FAIS & POPIA Disclosure

3 20. Please note that no employee of KIA is mandated to provide you with any form of financial advice during the claims process. Such employees conduct clerical administrative duties only and may not exercise any judgement in their dealings with you. KIA Service Centre Managers and Claims Clerks, where applicable, may therefore only provide you with information relating to the submission and outcomes of your claim. DECLARATION IN TERMS OF THE PROTECTION OF PERSONAL INFORMATION ACT PUKWANA YA KGANYA In order for your claim to be assessed, Kganya Insurance Administrators (Pty) LTD (RF) (KIA) as intermediary is required to collect, use and hold the personal information you provide. In terms of the Protection of Personal Information Act, No. 4 of 2013 (POPIA), KIA requires your consent before it can collect, use or share the personal information you provide in order to assess your claim. In the event that you do not consent to KIA collecting and handling this information, KIA will be unable to process your claim. KIA respects your privacy and processes your personal information as set out in our privacy statement. The privacy statement can be found in the Pukwana ya Kganya membership book annexure or on Kganya’s website at www.mykganya.com . By signing this declaration, you authorise KIA, subject to applicable law, to use and store and to disclose, transfer, obtain or exchange the personal information you supply with all such persons as KIAmay consider necessary in order to provide you with the benefits and services requested. This specifically includes: • Consenting to KIA collecting, using, and storing the personal information you provide for the sole purpose of facilitating your claim and aiding in KIA’s compliance with applicable legislation. KIA, as an accountable institution, has a duty to comply with its obligations in terms of the Financial Intelligence Centre Act. To do so KIA must obtain, use, and further process certain personal information and special personal information. • Consenting to KIA collecting, using, and storing any health information you provide for the sole purpose of facilitating your claim and aiding in KIA’s compliance with applicable legislation. Information about your health is regarded as ‘special personal information’ for the purposes of POPIA. KIA requires your consent before it can collect, use or share your special personal information. • Consenting to KIA collecting, using, and storing any information relating to children that you have provided, the sole purpose of which is the facilitation of your claim and aiding in KIA’s compliance with applicable legislation. Information about children is regarded as ‘special personal information’ for the purposes of POPIA. KIA requires your consent as legal custodian before it can collect, use or share this special personal information.