Founding Affidavit and Annexures

Provisionsof the existingDreadDiseaseRegulations ("DDR")and the Thari YaBarutiRegulations ("TYBR") 6of11 7.,9.,10. and Schedule 2Claims Memberswhohave contracted,experiencedor sufferedaDreadDiseasewill beentitled to submit a claim. No claim shallbe consideredby theTrustunlessaMemberhas submitted the relevantdocumentswithina12monthperiodafterDateofDread Disease.TheClaimmust alsobenotifiedwithin this12monthperiod. (a) The claim ispaidby theTrustonceapproved. TheTrust shallonlypay a singleBenefitAmount regardlessof thenumberof Claimsmade. Claims shallbemadeby aMemberwithin12months fromDateofDread Disease. Claimsmustbe submitted to SDMor itsauthorisedagent at aKganya InsuranceAdministratorsServiceCentreor anydesignatedofficeof SDM. Membersmust submit the followingdocumentation: (i) theClaim Form signedby the church committeeof theMember'sChurch; (ii) the IDof the Member; (iii)MembershipBook; (iv) theDreadDiseaseReport; (v) confirmationofbank account; and (vi) anyotherdocuments requiredby the Trust (andasdeterminedby theTrust from time to timeandas setout in the Schedule to theDDR). Shallnotbepayablewhere (i) theMemberdies (whether asa resultof the DreadDiseaseorotherwise)prior to thedateonwhichaClaim is submitted; and (ii) theTrust shallhaveno liability in respectofClaims submitted to the Trust after thedeathof suchMemberwherenoClaimhasbeen submitted prior to thatdeath. 8.1Member inGood Standing AMember inGood Standing shallbeaMemberwho: (i)paidContributions withaDateofPayment ineachof the3 consecutiveMonthspreceding the Month inwhich theDateofDreadDiseaseoccurred; and (ii) if themember becameaMemberwithin3Monthspreceding theMonth inwhich theDate ofDreadDiseaseoccurred, theDateofDreadDisease isat least 91days after theDateofPaymentof theearliestContribution. (b) 8.2 ForgivenessRule Inaccordancewith theFinancial SectorCharter and theZimele standards, if at the time the relevanteventoccurred giving rise toa claimanyof the aboveReceiptswasnotpurchasedas required in theseRegulations,a Memberwill, in certain circumstances,begranted leniency andGood Standingwillbedeemed.Therefore,missedReceiptswillbe condoned dependingon theMember'spayment record. ThenumberofReceiptspurchasedduring completed12-monthperiods calculated retrospectively (withamaximumof six completed12-month periods) from themonthofdeathwillbe considered.Good Standingwillbe deemedwhere theMemberpurchased11,22,33,44,55or66Receipts in theprior12,24,36 ,48,60or72months. 12.Cancellation TheTrustmay terminate theDDR inwritingprovided thatwrittennotice is given to theMembersat aPaypoint.Notwithstanding such termination, the Trust shall remain liable for all claims that aroseprior to such termination. (c) Cooling-off rights This isnotprovided for in theDDR. 11.Amendments and 8.Amendments to the TYBR TheTrustmay amend theDDR inwriting in their solediscretionand shall haveeffecton thedate indicated in that amendmentoron signatureby the Trust. TheTYBRmaybeamendedby theTrust inwriting in its solediscrettionnd shallhaveeffecton thedate indicated in that amendmentoron signatureby theTrust, ComplaintsProcedure This isnotprovided for in theDDR. 12.Delegation and cession and 10.Delegation andCession (TYBR) TheTrustmay appoint any administrators toperform administration services togiveeffect to theBBR and theTYBR.AMembermaynot cededor assign any rightsordutiesunder theBBRor inaBurialBenefit. TheCommitteeMember,YouthCommitteeMemberorMoria StaffMember maynot cedeany rightsoronligationsunder theTYBRor theAdditional BurialBenefits. Part1 -21.4 Delegation and cession Other thanas contemplated in clause7.4ofPart IV thePolicyor anyBenefitmay notbe cededor assigned. Part1 -9.3 andAnnexe E ForgivenessRules In theeventofnon-paymentof aPremiumorAdditionalPremiumsof a Policyholder,noBenefit shallbepaidunless: (i) the requirementsofPart 1 clause8.2of theTYBContract aremet;or (ii) theForgivenessRules setout in AnnexeE canbeapplied in respectof aMissedPremium(s). TheForgivenessRulesare informedby theprinciplesof “Treat YourCustomer Fairly”andwas formulated togrant aPolicyholder a concessionwhenaClaim for a Thari yaBarutiDreadDiseaseBenefit is submitted to the Insurer.The ForgivenessRulesprovide for leniencyby considering the consistencyof the Premiumpaymenthistoryof thePolicyholder (with reference tohis/her paymentofMembershipContributionsas contained in thePaymentReceipt Booklet) (i)where theClaimwouldordinarilybedeclinedupon theapplication of theprovisionsof clause8.2ofPart I; andupon submissionof theClaim, in considering theapplicationof theForgivenessRules, theTYBContractmust havebeen in force foroneormore completed12 (twelve)Month cycles ("Periods").ThenumberofPeriods is calculatedbackwards fromand including theMonthprior to theMonth inwhich the InsuredEventoccurred, toand including theMonthof the InceptionDate. In suchevent, SDM shall considerwhether thePolicyholderhas the required numberofPremiumspaidas specified in the tableprovided for inAnnexeE foreachof thePeriods, calculated.ThePolicyholder shall therebybeallowed suchnumberofMissedPremiumsas specified in the table setout inAnnexeR, without affecting thepaymentofBenefitsevenwhereaPremiummayhave beenmissed. Part1 -16. and 17.Cancellation SDMhas the right to terminate thepolicyby31days'written notice to thepolicyholder in theevent that: (i) any fraud is committed in respectof the conclusionand/ormaintainingof theTYBContract,orClaims submitted in termsof theTYB Contract; (ii) in theeventof falseand/oruntrue representationsweremade to SDM (and/or to its administrator)or ifmaterial informationwasnotdisclosed thatmay affect SDM'sability toassess risk (suchas misrepresentationof theageorMembershipof the Policyholder); (iii) termination is requiredbya change in law which cannotbe remedied throughanamendment; (iv) the policyholderno longerqualifiesasaMemberof theTrust; and (v) if theTrust and/or SDM terminates its relationship for whatever reason. This cancellation shallnot affect (i) thebenefitspayableby SDM (asapproved)prior to thedateof cancellation;or (ii) Claims if the InsuredEventsoccurredprior to thedateof cancellation (provided that SDM receivesnoticeof such InsuredEventwithina certainperiodafter the Insured Event).NoBenefit shallbepayablewhere the InsuredEvent occursafter the cancellationof theTYBContract. In theevent that thePremiumPaymentAgreementor relationshipbetween SDM and theTrust is cancelled for any reasonwhatsoever, thePukwana yaKganyaContractwill terminateat the same time. Part1 -18.Coolingoff rights Apolicyholderhasa coolingoff right for aperiodof31 days from the InceptionDate,unlessaBenefithasbeen claimedorpaid,or an InsuredEventhasoccurred ("coolingoffperiod"). In suchanevent, it shallbe deemed that theMember similarlyexercisedhis/her cooling-off rights in termsofhis/herMembership to the KganyaBenefitsFundTrust,asprovided for in the MasterRegulations,whereby cover in termsof theTYB Contract andMembership to theTrustwill come toan endat the same time. ThePolicyholdermust submit such cancellation instruction to SDMor itsduly appointedadministrator, Kganya InsuranceAdministrators,provided thatnotice to the Trust for cancellationofhis/herMembership, shallbedeemed toalsobenotice to SDM. PremiumsandAdditional Premiumspaidafter the EffectiveDate shallbe refunded in full to theTrust pursuant toaPolicyholderexercising the cooling-off rightsduring the coolingoffperiod inaccordancewith the termsof thePremiumPaymentAgreement.The MembershipContributionwill similarlybe refunded to thePolicyholder asMember, in termsof theMaster Regulations. Part1 -14.Amendments SDM isentitled toamendanyprovisionof theTYB Contract (and, for theavoidanceofdoubt, the Policies formingpart thereof)by giving31days' writtennotice to thepolicyholder.SDMmay also amend theTYBContract as itdeemsnecessary to giveaffect toa change in lawwhich impacts the TYBContract. Any amendmentswhich changes theBenefits payableunder thepolicywillnot affectClaims in respectof an InsuredEvent thatoccurredprior to suchamendment. Any amendment shallhaveeffect from thedate indicatedby SDM inanotice to thepolicyholder. Apolicyholdermay alsoamendment any information inMPP Formand/or thePayment ReceiptBookletby (i) completing anAMPP and submitting it to SDM'sduly appointed administratoror through theChurchBranches; and/or (ii)by calling the call centreof the Insurer's dulyappointedadministrator. Part1 -19.Complaintsprocedure TheTYBContractprovides for aprocedure throughwhicha policyholdermay lodgea complaintwith SDM and further informs the policyholdersof its right toapproach the Long-TermOmbudsman, the FAISOmbudor the Financial SectorConductAuthority. In theeventof a complaint, sucha complaintmustbedealtwith in termsof SDM's complaintsprocedureapplicableat thedateof the lodgingof the complaint. A complaintmaybe lodged in the followingmanner: (i)By contacƟng SDMon (011)359 3014oremailin g gbcomplaints@sanlamsky.co.za; or the Insurer'sduly appointedadministratorKganya Insurance Administratorson telephonenumber0800 000 538or viaemail at complaints@kganya.co.za andhave the following information available:Policynumberas contained in theMembershipBook (referred toasControlNumber), Identitynumberof thePolicyholder; andNatureof enquiry and/or complaint; (ii)Complaintswhicharenot resolved to thePolicyholder’s satisfactionmust firstbe referred to SDM's Legal&Compliancedepartment; (iii)Complaintswhichare still not resolved to thePolicyholder’s satisfactionmaybe referred to SDM'sarbitrator; (iv)Complaintswhichare stillnot resolvedmaybe referred to theOmbudsman for Long-term Insurance, theFAISOmbud or theFinancial SectorConductAuthority. Review ofChanges to the DreadDisease Benefitsof the KganyaBenefitsFundTrust Reasons formaterialdifferences a)Amended toprovide for amended insurance scheme.AlthoughSDM can, in termsof the current insurance scheme,exercise the rights setouthere in termsof thegrouppolicies, theexerciseof such rightsby SDMwouldnot affect 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 respectof anydreaddisease in that thedateofdreaddiseasemustbe91days frompaymentof the initialMembershipContribution.Thewaitingperiodof91dayshasbeen included in thePYKContract. c)Refer to commentundera) above *To theextentanydifferencesbetween theprovisionsof the existingDreadDiseaseRegulations and theproposed Thari yaBarutiPukwana yaKganyaContractshavebeen identified thatdonotadversely affect the rightsof themembers to theKganyaBenefits Fund Trust, such changeshavebeenmarked inorange in the corresponding cellsbelow. **To the extentanydifferencesbetween theprovisionsof the existingDreadDiseaseRegulations and theproposed ThariyaBarutiPukwanayaKganyaContractshavebeen identified thatdo adversely affect the rightsof themembers to theKganyaBenefits Fund Trust, 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 Provisionsof the ThariYaBarutiPukwanaYaKganyaContract ("TYB Contract") Part1 -6.1.26 and 6.1.27 andPart3 -2 andAnnexeC. Determinationof dreaddiseasebenefit Payableon the contraction,experience or sufferingof aDread Diseaseby an PolicyholderasAssured Lifeandasdiagnosed byaMedical Practitioner and supportedby clinical, radiological, histological and laboratoryevidence acceptable to SDM. Part1 -13 SDMwillnotbe liable topay a Claim: (i) if the claimwasnot made inaccordancewith the PYKContract;or (ii)Where the InsuredEventoccurred: (a) prior to the InceptionDate, (b) after cancellationof thePYK Contract,or (c) after coverof anAssured Life ceases;or (iii) whereapremiumhasnotbeen paid, subject to the Forgiveness Rulesor theWaitingPeriod still applies;or (iv) if anAssured Life is subject toaWaiting Period asprovided for in termsof the Policies,whereapplicable. Part1 -13Claims Claims shallbe settled by the Insurerby electronic funds transfer ("EFT") into thebank account nominatedby the Beneficiaryupon submissionof the Claim. Thenominatedbank accountmustbea bankaccountheldwith a SouthAfricanbank, andpaymentwillbe made in SouthAfrican Rands into suchbank account. Part1 -13Claims SDM reserves the right to cancel theTYBContract, repudiateaClaim and declareall Premiumsand AdditionalPremiumspaidby theTrust in respectof the Policies forfeited, should therebeevidenceof,or an attempted submissionof a fictional claim, fraudor misrepresentationwhich fictional claim, fraudor misrepresentationmaterially affects the Insurer'sability to assess the riskunder theTYB Contract. Part1 -13.2 andPart3 -6.Claims Submitted to SDM (or itsdulyappointed administrator,Kganya InsuranceAdministrators)by theBeneficiarywithin12monthsafter thehappening of an InsuredEvent,whichmustbe submittedwithall ClaimsDocuments, Part 3 -6 ClaimDocuments include: (i) theDreadDisease claims form signedby3CommitteeMembersand supported by suchdocumentsas setout in theDreadDisease claims form; (ii)originalor certified IDof the policyholder; (iii) confirmationofmembership to the Trust, includingoriginal and/or certified copyof the PaymentReceiptBooklet; (iv)originalor certified copy of theMedicalReport; (v) confirmationofbank account; and (vi) anyotherdocuments requiredby SDM. Part1 -13.2.2 Claims AClaimmaybe repudiatedby SDM if aClaim is madeafter12 (twelve)Months form the Insured Event and/or ifnot supportedwithall the relevant Claims Documentation Part1 -13.2.3Claims Claimsmustbe submitted toSDMor itsappointed administrator,Kganya Insurance Administratorsat a Kganya Insurance AdministratorsService Centre, thedetailsof which canbe foundon thewebsiteofKganya Insurance Administratorsat https://mykganya.com oranydesignated officeof SDM. Part1 -13.3Claims Ifdisputedor rejected, SDMwill giveanoticeof such rejection settingout the reasons.TheBeneficiarymay make representationswithin90days regarding this decision.Failure tomake representationswill result in SDMnotbeing liable topay aClaim. If theBeneficiarymakes representations to SDMwill, SDM shall inform theBeneficiaryof itsdecisionwithin 45daysafter receiving representations. All claimsare timebarredafter aperiodof12months tobeheard in court inorder todetermineSDM's liability.Thisperiodwillbe suspended for90days duringwhich theBeneficiary canmake representations andprovided that theBeneficiary shall at all timeshave at least6monthsafter this90dayperiod to institute courtproceedings. Part3 -3.6. Exclusions SDM shallnotpay anyDread DiseaseBenefit if thePolicyholder dies (whether asa resultof the InsuredEventor any cause whatsoever)prior to thedateon which the claim foraDread DiseaseBenefit is submitted. In theevent that SDM acceptsa claim forDreadDiseaseBenefits, and thePolicyholderdies, SDM shallmakepaymentof theDread DiseaseBenefit to theBeneficiary in termsof theThari yaBaruti Funeral Policy, inaddition toany claimspayable in termsof the Thari yaBaruti Funeral Policy . Part3 -3.4.Member inGood Standing Thebenefit isonlypaidon theoccurrence of aDreadDisease if (i) SDMor itsduly appointedadministrator,Kganya InsuranceAdministrators, recordeda Premium in respectof thePolicyholder withDatesofPayment ineachof the3 consecutiveMonthspreceding theMonth inwhich theDateofDreadDisease occurred; and (ii) theDateofDread Disease is91 (ninetyone)daysafter the InceptionDate in respectof the Policyholder,being theWaitingPeriod. AllReconciledPremiums recordedby the Insurer shallbepaid to the Insurer in accordancewith the termsof the PremiumPaymentAgreement. Part3 -4.Waiting Period Benefitpayments are subject toa waitingperiodof 91days, calculated from the Inception Date. NoDread DiseaseBenefits willbepaid in the event that the InsuredEvent occurswithin the WaitingPeriod