Founding Affidavit and Annexures

Provisionsof the existingBurialBenefitRegulations ("BBR") 6.,9. andSchedule 2Claims Noperson shallhavea claim except for: (i) aBeneficiaryon deathof aMember inGood Standing; (ii) aMember inGood StandingonDeathof aDependent; (iii) aMember inGood Standing in respectof a Stillbirthof aMember inGood Standing; and (iv) aBeneficiaryon thedeathof aPaid-up Dependent. No claim shallbe consideredby theTrustunless aMember orBeneficiaryhas submitted the relevantdocumentswithin a12monthperiod. The liabilityof theTrust in termsof theBBR shallbe limited topaymentof aBurialBenefit (a) The claim ispaidby theTrustonceapproved. TheTrust shallonlypaya singleBurialBenefitondeathof anAssured Life, regardlessof thenumberofClaimsmade. Thebenefits arepaidbySDMandno longer theTrust Thebenefits arepaid bySDMandno longer theTrust Claims shallbemadebyaMemberorBeneficiarywithin12 months Claimsmustbe submitted to SDMor its authorisedagentat aKganya InsuranceAdministrators ServiceCentreor any designatedofficeof SDM. MembersorBeneficiariesmust submit the following documentation: (i) theClaim Form signedby the church committeeof theMember'sChurch; (ii) the IDof the Member; (iii)MembershipBook; (iv)originaldeath certificateof theAssured Life; (v) confirmationofbank account TheMemberorBeneficiarymust submit the following additionaldocuments: Where theAssured Life is aDependantor aPaid-up Dependant: (i) theoriginal IDorbirth certificateof such DependantorPaid-upDependant; (ii)Where theAssured Life is aDependantor aPaid-upDependant,proof that such DependantorPaid-upDependant isorwouldbe permanentlydependenton theMemberorDeceased Memberbecauseofmental and/orphysicaldisability; (iii) Where theMember isdeceased, theoriginal identity documentof theBeneficiary; (iv)Where theAssured Life hasdiedanAccidentalDeath,proofof suchAccidental Death; (v)Anyotherdocuments requiredby theTrust to satisfy the requirementsof theseRegulations includingbut not limited to -medical confirmation in the caseof a Stillbirthandamarriage certificate,adoption certificateor otherproof sufficient to show thatanAssured Lifewho is adoptedordoesnothave the same surnameas theMember was aDependantorPaid-upDependant. Shallnotbepayable in respectofmiscarriages,abortionsor if the incorrectdocumentation is submitted Theonusofproof restson theMemberorBeneficiary to prove theywereaMember inGood Standingor a Beneficiary,or a child is aDependantof adeceased Member,or the childwas aDependantondateofdeathof theMember,orproofofAccidentalDeath 7.1Death fromaccidental causes Paidonly if aMember is aMember inGood Standingby virtueof: (i)paying theirContributionwithaDateof Payment in theMonthpreceding theMonthofDateof Death;or (ii)paymentof theirContributionwithadateof payment in theMonthofDateofDeath,provided that the DateofPayment isprior to theDateofDeath. 7.2Death fromnatural causes Paidonly if aMember is aMember inGood Standingby virtueof: (i)paying theirContributionwithaDateof Payment ineachof the3Monthspreceding theMonthof DateofDeath; and (ii) if thememberbecameaMember within3Monthspreceding theMonthofDateofDeath, the DateofDeath is91days after theDateofPaymentof the earliestContribution. (b) 7.3 ForgivenessRule Inaccordancewith theFinancial SectorCharter and the Zimele standards, if at the time the relevanteventoccurred giving rise toa claim anyof theaboveReceiptswasnot purchasedas required in theseRegulations,aMemberwill, in certain circumstances,begranted leniencyandGood Standingwillbedeemed.Therefore,missedReceiptswillbe condoneddependingon theMember'spayment record. ThenumberofReceiptspurchasedduring completed12- monthperiods calculated retrospectively (withamaximum of six completed12-monthperiods) from themonthof deathwillbe considered.Good Standingwillbedeemed where theMemberpurchased11,22,33,44,55or66 Receipts in theprior12,24,36 ,48,60or72months. 8.Paid-upDependants WhereaBurialBenefithasbeenpaidon thedeathof a Member inGood Standing ("theDeceasedMember") each Dependantof theDeceasedMember shall,on theDateof Death,be regardedas aPaid-upDependantduring the periodbetween: (i)DateofDeathof theDeceasedMember; and (ii) thedateprior to thedate that suchpersonwould cease toqualifyas aDependant,being theageof 25 years had theDeceasedMemberbeenaliveandaMember in Good Standing. APaid-upDependantwithamental and/orphysically disabilitywhichexistedat theDateofDeathof theMember shall continue tobeaPaid-upprovided that thePaid-up Dependantwouldhavebeenpermanentlydependenton the DeceasedMemberhad theDeceasedMemberbeenalive. 11.Cancellation TheTrustmay terminate theBBR inwritingprovided that writtennotice is given to theMembers ataPaypoint. Notwithstanding such termination, theTrust shall remain liable for all claims thataroseprior to such termination. (c) Cooling-off rights This isnotprovided for in theBBR. 10.Amendments TheTrustmayamend theBBR inwriting in their sole discretionand shallhaveeffecton thedate indicated in that amendmentoron signatureby theTrust. ComplaintsProcedure This isnotprovided for in theBBR. 12.Delegationand cession TheTrustmayappointanyadministrators toperform administration services togiveeffect to theBBR.AMember maynot cededor assignany rightsordutiesunder theBBR or inaBurialBenefit. UnclaimedBenefits This isnotprovided for in theBBR. Part 1 - 19.Complaintsprocedure ThePYKContractprovides for aprocedure through whichapolicyholdermay lodgea complaintwith SDMand further informs thepolicyholdersof its right toapproach the Long-TermOmbudsman, the FAISOmbudor theFinancial SectorConduct Authority. In theeventof a complaint, sucha complaintmust bedealtwith in termsof SDM's complaints procedureapplicableat thedateof the lodgingof the complaint. 19.2A complaintmaybe lodged in the following manner: (i)By contacting SDMon (011) 359 3014or emailing gbcomplaints@sanlamsky.co.za; or the Insurer'sdulyappointedadministrator Kganya InsuranceAdministratorson telephonenumber0800 000 538or viaemail a t complaints@kganya.co.za andhave the following informationavailable:Policy number as contained in theMembershipBook (referred toasControlNumber), Identitynumberof thePolicyholder; andNatureof enquiryand/or complaint; (ii)Complaintswhich arenot resolved to thePolicyholder’s satisfactionmust firstbe referred to SDM's Legal&Compliancedepartment; (iii) Complaintswhichare stillnot resolved to the Policyholder’s satisfactionmaybe referred to SDM's arbitrator; (iv)Complaintswhichare stillnot resolvedmaybe referred to theOmbudsman for Long-term Insurance, theFAISOmbudor the Financial SectorConductAuthority. Part 1 - 20UnclaimedBenefits AnunclaimedBenefit iswhen the Insurerbecomes aware that there is aClaim for aBenefit tobepaid, but theBeneficiary cannotbe found topay theClaim. In such case, the Insurerwill start theprocessof tracing the Beneficiary. If theprocessdoesnotmatch the rightfulownerwith theBenefit, the Insurer shall repeat the tracing processwithina3 (three) year periodandagainwithin10 (ten) years if theBenefit remains unclaimed. Part 1 - 9.3 andAnnexe E ForgivenessRules In theeventofnon-paymentof aPremium if aPolicyholder, noBenefit shallbepaidunless: (i) the requirementsofPart2, clause2.3 and2.4 in relation to FuneralBenefits aremet;or (ii) theForgivenessRules canbeapplied in respectof a MissedPremium. TheForgivenessRules are informedby theprinciplesof “TreatYourCustomer Fairly”andwas formulated togranta Policyholder a concessionwhenaClaim for a FuneralBenefits orPersonalAccidentorDreadDiseaseBenefits is submitted to the Insurer.TheForgivenessRulesprovide for leniencyby considering the consistencyof thePremiumpaymenthistory of thePolicyholder (with reference tohis/herpaymentof MembershipContributions as contained in thePayment ReceiptBooklet) (i)where theClaimwouldordinarilybe declinedupon theapplicationof theprovisionsof clause8.2 ofPart I; andupon submissionof theClaim, in considering theapplicationof theForgivenessRules, thePYKContract musthavebeen in force foroneormore completed12 (twelve)Month cycles ("Periods").ThenumberofPeriods is calculatedbackwards from and including theMonthprior to theMonth inwhich the InsuredEventoccurred, toand including theMonthof the InceptionDate. In suchevent, SDM shall considerwhether thePolicyholder has the requirednumberofPremiumspaidas specified in the tableprovided for inAnnexeE for eachof thePeriods, calculated.ThePolicyholder shall therebybeallowed such numberofMissedPremiums as specified in the table setout inAnnexeR,withoutaffecting thepaymentofBenefits even whereaPremiummayhavebeenmissed. Part 2 - 6.Paid-upDependants WhereaClaim for a FuneralBenefithadbeenacceptedandpaidbySDM in theeventof the deathof aPolicyholder ("theDeceasedPolicyholder"),eachDependantChildof theDeceased Policyholder at theDateofDeath, shall: (i)qualifyas aPaid-upDependant from theDateof Deathof theDeceasedPolicyholderuntil theDependentChildno longerqualifies as a DependentChild; and (ii) entitled to coverwithoutany furtherPremiumsbeingpaid in respectof suchPaid-upDependent. Upon thedeathof aPaid-upDependant, theFuneralBenefits as applicableat thedateof deathof thePaid-upDependant,willbepaid to theBeneficiary in respectof suchPaid-up Dependant,whichBeneficiary shallbe the samepersonasnominatedby theDeceased Policyholder as aBeneficiairyprior to theDateofDeath. APaid-upDependantwithamentalorphysicaldisabilitywhich (i)ofDeathof theDeceased Policyholder;or (ii)before thedate theDependantChildno longerqualifies as aDependant Child, shall continue tobeaPaid-upDependanteven ifhe/sheno longerqualifies as a DependentChild,provided that suchPaid-upDependantwouldhavebeenpermanently dependenton theDeceasedPolicyholderhad thePolicyholderbeenalive. Upon thedeathof thePolicyholder,and for long as the cover remains in force in respectof thePaid-upDependant, theBeneficiary (whomustbeolder than18 (eighteen) yearsof age) andmeet the reqeuirements in respectofnomination,willbe thePolicyholder forpurposes of theFuneralPolicy, insofar as it relates to thePaid-UpDependant(s).This shallnotentitle theBeneficiarywithany rights to coverorBenefits in respectofhimself /herself andall rights andobligationswillbe limited insofar as relates to the cover andBenefitspayable in respectof thePaid-upDependants. For the sakeof clarity, it is recorded that cover and theFuneralBenefit forPaid-up Dependants are limited to theFuneralPolicyandwillnotbeapplicable in respectof the DreadDiseaseandPersonalAccidentPolicy. Part 1 - 16. and17.Cancellation SDMhas the right to terminate thepolicyby31days' writtennotice to thepolicyholder in theevent that: (i) any fraud is committed in respectof the conclusionand/ormaintainingof thePYKContract, orClaims submitted in termsof thePYKContract; (ii) in theeventof falseand/oruntrue representations weremade to SDM (and/or its administrator)or if material informationwasnotdisclosed thatmay affectSDM's ability toassess risk (suchas misrepresentationof theageorMembershipof the Policyholder); (iii) termination is requiredbya change in lawwhich cannotbe remedied throughan amendment; (iv) thepolicyholderno longerqualifies as aMemberof theTrust; and (v) if theTrustand/or SDM terminates thePremiumPaymentAgreement and/or its relationship forwhatever reason. This cancellation shallnotaffect (i) thebenefits payablebySDM (as approved)prior to thedateof cancellation;or (ii)Claims if the InsuredEvents occurredprior to thedateof cancellation (provided thatSDM receivesnoticeof such InsuredEventwithin 12months from theoccurenceof the Insured Event).NoBenefit shallbepayablewhere the Insured Eventoccurs after the cancellationof thePYK Contract. In theevent that thePremiumPaymentAgreement and/or relationshipbetween SDMand theTrust is cancelled for any reasonwhatsoever, thePukwana ya KganyaContractwill terminateat the same time. Part 1 - 18.Coolingoff rights Apolicyholderhas a coolingoff right for aperiodof 31days from the InceptionDate,unless aBenefithas been claimedorpaid,or an InsuredEventhas occurred ("coolingoffperiod"). If thePolicyholder elects to cancel thisPukwana yaKganyaContractas contemplated in clause18.1of thisPart I. it shallbe deemed that thePolicyholder (inhis/her capacityas a Member) similarlyexercisedhis/her cooling-off rights in termsofhis/herMembership to theKganya Benefits FundTrust,asprovided for in theMaster Regulations,whereby cover in termsof thePYK ContractandMembership to theTrustwill come to anendat the same time. ThePolicyholdermust submit such cancellation instruction to SDMor itsdulyappointed administrator,Kganya InsuranceAdministrators, provided thatnotice to the Trust for cancellationof his/herMembership, shallbedeemed toalsobe notice to SDM. Premiumspaidafter theEffectiveDate in respectof anExistingMember shallbe refunded in full to the Trustpursuant toaPolicyholder exercising the cooling-off rightsduring the coolingoffperiod in accordancewith the termsof thePremiumPayment Agreement.TheMembershipContributionwill similarlybe refunded to thePolicyholder asMember, in termsof theMasterRegulations. Part 1 - 14.Amendments SDM is entitled toamendanyprovisionof thePYK Contract (and, for theavoidanceofdoubt, the Policies formingpart thereof)bygiving31days' writtennotice to thepolicyholder.SDMmayalso amend thePYKContractas itdeemsnecessary to giveaffect toa change in lawwhich impacts the PYKContract. Anyamendmentswhich changes theBenefits payableunder thepolicywillnotaffectClaims in respectof an InsuredEvent thatoccurredprior to suchamendment. Anyamendment shallhaveeffect from thedate indicatedbySDM inanotice to thepolicyholder. Apolicyholdermayalsoamendmentany information inMPP Form and/or thePayment ReceiptBookletby (i) completing anAMPP and submitting it to SDM'sdulyappointed administrator,Kganya InsuranceAdministrators, or through theChurchBranches; and/or (ii)by calling the call centreof the Insurer'sduly appointedadministrator,Kganya Insurance Administrators. Part 1 - 21.4Delegationand cession Other thanas contemplated in clause 7.4.4ofPart IV, thePolicyor any Benefitmaynotbe cededor assigned. ReviewofChanges to theBurial / FuneralBenefitsof theKganyaBenefits FundTrust Reasons formaterialdifferences a)Amended toprovide for amended insurance scheme.Although SDM can, in termsof the current insurance scheme,exercise the rights setouthere in termsof thegrouppolicies, theexerciseof such rightsbySDMwouldnotaffect theMembersor its vested rights against theTrust,but rather the rightsof theTrust (asPolicyholder in termsof thegrouppolicy). It ishowevernecessary toprovide the insurerwith the rights includedhere in termsof the individualpolicy,and theprovisions complywith theapplicable laws. a) TheBBR imposes awaitingperiod in respectofdeathoccurringdue tonatural causes (i.e.notan accident) in that thedateofdeathmustbe91days frompaymentof the initialMembershipContribution.Thewaitingperiodof 91dayshasbeen included in thePYKContract,butprovisionhavebeenmade for reducedwaitingperiods toapply,perRule2Aof thePolicyholderProtectionRules.Thewaitingperiod is therefore i)notanew inclusionand ii) alignedwith theapplicable laws. c) See commentata) above. *To the extent anydifferencesbetween theprovisionsof the existingBurialBenefitRegulationsand theproposedPukwanayaKganyaContractshavebeen identified thatdonot adversely affect the rightsof themembers to theKganyaBenefits FundTrust, such changeshavebeenmarked inorange in the corresponding cellsbelow. **To the extent anydifferencesbetween theprovisionsof the existingBurialBenefitRegulationsand theproposedPukwanayaKganyaContractshavebeen identified thatdoadversely affect the rightsof themembers to theKganyaBenefits FundTrust, such changeshavebeenmarked in red in the corresponding cellsbelow. ***Materialdifferencesor changes indicated in red shading shallbe accompaniedby a letter referencing thematerialdifferenceor change in the leftmost columnof the table and the corresponding letter referencing suchmaterialdifferenceor changewillbe accompaniedby anexplanation for thematerialdifferenceor change. ****Capitalised termsused in this comparison shallhave themeaningascribed to them in thedocuments considered in this comparison,unless indicatedotherwise 2of 8 Provisionsof the PukwanayaKganyaContract ("PYK Contract") Part 1 - 6.1.16 and 6.1.37Claims Payableondateof deathof anAssured Life. Part 1 - 13.1.2 Claims SDMwillnotbe liable topayaClaim: (i) if the claimwasnotmade inaccordance with thePYKContractoroutside the timeperdiodsprescribed;or (ii)Where the InsuredEventoccurred: (a)prior to the InceptionDate, (b) after cancellation of thePYKContract,or (c) after cover of anAssured Life ceases;or (iii)where apremiumhasnotbeenpaid, subject to theForgivenessRulesor theWaiting Period still applies;or (iv) if anAssured Life is subject toaWaitingPeriodas provided for in termsof thePolicies, whereapplicable,and theWaiting Periodhasnot yetexpired. SDM isno longer limited topayonlya singlebenefit like itwaspreviously. Part 1 - 13.4Claims Claims shallbe settled by the Insurerby electronic funds transfer ("EFT") into thebankaccount nominatedby the Beneficiaryupon submissionof the Claim. Thenominatedbank accountmustbea bankaccountheld witha SouthAfrican bank,andpaymentwill bemade in South AfricanRands into suchbankaccount. Part 1 - 13.1.3Claims SDM reserves the right to cancel thePYKContract, repudiateaClaim anddeclare allPremiumspaidby theTrust in respectof thePolicies forfeited, should therebe evidenceof,or anattempted submissionof a fictional claim, fraudormisrepresentation which fictional claim, fraudor misrepresentationmaterially affects the Insurer's ability to assess the riskunder thePYK Contract. Part 1 - 13.2 andPart 2 - 4. Exclusionsand Limitations and 7.Claims 13.2Claimsmutsbe submitted to SDM (or itsdulyappointedadministrator,Kganya InsuranceAdministrators)by theBeneficiarywithin12months after thehappening of an InsuredEvent,whichmustbe submittedwithallClaimsDocuments Part2 - 7.1 and7.2 Claimsdocuments include: (i) theFBCN Form signedby3CommitteeMembers; (ii) theoriginalor certified copyof the IDof thepolicyholder (or theBeneficiarywhere thepolicyholder isdeceased); (iii) confirmationofmembership to theTrust, includingoriginal and/or certified copyof thePaymentReceiptBooklet to verify receipts; (iv)originalor certified copyof the death certificateof theAssured Life; (v) confirmationofbankaccount intowhich theFuneralBenefitsmustbepaid; (vi) where theAssured Life is aDependantChildor aPaid-upDependant, theoriginal identitydocumentofbirth certificate theDependantChildorPaid-upDependant; (vii)where theAssured Life is aDependantChildor aPaid-upDependantwho is25 (twenty-five) yearsorolder, theoriginalor certified copyof the identitydocument ofbirth certificate theDependantChildor thePaid-upDependantaswell asproof of themental and/orphysicaldisabilityof suchDependantChildorPaid-up Dependant; (viii)where theAssured LifehasdiedbyAccident,proofof such AccidentalDeath; and (ix) anyotherdocuments requiredbySDM from time to time includingbutnot limited tomedical confirmation in the caseof a Stillbirthanda marriage certificate,adoption certificateorotherproof sufficient to show thatan Assured Lifewho is adoptedordoesnothave the same surnameas the Policyholder is aDependantorPaid-upDependant. SDMwillnotify theBeneficiarywithin2 (two)BusinessDays after receiptof all the ClaimDocuments to the satisfactionof SDMwhether itaccepts (andauthorises paymentof theFuneralBenefit), repudiatesordisputes theClaim. Part2 - 4. SDM shallonlypay1 (one) claim for FuneralBenefitson thedeathof anAssured Life regardlessof thenumberofClaimsmade.SDM shallnotpayanyFuneral Benefit if theDeathof anunborn childwas causedby, related toor in consequence of amiscarriagewhichdoesnot constitutea Stillbirth;or anabortion. Part 1 - 13.2.2 Claims AClaimmaybe repudiatedby SDM if aClaim is madeafter12 (twelve)Months form the Insured Eventand/or if not supported withall the relevantClaims Documentation Part 1 - 13.2.3 Claims Claimsmustbe submitted to SDM or its appointed administrator, Kganya Insurance Administrators at aKganya Insurance Administrators ServiceCentre, thedetailsof which canbe foundon the websiteofKganya Insurance Administrator at https://mykganya. comor any designatedoffice of SDM. Part 1 - 13.3Claims Ifdisputedor rejected, SDMwill giveanoticeof such rejection settingout the reasons.The Beneficiarymaymake representationswithin90days regarding thisdecision.Failure tomake representationswill result in SDMnotbeing liable to payaClaim. If theBeneficiarymakes representations to SDMwill, SDM shall inform theBeneficiary of itsdecisionwithin45days after receiving representations. All claims are timebarredafter aperiodof 12months tobe heard in court inorder to determineSDM's liability.This periodwillbe suspended for90 daysduringwhich the Beneficiary canmake representations andprovided that theBeneficiary shall atall timeshaveat least6months after this90dayperiod to institute courtproceedings. Part 2 - 2.3 FuneralBenefits in the eventofAccidental Death FuneralBenefits in respectof anAssured Lifewillonlybe paidon thehappeningof an AccidentalDeath if 1 Premium is recordedbySDM (or itsdulyappointed administrator,Kganya InsuranceAdministrators) (i) withaDateofPayment in the Monthpreceding theMonth inwhichDateofDeath occurred,or (ii)withaDateof Payment in theMonthof Death,butbeforeDateof Death. AllPremiums recordedby the Insurer shallbepaid to SDM in accordancewith the termsof thePremiumPayment Agreement. Part 2 - 3.WaitingPeriod Benefitpayments are subject toawaitingperiodof 91days, calculated from the InceptionDate,whichwillnotapply in instanceswhere: (i) an InsuredEvent occurs as a resultof anAccident; (ii) thepolicyholder confirms that the policyholder andallAssured Liveswere covered in termsof another funeralpolicy thathad lapsedorhadbeen terminatedor cancelled withanother insurer,which previouspolicywas in forceat least31daysbefore the InceptionDate; (iii) the policyholder confirms that thepreviouspolicyprovided cover for similar risks covered in termsof this FuneralPolicyand for the sameAssured Lives; and (iv) the previouspolicy imposedaWaitingPeriod shorter than91 (ninety-onedays), whichhadbeen completed in full;or (v)thepreviouspolicy imposedaWaitingPeriodof 91 (ninety-one)daysor longer, ofwhich91 (ninety-one)dayshadbeen completed. No FuneralBenefitswillbepaid in theevent that the InsuredEventoccurswithin theWaitingPeriod. TheWaitingPeriod canbe reduced if thepreviouspolicy imposedaWaiting Periodof 91 (ninety-one)daysor longer,andat least 91daysof theprevious policyhadnotbeen completed in full and risk coveredunder thatpreviouspolicy were the same. To theextent that (i) thePolicyholderdoesnotgive such confirmation,or (ii) SDM cannot verify the correctnessof such confirmation, then aWaitingPeriodof 91 (ninetyone)dayswillbeapplied. Inorder for SDM to reduce theWaitingPeriodand/or for theWaitingPeriodnot toapply, thePolicyholdermustprovide confirmationof thepreviouspolicy, in the form andmanner as the Insurermay request.To theextent that (i) the Policyholderdoesnotgive such confirmation,or (ii) the Insurer cannot verify the correctnessof such confirmation, thenaWaitingPeriodof 91 (ninetyone)days willbeapplied. Confirmation for thepreviouspolicy is consideredbySDM tobematerial to the assessmentof the risk in termsof thisPolicy. Part 2 - 2.4. FuneralBenefits in the eventofdeathdue to natural causes FuneralBenefits in respectof an Assured Lifewillonlybepaidon thehappeningof thedeathof anAssured Lifedue tonatural causes if: (i) SDM (or itsduly appointedadministrator, Kganya Insurance Administrators) recordeda Premium in respectof the Assured LifewithDatesof Payment ineachof the3 consecutiveMonthspreceding theMonth inwhich theDateof Deathoccurred; and (ii) the Dateof theDeath is91days after the InceptionDate in respectof thePolicyholder, being theWaitingPeriod. AllPremiums recordedbySDM (or itsdulyappointed administrator,Kganya Insurance Administrators) shallbepaid to the Insurer inaccordancewith the termsof thePremium PaymentAgreement.