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Income
Protection claim


Injury and illness affects your ability to work. Income protection cover helps you maintain your lifestyle when you're unable to work so that you and your family are financially protected.

Income Protection claim requirements

  • The Income Disability and Impairment Benefits Form completed and signed by the policyholder or duly authorised representative of the policyholder..
  • The POPIA Consent Form completed and signed by the claimant or duly authorised representative of the claimant.
  • A copy of the life insured’s identity document.
  • Proof of banking details, in the name of the policyholder (natural person or legal entity), not older than three months on a bank letterhead or that has a bank stamp on it.
  • Proof of your income for the last 12 months before the date on which you were diagnosed with the claim event. This may include salary slips, tax returns, bank statements and audited statements.
  • A copy of the medical certificate from a medical specialist that confirms the injury or illness (full diagnosis); and the exact period of sick leave (start and end date of sick leave).
  • A copy of the hospital account which must include the times and dates of admission and discharge (if applicable).
  • A copy of the radiology report(s) in the event of a fracture claim.
  • A copy of the operation report(s) (if applicable).
  • A copy of the accident report from the police or your employer (only applicable if claim event was caused by an accident).
  • Any other reports or relevant supporting documents.
  • Curator bonis appointment if the claimant is not able to handle his/her own financial affairs (if applicable).

And the following additional requirements:

If there is a cessionary

  • A copy of the authorised representative’s identity document.
  • A written instruction from the cessionary confirming the bank account to use for the claim payment as well as proof thereof not older than three months on a bank letterhead or that has a bank stamp on it.

If the claimant is a trust

  • A copy of the trustee’s identity document.
  • A copy of the letter of authority issued by the Master of the High Court.
  • A copy of the trust deed and resolution.

If the claimant is a company

  • A copy of the authorised representative’s identity document.
  • A copy of the CK1 documents and resolution

Please note:

  • The income section on the claim form must be fully completed and if not, then we will require proof of income for the last 12 months before the date on which you were diagnosed with the claim event. This may include salary slips, tax returns, bank statements and audited statements.
  • A copy of the official proof of the business' overhead expenses for the past 12 months.

We may require additional information for medical requirements and legal entities.

Contact details to submit an Income Protection claim


incomeclaims@momentum.co.za

Fax: +27 12 675 3947

Types of
Life Insurance claims

Funeral Benefit
claim

Lump sum Disability and
Impairment Benefit claim

Critical Illness Benefit
claim

Retirement Annuity
claim

Terminal Illness Benefit
claim

Contact Life Insurance

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Business hours are Monday to Friday from 08:00 to 19:00. Closed on weekends and public holidays.

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Business hours are Monday to Friday from 08:00 to 19:00. Closed on weekends and public holidays.

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