Al Khalij Commercial Bank (al khaliji) Q.S.C. Asia Street 60, West Bay P.O.BOX 28000, Doha STATE OF QATAR Detailed Policy Terms & Conditions of GROUP CREDIT LIFE INSURANCE SCHEME Issued by Q Life & Medical Insurance Company LLC (Incorporated at Qatar Financial Centre - License No. 141, Authorized by the QFC Regulatory Authority) P.O. Box: 201233, Doha, State of Qatar (A QIC Group Company)
DEFINITIONS For the purpose of this policy, the following definitions shall apply unless the context otherwise requires: Accident means where the bodily injury/death is caused solely and directly by external violent means, is unexpected, unforeseeable and not attributable to the Borrower s / Cardholder s intentional self-injury or suicide. Bank Benefit Borrower / Cardholder Commencement Date means Al Khalij Commercial Bank (al khaliji) Q.S.C., Qatar means the indemnity payable under the scope of this policy in respect of Death or Permanent Total Disablement of the Borrower / Cardholder and Involuntary Loss of Employment of the Cardholder. Borrower means an individual resident borrower of personal loans or mortgage loans covered under this policy excluding customers borrowing for self medical purposes. Cardholder means primary account holder of the Credit Card Facility with the Insured who has not unsubscribed to the benefits under this policy and has not been disqualified by the provisions of this policy to be eligible to receive the benefits under this policy. means the date on which the Loan / Credit Card was disbursed / approved by the Insured. Credit means the credit or other form of financial accommodation provided by the Insured to the Borrower/Cardholder under the Personal Loans/ Mortgage Loans / Credit Card Facility. Credit Card Facility Company Date of Event means the Insured s Credit Card Facility including additional/supplementary cards which have been nominated as the facilities to which the benefits under this policy is to apply. means Q Life & Medical Insurance Company LLC, P.O. Box No.201233, Doha, State of Qatar. means any one of the following: 1. In respect of death the date of death is resulting from an accident or illness happening after the Commencement Date and during the policy period. 2. In respect of Permanent Total Disablement the date of recognition of Permanent Total Disablement by a competent authority results from an accident or illness happening / manifesting after the Commencement Date and during the policy period. Page 2
Death Illness Indebtedness Indemnity Period Injury Insured Involuntary Loss of Employment Maximum Coverage Age Minimum Payment Due Permanent Total Disablement 3. In respect of Involuntary Loss of Employment, the date of notice of termination served to the Cardholder after the Commencement Date and during the policy period. means death by injury or illness. means a disease or sickness first occurring after the Commencement Date means the outstanding loan amount or the amount outstanding in the Credit Card Facility as on the Date of Event but excluding any loan or Credit facility availed after the Date of Event, subject to the prescribed maximum but not exceeding the loan/credit facility availed. means in respect of Involuntary Loss of Employment the Indemnity Period specified in the schedule of this policy commencing from the date of actual unemployment means bodily injury resulting from an Accident occurring after the Commencement Date. means the Bank as specified in the schedule of this policy means unemployment of the Cardholder arising out of the unilateral decision of the employers to terminate his employment contract without citing any reason or for any reason other than those mentioned under exclusions in the policy. means attainment of 70 years for death benefit, 65 years for disability benefit and in case of involuntary loss of employment it means 60 years. means the Minimum Payment Due mentioned in the Credit Card billing statement issued for the period covering the Date of Event. means either of the below as a result of the injury or illness arising out of a cause not specifically excluded under this policy Permanent Loss of sight of both eyes. Physical severance/amputation of two limbs Complete and Permanent Paralysis Totally Disabled and the Borrower / Cardholder is rendered unable to earn income in any occupation, trade or profession for which the Borrower / Cardholder could reasonably be expected to be suited through education, training or experience Provided that the disability shall be for a period of six Page 3
Policy Term consecutive months and that the Company is satisfied that the Borrower / Cardholder will be so rendered indefinitely. However this time limit shall not apply to cases of physical severance/amputation of limbs. Means the term set out in the schedule Pre-existing Condition means illness, disease or sickness occurring or manifesting prior to the Commencement Date, for which advice or treatment was sought or obtained from a medical practitioner, chiropractor, naturopath, or any other practitioner of a similar kind within twelve months immediately prior to the Commencement Date. Re-Employment means accepting and starting work for a new employer or the same employer under a new employment contract within 10 (ten) months from the date of actual unemployment. SCOPE OF COVER Subject to the terms and conditions provided in this policy the Company shall indemnify the Insured as hereinafter provided: SECTION 1 DEATH BENEFIT In the event of the death of a Borrower / Cardholder due to injury or illness arising out of a cause not specifically excluded under this policy after the Commencement Date and during the Policy Term, the Company shall, subject to the limit(s) specified under the schedule of this policy, indemnify the Insured with an amount of the Borrower s / Cardholder s indebtedness as on the Date of Event on which the premium is paid. SECTION 2 PERMANENT TOTAL DISABLEMENT BENEFIT In the event of the Permanent Total Disablement of a Borrower / Cardholder due to injury or illness arising out of a cause not specifically excluded under this policy after the Commencement Date and during the policy period, the Company shall, subject to the limit(s) specified under the schedule of this policy, indemnify the insured with an amount of the Borrower s / Cardholder s indebtedness as on the Date of the Event on which the premium is paid. SECTION 3 - INVOLUNTARY LOSS OF EMPLOYMENT BENEFIT FOR CREDIT CARDHOLDERS ONLY In the event of the Primary Cardholder s Involuntary Loss of Employment during the Cover Period due to reasons not specifically excluded under this policy, the Company shall, subject to the limit(s) specified under the schedule of this policy, indemnify the insured with an amount of the Borrower s / Cardholder s indebtedness. Page 4
PROVIDED THAT: 1. The Date of Event falls after a waiting period of 90 days from the Commencement Date. 2. The Borrower / Cardholder shall provide all necessary proofs as may be called upon by the Company in order to substantiate his unemployment EXCLUSIONS 1. No Benefits under this policy shall be payable in respect of a Borrower / Cardholder where the event giving rise to a claim under this policy occurs as a result of: (a) Death by suicide or any self-inflicted injury. (b) Illness occurring within 30 days of the Commencement Date; (c) Any accident occurring on or in or about any aircraft other than an aircraft in which the Borrower / Cardholder was travelling as a bonafide passenger and which is operated by a licensed commercial or chartered airline; however this exclusion is not applicable to Borrower / Cardholder who are air crew and pilots of airlines while on duty as paid employees; (d) Nuclear radiation, nuclear fission, nuclear fusion and/or radioactive/ or biological /or chemical contamination; (e) Riot, civil commotion, strikes and war (whether war be declared or not), rebellion, insurrection, resurrection, popular rising, usurped power, terrorism. However, terrorism exclusion is not applicable as long as the Borrower / Cardholder are not an active participant of the terrorist activity. Passive war is covered. Borrowers / Cardholders engaged in military / naval services are not covered while actively engaged in war (whether war be declared or not) or war like operations but covered whilst engaged in training activities. (f) The influence of alcohol or drugs other than proper use of drugs prescribed by a legally qualified medical practitioner but this exclusion shall not apply to death arising out of the above reason or due to natural death. (g) Due to chronic illness / condition but this exclusion shall not apply to Death resulting from this reason. Page 5
(h) Any breach of law or participation in a criminal act by the insured; (i) Illness due to Pre-existing Condition. However, this exclusion is applicable only if the Company is able to substantiate Preexisting Condition within 60 days from the date of submission of all required claims documentation to the Company; (j) (i) Acquired Immune Deficiency Syndrome (AIDS), AIDS related Complex (ARC) as defined by the World Health Organisation from time to time; or (ii) the presence of the Human Immunodeficiency Virus (HIV) as revealed by the positive HIV anti-body or HIV test; 2. 3. The benefits under this policy shall not be payable to the Borrower / Cardholder where the Borrower / Cardholder has received or has applied to receive a similar benefit covering the same interest under any other product or insurance in respect of the period for which the indemnity under this policy shall apply. Exclusions applicable to Death caused by an Accident: No payment shall be made under this policy on the death of the cardholder if such death occurs as a result of: (a) Motor cycling as a driver if the Borrower / Cardholder does not have a valid motor cycle licence. (b) Taking part or participating in any dangerous or hazardous sports as a professional including but not limited to boxing, caving, horse racing, martial arts, mountaineering, off-piste skiing, potholing, steeple chasing, powerboat racing, under water diving, yacht racing, or any race, trail or timed motor sport. 4. Exclusions applicable to Involuntary Loss of Employment: The benefits under this Cover shall not be applicable in respect of Involuntary Loss of Employment arising out of and/or attributable to and/or in connection with the following: (a) Borrowers / Cardholders who are on probation, or if are not subject to a probation period but not have been continuously employed with the same employer for a minimum period of 3 months; (b) Employment on a fixed term contract for less than 1 year or part time or temporary employment; (c) Resignation or leaving by mutual agreement or voluntary unemployment or redundancy after voluntary breaks from employment in excess of normal holiday entitlement; (d) Disability, sickness or accident or any other medical reasons (mental and / or physical). (e) Where the Borrower / Cardholder was aware of pending Page 6
unemployment on or before the Commencement Date. (f) Where the unemployment is a normal seasonal part of the employment or due to non-renewal of employment contract by the authorities. (g) Where the Borrower / Cardholder has neither been terminated nor become redundant but his/her salary or allowances is being withheld in part or in full for any reason of the employment contract. (h) Unemployment due to any of the following: i. Misconduct ii. Refusal to accept orders from superiors iii. Convicted in a crime iv. Dishonesty or fraudulent act v. Non-performance or underperformance (i) The period for which payment from the employer is received instead of working notice (j) Payment after the Borrower / Cardholder reaches the maximum coverage age specified in the schedule of this policy. (k) Termination of employment due to voluntary retirement. (l) Company failure where a contributing cause was a natural catastrophic peril is covered subject to a maximum of QR 500,000. 5. Claims reported later than 90 days from the Date of Event. CONDITIONS 1. The Borrower / Cardholder / Insured shall furnish the Company with any information the Company may require (including details of the state of health) in respect of the Borrower / Cardholder for the benefits hereunder. Prior to acceptance, the Company may, at its sole discretion, require the Borrower / Cardholder to undergo a medical examination by a legally qualified medical practitioner in the manner the Company deems required or fit. 2. The benefits under this policy shall be extended to Borrowers and to Primary Cardholders and not to an additional or supplementary Cardholder. In case of joint loans, each joint account holder (borrower) shall be covered for 50% of the outstanding loan amount or in the ratio as indicated by the bank. 3. No Benefits shall be paid in respect of a Borrower / Cardholder who attains the Maximum Coverage Age specified in the schedule of this policy (at which time the Borrower / Cardholder shall cease to be covered). 4. Notwithstanding anything contained herein to the contrary, the benefits under this policy in respect of the Borrower / Cardholder shall terminate upon the happening of any one or more of the following: Page 7
(a) Cancellation of the Borrower s / Cardholder s Loan/Credit Card Facility. However, the cancellation of cover shall be effective only from the 90th day of cancellation of the respective Credit Card Facility. (b) The Borrower / Cardholder having attained the Maximum Coverage Age specified in the schedule of this policy (c) upon payment of a claim under Section 1 or Section 2 of this policy. (d) The Borrower s / Cardholder s Loan Account / Credit Card Account with the Bank becomes overdue for a period of 180 days or a complaint is filed with authorities about non-payment of dues or the Borrower / Cardholder is declared absconding or a judgment is entered in any court. (e) Borrower / Cardholder becoming unemployed voluntarily. However, the termination of cover in such event shall be only in respect of Section 3 Involuntary Loss of Employment; (f) Cancellation of the benefits under this policy by the Insured or the Borrower / Cardholder at any time in accordance with the terms and conditions of this cover. (g) Transfer of Borrower s / Cardholder s indebtedness to another person. 5. The observance by the Insured of the terms of this policy and the truth of the statements and the answers by the Insured in the proposal and other material information provided by the Insured shall be condition precedent to any liability of the Company. If the circumstances in which the insurance contract was entered into are materially altered without the written consent of the Company, the policy shall become null and void. 6. If any claim under this policy is in any way fraudulent or unfounded, all benefits under this policy shall be forfeited in respect of the particular Borrower / Cardholder. 7. If any difference shall arise as to the amount to be paid under this policy (liability being otherwise admitted) such difference shall be referred to an arbitrator to be appointed by the parties in accordance with statutory provisions. Where any difference is to be referred to arbitration, the making of an award shall be a condition precedent to any right of action against the Company. 8. This policy and any disputes arising hereunder are subject to and are to be construed in accordance with the laws of the State of Qatar. All claims and/or disputes shall be subject to the non-exclusive jurisdiction of the competent courts of Qatar. Page 8
9. Annexures: The following annexures attached form part of this policy: Annexure 1 Medical Questionnaire. Annexure 2 Evidence Requirements. Annexure 3 Medical Request Letter. Annexure 4 Death Claim Form. Annexure 5 Disbaility Claim Form. Annexure 6 ILOE Claim Form. CLAIMS PROCEDURE Upon happening of an event giving rise to a claim under this policy, the Borrower / Cardholder or their Legal Representatives shall follow the following procedure: 1. Give immediate written notice to the Bank but not later than 90 days from the Date of Event. 2. The Borrower / Cardholder or their legal representative / Bank shall complete the standard claim form issued by the Company and submit the same with such evidence to substantiate the claim to the satisfaction of the Company as the Company may reasonably require; 3. The Borrower / Cardholder or their legal representative / Bank or the Insured shall submit the following documents within 180 days from Date of Event. However, the delayed cases may be considered on case by case basis : 1. for Death Claims a. Copy of death certificate b. Copy of post mortem report (wherever legally required) c. Copy of police report (if death was due to an accident) d. Copy of *medical report with detailed diagnosis and cause of death if required by the Company when the actual cause of death is not clearly mentioned in the death certificate. e. Copy of Passport with valid residence visa page (expatriates) or national identity card (Qatari nationals) f. Copy of loan / credit card outstanding statement. g. Any other document that may be required from time to time. 2. for Permanent Total Disablement Claims a. Copy of disability certificate from an authorised medical board to assess disability b. Copy of police report (if disability is due to an accident) c. Copy of *medical report with detailed diagnosis, cause of disability and details of treatment given (if any) d. Copy of Passport with valid residence Visa page (expatriates) or national identity card (Qatari nationals) e. Copy of loan /credit card outstanding statement Page 9
3. for Involuntary Loss of Employment Claims a. Notice of termination from the employer b. Copy of Passport with valid residence visa page (expatriates) or national identity card (Qatari nationals) c. Salary slips for the 3 months preceding date of notice of termination with contract details d. Copy of credit card outstanding statement e. Any other documents as may be required The Company may also request for a copy of the labour contract from the employer if it is required to verify the period of employment contract. All papers as indicated above may be required to be produced as attested copies (other than those surrendered to the authorities or employer) for verification before the final settlement of claim. * Medical report should be obtained from the chief medical officer or any other registered medical practitioner recognized by the local authorities. Page 10