2. Zestlife
Zestlife is management owned started in 2009.
Operates as an insurer using Guardrisk cell captives.
Employs 100 staff and has 90 0000 policies mainly life and health.
JV with Liberty who sell the Zestlife gap cover under Liberty brand.
6. The Solution
Zestlife Gap will protect the members against these shortfalls for in-hospital procedures
and a defined list of 50 out-patient procedures by;
•Covering the shortfall (Gap) resulting from any Medical Practitioner charging above
the Medical Aid Tariff; No annual limit.
•Covering co-payments with no annual limit
•Covering excess of sub limit on internal prosthesis up to R30 000
Extra Benefits;
•R25 000 benefit on first diagnosis of cancer
•R20 000 mastectomy
•Accidental death and disability insurance of R25000 with emergency services
•Access to Hello Doctor
This is affordable and essential insurance for every medical
scheme member at R207.
7. Market Differentiators
Products with similar benefits to Zestlife Gap.
Stratum Comprehensive R205
Zestlife R207
Turnberry Extend a Care R212
Sirago Ultimate R220
Complimed Gap Shield Co-PayR235
Stratum Elite R244 Average Gap Premium
Sirago Elite R255
Complimed Gap Select R275
Ambledown R275
Sirago Cancer R278
Turnberry Execucare R282
Premium discount for employer groups.
Average age and number of members for a quote.
8. Market Differentiators
Adult Dependants, Child Dependants and Age Limits
Most other Gap Providers:
•Exclude Adult Dependants or charge extra premium
per dependant;
•Limit the number of children covered or the age up to
which children are covered
•Impose entry age limits and provide a “Senior’ product
if older than 70 or no cover.
All dependants on the medical scheme are covered
under Zestlife Gap regardless of age or number.
9. Market Differentiators
Co-Payments
All the gap products cover co-payments but most of
them have an annual maximum or an incident limit.
Zestlife has no incident limit or annual maximum and as
with most other products MRI and CT scans are covered.
Zestlife covers co payments for using Non DSP hospital.
10. Market Differentiators
Cancer Benefits
Most other gap products cover cancer by paying the shortfall
over a certain limit or excess up to a maximum annual amount.
Zestlife Gap Standard Cancer Benefit pays:
•Lump sum payment of R25 000 on first diagnosis of cancer.
•Lump sum benefit of R20 000 benefit for reconstruction of the
non-affected breast in the event of a single mastectomy
•20% co-payment cover payable when oncology limit is
exceeded limited to R250 000 per annum per beneficiary.
•Treatment shortfalls on chemotherapy and radiotherapy
ZESTLIFE HAS CANCER EXTENDER OPTION AT TOTAL
PREMIUM OF R255
11. Optional Benefits 2015
Cancer Extender Total cancer cover R100 000 per beneficiary
Optional cancer extender benefit of an additional R75 000 for all cancers.
The term Cancer for the purposes of this Cover is defined as the presence
of one or more tumours classified as malignant cells and with the invasion
of normal tissue. Hodgkin’s disease and the Leukaemia’s are included in
this definition, but excluded are all skin tumours and/or carcinoma-in-situ
There is a medical history question on previous cancers in the application
form and there is a termination age of 65 and 6 month waiting period.
The additional premium for the cancer extender is R48 which
covers the whole family on the medical scheme.
12. Optional Benefits 2015
Dentistry Benefit
The dentistry benefit covers the principal member and
the dependants for emergency, accidental and
specialised dentistry.
The Dental Gap Cover option will have a six-month
waiting period (except in the event of an accident) and
a termination age of 65.
The additional premium for Dental Gap Cover is R238 per
month, which covers the whole family on the medical
scheme.
13. Market Differentiators
Dentistry Benefit
There is a pre-existing condition exclusion for the first 12
months of the policy.
If the insured is aware of a condition requiring specific
treatment plan before commencement of the Policy
which has been diagnosed and written up by a dental
practitioner then such treatment is deemed to be a pre-
existing condition.
Benefit is paid on the occurrence of an insured event
regardless of the treatment that is required.
16. Accreditation
Short Term Insurance annually renewable policy.
Short Term FSP is required.
Zestlife can appoint FA as a representative.
Appointed approximately 2000 representatives.
17. Commission is 20% of premium paid on the 15th
day of
the month following the previous months premium
collection.
Opportunity to build annuity income as well as being a
great door opener.
Commission
18. Assume you sell 5 policies a month. 1 with dentistry and
cancer and 2 with cancer. Lapse rate of 12% per year
and 15% annual premium increase.
After 12 months 56 policies and R3188 per month;
After 24 months 106 policies and R6915 per month;
After 36 months 150 policies and R11 265 per month;
After 60 months 224 policies and R22 222 per month;
Total commission earned in 5 years R629 898.
Commission
