Policy Provisions
Your policy, and our contractual commitment, takes effect on the 1st of the following month after we accept your application for the policy. Your policy documents and these policy provisions are the complete and only record of your policy, and also the summary of your policy required by section 48 of the Long-term Insurance Act.
Life Insured
This is a person whose life is insured under your policy. This is you, or the main life insured, and anyone included as immediate family orextended family. You must have an insurable interest, in all lives insured. You have, for example, such an interest in your spouse, children, parents and other family members.
Main life insured
This is the person whose life you insure under your policy, if your life is not insured under the policy. In this case, immediate family and extended family included in your policy are those of the main life insured.
When cover and waiting periods start
For every life insured death cover for an accidental death starts, and the waiting period for death cover for natural (non-accidental) death and suicide starts, on the first day of the month in which the first monthly premium for cover for that life insured is due. The waiting periods are given below. During a waiting period premiums must be paid, but benefits are not provided
Accidental death
(0 – 64 years) no waiting period
(65 – 74 years) no waiting period
(75 – 84 years) no waiting period
Natural death
(0 – 64 years) 6 months
(65 – 74 years) 6 months
(75 – 84 years) 6 months
Suicide
(0 – 64 years) 12 months
(65 – 74 years) 12 months
(75 – 84 years) 12 months
Accidental death is death caused by an incident that causes harm to the body of the life insured from outside the life insured, which harm excludes any sickness – and which incident and harm the life insured did not intend and reasonably could not have foreseen. The incident must be the direct and only cause of death, and death must happen within 30 days after the incident.
Age of lives insured when cover starts
You, or the main life insured, and the spouse included as immediate family, must be under age 65. Children included as immediate family must be under age 21. Children who are permanently disabled and totally dependent on you or the main life insured may be included at any age. Children who are unmarried and full-time students at an education institution approved by us may be included if they are under age 25.
When cover for children stops
Cover for children stops when they turn 21. For disabled children (described above) it does not stop at any specific age. For a still-born child the death benefit will be paid only if the birth takes place after 26 weeks of pregnancy, and is not self-induced.
Maximum funeral cover for one person
When a person takes out funeral insurance with us, the total funeral cover for that person under all individual and group policies with us may not be more than the following maximums: R20 000 if the insurance is taken out when the person is under age 6; R50 000 if it is taken out when they are aged 6-13 years, R104 000 if it is taken out when they are 14 years or older. Any cover above the maximum limit automatically falls away
About your premiums
The premium for your policy is payable monthly, before the 12th of every month. The premium we receive in a particular month provides cover for the next month. The premium pays for death cover only, and not for any investment or cash value. Premiums are not refunded if your policy ends for any reason.
If two monthly premiums in a row or within the duration of the policy are not paid, and both are not paid by the end of the month in which the second premium should have been paid, your policy ends automatically. If within 30 day of your policy ending, we again receive a premium, we may reinstate your policy, and if we receive it after the 30 days grace period, new waiting periods will then apply.
If premiums are not paid in full, benefits also cannot be paid in full. Only a percentage of the benefit can then be paid –namely a percentage that is the same as the percentage of premiums paid. For example, if you had to pay premiums of R1 000, but paid only R500, it means you paid only 50% of the premiums. Therefore, only 50% of the benefits can then be paid. So, if the benefit amount is R10 000, only R5 000 can be paid.
When policy benefits will not be paid
A benefit will not be paid if information (for example, about your relationship with lives insured or the age of lives insured), was not provided to us before the start of the policy, or is not correct. A benefit will also not be paid if the life insured’s death is caused or accelerated directly or indirectly by war, civil commotion or terrorist activity, or if the life insured dies while committing a criminal activity
You can cancel your policy
You can cancel your policy at any time by written notice to us. If we receive your notice within 30 days after you have received these policy provisions, your policy ends when we receive your notice. This is known as a cooling-off cancellation. If we receive your notice after the 30 days, your policy will end at the end of the month in which we receive your notice, and then premiums received after the policy has ended will be refunded.
The actuarial basis of your policy
Your policy operates according to actuarial rules, specifications and formulae, which are approved according to law, and which are known as the actuarial basis of your policy. This ensures that your policy is financially sound, and is carried out properly and fairly.
Information about you
We may use information about you, also personal information meant in the Protection of Personal Information Act, that we lawfully obtained in the past or may obtain in future, including the information provided for your application for this policy, for the following purposes:
· to consider applications for insurance of which you are the policyholder or a life insured; and
· for all purposes of such insurance, issued in the past or in future, particularly to consider claims for benefits and to trace persons who could receive benefits.
We may for these purposes, at any time, also after your death:
· obtain such information from other persons and entities, particularly from other insurers and registered credit bureaus, and you authorize them to give such information to us;
· share such information with other insurers – directly or through a data base that insurers operate as a group, and in such form as we or the operators of the data base may decide.
How to claim a policy benefit
Visit any of our offices, set out on the back of this folder or phone 011 568 9094.
We must receive a completed claim form within six months, after the death of the life insured. The persons who claims must, at their own cost, prove the claim, show that no exclusions apply, and give us all information and documents we need to consider the claim.
This must include:
· the claim form – completed and signed as required
· certified copy of the valid ID document of the person who claims
· certified copy of the original death certificate of the life insured – form DHA 5
· certified copy of the valid ID document of the life insured, with “deceased”or a similar notice stamped on it
· copy of the notification/registration-of-death – form DHA1663
· copy of a valid bank statement of the person who claims, not older than three months, showing the account-holder and the account number
· police report if the death is due to unnatural causes – for example, a motor-vehicle accident
· other documents that we may reasonably require.
For other assistance
Tel: (011) 568 9064
Hotline: 061 581 4089
info: hello@havanalife.co.za
claim: claim@havanalife.co.za
Complaints and compliments
Our commitment is to provide excellent service to you. Should it happen that you, after having contacted one of our offices or our client services department, are still not satisfied, please contact our complaints department: e-mail: support@havanalife.co.za
Banking Details
Account Holder: Havana Life (Pty) Ltd
Account Number: 62858400006
Branch Code: 250655