I
,SR3702 Assignment 2 Semester 2 Memo | Due 15
MULTIPLE CHOICE,ASSURED EXCELLENCE
1. Describe life policies that are covered by National Health
Insurance. (2)
Short answer: NHI is not a life-insurance scheme and therefore
does not cover conventional life-insurance “life policies” (term
life, whole life, funeral cover, dependants’ death payouts,
income-replacement on death, etc.).
What NHI does cover are healthcare services across the care
continuum (preventive, promotive, curative, rehabilitative and
palliative care) delivered by accredited providers according to
an approved benefits/service package. In practice that means
medical treatment, hospital care, medicines on the
national/essential medicines list, maternity care, primary
health care and end-of-life/palliative clinical services — not
lump-sum death or funeral payouts typical of life insurance.
health.gov.zahst.org.za
2. Describe five policy clauses of life insurance (from typical
life-insurance policies) that do not apply to NHI. (10)
Below are five standard life-insurance policy clauses and why
they don’t apply under NHI:
, 1. Sum Assured / Benefit Amount Clause — life policies
specify a contractual lump-sum (sum assured) paid on
death/crit. illness. NHI does not pay lump-sum death or
funeral benefits; it finances healthcare services instead.
health.gov.za
2. Beneficiary Designation Clause — life policies name
beneficiaries who receive payouts. NHI provides health
services to registered users; there is no contractual
beneficiary payout mechanism. health.gov.za
3. Premium and Policy Payment Clause — life insurance
requires a premium schedule (monthly/annual). NHI is
funded from public financing mechanisms
(taxation/contributions to the Fund) and does not
operate as a contract where individuals pay premiums for
a specified lump sum. health.gov.za+1
4. Surrender / Cash-Value Clause — many life policies
(whole life) accumulate surrender values that the
policyholder can redeem. NHI carries no surrender/value
accumulation function — it’s a purchaser/provider
financing arrangement. hst.org.za
5. Suicide / Exclusion Clauses and Contestability Periods —
life policies often exclude or limit cover for suicide within
an initial period or have incontestability rules for
misstatements. NHI doesn’t issue insurable interest
,SR3702 Assignment 2 Semester 2 Memo | Due 15
MULTIPLE CHOICE,ASSURED EXCELLENCE
1. Describe life policies that are covered by National Health
Insurance. (2)
Short answer: NHI is not a life-insurance scheme and therefore
does not cover conventional life-insurance “life policies” (term
life, whole life, funeral cover, dependants’ death payouts,
income-replacement on death, etc.).
What NHI does cover are healthcare services across the care
continuum (preventive, promotive, curative, rehabilitative and
palliative care) delivered by accredited providers according to
an approved benefits/service package. In practice that means
medical treatment, hospital care, medicines on the
national/essential medicines list, maternity care, primary
health care and end-of-life/palliative clinical services — not
lump-sum death or funeral payouts typical of life insurance.
health.gov.zahst.org.za
2. Describe five policy clauses of life insurance (from typical
life-insurance policies) that do not apply to NHI. (10)
Below are five standard life-insurance policy clauses and why
they don’t apply under NHI:
, 1. Sum Assured / Benefit Amount Clause — life policies
specify a contractual lump-sum (sum assured) paid on
death/crit. illness. NHI does not pay lump-sum death or
funeral benefits; it finances healthcare services instead.
health.gov.za
2. Beneficiary Designation Clause — life policies name
beneficiaries who receive payouts. NHI provides health
services to registered users; there is no contractual
beneficiary payout mechanism. health.gov.za
3. Premium and Policy Payment Clause — life insurance
requires a premium schedule (monthly/annual). NHI is
funded from public financing mechanisms
(taxation/contributions to the Fund) and does not
operate as a contract where individuals pay premiums for
a specified lump sum. health.gov.za+1
4. Surrender / Cash-Value Clause — many life policies
(whole life) accumulate surrender values that the
policyholder can redeem. NHI carries no surrender/value
accumulation function — it’s a purchaser/provider
financing arrangement. hst.org.za
5. Suicide / Exclusion Clauses and Contestability Periods —
life policies often exclude or limit cover for suicide within
an initial period or have incontestability rules for
misstatements. NHI doesn’t issue insurable interest
