Products > Policies
1 DEFINITIONS
1.1 ADMINISTRATORS: The organization that is responsible for the Marketing, Liaison, Processing and Administration of all functions of the Scheme.
1.2 Claim: The process followed to obtain benefits in the event of a death
1.3 Cover: Funeral insurance
1.4 Group: A number of individuals who are grouped together by some entity and whose premium is derived from a calculation based on Statistics of a group.
1.5 Insurance: Funeral Insurance as stipulated in the Long-Term insurance Act. 1998 (Act No. 52 of 1998) as amended.
1.6 Member: A person insured by the Scheme.
1.7 Participant: A person who qualifies for membership of the Scheme.
1.8 Premium: A regularly payable monetary amout to enjoy the benefits of the Scheme.
1.9 Principal Member: An insurance member under whose name the insurance Policy is recorder.
1.10 Scheme: "DNCC Tombstone Scheme", "DNCC Funeral Scheme"
1.11 Subscribe: To comply with all requirements to benefit from and to become a member of the scheme.
1.12 Underwriters: The insurance Company that underwrites the insurance portfolio.
1.13 Special Case Child: The under aged brothers and sisters (under) 21 of a principal member.
2 CONTRACT
On official acceptance of an application for membership. These regular together with the Application for Membership Form constitute the Entire contract of membership. These rules are binding on all members.
3 QUALIFICATION FOR MEMBERSHIP
The following persons qualify for inclusion in the Scheme:
3.1 The Principal Member
3.2 The Principal Member's spouse of common-law spouse or such other person residing with the member who is normally regarded by the Community as the member's Spouse
3.3 The biological parents of the principal member and the member's spouse. Parents together with parents' in-law will be limited to four. No substitutions of aunts, uncles or grandparents will be made.
3.4 The principal member's unmarried children (naturallly bord or legally adopted) who, at the time of application, have not attained the age of 21 years and who are still dependent on the principal member for support and maintenance.
3.5 The principal Member's children who have attained the age of 21 years, and are full-time attending a recognized school, collage or universaty for as long as they are attending such school, collage or university as full time students, and are financially fully dependent on the principal member until they have reached the age of 25 years.
3.6 Should the principal member have more than one spouse, the additional spouse may be covered as an extended member or under a separate policy.
3.7 Should the principal members spouse die or should the member get divorced any subsequently remarry Then subject to par. 5, the new spouse may be included provided such nomination is made in writing by prepaid registared post within 30 days of the date of marriage. Failure to comply with this requirement will result in the ne spouse and parents not participating in the scheme.
3.8 New participants, including guardians and peers may be nominated for inclusion in the scheme subject to par. 5 and provide that such nomination of the new participant is made in writing by prepaid registered post.
3.9 Newborn children are automatically included but details as to their names, date of birth, gender and other information prescibed by the administrator from time to time much be given by prepaid registered post within 30 days of their date of birth.
3.10 The onus to ensure that all participants are properly subscribed and recorded with the administrator rest entirely with the member and the member cannot hold the scheme responsible for any ommissions.
3.11 Changes of benefits and members can be effected on application and are subject to par. 5.
3.12 Membership pf a person is limited to one policy.
3.13 An existing member cannot be added as a child or a parent or any other person to another person's policy.
3.14 Should the event contemplate in par.3.13 occur then the cover with the best benefits, in the opinion of the administrator, will apply.
4 TYPES OF MEMBERSHIP
4.1 Membership can be voluntary or compulsory and is open to all races and al genders .To become a Principal member the applicant must be over the age of 18 years and under the age of 80 year.An extended member of the principal member may not exceed the age of 80
7 CESSATION AND TERMINATION
7.1 Membership is dependent upon the regular payment of monthly premiums which are due and payable on the first day of each month in advance. The onus to effect payment of these premiums rest on the member and failure to effect payment in time will result in the termination of membership subject to par.7.2.
7.2 Subject to the discretion of the administrator, membership shall remain in full force and effect for a period of one month if a premium is not paid on the date it falls due. Should the premium then still be unpaid, membership shall terminate immediately and all benefits shall be void and al monies previously paid to the scheme by or on behalf of the member shall be forfeited. No responsibility rest on the administrator of the scheme to notify the member or any insured of the termination of membership.
7.3 In the case of family insurance the cover of children who have attained the age of 21(twenty one) years ceases.
8 SPECIAL CONDITIONS AND MITIGATION FACTORS.
8.1 Should membership have terminated in terms of par.7 and within 30 days of such termination, it is found prevented from paying the subscription, then the policy will remain in effect and the cessation of provided that the membership as par.7 shall not come into effect premiums are paid immediately.
8.2 A child who has reached the age of 21 years as indicated in par.7.3 and who is incapacitated by mental or infirmity and is wholly dependent on the principal member for support and maintenance shall retain membership of the scheme up to the age of 25 years.
8.3 Special Case Child: If a principal member wishes to insure his minor brothers/sisters (under the age of 21) these members will be considered special case children and the premium will be calculated at 30% (thirty percent) of the rate of an extended member.
10 RESTRICTIONS
10.1 Notwithstanding anything to the contrary contained in these rules no benefit will be payable if the death of the principal member or any of the members nominated participants occurs as a direct result of or due to the deceased’s committing any of the following; suicide, participation in any form or act of terrorism, illegal strike, political, dangerous sport, civil disobedience, or any unlawful act.
10.2 Any member aged 55years or older at the time of application may not automatically nominate parents or parents in law.
10.3 If a members spouse dies, the parents in –law will remain members of the scheme. In the event that such a member remarries, the former parent’s in-law shall retain membership unless the member nominates their substitution in writing by prepaid registered post within 30 days of the date of remarriage or the member nominates the new parents in law additionally.
10.4 Only persons who are healthy and are not infected with or carry one or more serious or terminal illness/as or disease/as at the time of joining will qualify for inclusion in the scheme.
10.5 Only properly nominated participants of the principal member who are recorded as such by the administrator are included in the scheme.
10.6 New benefits or any change in members or benefits will commence subject to the waiting periods stipulated in par.5.
10.7 No claims in respect of benefits will be contemplated unless notification of death is given within 90 days of death.
10.8 No claim in respect of benefits will be recognized, even in the event that notification of death is given
timorously, but any outstanding documentation or information requested from the member has not been successfully received within 90 days from the date of notification of the death, by the administrators of the scheme.
10.9 Except as provided in par. 8.1 and notwithstanding anything to the contrary and not with standing par 7.2 specifically, no benefits shall be payable if the member’s subscription shall have been unpaid at the date of death.
10.10 If a child as stipulated in par.8.2 and par. 3.5 is older than 25 years the benefits will not be paid.
10.11 If a member exceeds the age of 65 years his benefits may not exceed R3000.00.
11 BENEFICIARY OF BENEFITS IN A MOMENTARY FORM
11.1 In the event that the premium is paid to an instance other than the principal member then the benefits shall be paid to the instance as follows:
11.1.1 To the payer of the premium or,
11.2 In the event of death of the principal member the benefits shall be paid to:
11.2.1 The members most senior nominated spouse or;
11.2.2 In the absence of such a nomination to the eldest nominated child of the member or;
11.2.3 In the absence of a nominated child to the member’s estate
11.3 To any other suitable instance as decided by the administrator taking the prevailing circumstances into account.
12 REQUIREMENTS FOR OBTAINING BENEFITS
Proof of identity and relationship of the deceased to the principal member in a form satisfactory to the administrator
12.2 The original death certificate stating the cause of death. If no cause of death could be ascertained the claim will not be approved.
12.3 In the event of a claim in respect of a child over the age of 21 who was a full time student, in addition to the usual documentation’s certificate signed by the principal of the educational institution which the child attended until the date of the Childs death stating that the child was a full time student at the date of the Childs death.
12.4 In the event of a claim in respect of a child over the age of 21 who was incapacitated by mental or physical infirmity and financially totally dependent on the principal member a declaration from a medical practitioner setting out the nature of the infirmity of the child during the period from his 21 st birthday to the date of his eath if the death occurs before the age of 25.
12.5 The completion of all claim forms as by the administrator from time to time.
12.6 The submission of any special documentation to facilitate the processing of the claim.
13 PROOF OF PAYMENT
13.1 Only a deposit into the administrator’s bank account is valid proof of payment
13.2 All premiums paid in advance or otherwise are non- refundable
13.3 For purposes of these rules the date of payment is the day the payment was received by the administrator
14 DETERMINING AMOUNT OF PREMIUM
14.1 The monthly premium shall be determined at the time of;
14.1.1 Joining; or
14.1.2 Changing of plans or
14.1.3 Changing of benefits or
14.1.4 Changing of members or
14.1.5 From time to time as determined by the administrator or the underwriters of the scheme to ensure the financial soundness of the scheme
14.2 The monthly premium will not be reduced upon the death of a participant but alternative members may be nominated
15 GENERAL ALTERATION OF BENEFITS AND PREMIUMS
15.1 At the sole discretion of the administrators of the scheme, ex-gratia consideration may be entertained. Such benefits will be made as tokens of goodwill and be without prejudice.
15.2 The administrators of the scheme have the right without prior notice being given thru to members to, alter, add to, amend, vary, limit or suspend any or all of the rules or benefits set out hereon should such opinion of the administrators, the legal advisor or the actuary of the underwriter be found necessary for the ongoing protection of the scheme and for the benefits of the members.
16 GENERAL
16.1 The administrator has the right to revise the monthly premiums from time to time should this be found to be necessary in the opinion of the administrator, the legal advisor or the actuary of the underwriter for the ongoing protection of the scheme and for the benefits of the members.
16.2 In the event that an increase in premiums occurs which the client does not accept, a reduction in benefits will apply to such an extent that it is equal to the percentage to the premium increase.
16.3 Should a client elect to take up the increase in premium referred to in 13.1 later than 30 days after the inception of the premium increase, in order to restore the benefits to the original status, a waiting period as stipulated in par 5 will apply to the increase of benefits
16.4 In order to protect the scheme or to improve the benefits of the members, the administrator has the right to change the underwriter from time to time.
16.5 The members will be advised timorously of such a change of underwriters
16.6 Should no written communication be received from the members within 30 days of such notification indicating disapproval of the change, then the change of underwriter will be considered as accepted and approved by the member.
16.7 Should written communication as indicated in par.13.11.2 be received by the administrator within the indicated time then the change of that members underwriting will not be effected.
16.8 An extended member cannot be insured for an amount exceeding the insured amount of the principal member.
16.9 Notwithstanding the stipulation in par 16.8, members exceeding the age of 65 cannot be insured for an amount in excess of R5000.
17 CONFLICT
In the event that there is conflict between any section of the general rules and an agreement/contract, then the stipulations in the general rules will apply unless specifically indicated to the contrary in the contract/agreement
18 CLAIMS RATIO
Should the monthly claims ratio, being the claims amount divided by the premium amount of a policy or a group exceed 65% then, and without further notice, the premium will with immediate effect increased or the decreased or both, for the protection of the scheme.
UNDERWRITTEN BY AN AUTHORISED INSURANCE COMPANY AS STIPULATED IN THE LONG TERM INSURANCE ACT NO.52 OF 1998 AS AMENDED.
CONTACT DETAILS
NAME:
DNCC TOMBSTONE &FUNERAL SCHEME
ADDRESS:
8 KROKODILDRIFT AVENUE
BRITS
POSTAL:
PO Box 2345
Brits
0250
TEL NO:
012 250 3120
FAX NO:
012 250 3121
E-MAIL:
jackietrade@telkomsa.net
CLAIMS MANAGER:
JACKIE VAN VUUREN
F.S.P NO.
36673
In the event of a complaint that cannot be resolved by the insurer and the financial administrator the following
1
Financial Service Board Tel no: 015 781 6913
2
Ombudsman for long term insurance Tel no: 086 101 3236