Pukwana ya Kganya Terms & Conditions

60 2. Background 2.1 All Members of the Kganya Benefits Fund Trust were, as part of the membership to the Kganya Benefits Fund Trust, previously covered as assured lives in terms of group policies between the Kganya Benefits Fund Trust and the Insurer for burial benefits, personal accident benefits and dread disease benefits ( “the Previous Group Policies” ). 2.2 Due to a change in the insurance laws, the Kganya Benefits Fund Trust and the Insurer are required to terminate all Previous Group Policies and replace them with individual insurance policies with the Members as Policyholders. This also resulted in the need for the Kganya Benefits Fund Trust to make certain changes to the Membership rights of its Members. 2.3 Accordingly, the Kganya Benefits Fund Trust procured access to this Pukwana ya Kganya Contract for all Members who satisfy the requirements for Membership to the Kganya Benefits Fund Trust, whereby the Existing Members, previously covered as assured lives under the Previous Group Policies, will become Policyholders in terms of this Pukwana ya Kganya Contract. 2.4 The amendments to rights of the Members as explained above, and set out in the trust deed of the Kganya Benefits Fund Trust, read with the Master Regulations and Basic Benefits Regulations, have been confirmed by an order of the High Court under case number 62972/2021 and will become effective from the Effective Date. 2.5 With effect from the Effective Date, all Existing Members who were covered as assured lives in terms of the Previous Group Policies, will no longer be assured lives under the Previous Group Policies, but will become Policyholders in terms of this Pukwana ya Kganya Contract. 3. Continuation of rights 3.1 It is recorded that: 3.1.1 all Membership Contributions paid by an Existing Member to the ZCC before the Effective Date, as recorded in the Existing Membership Book, will be taken into consideration for purposes of this Pukwana ya Kganya Contract; 3.1.2 all Membership Contributions missed by an Existing Member before the Effective Date, as recorded in the Existing Membership Book, will be taken into consideration as Missed Premiums for purposes of this Pukwana ya Kganya Contract; 3.1.3 this Pukwana ya Kganya Contract commences on the Effective Date. Notwithstanding the commencement of this Pukwana ya Kganya Contract, the date of inception of insurance cover in terms of the Policies is deemed to be the date of commencement of cover in respect of the Existing Member as assured life under the Previous Group Policies, subject to the provisions of clause 6 of this Part IV; 3.1.4 any waiting periods completed and/or partially completed in respect of the Existing Member as assured life under the Previous Group Policies, will be taken into account to determine the Waiting Period or any remaining portion thereof to be applied for purposes of the Policies; 3.1.5 without limitation to clause 3.1.4 of this Part IV, it is recorded that the Previous Group Policies constitute a previous policy for purposes of clause 3 of Part II; 3.1.6 any Membership Books (including all records relating to the payment history of Membership Contributions evidenced by Receipts) issued by the Kganya Benefits Fund Trust to an Existing Member before the Effective Date, shall remain in force, subject to any amended terms and conditions as contained in any endorsements issued by the Kganya Benefits Fund Trust; 3.1.7 all MPP Forms and AMPP Forms completed before the Effective Date shall be accepted by the Insurer for purposes of the cover in terms of the Policies; 3.1.8 all claims for Benefits which arose under the Previous Group Policies shall – 3.1.8.1 if submitted before the Effective Date, be dealt with in accordance with the terms of the Previous Group Policies; or 3.1.8.2 if submitted after the Effective Date, be dealt with in accordance with the terms of this Pukwana ya Kganya Contract; and 3.1.9 all claims made under the Previous Group Policies shall be considered in terms of this Pukwana ya Kganya Contract to determine whether the limitations in terms of the number of claims, as provided for in terms of the Policies, have been reached, in which event a claim for Benefits shall be rejected. 4. Use of information In addition to the requirements of clause 4 of Part I, an Existing Member agrees that the information provided to the ZCC and/or the Kganya Benefits Fund Trust in terms of the Previous Group Policies for Membership, may and shall be provided by the Kganya Benefits Fund Trust (or its administrator, Kganya Insurance Administrators) to the Insurer for purposes of this Pukwana ya Kganya Contract. 5. Policy documents Notwithstanding the provisions of clause 5.1 of Part I, this Pukwana ya Kganya Contract and the Policy Schedule will be contained in the Membership Terms and Conditions Booklet to be issued to all Members on or before the Effective Date. 6. Insurance cover for Existing Members 6.1 With effect from the Effective Date and notwithstanding the provisions of clause 7 of Part I, insurance cover in respect of the Assured Lives of Existing Members, commences on the date that insurance cover in respect of the Assured Lives in terms of the Previous Group Policies commenced provided that the Existing Member – 6.1.1 completed the MPP Form and purchased a Membership Book; and 6.1.2 paid a Membership Contribution at any time before the Effective Date. 7. Minors who are Existing Members 7.1 The previous terms and conditions of Membership to the Kganya Benefits Fund Trust permitted members of the ZCC who are 16 (sixteen) years and older, to apply for Membership to the Kganya Benefits Fund Trust. 7.2 With effect from the Effective Date, the entry age for Membership to the Kganya Benefits Fund Trust has been increased to 18 (eighteen) years of age. 7.3 This means that some Existing Members may be below the age of 18 (eighteen) years of age upon conclusion of this Pukwana ya Kganya Contract ( “Minor Existing Members” ), and therefore legally unable to conclude the Pukwana ya Kganya Contract. 7.4 For this reason, it is agreed that: 7.4.1 the Kganya Benefits Fund Trust will conclude the Pukwana ya Kganya Contract for each Minor Existing Member and will hold the Policies for the exclusive benefit of the Minor Existing Members; 7.4.2 the Kganya Benefits Fund Trust shall comply with all lawful, reasonable and permissible requests of the Minor Existing Members insofar as it relates to the rights and obligations in terms of this Pukwana ya Kganya Contract and shall communicate all such requests to the Insurer promptly and without delay; 7.4.3 the conclusion of the Pukwana ya Kganya Contract by the Kganya Benefits Fund Trust for the benefit of a Minor Existing Member shall not entitle the Kganya Benefits Fund Trust to any rights to cover or Benefits in respect of the Kganya Benefits Fund Trust or any of the trustees of the Kganya Benefits Fund Trust; and 7.4.4 upon a Minor Existing Member attaining the age of 18 (eighteen) years of age, the rights and obligations under this Pukwana ya Kganya Contract will automatically be ceded and delegated to the Minor Existing Member, whereby such Minor Existing Member will become the Policyholder in terms of this Pukwana ya Kganya Contract.