Administrator
shall mean:
Genlife Financial Services
- an Authorized Financial Services Provider with FSP no. 43895 (see contact details below).
Underwriter shall mean:
Safrican
- an Authorized Financial Services Provider with FSP no. 15123 ( see contact details below).
Underwritten on a Group Scheme Basis
- has the meaning assigned to it in Schedule 2 of the Insurance Act.
Accidental Death has the meaning assigned to it in section 1 of the Insurance Act.
Funeral Policy - means a life insurance policy under the funeral class of life insurance business as set out un Table 1 of Schedule 2 if the Insurance Act.
Reseller
- shall mean any party selling Genlife products on behalf of Genlife.
General Information
- This document is furnished to you in compliance with section 48 of the Long-Term Insurance Act, 1998 as amended and the General Code of Conduct of the Financial Advisory and Intermediary Service Act, 2002 as amended. Benefits are underwritten on a group basis provided by the Underwriter to the group administrated by Genlife Financial Services. The cover of an additional or extend member may not exceed that of the principal member. New-born children must be added to the policy within 60 days after date of birth. If not, no claim will be considered in the unfortunate event of the death of such a new born child.
- The cover in respect of assured lives commences on the last date upon which the Underwriter approves the application by the member for the benefits or receives the first premium payable in terms of this Group Policy. Whichever is the latest. Applications received after the 15th of the month will commence on the 1st day of the following month on condition that the application was accepted by the Underwriter and the first premium was paid.
- The Underwriter shall be entitled to amend the benefits in terms of the Group Policy by means of a 60 (sixty) day written notice to the Administrator of this Group Scheme Notice to the Administrator shall constitute proper and sufficient notice to the members of the Group.
- The rules and conditions of this plan are consistent with the provisions of the Long-Term Insurance Act, 1996 as amended and with the terms of the Genlife Voluntary Umbrella Group Policy. The Underwriter shall be entitled to cancel the Group Policy by means of two (2) calendar month written notice to the members. Notice to the Administrator shall constitute proper and sufficient notice to the members of the group.
- Maximum cover for children below the age of six years is R10 000, irrespective of the cover of the principal member.
- All assured lives in terms of this Group Policy must be permanently residents of the Republic of South Africa.
- The maximum cover allowed on the life of any member is R30 000.00 Members can however have more than one policy as allowed by the underwriter. Each policy will be identified by a separate policy number and a separate claim should be submitted for each policy.
- The scheme is underwritten by Safrican Insurance Company and administrated by Genlife Financial Service.
Terms and Conditions
- A period of grace of 15 (fifteen) days is permitted for the payment of premiums. If the premium is not paid within this period, the Underwriter has the right to reject claims, subject to the provisions of the Long-Term Insurance Act, 1998 as amended. Premiums are payable in advance and a premium received on or before the 15th of a month will be for cover for the month in which the premium is paid. Should the client be in arrears with premiums, the first premiums will be allocated to the months for which no premiums have been received. If the policy has lapsed because of no premium received, the principal member can apply for the reinstatement of the policy. A funeral policy lapse when the premiums are not paid within the required period of grace. No premiums will be refunded should the policy lapsed or be cancelled.
- Premiums are guaranteed for 30 days. The premium, conditions and benefits shall from time to time be revised and adjusted by the Administrator on behalf of the Underwriter to ensure that the scheme remains actuarially sound. In addition, the Underwriter may always amend benefits and premiums by means of 60 (sixty) day written notice to the Administrator. Notice to the Administrator shall constitute proper and sufficient notice to the members of the Group.
- Premiums shall be calculated based on the Assured Life’s age at the inception date of the policy and shall not increase incrementally with each birthday of an assured Life (lives), subject always to the Underwriters right to increase the premiums payable as provided for terms of this Group Policy. In the case of a family plan premiums shall be calculated on the eldest of the principal member or spouse and in the case of society plan the premium will be calculated on the eldest of the principal member or nominated members added to the policy. Should the member increase cover or add additional benefits at any stage after the policy commenced, the premium for the increased part of the cover or benefits will be calculated based on the age of the member when the increase takes place.
- In the event of the death of an additional Assured Life, the total premium payable in respect of the extended member will be reduced by the component of the premium payable in respect of the deceased extended member. This is however not applicable on the society plan.
- Extended/ nominated members on any of the 1+5, 1+9 or 1+13 plans may not be replaced by another extended/ nominated member in case of the death/ cancellation of such member. Children of nominated or extended members are not covered.
- Cover ceases when the Group Policy is cancelled, has been terminated by the Underwriter, the policy has lapsed, if the member terminates his/her membership to the Group, the member terminates the cover in terms of the main benefit plan, upon the death of the principal member unless the spouse or a nominated member select in writing to continue with the policy as the principal member, if the premium is validly received by the Underwriter within the period of grace, or when the dependent child (other than mentally or physically disabled child), reaches the age of 21 years, and in the event of a child who is unmarried and full time student at any registered University. Technicon or Tertiary education institution, reaches the age of 25 (twenty five) years.
- The cover granted is whole life and shall remain in force until the death of Assured Life for as long as premiums are paid.
- The Underwriter shall be entitled to apply set-off or deduct any unpaid premiums against the benefits payable in terms of the Group policy.
- The member is responsible to ensure that the monthly premium is paid. The principal of “No Premium- No Cover” will apply.
- The Group Policy does not accumulate cash or a surrender value and may not be converted into a paid-up policy. No loans will be allowed in terms of this Policy.
- No premiums will be refunded should this policy be cancelled due to incorrect information provided at application stage or if no I number is provided or provided incorrectly and cannot determine the risk on the life of the member a claim the arise for such a member might be repudiated.
Waiting Periods and Exclusions
- No insurance cover shall be granted or benefits paid in the event of the death other than the accidental death of an assured life in terms of this Group Policy within 6 months from inception date.
- The waiting period on accidental death is one month on condition that the policy has commenced and the first premium has been paid and received by the underwriter.
- No benefit shall be paid in the event of suicide within 12 months from inception date of the cover.
- No benefits shall be paid in the event of death resulting directly or indirectly from negligence, recklessness, transgression of the law, intentional exposure to danger or and wilful self-inflected injury.
- If benefits in terms of the Group Scheme are increased at any stage, the waiting period of 6 months shall again apply with regard to the increased benefits as from the date of the increase of the benefits or when the first premium was received by the Underwriter (whichever is the latest).
Reinstatement of policies
In the event of the reinstatement within 2 calendar months after a policy has lapsed, the arrear premium must be paid in full and no waiting period will apply. Should a request for a reinstatement of lapsed policy be received after the expiry of 2 calendar month period, a new policy with a new waiting period will be issued. Should a policy lapse within the waiting period and the policy is being reinstated the full arrear premium must be paid and the reminder of the waiting period will apply.
Claims Procedure
In the event of a valid death claim, the specified benefit will be paid to the Member of Beneficiary. Claims must be submitted to Administrator with 3 months of the death of the Assured Life. The Underwriter reserves the right to cancel the policy and declare all premiums paid by the member in terms of the policy forfeited if there is any evidence of, or attempted submission of a fictional claim, fraud or misrepresentation. Claims must be accompanied by the following clearly legible documents:
- An official copy of the original death certificate certified by the SA Police.
- A completed official claims form as prescribed by the Administrator from time to time.
- Copy of a completed BI-1663 certified by the SA Police.
- Clearly legible certified copies of the deceased member and principle’s member’s ID documents. In case of third- party payments, a certified copy of the third party’s ID document is required certified copy of a Police Statement, in event of death due to unnatural causes.
- Bank details and a copy of a bank statement of the payee or beneficiary (or the third party in respect of third- party payments) for payment of the benefit. The underwriter may request a medical report in the case of stillborn babies, indicating that the pregnancy reached the 26th (twenty-six) weeks.
- Any additional documents that the Underwriter in its sole discretion deems necessary.
- If, in the case of a Family plan, the spouse was erroneously not listed, a certified copy of a marriage certificate will be required . This only applies to new takeover schemes and does not apply to new members added to the scheme after the scheme has been taken over by Genlife.
- If, in the of a family plan or Single member with children, the children were erroneously not listed, a certified copy of the birth certificate will be required. This only applies to new takeover schemes and does not apply new members added to the scheme alter the scheme has been taken over by Genlife.
- Benefits on a funeral policy is seen as a separate policy with a separate policy number for which a separate claims must be submitted.
- Stillborn of an extended member is not covered.
Complaints Procedure
- Please contact the Administrator and have the following information ready *Policy number, *Identity number, *Nature of enquiry.
- Complaints which are not resolved to your satisfaction may be referred to the Underwriter.
- Complaints which are still not resolved may be referred to the Ombudsman for Long-Term Insurance or the Register of Long-Term Insurance please refer to the contact details below.
Right To Cancel & Replacement
After the Underwriter has accepted the member’s application for insurance cover, the member may decide to instruct the Underwriter to cancel the policy. The member must submit this instruction in writing to the Administrator within 30 days after receipt of this Policy Schedule. The member may only submit such cancellation instruction to the Administrator if no benefit has yet been paid or claimed or an insured event has not yet occurred. The Underwriter may deduct the cost of any risk cover the member enjoyed under the policy before it was cancelled. If this policy is being purchased to replace another policy that has been cancelled or which will be cancelled in the near future, the member should be aware that it might be their disadvantage to do so. The member must please contact the Administrator in order to be informed of these disadvantages and consequences and ensure that a Policy Replacement Advice Record is completed, if applicable.
The Ombudsman for Long-Term Insurance Financial Sector Conduct Authority (FSCA) Contact Details
Physical Address: Third Floor, Sunclare Physical Address: 41 Matroosberg Road, Ashley Gardens,
1. Genlife Financial Services (Pty) Ltd
Building, 21 Dreyer Street, Claremont, Cape Town, 7700 Pretoria, South Africa, 0002 t: +27 12 450 5581
Postal Address: Private Bag X45, Claremont, Cape Town, 7735 Postal Address: P. O. Box 35655, Menlyn Park, 0102 f: +27 86 718 1504
t: +27 21 657 5000/ 86 010 3236 Contact Centre: 0800 203 722 e: admin@genlife.co.za
f: +27 21 674 09 51 t: +27 12 428 8000
2. Safrican
e: info@ombud.co.za f: +27 12 346 6947 t: +27 11 778 8000
e: info@fsca.co.za