Terms and conditions
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This product is a Term Credit Life Insurance Policy covering death, temporary disability, permanent disability, and retrenchment. This Policy is underwritten by
Guardrisk Life Limited (FSP No. 76) and administered by niftycover (Pty) Ltd. (FSP No. 43574).
SCOPE OF COVER
In return for payment of a monthly Premium, a Benefit will be paid based on the following:
- an insured Event occurs within the Period of Insurance;
- the Event giving rise to a claim is covered in terms of the Policy;
- the truth and accuracy of the information given at the time of application by the Insured to Us;
- in the event of a health declaration being made, written acceptance of the proposal in writing by Us or Our appointed administrator;
- You provide Us with all the relevant documents that We may require;
- the claim is reported within the prescribed periods to Us; and
- the claim documentation is submitted to Us within the allowed period
The Benefit payable will be based on the following:
- in the Event of death, the Benefit will be a lump sum of the Outstanding Loan Amount;
- in the Event of Temporary Disability, We shall pay the Credit Provider all the obligations that become due and payable:
- for a period of 12 (twelve) months;
- during the remaining repayment period of the Agreement; or
- until the Insured is no longer disabled, whichever is the shorter period;
- in the Event of Retrenchment / Loss of Income, the Insurer shall pay the Credit Provider all the obligations that become due and payable:
- for a period of 12 (twelve) months;
- during the remaining repayment period of the Agreement;
- until the Insured finds employment or is able to earn an income, for whichever is the shorter period.
The following words, terms and phrases have the meanings appearing under them when used in this Policy:
Administrator: niftycover (Pty) Ltd with company Reg Nr.2011/005787/07 and FSP 43574.
Age: age next birthday when determining Premium at Entry Date.
Benefit: the amount payable on the Death, or Temporary Disability, or Total Permanent Disability or Retrenchment of the Insured as defined in the Policy.
Category 1 Customer: refers to a customer that qualifies and is covered for all the Benefits in this Policy and who is;
- permanently employed and earns a salary/income and is;
- not occupationally disabled at time of the Loan Disbursement Date.
Category 2 Customer: refers to a customer who qualifies only for Death cover and Disability cover and who is not employed and not eligible for Retrenchment/Loss of Income benefits.
Business Day: Means any day that is not a Saturday, Sunday or public holiday.
Claim: Means, unless the context indicate otherwise, a demand for policy benefits by a claimant, irrespective of whether or not the claimant’s demand is valid, made by submitting a completed claim form and supporting documentation to the administrator.
Claimant: Means a person who makes a claim in relation to this policy.
Credit Agreement: the agreement, as defined in the National Credit Act 34 of 2005 (or as amended and referred to in the Policy, which is a valid and current credit agreement concluded between You and the Credit Provider and to which You are bound as debtor/creditor.
Credit Life Insurance: Has the meaning assigned to it in the National Credit Act.
Credit Provider: smartadvance (Pty) Ltd, the institution granting the loan, as per the Credit Agreement.
Entry Date: the date on which cover commenced and will be the 01st day of the month in which the first Premium is received by the Insurer. A premium will be deducted from any benefit payable if a claim event arises in the first month prior to the first premium being received.
Event: the event which gives rise to Your claim in terms of this Policy.
Exclusion: Means the losses or risk events not covered under this Policy.
Grace Period: the period of 31 (thirty-one) days after the premium payment date where cover and benefits are still in force, but the Policy is in arrears. If any event occurs during the Grace Period that results in a valid claim, the unpaid Premium will be deducted from any benefit paid. Failure to pay the Premium within this period will lead to the Policy lapsing. The Grace Period does not apply to the payment of the first Premium in terms of this Policy.
Insured: a person who has successfully applied for cover under this Policy, who is listed in the Policy Schedule and for whom the full Premium has been paid up to date.
Insurer: means a long-term insurer, namely Guardrisk Life Limited,registration number 1999/013922/06 and FSP number 76.
Intermediary: niftycover (Pty) Ltd with registration nr 2011/005787/07 and FSP43574.
Maximum Indemnity: the Outstanding Amount.
Loan disbursement date: the date when the credit agreement came into effect.
Loss of income: The involuntary loss of the ability to earn an income by a person, which loss is caused by extraneous factors that are not within that person’s control, and that person is self- employed and a pensioner. For purposes of this Policy, Loss of Income shall not extend to the loss of any supplementary income whilst the main income remains in force.
Loss Payee: the nominated beneficiary of the Policy which is the credit provider.
National Credit Act: Means the National Credit Act, 2005 (Act. 34 of 2005).
Outstanding Loan Amount: the amount owed by the Insured (qua borrower) in terms of the Credit Agreement, including capital; interest; permissible fees; and other fees and costs charged on arrear loans, as provided for in the National Credit Act 34 of 2005.
Period of Insurance: the period for which Premiums remain paid and the Policy remains in force.
Policy: the Policy Schedule, the terms and conditions, and any endorsements thereto. As set out in this document.
Pre-Existing Condition: an illness or bodily injury sustained or contracted by an Insured which the Insured:
- was aware of; or
- should reasonably have been aware of; and/or
- received medical treatment or advice for from a physician, in the 12 (twelve) months preceding the Entry Date of this Policy. Pre-existing Conditions will only be covered after the first 6 months have elapsed from the Entry Date.
Premium: the monthly amount payable, as stated in the Policy or any endorsement issued in terms of this Policy.
Repudiate: In relation to a claim means any action by which Guardrisk rejects or refuses to pay a claim or any part of a claim, for any reason and includes instances where a claimant lodges a claim; - in respect of a loss event or risk covered by the policy; and in respect of a loss event or risk covered by a policy, but the premium or premiums payable in respect of the policy are not paid.
Retrenchment: the termination of employment of the Insured by his/her employer due to:
- adverse conditions or anticipation thereof; or
- any other business decision by his/her employer resulting in staff reductions; or
- the introduction of new technology; or
- re-organisation of the employer’s enterprise.
Loss of income due to becoming unemployed or being unable to earn an income will also be included under this definition.
Sum Assured: the equivalent of the Maximum Indemnity.
Temporary Disability: medically-certified temporary disability as a result of illness, injury or disease, which prevents the Insured from earning his/her normal income by following his/her own occupation for a period in excess of 31 (thirty-one) consecutive days.
Total Permanent Disability: such incapacity which prevents the Insured from following the Insured’s own, or any similar, occupation (and being prevented from earning an income or profit) for which the Insured is, or could reasonably be expected to be, qualified for by virtue of his/her knowledge, training, education, ability, experience and age.
The Insured shall also be deemed to have suffered Total Permanent Disability upon the total and permanent loss of or loss of use of: both hands; or both feet; or both eyes.
We, Us, Our: The Insurer.
Variation of a Policy: Means any act that results in a change to:
- the premium;
- any term;
- any condition;
- any policy benefit;
- any exclusion;
- the duration of the policy;
and “Vary” or “Variations” shall have a corresponding meaning.
You, Your: the person named as the Insured in the Policy.
You qualify for this Policy if:
- You have an approved Credit Agreement with the Credit Provider;
- You have an Outstanding Loan Amount;
- At the Entry Date of the Policy, Your Age was older than 18.
For Your protection, this Policy is offered in terms of the Loan Agreement with the Credit Provider. You have the right not to take this Policy, but then You have to cede an alternative policy to the Credit Provider. Such alternative policy must have at least the same benefits as this Policy.
You have the right to cancel this policy within 31 days from the receipt of the terms and conditions or within 31 days from the date on which it is deemed that You receive the terms or conditions or within 31 days of the Entry Date, provided no benefit has been claimed or paid or an event giving rise to a claim has not yet occurred, in which instance any premium paid will be refunded less the cost of any risk cover enjoyed by You by making a written request for cancellation.
If you elect to cancel, you must cede an alternate policy to niftycover with the same minimum benefits that this policy offers, failing which we reserve the right not to cancel this insurance.
The niftycover credit life policy can only be cancelled if the alternate policy has been approved and accepted by smartadvance, as the credit provider.
Payment of any Benefit under this Policy will only be considered or made if: You have complied with all the terms and conditions of this Policy; and You or Your representative has complied with all the requirements of the claims process.
An amount equal to, but not exceeding, the Outstanding Loan Amount will be paid to the Credit Provider if You pass away from either natural or unnatural causes.
TOTAL PERMANENT DISABILITY BENEFIT
An amount equal to, but not exceeding, the Outstanding Loan Amount will be paid to the Credit Provider if You suffer a Total Permanent Disability. For purposes of this Benefit, a claim cannot be lodged if the disability occurred prior to the Entry Date of the Policy.
TEMPORARY DISABILITY BENEFIT
If You suffer from a Temporary Disability for a period in excess of 31 (thirty-one) consecutive days, an amount equal to Your monthly instalment under the Credit Agreement will be paid to the Credit Provider:
- for a period of 12 months;
- for the remaining repayment period of the Credit Agreement; or
- until You are no longer disabled.
The benefit is payable for whichever is the shorter period.
An amount equal to Your monthly instalment under the Credit Agreement will be paid to the Credit Provider:
- for a period of 12 (twelve) months;
- for the remaining repayment period of the Credit Agreement; or
- until You find employment or are able to earn an income.
The benefit is payable for whichever is the shorter period. For purposes of this Retrenchment Benefit, a claim cannot be lodged against this Benefit if Retrenchment occurs prior to the Entry Date of this Policy, or if You received notification of a possible retrenchment prior to the Entry Date. By notification, We mean you were aware of pending Retrenchment or possible Retrenchment that may occur even if the possible Retrenchment notification includes a consultative process before a final decision is made.
The Insurer shall not be obliged to make any payment in respect (of any Death and Disability claims) of any condition or Event which is directly or indirectly caused by, arising from, contributed to by, aggravated by, connected with, traceable to or resulting from any of the following:
- willful self-inflicted injury or suicide (whether sane or insane) within the first 12 months of the Entry Date;
- any Pre-Existing Condition within the first 12 months from the Entry Date;
- the Insured’s participation in any criminal activities;
- if the Premiums have not been paid up to date or if the Insured has not complied with all the obligations and conditions of this Policy;
- active participation in war, invasion, acts of foreign enemies, hostilities, warlike operations (whether war declared or not), civil war, insurrection, rebellion, revolution, civil commotion or uprisings, military power;
- the Insured’s abuse of alcohol, drugs or narcotics; • participation in hazardous activities such as mountain climbing, bungee jumping and speed racing;
RETRENCHMENT / LOSS OF INCOME EXCLUSIONS
The following exclusions apply to Retrenchment and Loss of Income claims. No Benefits will be payable for Retrenchment/ Loss of Income:
- if the Retrenchment/Loss of Income is due to resignation; normal or early retirement; voluntary Retrenchment or termination of employment outside of a company restructure;
- lawful dismissal, dismissal as a result of the Insured’s own misconduct that is a violation of some established, definite rule of conduct, a forbidden act, willful dereliction of duty or misconduct;
- for any claim caused by voluntary forfeiture of salary, wages or other employment income;
- if the Insured has not complied with all the obligations and conditions of this Policy;
- if the Retrenchment/Loss of Income has arisen and is traceable to an unprotected strike. If evidence can be provided that the strike in question was a protected strike, then the claim will be considered by Us.
SPECIFIC RESTRICTIONS ON LIABILITY
The Insurer’s liability in terms of the Policy shall cease in the event of a claim settlement being made for the Outstanding Loan Amount. This is applicable to a once-off claim payment.
CHANGE IN EMPLOYMENT STATUS
Should You become unemployed for any reason that does not meet the requirements of a valid Retrenchment claim under this Policy, such as retirement or resignation, you need to notify Us in order to update Your Policy and not charge You for this Benefit. Please send an email to firstname.lastname@example.org
TERMINATION OF THE POLICY
This Policy will terminate or end on the earliest of the following:
- on the date that the Credit Agreement with Credit Provider ends;
- on Your death or Your Total Permanent Disability, and the subsequent payment of either of these Benefits;
- the lapsing of the Policy due to non-payment of the Premiums;
- when either You or Us cancel the Policy; • the written request for cancellation by the Insured, with the consent of the Credit Provider, giving 1 calendar months notice from the date of the request;
- the full settlement of the loan granted by the Credit Provider
CANCELLATION PROCEDURE AND CONSEQUENCES
You have the right to cancel this Policy at any time by giving Us 1 calendar months notice of the intention to cancel. Such cancellation, after the initial 31 (thirty-one) days from the Entry Date, will not attract a refund of any Premiums paid.
Please also contact the Credit Provider, as You need to provide alternative cover that meets the Credit Provider’s requirements. If the alternate policy does not meet Our requirements, we have the right to refuse cancellation. Please refer to Your Credit Agreement for requirements during the loan term.
NO SURRENDERS OR CESSIONS
This Policy acquires no surrender, paid-up or loan values. There is no cumulative effect of Premiums paid and each monthly Premium is used to cover the risk for that specific month. Each month a Premium is to be paid to renew cover.
The Premium payable monthly for this cover is calculated and based on the initial loan amount (deferred amount), as stated in Your Policy. The Premium is calculated at a fixed rate per R1,000 of deferred amount, under the Credit Agreement, as per applicable legislation, up to a maximum R4.50 perR1,000 thousand insured.
A Premium is payable on the first day of each calendar month (“Due Date”). If We do not receive Your Premium on the Due Date, a period of 31 (thirty-one) days (“Grace Period”) will be given to You in which to make payment to keep the Policy in force. Should a Premium remain unpaid for a period longer than the Grace Period, the insured will be notified that failure to pay the next premium, may lead to the lapsing of the policy. Should two consecutive Premiums remain unpaid, the Policy will lapse automatically and all Benefits will cease.
In the event that the Premium(s) actually paid to the Insurer are incorrectly calculated so that they are in fact insufficient to pay for the Benefits, as set out in the Policy, then:
- We reserve the right to review, by Our actuaries, of all Premiums at Our discretion and should We find that they are insufficient to cover the Sum Assured, then We may, after notifying You at Your last known address on record using post, email or telephonically or via SMS, adjust the Premium to the corrected amount after a period of 60 days.
Please notify Us of Your claim. Claims can be sent email@example.com You may also firstname.lastname@example.org information. You will be notified of the various documents required, after which the claim will be assessed and the outcome of the claim will be communicated directly to You.
REJECTION OF THE CLAIM AND TIME BAR
In the event of a claim being rejected or You are disputing the quantum of the Benefit paid by Us, You are entitled to make representations to Us in respect of Our decision to reject the claim or as to the manner in which the quantum of the Benefit was calculated for a period of 90 days from the date of receipt of the letter of rejection or the date of the claim payment.
Representations must be submitted in writing, in the first instance to:
PO Box 786015, Sandton, 20196.
Tel: (011) 669-1000
Where You are not satisfied with the response from the Insurer, You are entitled to escalate the matter to the Ombudsman for Long-Term insurance in the second instance on:
Private Bag X45, Claremont, 7735,
Tel: (021) 657-5000
Fax: (021) 674-0951
In terms of Section 15 of the Financial Services Ombudsman Schemes Act No. 37 of 2004, on receipt of the official referral to the aforementioned Ombudsman, any applicable time barring clause in terms of this Policy or the running of prescription in terms of the Prescription Act No 68 of 1969 from the date of referral to the date of withdrawal of the referral, or determination of the referral by the Ombudsman, shall be stayed. If the dispute is not satisfactorily resolved in this manner, legal action may be instituted against the Insurer for the enforcement of the claim by way of the service of summons against the Insurer. Summons must be served on the Insurer within 6 months from the date You receive the outcome in respect of the representations You have made, failing which all Benefits in respect of such claim shall be forfeited and no liability can arise in terms of such claim.
- any claim under this Policy is in any way misrepresented;
- any fraudulent means are used by You or anyone acting on Your behalf to obtain any Benefit under this Policy;
- any of the Events insured against are occasioned by Your intentional act or with Your collusion, then all Benefits under the Policy and all Premiums paid in terms of the Policy will be forfeited and the Policy will be voidable at Our option. Appropriate action will be taken as deemed necessary by the Insurer; or
- The Insurer shall immediately cancel this Policy or place it on hold, refuse any transaction or instructions, or take any other action considered necessary in order to comply with the law and prevent or stop undesirable or criminal activity.
The Insurer shall be entitled to require that any Insured, whether or not then alleged to be suffering from the effects of injury, be examined at any reasonable time by a medical practitioner of the Insurer’s choice and expense. The report of such medical practitioner shall, for all purposes under this Policy, be final and binding upon the Insured and the Insurer.
DISCLOSURE OF PRIVATE INFORMATION
Should it be required by law, regulations or the Insurer, the Insured’s personal information pertaining to the Policy may be disclosed.
No variation to this Policy will be binding on the Insurer unless made in writing and signed by a duly authorized officer of the Insurer and confirmed thereafter by payment of the Premium, whether varied or not. No act or omission to act by the Insurer, or any officer or employee of the Insurer, shall be deemed to be a representation on behalf of the Insurer upon which the Insured or the Insured’s heirs, executors or assigns are entitled to act.
This Policy is issued on the basis that the statements and information made and set forth in the application and all declarations made in respect thereof are true and correct and constitute a full disclosure of all facts and circumstances likely to materially affect the assessment of the risk at the time of the issue of this Policy.
The Insurer reserves the right to amend, add or change the terms and conditions of this Policy by giving 1 month’s written notice to the Insured of its intention to do so. Any variations and or changes will be binding on both the Insurer and the Insured and can be applied at any time to the existing terms and conditions after written communication of these changes has been sent to the Insured’s last known address as it appears in the Insurer’s records at that time.
COMPLAINT RESOLUTION PROCESS
niftycover (Pty) Ltd.
Postal Address: P.O. Box 39960, Garsfontein East,0061.
Tel: 012 045 0606
Guardrisk Life Limited
Postal Address: P.O. Box 786015, Sandton,0196.
Tel: (011) 669-1000
Ombudsman for Long-Term Insurance(complaints relating to claims repudiations)
Postal Address: Private Bag X45,Claremont,7735.
Tel: (021) 657-5000
Sharecall: 0860 103 236
Fax: (021) 674-0951
FAIS Ombudsman (complaints relating to the selling of the financial service)
Postal Address: P.O.Box 74571, Lynwood Ridge,0040.
Tel: (012)762-5000/012 470-9080
Fax: (012)348-3447/0860 764 1422
Premiums will be reviewed annually according to regulatory changes and an annual escalation may automatically apply. You will be notified 31 (thirty-one) days in advance of any Premium increases and/or product changes.
TREATING CUSTOMERS FAIRLY ("TCF")
The TCF principles are viewed seriously by the Insurer and we strive to practice all 6 TCF (“Outcomes”) at all times. We will, in all Our interactions with any Insured, endeavor to deliver excellent customer experiences which We will achieve through the ongoing review of all Our business practices and analysis of complaints. It is Our objective to be:
- fair in Our treatment of all Insureds and partners; and
- compliant, in all aspects, with the 6 Outcomes of the TCF framework.
The TCF Outcomes are:
- You are confident that Your fair treatment is key to Our culture;
- products and services are designed to meet Your needs;
- We will communicate clearly, appropriately and on time;
- We provide advice which is suitable to Your needs and circumstances;
- Our products and services meet Your standards and are of an acceptance level; and
- there are no barriers to access Our services or to lodge any complaints.
DISCLOSURE NOTICE TO LONG-TERM INSURANCE POLICYHOLDER: IN TERMS OF THE FINANCIAL AND ADVISORY AND INTERMEDIARY SERVICES (“FAIS”) ACT 37 OF 2002.
Details of Insurer: Guardrisk Life Limited
FSP Number: 76
Physical Address: The Marc,Tower 2,129 Rivonia Road,Sandown,Sandton,2196
Postal Address: PO Box 786015,Sandton, 20196
Telephone Number: (011) 669-1000
General Email queries: email@example.com
Complaints Contact Number: 0860 333 361
In terms of the FSP license held by Guardrisk, it is authorised to give advice and render financial services for Long-Term Insurance:
- Long-term Insurance : Category A
- Long-term Insurance : Category B1
- Long-term Insurance subcategory B1-A
- Long-term Insurance : Category B2
- Long-term Insurance subcategory B2-A
- Long-term Insurance : Category C
Guardrisk holds Professional Indemnity Cover and Fidelity Guarantee Cover. You can access the Guardrisk Complaints Resolution Policy and the Guardrisk Confliict of Interest Management Policy at www.guardrisk.co.za
Details of Intermediary:
Company name: niftycover Proprietary Limited with Reg. No. 2011/005787/07 An FSP No. 43574 (“niftycover”)
Physical address:1st Floor, The Wedge, Garsfontein Rd, Waterkloof,Gauteng, 0045.
Postal address: P.O. Box 39960, Garsfontein East, 0060.
Telephone number: 012 045 0606
E-mail address: firstname.lastname@example.org
- niftycover has been appointed by the Insurer to act as an Intermediary and is approved to market and sell Long-Term Insurance: Category 1; A, B1, B2 and C.
- The Intermediary receives the following fees from the sale of this Policy: an Intermediary fee of 3.25% (seven and a half) and a binder fee of 9% (nine).
- niftycover holds Professional Indemnity Cover as well as Fidelity Guarantee Cover.
- Without in any way limiting and subject to the other provisions under the Services Agreement/Mandate, niftycover accepts responsibility for the lawful actions of their Representatives (as defined in the FAIS Act) in rendering financial services within the course and scope of their employment.
Compliance Practice: ISS Compliance (Pty) limited
Practice Number: CO28
Telephone number: +27 11 064 1672 & +27 31832 0300
E-mail address: COMPLIANCE@NFSGROUP.CO.ZA
- Policy wording: A copy of the policy will be made available to you by requesting such from email@example.com
- The Intermediary derives more than 30% (thirty percent) ofits total commissions from Guardrisk Life Limited.
- do not sign any blank or partially completed application forms;
- complete all forms in ink;
- try and keep all documents handed to You;
- place Your Policy in safe keeping;
- incorrect information or a material non-disclosure or misrepresentation of important information including facts by You may influence the Insurer on any claims arising from Your Policy;
- if You are unsure what information to disclose, rather give too much information than too little.
WAIVER OF RIGHTS
No insurer and/or underwriting manager and/or intermediary may request or induce in any manner a client to waiver any right or benefit conferred on the client by/or in terms of any provisions of the said Code, or recognise, accept or act on any such waiver by a client. Any such waiver is null and void.