Pukwana ya Kganya Terms & Conditions

57 6.4.2 occurred before the date the Dependent Child no longer qualifies as a Dependent Child, shall continue to be a Paid-up Dependant even if he/she no longer qualifies as a Dependent Child, provided that such Paid-up Dependant would have been permanently dependent on the Deceased Policyholder had the Policyholder been alive. 6.5 Upon the death of the Policyholder, and for as long as the cover remains in force in respect of any Paid-up Dependant, the Beneficiary, who must i) be older than 18 (eighteen) years of age; and ii) meet the requirements as set out in clause 5.5 of this Part II, will be the Policyholder for purposes of the Funeral Policy insofar as it relates to the Paid-Up Dependant(s). However, the provisions of this clause 6.5 of this Part II, shall not entitle the Beneficiary with any rights to cover or a Funeral Benefit in respect of himself/herself and all rights and obligations will be limited insofar as these relate to the cover and the Funeral Benefit payable in respect of the Paid-up Dependant(s). 6.6 For the sake of clarity, it is recorded that cover and the Funeral Benefit for Paid-up Dependants are limited to the Funeral Policy and will not be applicable in respect of the Dread Disease and Personal Accident Policy. 7. Claim Documents for Funeral Benefit 7.1 Without limitation to the provisions of clause 13 of Part I, the following Claim Documents must be submitted to the Insurer in respect of a claim for a Funeral Benefit: 7.1.1 FBCN Form signed by 3 (three) Committee Members and all such documents as set out in the FBCN Form. In the event that the Committee Members are unable or unwilling for whatsoever reason to sign the FBCN Form, the Beneficiary can approach the Insurer directly with such claim, or lodge a complaint as contemplated in clause 19 of Part I; 7.1.2 original or certified copy of the identity document or identity card (copied both sides) of the Policyholder; 7.1.3 original or certified copy of the identity document or identity card (copied both sides) of the Beneficiary where the Policyholder is deceased; 7.1.4 confirmation of Membership to the Kganya Benefits Fund Trust; 7.1.5 original and/or certified copy of the Payment Receipt Booklet to verify Receipts; 7.1.6 original or certified copy of the death certificate of the Assured Life; 7.1.7 confirmation of bank account into which the Funeral Benefit must be paid; 7.1.8 where the Assured Life is - 7.1.8.1 a Dependent Child and/or Paid-up Dependant, the original or certified copy of the identity document, identity card (copied both sides) or birth certificate of the Dependent Child and/or Paid-up Dependant; 7.1.8.2 a Dependent Child and/or Paid-up Dependant who is 25 (twenty-five) years or older, the original or certified copy of the identity document, identity card (copied both sides) or the birth certificate the Dependent Child and/or Paid-up Dependant as well as proof of the mental and/or physical disability of such Dependent Child and/or Paid-up Dependant, 7.1.9 where the Assured Life has died by Accident, a copy of the police report confirming such Accidental Death; and 7.1.10 any other documents required by the Insurer from time to time including but not limited to – 7.1.10.1 medical confirmation in the case of a Stillbirth; 7.1.10.2 a marriage certificate, adoption certificate or other proof sufficient to show that a Dependent Child who is adopted or does not have the same surname as the Policyholder, is a Dependent Child and/or Paid-up Dependant. 7.2 The Insurer will notify the Beneficiary within 2 (two) Business Days after receipt of all the Claim Documents to the satisfaction of the Insurer whether it accepts (and authorises payment of the Funeral Benefit), repudiates or disputes the Claim. 8. Cessation of cover in respect of Funeral Benefit 8.1 Insurance cover in terms of this Funeral Policy for all Assured Lives shall cease in the event that - 8.1.1 this Pukwana ya Kganya Contract is cancelled; or 8.1.2 the Policyholder ceases to be a Member of the Kganya Benefits Fund Trust in accordance with the terms of the Master Regulations, read with the Basic Benefits Regulations; or 8.1.3 the last Assured Life covered in terms of the Funeral Policy dies; or 8.1.4 the Kganya Benefits Fund Trust fails to pay the Premiums in respect of the Assured Lives as a result of the Policyholder’s failure, as a Member, to pay his/her Membership Contribution, subject at all times to the Forgiveness Rules. PART III: DREAD DISEASE AND PERSONAL ACCIDENT POLICY 1. Introduction 1.1 This Pukwana ya Kganya Contract comprises Part I, Part II, this Part III and Part IV (in respect of Existing Members). 1.2 Part III constitutes a several and distinct Dread Disease and Personal Accident 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 III. 1.4 All terms and conditions contained in Part I, and Part IV as they apply to Existing Members, are incorporated in this Part III, which collectively constitutes the Dread Disease and Personal Accident Policy between the Policyholder and the Insurer. 2. Dread Disease and Personal Accident Benefits 2.1 The Dread Disease Benefits and Personal Accident Benefits are set out in Annexe E.3 and Annexe E.4 , respectively, as amended from time to time, as provided for in Part I of this Pukwana ya Kganya Contract. 2.2 The Dread Disease Benefits and the Personal Accident Benefits are dealt with separately below. Dread Disease Benefits 3. Dread Disease Benefits 3.1 Upon the happening of an Insured Event as specified in clause 6.1.37.2.2 of Part I, the Dread Disease Benefits payable in terms of this Dread Disease and Personal Accident Policy will be paid by the Insurer to the Policyholder, in respect of a Dread Disease contracted, experienced or suffered by a Policyholder, where the Date of Dread Disease is after the Inception Date.