GENERAL 1. Is the insurer (itself or through an intermediary) deducting premiums from social assistance grant beneficiaries:

Transcription

1 the Regulations issued under the Social Assistance Act No. 13 of 2004: Request for information Annexure A DEDUCTIONS FOR FUNERAL INSURANCE OR SCHEME UNDER REGULATION 26A OF THE REGULATIONS ISSUED UNDER THE SOCIAL ASSISTANCE ACT NO. 13 OF 2004: REQUEST FOR INFORMATION INSTRUCTION: This Form must be completed and submitted electronically by the public officer of registered insurers (excluding linked insurers, captive insurers, insurers in run-off and reinsurers) to the FSB c/o FSB.INSSocialgrants@FSB.co.za by no later than 30 September INSURER S NAME: GENERAL 1. Is the insurer (itself or through an intermediary) deducting premiums from social assistance grant beneficiaries: Yes No 2. If the answer to 1 is No the remainder of the questions in Annexure A need not be answered. DEDUCTIONS 3. Are deductions made in the name of the insurer or that of an intermediary that collects premiums on behalf of the insurer 3.1 the insurer: Yes No 3.2 FSP/s: Yes No Page 1

2 4. If the answer to 3.2 is Yes, furnish details (full names and FSP numbers) of the FSP/s: 5. Is the deduction of premiums from social grants for funeral insurance or scheme: Yes No 6. If the answer to 5 is Yes, indicate under which class of business the insurer issued the insurance policy: 7. If the answer to 6 is No, please explain (i.e. for what other type of policies are premiums deducted?): 8. Please indicate if the policies are structured as: Individual policies Group policies Both individual and group policies Page 2

3 9. Please indicate if and how the insurer monitors that only one deduction for funeral insurance or scheme not exceeding ten percent of the value of the beneficiary s social grant per month, is made: 10. Please state the average total number of monthly deductions from beneficiaries for funeral insurance or scheme during the insurer s financial year ending in 2012: 11. Please state the average total monthly gross premium deductions from beneficiaries for funeral insurance or scheme during the insurer s financial year ending in 2012: R 12. Please state the geographical spread of total gross premium deductions for funeral insurance or scheme during the insurer s financial year ending in 2012 as a % per province: Eastern Cape % Free State % Gauteng % KwaZulu-Natal % Limpopo % Page 3

4 Mpumalanga % Northern Cape % North West % Western Cape % BENEFIT PAYMENTS 13. Please describe the types of benefits under the funeral insurance or scheme and state the average and maximum amount of benefits: 14. Please state the average total monthly policy benefit payments to beneficiaries under a funeral insurance or scheme during the insurer s financial year ending in 2012: R CLAIMS AND COMPLAINTS HANDLING 15. Please indicate the following during the insurer s financial year ending in 2012 for funeral insurance or scheme directly from a social grant: 15.1 Lapse rate: 15.2 Claims ratio: 15.3 Claim rejection rate: 16. Please describe the claims handling processes for funeral insurance or scheme and how fair treatment of customers is ensured during this process: Page 4

5 17. Please describe the complaints handling processes for funeral insurance or scheme and how fair treatment of customers is ensured during this process: 18. Please indicate how and when consumers are informed of the relevant ombud to whom they can complain: MARKET STRUCTURE 19. Please describe the types of distribution models used for funeral insurance or scheme: Page 5

6 20. Please indicate which of the following types of distribution models are used for funeral insurance or scheme as a % of overall funeral insurance or scheme distribution: Direct marketing: 20.1 Face-to-face by insurer s own individual representatives ( tied agents ) or juristic representatives (please indicate which): 20.2 Face-to-face by independent intermediaries (FSP s that are not representatives of the insurer): 20.3 Other (please describe and state %): % % % 21. Please describe the competency levels of financial services providers and/or representatives used for funeral insurance or scheme (e.g. FAIS licence category fit and proper levels, whether representatives for FAIS purposes, etc.) and how these competency levels are monitored by the insurer: DISCLOSURE 22. Please describe the insurer s practices in respect of disclosing key product features to the consumer in respect of funeral insurance or scheme. Please summarise the types of policy information (e.g. the amount and frequency of the premium, who is the policyholder, terms and conditions, the circumstances under which policyholders can claim, exclusions or special conditions, where policyholders can complain, etc.) and the format in which information is provided at each of the following stages: 22.1 Pre-sale: Page 6

7 22.2 Post-sale: 22.3 On an ongoing basis during the life of the policy: 22.4 On the happening of any other events (including but not limited to disclosures in the event of missed premiums and at claim stage): Page 7

8 23. Please describe the level of testing of suitability of disclosures for the target market (e.g. simplicity, choice of language, etc.): 24. Please elaborate on how any and all fees or charges, including how the fee or charge was determined and what it is being charged for, are relayed to the beneficiary: 25. Please indicate at which point and in what manner the consumer is informed of who the underwriter is: PRODUCT STANDARDS 26. Please state the average total premium per R 1000 cover provided. 27. Please state the average risk premium per R 1000 cover provided. Page 8

9 28. Please state the average commission paid per R 1000 cover provided. 29. Please state the average of other fees paid per R 1000 cover provided. 30. Please indicate whether amounts are added to premiums or deducted from claim payments by intermediaries (including whether the total premium or other amount paid by insured exceeds the contractual premium paid to the insurer) and provide details of such amounts/practices: 31. Please describe the policy exclusions, waiting periods and time bars applicable to funeral insurance or scheme policies: 32. Please describe when and what level of underwriting takes place for funeral insurance or scheme: Page 9

10 33. Please describe whether, as a result of any medical underwriting performed, policies can be declined, rated or postponed and, if so, the percentage of applications to which such actions were applied during the insurer s financial year ending in 2012: Page 10