Group cover sits with the employer
Absence registers, payslips, the job specification, and the employer statement are often decisive. The claimant does not hold them. The compiler names who does.
Live
South Africa
riskatlas.co.za
We serve South Africa too. Group income protection, a Date of Absence, an employer who holds the records, and a medical scheme that runs beside the policy — not instead of it.
Why this market
South African income-protection claims fail on paper more often than on medicine. Dates do not line up. ‘Illness’ is written as if it were incapacity. The scheme file and the insurer file are treated as one thing. The National Financial Ombud is the complaint path after internal review — but only if the file can be argued from.
Scheme ≠ policy
CMS medical schemes, PMB, CDL, and DTP are a parallel system. They do not decide disability. Mixing the two languages is a common way a valid claim is refused.
Date of Absence is a legal fact
It is not averaged with the first sick note or the insurer’s own calculation. Conflicts stay visible. That is what the waiting period and the NFO clock run from.
How a claim works here
- Cover
- Group and individual income protection; disability / lump-sum
- Disablement date
- Date of Absence (DOA)
- Privacy / access
- POPIA and, where it applies, PAIA
- Internal challenge
- Internal review
- External complaint
- National Financial Ombud (NFO)
- Clinicians
- HPCSA
- Financial conduct
- FSCA
- Health overlay
- Medical schemes — CMS, PMB, CDL, DTP
- Currency
- ZAR
- Offsets
- UIF, sick pay, other IP
What we build here
The tool
Compiler
Same job as the other market: documents in, a file out. Local complaint path, local privacy basis, local cover types.
Open →Alongside it
Library
Language, traps, and IP directories for this jurisdiction. Wired into the compiler when you need it. Not medical schemes.
Open →State social security
Social Security Compass
Government support for this country — conditions and rates. Private insurance is a different contract.
Open →Standalone · ZA only
SchemeBook
Independent medical scheme directory and jargon guide — for consumers, industry, international bodies, and institutional reformists alike. Not part of RiskAtlas; referenced by it.
Open →Based in Melbourne
We are based in Melbourne and serve Australia as well. Same compiler; the legal wrapper is not.
Sentrix Digital, Melbourne.