INSURANCE KUMUDZI GROUP FUNERAL INSURANCE POLICY
TERMS AND CONDITIONS
1. Your Policy
The provisions and benefits of this policy, together with the application and any declaration made by the Policy Owner / Life Assured constitutes the entire contract and cannot be waived or modified except in writing by an authorised official of Smile Life Insurance Company Limited (Smile Life).
2. General policy definitions
Benefit shall constitute the Funeral Insurance benefit where required, which shall mean, subject to the terms and conditions of this policy, an amount equal to the Funeral Insurance benefit specified in the policy which is payable in terms of this policy on the Member’s or dependents’ death.
Child shall mean the Main Member’s biological child, adopted or any other child who is legally dependent on the Main Member. The child must be named, unmarried and up to maximum of age of 21 years or 24 years if he / she is a full time student at a recognized institution.
Child Addition shall mean the inclusion of any new born child or additional children for cover within 12 months of birth / adoption provided that the child is Main Member’s own child, adopted or is legally dependent child on the Main Member and provided that total number of children shall not exceed maximum of 4.
Cover shall mean the cover effected by the Policyholder to secure the Benefits provided in terms of this policy.
Commencement Date: The first date of a given month from which cover of a particular group commences upon successful receipt of the first premium.
Duration: The policy is an annual policy and shall be renewed annually upon the expiry of 12 months from the commencement date or prior year that cover was provided.
Dependent Adult means:
· Anyone who meets the definition of a child as per this policy and is a full time student at a recognised institution. Cover for such lives ceases at age 24.
A parent to the Principal Life Insured, or his/her spouse, who is financially dependent on the Principal Life Insured. Cover for such lives ceases at age 70
- A total maximum of two parent nominations and two parents-in-law nominations is permitted.
Entry Date shall mean the Commencement Date for all members existing at the Commencement Date and shall mean the first day of joining the policy
Expiry Date: The Expiry Date will be the date that the cover ceases.
Insurer shall mean “Smile Life Insurance Company Limited”
Immediate family shall mean Main Member, Spouse and up to a maximum of 4 children.
Life Insured is the person whose life is insured under this insurance
Main Member shall mean an Eligible person, up to maximum age of 70 years, who has been accepted for cover under this policy and has the option of choosing his or her spouse and other dependents for cover provision as per the terms and conditions of the policy.
Member shall mean an eligible person who has been accepted for cover under the policy i.e. Main Member, Spouse, Child, Parents and Parents In-law.
Policy: Policy means the terms and conditions applying to this insurance, as described in the Policy Wording.
Policy owner: The Policy Owner is the group that owns a particular insurance policy and who has all contractual rights with regards to this policy. The policy owner is also the premium payer.
Risk benefits: Risk benefit refers to the sum assured payable under this policy in the event of contingencies such as funeral benefits as defined in this Policy.
Spouse shall mean a person married to the Member either by civil, tribal, common or customary law.
Only one spouse will be eligible for the Funeral Benefit on a policy up to maximum age of 70 years. A spouse married to the member at a later stage can be included for cover within 12 months following the date of marriage, provided that the funeral benefit has not been previously claimed.
Termination Age shall mean 70 years in respect of Main Member, Spouses, Parents and Parents In-law. The termination age for children is 24 years.
Termination Date shall mean the last day of the month in which a Member attains the Termination Age.
Terrorism: Terrorism means the use or threatened use of force or violence against person or property, or the commission of an act dangerous to human life or property, or the commission of an act that interferes with or disrupts an electronic or communication system, undertaken by any person or group, whether or not acting on behalf of or in any connection with any organisation, government, power, authority or military force, when the intent is to intimidate, coerce or harm a government, the civilian population or any segment thereof, or to disrupt any segment of the economy.
- What you are insured for
- Funeral Cover
An agreed sum assured of MK 200,000.00 will be payable upon death of the life insured, provided death does not occur during the Waiting Period of 1 month and is not caused by any event listed in section 5 (Exclusions).
The benefit is payable provided that premiums are paid up to date.
- Surrender or Maturity value
This policy neither pays a surrender value nor a maturity value.
- General Policy Provisions
- Currency and jurisdiction
This contract is issued in, and subject to the laws of the Republic of Malawi. All monies payable in respect hereof whether by or to Smile Life are payable in the official currency of the Republic of Malawi, unless or otherwise stated elsewhere in this policy.
- The premium payable is MK 2,000.00 per year.
4.2.2. A period of grace of thirty days shall be allowed for payment of the premiums.
4.2.3. If the full amount of premiums due is not received by Smile Life within the period of grace, all Cover shall cease, unless it is agreed otherwise by Smile Life in writing. If death occurs after a policy has lapsed, Smile Life will not be liable to pay any benefits to the beneficiaries.
4.2.4 Smile Life shall be entitled to charge the Policy Owner interest on any overdue premium at the most recent average call interest rate charged by the Commercial Banks in Malawi for the period from the expiry of the period of grace to the date of payment of the overdue premium.
4.2.5 Smile Life reserves the right to review the premiums and adjust these if the assumptions on claims or other regulatory, economic and market factors differ significantly from the actual experience over the period. Any increases resulting from the review will not be determined by individual circumstances such as your health at that time. Any premium increases will only apply to new policies and not to existing policies.
4.4.1 The policyholder shall notify Smile Life in writing immediately that an incident occurred that is likely to give rise to a claim under this policy.
4.4.2 The policyholder will lodge a claim so that it can be assessed. Claims can be made as follows:
- Lodge a claim through USSD Application or Whatsapp Chatbot;
- Visit us at any of our official offices;
- Contact us on 0882777777 or 0111832211
4.4.3 The Claims Department will require information including the following:
- A copy of National Identity Card / Employee number / copy of drivers licence / copy of passport or other acceptable form of identification
- Evidence of death as specified below:
- Death certificate or death report or an affidavit of death sworn by a Commissioner of Oaths or;
- Indemnity form in the absence of a death certificate or death report, in this case the death certificate / report has to be submitted within a month from date of death or;
- Personal Medical Attendant’s report at time of death or;
- Accident report in the case of a Motor Vehicle accident or;
- Inquest (Police) report in the case of unnatural cause of death.
4.4.3 Failure to submit a claim within six (6) months from the date of death, may render the claim null and void.
4.4.4 The Policyholder shall, at its own cost, provide Smile Life with all the initial information and assessments required by Smile Life in order to adequately assess the claim, failing which the claim shall not be admitted.
4.4.5 On admission of the claim, and on the satisfaction of the provisions of this policy, Smile Life shall pay the Benefit to the group or such other person as the group may direct in accordance with the provisions of this policy.
4.4.6 Where Smile Life has agreed to extend the period of grace for the payment of premiums in terms of clause 4.2, no claim shall be paid nor shall it accrue before Smile Life receives all outstanding premiums.
4.4.7 Where the Policyholder or a Member has made a negligent or innocent misrepresentation to Smile Life, whether at the time of entering into the Policy agreement, lodging a claim with Smile Life or at any other time, Smile Life may in its sole and absolute discretion determine whether or not it will pay any benefit under the Policy in respect of the Main Member or Members concerned.
4.4.8 If Smile Life becomes liable at any time to account to any authority for any tax or duty on any payment due by the Company under this Policy, a sum equivalent to the amount which Smile Life shall be so liable shall be deducted from the benefit payable.
- Change of residence
The risk benefits are payable while the life insured is resident in the Republic of Malawi. The policy owner shall notify Smile Life in writing if the life insured permanently leaves the said territory whereupon Smile Life shall have the right to adjust the premium or modify the benefit by sending written notification to the policy owner.
- Changes of legislative provisions
Smile Life reserves the right to alter the terms of this contract if necessary to do so, in order to comply with legislative requirements or changes in income tax legislation.
- Policy Exclusions
Smile Life will not pay any benefit if:
5.1 In respect of the nominated Members, Spouse, Children, Dependent Adults and Parents during the first month following the date of nomination unless death is solely as a result of accident;
5.2 If death is as a result of suicide within twelve months of the commencement or reinstatement date of the policy;
5.3 Suicide or attempted suicide within twelve months of the Life Assured’s entry date, intentional self-injury, participation in a criminal act, committing any breach of criminal law, or participation in hazardous pursuits
5.4 The Life Assured being affected by narcotics or drugs other than as prescribed by a medical practitioner;
5.5 Whilst the Life Assured is travelling by air other than as a passenger in a licensed passenger-carrying aircraft and not as a member of the crew, nor for the purpose of any trade or technical operation therein or thereon.
5.6 Whilst participating in any riot or civil commotion or public disorder.
5.7 Arising directly or indirectly from war, warlike operations (whether war be declared or not) civil war, mutiny, insurrection, rebellion, revolution, military or usurped power whilst the Life Assured is on active service with the military, naval, air or police services of any nation, and / or any political organization, provided that this Policy shall continue to apply in respect of the elected covers sustained independently of such contingencies.
5.8 Should the Policyholder commit any act of dishonesty or fraud in relation to any provision contained in this policy.
5.9 Should the Policyholder commit any act of non-disclosure of material facts (such as existing medical condition) in relation to any provision contained in this policy.