R250,000 when the injury is confirmed
Paid within 7 business days of confirmation, to the parent. It is unconditional. It is never repaid, even if the final impairment is low. No settlement is signed for this payment.
Newborn Extension
Every baby born to a covered mother is insured from the start of labour, with its own R3 million.
No enrolment, no premium, no form. No South African product has given a family a no-fault route to a payment for a brain-injured baby. This one does, for every birth.
This is a summary only. The policy wording governs. Patient Cover is not a medical scheme, and it is not a substitute for medical scheme membership.
Who is covered
From the start of labour, until discharge.
- Every baby born alive to a covered mother. Twins are insured separately, each with R3 million.
- Cover attaches when labour starts, or when the mother is admitted for delivery. There is no form.
- The mother needs 270 days' cover, or the antenatal record must show conception after her cover began.
- The mother's own injury in the same delivery is a separate claim, under her own cover.
What it pays
Early money, then a rating, and the child's right stays open.
The balance at rating
Impairment is rated at age two, and can be deferred to age four. The benefit is the band for that rating, less the R250,000 already paid, up to R3 million.
If the baby dies
Death from a birth injury pays R3 million to the mother. If a baby dies during labour because of the care, a bereavement benefit of R500,000 is paid to the mother.
The money is protected
Any single payment above R250,000 goes to an umbrella Benefit Trust, with an independent trustee, in a sub-account for that child. nownow pays the trust costs. The child keeps the right to sue for more. Nothing is waived.
Birth injury
Injury caused by the care.
A birth injury is an injury caused by the care during labour, delivery, or immediately after birth, including a failure or delay to monitor or intervene. It must leave permanent impairment of 6% or more, or cause death. No fault has to be proved.
The cover names, as examples, hypoxic-ischaemic encephalopathy and cerebral palsy, brachial plexus injury, skull fracture, and intracranial haemorrhage.
Not covered
What the extension leaves out.
- Congenital, genetic or metabolic conditions.
- Prematurity, and anything that arose before labour began.
- A claim can be sent up to 36 months after the birth, by a parent or by someone caring for the child.
Photograph by Md Ishak Raman, used under the Unsplash Licence.