Founding Affidavit and Annexures

Provisionsof theexistingDreadDisease Regulations ("DDR")and theThariYaBaruti Regulations ("TYBR") 5of11 1.1.7andSchedule3DreadDiseaseClassification HeartAttack: Where thedeathofaportionof theheartmuscle results from inadequateblood supply to the relevant area.Thediagnosiswillbebasedon: (i)ahistoryof typical chestpain; (ii)newcharacteristic electrocardiogram changes;and (iii)elevationof infarction specificenzymes,Troponinsorother biochemicalmarkers. Stroke: Wherea cerebrovascularaccidentor incidentoccurs, producingpermanentneurological sequelae lasting more than48 (fortyeight)hoursasa resultof infarctionofbrain tissue,haemorrhageand embolisation fromanextracranial source,excluding traumatic injury.Evidenceofneurologicaldeficit for at least3 (three)monthshas tobeproduced. Cancer: Whereanymalignant tumouroccurs characterised by theuncontrolledgrowthofmalignant cellsand invasionof tissue.The termmalignant tumour includes lymphomaand sarcoma. CoronaryArtery (bypass)Surgery: Theactualundergoingofheart surgery tocorrect narrowingorblockageof twoormorecoronary arterieswithbypass grafts.The surgerymusthave beenproven tobenecessarybymeansof coronary angiographyand realisationof the surgeryhas tobe confirmedbyaMedicalSpecialist. TotalKidneyFailure: Theend stage renal functionpresentingas chronic irreversible failureofbothkidneys to functionasa resultofwhich regularperitonealdialysisor haemodialysis is instituted. MajorOrganTransplant: Theactualundergoingasa recipientofa transplant ofanyoneormoreofadonorheart, liver,pancreas, bonemarrow, kidneyor lungs.Realisationof the transplantationhas tobeconfirmedbyaMedical Specialist. Blindness: The total,permanentand irreversible lossof sight in botheyesasa resultof sicknessordisease.Vision measuredat3/60orworse in thebettereyeusinga Snelleneyechart. Coma: A stateofunconsciousnessasa resultof sickness withno reaction toexternal stimulior internalneeds persisting continuously foraperiodofat least96 (ninety six)hourswith theuseof life support systems, resulting inpermanentneurologicaldeficit. Multiple sclerosis: Theunequivocaldiagnosis thereofbyaMedical Specialist (preferablybyaneurologist).Thedisease has tobeevidencedby typical clinical symptomsof demyelinationand impairmentofmotorand sensory functionsaswellasby typicalMRI findings. Forproving thediagnosis, themembermust: (i) eitherexhibitneurologicalabnormalities thathave existed fora continuousperiodofat least6months; or (ii)havehadat least two clinicallydocumented episodesat least1monthapart;or (iii)havehadat least1 clinicallydocumentedepisode togetherwith characteristic findings in thecerebrospinal fluidas wellas specificcerebralMRI lesions. 6.Exclusions HeartAttack: The followingareexcluded: (i) Non-ST-segment (NSTEMI); (ii)ElevationofTroponin IorT; (iii)Other acuteCoronarySyndromes (e.g. stable/unstable Anginapectoris);and (iv)Silentmyocardial infarction. Nobenefit ispayable ifa claim forCoronaryArtery (bypass)SurgeryoraHeartTransplanthasbeen previouslyadmitted in respectof theClaimant. Stroke: The followingareexcluded: (i)Transient ischemic attacks (TIA); (ii)Neurological symptomsdue to migraine;and (iii) Lacunar strokeswithout neurologicaldeficit. Cancer: The followingareexcluded: (i)All tumourswhichare histologically classifiedaspremalignant,asnon- invasiveoras cancer in situ includinganyGIN stage (cervical intraepithelialneoplasia); (ii)Non-malignant conditions that canbecomemalignant, including essential thrombocythaemiaandpolycythaemia rubra vera; (iii)All tumoursof theprostateunless histologically classifiedashavingaGleason score greater than6orhavingprogressed toat least clinicalTNM classificationT2nOMO; (iv)All cancers arising in the skinother thanmalignantmelanoma histologically classifiedashavingprogressed toat leastClark's Level II; (v) Lymphoma limited to1 (one) regionof lymphnodes;and (vi)Any cancer diagnosedand treatedbyprimarybiopsyonlyand doesnot requireanyadditional surgical,medical, radiotherapyorothermodalities, shallnotqualifyas "cancer". CoronaryArtery (bypass)Surgery: The followingareexcluded: (i)Angioplasty; (ii)Any other intra-arterialprocedures;and (iii)Key-hole surgery. Nobenefit ispayable ifa claim foraheartattackor heart transplanthasbeenpreviouslyadmitted in respectof theClaimant. TotalKidneyFailure: Nobenefit ispayable ifa claim foraKidney TransplantorKidneyCancerhasbeenpreviously admitted in respectof theClaimant. MajorOrganTransplant: Nobenefit ispayable foraHeartTransplant ifa claim forCoronaryArtery (bypass)SurgeryoraHeart Attackhasbeenpreviouslyadmitted in respectof theClaimant. Nobenefit ispayable foraKidneyTransplant ifa claim forTotalKidneyFailurehasbeenpreviously admitted in respectof theClaimant. Nobenefit ispayable foranyorgan requiring transplantand forwhichorgana claim forCancer hasbeenpreviouslyadmitted in respectof. Blindness: No furtherexclusionsapply. Coma: The followingareexcluded:A coma secondary to alcoholordrugmisuse isnot covered. Multiple sclerosis: Noexclusionshavebeenprovided for. GeneralExclusions:Therearenogeneralexclusions Provisionsof theThariYaBarutiPukwanaYa KganyaContract ("TYBContract") Part3 -3.andAnnexeDreadDisease Classification HeartAttack: Thedeathofaportionof theheartmuscle results from inadequateblood supply to the relevantarea.Thediagnosiswillbebased on: (i)ahistoryof typical chestpain; (ii)new characteristicelectrocardiogram changes; and (iii)elevationof infarction specific enzymes,Troponinsorotherbiochemical markers. All three factorsare requiredand confirmation in theaffirmative is required on theprovidedMedical report (thiswas previously included in theGroupPolicy) . Part3 -3.andAnnexeDreadDisease Classification Stroke: Wherea cerebrovascularaccidentor incidentoccurs,producingpermanent neurological sequelae lastingmore than48 (fortyeight)hoursasa resultof infarctionof brain tissue,haemorrhageandembolisation fromanextracranial source,excluding traumatic injury.Evidenceofneurological deficit forat least3 (three)monthshas to beproduced. Neurological sequelaearemedical conditionsassociatedwithdamaged neurons resulting fromapreviousdisease, injuryorother trauma (thiswaspreviously included in theGroupPolicy). Part3 -3.andAnnexeDread DiseaseClassification Cancer: Whereanymalignant tumour occurs characterisedby the uncontrolledgrowthof malignant cellsand invasionof tissue.The termmalignant tumour includes lymphomaand sarcoma. A tumourmaybebenignor malignant.Amalignant tumour is cancerand can invade neighbouring tissueandorgans throughbloodor lymph system (thiswaspreviously included in theGroupPolicy). Part3 -3.andAnnexe DreadDisease Classification CoronaryArtery (bypass) Surgery: Theactualundergoingof heart surgery tocorrect narrowingorblockageof twoormorecoronary arterieswithbypass grafts.The surgerymust havebeenproven tobe necessarybymeansof coronaryangiographyand realisationof the surgery has tobeconfirmedbya MedicalPractitioner. Part3 -3.and AnnexeDread Disease Classification TotalKidneyFailure: Theend stage renal functionpresenting as chronic irreversible failureof bothkidneys to functionasa result ofwhich regular peritonealdialysisor haemodialysis is instituted. Part3 -3.andAnnexe DreadDisease Classification MajorOrgan Transplant: Theactualundergoing asa recipientofa transplantofanyone ormoreofadonor heart, liver,pancreas, bonemarrow, kidney or lungs.Realisationof the transplantationhas tobeconfirmedbya MedicalPractitioner. Part3 -3.and AnnexeDread Disease Classification Blindness: The total, permanentand irreversible lossof sight inbotheyesas a resultof sickness ordisease.Vision measuredat3/60 orworse in the bettereyeusinga Snelleneyechart. Part3 -3.andAnnexe DreadDisease Classification Coma: A stateof unconsciousnessasa resultof sicknesswith no reaction toexternal stimulior internal needspersisting continuously fora periodofat least96 (ninety six)hourswith theuseof life support systems, resulting in permanentneurological deficit. Part3 -3.andAnnexeDreadDiseaseClassification Multiple sclerosis: Theunequivocaldiagnosis thereofbyaMedicalPractitioner (preferablybya neurologist).Thediseasehas tobeevidencedby typical clinical symptomsof demyelinationand impairmentofmotorand sensory functionsaswellasby typicalMRI findings. Multiple sclerosis (MS) isademyelinatingdisease inwhich the insulating coversofnervecells in thebrainand spinal cordaredamaged.Thisdamage disrupts theabilityofpartsof thenervous system to communicate, resulting ina rangeof signsand symptoms, includingphysical,mentaland sometimes psychiatricproblems (thiswaspreviously included in theGroupPolicy). Forproving thediagnosis, themembermust: (i)eitherexhibitneurological abnormalities thathaveexisted fora continuousperiodofat least6 months;or (ii)havehadat least two clinicallydocumentedepisodesat least 1monthapart;or (iii)havehadat least1 clinicallydocumentedepisode togetherwithcharacteristic findings in thecerebrospinal fluidaswellas specificcerebralMRI lesions. Part3 -5.andAnnexeDExclusions HeartAttack: The followingareexcluded: (i) Non-ST-segment (NSTEMI) - (A STEMIorST-elevationmyocardial infarction is causedbya sudden complete (100%)blockageofaheartartery (coronaryartery).Anon-STEM/ isusuallycausedbya severelynarrowedarterybut theartery isusuallynot completelyblocked.Thediagnosis is initiallymadebyanelectrocardiogram (ECGorEKG) (thiswas previously included in theGroupPolicy); (ii)ElevationofTroponin IorT - (ElevationofTor I is indicativeofcardiacdamage,but this canoccurasa resultof causesother thanheartattacke.g.myocarditis, coronaryartery spasm, severecardiac failure, cardiac trauma from surgeryetc) (thiswaspreviously included in theGroupPolicy); (iii)OtheracuteCoronarySyndromes (e.g. stable/unstableAnginapectoris) - (Angina,a/soknownasanginapectoris, is chestpainorpressure,usuallydue tonotenough blood flow to theheartmuscle.Worseninganginaattacks, sudden-onsetanginaat rest,andangina lastingmore than15 (fifteen) minutesare symptomsofunstableangina (usuallygroupedwith similarconditionsas theacutecoronary syndrome).As these mayprecedeaheartattack, they requireurgentmedicalattentionandare, ingeneral, treated in similar fashion tomyocardial infarction) (thiswaspreviously included in theGroupPolicy);and (iv)Silentmyocardial infarction - ("Silent"myocardial infarctions canhappenwithoutany symptomsatall.Thesecases canbediscovered lateronelectrocardiograms,usingbloodenzyme tests oratautopsyafterapersonhasdied) (thiswaspreviously included in theGroupPolicy). Nobenefit ispayable ifa claim forCoronaryArtery (bypass)SurgeryoraHeartTransplanthasbeenpreviouslyadmitted in respectof thePolicyholder (thiswaspreviously included in theGroupPolicy). Part3 -5.andAnnexeC Exclusions Stroke: The followingareexcluded: (i) Transient ischemicattacks (TIA) - (A ischemicattack (TIA) isa briefepisodeofneurological dysfunction causedby lossof blood flow (ischemia) in the brain, spinal cordor retina, without tissuedeath (infarction) (thiswaspreviously included in theGroupPolicy); (ii)Neurological symptomsdue tomigraine;and (iii) Lacunar strokeswithoutneurological deficit. Part3 -5.andAnnexeCExclusions Cancer: The followingareexcluded: (i)All tumourswhichare histologically classifiedaspremalignant,asnon-invasiveoras cancer in situ includinganyGIN stage (cervical intraepithelial neoplasia); (ii)Non-malignant conditions that canbecome malignant, includingessential thrombocythaemiaand polycythaemia rubra vera; (iii)All tumoursof theprostate unlesshistologically classifiedashaving aGleason score greater than6orhavingprogressed toat least clinicalTNM classificationT2nOMO; (iv)All cancersarising in the skinother thanmalignantmelanomahistologically classifiedashaving progressed toat leastClark's Level II; (v) Lymphoma limited to 1 (one) regionof lymphnodes;and (vi)Anycancerdiagnosed and treatedbyprimarybiopsyonlyanddoesnot requireany additional surgical,medical, radiotherapyorothermodalities, shallnotqualifyas "cancer". Part3 -5.andAnnexeCExclusions CoronaryArtery (bypass)Surgery: The followingareexcluded: (i) Angioplasty - (Angioplasty isa minimally invasiveendovascular procedure towidennarrowedor obstructedarteriesorveins, typically to treatarterialatherosclerosis) (this waspreviously included in theGroup Policy); (ii)Anyother intra-arterial procedures;and (iii)Key-hole surgery. Nobenefit ispayable ifa claim fora heartattackorheart transplanthas beenpreviouslyadmitted in respectof thePolicyholder. Part3 -5.andAnnexeC Exclusions TotalKidneyFailure: Nobenefit ispayable ifa claim foraKidney TransplantorKidneyCancer hasbeenpreviously admitted in respectof the Policyholder. Part3 -4.andAnnexeCExclusions MajorOrganTransplant: Nobenefit ispayable foraHeart Transplant ifa claim forCoronaryArtery (bypass)SurgeryoraHeartAttackhas beenpreviouslyadmitted in respectof thePolicyholder. Nobenefit ispayable foraKidney Transplant ifa claim forTotalKidney Failurehasbeenpreviouslyadmitted in respectof thePolicyholder. Nobenefit ispayable foranyorgan requiring transplantand forwhichorgan a claim forCancerhasbeenpreviously admitted in respectof. Part3 -5.and AnnexeC Exclusions Blindness: No further exclusionsapply. Part3 -5.and AnnexeC Exclusions Coma: The followingare excluded:A coma secondary to alcoholordrug misuse isnot covered. Part3 -5.and AnnexeC Exclusions Multiple sclerosis: Noexclusionshave beenprovided for. Part3 -3.6.1.Exclusions SDM shallnotpayanyDread DiseaseBenefit if thePolicyholder dies (whetheras a resultof the InsuredEventorany cause whatsoever)prior to thedateon which the claim foraDread DiseaseBenefit is submitted. In theevent thatSDMacceptsa claim forDreadDiseaseBenefits, and thePolicyholderdies, SDM shallmakepaymentof theDread DiseaseBenefit to theBeneficiary inaddition toany claimspayable in termsof theThariyaBaruti FuneralPolicy . ReviewofChanges to theDreadDiseaseBenefitsof theKganyaBenefitsFundTrust *To theextentanydifferencesbetween theprovisionsof theexistingDreadDiseaseRegulationsand theproposedThariyaBarutiPukwanayaKganyaContractshavebeen identified thatdonotadverselyaffect the rightsof themembers to theKganyaBenefits FundTrust, suchchangeshavebeenmarked inorange in the corresponding cellsbelow. **To theextentanydifferencesbetween theprovisionsof theexistingDreadDiseaseRegulationsand theproposedThariyaBarutiPukwanayaKganyaContractshavebeen identified thatdoadverselyaffect the rightsof themembers to theKganyaBenefits FundTrust, suchchangeshavebeenmarked in red in the corresponding cellsbelow. ***Materialdifferencesor changes indicated in red shading shallbeaccompaniedbya letter referencing thematerialdifferenceor change in the leftmostcolumnof 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 Reasons formaterialdifferences N/A