Founding Affidavit and Annexures

Provisionsof theexistingDreadDiseaseRegulations ("DDR") 5of8 7.,9.,10. and Schedule2Claims Memberswhohavecontracted,experiencedor suffereda DreadDiseasewillbeentitled to submita claim. No claim shallbeconsideredby theTrustunlessaMemberhas submitted the relevantdocumentswithina12monthperiod afterDateofDreadDisease.TheClaimmustalsobenotified within this12monthperiod. (a) Theclaim ispaidby theTrustonceapproved. TheTrust shallonlypaya singleBenefitAmount regardlessof thenumberofClaimsmade. Claims shallbemadebyaMemberwithin12months fromDate ofDreadDisease. Claimsmustbe submitted toSDMor itsauthorisedagentata Kganya InsuranceAdministratorsServiceCentreorany designatedofficeofSDM. Membersmust submit the followingdocumentation: (i) the Claim Form signedby thechurch committeeof theMember's Church; (ii) the IDof theMember; (iii)MembershipBook; (iv) theDreadDiseaseReport; (v) confirmationofbankaccount;and (vi)anyotherdocuments requiredby theTrust (andas determinedby theTrust from time to timeandas setout in the Schedule to theDDR). Shallnotbepayablewhere (i) theMemberdies (whetherasa resultof theDreadDiseaseorotherwise)prior to thedateon whichaClaim is submitted;and (ii) theTrust shallhaveno liability in respectofClaims submitted to theTrustafter the deathof suchMemberwherenoClaimhasbeen submitted prior to thatdeath. 8.1Member inGood Standing AMember inGoodStanding shallbeaMemberwho: (i)paid ContributionswithaDateofPayment ineachof the3 consecutiveMonthspreceding theMonth inwhich theDateof DreadDiseaseoccurred;and (ii) if thememberbecamea Memberwithin3Monthspreceding theMonth inwhich the DateofDreadDiseaseoccurred, theDateofDreadDisease isat least91daysafter theDateofPaymentof theearliest Contribution. (b) 8.2 ForgivenessRule Inaccordancewith theFinancialSectorCharterand theZimele standards, ifat the time the relevanteventoccurredgiving rise toa claimanyof theaboveReceiptswasnotpurchasedas required in theseRegulations,aMemberwill, in certain circumstances,begranted leniencyandGoodStandingwillbe deemed.Therefore,missedReceiptswillbecondoned dependingon theMember'spayment record. ThenumberofReceiptspurchasedduring completed12-month periods calculated retrospectively (withamaximumof six completed12-monthperiods) from themonthofdeathwillbe considered.GoodStandingwillbedeemedwhere theMember purchased11,22,33,44,55or66Receipts in theprior12,24, 36 ,48,60or72months. 12.Cancellation TheTrustmay terminate theDDR inwritingprovided that writtennotice isgiven to theMembersataPaypoint. Notwithstanding such termination, theTrust shall remain liable forall claims thataroseprior to such termination. (c) Cooling-off rights This isnotprovided for in theDDR. 11.Amendments TheTrustmayamend theDDR inwriting in their solediscretion and shallhaveeffecton thedate indicated in thatamendment oron signatureby theTrust. ComplaintsProcedure This isnotprovided for in theDDR. 13.Delegationand cession TheTrustmayappointanyadministrators toperform administration services togiveeffect to theDDR.AMember maynot cededorassignany rightsordutiesunder theDDRor in aDreadDiseaseBenefit. UnclaimedBenefits This isnotprovided for in theDDR. Review of Changes to the Dread Disease Benefits of the Kganya Benefits Fund Trust Reasons formaterialdifferences a)Amended toprovide foramended insurance scheme.AlthoughSDM can, in termsof thecurrent insurance scheme,exercise the rights setouthere in termsof thegrouppolicies, theexerciseof such rightsbySDMwouldnotaffect theMembersor its vested rightsagainst 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. b) TheDDRs imposeawaitingperiod in respectofanydreaddisease in that thedateofdreaddiseasemustbe91days frompaymentof the initialMembershipContribution.Thewaitingperiodof91dayshasbeen included in thePYKContract. c)Refer tocommentundera)above *To theextentanydifferencesbetween theprovisionsof theexistingDreadDiseaseRegulationsand theproposedPukwanayaKganyaContractshavebeen identified thatdonotadverselyaffect the rightsof themembers to theKganyaBenefitsFundTrust, such changeshavebeenmarked inorange in the corresponding cellsbelow. **To theextentanydifferencesbetween theprovisionsof theexistingDreadDiseaseRegulationsand theproposedPukwanayaKganyaContractshavebeen identified thatdoadverselyaffect the rightsof themembers to theKganyaBenefitsFundTrust, such changeshavebeenmarked in red in the corresponding cellsbelow. ***Materialdifferencesor changes indicated in red shading shallbeaccompaniedbya letter referencing thematerialdifferenceor change in the leftmost columnof the tableand the corresponding letter referencing suchmaterialdifferenceor changewillbeaccompaniedbyanexplanation for thematerialdifferenceor change. ****Capitalised termsused in this comparison shallhave themeaningascribed to them in thedocuments considered in this comparison,unless indicatedotherwise Provisionsof thePukwanayaKganyaContract ("PYK Contract") Part1 -6.1.17and 6.1.22andPart3 - 2andAnnexeC. Determinationof dreaddisease benefit Payableon the contraction, experienceor sufferingofaDread Diseasebyan Policyholderas Assured Lifeandas diagnosedbya MedicalPractitioner as setout ina MedicalReport Part1 -13.1.2 Claims SDMwillnotbe liable topaya Claim: (i) if theclaimwasnotmade inaccordancewith thePYK Contractoroutside the time perdiodsprescribed;or (ii)Where the InsuredEventoccurred: (a) prior to the InceptionDate, (b)after cancellationof thePYKContract,or (c) after coverofanAssured Life ceases;or (iii)whereapremiumhas notbeenpaid, subject to the ForgivenessRulesor theWaiting Period stillapplies;or (iv) ifan Assured Life is subject toaWaiting Periodasprovided for in termsof thePolicies,whereapplicableand theWaitingPeriodhasnotyet expired. Part1 -13.4Claims Claims shallbe settled by the Insurerby electronic funds transfer ("EFT") into thebankaccount nominatedby the Beneficiaryupon submissionof the Claim. Thenominatedbank accountmustbea bankaccountheld withaSouthAfrican bank,andpayment willbemade inSouth AfricanRands into suchbankaccount. Part1 -13.1.3Claims SDM reserves the right to cancel thePYKContract, repudiateaClaimanddeclare allPremiumspaidby theTrust in respectof thePolicies forfeited, should therebe evidenceof,oranattempted submissionofa fictional claim, fraudormisrepresentation which fictional claim, fraudor misrepresentationmaterially affects the Insurer'sability to assess the riskunder thePYK Contract. Part1 -13.2andPart3 -6Claims Part1 -13.2 Claimsmusbe submitted toSDM (or its dulyappointedadministrator,Kganya InsuranceAdministrators)by the Beneficiarywithin12monthsafter the happeningofan InsuredEvent,which mustbe submittedwithallClaims Documents. Part3 -7.1and7.2 ClaimsDocuments include: (i) theDDCN Form signedby3CommitteeMembers and supportedby suchdocumentsas set out in theDreadDisease claims form; (ii) originalor certified IDof the policyholder; (iii) confirmationof membership to theTrust, including originaland/or certified copyof the PaymentReceiptBookletvtoverify Receipts; (iv)originalor certified copyof theMedicalReport; (v) confirmationof bankaccount;and (vi)anyother documents requiredbySDM. Part1 -13.2.2 Claims AClaimmaybe repudiatedby SDM ifaClaim is madeafter12 (twelve)Months form the Insured Eventand/or if not supported withall the relevantClaims Documentation Part1 -13.2.3Claims Claimsmustbe submitted toSDMor itsappointed administrator,Kganya Insurance Administratorsata Kganya Insurance AdministratorsService Centre, thedetailsof which canbe foundon thewebsiteofKganya Insurance Administratorat https://mykganya.co moranydesignated officeofSDM. Part1 -13.3Claims Ifdisputedor rejected, SDMwillgivea noticeof such rejection settingout the reasons.TheBeneficiarymaymake representationswithin90days regarding thisdecision. Failure tomake representationswill result inSDMnot being liable topayaClaim. If theBeneficiarymakes representations toSDMwill,SDM shall inform theBeneficiaryof itsdecision within45daysafter receiving representations. All claimsare timebarredaftera periodof12months tobeheard in court inorder todetermineSDM's liability.Thisperiodwillbe suspended for90daysduringwhich the Beneficiary canmake representations andprovided that theBeneficiary shall atall timeshaveat least6monthsafter this90dayperiod to institute court proceedings. Part3 -3.6.Exclusionsand5. Exclusionsand Limitations SDM shallnotpayanyDreadDisease Benefit if thePolicyholderdies (whetherasa resultof the Insured Eventorany causewhatsoever)prior to thedateonwhich theclaim fora DreadDiseaseBenefit is submitted. In theevent thatSDM acceptsa claim forDreadDiseaseBenefits,and the Policyholderdies,SDM shallmake paymentof theDreadDiseaseBenefit to theBeneficiaryas contemplated in theFuneralPolicy, inaddition toany Claimspayable in termsof theFuneral Policy . Theexclusionsand limitationsapplied by the Insurer in respectof theDread DiseaseBenefits in termsof thisDread DiseaseandPersonalAccidentPolicy are indicated inAnnexeC Part3 -3.4.Member inGood Standing Thebenefit isonlypaidon the occurrenceofaDreadDisease if (i)SDMor itsdulyappointed administrator,Kganya Insurance Administrators, recordeda Premium in respectof the PolicyholderwithDatesof Payment ineachof the3 consecutiveMonthspreceding theMonth inwhich theDateof DreadDiseaseoccurred;and (ii) theDateofDreadDisease is91 (ninetyone)daysafter the InceptionDate in respectof the Policyholder,being theWaiting Period. AllPremiums recordedby the Insurer shallbepaid to the Insurer inaccordancewith the termsof thePremiumPayment Agreement. Part3 -4. WaitingPeriod Benefitpayments are subject toa waitingperiodof 91days, calculated from the Inception Date. NoDread DiseaseBenefits willbepaid in the event that the InsuredEvent occurswithin the WaitingPeriod Part1 -21.4Delegationand cession Other thanas contemplated in clause7.4.4ofPart IV, thePolicy oranyBenefitmaynotbe ceded orassigned. Part1 -20UnclaimedBenefits AnunclaimedBenefit iswhen the Insurerbecomesaware that there isaClaim foraBenefit to bepaid,but theBeneficiary cannotbe found topay the Claim. In suchcase, the Insurerwill start theprocessof tracing the Beneficiary. If theprocessdoesnotmatch the rightfulownerwith the Benefit, the Insurer shall repeat the tracingprocesswithina3 (three)yearperiodandagain within10 (ten)years if the Benefit remainsunclaimed. Part1 -9.3andAnnexeEForgivenessRules In theeventofnon-paymentofaPremium ifaPolicyholder,no Benefit shallbepaidunless: (i) the requirementsofPart2, clause2.3and2.4 in relation toFuneralBenefitsaremet;or (ii) theForgivenessRules canbeapplied in respectofaMissed Premium. TheForgivenessRulesare informedby theprinciplesof“Treat YourCustomerFairly”andwas formulated togranta Policyholdera concessionwhenaClaim fora FuneralBenefits orPersonalAccidentorDreadDiseaseBenefits is submitted to the Insurer.TheForgivenessRulesprovide for leniencyby considering theconsistencyof thePremiumpaymenthistoryof thePolicyholder (with reference tohis/herpaymentof MembershipContributionsas contained in thePayment ReceiptBooklet) (i)where theClaimwouldordinarilybe declinedupon theapplicationof theprovisionsof clause8.2of Part I;andupon submissionof theClaim, in considering the applicationof theForgivenessRules, thePYKContractmust havebeen in force foroneormorecompleted12 (twelve) Monthcycles ("Periods").ThenumberofPeriods is calculated backwards fromand including theMonthprior to theMonth in which the InsuredEventoccurred, toand including theMonth of the InceptionDate. In suchevent, SDM shall considerwhether thePolicyholderhas the requirednumberofPremiumspaidas specified in the table provided for inAnnexeE foreachof thePeriods, calculated. ThePolicyholder shall therebybeallowed suchnumberof MissedPremiumsas specified in the table setout inAnnexeR, withoutaffecting thepaymentofBenefitsevenwherea Premiummayhavebeenmissed. Part1 -16.and17.Cancellation SDMhas the right to terminate thepolicyby31days' writtennotice to thepolicyholder in theevent that: (i) any fraud is committed in respectof theconclusion and/ormaintainingof thePYKContract,orClaims submitted in termsof thePYKContract; (ii) in theevent of falseand/oruntrue representationsweremade to SDM (and/or itsadministrator)or ifmaterial information wasnotdisclosed thatmayaffectSDM'sability toassess risk (suchasmisrepresentationof theageor Membershipof thePolicyholder); (iii) termination is requiredbya change in lawwhich cannotbe remedied throughanamendment; (iv) thepolicyholderno longer qualifiesasaMemberof theTrust;and (v) if theTrust and/or SDM terminates thePremiumPayment Agreementand/or its relationship forwhatever reason This cancellation shallnotaffect (i) thebenefitspayable bySDM (asapproved)prior to thedateofcancellation;or (ii)Claims if the InsuredEventsoccurredprior to thedate ofcancellation (provided thatSDM receivesnoticeof such InsuredEventwithin12months from theoccurence of the InsuredEvent).NoBenefit shallbepayablewhere the InsuredEventoccursafter thecancellationof thePYK Contract. In theevent that thePremiumPaymentAgreement and/or relationshipbetweenSDM and theTrust is cancelled forany reasonwhatsoever, thePukwana ya KganyaContractwill terminateat the same time. Part1 -18.Coolingoff rights Apolicyholderhasa coolingoff right foraperiodof 31days from the InceptionDate,unlessaBenefithas been claimedorpaid,oran InsuredEventhas occurred ("coolingoffperiod"). If thePolicyholder elects to cancel thisPukwana yaKganyaContractas contemplated in clause18.1of thisPart I. it shallbe deemed that thePolicyholder (inhis/her capacityas aMember)In suchanevent, it shallbedeemed that theMember similarlyexercisedhis/her cooling-off rights in termsofhis/herMembership to theKganya BenefitsFundTrust,asprovided for in theMaster Regulations,whereby cover in termsof thePYK ContractandMembership to theTrustwill come to anendat the same time. ThePolicyholdermust submit such cancellation instruction toSDMor itsdulyappointed administrator,Kganya InsuranceAdministrators, provided thatnotice to the Trust for cancellationof his/herMembership, shallbedeemed toalsobe notice toSDM. Premiumspaidafter theEffectiveDate in respectof anExistingMember shallbe refunded in full to the Trustpursuant toaPolicyholderexercising the cooling-off rightsduring thecoolingoffperiod in accordancewith the termsof thePremiumPayment Agreement.TheMembershipContributionwill similarlybe refunded to thePolicyholderas Member, in termsof theMasterRegulations. Part1 -14.Amendments SDM isentitled toamendanyprovisionof the PYKContract (and, for theavoidanceof doubt, thePolicies formingpart thereof)by giving31days'writtennotice to the policyholder. SDMmayalsoamend thePYK Contractas itdeemsnecessary togiveaffect toa change in lawwhich impacts thePYK Contract. Anyamendmentswhich changes theBenefits payableunder thepolicywillnotaffect Claims in respectofan InsuredEvent that occurredprior to suchamendment. Anyamendment shallhaveeffect from the date indicatedbySDM inanotice to the policyholder. Apolicyholdermayalsoamendmentany information inMPPFormand/or the PaymentReceiptBookletby (i)completing an AMPPand submitting it toSDM'sduly appointedadministrator,Kganya Insurance Administrators,or through theChurch Branches;and/or (ii)by calling thecall centre of the Insurer'sdulyappointedadministrator, Kganya InsuranceAdministrators. Part1 -19.Complaintsprocedure ThePYKContractprovides foraprocedure through whichapolicyholdermay lodgea complaintwith SDM and further informs thepolicyholdersof its right toapproach theLong-TermOmbudsman, the FAISOmbudor theFinancialSectorConduct Authority. In theeventofa complaint, sucha complaintmust bedealtwith in termsofSDM's complaints procedureapplicableat thedateof the lodgingof thecomplaint. 19.2A complaintmaybe lodged in the following manner: (i)By contacting SDMon (011)3593014or emailing gbcomplaints@sanlamsky.co.zaor the Insurer'sdulyappointedadministratorKganya InsuranceAdministratorson telephonenumber 0800000538or viaemailat complaints@kganya.co.zaandhav e the following informationavailable:Policynumberas contained in theMembershipBook (referred toasControl Number), Identitynumberof thePolicyholder;and Natureofenquiryand/or complaint; (ii)Complaints whicharenot resolved to thePolicyholder’s satisfactionmust firstbe referred toSDM's Legal& Compliancedepartment; (iii)Complaintswhichare stillnot resolved to thePolicyholder’s satisfaction maybe referred toSDM'sarbitrator; (iv)Complaints whichare stillnot resolvedmaybe referred to the Ombudsman for Long-term Insurance, theFAIS Ombudor theFinancialSectorConductAuthority.