Terms and Conditions
The Funeral Cover benefit amount displayed and indicated as being selected by the client is deemed to be the true reflection of what has transpired between the client and the Representative and thus forming part of this Policy Contract between the client and the Khululeka Life. The Funeral Cover amount chosen for the Extended Family members or Parents and Parents – in – Law cannot be higher than the cover chosen for the Policy Holder, unless the extended family member is covered on an Extended/Parent Stand-Alone Option, in which case the maximum Funeral Cover benefit amount of R50 000.00 (fifty thousand rand) depending on the selection of the client.
Double Accidental Death Cover:
This benefit only applies to Essential Family Funeral Cover with benefit amount of R25000 rand or less. When any life assured in this policy dies due to any un-natural causes, an amount equal to double the Funeral Cover benefit will be paid out for a valid claim provided all required documentation to conclude a claim has been provided to Khululeka Life. The Double Accidental Death Cover applies to all lives Assured EXCEPT For Stillborn Children. The maximum Funeral Cover benefit amount payable for Children will apply (please refer to the section relating to the Maximum Funeral Cover Benefit Amount per Life Assured on each product).
Funeral Support Services and Repatriation:
On registering the funeral cover claim, the Repatriation Service will automatically be invoked and will be ready for further instruction. The client is not expected to call any number for the service to be rendered. These support Services for all the lives in the Policy except for the Tombstone which covers only the Policyholder. all Life Assured in the Policy will be covered by choice of the policyholder, and if there is no selection and payment in this regard, the extended family members, parents, and parents – in – law and children do not qualify for a tombstone. These Support Services are automatically included in the premium the client is paying except for the Extended Family members, Parents/Parents–in–law, and children and they are available immediately without any waiting period. Southern Cape Tombstones are the preferred Services Provider appointed to Supply, Deliver, and Install the Tombstone anywhere in South Africa, and they will pay a R10 000 fee for all cross-border services as they are not accredited to supply and install their services outside the borders of South Africa. Khululeka Life and its Service Providers are therefore not responsible for the quality, workmanship, and delivery of the Tombstone conducted outside the Republic of South Africa, except to say that Khululeka Life will invoke its rights for quality Services to their client’s satisfaction at all cost, liabilities, damages, loss expenses which a client may suffer, in as far as the tombstone is concerned Khululeka Life is not responsibly, but their Service Provider (Southern Cape Tombstones) are fully responsibly thereof. The services provided by Southern Cape Tombstone may also include the identification of credible undertakers and suppliers of flowers ceremonial services and the preparation of the grave. They pride themselves in taking extra care to meet the client’s special needs or cultural preferences regarding their services. They further can recommend Funeral Parlor Services known to them when requested to do so. If repatriation is needed and the client chooses to use a different means of transport rather than what Khululeka Life is providing, the client will be paid an amount on receipt of such a claim an amount up to R20 000.00 for such a service on presentation of the receipt, any money more than the R20 000 will be for the account of the client. If no invoice is submitted, Khululeka Life will not pay any of such a claim. The benefit also includes accommodation for a maximum of one night for two adults accompanying the deceased body to the place of burial, should there be an eventuality that leads to such an accommodation being needed. For all other benefits associated with KLA ON-CALL benefits the client may from time to time contact our CALL CENTER @ 087 188 5649 during working hours or 084 124 (24 hours 7 days per week)
TERMS and CONDITIONS:
POLICY CONTRACT TERM:
The Contract term of this Policy shall be 12 (Twelve) Months and will automatically be renewed unless Khululeka Life is informed in writing by the policyholder not to renew the policy 30 days before the end of the contract term. Upon renewal of the policy, there will be no new waiting period applied. the policy will continue uninterrupted and there is no new application is required.
Membership of the Policy including the Beneficiary:
All live Assured as well as the Beneficiary must either be South African Citizens, or an adult person holding dual Citizenship of which one must be a South African Citizenry or holding a valid work or educational permit issued by the Department of Home Affairs and such a permit must at least still be 12 months or longer period left before expiry date at inception date of the policy.
Funeral Cover Benefit Amount:
The benefit amounts for each Life Assured in the Policy are covered as the funeral Benefit Selected, captured, and accepted by the Board of Khululeka Life.
Premiums are Payable Monthly:
Premiums are payable monthly in advance. A premium received for a month provides cover for that month.
Our policies carry a minimum monthly premiums as follows
- Essential Family Funeral Plan R155.00 (One Hundred and Fifty-Five Rand).
- Ultimate Family Funeral Plan R140.00 (One hundred and forty Rand).
- Optima Family Funeral Plan R125.00 (One Hundred and Twenty-Five Rand).
WAITING PERIODS:
NATURAL CAUSES | THREE (3) MONTHS |
ACCIDENTAL CAUSES | ZERO (0) MONTH |
SUICIDE | TWELVE (12) MONTHS |
REINSTATEMENT | THREE (3) MONTHS |
REPLACEMENT “A” | ONE (1) MONTH ON NEW COVER |
REPLACEMENT “B” | ZERO (0) MONTH ON CURRENT COVER |
Premium Payment Method:
There are two preferred premium payment methods for Khululeka Life. Stop Order Payment Method and Bank Debit Order, however, clients can pay their premiums through Pay@ at all participating retail stores including but not limited to. Pick n Pay, Shoprite/Checkers, Ackerman’s, Pep Store, Boxer, and many more. All these different types of payments are administered monthly. Should an approved Stop Order be selected as a monthly collection method and for whatever reason it is rendered not to be successful, the collection method will default after two consecutive attempts to a Bank Debit Order, such will take place provided you have authorised it on your Stop Order/Debit Order Mandate. When experiencing challenges in invoking your chosen payment method, you may contact ASF Services @ 044 004 0367 or e-mail us at sales@khululeka.co.za having your ID Number, Policy Number, or Cell phone Number you registered on the application handy and we will be able to assist you to affect your premium payment.
Important Dates:
The Signature Date is the date the Application is signed by the Policyholder.
The Application Date is the date on which the policy application is captured and accepted by Khululeka Life.
The First Deduction Date is the date on which Khululeka Life will deduct the first premium.
Effective Date is the date on which Khululeka Life will receive the first premium and allocate such premium to the relevant policy.
Can The First Deduction Date Be Changed?
Khululeka Life reserves the right to move the First Deduction Date to the same date of the following month should your premium not be paid on the original preferred First Deduction Date. However, Khululeka Life will move the First Deduction Date only one time in the duration lifetime of your policy. Should the First Deduction Date be moved, so shall all your waiting period be moved, and no claim payments shall be honoured by Khululeka Life. Should the premium still not be paid the following month as it is so moved, the policy will be deemed to be NOT – TAKEN UP (NTU) and such a status will appear on our systems for Five (5) Years from the date of such status unless the policy shall be RE – DATED by the Client and pay all money in arrears on Re – Dating. in the case a policy has been Re-Dated the waiting period shall commence for the same period as it is stated on the Waiting Period Schedule for whatever the occasion.
Exclusions To The Policy:
Khululeka Life will not be obliged to honour any claim that arises in respect of any of the following conditions or events, directly or indirectly from a traceable or giving rise to a consequence of the life Assured being involved or participated in any riot, strike, commotion or rebellion, war, civil commotion or terrorist activity wilful exposure to danger, involvement in any criminal activity, radioactivity or a nuclear explosion, use of drugs other than prescribed by a medical practitioner, excessive use of alcohol above the legal limit in force in the RSA that lead to an accident whether one was a pedestrian, passenger or driving the vehicle at the time of an accident or any other un-natural death as a result of such an occasion
Un-Natural Death:
Un-Natural death means unexpected death caused by a sudden, uncertain, and fortuitous event that happens at an identifiable time and place independent of any other cause. this does not include sickness or disease or any naturally occurring condition or degenerative process. Self – Inflicted injuries that lead to death and suicide as defined by the laws of the RSA are also excluded from this definition, Accidental has a corresponding meaning also defined by the laws of the Republic of South Africa.
References To Age:
All references to age will be the person’s Age Next Birth Birthday on the acceptance Date. The maximum Age at entry for the Policyholder and Spouse is 64 (sixty-four) years next birthday for both the Essential Family Funeral Plan and Optima Family Funeral Plan. Parents and Parent – In – Law Extended Family Members included are 84 (Eighty-Four) years next birthday on the Essential Family Funeral Plan and 64 years next birthday (Sixty-Four Years) on the Optima Family Funeral Plan. Biological Children it is 20 (twenty) years next birthday. Children will fall away at 21 (twenty-one) last birthdays if they are not full-time student/s but will remain covered up to 26 (twenty-six) years if still full-time study. There is no Age limit on the Ultimate Family Funeral Plan.
Insurable Interest:
All Insured persons under these policies are referred that are referred to as Insurable Interest persons to the Policyholder or Premium Payer are:
Spouse, Biological Children, Parents, and Parents – In – Law including Extended Family Members. The Policyholder must have an Insurable Interest in all lives Assured in this policy and such a relationship must be disclosed by means of declaring on the application form’s RELATIONSHIP COLUMN on the acceptance date of this policy, otherwise any false declaration whether perceived, known, or unknown at the time of the application, such false information may render the claim invalid and be repudiated.
Immediate Family:
Shall mean the Policyholder, Spouse if any exist at the time of application or added later on, and 6 (six) unmarried biological children or those of the
Spouses commonly known as (STEP – CHILDREN) under the age of 21 years or 26 years if they are still full-time students.
Policyholder:
Policyholder and premium payer may differ from time to time only on the Essential Family Funeral Plan. The policyholder shall mean the main Life Assured in the policy, The Premium Payer may be a different person from the Policyholder depending on the Interest the Premium Payer has on the life of the Policyholder. (Refer to Insurable Interest Clause Supra) The policyholder is the person who signs the application form and nominates beneficiaries from time to time as it is deemed necessary to him/her. On the Ultimate Family Funeral Plan and Optima Family Funeral Plan, the policyholder and the premium payer must be the same person.
Spouse:
The person to whom the Policyholder is married, and which marriage is accepted under the law of the Republic of South Africa, including civil, customary and same – sex marriages, with whom the policyholder lives in a relationship similar to a marriage, which relationship is intended to be permanent like a marriage and has existed for at least 2 (two) years. the relationship of this nature must be accepted like this on the acceptance date of the policy. Only one spouse can be nominated as a spouse in this policy, any other spouse can only be nominated as an extended family member but notwithstanding the fact that on the Relationship column, the fact must be divulged as such. (Spouse)
Children:
Children’s status has been extensively spelled out under the heading Immediate Family, please refer to it for further information.
Newborn Child/ren:
Newborn child/ren must be nominated in writing within 6 (six) months of the date of birth. If the child has not been nominated at the expiry of the 6 (Six) months period, when nominated the 3 (Three) months waiting period will be effective unless the policyholder has successfully applied for a condonation of the omission.
Children’s Funeral Cover Benefits:
The funeral cover benefit amount payable for the children’s cover on all Funeral Policies is as follows:
Age Group | Cover % |
Stillborn | 12.5% OF THE POLICYHOLDER COVER |
0 – 5 | 25% OF THE POLICYHOLDER COVER |
6 – 13 | 50% OF THE POLICYHOLDER COVER |
14 > | 100% OF THE POLICYHOLDER COVER |
For further information on the eligibility of children please refer to the Immediate Family clause supra. The benefit amount is subject to the Maximum Funeral Cover Benefits Selected for the Policyholder.
Parents and Parents–In–Law:
Parents means the biological Mother and Father of the Policyholder, the Legal Guardian of an Adopted Policyholder, and the Stepparent of the Policyholder. Parent – In-Law is the Mother or Father of the Policyholder’s Spouse whether they are the Biological Parents or Legal Guardian Parents, Adopting Parent/s of the spouse, or Stepparent/s of the spouse. These Relationships must be recognised and accepted from the inception date of this policy, provided that there will only be one father or mother and one father – In – Law or Mother – In – Law nominated in the lifetime of this policy. A replacement of any Parent for stepparent in this policy after the acceptance date can only be manifested through a proof of death certificate of any other parent that was originally nominated from the date of acceptance. Any such a late–date nomination of a parent, such newly nominated shall undergo the normal waiting period save that the parent was already been nominated as a life assured in this policy.
Beneficiary:
Only one Beneficiary can be nominated in these Policies. The Policyholder is the only person who can nominate and withdraw such a nomination at any time and there are no limitations in either nomination or withdrawing a beneficiary, provided that an official Nomination Form must be filled in and signed by the policyholder providing a copy of their ID, and that there shall always be a beneficiary registered in the policy.
Extended Family Member/s:
A maximum of up to 10 (Ten) Extended Family Members can be nominated and be covered under the policy. The Following person(s) qualify to be covered as
Extended Family Members on this policy: –
- Spouse is defined where you have more than 1 (one) spouse, or your spouse falls outside of the age requirements for a Spouse, that spouse/s can be nominated as Extended Family Member/s.
- Child is defined as where you have more than 6 (six) children or your child falls outside of the age requirements for a child to be covered as a child in this policy.
- Parent and Parents – In – Law is defined where you have more than 2(two) parents or 2 (Two) Parents – In – Law, your additional Parents or Parents – In – Law can be nominated as Extended Family Members.
- Grandfather or Grandmother and Grandfather – In – Law and Grandmother – In – Law are defined as the Policyholder and the Spouse’s Parents see the definition of a parent under (Parent and Parent – In – Law column above).
- Aunt is the Policyholder and Spouse’s Father or Mother’s Sister or the Policyholder or Spouse’s uncle’s Female spouse.
Uncle is the Policyholder and Spouse’s Father or Mother’s brother or the Policyholder and Spouse’s Male Spouse
- Brother is the Policyholder and Spouse’s Parent’s Male Child, THIS INCLUDES STEP – BROTHER or HALF – BROTHER.
- Sister is the Policyholder or Spouse’s Parent’s Female Child, this INCLUDES STEP–SISTER or HALF–SISTER.
- Brother – In – Law is the male person married to the child of the policyholder’s parents.
- Sister – In – Law is the female person married to the child of the policyholder’s parents.
- The first cousin is the child of the Policyholder’s Aunt or Uncle as defined above. Only First Cousins can be covered under this policy.
- Son–in–law is the male person married to the Policyholder’s daughter, stepdaughter, or adopted daughter. as defined under children above.
- Daughter – In – Law is the female person married to the Policyholder’s son, stepson, or adopted son. as defined under children above.
- Nephew is the male child of the Policyholder’s brother or sister.
- The niece is the female child of the Policyholder’s brother or sister.
- A grandchild is the Policyholder’s child’s child.
Cover for Extended Family Members:
It is the Policyholder’s responsibility to ensure that the details of the Extended Family Members selected and added to the policy application form are correct and authentic. Further, they all qualify as per the definitions as stipulated in this policy by Khululeka Life.
Waiting Period Defined:
The Waiting Period is the period during which Khululeka Life will not pay a claim. All Waiting Periods start from the Acceptance Date. When a new Life Assured is added to the policy, all Waiting Periods will apply to the new Life Assured (this also will apply to the newborn babies when the rule is not adhered to). If you increase a benefit, the waiting period will also apply to the amount the Funeral Cover benefit amount is increased by. No waiting period will be imposed, provided that: –
The Policyholder had a previous Funeral policy provided cover in respect of a similar risk related to the same lives assured as those covered under this new policy. The Lives Assured had completed the waiting period on the previous policy or a portion thereof that is more than a month of the said waiting period of the previous similar funeral policy. Should the Waiting Period under the previous Funeral Policy not been completed but the portion thereof that has been completed is equal to or more than the Waiting Period on this policy, the Applicant will not be subjected to any Waiting Period for the amount already completed the waiting period for, but only for the Funeral Cover Portion that is more than that what the Policyholder is applying for under this policy.
Benefits Payable Under This Policy:
All Lives Assured on this policy will qualify for the benefits that they are Assured for, as specified under the terms and conditions of this policy. Benefits are provided on a month–to–month basis, Claims are processed within 2 (two) hours after they have been received with all required information and they will be paid out within 24 hours from the completion of information gathering. The benefit will only be paid once the information provided is proven that it is for the Life Assured listed on the policy. If your premiums are not paid in full at the time a claim is lodged, yet your policy has completed the waiting period and it is still in – force on the day the Life Assured died, Khululeka Life reserves the right to either return you are paid-in premiums if they are less than 12 months or pay pro-rata depending to the merit of each case at the time of the event. Should the decision be that the cover be paid it will be paid less the outstanding premiums.
Claims:
After an event giving rise to a Claim Khululeka Life must be notified of the claim in writing within 3 (three) Months after the event giving rise to the claim has occurred. All claims will be considered according to their specific product terms and conditions and claims procedures. All claims for persons with a relationship to yourself, or to your spouse, who do not qualify for cover under this policy, will be rejected and all premiums paid will be forfeited. If the policyholder is still alive at such a claim stage and the claim is valid, it will be paid out to the policyholder not to the beneficiary, even if the beneficiary is the premium payer. Only upon the death of the Policyholder that the claim will be paid to the Beneficiary. If the nominated beneficiary is a minor at the time of paying the policy Benefits, 50% of the benefits payable to such a Beneficiary will be paid out to the Guardian of the said Under Age Beneficiary, since the policy is for the burial of the deceased. The remaining cover benefit will be Invested for the Under Age Beneficiary/s and will be paid out to them when he/she reaches the age of 18 (Eighteen) years with interest according to the inflation rate at the time.
Beneficiary/s;
The person/s nominated by the Policyholder as his/her beneficiary/s to whom the Policy Benefits will be payable, after the death of the Policyholder. The Premium Payer has chosen to be the premium payer and he/she may not be coerced to be the premium payer in this policy, thus he/she cannot demand to be the beneficiary or be one of the beneficiaries in this policy. the nomination of beneficiary/s is the sole discretion of the policyholder, and he/she may change them anytime he/she wishes to do so with or without the agreement of the premium payer.
Maximum Funeral Cover Benefit Amount per Life Assured.
The total Benefits payable to a Life Assured on All Khululeka Life where you or someone else insured in this policy and you are either the Policyholder or Family member or an Extended Family Member is as follows: Children Up to the Age of 5 (Five) years old = R10 000 (Ten Thousand Rand Only Combined) Children Aged 6 (Six) to 13 (Thirteen) years old = R50 000 (Fifty Thousand Rand Combined) Children Aged 14 (Fourteen) to 21 (Twenty-One) or 26 (Twenty-Six) if still full-time study and anyone above this legal age will be paid an amount equivalent to = R100 000 (One Hundred Thousand Rand). The maximum Funeral Cover Benefit paid out to all Lives Assured on all Khululeka Life policies where you or someone else is the policyholder or under any other category as mentioned above is outlined above.
- This means that, if a Life Assured is to be covered on a policy Administered by Khululeka Life and adding a funeral cover benefit such an addition exceeds the above limit for any of the age groupings. Such a Funeral Cover Shall be Limited to the amounts above.
- In the event for whatever reason, a cover has been accepted for whoever is the Life Assured and such a benefit exceeds the limitations and Khululeka Life and both the Client and Khululeka Life did not pick up the error, Khululeka Life will only pay the maximum as per the scale above.
- by signing this policy the Policyholder acknowledges that he/she has been informed of the terms and conditions of this policy and the above being one of them.
Premiums & Benefit Increases.
From the date of Acceptance, the premiums shall be reviewed every 3 (three) Months and may be amended if the risk profile of Khululeka Life has changed. A written Notice or Proclamation of any premium change or amendment shall be provided to the client/s by not later than 30 (thirty) days either in Writing, SMS, WhatsApp, phone call, or e-mail.
Information In the System.
The information provided in the Application form, Khululeka Life regards it as the communication tool that you the client are giving in so that Khululeka Life can communicate with you from time to time.
Cover Outside The Borders of The Republic of South Africa.
All Life Assured who are from Outside the Republic Of South Africa must inform Khululeka Life at the time of application of their Original Descent. Those who wish to visit their families or friends outside the borders of The Republic of South Africa must likewise inform Khululeka Life before they undertake their trips even if the trip will only last for an hour or less. the risk cover will not increase because one has left the borders of the Republic of South Africa, rather Khululeka Life undertake to negotiate both with the beneficiary and the relevant Authorities for a more favorable rate to be agreed upon, in the case of repatriation for the remains of the deceased.
Incorrect or Withheld Information.
A claim under this policy that involves fraud, misrepresentation, or false information, will lead to this policy being canceled forthwith and all premiums paid will be forfeited. In such a case no benefits will be paid whether in lieu or kind. All benefits will be canceled likewise.
Cash Values:
This policy does not have any cash values. No part of the Premium makes provision for investment. No loan can be made against the Policy and the Policy Cannot be ceded. The Policy therefore does not have any surrender values.
Term of The Policy.
Essential Family Funeral Plan Policy will be a PAID-UP policy once the Policyholder reaches the AGE of 65 YEARS old and it has been paid for 36 Months (Three Years) without a breach on premiums. After the death of the Policyholder and Spouse the policy will lapse even if there are Extended Members covered in the Policy unless the Beneficiary or any one of the Life Assured in this policy is willing to take over premiums either as a Policyholder or just a premium payer and nominate one of the Life Assured being the Policyholder. in the case when the newly elected Policyholder also passes away, the policy cannot be passed to a third policyholder.
Ultimate Family Funeral Plan and Optima Family Funeral Plans are WHOLE LIFE PLANS.
Amendments.
The Policyholder can make changes to his/her Policy at any stage when it is necessary to do so. When the Policyholder wishes to make such changes it will be deemed that the Policy has been AMENDED and such can only be effected and completed on receipt of a signed Policy Amendment Form Provided by Khululeka Life, with the Policyholder’s ID copy attached on the application.
YOUR INSURER:
Khululeka Life Assurance (PTY)Limited with FSP License No: 21311 under the FAIS Act. Khululeka Life is an Authorised Financial Service to give Financial Advice and render Financial Services under the Long Term Insurance Act (18 of 2017) underwritten by RAND MUTUAL ASSURANCE FSP No:
Claims Procedure.
In the event of a claim, the following procedure must be followed:
- Contact Khululeka Life by visiting their Offices in your Area or by calling CLAIMS DEPARTMENT at
1.a Telephone (044 004 0369)
1.b Fax Number (044 004 0368)
1.c e-mail@ claims@khululeka.co.za
- Provide the following Documents.
2. A certified Copy of the Death Certificate
2. b Certified Copy of Deceased ID.
2. c Copy of the DHA (BI 1663)
2.d Certified Copy of the Beneficiary/s ID/s
2. e Bank statement/s of the Beneficiary/s
IN THE CASE OF THE UN – NATURAL DEATH
2.f For S A Police Services Report Khululeka Life will provide the form.
Cover Termination Age
ULTIMATE FAMILY FUNERAL PLAN IS A WHOLE-OF-LIFE PLAN.
- OPTIMA FAMILY FUNERAL PLAN IS A WHOLE-OF-LIFE PLAN.
- ESSENTIAL FAMILY FUNERAL PLAN TERMINATES AT AGE 65 YEARS LAST BIRTHDAY.
The ESSENTIAL FAMILY FUNERAL PLAN must at least have been paid for TEN (10) Years to be a PAID-UP Plan at Age 65 Last Birth Day.
Consequently, if the policyholder retires before the ten years, the plan will be considered to be a whole-of-life plan.
Maximum Number of Lives
- Dependents Seven (7)
- Extended ten (10)
- Biological Parents two (2)
- Stepparents two (2)
- Parents In – Law (2)
- Stepparents In – Law (2)
In the case a Stepparent or Stepparent in–law is added, he or she will replace the missing (gender) biological parent. Stepmother replaces Biological Mother or Stepfather replaces Biological Father.
The set of parents to be covered can only be either two mothers or two fathers or all four in their natural order. [ Father – Mother] Father In – Law Mother In – Law] order.
- Spouses can be of the Same SEX but one cannot have two Fathers whether it is the biological parent or Stepparent. The policyholder must choose which of the two parents will be covered as a parent.
- In such a situation the other parent can only be covered under the Extended Benefit and indicated as such (Mother or Father)
- Accepted Relationship.
1 | Father | Step Father |
2 | Mother | Step Mother |
3 | Father In – Law | Step Father In – Law |
4 | Mother In – Law | Step Mother In – Law |
9 | Son | Step Son |
10 | Daughter | Step Daughter |
13 | Brother | Step Brother |
14 | Sister | Step Sister |
15 | Cousin is | |
16 | Uncle | |
17 | Aunt |
Maximum Benefits Payable
R50 000 will be paid out per Life Insured from all policies covered by Khululeka Life Assurance for all adults lives Insured. For all other Ages maximums are determined by law; see pay out % on Table E above.
Claim Notification Period
There will be a 12-month claim notification period. Claims will need to be submitted within 12 months of the deceased’s date of death.
Termination of Cover
Cover in respect of the principal member, spouse, children, and extended family members will terminate on earlier of:
- A Principal Member(s) means any person who satisfies the eligibility requirements on or after the commencement date.
- A Policyholder is the employee of the employer who has elected to cover under the scheme.
- Immediate Family means the Spouse and Children of the Principal Member.
- Dependent means the Spouse, Child, Extended Family member, or Parents of the Principal Member
- A Spouse means the spouse of the Principal Member who is resident within the Republic of South Africa, including a pat)/ to a customary marriage concluded under the applicable Indigenous law as well as a union concluded between parties married under the doctrines of any recognized religion or tradition, as well as a partner to a civil partnership in terms of the Civil Union Act, 2006, a common law spouse or life partner, provided that the Principal Member provides, upon request, satisfactory proof of the permanency of his relationship with his life partner.
- A Child means an unmarried child of the Principal Member who is resident in the Republic of South Africa and shall include an adopted child, a biological child, a dependent stepchild, including the child of any Spouse, and a Stillborn child. Children shall have the corresponding meaning.
- Stillborn means the death of a foetus of at least 26 (twenty-six) weeks or longer after conception or immediately before or during delivery, limited to a maximum claim of 2 (two) stillbirths.The principal member ceases to be a member of Khululeka Life Assurance.
- The death of the principal member or on termination or cancellation of the policy.
Cover in respect of a child will terminate on reaching the age of 22 years unless such a child is:
- A full-time student at a recognised educational institution in which case cover will terminate on reaching the age of 26 years; or
- Has continuously been depended on the principal member and is mentally or physically disabled and totally and completely depended on the principal member, in which case such a total and permanent disability must have occurred before the age of 22 years (evidence to the satisfaction of Rand Mutual Assurance in respect of such a disability must be provided)
- Cover for any spouse, children, domestic worker, or extended family member will cease on the cessation of cover of the principal member.
Cooling Off Period
After Rand Mutual Assurance has accepted the Policyholder’s application for insurance cover, the Policyholder may instruct Sanlam to cancel cover under the Policy. The Policyholder must submit this instruction in writing to Sanlam within 31 (thirty-one) days after receipt of the policy schedule. The Policyholder may submit such cancellation instruction to Sanlam if no Benefit has been paid or claimed or the Insured Event has not yet occurred. Sanlam may deduct the cost of any risk covered by the Policyholder and/or Assured Lives enjoyed under the Policy before it was canceled.
After the completion of the 31 (thirty-one) days period referred to above, the Policyholder shall be entitled to cancel cover at any time by giving Sanlam written notice. The effective date of the cancellation will be the end of the calendar month for which Premiums have been requested. This may result in 2 (two) Premiums being deducted after the date the cancellation is requested. All Premiums received after the effective date of cancellation will be refunded.
Condition for Payment of Benefits
Benefits will only be payable while the cover is still in force. Cover for a member will commence from the later of the day that the first premium is received, in respect of that member or the day that the completed application form for cover is received from the member.
Cover will cease when premiums are not paid within the 30-day grace period allowed for the payment of premiums that are due.
Premiums
The policyholder shall bear the cost of the premiums required to provide the benefits under this Policy and shall pay the premiums and administrative charges due to Rand Mutual Assurance. The premiums required to secure a Principal Member’s benefits in terms of the Policy shall be payable throughout the Principal Member’s membership of the scheme. All premiums are payable monthly in advance.
The premium rate will be guaranteed for a period of 12 months from the inception date of the scheme or until the next scheme renewal date, whichever occurs first and will be reviewed annually thereafter.
Rand Mutual Assurance reserves the right to revise the premium rates if any of the following changes occur to the membership of the scheme in a month:
- A change in the membership size of over 10%
- A change in the average salary of the scheme of over 10%
- A change in the average age of the scheme of over 10%
- A change in the split of the membership between males and females of over 10%.
- A change in the mix between regions of over 10%
Exclusion Rules
A life (lives) assured is required to be a permanent resident in the Republic of South Africa to be covered under this scheme. Cover under this policy in respect of the assured lives shall terminate if the principal life assured resides for a continuous period exceeding three months outside of the Republic of South Africa.
No insurance cover shall be granted, or Benefits paid upon the occurrence of an Insured Event in respect of an Assured life- –
- within 6 (six) months from the Inception Date other than by Accidental Death and death due to unnatural causes (excluding suicide) for all Assured Lives.
- resulting directly or indirectly from, or which is attributable to, attempted suicide or suicide during the first 12 (twelve) months from the Inception Date in respect of each Assured Life;
- resulting directly or indirectly from the consequence of active participation in war, invasion, acts of foreign enemies, hostilities, warlike operations (whether declared or not), civil war, rebellion, revolution, insurrection, or civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or.
- where an Assured Life is resident in a Foreign Country.
The Waiting Periods as set out above will not be applicable where a Principal Life Assured confirmed at the application stage that:
- he/she had an active funeral policy with another insurer at least 31 (thirty-one) days before applying for cover in terms of the Policy.
- the benefits under the previous policy were similar to the Benefits provided in terms of the Policy.
- the Assured Lives covered in terms of the Policy are the same as the previous policy, and
- the Assured Lives have completed the waiting period(s) under the previous policy.
Where an Assured Life has not completed the waiting period under the previous policy, the Assured Life has to complete the balance of the previous policy’s waiting period under the Policy.
The Waiting Period shall apply concerning increased Benefits or reinstated Benefits, from the Inception Date of the increased Benefits or reinstated Benefits.
Territorial Limits
All Principal Members and/or Policyholders in terms of this policy must be permanent residents within the Republic of South Africa with effect from the start of cover. All other assured lives must be resident within the following countries with effect from the start of cover:
- Republic of South Africa
- Lesotho
- Swaziland
- Namibia
- Botswana
- Zimbabwe
- Mozambique
Benefits will not be paid to the beneficiary for a life assured who is a permanent resident or who resides for a continuous period exceeding 3 months in a country other than the countries specified above.
Currency and Benefit Payment
Premium and benefit payments will be made in South African currency (Rands) and will only be paid to a South African bank account.
Definitions
Extended Family means mother, father, mother-in-law, father-in-law, aunt, uncle, brother, sister, brother in-law, sister-in-law, cousin, niece, nephew, grandparent, grandchild or child over the age of 21 (twenty one) next birthday, of the Principal Member for which the Principal Member would suffer a financial loss, such as the funeral costs or related burial
costs for the nominated life, as a result of the death of the nominated life.
Aunt means the sister of a parent of a Principal Member, who the Principal Member nominates to enjoy cover under the Extended Family funeral cover, and ‘uncle’ shall bear the same meaning to the male gender.
Brother means a male sibling of a Principal Member, who the Principal Member nominates to enjoy cover under the Extended Family funeral cover, and ‘sister’ shall bear the same meaning to the female gender.
Brother-in-law means the brother of a Principal Member’s wife or husband, who the Principal Member nominates to enjoy cover under the Extended Family funeral cover, and “sister-in-law” shall bear the same meaning in respect of the female gender.
Cousin means a child of the uncle or aunt of the Principal Member, who the Principal Member nominates to enjoy cover under the Extended Family funeral cover.
Nephew means the male dependent child of a brother or sister of a Principal Member, who the Principal Member nominates to enjoy cover under the Extended Family funeral cover, and ‘niece’ shall bear the same meaning with respect to the female gender.
Parents means the natural or adoptive or step-parents of the Principal Member, who the Principal Member nominates to enjoy cover under the Extended Family funeral cover, and ‘parents-in-law’ shall bear the same meaning to the Spouse of the Principal Member.