Terms and Conditions
General
- Premiums are payable monthly in advance on or before the 1st of each month.
- Main member and spouse should be between 18-65 years to join the scheme.
- The insured lives will be limited to those declared on the application form.
- Members who are not legally married but who are living together as a family can still enjoy family benefits provided that all relevant particulars are declared on the application form.
- Unmarried children under the age of 21 are covered. Cover is extended up to, but not including age 26 if the child is unmarried fulltime student.
- Physically or mentally disabled children, who don’t receive a grant, and who are dependent on his/her parents are covered.
- Benefit Options are not covered under the FAIS ACT.
Waiting Periods
- Membership under the scheme can only commence on the 1st day of the month.
- If the 1st premium for inception of the policy is received after the 1st of the month, the cover will only commence on the 1st of the following month.
- Immediate cover is granted for accidental death if a member has paid the 1st premium.
- Three (3) months waiting period for new members between 18-65 years who falls into the immediate family category.
- Six (6) months waiting period for new members who falls into the extended family category.
- A twelve (12) month waiting period for death resulting from suicide or attempted suicide.
- Immediate cover on receipt of the first premium for members who have more than six (6) months continued cover under an existing scheme. (Such proof is required should deaths occur during the first three (3) months from inception). All members still within the waiting period imposed by the previous insurer will serve out the balance of such waiting period with Zororo-Phumulani before their cover will commence.
Payment of Premiums
- Premiums shall be payable as indicated in the Schedule to the Insurer by the Policyholder at the Premium Rate as specified in the Schedule.
- Payments shall be made from the Commencement Date to the date of termination of this Policy. Should the insured event occur before premium payment is effected, the Insurer will have no liability, unless the Insurer is satisfied that at the time, an insurable risk did exist and that the insured had been in good standing in terms of premium payments prior to the happening of the insured event. In the event of such a situation, the Insurer’s decision shall be final.
- Cover on the Scheme is provided for on a month-to-month basis. No reserves are built up under the scheme, therefore premiums are payable lifelong and there are no surrender values when cover ceases.
- Premiums under the scheme are not guaranteed and can be adjusted by the insurer at any stage.
- Membership for new applicants will be restricted to a maximum entry age of 65 years (next birthday) at commencement.
- Only claims submitted within six (6) months of the date of death will be considered for payment
- No claim will be honoured if premiums are in arrears or short paid for more than 45 days.
- No claims in respect of grandchildren or foster children will be considered, unless proof of legal adoption has been supplied.
- In the event of the death of the Policyholder, ownership of the policy may be switched to the surviving spouse; the spouse will then become the Policyholder of the policy, subject to the payment of the premium by the spouse. Please note, however, that this does not automatically happen and it is the responsibility of the remaining spouse to notify the Insurer of the change.
Termination of the Policy
1. The Policyholder may terminate the policy upon one (1) month notice of cancellation being given to the Insurer, in writing.
2. If the Policyholder fails to fulfil any obligation under the Terms and Conditions of the policy and the schedule(s), the policy shall lapse.
3. Zororo Phumulani or the insurer may terminate the policy on one (1) month written notice.
4. Cover for policyholders and/or dependents will cease on:
- The Policyholder withdrawing from the policy for any reasons whatsoever;
- Non-payment of premiums by policyholder.
- A member has a grace period of 60 days to pay premiums in arrears, after which the policy will lapse.
Notes
Sums Insured for Eligible Children are payable in accordance with the following:
- 14 years and Older : 100%
- 6 to 13 years : 50%
- 0 to 5 years : 25%
- Stillborn is defined as the death of a baby after 25 weeks of pregnancy.