FUNERAL BENEFITS

The basic funeral plan provides for a cash benefit to be paid in settlement of a death claim of a Principal Member, his/her Spouse, Eligible Children and Extended Family Members, where applicable.

FUNERAL PACKAGE

Principal Member: a permanent, genuine, and active person of the IEnsure Brokers (PTY)LTD, who is allowed to elect participation in the policy, in accordance with the eligibility conditions as stated in the policy schedule. The maximum entry age to the Fund is 65 years.

Spouse: a person married to the Principal Member by law or tribal custom or under the tenets of any Asian religion, which shall include a Common Law Spouse of the Principal Member. A spouse may not exceed the maximum entry age of 65 years.

Common Law Spouse: a person who is deemed by iEnsure Brokers (PTY)LTD, at its sole discretion, to a Spouse, having regard to the particular circumstances of each case, and shall include, where applicable, Customary Marriages or a relationship between two people of the same gender, or a relationship between two people after a continuous cohabitation period of 6 (six) months.

Child: an unmarried child, age 21 years and younger, of the Principal Member, including a stepchild, posthumous child, an illegitimate child, a legally adopted child or a stillborn child (from the 26th week of pregnancy). Only 2 stillbirth claims will be accepted per family during the term of the Policy. Children are covered to the age of 21 years and this is extended to age 25 years if the child is a full-time student at a recognized institution. This does not include part-time and correspondence students. Children who are mentally disabled or totally and permanently disabled before age 21 years, who are unable to care for themselves, are covered until death or until the Principal Member ceases to be covered. Details of any children of a Common Law Spouse, illegitimate child and stepchild must be supplied to iEnsure Brokers (PTY)LTD at the time that the Principal Member joins the scheme, or within 1 month of the child becoming eligible for cover. Failing this, iEnsure Brokers (PTY)LTD will require satisfactory proof to support any claim.

Optional Extended Family: Family members, who are dependent on the Principal Member for financial assistance in the event of a death in the family, may be covered. These may include parents, parents-in-law, uncles, aunts, brothers, sisters, nephews, nieces, grandparents and children of the Principal Member who are over age 21 years. Please Note:

• Maximum entry age is 70 years
• Up to 10 Extended Family members may be nominated for cover.
• Only in case of a marriage may Extended Family (parent-in- law) be added, provided the maximum number of Extended Family Members has not been exceeded (approval to be granted by IEnsure Brokers (PTY)LTD before premiums are amended).
• Extended Family Members may only be covered once under the Fund.

TERMS & CONDITIONS:

Each Principal Member must complete an application form electing his/her dependents and extended family. • Benefits for the dependents of the Principal Member will cease if withdrawal from the Plan by the Principal Member.

GRACE PERIOD:

A one-month grace period is allowed to pay any premium once the policy is in force (i.e. first premium has been received). If the premium is not paid within that month, please notify iEnsure Brokers (PTY)LTD immediately to make arrangements.

The funeral package consists of the following benefits:

• Basic Family Benefit
• Optional Extended Family Benefit

WAITING PERIODS: 

From the start date of the policy, there is a 6 (six) month waiting period for claims due to natural causes for extended family members less than age 70 years, and a 9 (nine) months waiting period for extended family members greater than age 75 years.

TERMS AND CONDITIONS

• Only claims due to accidental death will be paid immediately, provided the first premium is received and the policy is not in arrears.
• 3 months waiting period is applicable in the event of the death of a principal member, spouse and eligible children due to natural causes.
• Should a member select a higher benefit than the one currently enjoyed, the waiting period mentioned above will apply on the improved benefit amount only.
• Where premium payments are missed then resumed, the applicable waiting period will apply from date payment of premiums is resumed.

EXCLUSIONS:

This benefit will not be paid if death is directly or indirectly caused by or attributable to:

• Terrorism or war (whether declared or not).
• Radioactive contamination, whether directly or indirectly.
• Death as a result of participation in illegal activities.
• Suicide will not be covered during the first 2 (two) years of membership.
• Divorced spouses at inception of the policy are not covered, and cover for spouses who divorce during the term of the policy will cease immediately on divorce.

COOLING OFF PERIOD:

• The policyholder has a 30 (thirty) day cooling off period from receipt of this document to examine the Policy.
• Provided that no death or claim has taken place in this period, should she or he elect not to take up the Policy, she or he must inform IEnsure Brokers (PTY)LTD in writing of her or his intention not to accept.
• All premiums already paid shall be refunded, less the cost of any risk cover.

SURRENDER VALUES:

There are no surrender values attached to this Policy. Benefits under this Policy may not be ceded or pledged in any way. No loans will be granted against this policy.

FRAUDULENT CLAIMS:

If any fraudulent claim is made against this Policy, iEnsure Brokers (PTY) LTD will be under no further obligation whatsoever to pay this claim, and shall, at its own discretion, be entitled to cancel this Policy, and any other Policy held by the Principal Member, with immediate effect, should any such fraudulent claim be lodged with the knowledge or intent of the claimant to iEnsure Brokers (PTY)LTD detriment

SUMMARY CLAIMS PROCEDURE:

In the event of a death, a Claim Notification Form must be requested from a IEnsure Brokers (PTY)LTD office, and submitted together with the relevant supporting documents within 6 (six) months of the date of death. Failure to do so within the 6 (six) month period from date of death, will result in the benefit being forfeited.

Documents to be submitted include, but are not limited to:

• Fully completed Claim Notification Form.
• Proof of Death:
• (BI-5) Original computer produced or faxed certified Death Certificate; or
• (BI-18) Original or faxed certified copy of unabridged Death Certificate; or
• (Bl – 20) Original or faxed certified copy of Abridged Death Certificate in respect of stillborn, together with supporting medical documents;
• (BI-1663) A copy of the Notification of death Certified copy of Principal Member’s Identity Document
• Certified copy of deceased’s Identity Document Copy of Principal Member’s most recent payslip (for the pay period immediately prior to death or the month in which the death occurred).
• In the event of a claim for a full-time student, a letter confirming fulltime study from a recognised educational institution, together with the last academic report, must be submitted.
• For a disabled child, confirmation of the Disability Grant, copy of Medical Application of the Principal Member or Medical Report must be submitted.

iEnsure Brokers reserves the right to request further documentation or information as it may deem necessary to accurately assess a claim.

iEnsure Brokers will endeavour to settle the claim within 48 hours, provided all the claim procedure criteria have been met.

Faxed copies must be clearly certified. The details of the Commissioner of Oaths with all the relevant details must be clear. Documentation submitted other than those listed, will not be accepted. Affidavits are not accepted.

NB: The policyholder is entitled to be provided, upon request, with a copy of the Policy.