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Short-Term Insurance Act, 1998 (Act No. 53 of 1998)

Regulations

Regulations under the Short-term Insurance Act, 1998 (Act No. 53 of 1998)

Part 7 : Contracts Identified as Accident and Health Policies under Section 70(2A)(a) of the Act

7.1 Definitions and interpretation

 

In this Part 7, unless the context indicates otherwise—

 

"condition-specific waiting period"

means a period in which a policyholder is not entitled to claim policy benefits under a policy in respect of a condition for which medical advice, diagnosis, care or treatment was recommended or received within a period of 12 months preceding the day on which the policy was entered into;

 

"general waiting period"

means a period in which a policyholder is not entitled to claim any, or may only claim certain, policy benefits;

 

"hospitalisation"

means any admission for a medical procedure or administration of a therapeutic or diagnostic medical intervention wherein a person is expected to stay overnight in a facility;

 

"insurer"

means a short-term insurer or a Lloyd's underwriter;

 
"medical scheme"

has the meaning assigned under section 1 of the Medical Schemes Act;

 
"member"

has the meaning assigned under section 1 of the Medical Schemes Act;

 

"policy"

means the short-term policy;

 

"product line"

in relation to a category and type of contract referred to in Regulation 7.2(1), means accident and health policies that have the same or closely related contractual terms offered or entered into by an insurer;

 

"relevant health service"

has the meaning assigned under section 1 of the Medical Schemes Act;

 

"this Part"

means this Part 7;

 

"underwritten on a group basis"

means where the risks relating to a policy forming part of a product line are rated based on the characteristics of a group of people (other than characteristics that relate to or may result in specific health conditions) together as opposed to that of the individual to whom the policy relates.

 

[Regulation 7.1 inserted by regulation 2 of Notice No. 1582 of 2016]