KHUTSANE TOMBSTONE POLICIES TERMS AND CONDITIONS
1. Application forms must be properly completed for the member and his dependents, reflecting full names, date of birth and identity document numbers.
2. Maximum number of children are 6 classified as dependents, any additional will be added as extended members.
3. Mentally disability as well as permanent and totally disabled children are covered until their death or for as long as the principal member participates on the scheme.
4. Common-law, civil as well as tribal marriages are recognized with the scheme – only one spouse is allowed as a dependent of the member, married to the member by law or tribal custom.
5. Immediate cover for accidental deaths. No waiting period applies
6. Claims must be notified to Five Star Funeral Insurance or Khutsane Tombstones Policy within 12 (twelve) months upon the death of an assured. Failure to submit a claim within the period specified would render the claim null and void.
7. Claims will be settled timeously on receipt of the following certified documents: Death certificate, copy of deceased's ID, copy of Claimants ID, Underwriter’s Insurance Certificate and any other additional documentation deemed necessary by the Underwriter.
8. In the event of the death of the Principal member, the surviving spouse can apply to become the Principal Member by notifying Five Star Funeral Insurance or Khutsane Tombstones Policy in writing.
9. The underwriter or Five Star Funeral Insurance will not be liable in the event of death from suicide or attempted suicide within 12 months on the inception of the policy and or within 2 years of the reinstatement following the lapse or failure to pay premiums.
10. No benefit will be paid if death is directly or indirectly caused by or attributable to:
10.1. Terrorism or war (whether declared or not), invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolution, insurrection, and civil commotion assuming the proportions of, or amounting to, an uprising, military, or usurped power;
10.2. Radioactive contamination, nuclear, biological, or chemical weapons whether directly or indirectly;
10.3. Claims where the cause of death is suicide in respect of the Principal member or Policyholder, immediate family member or extended family will not be subjected to any exclusion and shall be paid provided all the other terms and conditions of cover in terms of the policy are met;
10.4. Willful self-injury or where the Principal insured was affected, temporarily or otherwise, by alcohol, narcotics, insanity or drugs, unless the latter is administered by or prescribed by or taken in accordance with the instructions of a registered medical practitioner (other than himself where the Principal insured is a medical practitioner.)
10.5. The members or member’s dependents or member’s nominated beneficiaries’ involvement in unlawful activity or activities; or
10.6. Divorced spouses at the start of the policy are not covered as Spouses, and cover for divorced spouses as Spouses who divorce during the term of the policy cover will cease immediately.
11. A six-months (6) waiting period will apply for all new members from date of inception.
12. Extended Family members will be subject to a six-months (6) waiting period, irrespective of attained age.
13. Extended Family includes Parents, Parents in-law and all other blood relatives, specified by the Principal Member.
14. The scheme covers the Principal member, plus nine (9) dependents, including spouse and children.
15. Maximum age for the Extended Family will not exceed 84 years on joining the scheme.
16. The Principal member is responsible to ensure that the monthly premium is paid on time and in full.
17. Failure to pay 3 consecutive premiums or should your premium arrears be to the value of 3x premiums, the policy will lapse.
CLAIMS PROCEDURES
18. To claim a benefit, submit the following documents to Five Star Funeral Insurance at the following email address claims@fivestarinsure.co.za or www.khutsanetombstonepolicies.co.za
18.1. A fully and correctly completed RMA Death Claim Notification Form;
18.2. An official copy of the original death certificate certified by the South African Police Services.
18.3. Computerized death certificate (abridged certificated and medical reports are unacceptable);
18.4. Clearly legible certified copies of the deceased member and Principal member’s ID documents. In case of third-party payments, a certified copy of the third party’s ID document is required;
18.5. Beneficiary’s Identity Document certified;
18.6. A Clear BI – 1663 certified by the South African Police Services;
18.7. Bank details and a copy of a bank statement of the payee or Beneficiary (or the third party in respect of third-party payments) for payment of the benefit.
18.8. Certified copy of a Police Statement, in event of death due to unnatural causes;
18.9. The underwriter and or Five Star Funeral Insurance may request a medical report in the case of stillborn babies, indicating that the pregnancy reached the 26th (twenty-six) weeks;
18.10. If, in case of a Family Plan, no spouse is listed, a certified copy of a marriage certificate will be required; and
18.11. If, in the case of a Family Plan or Single member with children, no children are listed, a certified copy of the birth certificate will be required.
19. Additional documents may be requested at the discretion of Five Star Funeral Insurance, depending on the nature of the claim or death.
20. RMA shall not consider any claims for common-law spouses or spouses married by tribal custom or under the tenets of any religious marriage, unless they are nominated on the application form or by way of an amendment form as a dependent, whichever is RMA in its sole discretion.
21. In the event of a valid death claim, the specified benefit will be paid to the Member or Beneficiary.
22. Claims must be submitted to Five Star Funeral Insurance within 12 (twelve) months of the death of the Assured Life.
23. RMA reserves the right to cancel the policy and to declare all premiums paid by the member in terms of the policy forfeited if there is any evidence of, or attempted submission of a fictional claim, fraud, or misrepresentation.
RIGHT TO CANCEL
24. After RMA has accepted the member’s application for insurance cover, the member may decide to instruct RMA/Five Star Funeral Insurance to cancel the policy.
25. The member must submit this instruction inwriting Five Star Funeral Insurance within 30days after receipt of this Certificate
26. The member may only submit such cancellation instruction to RMA or Five Star Funeral Insurance if no benefit has yet been paid or claimed or an insured event has not yet occurred. RMA may deduct the cost of any risk cover the member enjoyed under the policy before it was cancelled
COMPLAINTS PROCEDURE
28. Please contact Five Star Funeral Insurance and have the following information ready:
28.1. Policy number;
28.2. Identity number; and
28.3. Nature of enquiry.
29. Complaints which are not resolved to your satisfaction may be referred to the underwriter.
30. Complaints which are still not resolved may be referred to the Ombudsman for Long-Term Insurance or the Registrar of Long-Term Insurance. Please refer to the contact details below.
Five Star Funeral Insurance
11 Wally Hayward
Drive
Ashburton
Pietermaritzburg
3213
Tel: 033 326 1011
@: complaints@fivestarinsure.co.za
RAND MUTUAL ASSURANCE COMPANY
10 St Andrews Rd,
Parktown Greenstone Hill
Johannesburg,
2093
Tel: 0860 22 132
@: complaints@randmutual.co.za
Should a complaint not be resolved to your satisfaction you may escalate the complaint to the FAIS Ombudsman:
P.O. Box 74571, Lynnwood Ridge, 0040.Tel: (012) 470-9080 Fax:
(012) 348 3447 Or the Ombudsman for Long-term Insurance
Private Bag x45, Claremont, 7735 Tel: (021) 657-5000 Fax: (021) 674-0951
ADDITION to Khutsane Tombstone Policy Terms & Conditions:
1. This is a Group Policy and premiums are payable monthly in advance on or before the 7th of each month.
2. No Joining FEE is applicable.
3. The Policy Member and/ or Beneficiary acknowledges that the maximum cash value if claim should take place and a tombstone is not being taken the maximum of R10 000 (ten thousand rand) shall be paid to the beneficiary in terms of this greement and that this agreement covers only the supply of a Tombstone to the benefit of the client's choice to the value of the plan chosen above (including message, delivery of Tombstone and installation on Lintels, no Picture engraving or pots included) any additional upgrades of your choice to a more expensive tombstone is available, if you require a more expensive Tombstone exceeding your cover, you will have to pay the balance in cash prior to erection.
4. Upon a valid claim, the Policy Holder / Beneficiary is required to get installation permits from the cemetery prior to the tombstone installation.
5. No same day Tombstone erection is allowed under this Policy. There is a 3 (Three) month waiting period for Tombstone erection after Burial. (Reason for this is that ground needs to naturally sag and settle before installation)
6. General Inquiries and or Queries or Complaints contact Khutsane Tombstones Policies on Tel: +27 72 166 0615 Alternatively send an email to policy@khutsanetombstonepolicies.co.za
7. F.A.Q – Frequently asked Questions please visit www.khutsanetombstones.co.za/policies/index.php/faq
8. People not on Policy but already passed on prior to joining Khutsane Tombstones Policy.
a. PAYMENT UP TO DATE BONUS: If you keep your Policy payments up to date for a period of 5 (Five) years, without skipping a payment, during this period you are Eligible to receive a Free Tombstone from our Special Offer Catalogue to put for people already passed on prior to joining. THIS ONLY APPLIES TO THE FIRST 5000 MEMBERS, there after Member 5001 and onwards we offer a 10% Cash back should
you keep your instalments up to date for a period of 5 (Five) years without skipping a payment.