A person married to the Principal member by law, tribal custom or under the tenets of any Asian religion, and shall include a Common Law Spouse, and where applicable a relationship between two people of the same gender, not exceeding the maximum entry age of 80 years. Only one spouse is allowed per Principal Member.
A maximum of 2(two) Spouse claims per Principal Member will be payable during the life of any policy.

1. Tribal Custom
A person recognized as a legal partner by the Tribal Chief and who has written confirmation that Lobola has been paid for such union

2. Tenets of Asian Religion
A union of any Asian culture where written proof is available.

3. Common Law Spouse
A person recognized by the Insurer at its sole discretion as a Spouse, after cohabitation of 6 months, supported by written proof from the chief, civic Association etc.

An married child, of the Principal Member who is 21 years and younger including a stepchild, posthumous child and legally adopted child or a stillborn child (after the 26th week of pregnancy). Only 2 stillbirth claims will be accepted per family during the term of the Policy. The age of 21 is extended to 25 if the child is a full-time student at a recognized institution or until the Principal Member ceases to qualify. Children who are mentally retarded or totally and permanently disabled before age 21, who are unable to care for themselves are covered until death or until the Principal Member ceases to qualify.

Details of any children of the Common Law Spouse, illegitimate children and stepchildren shall be submitted to the Insurer at the date the Principal Member joins the scheme or within 1 (one) month of the dependant becoming eligible for cover. Failing this, the Insurer will require satisfactory proof to support any claim.
No other children will be eligible for cover under the Principal Member.

A child who is 18 year or younger and does not qualify to be an eligible child but is financially dependent on the Principal Member. Proof of dependency must be provided at application and claim stage. Up to 4(four) Wider Children may be nominated for cover.

Applies to parent, parent-in-law, brothers, sisters, uncles, aunts, nephew, nieces, divorced spouses, grand children of the Principal Member, and his or her immediate children once they are 21 years of age or any distant relative of the Principal Member whom the Insurer will deem fit to be an extended family. Up to 10 Extended Family members may be nominated for cover. Maximum entry age for Extended Family members is 84 anb.

• For a Principal Member, his/her Spouse and Eligible Children, and his/her Extended Family below age 74 years, there is a 6(six) months waiting period for claims due to natural causes.
• Only claims due to accidental death will be paid after a waiting period of 1 (one) month, provided that premiums were received.
• For Extended Family above age 74 years, there is a 12(twelve) month waiting period for claims due to natural causes.
• Suicide will not be covered during the first 2(two) years of membership from the commencement of the policy.
• Should a member select a higher benefit than the currently enjoyed, the waiting period mentioned above will apply on the improved benefit, not the then current benefit amount enjoyed.
• Where premium payments are missed then resumed, the original waiting period will apply from the date payment of premiums is resumed.

The debit order will be lodged on the date as selected by the accountholder. In the event of the Debit Order not being honored on the due date, two debit order amounts will be run the next month. At this run, should the debit order still not be honored the policy will lapse without further notice.
First premium on all new policies must be honored failure to do so the policy will lapse without any notice.

The Principal Member must apply to have the membership reinstated. If approved, the original waiting periods will come into force with effect from the date on which the debit order is successful. During this period until the actual debit order is honored no claims will be paid.

The Insurer reserves the right to refuse to reinstate any policy

• Different surnames of the members must be supported by written proof on application..
• Relationship of your family members must always be shown on the proposal form. If you include person other than a member of your family in your policy, no claim will be paid in respect of this person.
• Date of birth and identity numbers. must always correspond with those that appear on the death certificate.
• Premiums are paid to death. There is no waiver of premium. If the Principal Member dies, the remaining members must continue with premium payment otherwise the policy will lapse.
•Benefits will be paid in cash

The Insurer reserves the right to increase the premium and will inform the Premium Payer thereafter.

The Principal Member as well as the Insurer, reserve the right to cancel this policy at anytime after giving the other party 3(three) months written notice of such intention.

There is no surrender value to this policy. Benefits under the policy may not be ceded or pledged in anyway. No loans will be granted against this policy.

There is a 30 (thirty) day period from receipt of this document to examine the benefits. In the event of not electing to take up this policy, the Principal Member must notify the Insurer in writing to cancel the policy and refund any premiums deducted, less the cost of any risk cover. If no such notification is received within 30 (thirty) days. The Insurer will consider the policy taken up.

The 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.

If any fraudulent claims is made against this policy, the Insurer will be under no further obligation whatsoever to pay this claim, and shall, at its own discretion, be entitled to cancel this policy with immediate effect, should any such fraudulent claim be lodged with the knowledge or intent of the Principal Member to prejudice or defraud the insurer.

In the event of death all relevant supporting document must be submitted to the Insurer within 6 (six) months from the date of death. Failure to do so 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 or faxed certified copy of computer produced 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; and
(BI-1663) A copy of the Notification of death
• Certified copy of Principal Member’s Identity Document for South African citizens
• Certified copy of Principal Member’s Passport for foreign nationals
• Certified copy of deceased’s Identity Document for South African citizens
• Certified copy of deceased’s Passport for foreign nationals
• Copy of Principal Member’s pay slip for 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 full-time study from a recognized 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.
• Proof of payment. If paid by Debit order, 3 (three) months bank statement.
• Proof of marriage e.g. certified copy of marriage certificate or confirmation letter from tribal authorities

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

The Insurer will endeavor 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.

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

MAIN CLIENT SERVICE CENTRE
Company : Professional Insurance Brokers, Reg. No.91/080031/23
(An authorized Financial Service Provider, FSP No.433)
Tel : (015)962 1403/1519/4896/4897, PIB MAXI LINE : 086 104 0690
Fax : 015 962 1807, E - mail : admin@pibholdings.co.za;
Website : www.pibholdings.co.za
Postal Address : P.O. Box 2321, THOHOYANDOU, 0950
Physical Address : Office No.21, Second Floor, LimDev Building, Block D, Thohoyandou Shopping Centre, Thohoyandou, 0950

6. UNDERWRITTEN BY:
Company : Safrican Insurance Company Limitted (“Safrican”), Reg No.1935/007463/06
(An authorised Financial Service Provider, FSP No.15123)
Website : www.safrican.co.za