severity of the disease, which product you are claiming and then we consider how likely it is that you will claim under a specific product and therefore this will come with an additional premium.

However, if a customer qualifies for coverage and their condition improves or stabilizes, they are advised to ask Sanlam to review changes to their insurance policy.

Morkel said: “We recognize that some people may be able to make a full recovery. So if your health has improved, you can always get back to us and ask us to review the conditions we gave you if you have new evidence that, for example, your lung or kidney function has returned to normal . And people do that frequently, not just for long Covid.”

Does a long Covid affect life insurance?

If you already have life insurance, your rate cannot be changed as you have been struggling with Covid for a long time, Morkel said.

She added: “For most long Covid patients, this doesn’t affect how we view life insurance. Of course, if you have impaired lung, kidney or heart function, we need to assess this and compare it to the “normal” population and how much higher your risk is compared to them, just like we do with someone who has had chronic obstructive airways disease and has impaired lung function – their risk is also compared to that of the general population.”

READ | Living with long Covid: “To this day I’m like a walking zombie”

discovery

Discovery Insurance does not discriminate against people who have had Covid for a long time, Sylvia Steyn, head of claims at Discovery Life, told Health24.

Said Steyn: “[We are] not change the way we evaluate applications and sign potential clients. Potential clients will be insured depending on the complications or conditions they have developed.”

Underwriting refers to the process insurance companies use to determine the risks involved in insuring people or their assets.

Steyn said the company applies the same underwriting standards to all of its prospective clients, whether or not the health condition is a result of Long Covid.

apply for coverage

The same process as usual is followed to obtain coverage, ie a full medical examination by your underwriting team.

“Since the emergence of the Covid-19 pandemic, we are now also asking potential customers if they have had Covid-19 in the past (how long has it been, have they fully recovered and are there any symptoms they are dealing with fight). ‘ Steyn said.

Existing policies are not affected by these changes, she added.

Discovery also does not require proof of a positive Covid test. “Their application will be evaluated based on the medical complication or condition they have, regardless of the cause,” Steyn said.

Do long-distance drivers pay more for life insurance?

Depending on the client’s medical profile and any circumstances that Steyn may have explained, the usual underwriting policy would apply.

“Customers who have faced common long-term Covid symptoms such as brain fog, fatigue and depression will not be penalized with increased premiums on their life insurance, but they can receive exclusions from critical illness, disability and other forms of coverage,” she said.

If you are an existing customer and already have life insurance with Discovery, they will not differentiate or change their terms based on a severe long Covid, Steyn added.

READ | Living with long Covid: ‘I feel like I’m on a long road to recovery’

freedom

Liberty Insurance offers risk protection for various life events. Kedibone Chuene, Chief Specialist: Product Marketing at Liberty, told Health24 that the level of coverage given to a customer will take into account the extent to which their health has been compromised, based on full health disclosure requirements.

“While we do not have a specific benefit for long Covid, should the client disclose that they have long Covid symptoms, we will assess those symptoms and their current health profile and offer the appropriate level of coverage at a reasonable premium based on the risk,” Chuene said.

apply for coverage

For example, if you are a long-distance driver and wish to apply for Liberty health or disability insurance, they will require a complete medical record and supporting medical reports to assess your health profile before they can issue you a policy.

Chuene said, “Our processes are designed to assess the health profile first, and where coverage is in place, customers have the assurance that their coverage will pay off in their most vulnerable moments should they make claims on the policy and meet all other contractual conditions terms and conditions must be met.”

No proof of Covid necessary

Like Sanlam and Discovery, Liberty does not require customers to have tested positive for Covid.

“Long Covid is not yet well understood by the medical research community, and it is not easy to distinguish between people suffering from the ongoing effects of severe Covid infection, Long Covid and other forms of fatigue syndromes,” Chuene said.

That’s why it’s even more important that clients fully disclose their health history so Liberty can assess their health profile, she said.

Does a long Covid affect life insurance?

“If the customer’s health profile at the time of purchasing a new policy or additional coverage is severe enough to reduce life expectancy or increase the likelihood of long-term disability, premiums will be adjusted accordingly,” Chuene said.

What about existing customers who have life insurance?

This does not change their coverage or premium provided full health disclosure was made when Liberty originally accepted risk for a policy.

“Their existing premium rates will not be changed just because they have long Covid. Liberty is committed to existing policyholders to continue providing coverage,” said Chuene.

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READ | Long Covid: More than 50% of people who survive infection will experience persistent symptoms – study

READ | Living with long Covid: ‘I’ve been infected again – it feels like the experience of PTSD left me behind’

READ | Long Covid brain fog not ‘all in the head’, needs urgent recognition, study shows

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