Absa idirect insurance policy Terms and conditions
Introducing your Absa idirect insurance policy Your policy is made up of the schedule as well as general and specific terms Thank you for choosing Absa idirect for your short-term insurance needs. Your insurance policy is made up of: 1. A schedule. This sets out the type of insurance you have bought, the amounts you are insured for, the excesses that apply and the monthly premium you must pay. It also sets out security measures you must have to protect the items you insure. 2. General terms of insurance. This sets out your responsibilities, what we do and don t compensate you for and how to claim for any loss or damage to items insured. 3. Specific terms for the individual sections. There are extra terms specific to each type of insurance you buy (for example, motor or home) and are set out in individual sections. Some insurance is optional you must check your schedule to see whether you have bought the optional insurance. When and how we will compensate you We will compensate you for loss or damage to items insured under this policy on condition that: you pay the premium set out in the schedule on time every month. you comply with all terms set out in your policy. We will decide how to compensate you for an event insured under this policy. This means we may pay out, replace or repair the insured item through a supplier or repairer of our choice, or we may choose to apply a combination of these. Key terms used in this document In this document the words you and your refer to the policyholder, regular driver or any member of your household that permanently resides at the risk address, which you intend covering unless indicated otherwise in a specific section. The words we, us and our refer to Absa idirect Ltd. Please contact us if you have any questions If you have any questions about your policy, please contact us on 0860 20 21 22. 2
Table of contents General terms of insurance 5 What you have bought 5 How to claim 5 Your monthly premium 6 Your responsibilities under this policy 7 What we will compensate you for 8 What we will not compensate you for 8 Other important terms 11 3
Sections of insurance Section 1: Motor vehicle insurance 13 (including Caravans and Trailers) Section 2: The contents of your home 23 Section 3: All risks insurance 31 Section 4: Your home (the buildings) 35 Section 5: Boat insurance 43 Section 6: Personal accident 47 Absa idirect Assist 51 4
General terms and conditions of insurance 1. What you have bought You have bought a short-term insurance policy. This means we will compensate you for certain insured events that cause loss or damage to the items you insure. The insured events are set out in this policy. The maximum amount we will compensate you for is set out on the schedule next to each insured item. In exchange for this insurance, you must: pay us a monthly amount (called a premium). comply with the terms set out in this policy. Make sure you understand what we will and will not compensate you for, both in these general terms and in the individual sections that follow. 2. How to claim 2.1 What you must and must not do If a claimable event happens, you must: 1. Inform the police within 24 hours of any event involving theft or loss of property or accident and take all reasonable steps to find out who the guilty party is and to recover the property 2. Inform us where you may need to claim or when another party may claim against you as soon as possible but not later than 30 days following the event, by phoning our claims department on the number set out on the schedule. You lose your right to claim if you do not do so in this time. You must tell the claims department what happened giving as much detail as possible 3. The claims department may ask you for and you must provide to them within 15 days of their request: details of any other insurance that covers the insured event proof, statements and any other information they need Unless we give you permission to do so in writing, you must not: tell anyone involved that the incident may have been your fault promise payment to anyone involved or accept payment from anyone involved 2.2 Check the policy for what we will not compensate you for Refer to Clause 6. 2.3 Check your schedule for the excess you are responsible for For some sections of this policy you are responsible for paying an excess. The amount of the excess is set out in the schedule. 2.4 We will only pay our portion if you have other insurance (Dual insurance/contribution) If any loss, damage or responsibility insured under this policy is also insured by another insurance product, we will not compensate you for more than our portion of the loss, damage or responsibility. 5
2.5 Time limits if we do not accept your claim If we do not accept your claim, you may appeal against our decision. You must appeal in writing within 90 days of the date of us not accepting the claim. If your appeal is not successful, you may take the matter further. However, you must start legal proceedings against us within 180 days of the date of your unsuccessful appeal. If you do not do so in time, you will lose your right to start legal proceedings against us. 2.6 Our rights after an event If, after payment of a claim in respect of lost or stolen property, the property (the subject matter of the claim) or any part thereof is located, you will render all assistance in the identification and physical recovery of such property if called on to do so by us, provided that your reasonable expenses in rendering such assistance will be reimbursed by us. Should you fail to render such assistance in terms of this condition when called upon to do so, you will immediately become liable to repay us all amounts paid in respect of the claim. 3. Your monthly premium You must pay your premium as agreed every month by debit order. We only accept premium payments by debit order. No other means such as cash payments are allowed. Although we will always submit your policy payment to the bank on your selected debit date, some banks do not collect premiums on Saturdays, Sundays or Public Holidays and your premium will then be collected on the next working day. 3.1 If we do not receive your premium on time You must make sure that there are sufficient funds in your bank account to pay your premium on the agreed date. If any debit order is not paid, you will be responsible for the related bank charges. If we do not receive your premium on time, you have a grace period of 30 days to pay it. At the end of the grace period, we will process your debit order twice. If we are able to collect your premium, your policy will continue as before. If we are still unable to collect your premium, we will cancel your policy. You are not entitled to any refund of premiums if your policy is cancelled. If you claim during the grace period, we will not consider your claim until you have paid the premium. 3.2 When do you receive some of your premium back (ibenefit) 10% for 36 months of no claims: If you do not claim for 36 consecutive months from the date of inception, we will pay you 10% of the total amount of the premium you paid for those 36 months. 15% for the 12-month period following: If you do not claim for the next 12 consecutive months, following the 36 months of no claims, we will pay you 15% of the premiums you paid for those 12 months. 20% for every 12 month period completed thereafter with no claims: For each 12-month period you do not claim, we will pay you 20% of the premiums you paid in that 12-month period. ibenefit rewards will be paid to you within 45 days of the due date. You will not receive an ibenefit reward if the policy is cancelled 6
You will not be entitled to receive an ibenefit reward if: your policy is cancelled before the end of a set period of no claims. If your policy is re-issued after it was cancelled, the ibenefit period will start again from zero on the first day of the month after the new policy started we cancel your policy before the end of a set period of no claims If we pay an ibenefit reward and we later discover that you were not entitled to receive it for any reason, you must pay it back when we ask for it. If we compensate you for a claim, the period of no claims comes to an end. Your ibenefit will start again from zero on the first day of the month after the insured event happened. Some claims do not affect your ibenefit If you claim for any of the following, your ibenefit will not be affected: 1. Windscreen repairs under vehicle insurance (However, full windscreen replacements will affect your period of no claims) 2. Insured events under the Personal accident section 3. The following extensions of insurance under your home (the buildings): injury to pets injury from assault at an ATM hole in one or perfect 8 4. Your responsibilities under this policy 4.1 You must give us relevant, true and complete information You must give us relevant, true and complete information about yourself and the items as well as the risk you insure. The amount we insure you for, the premium you pay and the other terms in this policy are based on all the information you give us, including the information you gave us on the phone to obtain a quote. You must tell us immediately: if any of the information you gave us is not true, complete and relevant if any of the information you gave us changes If you do not tell us immediately, you might not be entitled to receive compensation if you have a claim. 4.2 You must take care of the insured items You must take all reasonable care to prevent or minimise loss or damage. If an insured event happens, you must take preventative steps to minimise any extra loss or damage from occurring. 4.3 You must keep all receipts and valuations We may ask you to prove that you own the items you are claiming for and to prove their value. You must therefore keep all receipts, proof of payment and valuation certificates of the items you have insured. 7
4.4 You must give us access to any damaged items You must give us access to the premises where the loss or damage took place. Where an item is damaged, you must allow us to take possession of it so that our specialists can inspect it to see the extent of the damage. 4.5 You must obtain our approval before getting repairs done You must obtain our approval before you have any damaged item repaired. If you do not, we will not compensate you for the cost of the repairs. You must have repairs and replacements completed within 6 months from the date we approve your claim. 4.6 You must comply with all security requirements as set out in the schedule. Should any of your security circumstances change, you should notify us immediately. Example: Your alarm system or security fence at home doesn t work anymore. This changes your security profile and has an impact on the premiums we charge you for the risk we are insuring. You should notify us immediately, even if you are in the process of getting it repaired. 5. What we will compensate you for We compensate you for loss or damage to insured items caused by certain insured events. These events are set out in the individual sections of the policy. 6. What we will not compensate you for There are certain events we do not insure and we will not compensate you if any of these events happen. In this section, we list the general events we will not compensate you for which apply to every section of insurance in your policy. There may be extra events we will not compensate you for in the individual sections, therefore you must check all sections to see whether we will compensate you. 6.1 Claims based on dishonesty, fraud and misrepresentation We will cancel your policy and we will not compensate you for claims based on dishonesty, misrepresentation or fraud or any combination of these. This includes not giving us true, correct and complete information about yourself and your property when you applied for insurance or when any of this information changed. If we compensate you for any claims that we later discover were based on dishonesty, misrepresentation or fraud, you must pay back the amount of the compensation as soon as we ask for it. 6.2 Claims for more than 100% of the sum insured We will never compensate you for more than 100% of the sum insured. 6.3 Illegal activities and property lawfully confiscated We will not compensate you for loss or damage to any property covered in terms of this policy that has been used for, or in connection with, illegal activities. We will not compensate you if any loss or damage to any property occurs due to the obtaining, using or soliciting of any narcotics. 8
We will not compensate you for any liability that may arise as a result of any injury suffered directly or indirectly by you or any other person as a result of a criminal offence. We will not compensate you for property that has been legally confiscated. 6.4 You must not hand over items until you have received valid payment We will not compensate you for loss or damage to insured items if you give possession of them to a buyer before prior confirmation from the bank that a valid and legal payment for the sale has been made. Example: If you sell your vehicle you need to obtain confirmation from your bank that the cheque has been honoured, or that the money is not counterfeit, before handing over the vehicle to the buyer. Syndicates operate whereby the purchase might seem legitimate, only to discover later that the cheque was fraudulent or the money used counterfeit. 6.5 Contractual obligations We will not compensate you for loss arising from contractual obligations, including legal responsibility, unless you would have had the responsibility if you had not entered into the contract. 6.6 Claims for loss or damage from asbestos We will not compensate you for loss of or damage caused by asbestos. 6.7 Any cause not sudden and unforeseen We will not compensate you for loss or damage that was not sudden and unforeseen. 6.8 Wear and tear and breakdown We will not compensate you for loss or damage arising from: mechanical, electrical or electronic breakdown or defect any cause that was not sudden and unforeseen damage to consumable parts or parts with a limited lifespan gradual deterioration including rising damp, mildew, fading, rust or wear and tear servicing, maintenance, cleaning, repairing, restoring, dyeing, bleaching or alteration 6.9 Claims for loss or damage caused by computer failure We will not compensate you for loss or damage caused by computer failure of any kind, including the computer s failure to: 1. Capture, process, store and respond to any data, code or command whether or not because of programming errors, corruption of data, human error, computer virus, harmful or unauthorised code, spyware or malware 2. Treat any date as the correct date A computer means data processing equipment, microchip and integrated circuit and includes software, hardware, operating systems and data whether this is your property or not. 9
6.10 Animals or pests We will not compensate you for loss of or damage caused by: Scratching, chipping, cracking, denting, biting, tearing or dying Animals, insects or pests 6.11 Items insured under SASRIA SASRIA Limited compensates you for loss or damage to your property in the Republic of South Africa caused by anyone taking part in a riot, strike, lock-out, civil commotion or committing an act which has a political, social or economic aim. A portion of your premium is automatically paid towards SASRIA Limited. A copy of the SASRIA policy is attached to your policy schedule. 6.12 Claims for loss or damage from war, riots or terrorism We will not compensate you for loss of or damage caused by: 1. war and warlike activities, for example invasion, acts of foreign enemies and civil war 2. any events for which a fund is established under the War Damage Insurance and Compensation Act, no. 85 of 1976 3. terrorism, including the use of violence or threat of violence for political, religious, personal or ideological reasons 4. activities intended to overthrow the government or any local or tribal authority 5. military might, for example martial law, mutiny, military uprising 6. revolution, including protests, rebellion, civil disobedience and inciting fear in the public 7. civil disturbances, for example riots, strikes, lockouts (whether legal or not) 8. the acts of any lawfully established authority in controlling, preventing, suppressing or in any other way dealing with any activities referred to in Exclusions 1-7 above 6.13 Claims for loss or damage from nuclear material We will not compensate you for loss or damage caused by: nuclear explosion, nuclear fission or nuclear fusion radiation, radioactivity or contamination from nuclear material in any form, including from nuclear waste 6.14 Consequential loss We will not compensate you for any consequential loss or damage. This refers to any loss or damage not directly caused by an insured event. For example, if your vehicle is involved in an accident, we will not be liable for any losses suffered as a result of you not having use of the vehicle. Please read your policy wording carefully since some consequential damage can be covered. 10
6.15 Claims for indirect loss We will not compensate you for indirect loss, which is loss arising from the results of loss or damage rather than the loss or damage itself. For example, if you are involved in a vehicle accident and instead of calling for assistance, you continue driving, which causes the vehicle s engine to seize. The damages caused as a result of the accident will be covered, however, the damages caused as a result of you continuing driving the vehicle will be excluded. 7. Other important terms 7.1 We share your information with other companies In an effort to keep premiums as low as possible and to combat insurance fraud, you must know that we share your policy information, including claims history, with other insurance companies, credit bureaus and related entities. We confirm that the sharing of information as highlighted above will not be used for marketing purposes. At Absa we do not sell or distribute any of our customer lists to third parties for marketing purposes. In order for us to send you information on the Absa Group s range of products and services as well as any special promotions, we must have obtained your permission when you purchased this insurance policy. We may also contact you to conduct research in order for us to improve our products and services to you. 7.2 You may not transfer your rights in this policy (Cession) This policy gives rights to you only. You may not transfer your rights to anyone else (this is known as ceding your policy). No other person may claim against us, even if we are responsible for any loss or damage they suffer. If another person has a claim for loss or damage, then you must tell us about the claim and we will deal with it on your behalf. 7.3 We may conduct proceedings in your name (Subrogation) In the circumstances set out in this policy, we might compensate you for claims made by other people against you. If another person has a claim against you, you give us the right to take over the defence or settlement of the claim and to conduct it in your name (this is known as subrogation). We may give up the defence or settlement of a claim and pay you the full amount we are responsible for, or any lesser amount for which the claim can be settled, after which we will no longer be responsible for any amounts arising out of the event that led to the claim. 7.4 We may change the terms of this policy We may change the terms of this policy by giving you 30 days written notice. 7.5 When does your policy end (Cancel) We can cancel this agreement by giving you 30 days written notice. You can cancel this agreement by giving us 30 days written notice. You do not receive your premium back if the policy is cancelled. 7.6 South African law applies to this policy South African law applies to this policy. The courts of the Republic of South Africa have the authority to hear any matters relating to this policy. 11
12 Section 1 Motor vehicle insurance (including Caravans and Trailers)
Sections of insurance Section 1: Motor vehicle insurance (including Caravans and Trailers) Contents 1. Conditions specific to your motor vehicle insurance 15 2. Your chosen type of insurance 16 3. What we will compensate you for: Comprehensive insurance 16 4. What we will compensate you for: Third party, fire and theft 17 5. What we will compensate you for: Third party only 17 6. Optional extra insurance 18 7. What we will not compensate you for 19 8. Legal responsibility to others what we will compensate you for 20 9. Legal responsibility to others what we will not compensate you for 20 Under the motor vehicle insurance section the policyholder and the regular driver might not be the same person. Although the policy does not restrict people using the vehicle, it is important for us to know who the regular driver is in order to calculate the correct premium for the risk. The premium is based on the regular driver. Factors used for rating include (but are not limited to): gender, age, driving experience and insurance history. The risk of a 45-year-old male with 25 years driving experience differs vastly from a 20-year-old with only 2 years driving experience. Not supplying us with the correct details in this regard would mean that we have not received the correct premium for the risk and it could mean that the vehicle is not covered. 13
Motor vehicle insurance In this section, the words below have their meanings shown: You refers to the policyholder, regular driver or any person using the vehicle with your permission Regular driver is the person who most often uses the vehicle in any month and on whose risk the premium is based. The regular driver will also be noted on the schedule Class 1 vehicle means: 0 private motor cars, including station wagons, designed to seat not more than 10 people including the driver 0 light delivery vehicles, microbuses and panel vans not exceeding 3,500kg gross vehicle mass Class 2 vehicle means: 0 motor cycles 0 motor scooters 0 four-wheeled motorised vehicle 4X4 vehicle means: 0 4X4 vehicle (excluding sedans) of not more than 3,500kg gross vehicle weight 0 2X4 double-cab vehicle of not more than 3,500kg gross vehicle weight 0 2x4 single-cab vehicle of not more than 3,500kg gross vehicle weight Caravans and trailers means a caravan or trailer, which is not self-propelled and specifically described on the policy schedule, including standard accessories Driving licence means a valid South African driving licence or, in the case of a foreign driver, a valid international driving permit Territorial limits refer to Republic of South Africa; Namibia, Lesotho, Malawi, Botswana, Swaziland, Zimbabwe and Mozambique Insured vehicle refers to the vehicle or vehicles set out in the schedule Retail value means the amount shown for the vehicle in the TransUnion Mead & McGrouther Auto Dealer s Guide 14
1. Conditions specific to your motor vehicle insurance A) Restrictions on the use of the vehicle When you bought this policy, you chose the category of use for the vehicle. You may only use the vehicle for the purposes in the category you chose. The four categories and their purposes are: Category Purposes 1. Housewife/Pensioner Social and domestic use ONLY 2. Private use - Social and domestic use This includes travelling to and from permanent place of employment but specifically excludes business use 3. Professional purposes example, an Auditor consulting at his client s premises 4. Business travel, for example visiting clients on a daily basis Caravans, trailers and motorcycles may be used for Private use only. General restrictions apply to all categories Social - domestic and business travel up to 24,000km a year Social, domestic and business travel You cannot use the vehicle for: any purpose other than Private use only outside South Africa carrying fare-paying passengers any commercial purposes carrying goods for reward carrying a greater load or more passengers than the vehicle is licensed to carry driving lessons for reward towing another vehicle for reward hiring out the vehicle for reward any contest involving driving in any kind of race or competition motor trade any armed response or policing duties including voluntary duties, for example, neighbourhood watch or community policing duties B) You must tell us about any changes to your driving licence You must tell us immediately if your driving licence is endorsed, suspended or cancelled, including a charge or conviction for negligent or reckless driving. C) We can decide to pay the value for unavailable parts If any part needed to repair the motor vehicle is not available in South Africa as a standard part, we can decide to compensate you for the value of the part at the time of loss or damage. The amount we pay includes the reasonable cost to transport the part, except for any air transport. 15
2. Your chosen type of insurance You chose one of three types of insurance for your vehicle when you bought this policy: 1. Comprehensive insurance 2. Third-party, fire and theft insurance 3. Third-party insurance only The insurance you chose is set out in the schedule. 3. What we will compensate you for: Comprehensive insurance If you chose comprehensive insurance, we will compensate you for the following: A) Loss or damage from insured events Loss or damage to the vehicle including standard fittings, tools and factory-fitted sound equipment caused by: fire, explosion, lightning, hail, storm, flood or snow theft and attempted theft accidents deliberate acts intended to cause loss or damage (this excludes any deliberate acts by you, the regular driver or any members of your household) Compensation is limited to the retail value of the vehicle at the time of the loss or damage. B) Towing and storage charges after an insured event We will pay for the reasonable towing and storage costs of the vehicle following any insured event set out in Clause 3A above. You will personally be responsible for the towing and storage costs if you do not call the idirectassist line and use the approved towing operator we appoint. You can reach idirectassist 24 hours a day, 7 days a week on 0861 434 7328. This compensation (towing and storage charges) does not apply if the vehicle is lost or damaged outside South Africa. C) Limited medical expenses If any occupant of the vehicle suffers bodily injury as a direct result of an insured event set out in Clause 3A above, we will compensate you for the medical expenses in connection with the injury. If the vehicle is a light delivery vehicle, we will only compensate you for the medical expenses of a person inside the driver s cabin. Compensation is limited to R1 000 for each occupant injured for any one claim. D) Amounts you owe under a credit agreement Following a total loss for an event you can claim for, we will pay the titleholder (for example, the motor vehicle financing company) the amount still owing to them (not exceeding the retail value). We will pay any balance to you. 16
Should you have selected the Optional Credit Shortfall cover on this policy and the cover reflects on your schedule of insurance, the claim for the Optional Credit Shortfall cover will be handled separately as set out in the terms and conditions under point 6. E) Responsibility to others (Legal liability) We will compensate you amounts you are legally responsible to pay to another person as set out in the Legal responsibility to others section 8 (this is known as legal liability). The maximum amount we will pay under the Legal responsibility is R3 million per accident. 4. What we will compensate you for: Third-party, fire and theft If you chose insurance for third-party, fire and theft, we will compensate you for: A) Loss or damage from certain events Loss or damage to the vehicle including standard fittings, tools and factory-fitted sound equipment from: fire and explosion theft or attempted theft Compensation is limited to the retail value of the vehicle at the time of the loss or damage. B) Towing and storage charges after an insured event We will pay for the reasonable towing and storage costs following any insured event set out in Clause 4A. You will personally be responsible for the towing and storage costs if you do not call the idirectassist line and use the approved towing operator we appoint. You can reach idirectassist 24 hours a day, 7 days a week on 0861 434 7328. This compensation (Towing and storage charges) does not apply if the insured vehicle is lost or damaged outside South Africa. C) Responsibility to others (Legal liability) We will compensate you amounts you are legally responsible to pay to another person as set out in the Legal responsibility to others section 8 (this is known as legal liability). The maximum amount we will pay under the Legal responsibility is R3 million per accident. 5. What we will compensate you for: Third-party only If you chose insurance for third-party only, we will compensate you for your responsibility to another person as explained in the Legal responsibility to others section 8 (this is known as legal liability). The maximum amount we will pay under the Legal responsibility is R3 million per accident. 17
6. Optional extra insurance (if stated on the policy schedule) A) Car hire After you have lodged your claim, and have been provided with a claim number, you will be entitled to the Car hire Benefit. We will pay the car hire costs for a car not more than a 1,600cm³ engine capacity, manual transmission - Catergory B, as rented by you from the car hire company of our choice in the following circumstances: if the vehicle cannot be driven following insured event if the vehicle is stolen and not recovered. Conditions for hiring a car 1. You must accept the terms and conditions of rent of the rental company, which may include a fuel deposit. You will also be responsible for any excess in the event of a claim for loss or damage to the rented car. 2. We will pay the costs for unlimited distance but we will not compensate you for the running costs (fuel and oil) or any collection or delivery costs. 3. You may opt for a different category rental car when the vehicle is rented but will be liable for the difference in cost between a Category B vehicle which is contracted to you under this policy and the vehicle you choose. The other terms and conditions as detailed under points 1,2 and 4 will remain applicable. 4. The period of rental expires at the earliest of: the day repairs are concluded the day we compensate you for the total loss of your vehicle 30 days. B) Vehicle sound equipment and other accessories We will compensate you for loss of or damage to: non-standard vehicle sound equipment if specified on the schedule non-standard fitted accessories if specified on the schedule accessories fitted to caravans, trailers and motorcycles if specified on the schedule C) Contents of caravans and trailers We will compensate you for loss or damage to the contents of the caravan or trailer if you chose to buy this insurance. We will pay you for the loose contents of the caravan, your personal possessions and the personal possessions of the family members that live with you. The contents will be covered for theft if there is forceable and violent entry into the caravan or trailer. Please check the schedule to see if you are insured for this. D) Credit shortfall cover If chosen, credit shortfall cover on the selected vehicle will provide you with cover on the following: Where the vehicle on this policy is stolen and not recovered or stolen and recovered and/or damaged beyond economical repair and is written off and we have settled the claim by means of a lump sum payment and 18
a shortfall arises between such payment and the Statutory Settlement Balance in terms of your credit agreement with the finance house, we will pay the following under this section: The Statutory Settlement Balance as defined, minus; Statutory Settlement Balance is the payment due by you at the date of loss, which will pay off your liability at the finance institution in terms of the credit agreement, excluding any arrear instalments due as at the date of loss, interest and/or finance charges on such arrear instalments and any early settlement penalties. a) The excess payable by you in terms of the underlying comprehensive cover b) The lump sum settlement already paid under the underlying comprehensive cover c) Any amount refundable to you by way of insurance premiums, including, inter alia but not limited to, any short-term, Credit Life assurance or motor warranty premiums as at the Date of Loss d) Any further or additional amounts added to the principal debt in terms of the Credit Agreement after its date of commencement, and any finance charges and interest thereon, for example, additional interest charges should your finance payments go into arrears. General conditions to credit shortfall cover You must ensure that the vehicle is comprehensively insured on this policy for the retail value Where a claim is rejected or cover voided on the comprehensive vehicle cover on this policy, this cover is not effective All the other general terms on this policy is also applicable to this section of cover It is very important that you contact us if your finance term has changed (your finance paid off earlier, or the finance term extended) as this will affect the cover you have under this section 7. What we will not compensate you for Remember to check Clause 6 in the general terms of this policy for general events and items we will not compensate you for. The extra events and items specific to motor insurance that we will not compensate you for are loss or damage: 1. caused by the vehicle not being roadworthy 2. to non-factory-fitted sound equipment or telephone equipment unless more specifically insured 3. to the vehicle which happens: outside the territorial limits 19
if the vehicle is used for any purpose other than the category of use you chose when you bought this policy if the vehicle is used by any member of the household without your express or implied permission while you drive or tow the vehicle under the influence of alcohol or drugs or your blood-alcohol level is over the legal limit or you fail a breathalyser test or you refuse to give either a breath or blood sample while any other person who drives or tows the vehicle with your express or implied permission is under the influence of alcohol or drugs, or their blood-alcohol level is over the legal limit while you or any other person who drives or tows the vehicle with your express or implied permission without a valid driving licence if the vehicle is involved in an accident and the driver of the vehicle then leaves the scene of the accident unlawfully with intention and caused by you or any members of your household 8. Legal responsibility to others (Legal liability) what we will compensate you for A) Legal responsibility for accidental death, injury, illness, loss or damage We will compensate you for legal responsibility following a vehicle accident, which causes death or bodily injury to other people or damage to their property. This includes legal costs which someone else can recover from you and which we agree to in order to settle or defend a claim against you. The accident must involve one of the following: the insured vehicle any vehicle being towed by the insured vehicle vehicle being driven by you or any member of your household that you or they do not own Compensation will be the lesser of either: R3 million the amount for which a claim can be settled 9. Legal responsibility to others (Legal liability) what we will not compensate you for Legal responsibility if we do not compensate you for loss or damage to the vehicle If we do not compensate you for loss or damage to the vehicle arising from an accident, we will similarly not compensate you for legal responsibility arising from that accident. Legal responsibility covered by other insurance or legislation We will not compensate you for legal responsibility where there is cover under any other insurance or under 20
any legislation, for example any compulsory motor-vehicle insurance act, the Occupational Health and Safety Act or the Compensation for Occupational Injuries and Diseases Act. Death or bodily injury We will not compensate you for legal responsibility for death or bodily injury suffered by: you, members of your household, your employees any fare-paying passengers any passenger in the vehicle who was not in a permanent enclosed compartment designed by the original vehicle manufacturer to carry passengers any passenger in or on a motorcycle, caravan or trailer any person in or on a vehicle that is being towed Loss or damage to property owned We will not compensate you for legal responsibility for loss or damage to property owned by you, any members of your household, any of your employees or any fare-paying passengers. Loss or damage to vehicle We will not compensate you for legal responsibility for loss or damage to a vehicle: being driven by you or members of your household, that you or they do not own being towed by the insured vehicle 21
22 Section 2 The contents of your home
Section 2: The contents of your home Contents 1. Insurance for the contents of your home 24 2. Conditions specific to contents insurance 24 3. What we will compensate you for 24 4. Extensions of insurance 25 5. What we will not compensate you for 27 6. Optional extra insurance 27 7. Legal responsibility to others what we will compensate you for 28 8. Legal responsibility to others what we will not compensate you for 28 23
1. Insurance for the contents of your home In this section, the words below have their meanings shown: You means the insured person named in the schedule and members of the insured person s household Home means your private home set out in the schedule in which you and members of your household live permanently made of brick, stone or concrete with a slate, tiled, concrete, metal or asbestos roof and includes the outbuildings (separate from the home or not, at the risk address noted on the schedule and the construction thereof approved by the relevant local authority) Household contents means the goods and personal items (including groceries) contained in your home that belong to you or that you are responsible for 2. Conditions specific to contents insurance Replacement value up to the sum insured If any of your household contents are lost or damaged, we will compensate you for the replacement cost at the time of loss or damage. Compensation is limited to the sum insured set out in the schedule, less an excess that applies. However, if you do not buy insurance for the full value of your contents, we will only compensate you for the percentage of insurance you do have with us. You will be responsible for the difference (this principle is known as Average). For example, if you insure your household contents for R300 000 but the value at the time of the loss or damage is R400 000, we will only compensate you for 75% of the loss you suffer. 3. What we will compensate you for A) loss or damage to the household contents caused by various insured events We will compensate you for loss or damage to the household contents from the following insured events up to the maximum sum insured as set out in the schedule: 1. Theft or attempted theft of the household contents: from the home. Compensation is limited to 5% of the sum insured unless there is violent or forcible entry or exit from a storage facility or a bank safe deposit if there is violent or forcible entry or exit Compensation is limited to R5 000 (unless another amount is stated on the schedule) while in transit from a storage facility or a bank safe deposit. Compensation is limited to R5 000 2. Theft or attempted theft of any laundry, garden furniture and swimming pool equipment (except the motor or filter) from the grounds of the home. Compensation is limited to R5,000 for any one claim 24
3. The household contents will be covered against damage caused by an accident involving the vehicle carrying the contents while the contents are being transported to a new permanent address 4. The deliberate act of any person other than yourself and members of your household 5. Fire, lightning, power surges, explosion, storm, wind, hail or snow. However, we will not compensate you for loss or damage to household contents that are in the open from any process involving the use of water 6. Earthquake 7. Bursting, leaking or overflowing of water-carrying equipment or fixed oil-fired heating equipment 8. Harmful impact, including: aircraft or any object falling from the sky a road vehicle crashing into the buildings falling trees and trees cut down by a professional tree feller 4. Extensions of insurance A) Costs you need to spend for loss or damage to household contents We will compensate you for the following costs you need to spend after an insured event has caused loss or damage to your household contents: Household contents and groceries while they are being transported: Loss or damage to household contents and groceries which you or any member of your household were personally transporting from the place you bought them, or to or from any place of repairs or renovation. The loss or damage could have been caused by: an accident involving the vehicle theft by violent or forcible entry to the vehicle you or the member of your household were using. You must prove that the household contents or groceries were in a locked boot or hidden in a compartment in the locked vehicle Compensation is limited to 3% of the sum insured. Broken glass and sanitary ware: Replacing broken mirrors, glass tops of furniture or fixed glass forming part of any stove, oven, bathroom fixture or furniture. Keys and locks: Replacing keys, cardkeys or locks for the home. Compensation is limited to R2 000. Documents: Replacing documents and making copies of personal documents up to R1 000. Money: Loss of money or negotiable instruments while inside your home caused by an insured event. Theft of money must be accompanied by violent or forcible entry or exit. 25
Compensation is limited to R500. Personal property of guests or domestic employees: Loss or damage to personal property belonging to: guests temporarily staying with you domestic employees, caretakers and nursing employees while inside your home Compensation is limited to 2% of the sum insured. Contents of fridges and freezers: Food going off in the fridge or freezer because of: accidental damage to the fridge or freezer accidental power failure Compensation is limited to 2% of the sum insured. Fire brigade costs: Reasonable costs of the fire brigade or other authorised fire-preventing organisations for putting out a fire to prevent or lessen damage to your household contents. Security guards: Cost to employ security guards to protect the household contents at your home after an insured event happened. Compensation is limited to R3 000. Emergency storage costs: Storage costs to protect any household contents after an insured event happens. Compensation is limited to R10 000. Rent: If an insured event makes it impossible for anyone to live in the buildings, we will compensate you for: rent you are legally responsible for. Compensation is limited to 20% of the sum insured any reasonable extra costs you spend to provide alternative board and lodging. Compensation is limited to the lesser of: 0 the reasonable period necessary for returning to live in your home 0 20% of the sum insured B) Financial loss from fraudulent use of credit and cash cards Financial loss you suffer from the fraudulent use of your credit or cash cards, as long as you have complied with the terms and conditions of the card issuer. Compensation is limited to R2 000. C) Costs for injury Injury from assault at an ATM: Medical treatment by a qualified medical practitioner for injuries following an assault while using an ATM (automatic teller machine). Compensation is limited to 1% of the sum insured. Injury to pets: Veterinary expenses for bodily injury to your domestic pet from a road accident. Compensation is limited to 1% of the sum insured. D) Costs you must pay for achieving a hole-in-one (golf) or perfect 8 (bowls) Costs you must spend if you score a hole-in-one or perfect 8 playing as an amateur at any recognised golf 26
club or bowling club affiliated to a provincial golf union or bowls club during a game played under the official rules of golf or bowls. When you claim, you must give us written confirmation from the secretary or captain of the club. Compensation is limited to R1 000. 5. What we will not compensate you for Remember to check Clause 6 in the general terms of this policy for general events and items we will not compensate you for. The extra events and items specific to household contents insurance that we will not compensate you for are: A) Theft without evidence of violent or forcible entry or exit We will not compensate you for loss or damage from theft or attempted theft unless there is evidence of violent or forcible entry or exit from: the home while you have lent it out or let it any holiday home B) Loss or damage to certain valuables We will not compensate you for loss or damage to precious metals, stones, jewellery, furs, rugs, carpets, works of art and any collections where the value is more than one-third of the sum insured, unless specifically agreed. C) Loss or damage to business computers Loss or damage to computers, computer accessories and software used for business. D) Value of information on tapes and discs The value of information lost or damaged from tapes or discs. 6. Optional extra insurance (if stated in the policy schedule) A) Accidental damage to household contents We will compensate you for accidental damage to household contents in your home. However, compensation is limited to: R3 000 for any single item R5 000 for any one set / pair R25 000 for any one claim What we will not compensate you for relating to this optional extra insurance 27
We will not compensate you for damage to: cellphones and laptop computers furniture and domestic appliances by scratching, denting or chipping musical instruments by scratching, bruising, broken strings or reeds and splitting skins firearms video, audio tapes, compact discs, digital video discs articles of china or glass (other than what is specified under Point 4A) locks or other mechanical apparatus that have been over wound tools, automatic pool cleaners or garden furniture B) Loss or damage to office and home industry equipment We will compensate you for loss or damage to office equipment and home industry equipment that belong to you and which is specified in the schedule following any of the insured events listed. Compensation is limited to the replacement value of any item and only up to the value you specified for the item. 7. Legal responsibility to others (legal liability) what we will compensate you for We will compensate you for any legal responsibility you might have for: the accidental death or bodily injury of any person, except for members of your household the accidental loss or damage to property belonging to another person, except for members of your household and domestic employees This includes legal costs, which someone else can recover from you and we agree to in order to settle or defend a claim against you. We will compensate you for all amounts you are legally responsible to pay to your landlord arising from accidental loss of or damage to the rented building where you are living permanently. The maximum amount we will pay under the Legal responsibility is R3 million per incident. 8. Legal responsibility to others (Legal liability) what we will not compensate you for We will not compensate you for any legal responsibility you might have to another person arising from: any trade, business or profession the ownership, possession or use of lifts the ownership or possession of animals other than cats and dogs the ownership or possession or use of aircrafts, vehicles and boat; the use of weapons and firearms; damages and legal costs awarded against you by a court outside South Africa; any incident which causes damage to other people s property or injury to them and where the claim for damage to the building, property and person is not covered. 28
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Section 3 All risks insurance 30
Section 3: All risks insurance Contents 1. All risks insurance 32 2. Conditions specific to the all risks insurance 32 3. What we will compensate you for 32 4. What we will not compensate you for 33 31
1. All risks insurance In this section, the words below have their meanings shown: You means the insured person named in the schedule and members of the insured person s household All risks means insurance for loss or damage to belongings you take out of the home with you. All risks means two types of belongings: specified belongings and unspecified belongings Specified belongings means personal items with an individual value of more than R1500 generally worn by a person or designed to be carried on a person, for example, jewellery, laptops and sporting equipment. These items must be individually listed on the schedule with their value shown Unspecified belongings means personal items with an individual value of less than R1500 generally worn by a person or designed to be carried on a person, for example clothing, sunglasses and handbags 2. Conditions specific to all risks insurance Maximum overall limit for unspecified belongings There is a maximum overall limit for unspecified belongings which you chose when you bought this insurance. Compensation is limited to R1,500 for any one article, pair or set. However, the most we will compensate you for any one incident is the maximum overall limit you chose. Example of a claim for unspecified belongings Peter chose a maximum overall limit of R5000 for unspecified belongings when he bought his insurance. He goes to gym with his gym bag. His bag gets stolen. Inside his bag are his running shoes (worth R1200), his tracksuit (worth R800), a heart monitor (worth R1600) and sunglasses (worth R2000). His gym bag is worth R500. We will compensate Peter up to the limit of R1500 per item lost but with the maximum overall limit of R5000. So we would compensate Peter R1200 for the running shoes, R800 for the tracksuit, R500 for the gym bag and R1500 for the sunglasses and R1500 for heart monitor. But because the total amount is more than the maximum overall limit, we will only pay the maximum overall limit of R5000. 3. What we will compensate you for Replacement value up to sum insured If any of your belongings are lost or damaged, we will compensate you for the replacement cost of the item or a similar item with a similar value at the time of the loss or damage. Compensation is limited to the sum insured set out on the policy schedule, less any excess that applies. 32