Insurance is subject to the Insurer accepting, at its own discretion, the application made herein by the applicant & proposed Principal Insured.
The Contract Term of the Policy is monthly, and both the policyholder and the Insurer can cancel the policy within 31days written notification. Upon renewal of the Policy, no new waiting period will apply, subject to the insured having a previous policy at least 31 days before.
For death due to Natural Causes or Suicide the Waiting Period will start from the entry date. The Waiting Period will not apply to accidental death. When a new Life Assured is added to the Policy, all Waiting Periods will apply to the new Life Assured. If you increase a benefit, Waiting Period will apply to the amount by which the benefit is increased. The premiums are payable during the Waiting Period for the Benefits.
Death as a result of an accident is covered from the Acceptance Date of the Policy provided the first premium is received.
If the first premium is received before the 7th of the month, the effective entry date will be on the first of the current month. If received after the 7th the effective entry date will be the 1st of the following month.
In the event of the Replacement of Policies, no Waiting Period will be imposed, provided that: the Policyholder had a previous policy with another insurer at least 31 (thirty-one) days before entering into this new policy; the Policyholder had completed the Waiting Period in respect of the previous policy; the policy benefits under the previous policy provided cover in respect of similar risks related to the same lives assured as those covered under this new policy. Should you not have completed the Waiting Period under the previous policy, a Waiting Period equal to the unexpired balance of the Waiting Period under the previous policy will apply.
Claims are processed within 2 (two) business days after receipt of all required claim documents (see Claims Procedure).
Spouse and Dependent Children's cover are as per the cover page under the Direct Family Plan section and varies according to the plan selected.
Dependent children will be covered until aged 21 last birthday and if the dependent child is a full-time student, he/she will enjoy cover until the age of 25 last birthday.
The Extended Family cover has four different options. Under each option the total cover amount is divided among the total number of extended family members covered to determine each extended member's cover amount. E.g. Platinum Option with R20 000 total cover and 10 extended family members= R2 000 cover per extended family member.
Cover is afforded on a month-to-month basis. Premiums are payable monthly. A premium received in a particular month provides cover for that month. No reserves are built up under the plan, therefore premiums are payable lifelong and there are no surrender values when cover ceases. The Policy never becomes paid up and no loans can be made against the Policy. Premiums do not decrease if a Life Assured passes away. The policy may not be ceded.
Policies will lapse after 2 consecutive payments was missed and the Policyholder fails to remedy the situation within 15 days from the date the premium becomes due (the grace period). Notice of outstanding premiums and the lapse of the policy will be sent to the Policyholder. Once the Policy has lapsed, no benefits will be in place. Upon re-instatement, no Waiting Period will be imposed, provided that: the Re-instatement Date is not more than 2 (two) months from the Lapse Date; the Policyholder had completed the Waiting Period in respect of the lapsed policy; the policy benefits under the lapsed policy provided cover in respect of similar risks related to the same lives assured. Should you not have completed the Waiting Period under the lapsed policy, a Waiting Period equal to the unexpired balance of the Waiting Period under the lapsed policy will apply. The remaining Rules, Terms, Conditions and Provisions of the reinstated policy will be the same as the original (lapsed) policy.
Claims will not be paid where such a claim arises from any condition or event directly or indirectly from or traceable to: participation in any act of war, military action, riot or unlawful strike, insurrection civil commotion, usurpation of power, martial law, terrorism and any usage of nuclear, chemical and biological weapons, device or agent. Or traceable to a disease, epidemic, pandemic. An act of government. Any act or deed by the Principal Insured deliberately committed in violation of any law as well as any other insured person under the Policy including but not limited to a minor child, where his/her parent and/or legal guardian knowingly allows such child to participate in any act which constitutes a violation of any law. Self-inflicted injury or self-inflicted illness, whether intended or not, or voluntary exposure to danger or obvious risk of injury. Any injury or disease which is caused partly by the actions or omissions of the insured, but in conjunction with the action or omission of some other party of some other contributory factor, will fall outside the ambit of the above exclusion.
Should due premiums not have been paid, any outstanding premiums shall be deducted at claim stage, provided that the policy is still active.
No one life assured may have insurance cover exceeding R30 000 (thirty thousand Rand) with EAP Financial Services (Pty) Ltd. Cover for a life assured in excess of R30 000 (thirty thousand Rand) will require 2 (two) or more application forms to be completed in full.
EAP Financial Services (Pty) Ltd who is an authorized juristic representative of EAP Financial Services (Pty) Ltd reserves the right to reassess the premium, terms, conditions, or provisions together with the Insurer and with its Actuary in order to keep the product actuarially sound in terms of the insurance Act (18 of 2017) and the Policyholder Protection Rules.
Failure to lodge a claim within 6 (six) months of the date of death will render the claim null and void.
The Principle Insured has the opportunity to cancel this policy (cooling-off period), providing no benefit has been paid or claimed within a period of 31 days after receipt of the policy schedule.