Pukwana ya Kganya Terms & Conditions

55 19. Complaints procedure 19.1 In the event of a complaint, such a complaint must be dealt with in terms of the Insurer’s complaint procedure applicable at the date of the lodging of the complaint. 19.2 A complaint may be lodged in the following manner: 19.2.1 By contacting – 19.2.1.1 the Insurer on telephone number (011) 359 3014 or via email at gbcomplaints@sanlamsky.co.za ; or 19.2.1.2 the Insurer’s duly appointed administrator, Kganya Insurance Administrators on telephone number 0800 000 538 or via email at complaints@ kganya.co.za. 19.2.2 The following information must be available: 19.2.2.1 Policy number as contained in the Membership Book referred to as the “Control Number” ; 19.2.2.2 Identity number of the Policyholder; and 19.2.2.3 Nature of enquiry and/or complaint. 19.2.3 Complaints which are not resolved to the Policyholder’s satisfaction must first be referred to the Insurer’s Legal & Compliance department. 19.2.4 Complaints which are still not resolved to the Policyholder’s satisfaction may be referred to the Insurer’s arbitrator. 19.2.5 Complaints which are still not resolved may be referred to the Ombudsman for Long-term Insurance, the FAIS Ombud or the Financial Sector Conduct Authority. 20. Unclaimed Benefits 20.1 An unclaimed Benefit is when the Insurer becomes aware that there is a Claim for a Benefit to be paid, but the Beneficiary cannot be found to pay the Claim. 20.2 In such case, the Insurer will start the process of tracing the Beneficiary. 20.3 If the process does not match the rightful owner with the Benefit, the Insurer shall repeat the tracing process within a 3 (three) year period and again within 10 (ten) years if the Benefit remains unclaimed. 21. General 21.1 Save as is expressly provided for in this Pukwana ya Kganya Contract, no provision of this Pukwana ya Kganya Contract constitutes a stipulation for the benefit of a third person (i.e. a stipulatio alteri ) which, if accepted by the person, would bind any Party in favour of that person. 21.2 A person shall not have a claim or right of action arising from any undertaking, representation or warranty not included in this Pukwana ya Kganya Contract. 21.3 The grant of any indulgence, extension of time or relaxation of any provision by the Insurer under this Pukwana ya Kganya Contract shall not constitute a waiver of any right by the Insurer or prevent or adversely affect the exercise by the Insurer of any existing or future right. 21.4 Other than as contemplated in clause 7.4.4 of Part IV, the rights and/or obligations under and to the Policies and/or any Benefits payable in terms of the Policies may not be ceded or assigned. 21.5 The Policies do not accumulate cash or a surrender value and may not be used to secure a loan. 21.6 This Pukwana ya Kganya Contract constitutes the whole agreement between the parties as to the subject matter hereof and no conditions, stipulations, agreements, representations or warranties of whatsoever nature between the parties regarding the subject matter hereof other than those set out in this Pukwana ya Kganya Contract are binding on the parties.  PART II: FUNERAL POLICY 1. Introduction 1.1 The Pukwana ya Kganya Contract comprises Part I, this Part II, Part III and Part IV (in respect of Existing Members). 1.2 Part II constitutes a several and distinct Funeral Policy which is offered to all Members of the Kganya Benefits Fund Trust, who are Policyholders in terms of this Pukwana ya Kganya Contract. 1.3 All capitalised terms defined in Part I, bear the same meaning in this Part II. 1.4 All terms and conditions contained in Part I, and Part IV as they apply to Existing Members, are incorporated in this Part II, which collectively constitutes the Funeral Policy between the Policyholder and the Insurer. 2. Funeral Benefit 2.1 The Funeral Benefit payable in terms of this Funeral Policy is set out in Annexe E.2 , as amended from time to time, as provided for in Part I of this Pukwana ya Kganya Contract, subject at all times to the maximum benefit amount prescribed in terms of the Applicable Laws in respect of an Assured Life. 2.2 Upon the happening of an Insured Event, the Funeral Benefit payable in terms of this Funeral Policy will be paid by the Insurer to - 2.2.1 the Policyholder, in the event of – 2.2.1.1 the death of a Dependent Child as an Assured Life; or 2.2.1.2 the happening of a Stillbirth, and/or 2.2.2 the nominated Beneficiary, in the event of the death of a Policyholder or a Paid-up Dependant. 2.3 Funeral Benefit in the event of Accidental Death 2.3.1 Subject to the Forgiveness Rules as provided for in clause 9.3 of Part I and Annexe E.5 , a Funeral Benefit in respect of an Assured Life will only be paid upon the happening of an Accidental Death if - 2.3.1.1 1 (one) Premium is recorded by the Insurer (or its duly appointed administrator, Kganya Insurance Administrators) – 2.3.1.1.1 with a Date of Payment in the Month preceding the Month in which the Date of Death occurred; or 2.3.1.1.2 with a Date of Payment in the Month of death, but before the Date of Death. 2.3.2 All Premiums recorded by the Insurer (or its duly appointed administrator, Kganya Insurance Administrators) shall be paid to the Insurer in accordance with the terms of the Premium Payment Agreement.