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Nature and scope of policy
The Personal Loan Credit Protection Plan offers optional credit life cover to Nedbank clients who:
· have a valid Nedbank Personal Loan agreement; and
· qualify for cover in terms of the policy.
Nedgroup Life Assurance Company Limited Reg No 1993/001022/06 (Nedgroup Life) underwrites this product.
In the case of a valid claim the proceeds of the policy will be used to settle your liability for your Nedbank Personal Loan fully or partially.
The minimum and maximum entry ages for this policy are:
Youngest: 18
Oldest: 65
The term of the policy will be the same as the term of your loan.
Explanation of terms
Accident
An accident is an unforeseeable event that in a violent, external and visible manner, independently of any other cause, directly causes an injury resulting in an insured person's death or disablement within 90 days of the event taking place.
Cover amount
The cover amount is the outstanding amount of your Nedbank Personal Loan agreement, less any arrears on the date of the event giving rise to a claim. The maximum amount payable will not be more than the initial loan amount.
Free cover
We will give you free cover from the day on which Nedbank pays out the loan until we receive the first premium or until 30 days have lapsed, whichever is the shorter period. During the period of free cover, you are covered for accidental death and accidental disability only. We will pay out no claims if you die or become disabled due to natural causes or pre-existing conditions.
Liquidation
The process in which a company is declared insolvent in terms of sections 79 to 83 of the Companies Act, 71 of 2008.
Pre-existing condition
Any condition, physical defect, illness, bodily injury or disability of which you were aware or for which you received medical advice or treatment during the 12 months before we received the first premium, or during the 12 months before the date on which we received the first premium after any reinstatement.
Retrenchment
If your employer ends your fulltime, permanent employment:
· in anticipation of adverse business conditions;
· due to the introduction of new technology;
· due to the reorganisation of their business; or
· due to company closure.
'Retrenchment' also includes 'redundancy' for the purposes of this policy. Retrenchment cannot apply to individuals who, among other things, are pensioners, receive social grants, are self-employed or employed in the informal sector.
Start date
The start date is the date on which we receive your first premium.
Unable to earn an income
This means through no election or fault of your own you are not able to carry out the duties of your own occupation, but remain employed, and therefore earn no monthly income. We will consider a case to qualify where earnings are less than or equal to 25% of your usual monthly income.
Unemployment
When you are without a paid job, but you are available to work, and you are actively seeking employment.
We, us and our refer to Nedgroup Life.
You and your refer to the policy owner or insured person.
Premiums
We calculate the premium, which will show on your statements, based on the risk and liabilities associated with your loan, including the risk of insured events happening.
You have to pay the first premium on the first day of the month after we have accepted your policy application and after that on the first day of each month, until your loan agreement is cancelled.
Charges included in the premium
We outsource certain administration functions to Nedbank at a fee of 7% of your monthly premium (excluding VAT).
Non-payment of premiums
We will allow you a grace period of one month to catch up and pay if you have missed a premium. If we do not receive the missed premium within the grace period, your credit protection cover will lapse and no benefits will be payable. We may reinstate your cover after it has lapsed, but will pay no benefits if an insured event happened while your policy was in a lapsed state.
If you have a valid claim, we will refund all premiums that you paid from the date of the insured event until the date that you notified us of the claim to your loan account.
Benefits of this policy
This section explains the purpose and key features of the benefits available to you.
1. Death benefit
The purpose of this benefit is to pay an amount into your loan account that is equal to the outstanding amount of your loan agreement with Nedbank, less any arrears on the date of the claim event.
In the first three months after the start date or reinstatement date of your policy we do not have to pay for any claim that arises directly or indirectly from or that is related to your death if the cause of death is from any pre-existing condition you had.
2. Comprehensive disability benefit (applicable if you have comprehensive cover)
Our comprehensive disability benefit covers both temporary and permanent disability.
The purpose of this benefit is to pay the monthly instalment of your loan agreement if you are unable to earn an income for 30 days or longer as a result of disablement, arising from illness or bodily injury.
We will pay this benefit until:
· the loan term expires or the loan is repaid;
· you recover;
· you die; or
· you reach the age of 65,
whichever happens first.
If we accept a claim, we will pay your instalments after the date of disablement as and when they are due. We will base the instalments on your original loan amount and term and calculate them at the interest rate charged on the account at the time of disablement.
During your period of disablement, we may request updated medical evidence of your disability. If we deem the disability to be total and permanent, we may settle the full outstanding balance instead of the monthly payments, at which point the policy will end. All premiums and benefits will then stop.
We will also pay the full cover amount under the following circumstances:
· Loss of use of two limbs.
· Total and permanent loss of speech.
· Total and permanent loss of sight in both eyes.
· Major burns covering at least 30% of your body.
· Your being in a coma (not drug-induced) for more than 96 hours.
· Your being diagnosed with cancer (excluding skin and in situ cancer).
In the case of loss of speech or sight, the benefit will pay out up to six monthly instalments while the permanency of the disability is being established.
We will also consider a claim for a major medical or a major surgical event for which hospitalisation is required, especially when it is related to cardiac and neurological conditions.
Pregnancy or confinement due to the birth of a child does not mean illness or bodily injury for the purpose of this benefit.
We will not pay for a claim that arises directly or indirectly from or that is related to:
· any existing disability you had before you took out the policy; or
· your disability resulting from any pre-existing condition in the first 12 months (or term of policy if shorter) from the start or reinstatement date of this policy.
Note: We encourage you to submit a claim even if you are not sure that it will be accepted. We will review the claim and, at our sole discretion, decide whether or not it is valid.
3. Loss of income benefit (applicable if you have comprehensive cover)
This benefit covers unemployment or if you are unable to earn an income while remaining employed. It includes retrenchment cover.
The benefit will pay the monthly instalment of your loan agreement if the event happens before your 65th birthday and we have not paid any claim under the comprehensive disability benefit.
We will pay this benefit for a maximum of 12 months or until:
· the loan expires or is repaid;
· you return to fulltime employment;
· you start earning an income again;
· you die; or
· you reach the age of 65,
whichever happens first.
You must return to fulltime employment for a period of 12 consecutive months before you can claim for another loss of income.
Clients who will be covered for death only:
The benefits available to you depends on your employment status at the start date of this policy.
If you are:
· a pensioner;
· self-employed;
· employed in the informal sector;
· employed by a family-owned business; or
· get a social grant
you will be covered for the death benefit only.
If you are not eligible for a specific benefit, you will not pay a premium for that benefit. It is your responsibility to let us know if your employment status changes and we will adjust your premium accordingly.
Exclusions
Death and disability
We do not have to pay for any claim that arises directly or indirectly from or that is related to:
· your abuse of alcohol, drugs or narcotics;
· your wilful self-inflicted injury or suicide in the first 12 months (or term of loan if shorter) from the start date or reinstatement date of this policy;
· your use of nuclear, biological or chemical weapons, or any radioactive contamination;
· your participation in criminal activities;
· your participation in hazardous activities such as mountain climbing, bungee jumping and speed racing; or
· your active participation in war, invasion, acts of foreign enemies, hostilities, warlike operations (whether war is declared or not), civil war, insurrection, rebellion, revolution, civil commotion or uprisings or military power.
Loss of income
We will not pay if you:
· were lawfully dismissed, including dismissed as a result of wilful misconduct that is in violation of some established, definite rule of conduct, a forbidden act, wilful dereliction of duty or misconduct;
· accepted voluntary forfeiture of salary, wages or your employment income;
· resigned or accepted voluntary termination of employment; or
· were aware of or received notice of retrenchment during the three months before the policy start date;
· retire or are retired;
· lost your job because you participated in an unprotected strike; or
· reached the end of a fixed-term contract.
Additional loss of income exclusion applicable to loan terms of more than six months only
We will not pay if you are retrenched within the first three months after the start date of this policy.
Claiming under your policy
If you claim, it is important that you do the following:
Give us written notice that includes the details of your policy and the event giving rise to the claim. Give us notice within 180 days of the event, otherwise we might not consider the claim.
Give evidence of the claim event so that we can determine if it is allowed, and the amount payable. We may have you examined by a medical practitioner of our choice before admitting liability under any claim for disablement benefits.
Claim requirements for each benefit
We can process your claim only if you (or a family member) completed the forms in full and gave us all the information, including medical records. These will include, but are not limited to, the following:
Death benefit
· A certified copy of your death certificate.
· A certified copy of your valid identity card or document.
· A claimant statement, completed by a family member.
Comprehensive disability benefit (applicable if you have comprehensive cover)
· A disability claim form.
· A certified copy of your valid identity card or document.
· A confidential disability report by a medical practitioner.
· A diagnosis from a registered medical practitioner supported by acceptable clinical, radiological, histological and laboratory evidence.
· A statement not older than three months of the loan account, stating the account number, original loan amount, interest rate, instalments and remaining term.
We may request your medical reports or that you go for an examination if you claim under the comprehensive disability benefit. All additional reports and examinations will be for our account.
Loss of income benefit (applicable if you have comprehensive cover)
· A certified copy of your valid identity card or document.
· Past three months’ payslips.
· Past three months’ bank statements (if your salary is not paid into your Nedbank account).
Retrenchment
· A retrenchment claim form.
· Satisfactory evidence that the employer is engaging on a legitimate retrenchment process or company closure.
· A certified copy of your letter of retrenchment from your employer, stating the reasons for your losing your job.
Unemployment
· A certified copy of the letter from your employer, stating the reasons for you losing your job.
Compulsory unpaid leave
· A certified copy of the letter from your employer, stating the actions that were taken and the reasons for the actions.
Liquidation
· A provisional liquidation order.
We may request additional documents to verify the authenticity and validity of your loss of income, whether the documents are in the form of UIF, IRP5 certificates or any other form, and whether they are from you or the creditor or your employer or anybody else.
We may also request reports from your current or previous employer stating that you are or were continuously and gainfully employed. We will pay the costs to get this information.
Changes to your loan agreement
If you apply for an increase of the loan amount or readvance of what you have already repaid or consolidate multiple loans, all exclusions, waiting periods and pre-existing condition clauses will apply to the increased loan amount or further loan from the date of the increase. The balance of the outstanding debt on the original loan will continue to be covered on the original terms and conditions from the original start date.
If you extend only the repayment period of your loan with Nedbank, the premium of the policy will remain unchanged and will continue to be payable for the entire extended loan repayment term.
Cancellations
You may cancel your policy within 31 days after you have received the policy documents (this is known as the cooling-off period). Send us a written cancellation notice. If your policy is cancelled, we will refund any premiums paid if you have not claimed under any benefit.
After the cooling-off period you may cancel your policy at any time by giving us written notice, but we will not refund your premiums.
General terms and conditions
We may waive any of the requirements under any of the clauses in this policy, as long as it does not spoil that you qualify for benefits under this policy.
This policy depends on the laws and entrenched agreements governing life insurance in South Africa, and we may, at our sole discretion, change the terms of that, including, but not limited to:
· the terms and conditions governing your policy;
· the rates and benefits applicable to your policy; and
· the terms of the closure of the policy itself
to facilitate the administration of your policy in line with legislation or regulations promulgated or announced from time to time and market forces that influence the viability of the policy.
Any change that may occur will depend on one month's notice.
· We agree and undertake to pay the benefits described in this policy, depending on the following:
· We may review the premium and benefits for new and active policies. Any changes will be lawful and are subject to three months' written notice to you and Nedbank.
· We will not be liable for any arrear instalments.
· We will not be liable for any claims if we do not receive written notice within 180 days of any event giving rise to a claim.
· The information that you and Nedbank give must be true and accurate.
In the event of a dispute this policy document will be the sole point of reference and will replace any other documents or quotations that you may have received.
Currency and law
All amounts payable for your policy, either to or by us, will be in the lawful currency of South Africa. Any question of law arising under your policy will be decided according to the laws of South Africa.
Important contact information
This section of the document contains important information and does not form part of the policy terms and conditions.
As a policy owner, you have the right to the following information:
1. The insurer
Name: Nedgroup Life Assurance Company Limited Reg No 1993/001022/06
Postal address: PO Box 149175, East End, 4018
Physical address: Nedbank Park Square, 9 Park Avenue, Umhlanga, 4320
Tel: 0860 333 111
Fax: 0860 065 435
Email: clientservices@nedgrouplife.co.za
Nedgroup Life Assurance Company Limited (Nedgroup Life) is a registered insurance company and an authorised financial services provider (licence number FSP40915). Nedgroup Life is a wholly owned subsidiary of Nedbank Group Limited.
2. Regulatory compliance
Nedgroup Life is a member of the Association for Savings and Investment South Africa (Asisa) and subscribes to the applicable Asisa codes and standards. For any compliance or regulatory matters about the Financial Advisory and Intermediary Services (FAIS) Act, 37 of 2002, or any other applicable legislation, contact our compliance officer or public officer:
Compliance officer
Tel: 031 820 8448
Fax: 0860 066 641
Email: compliance@nedbankinsurance.co.za
Public officer
Email: publicofficer@nedbankinsurance.co.za
To comply with the requirements of the FAIS General Code of Conduct Nedgroup Life has adopted and implemented a conflict of interest policy, which is on our website at nedbankinsurance.co.za. If you not have access to the internet, please call us on
0860 333 111 for a copy.
3. Claims procedure
If you have a claim, notify the Claims Department within 180 days of the claim event:
Tel: 0860 333 111
Fax: 0860 065 437
Email: claims@nedgrouplife.co.za
4. Complaints procedure
We recommend that you take the following steps when you become aware of the issue giving rise to the complaint:
First, try to resolve the problem by contacting our Client Services Contact Centre:
Tel: 0860 333 111
Fax: 0860 065 437
Email: clientservices@nedgrouplife.co.za
If you are still not satisfied, escalate the complaint to the Complaints Resolution Officer:
Tel: 0860 333 111
Fax: 0860 066 641
Email: complaints@nedbankinsurance.co.za
Complaints must, if possible, be made in writing. We will acknowledge receipt of the complaint within three working days. The Complaints Resolution Officer has 20 working days to resolve a complaint. We will tell you in writing what the Complaints Resolution Officer has decided.
If a complaint is resolved in your favour, we will offer a full and appropriate redress. If the complaint is not resolved in you favour, we will give you reasons in writing, as well as details of the Long- term Insurance Ombudsman, if you want to take the matter further.
Long-term Insurance Ombudsman
If you need advice on complaints about claims or any other matter that has not been satisfactorily resolved, contact the Long-term Insurance Ombudsman:
Postal address: Private Bag X45, Claremont, 7735
Tel: 086 010 3236
Fax: 021 674 0951
Email: info@ombud.co.za
FAIS Ombud
If a complaint about advice or intermediary services you received is not resolved within six weeks, or if you are not satisfied with the resolution, refer the matter to the FAIS Ombud:
Postal address: PO Box 74571, Lynnwood Ridge, 0040
Tel: 012 348 3447
Fax: 0860 324 766
Website: faisombud.co.za