, PLEASE USE THIS DOCUMENT AS A GUIDE TO ANSWER YOUR ASSIGNMENT
Discuss the National Health Insurance strategy implemented by the South African government,
with specific reference to the following:
1. Describe life policies that are covered by National Health Insurance.
The National Health Insurance (NHI) in South Africa is not a life insurance product but rather a
healthcare financing system aimed at ensuring universal access to quality health services. NHI
strategy to specific life insurance–related policies that provide healthcare protection. According to
the ISR3702, Study Guide. p. 19, the life policies covered under National Health Insurance include
medical aid policies and health insurance policies, since these provide for the funding of healthcare
services and help reduce the financial burden of illness on individuals and families.
2. Describe five policy clauses of life insurance, from the policies described in 1 above, that do
not apply to National Health Insurance.
The following policy clauses found in traditional life and health insurance policies do not apply
under the National Health Insurance (NHI) system, because NHI is a state-run universal health
financing model rather than a contractual insurance product:
Waiting periods – In private medical schemes and health insurance, waiting periods apply
before certain benefits can be claimed. Under NHI, access to healthcare is immediate and
universal (ISR3702, Study Guide. p.20).
Exclusions – Life and health policies often exclude cover for specific conditions (e.g.,
pre-existing illnesses or hazardous activities). NHI does not operate with such exclusions, as it
is designed to provide equitable healthcare for all (ISR3702, Study Guide. p.21).
Premium payment clauses – In insurance contracts, cover only exists while premiums are
paid. NHI is tax-funded, so cover does not depend on individual premium contributions
(ISR3702, Study Guide. p.22).
Lapse and reinstatement clauses – Traditional policies lapse if payments stop, and
reinstatement requires underwriting. NHI cannot lapse, since it is not dependent on contractual
payments but on national funding (ISR3702, Study Guide. p.22).
Surrender values or policy loans – Many life policies (like endowments) accumulate value
and can be surrendered for cash or used for policy loans. NHI has no such savings or loan
features because it is not an investment-based product (ISR3702, Study Guide. p.23).
Discuss the National Health Insurance strategy implemented by the South African government,
with specific reference to the following:
1. Describe life policies that are covered by National Health Insurance.
The National Health Insurance (NHI) in South Africa is not a life insurance product but rather a
healthcare financing system aimed at ensuring universal access to quality health services. NHI
strategy to specific life insurance–related policies that provide healthcare protection. According to
the ISR3702, Study Guide. p. 19, the life policies covered under National Health Insurance include
medical aid policies and health insurance policies, since these provide for the funding of healthcare
services and help reduce the financial burden of illness on individuals and families.
2. Describe five policy clauses of life insurance, from the policies described in 1 above, that do
not apply to National Health Insurance.
The following policy clauses found in traditional life and health insurance policies do not apply
under the National Health Insurance (NHI) system, because NHI is a state-run universal health
financing model rather than a contractual insurance product:
Waiting periods – In private medical schemes and health insurance, waiting periods apply
before certain benefits can be claimed. Under NHI, access to healthcare is immediate and
universal (ISR3702, Study Guide. p.20).
Exclusions – Life and health policies often exclude cover for specific conditions (e.g.,
pre-existing illnesses or hazardous activities). NHI does not operate with such exclusions, as it
is designed to provide equitable healthcare for all (ISR3702, Study Guide. p.21).
Premium payment clauses – In insurance contracts, cover only exists while premiums are
paid. NHI is tax-funded, so cover does not depend on individual premium contributions
(ISR3702, Study Guide. p.22).
Lapse and reinstatement clauses – Traditional policies lapse if payments stop, and
reinstatement requires underwriting. NHI cannot lapse, since it is not dependent on contractual
payments but on national funding (ISR3702, Study Guide. p.22).
Surrender values or policy loans – Many life policies (like endowments) accumulate value
and can be surrendered for cash or used for policy loans. NHI has no such savings or loan
features because it is not an investment-based product (ISR3702, Study Guide. p.23).
