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All Women Policy Brochure

The love and support you give to your family, even when the unthinkable happens, make you irreplaceable. You do so much for so many and seldom put yourself first. That’s why we do with our tailor-made All Woman Dread Disease cover.

We will pay out a percentage of the sum assured stated in your schedule if you, the life assured, or up to four children of your children suffer an event as defined and according to the criteria described in the tables below. Only one claim will be paid per event, and any claim that is paid out will reduce the amount available for future claims. Once a cumulative amount of 100% of the total sum assured has been paid out, no further pay-outs under this benefit will be considered and cover will cease.

You don’t need to have an existing life policy with 1st for Women, as All Woman Dread Disease cover can be taken out on its own.

Definition of a child: The life assured’s biological child, stepchild, or legally adopted child. The cancer must require treatment by surgery, radiotherapy, or chemotherapy. The diagnosis must be confirmed with a valid pathology report and a report from an approved specialist.

  • The child must be 18 years or younger and unmarried at the date of diagnosis
  • Maximum of one claim per child
  • A maximum of four children will be covered
  • A six-month waiting period will be enforced
  • The benefit paid out on child cancer is the lesser of 50% of the sum insured or R250,000
  • Multiple claims are allowed; however, all cover under this policy falls away once a 100% of the sum insured is paid out.

Expiry of cover: Cover is on a whole-of-life basis and will expire once 100% of the total sum assured has been paid out.

Waiting period: You will not be entitled to claim on certain events covered under this benefit for the duration of the period indicated in your schedule from the date of commencement of this contract. Please see your schedule for the details of any applicable waiting periods.

Pre-existing conditions exclusions: The life assured will not be covered for any claim arising from any disease, injury or other condition which, in the opinion of your product supplier, is related to a previous disease, injury or other condition for which the life assured has received medical treatment or advice at any time prior to the start of this policy.

Claims should be submitted within three (3) years of the birth of a child in the case of claims for conditions relating to congenital abnormalities.

The different events covered and their definitions under this policy are as follows:

EVENT

Payout (as a percentage of total sum assured)

CANCER

25% payout

100% payout

A malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant tumour includes leukaemia, lymphoma and sarcoma.

 

Cancers covered are:

  • Breast cancer
  • Cervical cancer
  • Ovarian cancer (all ovarian cancers classified as low malignant potential/borderline cancers are excluded from this definition)
  • Uterine cancer
  • Cancer of the fallopian tubes
  • Choriocarcinoma
  • Cancer of the vagina
  • Cancer of the vulva

Stage 1 and 2 cancer

Stage 3 and 4 cancer

Specific exclusions:

  • Cancers for which the life assured had treatment or advice prior to the policy commencement date
  • All tumours which are histologically described as benign, pre-malignant, borderline malignant, low malignant potential, or non-invasive
  • All cancers in situ
  • All pre-malignant conditions
  • Carcinoma-in-situ
  • Stage 0 chronic lymphocytic leukaemia
  • Any skin cancer other than malignant melanoma with Breslow level greater than 1mm
  • All tumours that occur within the six-month waiting period, or are a recurrence or metastases of a tumour that first occurred within the six-month waiting period
  • Central nervous system lymphoma
  • Kaposi’s sarcoma.

 

PREGNANCY COMPLICATIONS (covering you and your child):

  • Pregnancy complications requiring the life assured to:
    • Spend 48 hours or more in ICU
    • Spend 24 hours in ICU and three or more consecutive days in a general hospital ward
    • Spend more than five consecutive days in a general hospital ward.
  • Birth defect or congenital anomaly in the newborn baby of the life assured requires life-saving surgery in the 90 days following birth, or resulting in a significantly reduced life expectancy for the newborn baby.

Pregnancy complications covered:

  • Miscarriage due to amniocentesis or chorionic villus sampling
  • Foetal death following at least 28 weeks of pregnancy as a result of unintended trauma - self-inflicted trauma is not covered
  • Abruptio placenta with any one of the following;
  1. Maternal hypovolaemic shock
  2. Foetal loss or
  3. Disseminated intravascular coagulopathy
  • Eclampsia which has been clinically documented
  • Hydatidiform mole treated with chemotherapy
  • Placenta praevia of grade three or four severity
  • Placenta accreta which has necessitated a hysterectomy
  • Embolism during pregnancy or delivery
  • Uterine rupture which has necessitated a hysterectomy
  • Third- or fourth-degree vaginal tear which has resulted in a fistula which has undergone surgical repair
  • ICU admission for a documented pregnancy-related complication of at least five days duration.

Complications affecting the newborn that are covered:

  • Confirmed chromosomal disorder confirmed by genetic testing where the baby has survived for at least one month
  • Other genetic disorders confirmed by genetic testing where the baby has survived for at least one month
  • Cerebral palsy with documented motor system involvement (diplegia, hemiplegia, quadriplegia) or mental retardation
  • Tracheo-oesophageal fistula, oesophageal atresia or exomphalos major which has undergone surgical repair
  • Congenital heart disease which has undergone surgical correction
  • Cleft palate involving the lip and the hard and soft palate and/or alveolus which has undergone surgical correction
  • Spina bifida
  • Hypospadias which has undergone surgical correction
  • Anal atresia with colostomy
  • Biliary atresia
  • Inborn metabolic disorders with a documented developmental delay over a 12-month period
  • Congenital blindness in one or both eyes
  • Congenital deafness confirmed by a specialist

20% payout

 

 

 

 

CHILDREN’S CANCER (covers cancers affecting your children):

Definition of cancer: A malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant tumour includes leukaemia, lymphoma and sarcoma.

 

Childhood cancers covered include:

  • Leukaemia
  • Lymphoma
  • Neuroblastoma
  • Retinoblastoma
  • Nephroblastoma (Wilm’s tumour)
  • Osteosarcoma
  • Rhabdomyosarcoma
  • Brain tumours (malignant or benign, as classified according to the World Health Organisation grading)

The lesser of 50% and R250 000 payout

Specific exclusions:

  • Cancers for which the child of the life assured had treatment for or advice on prior to the policy commencement date
  • All tumours which are histologically described as benign (except brain tumours), pre-malignant, borderline malignant, low malignant potential or non-invasive
  • All cancers in situ
  • All pre-malignant conditions
  • Carcinoma-in-situ
  • Stage 0 chronic lymphocytic leukaemia
  • Any skin cancer other than malignant melanoma with Breslow level greater than 1mm
  • Central nervous system lymphoma
  • Kaposi’s sarcoma

 

ACCIDENTAL HIV INFECTION AS A RESULT OF A VIOLENT CRIME INCLUDING RAPE

  • The offence must have been reported to the South African Police Service (SAPS) and a criminal case opened.
  • An HIV test must have been performed within 24 hours of the assault to confirm HIV negative status at the time of the assault.
  • A medical examination of the victim must have been performed within 24 hours of the incident. Proof should also be supplied that the patient has started a course of anti-retroviral drugs.

40%

 

SYSTEMIC LUPUS ERYTHEMATOSIS

Systemic lupus erythematosus with documented involvement of any one of the following organ systems:

  • Kidneys
  • Eyes
  • Brain

The following gastrointestinal tract involvement:

  • Hepatomegaly AND splenomegaly
  • Lungs

The following cardiovascular system involvement:

  • Endocarditis, cardiomyopathy OR recurrent arterial thrombosis

 

 

10%

Specific exclusions:

  • Involvement of the skin, joint(s) or any mental and behavioural disorders do not qualify under this definition

 


Claims
examples:

  1. A client with a R500 000 insured amount is a victim of a violent crime including rape and is accidentally infected with HIV. She qualifies for a 40% payout and thus receives an amount of R200 000. She is later diagnosed with cancer. She qualifies for a 100% payout and receives the remaining R300 000. The Female Cancer policy ceases with this payment.
  2. The child of a client with a R750 000 insured amount is diagnosed with cancer. The client qualifies for and receives the lesser of between 50% of the sum assured and R250 000, thus bringing the sum assured amount to R500 000. A few months later, the client is a victim of a violent crime including rape and is accidentally infected with HIV. She qualifies for a 40% payout of the remaining sum assured of R500,000 and thus receives a payout of R200 000. A few years later, the client is diagnosed with Systemic lupus erythematosis. She qualifies for a 10% payout of the remaining sum assured amount of R300 000 and receives R30 000. The Female Cancer policy will remain active with a sum assured of R270 000.

General exclusions:

No woman-related cancer claim will be paid if your condition is caused or accelerated, whether directly or indirectly, by:

  • Radioactivity and nuclear explosions
  • Material misrepresentation or non-disclosure of information before the commencement of the policy
  • Excessive consumption of alcohol, intentional inhalation of fumes, intentional and negligent consumption of poisons, drugs, narcotics or medication (unless prescribed by an independent medical practitioner and used as described)
  • Intentional and gross negligent self-inflicted injury
  • Elective termination of pregnancy

Specific exclusions

We will not pay the claim amount if the dread disease you suffer from arises or is accelerated, directly or indirectly, by any one of the events listed in the policy schedule under the specific exclusions section.

First for Women Insurance Company Limited is an authorised financial services provider (FSP licence number: 15261).Long-term policies underwritten by 1Life (FSP: 24769).