Y’ello Africa Funeral and Repatriation Cover – Terms and Conditions

FUNERAL BENEFITS:

The basic funeral plan provides:

  • Cover from R 20 000 up to R75 000, which covers up to 18 family members which comprises of yourself, your partner, your 6 children, 4 parents and 6 extended family members provided that you cover yourself or
  • cash lump sum or
  • funeral service within the borders of South Africa with an added cash pay-out and airtime benefit or
  • repatriation services outside the borders of South Africa to the SADC region with an added cash pay-out and airtime benefit to be paid in settlement of a death claim of a Principal Member, his/her Spouse, Parents, Eligible Children and Extended Family members, where applicable.
DEFINITIONS IN TERMS OF THIS POLICY:

Policy Holder: refers to the owner of the policy who is also the main life insured; who is allowed to elect participation in the policy.
The main insured person must be 18 years or older but under the age of 66 years as at the benefit start date.
Spouse: refers to a person who is the permanent life partner (whether heterosexual or homosexual) or civil union partner of the
main insured in accordance with:

  • the Recognition of Customary Marriages Act 68 of 1997
  • the Civil Union Act, 17 of 2006; or
  • the tenets of any Asiatic religion

A permanent life partner is a partner who you live with for longer than 12 months. A spouse must be 18 years or older but under
the age of 66 years as at the benefit start date.

Child: refers to an unmarried, financially dependent child of the main insured or partner, who has not yet attained the age of 21, and will include:

  • the biological child, a posthumous child and a grandchild
  • a stepchild, a legally fostered child and an adopted child
  • a stillborn child from 26 weeks from the date of conception

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 and children who are mentally disabled or totally and permanently disabled.
Extended Members: refers to family members, who are dependent on the Main Member for financial assistance in the event of a death in the family, may be covered. These may include uncles, aunts, brothers, sisters, nephews, nieces, cousins, grandparents and children of the Principal Member who are over age 21 years. The extended members must be <18 years or older but under the age
of 66 years as at the benefit start date.
Parents: includes the parent of the main insured and/or partner where the main insured and/or partner is a biological child, a stepchild, a legally fostered child or adopted child of the parent. Parents must be 18 years or older but under the age of 81 years as at the benefit start date.

WAITING PERIODS:
  • You and other life insureds are covered immediately for accidental death after your first premium is paid.
  • There is a waiting period of six (6) months from the benefit start date and we must receive six (6) benefit premiums consecutively before a claim can be submitted in the case of death caused by natural causes.
  • There is a waiting period of twelve (12) months consecutively from the benefit start date and we must receive twelve (12) benefit premiums consecutively before a claim can be submitted in the case of death caused by suicide.
Prior Insurance Waiting Periods:

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 however many complete months that the insured person had uninterrupted cover for the same benefit on the replaced policy. The following additional conditions apply:

  • the replacement must have conformed to the replacement requirements of applicable South African insurance legislation.
  • the replacement 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.
  • the policy holder must have also been the policyholder on the replaced policy.
  • the insurer that issued the replaced policy must have been a registered insurer in the Republic of South Africa.
  • the replaced policy must have been cancelled within 31 days before this policy’s start date. Evidence that these conditions have been met will be required if the conditions are not met, then the waiting periods will not be reduced
Grace Period:

A period of 30 (thirty) days is allowed for the payment of a missed premium. During this period, 21st Century Life attempt to collect the missed premium and if unsuccessful, the policy will lapse. All benefits will remain in force during this 30-day period.
If any event occurs during the 30 days period that results in a valid claim, the unpaid premium will be deducted from any amount paid out. The 30-day period does not apply to the payment of the first premium on inception of the policy.

Cooling Off Period:

You may cancel this policy by giving us immediate notice, it is within 31 days from the policy start date or of receiving the policy documents. If we have not paid a benefit or no insured event has yet occurred, we will refund all the total premiums paid, less the deduction of costs for any cover provided for risk benefits.

EXCLUSIONS:

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, 21st Century Life 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 main member, with immediate effect, should any such fraudulent claim to be lodged with the knowledge or intent of the claimant to 21st Century Life detriment.
Criminal Activities: We will not pay a claim if any insured event is directly or indirectly caused by criminal activities. Criminal activity means the insured person is or was:

  • under investigation for committing a crime;
  • being prosecuted for committing a crime; or
  • Convicted by a Court of Law for having committed a crime.

We will delay our claims decision until the finalisation of the investigation, or criminal trial. You must give us proof of the outcome of the investigation or the criminal trial.
Insured event or accident before the benefit start date: We will not pay a claim for an insured person if the insured event or accident leading to the insured event, happened before the benefit start date.

CONDITIONS OF COVER:

Start Date: The policy will begin on the policy start date, subject to us receiving the first total premium.
Policy End Date: The policy will end if premiums are not paid in two consecutive months, when the main insured ends the policy, when the main insured dies and the spouse declines continuation of the policy.
Escalations: The monthly payment on your funeral cover policy will increase by 7% every twelve (12) months. When your
monthly premium increases we will also increase your cover benefit by 7%. The escalations will stop at age 55.

CLAIMS PROCEDURE:

In the event of death, a Claim Form must be requested from 21st Century Life, and submitted together with the relevant supporting documents within 180 days of the date of death. Failure to do so within the 180 days 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 Form.
  • (BI-5) Certified computer produced Death Certificate; or
  • (BI-18) Certified copy of unabridged Death Certificate; or
  • (Bl – 20) Certified copy of Abridged Death Certificate in respect of stillborn, together with supporting medical documents;
  • (BI-1663) Certified copy of the Notification of death
  • Police Report in respect of accidental death
  • Certified copy of main member’s Identity document/Passport
  • Certified copy of deceased’s Identity Document / Passport
  • Certified copy of the claimant
  • In the event of a claim for a full-time student, a letter confirming full-time study from a recognized educational institution must be submitted
  • For a disabled child confirmation of the Disability Grant or Medical Report must be submitted.

21st Century Life reserves the right to request further documentation or information as it may deem necessary to accurately assess a claim. 21st Century Life 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.

INTERMEDIARIES:

21st Century Life (Pty)Ltd410 Janadel Ave, Halfway Gardens, Midrand, 1685Telephone No: (011) 805 1621 or 012 285 0017FSP No. 35947Reg. No. 2007/021608/0721st Century Life is Authorized to sell the following products: Long-Term Insurance:Category A and Category B121st Century Life holds Professional IndemnityYour policy is underwritten by Old Mutual Life Assurance Company (SA) Limited. A licensed FSP and Life Insurer.

We hope never to give you any cause for complaint. But if you’re ever unhappy with our service or the advice you’ve received, please contact us on the following details: 410 Janadel Avenue, Halfway House, Midrand email compliance@21stcenturylife.co.za  Telephone 012 285 0017

If you are not satisfied, call Old Mutual on 086 000 4139 or e-mail GSFMQueries@oldmutual.com

If we’re still not able to resolve the problem, you can contact these independent industry bodies for help:

The Ombudsman for Long-term Insurance: The Ombudsman’s role is to mediate between policyholders and life insurers when they have a dispute that they can’t resolve in a way that’s fair, independent, and objective. The provisions of the Long-term Insurance Act guide the Ombudsman’s decisions.

Private Bag X45, Claremont, 7735 | Telephone: 021 657-5000 | 0860 103 236 Email: info@ombud.co.za | Third Floor, Sunclare Building, 21 Dreyer Street, Claremont, Cape Town, 7700

The FAIS Ombud: The FAIS Ombud’s role is to mediate fairly and independently between clients and financial services providers on matters to do with financial advice. The Ombud follows the provisions of the Financial Advisory and Intermediary Services Act (FAIS Act).

P.O. Box 74571, Lynnwood Ridge, 0040 | Kasteel Park Office Park, Orange Building, 2nd Floor, c/o Nossob & Jochemus Street, Erasmus Kloof, Pretoria, 0048 Telephone: 012 762 5000 | 086 066 3247 | Fax: 012 348 3447| Email: info@faisombud.co.za