AVBOB FUNERAL COVER (LIFESAVER) POWERED BY CELL C PRIVILEGES, CONDITIONS AND PROVISIONS 1. DEFINITIONS Unless contrary to the context, the words in this policy indicating the male gender will also apply to the female gender and references to the singular will also apply to the plural and conversely. The under mentioned words and terms in this policy have the following meanings: "Administrator"
:
Means REFIN FINANCIAL SERVICES (PTY) LTD an authorised Financial Services Provider (45275) of Glen Forum Building, Cnr Corobay & Garsfontein Roads, Menlyn, Pretoria, 0001.
“Assurer”
:
Means AVBOB MUTUAL ASSURANCE SOCIETY, an authorised and licensed Financial Services Provider (20656) of 368 Madiba Street, Pretoria (duly incorporated under Private Act 7 of 1951).
“CELL C”
:
CELL C (PTY) LTD AND CELL C SERVICE PROVIDER (PTY) LTD COMPANY.
2.
"Commencement date”
:
"Member"
:
"Group Scheme"
:
“Personal Information”
:
“Consent”
:
"Waiting period"
:
Means the date on which the Group Scheme commences. Means a CELL C prepaid customer whose life has been assured under the GROUP SCHEME. Means AVBOB FUNERAL COVER (LIFESAVER) POWERED BY CELL C with funeral benefits for the Members. Means any information of/relating to a Member which identifies a Member. Means any voluntary, specific and informed expression of will in terms of which permission is given for the processing of Personal Information. Means a (6) six months waiting period for Members from the date the Member joins this Group Scheme during which period only claims arising from accidental causes, excluding suicide, shall be considered.
COMMENCEMENT DATE The commencement date of the Group Scheme is 15 DECEMBER 2015.
3.
MEMBERSHIP Any natural person who is a prepaid customer and migrated to the CELL C Tariff Plan, and who has not yet attained the age of 80 years may become a Member of the Group Scheme. Membership of the Group Scheme starts on confirmation of cover.
Membership of the Group Scheme ends: when the Member ceases to pay premiums in arrears; on cancellation by the Assurer or Member; on the death of the Member. Multiple use of a Member’s identity number for more than one membership under the Group Scheme is not allowed. Benefits under this Group Scheme will be payable only once, per Member’s identity number provided at the inception of the policy. By accepting the Terms and Conditions contained in this agreement, the Member consents to the processing of his/her personal information for the purpose of effecting this agreement. 4.
PREMIUM AND BENEFITS 4.1
Premium Plan for member only
Risk premium per member Admin fee Total premium 4.2
Premium per member per R1000 cover (max R30 000 cover) R0.70 R0.30 R1.00
Death Benefits For further information and terms and conditions on the Cell C Tariff Plan for AVBOB Funeral Cover (Lifesaver) powered by Cell C, click here www.c.co.za/avbob-lifesaver 4.2.1
On the death of the Member a cash benefit in accordance with the table below will be payable: Billed Minutes Used per month
Funeral Cover
Basic cover of R1000*
141-150
up to R15000
151-160
up to R16000
01-10
up to R1000
161-170
up to R17000
11-20
up to R2000
171-180
up to R18000
21-30
up to R3000
181-190
up to R19000
31-40
up to R4000
191-200
up to R20000
41-50
up to R5000
201-210
up to R21000
51-60
up to R6000
211-220
up to R22000
61-70
up to R7000
221-230
up to R23000
71-80
up to R8000
231-240
up to R24000
81-90
up to R9000
241-250
up to R25000
91-100
up to R10000
251-260
up to R26000
101-110
up to R11000
261-270
up to R27000
111-120
up to R12000
271-280
up to R28000
121-130
up to R13000
281+
up to R29000
131-140
up to R14000
Billed Minutes Used per month
Funeral Cover
0*
* Upon migration to the Tariff Plan offered by Cell C and on joining the Group Scheme, the Member/customer will receive basic funeral cover of R1000.00 (one thousand rand), providing that the customer has performed a recharge (of any amount) after migration and on joining the Group Scheme. To maintain this basic funeral cover every month, the customer will need to remain active on the Tariff Plan as well as have performed a recharge (of any amount) during that month. This basic funeral cover, if applicable, is over and above the funeral cover accumulated for every billed minute. This basic funeral cover of R1000.00, as well as any funeral cover based on the billed minutes used, will only be available to a Member/customer in the succeeding calendar month.
4.2.3 The total funeral cover payable by the Assurer under the Group Scheme shall not exceed an amount of R30000. 5.
PAYMENT OF BENEFITS Payment of the benefits is subject to the Assurer accepting the claim. The beneficiary will be notified via sms, within 24 hours of the Assurer receiving all claim documentation. The following documentation must be submitted to the Assurer by way of any method provided for in Schedule A, in substantiation of every claim:
Fully completed claim control sheet.
Certified copy of the computerized death certificate.
Copy of the BI – 1663 form (Notification/Registration of death).
Certified copies of the deceased and claimant’s Identity Document/Birth Certificate.
In the instance where AVBOB Funeral Service Ltd is not conducting the funeral service a letter of confirmation from the undertaker conducting the funeral service is required.
SAPS report (in respect of death by unnatural causes).
Certified copy of the bank statement of the beneficiary/claimant (not older than 3 (three) months).
In cases where there is no copy of the identity document available for the deceased or claimant, an affidavit from the claimant or letter from the Department of Home Affairs confirming this must be submitted. If the claimant does not have an identity document, proof of application for an identity document must be submitted with the claim documents.
The membership number of the Member, where applicable.
Should a funeral/cremation be carried out by AVBOB Funeral Service Ltd, the benefits payable in terms of this Group Scheme will in the first instance be applied to assist in the defraying of the costs of such funeral/cremation and the balance, if any, will be payable to the person(s) entitled thereto or the deceased estate.
6.
WAITING PERIOD No benefits will be payable if a Member dies within (6) six months of joining the Group Scheme, unless such death occurs as a result of an accident (suicide excluded).
7.
PROOF OF AGE Should the date of birth of a Member differ from the information provided to the Assurer where the age exceeds the eligible age under the Group Scheme, no benefits shall be payable.
8.
9.
GRACE PERIOD 8.1
In the event that a Member migrates out of the Tariff Plan connected to this Group Scheme, the Member will forfeit all benefits in terms of the Group Scheme.
8.2
In order to ensure uninterrupted membership in the Group Scheme, the Member must opt back into the Tariff Plan within 90 days of opting out. In this regard no new waiting period will be applicable other than the remaining waiting period, if any.
UNCLAIMED BENEFITS A Member has the right to unclaimed benefits regardless of the time frame. The Assurer will where benefits become payable and no claim has been submitted, trace the Member within a period of 6 (six) months. Should the Assurer be unsuccessful in tracing the Member it will repeat the tracing process within a period of 3 (three) years and again within a period of 10 (ten) years if the benefits remain unclaimed. If after 10 (ten) years the Assurer cannot trace the Member, an external tracing company will be used. This requirement will only be waived if the benefits are worth less than R1000.00 and the cost of the tracing exceeds the amount available. Any reasonable administrative and tracing costs incurred after the first attempt to trace the Member may be recovered from the unclaimed benefits. It remains the responsibility of the Member to inform the Assurer of any changes in respect of his or her contact information and any changes in respect of the contact information of the beneficiary. The Assurer will rely on the Member’s consent which was given to share any personal information with a tracing company to facilitate tracing in the event that tracing becomes necessary in future.
10.
GENERAL The Benefits, Premiums, Privileges, Conditions and Provisions of the Group Scheme are guaranteed for nine (9) months as from the Commencement date after which period the Assurer may review it. The Assurer undertakes to review the premiums quoted at quarterly intervals, taking in consideration claims experience and total membership of the
Group Scheme. Notice to this effect will be given in writing to the Administrator, Cell C and Members at least (3) three months in advance. 11.
CONTACT DETAILS 11.1 Queries 11.1.1
For any queries in respect of the Group Scheme, please contact REFIN FINANCIAL SERVICES (PTY) LTD, the Administrator of the Group Scheme:
Telephone: 012111 0033 Telefax: 086 243 7411 Email:
[email protected] 11.1.2
For any queries in respect of claims under the Group Scheme, please contact AVBOB Mutual Assurance Society:
Telephone: (012) 303 1170/ (012) 303 1524/ (012) 303 1393 Telefax: 012 303 1458 or 0866 465 349 Email:
[email protected] Postal: PO BOX 1661 PRETORIA 0001 11.2 Complaints For any complaints regarding this Group Scheme, kindly contact the Complaint’s Department of AVBOB Mutual Assurance Society: Telefax: 086 754 6876 Email:
[email protected] If your complaint is not resolved to your satisfaction after you have contacted the Complaints Department, you have the right to approach the office of the LongTerm Insurance Ombudsman at telephone number (021) 657 5000 / 0860 103 236 or fax number (021) 674 0951. Alternatively, you can write to: the Ombudsman for Long-Term Insurance, Private Bag X45, Claremont, 7735; or email to:
[email protected]. Please note: according to the Rules of the Office of the Ombudsman for LongTerm Insurance, it will not consider a complaint if:
such a complaint is the subject of ongoing legal proceedings; or a determination had previously been made by the Ombudsman on the same complaint, unless new evidence has come to light that could affect the outcome; or three years or more has gone by from the date on which the complainant became aware that he/she had cause to complain to the Ombudsman, unless the failure to do so within the prescribed period was due to circumstances for which, in the opinion of the Ombudsman, the complainant could not be blamed.
SUBMISSION OF CLAIM DOCUMENTS – SCHEDULE A Claim documents may be submitted as follows: AVBOB Mutual Assurance Society: Telefax: 012 303 1458 or 0866 465 349 Email:
[email protected] OR At any of the AVBOB Funeral branches
