Edgars Club Funeral Plan

 HOLLARD LIFE ASSURANCE COMPANY LIMITED RECORD OF DISCLOSURE
 

Edgars Club Funeral Plan

This product is sold to you on a non-advice basis.

 

Confirmation of policy and information about financial services:

You are applying for the Edgars Club Funeral plan.

 

Funeral Policy Benefits

The purpose of this document is to provide you with a summary of the benefits and terms and conditions about this product.

The benefits and terms & conditions are provided below:
 

Funeral Benefits

This benefit pays a lump sum of R7 000 on the death of the main insured person and a lump sum of R3 000 on the death of the main insured person’s partner.

 

Who is allowed to be insured under this policy?

When you want someone to be insured under the policy, it is only allowed if you can say yes to the questions below. When you can say yes to these questions, we say that person is “eligible” for cover.
 

• Is the person over the age of 18?
• Are they a citizen of the Republic of South Africa or do they have official permission from the South African authorities to live and work in the Republic of South Africa?
• Do they have a valid South African ID number?
• Do they live in the Republic of South Africa (in other words, they do not stay in another country for more than ninety (90) days in a row or a total of 180 days in a year)?

If the above conditions are in place, and you have not exceeded any of the limits regarding the number of people who are allowed to be insured under this policy, then you can ask us to put them on this policy. Check that you see their name and correct details on the policy schedule we send you.

 

Policy Conditions

1. The cover will start on the benefit start date as noted on the policy schedule, if you pay the total membership fee that is due and depending on the outcome of FICA results.
 

2. In accordance with applicable anti-money laundering laws in South Africa, we are required to obtain specific information and evidence to verify your identity and source of funds (and in many cases the identities of related persons, such as premium payer and nominated beneficiaries) and persons instructing us on your behalf (where applicable) when applying for cover and on an on-going basis after your policy is activated.
 

3. If we ask you for information or documents (including originals or certified copies) you must provide them to us within 31 days. If we do not receive adequate information and evidence within 31 days of our request, we may be unable to provide you with cover or may cancel your application in accordance with applicable law.
 

4. Hollard Life reserves the right to accept or reject your proposal for insurance cover based on a variation of factors. Your application for this policy is therefore conditional to an assessment of our risk exposure.
 

5. Your policy will be incepted subject to the following:

• Further processing of information which includes assessing Hollard’s risk exposure.
• Payment of the first membership fee.

6. We may change the terms and conditions of this policy at any time and not just at the policy review date. We will tell you 31 days before the effective date of any changes we make as set out below. We will send you an updated policy schedule and an explanation of the changes. However, we will not change the terms and conditions of this policy during the first 12 months after your policy start date unless:

• There are reasonable grounds to change the terms and conditions that are determined by the actuarial department of Hollard Life; or
• The change of the policy terms and conditions will be to your benefit.
• If any statutory authority introduces measures which affect this policy or if the law changes, we will make the necessary changes and tell you of the reason for the changes. This could mean that we may have to make changes to your policy.

7. The policyholder may ask Hollard Life to restart the policy after six months from the last day of the month for which a Membership fee was received.

8. If you restart the policy after cancelling the policy, or restarting after six months from the last day of the month for which the Membership fee was received:

• The waiting periods will start again.
• The age eligibility criteria applicable to new sales will apply upon restart.
   

The following rules apply to restarting policies:

• Cover will only restart once a Membership fee has been received following your request to restart the policy.
• There will be no cover provided from midnight of the last day of the month that we received a payment for, up to the restart date.
• Cover will only restart for insured persons that are alive as at the restart date.

9. There is a 3-month waiting period for death due to natural causes for all insured people. You will be able to receive the full benefits of the products after these waiting periods have passed on the happening of an insured event and upon receipt of a valid claim. There is no waiting period for death due to suicide or accidental causes.

10. .

11. A cooling off period is the time within the 31 days from the policy start date. You cancancel this benefit within the cooling off period.

12. You are responsible for the completion of all information required for taking out this insurance policy, even if information has been completed for you by the support person. Incorrect information supplied by you may affect your claim.

13. It is your responsibility to provide accurate information. Misrepresentation, incorrect information, or non-disclosure by you of any material facts or circumstances may impact negatively on any claims arising from your insurance contract.

14. You must not sign any incomplete or blank documents. No person may request or insist that you do so.

15. Upon your request we will issue you with the appropriate insurance documents within a reasonable time

16. Please note that if you currently have a similar policy in place and would like to replace the existing policy, we are unable to offer you advice about the replacement and advise that you contact your financial advisor.

17. Your policy benefit will be paid out within 48 hours after death, as long as the claim is valid, and that Hollard receives al l the claims documentation requested.

18. A full list of policy conditions and exclusions is contained in your policy wording document.

19. Hollard Life will also not pay if the claim is a result of:

• Any criminal acts committed by you, an insured person or the person claiming,
• The insured person not being eligible for cover,
• The insured event or accident is before the benefit start date.
  
   

Waiting Periods

Protection of Personal Information

We care about the privacy, security and online safety of your personal information and we take responsibility to protect this information. We have to collect and process some of your personal information to provide you with our products and services as req uired by insurance, tax and other legislation. We will share your personal information with other insurers, industry bodies, credit agencies and service providers. This includes information about your insurance, claims and premium payments. We do this to assess claims, prevent fraud and to conduct surveys. We may also share your personal information to trace you or your beneficiaries for any unclaimed benefits. You can check if unclaimed benefits are due to you by searching the central database on the Financial Sector Conduct Authority’s website – www.fsca.co.za.

Product Provider Information

The product is underwritten by Hollard Life Assurance Company Limited (Reg No. 1993/001405/06), a Licensed Life Insurer and an authorised Financial Services Provider. Hollard is authorised to sell long-term insurance products.
 

Physical address: 22 Oxford Road, Parktown, Johannesburg.

Postal address: PO Box 87419, Houghton, 2041.

Tel: 0860 666 675
 

You can reach Hollard’s Compliance Department on 0860 666 675.

Retailer Details

Retailability Pty (Ltd)
 

Physical Address: 15 Nollsworth Crescent, Nollsworth Park, La Lucia, Durban KZN, 4051.

Tel: +27 31 010 0800

Email: enquiries@retailability.co.za
 

There are other exclusions that are listed in your policy, and we encourage you to check these when you receive your policy documents.

 

About the Policy and Claims Administrator (Hollard)

Hollard Life Assurance Company Ltd performs the policy administration for your policy.
 

In the event that you have a query or a claim, please contact Hollard Life on 0860 111 343 or lifeclaimsadmin@hollard.co.za.
 

Please have your membership number available when you contact Hollard Life.

 

Hollard Complaints

Hollard’s Complaints Department can be contacted at:
 

Tel: 011 351 4150 OR Email: mycomplaint@hollard.co.za

 

Hollard Internal Adjudicator

If you are still unhappy after the response received from the Complaints Department; or administrator, you may email Hollard’s Office of the Internal Adjudicator. The Internal Adjudicator will investigate your complaint objectively and independently.
 

Email: Lifeoia@hollard.co.za

 

The NFO contact details

National Financial Ombud Scheme South Africa NPC (the NFO)
 

Head Office, Postal Address and JHB Physical Address: 110 Oxford Road, Houghton Estate, Illovo, Johannesburg, 2198.
 

Cape Town Physical Address: Claremont Central Building, 6th Floor, 6 Vineyard Road, Claremont, 7708.
 

Tel: 0860 800 900

Email: info@nfosa.co.za

Website: www.nfosa.co.za

 Welcome to Hollard

Welcome to the Hollard family. Congratulations on your decision to activate your Edgars Club funeral policy. This policy is underwritten by Hollard Life Assurance Company Limited (Reg No. 1993/001405/06), Hollard is a Licensed Life Insurer and an Authorised Financial Services Provider.
 

This cover is provided at no additional cost as part of your membership to the Edgars Club, provided that:

• You have opted in for this cover,
• Your Edgars Club Membership Fees are up to date, and
• You have provided the details of all lives insured and the details of the beneficiary to Hollard.
   

This funeral policy will provide a cash payment, specified in the policy schedule, to help pay for funeral costs if you or your partner pass away. We will pay a valid claim for the benefit set out in this policy on condition that:

• You pay the membership fee on a monthly basis subject to the grace period and there are no Membership fee payments in arrears; and
• You give us all the information we ask for that materially affects our risk assessment; and
• You keep to the terms and conditions of this policy.
   

Our aim is to ensure that all our communication with you is honest and easy to understand.

The parties to this policy

This policy is a legal contract between you and Hollard. Only you have rights under this policy and nothing in this policy will give rights to any person other than to you. Only you may seek to enforce the terms of this policy.
 

"We", "Our", "Us" and “Hollard” refers to Hollard Life Assurance Company Limited (Reg No. 1993/001405/06 ), a Licensed Life Insurer and an authorised Financial Services Provider.
 

"You" and "Your" refer to the main insured person named in the policy schedule who is the owner of this policy.

Key definitions used in this policy

We have given a specific meaning to certain words. These words appear in italics. The defined terms at the end of this policy document gives the definitions that have the same meaning anywhere in this policy. Where a defined term is used but does not appear in italics, it must still be afforded the same meaning as the defined term.

How to read this policy

The plural of defined terms is used where appropriate and must be interpreted as having the same meaning as the defined terms.
 

Where undefined terms are used, they must be interpreted in accordance with their ordinary and grammatical meaning, and in the context of this policy.
 

The headings in the policy are for reference only, are not intended for the purpose of interpreting this policy and will not affect the meaning of the terms and conditions to which they relate.
 

When we refer to a specific section of this policy, the reference will include the name of the heading. For example, certain benefits might have additional events when cover ends as set out in When cover for the main insured person ends under the benefit section.
 

Days refer to ordinary calendar days, including weekends and public holidays.
 

Month means a calendar month excluding the first day, including the last day and including weekends and public holidays.
 

Words which refer to natural persons will also refer to legal persons.

This policy

The policy wording includes all the terms, conditions and exclusions that apply to your cover.
 

The schedule, call recordings, application, and this policy wording make up the contract between you and us. You must carefully read these documents together. Make sure you understand what you are covered for as well as what your responsibilities are. If you do not keep to the rules, and terms and conditions of this policy, it may mean that we don’t pay your claim or must cancel this policy or void this policy.
 

If you find any errors on your policy schedule, please tell us immediately on the contact details set out in the Additional information section of this document.
 

We are not bound by any changes unless we have agreed to them in writing and have included them into this policy by issuing you with a new policy wording or a policy schedule. This policy document replaces all previous policy documents issued by us to you covering the same or similar risk.
 

The policy document (consisting of those documents referred to above) will always be the final determining factor in the event of any disagreement around meaning or interpretation.

WHAT ARE THE BENEFITS?

In this section, we list all the benefits that are available under this policy.
 

When you applied for this policy, you chose the benefits that you wanted. The benefits you chose are shown on your policy schedule.
 

If any of the benefits shown in this section are not shown on your policy schedule, it means that you do not have that benefit on this policy. Either you did not choose that benefit, or we did not give you that benefit.
 

You can contact us if you want to change your benefits.

1. Individual funeral benefit

This benefit covers the main insured person.
 

 1.1 The main insured person must be 18 years or older, but under the age of 65 years as at the benefit start date.

1.2 If the main insured person dies during the period of insurance, we will pay the benefit as set out in the policy schedule as a lump sum.

2. Family funeral benefit – partner

This benefit covers the main insured person’s partner.
 

2.1 The main insured person must be covered under the individual funeral benefit for this benefit to be available.
 

2.2 You can choose to cover the partner if you pay the additional Membership fee.
 

2.3 The partner must be 18 years or older, but under the age of 65 years as at the benefit start date.
 

2.4 We will cover a maximum of one partner at any one time.
 

2.5 If the partner dies during the period of insurance, we will pay the benefit as set out in the policy schedule as a lump sum.

CONDITIONS FOR COVER

The policyholder and the main insured person must be the same person.
 

In the section titled What are the benefits, we say who can be covered for each benefit and in your policy schedule you will see the name of the person who is covered under this policy for each benefit.
 

If a person's name is not shown on your policy schedule it means that person is not covered. Please see the section titled How to add and remove insured persons after the policy start date if you want to change the people who are covered under this policy.

3. The following relationships to the main insured person are eligible to be covered for the benefits:
 

3.1 Partner

4. Who can be insured under this policy?
 

4.1 When you want someone to be insured under the policy, they will only be allowed if you can say yes to the questions below. When you can say yes to these questions, we say that person is “eligible” for cover.
 

4.1.1 Is the person within the age limits explained in the policy What are the Benefits Section?

4.1.2 Are they a citizen of the Republic of South Africa or do they have official permission from the South African authorities to live and work in the Republic of South Africa?

4.1.3 Do they have a valid South African ID number?

4.1.4 Do they live in the Republic of South Africa (in other words, they do not stay in another country for more than 90 days in a row or a total of 180 days in a year)?
 

4.2 If the above conditions are in place, and you have not exceeded any of the limits regarding the number of people who are allowed to be insured under this policy, then you can ask us to put them on this policy. Check that you see their name and correct details on the policy schedule we send you.

5. When does cover for an insured person start?

On the policy schedule there is a start date next to each insured person’s name. We call that the benefit start date. That is the date that cover starts for that insured person, only if the full monthly Membership fee is paid.

6. When does cover for an insured person end?

This is very important for you to know. Here we explain the events when cover ends for any of the benefits on this policy. However, depending on the type of benefits you have, there might be additional situations when cover will end. Therefore, you must read this section together with the policy What are the Benefits section.
 

6.1 When does cover for the main insured person end?
 

6.1.1 Cover for the main insured person ends when any of the following happens:
 

6.1.1.1 you are no longer eligible (you can no longer answer yes to all questions in point 4 above); or

6.1.1.2 Membership fees are not paid; or

6.1.1.3 you tell us to end this policy; or

6.1.1.4 when you die (you, the main insured person).

6.1.1.5 You resign from being an Edgars Club member.
 

6.2 When cover for other insured persons ends?
 

6.2.1 Cover for an insured person (other than the main insured person) ends when any of the following happens:
 

6.2.1.1 cover for the main insured person ends for any of the reasons explained above; or

6.2.1.2 the other insured person is no longer eligible (you can no longer answer yes to all questions in point 4 above); or

6.2.1.3 you have not paid the Membership fees that are due; or 5 / 24 Initial here

6.2.1.4 the insured person dies; or

6.2.1.5 the insured person is no longer listed on the policy schedule.

6.2.1.6 The policyholder resigns from being an Edgars Club member.

7. When can you restart this policy?

If this policy ends because of nonpayment of the membership fee, or because you asked us to cancel the policy, you may ask us to restart the policy.
 

7.1 Restarting after six months, or if you cancelled a policy

If you restart the policy after cancelling or restart after six months from the last day of the month for which the Membership fee was received:
 

7.1.1 The waiting periods will start again.
 

7.1.2 The age eligibility criteria applicable to new sales will apply upon restart.
 

7.2 General rules about restarting policies
 

7.2.1 Cover will only restart once a Membership fee has been received following your request to restart the policy.
 

7.2.2 There will be no cover provided during the period from midnight of the last day of the month that we received a payment for up to the restart date.
 

7.2.3 Cover will only restart for insured persons that are alive as at the restart date.

CLAIMING UNDER THIS POLICY

8. Who we will pay the benefit amount to

If we assess a claim as valid, we will pay any benefits that must be paid to the right person depending on which insured person we are dealing with. Refer to the Claimant Table in the Appendix.

9. General claims process
 

9.1 The steps below outline the general claims process. Please refer to the Additional Information section of this policy for the claims process that is specific to this policy.
 

9.2 If someone insured on this policy dies, the claimant must please tell us so we can pay out the benefits that are due. This is how to submit a claim:
 

9.2.1 Check the exclusions list (what this policy does not pay for) first. Before submitting a claim to us, check the exclusions to see if what you want to claim for is excluded.

9.2.2 Contact us to find out what documents are required to submit a claim. See the Additional information section of this policy for contact details.

9.2.3 Make sure the right person submits the claim. We do not accept just anyone submitting a claim. It must be one of the following three people (1) You, the main insured person; or (2) the beneficiary; or (3) the appointed executor. We call this person the qualified claimant.

9.2.4 Tell us in writing within 180 days from the date of death. The claimant must give us your policy details and tell us who passed away. They must do so as soon as possible because a claim cannot be submitted more than 180 days after the death.

9.2.5 Send evidence and other documents to us on time. We will tell the claimant how soon they must send documents and other information to us, so we can process the claim. These documents must be sent to us on time and in the format we ask for. We will not pay for these documents.

9.2.6 The policyholder and beneficiary need to have valid South African bank accounts in order for a claim to be payable.

9.2.7 The claim will not be paid if it is not done properly. It is very important that the claimant sticks to all the rules above. If what you want to claim for is excluded, or we do not receive the information we ask for within the agreed time, your claim may not be successful. We want to pay your benefits so please stick to the rules.

10. When we will pay the benefit amount

We will pay the benefit after we have received all the information you have to send us, and we have assessed a claim as valid.

11. We will pay the right person as noted in your policy schedule

If the claim is correct (i.e., meets all the rules above and is correctly due in terms of this policy) we call the claim valid. When we assess that a claim is valid, we pay the benefits to the right person or persons as we have noted in your policy schedule and as explained in the policy What are the Benefits section.

12. We pay interest on the benefit amount
 

12.1 When a claim is valid, we try to pay the benefit amount as soon as possible and to the right person. Sometimes we struggle to get hold of the right person or await outstanding information or documentation and so the amount waits to be paid.
 

12.2 We will pay interest on the benefit amount from the time that the claim is assessed as valid. We calculate this interest on a monthly basis at a rate of:
 

12.2.1 The daily rate applicable to the 91-day Treasury bill issued by the South African government for the period that the benefit remains unclaimed.

13. If we do not receive claims information or cannot find the right person to pay
 

13.1 A claim will not be paid should all correct information not be provided.

13.2 Please make sure the contact details on the policy are correct. It is your responsibility, as the main insured person, to make sure that all the contact details noted on the policy schedule are correct and updated if any of them change.

13.3 We need all the contact details on this policy to be up to date so that we can speak to the right person to send us claims documentation and so we can pay the benefits to the right person when we are supposed to.

13.4 When we cannot find the right person within three years of the date that a benefit would have been paid for a valid claim, it is called an “unclaimed benefit”. We will keep the claim case open until we have obtained the outstanding information that will make it possible for us to pay the claim.

13.5 We will take the following steps to find the main insured person or the nominated beneficiary:
 

13.5.1 Using the contact details that you provided, we will try to contact the main insured person, or the nominated beneficiary, or partner, or an adult child (as applicable) to tell them of the available benefit.

13.5.2 If we cannot reach any of the people mentioned above, we will compare our internal database with an external database or make use of an external tracing company to try to find updated contact details. We call this a “tracing” process.

13.5.3 If we still cannot reach any of the people mentioned above, even with the new contact details found through the tracing process, we will repeat the tracing process after three years.

13.5.4 Every time we have to follow the tracing process, we incur costs. These costs include administrative, tracing and management fees. We will deduct these fees incurred from tracing from the value of your claim. These fees may change over time.

14. If you or the claimant do not agree with our claim’s decision
 

14.1 When we assess a claim, we could:
 

14.1.1 Pay an amount; or

14.1.2 Say that it is not valid; or

14.1.3 Cancel this policy.
 

14.2 We will always explain why we made one of the three decisions above. You or the claimant might disagree with us and may request that we review our decision. Please see the Additional Information section of this policy for details on how to complain.

15. What is a beneficiary and how do you nominate one?

A beneficiary is a person who will receive the benefits we pay out if you die (you, the main insured person). You nominate that person by informing us in writing who you want to have as the beneficiary on this policy and providing the relevant details.
 

15.1 If the beneficiary is a person:
 

15.1.1 full name; and

15.1.2 identity number, date of birth and gender; and

15.1.3 relationship to the main insured person.

We will only pay a benefit to the nominated beneficiary if the main insured person dies. If any insured person (other than the main insured person) dies, we pay the benefits to the main insured person.

16. Rules about choosing a beneficiary
 

16.1 Choosing a beneficiary
 

16.1.1 You must choose a beneficiary to receive the benefits if the main insured person, as noted in the policy Benefits section, dies.

16.1.1.1 You may choose more than one beneficiary.

16.1.1.2 You may change or cancel the nomination at any time, but you must tell us in writing for the change or cancellation to be made.

16.1.1.3 A beneficiary will have no interests or rights in the policy while the main insured person is alive.

16.1.1.4 Nominations in a will or any other testamentary instrument that the main insured person agreed to, shall not affect any existing beneficiary nomination that we have recorded.
 

16.1.2 If the beneficiary is under the age of 18

16.1.2.1 We will only accept this beneficiary if you give us the details of:

16.1.2.1.1 the child’s legal guardian; or

16.1.2.1.2 the trust set up for child.

16.1.2.2 If the beneficiary is under the age of 18 at the time that the main insured person dies, we will pay the benefit to the legal guardian, or the trust based on the information you provided.
 

16.2 Who we pay if there is no beneficiary
 

16.2.1 If there is no beneficiary, it means that:
 

16.2.1.1 the main insured person died without choosing a beneficiary; or

16.2.1.2 the beneficiary is not alive when the main insured person died; or

16.2.1.3 the beneficiary cannot be found within 12 months of the death of the main insured person; or

16.2.1.4 the beneficiary is under the age of 18 and there is no legal guardian or trust.
 

16.2.2 When we find no beneficiary, we will look to find the next best person (who will then be the correct claimant) to receive the benefits that we would have paid to the beneficiary.
We will pay:
 

16.2.2.1 The partner as noted in the policy schedule, or if there is no partner, then

16.2.2.2 Adult child as noted in the policy schedule, or if there is no adult child, then

16.2.2.3 Parent: or if there is no parent, then

16.2.2.4 The estate of the deceased main insured person.

16.2.3 The claimant must be over the age of 18 and must give us proof of their relationship to the main insured person.

16.2.4 If someone other than one of the claimants listed above contacts us to claim the main insured person’s benefit, we will pay the benefit to the main insured person’s estate.

HOW TO ADD AND REMOVE INSURED PERSONS AFTER THE POLICY START DATE

17. Give us the details of the new insured person in writing
 

17.1 You may ask us in writing to add a new insured person at any time but only up to the limited number of insured persons as explained in the section called Who this policy covers for this benefit.
 

If we accept the new insured person, we will send you an updated policy schedule showing their name and the benefit amount for them. The new insured person’s cover will start on the benefit start date as noted on the updated policy schedule.

18. If the new insured person is a new partner
 

18.1 You may add a new partner only if:
 

18.1.1 Your partner dies or

18.1.2 You instruct us to remove the existing partner first.
Then at any time afterwards, you may tell us in writing that you want to add a new partner.
 

18.2 We will cover a maximum of one partner at any one time across all the benefits provided under this policy. You cannot have different partners for different benefits.
 

18.3 If we accept the new partner, we will send you an updated policy schedule showing their name and the benefit amount for them. The new partner’s cover will start on the benefit start date as noted on the updated policy schedule.

19. If you want to remove an insured person
 

19.1 Let us know in advance if you want to remove an insured person.
 

19.2 That person’s cover will end on the 1st of the month following you notifying us.
 

19.3 We will send you an updated policy schedule so you can see that their name is no longer listed as an insured person on this policy.

20. WAITING PERIODS

• If an insured person dies during a waiting period relevant to that insured person, it means that we will not pay out the funeral benefit for that person if you try to claim.
• Different waiting periods apply for different reasons for death as shown in the Waiting Periods Table in the Appendix. The waiting periods will apply to all benefits unless stated otherwise.
• If a benefit or cover under this policy ends for any reason and then is restarted, the waiting periods will apply as per the restart rules. The waiting period applies from the benefit start date or any date on which any benefit amount is increased.
• Recognising prior insurance
  a. If this policy is a replacement of an existing funeral policy issued by another insurer or by us, we will reduce the waiting period on any benefit for any insured person for however many complete months that insured person had uninterrupted cover for the same benefit and amount on the replaced policy.
  b. The following additional conditions apply:

20.1.1 the replacement must have conformed to the replacement requirements of applicable South African insurance legislation.

20.1.2 the replaced policy must have been cancelled with effect from no later than the policy start date and must still be cancelled at the date of death of the insured person.

20.1.3 the main insured person must have been the main insured person on the replaced policy.

20.1.4 the insurer that issued the replaced policy must have been a licensed insurer in the Republic of South Africa.

20.1.5 the replaced policy must have been cancelled within 31 days before this policy’s start date.

20.1.6 Evidence that these conditions have been met will be required. If the conditions are not met, then the waiting period will not be reduced.

THERE ARE LIMITATIONS TO WHAT WE PAY
 

21. Maximums under this policy

a. The maximum total amounts that we will pay for Funeral benefits under this policy are:
 

• R7 000.00 for the main insured person.
• R3 000.00 for the partner.
   

b. The maximum total amount that we will pay for the total Funeral benefits for any member may not be more than the total benefit amount for the main insured person or partner, if applicable.

22. Maximums under all Hollard policies
 

a. If we cover an insured person under more than one Hollard policy, and the insured person qualifies for more than one benefit, we will limit the total amount we will pay.
 

• The maximum total amounts that we will pay on all policies for Funeral benefits are: R100 000.00 for an insured person who is 18 years or older.
   

b. The maximum cover for an insured person who is 18 years or older is R100 000.00 across all Hollard policies.
 

c. We may increase the maximum benefit amounts from time to time, or when the law changes.

23. Other conditions
 

a. We may increase the maximum benefit amounts from time to time, or when the law changes.
 

b. The limits apply at the benefit start date.

GENERAL EXCLUSIONS - WHEN WE WILL NOT PAY ANY BENEFITS

Certain benefit sections might have specific exclusions that apply in addition to these general exclusions. You must read this section together with the What are the Benefits section.
 

In addition to any specific exclusions set out in each benefits section, we will not pay a claim for an insured event because of any of the exclusions listed below:

24. Criminal activities

a. We will not pay a claim if any insured event is directly or indirectly caused by criminal activities. Criminal activity means the insured person or claimant is or was:
 

• under investigation for committing a crime; or
• being prosecuted for committing a crime; or
• convicted by a court of law for having committed a crime.
   

b. We will delay our claims decision until the finalisation of the investigation, or the criminal trial (as applicable). You must give us proof of the outcome of the investigation or the criminal trial (as applicable).

25. The insured person was not eligible

a. We will not pay a claim for the insured person if they were not eligible or did not meet the definition of insured person on the benefit start date. See the section about Who can be insured under this policy to see the questions to ask about an insured person to see if they are eligible or not.

26. Insured event or accident before the benefit start date

We will not pay a claim for the insured person if the insured event, or accident leading to the insured event, happened before the benefit start date.

GENERAL RULES

27. Cancelling this policy

a. We may cancel this policy at any time.
 

We may cancel this policy by giving you 31 days written notice. If this happens, we will always explain why we are cancelling this policy.
 

b. You may cancel this policy at any time
 

• A cooling off period is the time within the 31 days from the policy start date.
• If you cancel at any time outside of a cooling off period
  1. You may cancel this policy by giving us one month’s written notice, if it is any date outside of the cooling off period as explained above.
  2. At the end of the notice period, this policy will automatically end. You may ask us to restart the policy as set out under the heading

28. Good faith

We will always act in good faith in our dealings with you. If we make an administration error, it will not take away any cover you were meant to have or give you any cover that you were not supposed to have.

29. Our liability

Our liability for this policy depends on you, or anyone acting for you, keeping to all the terms and conditions of this policy.
 

a. We will check whether all claims are valid before we pay any claim payments.
 

b. Our payment of any benefit is a full and final discharge of our responsibilities for a specific claim. Once we have paid a valid claim, we will not be responsible for anything else on the claim.
 

c. Our responsibility cannot be more than the limits mentioned under the policy, or the benefit.
 

d. There are no investment or surrender values for any benefits under this policy.
 

e. We will not be liable to make any payment unless the Membership fees have been paid and we have received satisfactory proof of a claim.
 

f. Payment by us of the benefits provided for in this policy will be a full and effective discharge by us of our liability and obligations in terms of this policy.

30. The privacy of your personal information

a. We care about the privacy, security and online safety of your personal information and we take responsibility to protect this information. By completing this form, you confirm that when you include your spouse and/or dependants and/or beneficiaries in your application, we will process their personal information in order to activate this policy and/or related benefits.
 

b. Processing of personal information will always be in the legitimate interests of the persons mentioned above. We may also process your personal information for underwriting and administering this policy and for the assessment of any claims.
 

c. We will share your personal information with other insurers, industry bodies, credit agencies, regulators or law enforcement agencies and service providers. We may also share your information to comply with any law and to enable any entity within the Hollard Group and any third-party provider or any financial services provider or its representative approved by us to advise you of, or offer to you, any enhanced benefits or new products that become available from time to time which you may be entitled to or qualify for, and providing relevant information, including your personal information, to a contracted third party (including any contracted reinsurer) who requires such information to render a service to you in relation to this policy, provided that such contracted third party agrees to keep the information confidential.
 

d. You may object to the processing of your personal information; however, we need this information to process your application, service this policy and pay claims. If you object to the processing of your personal information, we cannot process the application.

31. FICAA

a. We are required by anti-money laundering legislation to obtain specific information and documentation from you and from certain related parties, to enable us to establish and verify your identity and your source of funds.
 

b. This applies when you apply for life cover, on an ongoing basis while you are a client of ours and when a claim is made under a policy.
 

c. You agree to co-operate fully with us and to provide us with all such information and documentation requested as soon as possible.
 

d. You understand that different information and documentation will be required depending on the type of client and related party.
 

e. The required information and documentation are available on our website and may be changed from time to time without notice.
 

f. You understand that if we do not receive the information and documentation requested from you or from a related party within a reasonable time, we may be unable to provide you with life cover and that we may have to cancel your existing policies immediately.
 

g. You consent to the processing of your personal information and to the disclosure of your personal information to any regulatory body, tax authority, or to comply with anti-money laundering legislation.
 

h. You consent to us conducting ongoing monitoring of your transactions and activities related to your business relationship with us, as required by anti-money laundering legislation, and understand that we are not required to disclose our monitoring activities to you.
 

i. If we are unable for whatever reason to conduct ongoing monitoring of your transactions and activities, we may be unable to provide you with life cover and we may have to cancel your existing policies immediately.
 

j. Related parties include but is not limited to: the proposer; a Membership fee payer; a person claiming under a policy; a beneficiary who has accepted a nomination; the employer in a group scheme; the principal member and beneficiaries in a group individual scheme and a proxy.
 

k. We will therefore be unable to process a claim before the claimant has provided us with the required information and documents for us to establish and verify their identity.

32. We will send correspondence to you

We will send all correspondence to your last known address or email address. We assume that you have received and read our correspondence if it was addressed to you.

33. Special arrangements do not become the rule

If we agree to change any deadlines or requirements for this policy, it does not mean that we have agreed generally or in all cases to change the deadlines or requirements.

34. Currency

Any claims paid under this policy must be paid in South African Rand only.

35. Law and jurisdiction

We will govern and interpret the policy in accordance with South African law in the courts of the Republic of South Africa.

36. When the policy conditions will change

We will tell you at least 31 days before we make any of the changes noted below. We will send you updated policy documents and an explanation of the changes.
 

a. We may make changes to the policy conditions
 

• We may change the terms and conditions of this policy and not just at the policy review date. Any change we make will not affect the extent of cover already in place in terms of this policy and any changes made will be in line with all relevant legislation.
• However, we will not change the terms and conditions of this policy during the first 12 months after your policy start date unless
  1. There are reasonable grounds to change the terms and conditions that are determined by the actuarial department of Hollard; or
  2. The change of the policy terms and conditions will be to your benefit.
• If any regulatory authority introduces measures that affect this policy or if the law changes, we will make the necessary changes and tell you the reason for the changes. This could mean that we have to cancel a benefit.
   

b. You may make changes to the policy
 

If you ask us to make any changes to the policy and we agree to make the change, it will be effective from the date agreed to by us.

37. You must be honest

a. All dealings about this policy must be honest. We will not accept any responsibility under this policy if you or any person acting for you is dishonest about any information.
 

b. You may lose your right to claim if we are prejudiced or suffer a loss under any cover section because of:
 

• any sort of dishonest behaviour; or
• criminal activity.
   

c. We may cancel your cover for a specific item from the policy start date or from the date of the actions listed above.
 

d. We will not pay a claim if there is any fraud involved. We may void the policy. We may take legal steps to recover costs and expenses from you.

38. You must give us true information

a. We use the information that you give us to provide you with cover. You must give us any important information that we need. You must give us the information when the policy starts and whenever any of the information changes, within 14 days of the change.
 

b. If the information is incomplete or incorrect at any point while this policy is in force, we may not have agreed to give you cover under this policy or continued your cover.
 

c. We may cancel this policy from the date that you gave us incorrect information, and you may lose your right to claim.
 

d. We may also apply special conditions, for example a reduced sum insured, limit or a higher excess.

39. You may not transfer your rights to anyone else

a. This policy does not give any rights to any person other than you. You may not transfer your rights to benefits payable under this policy to another person. This is known in law as a cession.
 

b. If you try to transfer the rights to any benefits in this policy to another person, we will not recognise that contract. We will continue our contract with you as if you had not contracted with someone else.

40. Our rights

a. If any incident happens which may lead to a claim, we have the right to check the documents relating to the claim. We will tell you if there are any problems.
 

b. We may take legal action in your name for any recovery of or contribution to a claim.

List of defined terms

We have given a specific meaning to certain words. These words appear in italics throughout your policy documents and have the same meaning each time we use these words.
 

It is extremely important that you understand the definitions that we have given for these words.
 

Additional Information

Additional Information document

This document contains contact details, disclosures and other important information to ensure you always have all the information you need. Please keep this document together with your policy wording and policy schedule.

About the Insurer - Hollard

Hollard Life Assurance Company Limited (Reg No. 1993/001405/06), a Licensed Life Insurer and an authorised Financial Services Provider.
 

How to claim for the benefits

Please contact Hollard Life Assurance Company Ltd on 0860 111 333 if you want to make a claim.
 

• The claimant must tell us of the claim in writing within 180 days from the date of the insured event. We will tell the claimant what evidence and other documents we need to process the claim.
• The claimant must send us the evidence and other documents we ask for within the time that we will give them. All the information that the claimant sends must be in the format we prescribe and without expense to us.
• If the steps mentioned above are not followed, or we do not receive the information we ask for within the agreed time, the claim may not be successful.
  
   

How to complain

We hope that you never have reason to complain, but if you do, we will do our best to work with you to resolve it. While you may contact the Ombud at any time or take legal action against us within 270 days of a claims decision, we encourage you to contact your administrator or Hollard first, as detailed in the five-step process below.

Rejected claims

If we do not accept a claim made in terms of this policy, cancel this policy or if the claimant disagrees with the amount of the claim, the claimant may request us to review our decision. We will only review our decision if the claimant sends us a written request to review within 90 days (the “representation period”) of the date that the claimant receives our rejection letter and covers all costs of the review.

Step 1: General policy and queries or complaints

Please contact Hollard Life with general queries or complaints.
 

Tel: 0860 111 333

Email: lifeclaimsadmin@hollard.co.za

Step 2: Unresolved complaints – contact Hollard Complaints

If your concerns are not resolved to your satisfaction by contacting the above details, please contact Hollard on:
 

Tel: 011 351 4150

Email: Mycomplaint@hollard.co.za

Step 3: Complain to Hollard’s Internal Adjudicator

If you are still unhappy after you have contacted the administrator or Hollard Complaints about your concern, you may email Hollard’s Office of the Internal Adjudicator (OIA). The Internal Adjudicator will investigate your complaint objectively and independently.
 

Email: lifeoia@hollard.co.za

Step 4: Complain to the Ombud

Whilst you may contact the Ombud at any time, we encourage you to contact your administrator or Hollard first, as detailed in the steps above.
 

If your concerns are not resolved to your satisfaction by Hollard, you may contact either the FAIS Ombud or the National Financial Ombud (NFO), depending on the nature of your complaint.

Complaints about this policy

If you are not happy about this policy or your complaint was not resolved to your satisfaction by contacting the administrator or Hollard’s Compliance Officer on the contact details provided above, you may also contact the Office of the Ombud for Financial Services Providers (FAIS Ombud).

FAIS Ombud Information

Particulars of Financial Sector Conduct Authority

Complaints about anything else:

The National Financial Ombud (NFO) provides a free and speedy complaints resolution process, and you may send your complaint to the NFO on the following details:

National Financial Ombud Scheme South Africa Information

The Information Regulator

Step 5: Taking legal action

If you are not satisfied with the outcome of the complaint, you may also take legal action against Hollard. To take legal action, you must instruct a lawyer to give a document to the sheriff of the court, who must serve the document on Hollard. This is called serving a summons. Summons must be served on Hollard within 180 days of the expiry of the representation period.
 

You may also choose to take legal action against Hollard without first requesting Hollard to review their decision or to contact the National Financial Ombud. If you decide to do this, summons must be served on us within 270 days of the date that you receive the rejection letter. If you take legal action against Hollard before contacting the Ombud, you can only approach the Ombud for assistance after you have withdrawn the summons against Hollard.
 

If you do not take legal action against Hollard within the times given above, your claim may not be successful.

Matters of importance

• You must accurately, fully and properly tell us all material facts. All information provided by you or on your behalf is your responsibility. You need to be satisfied with the accuracy of any and all transactions submitted by anyone on your behalf.
• Misrepresentation, incorrect information or non-disclosure by you of any material facts or circumstances may impact negatively on any claims arising from your insurance contract.
• You are entitled to a copy of the document that represents our contract with you, or a policy summary, within 31 days from the date of entering into or changing the policy. You are also entitled to a full copy of the policy upon request.
• If you have not received these documents, or you feel that the policy does not meet legal requirements, please send your complaint in writing to us on the details given above.
• You must be informed of any material changes to the information provided above.
• If the information above was given to you verbally, it must be confirmed in writing within 31 days.
• Complete all forms in ink, keep all documents handed to you and make notes of what is said to you.
• You must not be induced to waive any right or benefit.
• You have a right to cancel a policy in writing within 31 days after receipt of the summary. You may not exercise this cooling off option if you have already claimed under the policy or if the event for which the policy insures you has already happened. If you wish to exercise this right, please contact Edgars Club customer care on 0861 988 899.
• Please remember to read through everything and make sure that the information we have on record for you is correct. If anything changes or needs to be amended, please contact us to ensure that you are not affected at claims stage.
• You must not sign any incomplete or blank documents. No person may request or insist that you do so.

APPENDIX

Waiting Periods Table

Claimant Table