What does Casualty Illness mean and what am I covered for?


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Casualty Illness

Everything you need to know about casualty illness cover and more!

Why do you need health insurance? There are plenty of reasons why but the most prevalent one is that you would be mad if you didn’t have it!

Not only does health insurance cover you for your day to day health costs, but it also covers you for the big stuff: like when you need to be admitted to the hospital or visit the emergency room.

Health insurance gives you access to private healthcare when you need it the most. What more could you want for you and your family? Having peace of mind knowing you will be able to have excellent healthcare in fantastic facilities is arguably one of the most appealing points of health insurance.

Let us ask you a question: are you prepared for when you fall ill? Do you know for a fact that when you get seriously sick, you will be taken care of financially? Are you secure in the fact that you can access the best possible doctors and amenities? If your answer is no, you need to read on.

Related: How much is health insurance and what am I covered for?

What is casualty illness?

Casualty illnesses are emergency treatments for illnesses that are serious but don’t require that you stay in the hospital overnight. In other words, you will be treated and the doctor will give you the all-clear to go back home.

You would have heard of the casualty section of a hospital, sometimes referred to as the ER (emergency room). This is where casualty illnesses are treated. Any emergency treatment you need for an illness that does not require an overnight stay will be covered with illness casualty cover.

It’s also good to keep in mind that this cover has a 90 day waiting period, meaning you’ll need to wait 3 months from the inception of your policy before you claim.

Read this next: Why are second medical opinions so important?

When will I be admitted for casualty illness?

Doctors work with a triage system to organise and prioritise the people that come into the hospital. The triage system works on a time schedule, as in how much time do you have until the situation becomes life-threatening or fatal.

You can check out the triage system below:

Green: 4 hours. This means you will initially qualify for general cover for a GP consult. Emergency cover will depend on your diagnosis after treatment.

Yellow: 1 hour. This emergency will not fall under emergency cover. It falls under general health cover and you will visit a GP, radiologist, pathologist or the x-ray team.

Orange: 10 minutes. This will fall under emergency casualty cover.

Red: Immediate. This will fall under emergency casualty cover.

In order for your emergency to be covered under casualty illness, your situation will need to be flagged as red or orange on the triage system.

What plans will cover me for casualty illness?

All four of our fantastic health plans will cover you for casualty illness. We know that getting sick can happen to anybody and being protected shouldn’t have anything to do with how much you can afford to pay in premiums.

Core Plan: R390pm

Casualty Illness Cover: R5000

Blue Plan: R770pm

Casualty Illness Cover: R5000

Professional Plan: 1035 pm

Casualty Illness Cover: R5250

Executive Plan: R1356

Casualty Illness Cover: R5500

Please note that these prices are reflective of the date that this article was written. For up to date pricing, please follow this link.

Will I also be covered for accident casualty cover?


Casualty cover as a whole includes illness and injury/accident cover. Again, we include accident casualty cover across all four of our health insurance plans. The difference between accident and illness is simple: an illness is when you have contracted a disease or sickness whereas an accident is a sustained injury from an external influence.

The great thing about your accident casualty cover is that there are NO waiting periods. So even if you get into an accident one week into your plan, you’ll be immediately covered.

What else makes Oneplan awesome?

To end off, let’s run through what else makes Oneplan the health insurance provider of choice for plenty of South Africans.

  1. Load claims through the Oneplan App.
  2. Get paid before you see the doctor by having funds loaded into your Onecard.
  3. Access your premium at any time, any place.
  4. Amazing routine care benefits.
  5. Awesome maternity, pre-birth and birth cover

Yours in excellent health insurance,


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