What are the Benefits payable ?

In return for payment of a monthly Premium, the Benefit, as stipulated on the Policy Schedule, will be paid based on the following conditions:

  • The Event occurs within the Period of Insurance;
  • The life in respect of whom the claim is made is named in the policy schedule, with the exception of a stillborn child;
  • The Event giving rise to a claim is covered under the terms of this Policy;
  • A natural death occurs after the expiry of the waiting period where applicable;
  • The information given at the time of application, and in the course of a claim, is materially true and accurate;
  • You provide Us with all the relevant documents and information that We may require; and
  • The claim is reported within the prescribed periods.

The Benefit payable will be based on the following:

The Eyethu Funeral Plan provides for the payment of cash within 48 hours of Us receiving all the documents and information required to approve the claim, to cover funeral expenses in the event of the death of an assured life covered under the policy.

The following core benefits may be selected by policyholder:

Life Assured Benefit - this is funeral cover for the policyholder.

Spouse Benefit - this is funeral cover for a spouse of the policyholder and may at any one time cover up to a maximum of 5 spouses only, where a spouse is defined under common law, customary law or a life partner arrangement. Proof of such relationship will be required at claim stage.

Parent Benefit - this is funeral cover for a parent of the policyholder and it can include a biological parent, step-parent or parent-in-law. Where the policyholder is an adopted child, parent can also include the person(s) who legally adopted the policyholder.  

Child Benefit - this is funeral cover for a child of the policyholder and it can include the biological children, adopted children, step children, and any other financially dependent children for whom the policyholder is financially responsible. For child-headed households (i.e. where the policyholder is aged 21 or less), the siblings of the policyholder may be regarded as children. If two of the children covered by the policy are aged between 1 year and 14 years, they are covered for free. A stillborn child is included under this definition provided that there has been at least twenty six weeks of intra-uterine existence, the child showed no signs of life after complete birth, and the life of the foetus child has not been intentionally terminated.

Abazala Benefit - this is funeral cover for an extended family member of the policyholder. A maximum number of 20 extended family members  may at any one time be covered under the policy. An extended family member is defined as one of the descendants, their spouses or their legally adopted children, of the great grandparents of the policyholder.

No claim will be payable under any Benefit unless that person is expressly named in the policy schedule, with the exception of a claim in respect of a stillborn child under the Child Benefit.

Benefit changes allowed:

  • Benefits may be increased at any time, subject to the full waiting period for a claim arising from natural death applying in respect of the increase amounts. The premium would be adjusted up accordingly.
  • Benefits may be reduced at any time, and the premium would be adjusted down accordingly.  Any decrease in cover will have no impact at all on the waiting period.

Additional benefits included are:

Grocery Benefit - This provides monthly payments and/or shopping vouchers to the value of R150 per month for 6 months when the policyholder or spouse assured dies , to be used for grocery expenses.

Education Benefits - This provides monthly payments of R200 for 12 months when the policyholder or spuse assured dies , to be used for education expenses.

Airtime Benefit - This provides a one-off R250 airtime voucher when any insured person dies , to help with making funeral arrangements.

Premium Break - This benefit recognises that with regularly paid policies, there may be months where it may be difficult to meet premium commitments due to unforeseen financial circumstances ( eg retrenchment , ending of employment contracts , etc.) and allows the policyholder to subsidise 'bad'months with 'good'months in terms of affordability . The policyholder may miss up to 9 premiums over the life of the policy , without the plan lapsing , subject to the following conditions :

- This Break only applies if premiums are paid monthly

- Only 3 consecutive premiums may be missed at a time without the policy lapsing

- Up to 9 non-consecutive premiums may be missed over the life of the poicy in total .

 

- The funeral cover core benefits during a Premium Break are reduced to 50% in

the second month of the Premium Break and to 25% in the third month of the

Premium Break.

- If more than 3 consecutive premiums are missed, the policy will lapse

automatically with immediate effect and all cover will cease.

- At the end of a Premium Break the policyholder will pay the outstanding, missed

premiums to bring the policy fully paid up-to-date. Failure to do so will result in

the policy lapsing and cover ceasing.

● Cash Back Benefit - Cash back of 50% of the quantum of premiums actually paid for

every 24 consecutive monthly premiums we receive. Any Premium Breaks will reduce to

zero the number of consecutive monthly premiums for the purpose of determining the

24 months.

● Legacy Benefit - In addition, if the policyholder dies and his biological brother

customarily assumes his responsibilities with respect to providing for the policyholder’s

family, the cover for the deceased’s spouses, children and extended family may continue

on condition that the deceased’s brother continues with the original premium payments

by becoming the new policy holder. The benefits may not be changed in this case, and

the only increases allowed will be those specified in the original contract, if any.

For a summary of your Benefit amount, please refer to your policy schedule

 

 

 

About the Eyethu Funeral Plan

The Eyethu Funeral Plan provides affordable funeral cover to finance funeral expenses in the unfortunate event of death. Every person deserves a dignified funeral ceremony, and to have the peace-of-mind afforded by knowing that their family or loved ones left behind will be assisted by a trusted financial partner when needed the most.

With our Eyethu Funeral Plan, policyholders can cover themselves, their spouse(s) or partner, their children, parents and extended family members. We have refined our definition of family to allow for families headed by children or grandparents, to accommodate this common occurrence in African communities.

We also cater for cultures that observe the practice of polygamy, and allow for more than one spouse to be covered. If a spouse becomes widowed, the deceased’ spouse’s brother may opt to continue as the main member and cover may continue at the same or increased level as prior to the passing of the deceased spouse. This is to recognise the African custom that the brother of a deceased widow takes responsibility of his deceased brother’s family.

The Eyethu Funeral Plan is flexible and allows policyholders to choose cover for their specific needs and to change their cover as their needs change over time. The Eyethu Funeral Plan offers additional benefits in addition to the basic funeral cover, as summarised below, such as a Cash Back benefit after every 24 premiums we receive.

What are the additional Benefits?

  • Grocery Benefit – This provides monthly payments and/or shopping vouchers to the value of R150 per month for 6 months when the policyholder or spouse assured dies, to be used for grocery expenses.
  • Education Benefits – This provides monthly payments of R200 for 12 months when the policyholder or spouse assured dies, to be used for education expenses.
  • Airtime Benefit – This provides a one-off R250 airtime voucher when any insured person dies, to help with making funeral arrangements.
  • Premium Break - This benefit recognises that with regularly paid policies, there may be months where it may be difficult to meet premium commitments due to unforeseen financial circumstances (e.g. retrenchment, ending of employment contracts, etc.) and allows the policyholder to subsidise 'bad' months with 'good' months in terms of affordability. The policyholder may miss up to 9 premiums over the life of the policy, without the plan lapsing, subject to the following conditions:
  • This Break only applies if premiums are paid monthy.
  • Only 3 consecutive premiums may be missed at a time without the policy lapsing.
  • Up to 9 non-consecutive premiums may be missed over the life of the policy in total.
  • The funeral cover core benefits during a Premium Break are reduced to 50% in the second month of the Premium Break and to 25% in the third month of the Premium Break.
  • If more than 3 consecutive premiums are missed, the policy will lapse automatically with immediate effect and all cover will cease.
  • At the end of a Premium Break the policyholder will pay the outstanding, missed premiums to bring the policy fully paid up-to-date.  Failure to do so will result in the policy lapsing and cover ceasing.   
  • Cash Back Benefit - Cash back of 50% of the quantum of premiums actually paid for every 24 consecutive monthly premiums we receive. Any Premium Breaks will reduce to zero the number of consecutive monthly premiums for the purpose of determining the 24 months.
  • Legacy Benefit - In addition, if the policyholder dies and his biological brother customarily assumes his responsibilities with respect to providing for the policyholder’s family, the cover for the deceased’s spouses, children and extended family may continue on condition that the deceased’s brother continues with the original premium payments by becoming the new policy holder. The benefits may not be changed in this case, and the only increases allowed will be those specified in the original contract, if any.
  • Abadala Paid-Up Benefit - When the policyholder turns 65, premiums may be stopped but the cover will continue, subject to the following conditions:
    • At least 10 years’ worth of premiums must have been received for the policyholder to be eligible for the Abadala Paid-Up Benefit.
    • No premium breaks or missed premiums must have occurred on the policy

 

 

Summary of Insurance Cover

Entry Ages  0 -64 age next birthday (ANB)
Maximum Cease Age  85 ANB
Term  85-Current ANB
Premium Paying Term  85-Current ANB
Minimum Premium  R20 p.m.
Mode of Payment  Monthly , Quarterly , Half-yearly or Yearly
Methond of Payment  Cash , Debit Order , EFT
Benefit Limits

 These limits apply throughout the term of the contract and may   be updated from time to time

Life Assured 

Minimum : R5,000

Maximum : R75,000

Spouse Assured

Minimum : R5,000

Maximum : Life Assured Benefit

Child Assured

Minimum : R2,000

Maximum : R10,000

Parent Assured

Minimum : R3,000

Maximum : R50,000

Umzala Assured

Minimum : R3,000

Maximum : R50,000

 

Waiting Period

 The period of 180 days in which no Benefit or only a reduced percentage of the Benefit is provided , and so no claim or only a limited claim sum is payable, for claims arising from death due to natural causes.

The waiting period in respect of each person covered by the policy commences on the date that the relevant policy holder , spouse, parent, child or extended family member becomes covered under the policy and is named in the policy schedule.

The amount of the Benefit that may be payable depends on the number of calendar days elapsed since the date on which the person became covered under the policy. Pleaes refer to the table below 

The cover provided in accordance with the phased-in approach described above , is as follows :

Calendar Days since start of cover for that person % of the Benefit
0-90  0%
91-120  10%
121-150  20%
151-180  30%
181+  100%

Once the Waiting Period has passed , death due to natual caused will be covered in full. There is no Waiting Period in respect of claims arising from Accidental Death. If any assured life was covered under a similar policy with another insurer in the 31 days before the start of this policy , the waiting period for such person will be waived. 

Proof of alternate cover will be required in order for the waiting period for such person to be waived. 

 

What to do in an event of an Claim ?

Claim assessments will be performed to validate claims and reduce the risk of fraud. Claimants will be required to provide evidence satisfactory to The Intermediary and Guardrisk of identification, of death certificates and the circumstances of death or stillborn child, and of family ties, financial dependence and other relationships where relevant to a claim.  If a natural death of an assured life occurs within the applicable waiting period, proof of previous cover for such person on a similar policy with another insurer in the 31  days prior to the start of this policy will be required for the waiting period to be waived and for the death claim to be deemed valid.  If no such proof is provided, the waiting period will be applied and the claim will not be valid. Proof submitted will be verified against central databases, such as that of the Department of Home Affairs.  We reserve the right to request any additional information or original claims documentation in order to verify or process the claim, which must be provided at the expense of the policyholder, claimant or beneficiary.

All claims payments will be made to the nominated beneficiary.  As the benefit is to assist with funeral arrangements, the beneficiary nomination must be a person who is not a minor and who will either be responsible for the funeral arrangements or who will assist with the funeral arrangements.  When claiming for a Dependent, the Policyholder is the Beneficiary and will be paid. When claiming because the Policyholder has died, the listed Beneficiary will be paid.  If there is no listed Beneficiary, the person claiming will be paid provided such person has paid for the funeral.

At claim stage,the appropriate claim forms will be sent to be completed

What is the Correspondence process ?

The normal mode of communicating with customers will be email. A call centre is available to assist clients with queries, enquiries and any escalations. We may also require to speak with claimants in the course of a claim. Automated emails will be sent to customers during the application process online, including an email of the customer’s policy contract and supporting documents. A paper copy may be posted to customers, if preferred or upon request.

Annual Benefit Update letters will be sent to customers 3 months preceding the automatic update of benefits, as specified in the contract. Annual Benefit Statements will be sent to customers annually.

Terms and Conditions relating to this Insurance cover

Policy Documents

This policy and all the benefits contained herein are underwritten by Guardrisk Life Limited, an Insurer registered to issue Life Insurance policies in terms of the applicable laws of the Republic of South Africa. In this policy words referring to the male gender shall include the female gender and words referring to the singular number shall include the plural number and vice versa.

Definitions

  • Accidental Death: An unforeseen event, which could not reasonably have been expected to occur. The event must result in death caused directly and independently of all other causes by some external, violent, physical and visible means arising from this event within 31 days of the accident, and excludes death by any natural causes.
  • Application form: The form that the Policyholder/Insured completes. This form shall state the names of the persons to be insured and the selection of benefits to be paid to nominated beneficiaries in the event of a claim. It shall also confirm the premium(s) payable monthly in order for cover to be in place.
  • Beneficiary: In respect of a registered insurer, means a person nominated by the policyholder as the person in respect of whim the insurer should meet the policy benefits on the death of the policyholder.  The beneficiary shall be the policyholder on the death of any other assured life.
  • Claim: Means, unless the context indicates otherwise, a demand for policy benefits by a person in relation to the policy, irrespective of whether or not the person’s demand in valid.
  • Claimant: Means the person who makes a claim.
  • Commencement Date: The date(s) that the insurance cover and Waiting Period(s) in respect of each person covered by the policy commences.  The initial commencement date is stated in the Schedule to this policy.  The date on which a named person is added to the policy or a Benefit is increased represents a new Commencement Date in respect of that person or increase in Benefit respectively.  
  • Cooling-off period: A 31-day period after the policyholder receives the copy of the policy, during which the policy can be cancelled with a full refund of premiums.
  • Day: Means a 24 hour period.
  • Exclusion: Means a loss or risk event not covered under this policy.
  • Insurer: Means a long-term insurer, namely Guardrisk Life Limited – registration number 1999/013922/06 and FSP Number 76.
  • Funeral Policy: Means a life insurance policy underwritten under the funeral class of life insurance business as set out in Table 1 of Schedule 2 of the Insurance Act.
  • No-Claim Bonus: Means the Cash Back Benefit that is directly or indirecty provided or made available to a policyholder by an insurer in the event that the policyholder does not claim or does not make a certain claim under the policy within a specified period of time.
  • Policyholder: The person who is stated as such on the Application Form and on whose death this policy shall cease. This person must be at least eighteen years of age but not older than sixty-four years of age.
  • Repudiate: In relation to a claim means any action by which an insurer rejects or refuses to pay a claim or any part of a claim, for any reason, and includes instances where a claimant lodges a claim-
    1. in respect of a loss event or risk not covered by the policy; and
    2. in respect of a loss event or risk covered by the policy, but the premium or premiums payable in respect of this policy are not paid.
  • Sum assured: The amount of insurance cover for each person insured under this policy. The amounts are stated in the Schedule to this policy.
  • Waiting Period: Means a period during which a policyholder (or any assured lives) is/are not entitled to policy benefits and is the period of 180 days in which no Benefit or only a reduced percentage of the Benefit is provided, and so no claim or only a limited claim sum is payable, for claims arising from death due to natural causes.  The waiting period in respect of each person covered by the policy commences on the date that the relevant policyholder, spouse, parent, child or extended family member becomes covered under the policy and is named in the policy schedule.  The amount of the Benefit that may be payable depends on the number of calendar days elapsed since the date on which the person became covered under the policy.  Please see Section 1.

Once the Waiting Period has passed, death due to natural causes will be covered in full. There is no Waiting Period in respect of claims arising from Accidental Death.

The Payment of the Benefit

In the event of the death of the Policyholder and any other insured, subject to the Waiting Period and the terms and conditions of this Policy, the settlement of the benefit will be made to the latest beneficiary nominated by the Insured. It is important that the Policyholder informs the Insurer should there be a need to amend the beneficiary. The beneficiary nominated must notify the Insurer or their appointed administrator within six months of the occurrence of a claim, otherwise no claim will be entertained.

The settlement of any claim is always subject to the Insurer receiving the following documentation, and such other evidence as it reasonably regards necessary:

  • A certified copy of the death certificate;
  • A certified copy of the deceased’s identity document;
  • A certified copy of the claimant’s identity document;
  • A fully completed death claim form signed by the person claiming the benefit;
  • Any medical records that the Insurer may require;
  • Any other evidence that the Insurer may require.

Please contact The Intermediary on the contact details provided in the policy schedule to make a claim.

Circumstances under which no benefit will be paid

No Benefit will be paid if the cause of death is as a result of either suicide, or circumstances under which the insured brought about his own death or deliberately exposed himself to danger, within twelve months of the Commencement Date of this policy, or the addition of a new insured person or an increase in Benefit.

No Benefit will be paid if the cause of death of any insured life listed in the policy schedule is as a result of natural causes within the first 90 days of a Waiting Period unless the policyholder or any assured live enjoyed cover on a similar policy with another insurer in the 31 day period before the start of this insurance, in which instance the waiting period will be waived.

No Benefit will be paid if the Pre-Existing Conditions Exclusion applies to the claim within the first 6 months from the start date of cover.  Any claim resultant from a pre-existing condition will be covered if the claim event arises in the period after the expiry of this initial 6 month period.

Pre-existing conditions exclusion

No claim will be payable if a death arises during the 6 (six) month period after the Commencement Date - of the policy, the addition of that life insured to the policy or (regarding the claim in respect of the increase) to the increase in Benefit of that life insured - and the death is directly or indirectly attributable to any condition (i.e. any medical condition diagnosed or not, physical defect, illness, bodily injury or disability) the insured suffered or of which the insured was aware or ought reasonably to have been aware and for which the insured received treatment or consulted, or should have consulted, a medical professional in the 12 (twelve) month period prior to the Commencement Date.   

Premiums

Premiums are to be paid monthly or annually in advance. The due date for every premium is detailed on the application form. The period of grace allowed for payment of the premiums is fifteen days commencing from the due date.

The Intermediary uses the Non-Authenticated Early Debit Order (NAEDO) system and may track your bank account to determine whether sufficient funds are available.

You must notify us immediately if your bank account details or your pay date change and we will be entitled to change your debit order details to collect the premium in terms of the Insurance policy agreement.

If premiums, in whole or in part, are in arrears, then the benefit will decrease as per the Premium Break benefit.  If 3 consecutive premiums remain unpaid, the policy will automatically lapse and all cover will cease with immediate effect.  Once the policy has lapsed, no claim will be entertained if a claim event arises after the policy has lapsed.

Reinstatement of lapsed Benefit

Where the policy has lapsed, a request to reinstate benefits must be made to the Insurer or your intermediary. The Insurer reserves the right to either accept or decline reinstatement of the policy.  Nol Waiting Period for claims arising from natural causes will apply unless the intial waiting period had not yet expired by the date of lapse in which instance the remainder of the period will be applied upon reinstatement provided the reinstatement occurs within 90 dys from the date of lapse.  Should the reinstatement occur after the 90 day period from the date of lapse, then the full waiting period dscribed above will be applied.

Termination of the Policy

The Policy shall terminate on the earliest of:

  • The death of the Policyholder;
  • Receipt of a written request from the Policyholder to cancel the Policy.  Such cancellation will not attract any refund of premiums paid during the currency of the plan;
  • The lapse of the policy in terms of the clause under the “Premium” section of this policy;
  • The 85th birthday of the Policyholder.
  • The cancellation of the policy by the insurer at any time by provided a 3 month notice period.

Cover under the Policy shall also terminate automatically in respect of any person who reaches the age of 85 years.

Notfications

The Insured must notify the administrator as soon as possible should there be a change of address, change to bank details or change to the nominated beneficiary.

Law and Currency

This policy shall be subject to the laws of the Republic of South Africa. All amounts paid to or from this policy will be in the lawful currency of the Republic of South Africa.

The Correctness of Statements made to the Insurer

The Insurer relies on the truth, completeness and correctness of all statements submitted. Should any benefits have been paid out on the basis of the information provided to the Insurer by anyone claiming a benefit , and such information subsequently proves to be incorrect in ay materail respeact , the Insurer shall have the right to take such steps as may be required to put it in the position it would have been in if the correct information had been provided in the first instance.

Surrender and Assignment

This policy acquires no surrender, loan or paid up value and it cannot be assigned. The policy may also not be pledged as security for a loan or debt.

Variations

  No Variation to this Policy will be binding on The Intermediary/Guardrisk unless made in writing and signed by a duly authorized officer of The Intermediary/Guardrisk and confirmed thereafter by payment by the Main Insured of the Premium whether varied or not.  No act of omission to act by The Intermediary/Guardrisk or any officer or employee of The Intermediary/Guardrisk shall be deemed to be a representation on behalf of The Intermediary/Guardrisk upon which the Main Member or the Main Member’s heirs, executors or assigns are entitled to act.

This Policy is issued on the basis that the statements and information made and set forth in the application and all declarations made in respect thereof are true and correct and constitute a full disclosure of all facts and circumstances likely to materially affect the assessment of the risk at the time of the issue of this Policy.

Guardrisk reserves the right to amend, add or change the terms and conditions of this Policy by giving 31 (thirty-one) days’ written notice of its intention to do so.

 Any variations and or changes will be binding on Guardrisk and the Main Insured and can be applied at any time to the existing terms and conditions after written communication of these changes has been sent to the Main Insured’s last known address (postal or email) as it appears in our records at that time.