b o n l i f e Bonben Assurance Namibia Limited Registration Number: 96 / 391 CERTIFICATE OF PARTICIPATION (NUMBER BONLIFE/01/07/14/DB) ISSUED
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1 b o n l i f e Bonben Assurance Namibia Limited Registration Number: 96 / 391 CERTIFICATE OF PARTICIPATION (NUMBER BONLIFE/01/07/14/DB) ISSUED to INVESTMED LTD Reg No. 2008/0614 SCHEDULE OF INSURANCE Policyholder: INVESTMED In respect of specified clients as per monthly bordereaux Term of Insurance Continuous Contract from 1 st of January 2014 Insurer Bonlife (Reg. No 96/0391) Purpose of the Certificate of Participation This certificate confirms the insurance cover and terms granted by the Insurer in respect of the funeral cover benefit selected by INVESTMED in accordance with the provisions hereof and as per the Master Policy. The signed Certificate of Participation and the Master Policy, constitutes the Agreement between INVESTMED, and Bonlife.(Reg.No 96/0391)
2 A. Benefits BONLIFE NAMIBIA Category Description COVER PREMIUM Premium over 65 Natural and accidental death Cover for the Principal Member and spouse in respect of death due to any cause. Member alone 10, N$ N$ Family member N$ N$ spouse children 5,000 B. Age Limits: Minimum of 16 and maximum of 65 next birthday at inception date for Basic Premium, 65 and maximum 85 next birthday at inception date for Premium over 65. C. Monthly Premium: As per Table. D. Payment of Premiums: Premiums are payable to Bonlife monthly in advance, in one amount and must be transferred electronically on the last day of the month preceding the month for which cover is intended or paid by cheque on or before the 7 th of each month. Banking Details: Bonlife Name of Bank Bank Windhoek, Name of Branch Main, Account Number , E. Guarantee Periods: Premium rates 12 months from 1 st January 2014 General policy conditions: - 12 months from 1 st of January 2014 F. Termination Conditions: The insurance cover is provided on a continuous contract basis for an irrevocable term of 2 years commencing on the 1 st of January 2014, during which period this agreement cannot be cancelled by the Policyholder. Hereafter the cover may be cancelled with either party providing the other with One (1) months written notice. G. Member Data Requirements: As at the 1 st of January 2014 and monthly thereafter, the following information must be transferred electronically by the Policyholder to the Insurer: client name, surname, gender, and identity number; for single cover
3 client name, surname, gender, identity number, spouse surname, name and identity, as well as children surname, name, gender and date of birth for family cover
4 MASTER POLICY WORDING Policyholder shall mean INVESTMED to whom this Master Policy will be issued. Insured Person - shall mean the person who is a client of the Policyholder as identified as such in the monthly bordereaux and for whom the correct monthly premium is paid up to date to the Administrator. Insurer shall mean Bonben Assurance Namibia. Ltd (Reg.No 96/0391) Only those Insured Person s for whom Bonlife has received and accepted the relevant personal information and premiums from as per the monthly bordereaux, shall be eligible for any claim under this Agreement. The benefit levels and terms, conditions and exclusions are set out in the Certificate of Participation and in the Master Policy Wording. Conditions 1. The Master Policy Wording and the Certificate of Participation 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 Master Policy Wording and the Certificate of Participation shall bear such specific meaning wherever it may appear. 2. This Agreement shall be governed by the laws of the Namibia, whose courts shall have jurisdiction in any dispute arising hereunder. 3. The Insured Persons shall take all reasonable precautions to prevent any claims against this policy. 4. The Insurer may cancel this Policy by giving 30 (thirty) days written notice to the Policyholder at his or her last known address, in which event cover shall cease at 24h00 on the last day of the month for which a premium has been paid. 5. Cover in respect of an Insured Person shall terminate immediately on the death of the Insured Person. 6. If any claim under this Agreement shall be in any respect fraudulent or if any fraudulent means or devices shall be used by an Insured Person or anyone acting on the Insured Person s behalf to obtain a benefit under this Agreement the Insurer shall be under no liability in respect of such claim. 7. Failure to comply with any part of these Conditions shall render the claim null and void.
5 Funeral Benefit On death of the Insured Person, subject to the terms, conditions and exclusions of the Agreement, the following documents being submitted in respect of the deceased Insured Person and the claim being admitted by the Insurer, the Insurer shall pay the amount as recorded in the Certificate of Participation: The death certificate or a certified copy thereof; The relevant Identity Document or a certified copy thereof; Any notice, coroners or medical report relating to the death, as may reasonably be required by the Administrator; No claim in respect of the deceased Insured Person shall be admitted by Bonlife, unless Bonlife receives written notice thereof within 30 days (thirty) after the date of death and receives the required documents, as referred to in this clause, within 3 (three) months of the date of notification of death. The Insurer reserves the right to consider a claim where, under exceptional circumstances a claim is submitted after the 3 (three) month period of grace. Admittance of liability of such claims by Bonlife will be at the sole and absolute discretion of Bonlife. Waiting Periods For this benefit the waiting period for the Insured Person is as follows: 3 months excluding accident Exclusions The Insurer shall not be liable to pay any claim and benefit under this Policy directly or indirectly consequent upon; 1. war, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, military or usurped power. 2. participation in labour disturbances, riot strikes, lock out or the Insured Person's commission of a criminal offence. 3. willful exposure to danger (except in an attempt to save human life), intentional selfinflicted injury, or the Insured Person being in a state of insanity. 4. The Insured Person engaging in aviation, gliding, parachuting or any form of aerial flight other than as a passenger in a fully licensed aircraft provided that the term "passenger" shall not include any person who is a member of the crew of the aircraft or who is in such aircraft for the purpose of undertaking any trade or technical operation therein. 5. The bodily injury being caused by or contributed to or arising from nuclear weapons, material, Ionising radiations or contamination by radioactivity from any nuclear fuel or
6 from any nuclear waste from combustion of nuclear fuel sustained during the course of such Insured Person's employment. For the purpose of this exclusion only, combustion shall include any self-sustaining process of nuclear fission. 6. The Insured Person being under the influence of alcohol, drugs or narcotics unless such drugs or narcotics were administered lawfully by a qualified medical practitioner (other than the Insured Person) or unless prescribed by and taken in accordance with the directions of a qualified medical practitioner (other than the Insured Person), Enquiries The Policyholder shall address enquiries and or any claims in respect of this policy to Bonlife Ltd Contact Person/s: Messrs. VG Kotze and/or U Haupt Company Registration Number: Reg.No. 96/0391 Physical Address: 73 John Meinert Str, Windhoek. Postal Address: P.O. Box 1189, Windhoek. Telephone Number: Fax Number: lallie@bonlifenam.com.na or sales@bonlifenam.com
7 Duly authorized to issue this Certificate of Participation on behalf of Bonben Assurance Namibia Ltd on this the day of 20 at Windhoek: Witnesses: VG Kotze for: Bonben Assurance Namibia Duly authorized to approve and accept the terms of this Certificate of Participation on behalf of INVESTMED Ltd on this the day of 20 at Windhoek: Witnesses: Hester Spangenberg for INVESTMED Ltd
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