SCHEDULE OF INSURED PERSONS AND COMPENSATION

Transcription

1 WORDING UNIVERSAL FUNERAL AND ACCIDENT DEATH DISABILITY POLICY Section A- Accidental Death, Injury and Disability Schedule Period of Insurance : Monthly Limit per Individual : As per schedule below Territorial Limits : Worldwide Monthly Premium : Per schedule below Cover Plan Sum Insured For Individual Plan Family Plan Plan choice Funeral Cover Accidental Death Accidental Monthly Premium Monthly Premium Permanent Disability 1 R5 000 R5 000 R R49 R100 2 R5 000 R R R59 R125 3 R R R R70 R160 4 R R R R80 R180 5 R R R R90 R200 SCHEDULE OF INSURED PERSONS AND COMPENSATION Insured Persons : Funeral Cover : Family 16 to 65 next birthdate Sum Insured Sum Insured Sum Insured Funeral Principle & Spouse R 5 000,00 R ,00 R ,00 Children if student to 25 R 5 000,00 R ,00 R ,00 Children 7-13 R 3 750,00 R 5 000,00 R 7 500,00 Children 1-6 R 2 500,00 R 3 500,00 R 3 500,00 Children 27 weeks - birth R 1 250,00 R 1 250,00 R 1 250,00 *Natural death 6 months waiting period *Accidental Death covered from inception date Circumstances Compensation (i) Death (Accident) : as per certificate of insurance Basis of Cover : 24 Hour, seven days a week basis applies, unless otherwise Endorsed. Memorandum 1: Notwithstanding anything to the contrary the Underwriters agree to indemnify the Insured, in excess of any compensation payable, for any VAT obligation the Insured may incur arising out of any claims settlement made hereunder.

2 2 A. Operative Clause A.1 If during the Period of Insurance the Insured Person sustains Bodily Injury as defined, the Underwriters agree to pay to the Insured or the Insured Persons Estate or the Insured Persons Legal representative the Compensation stated in the Schedule. B. Definitions: For purposes of this Policy the following words and phrases shall have the meaning as assigned to them hereunder: B.1 Accident: a sudden, unexpected, specific event which occurs at an identifiable time and place during the Period of Insurance, but shall also include starvation, thirst or exposure to the elements resulting from a mishap to a conveyance in which the Insured Person is travelling. This shall also include insect, spider or animal bites other than those causing Malaria. For the purposes of this Insurance it is noted that any sporting activity shall not be classed as an occupation. C. General Conditions of Insurance This Policy and the Schedule shall be read together as one contract and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear such specific meaning wherever it may appear. This Policy will be governed by the laws of the Republic of South Africa, whose courts alone shall have jurisdiction in any dispute arising hereunder: C.1 If the Insured or the Insured Person makes any statement which is inaccurate or if he fails to disclose information material to the assessment of this risk, he may forfeit all or part of his right for Compensation or the Insurance may be cancelled. C.2 Premium is payable on or before the inception date or renewal date as the case may be. The Underwriters shall not be obliged to accept premium tendered to it or any intermediary after such date but may do so upon such terms as it, in its sole discretion, may determine. C.3 Any amendment to the Insurance must be evidenced in writing. C.4 Notice must be given to the Underwriters in writing as soon as practicable of any occurrence which may give rise to a claim under this Policy, but in any event within 180 days of such occurrence failing which the claim will prescribe. C.5 The Insured and/or the Insured Person shall take all reasonable precautions to prevent Accidents and to comply with all statutory requirements and regulations. C.6 Where the Insured disputes the rejection of his/her claim or cancellation of the policy, the Insured must make representations to the Company in respect of the decision within 90 (ninety) days of such rejection or cancellation letter. Thereafter, the Insured must take legal action by way of the service of summons against the Company within 9 (nine) months, failing which the Insured will forfeit his/her claim and no liability can arise in terms of such claim. C.7 This Policy may be cancelled at any time by the Underwriters giving 30 days notice in writing C.8 If any claim under this Policy be in any respect fraudulent or intentionally exaggerated or if any fraudulent means or devices are used by the Insured or anyone acting on his behalf to obtain any benefit under this Policy the benefit there under shall be forfeited. D. Provisions It is warranted that all Insured Persons at the inception and each subsequent renewal of this Insurance are between the ages of years and to the best of the Insured s knowledge and belief are in good health and free from physical or mental defect or infirmity. E. Exclusions This Insurance excludes Accidents arising from:

3 E.1 suicide, attempted suicide or intentional self- injury or deliberate exposure to obvious risk or injury (unless in an attempt to save human life); E.2 Nuclear/Chemical/Biological Exclusion Notwithstanding any provision to the contrary within this Policy or any endorsement thereto it is agreed that, regardless of any contributory cause(s) this insurance does not cover any claim(s) in anyway caused or contributed by an act of war, invasion, act of foreign enemy, hostilities or warlike operations (whether war be declared or not) civil war, mutiny, insurrection, rebellion, revolution, an act of terrorism, military or usurped power involving the use or release or the threat thereof of any nuclear weapon or device or chemical or biological agent. 3 For the purpose of this exclusion an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public in fear. If the Underwriters allege that by reason of this exclusion any claim is not covered by this insurance the burden of proving the contrary shall be upon the Insured. Section B - Funeral Care Benefit Schedule under the Masterpolicy issued to the Insured- Myfin 1237 Financial Services (Pty)Ltd FSP Willsfactory All the risk benefits are underwritten by African Unity Insurance under the Group Masterpolicy of Cellsurance. For as long as the Insured Person(s) pays the monthly premium, the benefits will apply. Willsfactory under My- Fin for the Insured has secured a Master Policy with African Unity Insurance Limited through LionHeart Underwriting Managers to underwrite the Insured Person(s) benefits. Non- Insurance benefits are supplied through various Service Suppliers and full disclosure is given in the section after the insured Section. Premiums include all benefits. Insured Section Principle Member: Funeral Benefit cover amount: Accidental Death cover amount: Single R5,000,00,R or R15000 as applicable R5,000,00 booster Total Premium per plan as per table above- Page 1 Description of benefits Principle Member Insured Benefits: The Insurer will pay the Insured s beneficiary or estate or funeral home the stated amounts upon the death of the Principal Member. In the event that the main member dies due to an un- natural. If the cause of death are an accidental death, the Insurer will pay an addisional amount as stated in the policy schedule to the Insured s beneficiary or estate. Insured Benefits Claim Procedure: The claims to the Client Services Centre on or immediately.(claims@my- fin.co.za). Claim forms can be requested from the Funeral Client Service Centre. Claim forms together with the relevant supporting documents, must be submitted to the Administrator within 90 (ninety) days of the date of event. Failure to do so could result in the benfit being forfeited. Copies must be clearly certified. The details of the Commissioner of Oath with all of the relevant details must be clear. NB Posted documents must be sent via registered mail if not faxed or ed. Definitions Principal Member: Any person who has applied for the Funeral plan and who has been accepted by the Insurer. Insured: The Principal Memberas stated in the Policy Certificate and who have been accepted by the Insurer.

4 Beneficiary: Any person nominated by the Principal Member to whom death benefits will be paid in the event of a seccessful claim, due to the death of the Principal Member. In the event of no beneficiary, will the claim be paid out to the first person that the Insurer feel have a right to claim. General terms and conditions: The Principal Member may not cede the benefit and any cession shall be null and void. The Insured may not be insured on more than two of the Insurers funeral plans. In the event that the Beneficiary or the Executor of the insured s Estate institutes claims for more than the maximum amount allowed, the amount payable by the Insurer shall be limited to the benefit provided in terms of this policy. Each Principal Member must complete an application form and nominate his/her beneficiary if the application is not voice recorded or personally captured though any electronic medium accepted to the Insurer. Benefits cease upon the death of the Principal Member or his/her written instruction to terminate the contribution and in case of non- payment of premiums. NOTE: It is accepted that R5 penalty will be debited to your cell phone airtime account if any deductions are returned unpaid. Grace Period: The Grace period is 15 days start from the 1st of every month in which period premiums have to be paid. Waiting Periods: A Minimum waiting period of 4 (four) concecutive paid weeks shall apply and cover will only commence after the 4th premium has been collected for any natural death. Death due to an accident will be covered from inception date. Should the policy be terminated or lapse for any reason all waiting periods will reapply as the re- instated policy is regarded as a new policy. Age Limitations: The Principal Member must be between the ages of 18 and 65 at the time of the application. Term of cover: The Wills Factory Universal Funeral and Accident plan is a monthly calculated plan. Surrended values: There are no surrender values. Benefits may not be ceded or pledged in any way. No loans will be accepted against any benefits. Specific Exclusions: The Administrator or the Insurer shall not be obliged to make payments in respect of any condition or event arising directly or indirectly from, contributed to by, or traceable to: 1. Suicide within the first 24 (twenty four) months of application. 2. War, invasion, acts of foreign enemy. Hostilities, rebellion, revolution, insurrection or milatary or a surper power, or by ionizing radiation or contamination by radioctivity from any nuclear fuel or waste. 3. Any participation in hazardous sports i.e. motor/cycle racing, mountain climbing as a professional sportsman. 4. Any involvement or participation in any criminal activity. 5. In the event that premiums are not paid up to date. Premium Increases: Premiums may be increased by the Insurer in the event were the claims ratio against the Risk Premium is more than 70%. A One calendar week notice shall be given in the event of any premium increase. 4 Premium Contribution Declaration The total premium includes Underwriting fees, non- insurance benefit fees, commission of 20%, Administration cost of 10%, Collection fee of 40% of the premium,and 3rd party suppliers of non- insurance services of R15.00 all inclisive of vat

5 5 IMPORTANT INFORMATION PLEASE READ CAREFULLY STATUTORY NOTICE TO POLICYHOLDERS, DISCLOSURES AND OTHER LEGAL REQUIREMENTS The Intermediary Administrator The Intermediary Administrator Myfin1237 Financial Services (Pty)Ltd is a registered, FSP no Willsfactory is a product of My-Fin. Physical address: 18 Sunninghill Office Park. 4 Peltier Drive. Sunninghill. Ext 71. Johannesburg Postal address: PO Box 2124,Lonehill, 2064 Telephone number: , Fax number r: Does the Intermediary have any interest in the Insurer or receive more than 30% of its total remuneration from the Insurer? No Has the Administrator/Underwriting Manager provided the Intermediary a written mandate to act on their behalf? Yes Does the Administrator/Underwriting Manager have any interest in the Insurer? No Has the Insurer provided the Administrator/Underwriting Manager with a mandate to act on its behalf? Yes Does the Administrator and Intermediary have a Professional Indemnity Policy in place? Yes Premium payment Premiums are payable in advance by debit order or salary deduction on the first working day of every month. In the event of non-payment a 15- day grace period is allowed in which to pay the premium. In the event that premiums stay unpaid after the 15-day grace period, the policy will be cancelled without any notice. How to institute a complaint Should you have any complaint about our policy or service you have received, please contact Cellshield s Complaints Department on The Ombudsman In the event of claims problems not satisfactorily resolved:- Postal address: PO Box 74571, Lynwood Ridge, 0040 Telephone number: address: info@ombud.co.za The FAIS Ombud In respect of complaints about the Administrator:- Postal address: PO Box 74571, Lynwood Ridge, 0040 Telephone number: , Fax number: address: info@faisombud.co.za Website: The Registrar of Short term Insurance Financial Services Board If any complaint to the Administrator or Insurer is not resolved to satisfaction:- Postal address: PO Box 35655, Menlo Park, 0102 Telephone number: , Fax number: Warning 1. Don t sign any blank or partially completed application form. 2. Complete all forms legibly in ink. Contact details: My-Fin 1237 Financial Services (Pty)Ltd Telephone number.: , Fax number: address: mike.e@my-fin.co.za. Intermediary Compliance Officer Peter Veal School of Insurance (Pty) Ltd FSP Licence Number Key Individual: James Veal Compliance Officer: James Veal Telephone number: (Landline) Fax number: (Fax to Desktop) address: james@pvsi.co.za Claims administration is done through My-Fin. The call centre can be contacted on Faxes can be sent to: s can be sent to: claims@my-fin.co.za Post can be sent to: PO Box 2124,Lonehill, 2064 or delivered to: No 18 Sunninghill Office Park 4 Peltier Drive. Sunninghill. Ext 71. Johannesburg. The Insurer African Unity Insurance Compliance Officer: Mike Terblance miket@africanunity.co.za How to institute a claim Contact Claim Centre on Claims can be lodged electronically by sending an to claims@my-fin.co.za or Fax to Claims to be reported within 90 days of the event. In the event that a claim is repudiated you have 90 days from the date of repudiation to make representation to the intermediary and 90 days thereafter to take legal action by the service of summons. Other matters of Importance 3. Keep all documents handed to you. 4. Make a note as to what was said to you. 5. Don t be pressurized to buy the product. You must be informed of any material changes to the information referred to in this disclosure. If any information above was given orally, it must be confirmed in writing in 30 days. Polygraph or any lie detector test is not obligatory in the event of a claim and the failure thereof may not be the sole reason for repudiating a claim. Your Insurer may not cancel your insurance merely by informing your Intermediary. There is an obligation to make sure the notice has been sent to you. You are entitled to a copy of the policy free of charge. 6. Incorrect or non-disclosure by you may impact on any claim arising from your contract of insurance. Duly authorised to market the product, the Intermediary confirms that according to Act No 37 of 2002, par 13.(1)b(i) (aa) and (bb) the Intermediary presenting this product is authorised to do so and the Intermediary accepts responsibility of the actions performed within the normal course and scope of duties, for license categories Long Term A, Long Term B, and Short Term Personal. The product information brochure and policy wording will be sent to the insured within 30 days. The Insured has 30 days to cancel this policy. The Insured confirms that he/she understands the policy with all its covers and/or exclusions and/or excesses. In the event that the policy is cancelled within the cooling off period, the Insured accepts that an Administration fee which includes bank costs of R50-00 will not be refundable. Any refunds will only be processed after the deducted premium was cleared by the Administrator s Bank and this can take up to 30 working days. Subject otherwise to the Terms, Conditions and Exceptions of this Policy.

6 Disclosure Notice to Short Term Insurance Policyholders in terms of the Financial Advisory and Intermediary Services Act.37 of 2002 (Please read carefully) Disclosure and other Legal Requirements As a short term insurance policyholder, or prospective policyholder, you have the right to the following information: (This notice does not form part of the Insurance Contract or any other document) 6 1.Your Intermediary 1.1 Contact details Company: Myfin 1237 Financial Servicxes Services Tel: Postal Address: P.O. Box 2124 Lonehill Fax: Physical Address: 18 Sunninghill Office Park,4 Maxwell Drive Sunninghill Intermediary Compliance Officer: Peter Veal Peter Veal School of Insurance (Pty) Ltd FSP Licence Number address: Telephone number: Fax number: peter@pvsi.co.za (Landline) (Fax to Desktop) Postal address : P O Box 125 Honeydew 2040 Registration Number: 2012/205235/07/ FSP No: VAT No: info@myfin.co.za 1.2 This intermediary does not hold directly/indirectly more than 10% of the Insurer s shares or any equivalent substantial interest in the Insurer. 1.3 Contact the intermediary to determine whether more than 30% of their total remuneration is received from the Insurer. 1.4 Contact the intermediary to obtain details of their guarantee, professional indemnity and fidelity insurances. 2. Your Insurer / Underwriting Manager 2.1 Contact Details Company Name: One Financial Services Holdings (Pty) Ltd T/A ONE- Juristic Representative of an FSP Tel Work: Postal Address: Postnet Suite: 221, Private Bag 75, Bryanston, 2021, Johannesburg, 2021 Physical Address: Maxwell Woodmead North Business Park, 54 Sunninghill Sandton, 2157 info@one.za.com Registration Number: 1998/005199/07 FSP No: 8783 The FSP license authorizes this entity to sell Short Term Insurance: Personal Lines and Short Term Insurance: Commercial Lines policies and to provide Advisory and Intermediary services. VAT No: Legal Status: The entity is in possession of Professional Indemnity and Fidelity Insurance This entity receives 100% of its income from the Insurer As premiums are not received by this entity IGF is not required.the Underwriting Manager is mandated to act as an Intermediary for the Insurer Compliance Officer: I.C.E. (Intelligent, Compliance and Education) Tel Work: (011) /4 Postal Address: P.O. Box 125, Honeydew, Johannesburg, 2040 peter@ice-sa.co.za Complaints procedure:please lodge any complaints in writing to Ms. Sally Skirving at sally@one.za.com Conflict of Interest policy: The Company has a comprehensive Conflict of Interest policy in place and can be accessed via the internet on There are no conflicts in terms of the FAIS Act identified at present in any of the following areas of our operations: 1. Associated Companies 2. Third Party relationships. 3. Ownership interests within these relationships. 4. Financial Interests or Immaterial Financial Interests paid or received from any of the above entities. 5. Our staff remuneration policies. 6. Insurer Company Name: Postal Address: Physical Address: Registration No: 2000/025898/06 FSP No: VAT No: Tel: (0861) ABSA Insurance Risk Management Services T/A AIRMS P.O. Box 221, Private Bag 75, Bryanston, Johannesburg, 2000 ABSA Towers, 180 Commissioner St, City and Suburban, J Johannesburg, 2094 Compliance Officer: ONE The Compliance Officer (AIC) Tel Work: (011) Postal Address: P O Box 421, Johannesburg, 2000 compliance@absa.co.za Complaints procedure: Please lodge any complaints in writing to The Complaints Department at ais.complaints@absa.co.za

7 7 4. How to Institute a Claim Contact the Underwriting Manager 1ComLoss One Commercial Investment Holdings (Pty) Ltd (detailed hereunder). Claim to be reported within 180 days of the event. In the event that a claim is repudiated you have 90 days from the date of repudiation to make representation to the Insurer and 90 days thereafter to take legal action by the service of summons on the Insurer. Claims Administrator Physical Address: Sunninghill, Leeanne Balfour Woodmead North Business Park, 54 Maxwell Dr, Sandton, 2157 Postal Address: Post net Suite 221, Private Bag 75, Bryanston, 2021 Telephone number: Cellular number : (084) Fax number: (086) General Matters of Importance (a) You must be informed of any material changes to the information provided above. (b) If the information was given to you verbally, it must be (c) confirmed to you in writing within 30 days. If any complaint of the intermediary or Insurer is not resolved to you satisfaction, you may submit a complaint to the Registrar of Short-term Insurance or to the FAIS Ombudsman. (d) Polygraph or any lie detector test is not obligatory in the event of a claim and the failure thereof may not be the sole reason for repudiating the claim. (e) (f) If the premium is paid by debit order. (i) It may only be in favor of one person and may not be transferred without your approval; (ii) The Insurer must inform you at least 30 days before the cancellation thereof, in writing, of its intention to cancel such debit order. The Insurer and not the Intermediary must give reasons for repudiating the claim (g) The Insurer may not cancel your insurance merely by informing your intermediary. There is an obligation to make sure the notice has been sent to you. (h) You are entitled to a copy of the policy free of charge. (i) (j) (k) (l) You must check your policy schedule to ensure that the items insured, their description and values are those you gave to us. You must advise any change to the description, use or value of the item insured as soon as reasonably possible to ensure that you are correctly insured. Incorrect or non-disclosure by you may impact on any claims arising from your contract of insurance. If you are not sure about, or do not understand any part of your policy, please contact us at the above address. 6. Particulars of the FAIS Ombudsman: Entity: FAIS Ombudsman Tel Work: (012) (a) a. Details of how to institute a complaint For any complaints relating to claims problems which are not satisfactorily resolved: Complaints Officer: Underwriting Manager: One Financial Services Holdings (Pty) Ltd T/A ONE- Juristic Representative of an FSP Tel Work: Postal Address: Postnet Suite: 221, Private Bag 75, Bryanston, 2021 Physical Address: Woodmead North Business Park, 54 Maxwell Dr, Sunninghill, sally.s@one.za.com a. Premium Payment Annual / Quarterly paid policies: Premium is payable on inception / renewal date. A 15 day grace period is allowed. Monthly Policies: Premium is payable in advance by debit order or salary deduction on the first working day of every month. In the event of non-payment a 15 day grace period is allowed in which to pay the premium 7. Warning (a) Do not sign any blank or partially completed application form. (b) Complete all forms in ink. (c) Keep all documents handed to you. (d) Make note as to what is said to you. (e) Don t be pressurised to buy the product. (f) Incorrect information or non-disclosure by you of relevant facts may influence an Insurer on any claims arising from your contract of Insurance 8. Particulars of the Short-term Insurance Ombudsman who is available to advise you in the event of claim problems that are not satisfactorily resolved by the insurance Intermediary and/or the Insurer: Entity: Short-term Insurance Ombudsman Tel Work: (011) Postal Address: P.O. Box 32334, Braamfontein, 2017 Fax: (011) Physical Address: 2 nd Floor JCC House, 22 Owl Street, Milpark info@osti.co.za 9. Particulars of the Registrar of Short-term Insurance: Entity: Financial Services Board Tel Work: (012) Postal Address: P.O. Box 35655, Menlo Park, 0102 Fax: (012) Postal Address: P.O. Box 74571, Lynnwoodrif, 0040 Fax: (012) Website: info@faisombud.co.za