GROUP TERM LIFE ASSURANCE SCHEME (CELCOM-BIMA) - ANNEXURE
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1 GROUP TERM LIFE ASSURANCE SCHEME (CELCOM-BIMA) - ANNEXURE This Annexure forms part of the Group Term Life Assurance Scheme certificate of insurance ( Certificate of Insurance ) to which it is attached and contains an extract of the Policy. The Certificate of Insurance is issued to You in consideration of the Policy Owner s payment to Us for benefits as described below subject to the terms, provisions, exclusions, limitation and conditions of and endorsed in this Annexure. This Annexure sets out the salient provisions provided under the Policy. 1. BENEFITS PAYABLE While the Certificate of Insurance is in force and subject to the provisions contained in this Annexure, We shall pay the Sum Assured in the event of death of the Life Assured. 2. TERMINATION OF INDIVIDUAL INSURANCE The death insurance coverage of the Life Assured under the Certificate of Insurance shall automatically terminate if any one (1) of the following occurs: on the date the Life Assured commences full-time military service; or 2.2. on the date when premium payments for Life Assured s insurance are discontinued for any cause; or 2.3. at the end of the Grace Period for the payment of premium as stipulated in Provision 4.6 below if the premium is not paid; or 2.4. upon the expiry of the Certificate of Insurance unless renewed by Us. 3. CLAIM PROCEDURES 3.1. NOTICE OF CLAIM Written notice of claim must be given to Us within thirty (30) days after the date of death. Failure to give notice within such time shall not invalidate any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible. Such notice given to Us at Our office with particulars sufficient to identify the Life Assured shall be deemed to be notice to Us PROOF OF CLAIM Such proof of claim as We may reasonably require are to be provided at the expenses of the Life Assured/claimant within ninety (90) days from the date of death. 3.3 INSTRUCTION TO PAY CLAIMS As the Policy Owner is merely the administrator of this Policy, the Policy Owner hereby agrees and irrevocably instructs that all benefits payable under this Policy shall be made to: the person named by the Life Assured in writing to Us using Our prescribed format; or in the event that the Life Assured did not give instructions to pay any person, We shall pay to: (a) lawful executor or administrator of the Life Assured s estate; or (b) where We are satisfied that there is no lawful executor or administrator of the Life Assured s estate, We may pay the benefits to the Life Assured s spouse, child or parent in accordance with Section 6 of the Distribution Act 1958; and (c) where there is no spouse, child or parent, We may pay the benefits without requiring a grant of probate or letters of administration or distribution order to a person that satisfies Us as the insurer that the person claiming is entitled to the property of the deceased Life Assured under his will or has the consent of all lawful beneficiaries to be the administrator of the estate of the deceased Life Assured The Policy Owner and Life Assured agrees that the benefits paid out in accordance with this Clause 3.3 shall be deemed to have been duly paid and We as the insurer shall be discharge from liability in respect of the benefits so paid notwithstanding the absence or invalidity of or any defect in the grant of probate or letters of administration or distribution order or any other document having the same effect. 4. GENERAL PROVISIONS 4.1. ALTERATIONS We reserve the right to amend the terms and provisions of this Annexure by giving a three (3) months prior notice in writing by ordinary post to Your last known address in Our records, and such amendment will be applicable from the next renewal of the Certificate of Insurance. No alteration to this Annexure shall be valid unless authorised by Us and such approval is endorsed. Level 29, Menara Allianz Sentral Page 1 of 3
2 4.2. ASSIGNMENT The insurance provided in this Certificate of Insurance and the benefits payable under such insurance are not assignable CURRENCY OF PAYMENT All amounts payable by the Life Assured or the Policy Owner to Us or by Us pursuant to this Certificate of Insurance shall be payable in the Malaysian currency NOTICE Every notice or communication to Us shall be in writing and sent to Us. No alterations in the terms of this Annexure or any endorsement on it, will be held valid unless the same is signed or initialed by Our authorised representative PARTICIPATION IN DIVISIBLE SURPLUS The Policy shall be Non-Participating and shall not share in Our Divisible Surplus PAYMENT OF PREMIUMS Payment of premiums payable shall be made by Policy Owner to Us. A grace period of thirty-one (31) days from its due date will be allowed for payment of each premium, during which period this Certificate of Insurance will remain in force (referred to as Grace Period in the Policy). If, at the expiration of the grace period, any premium due remains unpaid, this Certificate of Insurance shall terminate PERIOD OF COVER AND RENEWAL The Certificate of Insurance shall become effective as of the date stated in the Certificate of Insurance Schedule or in the notification sent to you which shall be the Individual Effective Date The period of cover of this Certificate of Insurance is three (3) months TAX In the event that any sales and services tax, value added tax or any similar tax and any other duties, taxes, levies or imposts (collectively Applicable Tax ) whatsoever are introduced by any authority and are payable under the laws of Malaysia in connection with any supply of goods and/or services made or deemed to be made under this Policy, the Company will be entitled to charge any Applicable Tax as allowed by the laws of Malaysia. Such Applicable Tax payable shall be paid in addition to the applicable premiums and other charges. All provisions in this Policy on payment of premiums and default hereof shall apply equally to the Applicable Tax ANTI-MONEY LAUNDERING, ANTI-TERRORISM FINANCING AND PROCEEDS OF UNLAWFUL ACTIVITIES ACT 2001 If We receive an order from the relevant authorities to freeze or seize the monies received as premium or monies payable in respect of the Certificate of Insurance as provided under the Anti-Money Laundering, Anti-Terrorism Financing and Proceeds of Unlawful Activities Act 2001 or such similar legislation or if We discover or have reasonable suspicion that the Certificate of Insurance is exploited for money laundering activities and/or to finance terrorism, We reserve the right to terminate the Certificate of Insurance immediately. We shall deal with all premiums paid and all benefits/sums payable in respect of the Certificate of Insurance in any manner which We deem appropriate, including but not limited to handing it over to the relevant authorities. 5. DEFINITIONS When used in this Certificate of Insurance: Age shall mean age nearest birthday. Certificate of Insurance shall mean the certificate, which forms a part of the Group Term Life Assurance Scheme, which the Life Assured will receive as a proof of his/her coverage. Eligible Person shall mean individuals entitled to participate in this Scheme, who are Celcom Subscribers aged between eighteen (18) to fifty (50) years old, nearest birthday. Life Assured shall mean the Eligible Person as listed or described in the Certificate of Insurance or by endorsement accepted by Us under the Scheme whose insurance coverage under the Certificate of Insurance is in force. Individual Effective Date shall mean the effective date of coverage of the Life Assured as stated in the Certificate of Insurance or notification sent to You. Non-Participating shall mean the Policy does not participate in the Divisible Surplus of Our life insurance business Policy shall mean the Scheme, any endorsement, annexure or schedule, any amendment to them signed by Our authorised representative and the Policy Owner s application. The Policy shall form an integral part of the entire legal contract between the Policy Owner and Us. Level 29, Menara Allianz Sentral Page 2 of 3
3 Policy Owner shall mean Milvik Malaysia Sdn Bhd. Scheme shall mean the Group Term Life Assurance Scheme. Sum Assured shall mean the amount payable by Us as specified in the Certificate of Insurance. We/Us/Our shall mean Allianz Life Insurance Malaysia Berhad. You/Your shall mean the Life Assured. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Level 29, Menara Allianz Sentral Page 3 of 3
4 GROUP TERM LIFE ASSURANCE SCHEME (CELCOM-BIMA) - LAMPIRAN Lampiran ini merupakan sebahagian daripada Sijil Insurans Skim Group Term Life Assurance Scheme ( Sijil Insurans ) yang mana ia dilampirkan dan mengandungi sebahagian daripada Polisi ini. Sijil Insurans dikeluarkan selaras dengan Permohonan Anda dan sebagai balasan bayaran Premium oleh Pemegang Polisi sebagaimana dinyatakan dalam lampiran ini. Sijil Insurans ini menyatakan peruntukanperuntukan penting yang disediakan di bawah lampiran ini. 1. PERUNTUKAN MANFAAT Ketika Sijil Insurans ini berkuatkuasa, Kami akan tertakluk kepada peruntukan-peruntukan yang terkandung dalamnya, membayar Jumlah Manfaat yang selaras dengan Sijil Insurans. 2. PERUNTUKAN PENAMATAN Sijil Insurans yang berkaitan yang dikeluarkan di bawah Polisi ini akan tamat dalam mana-mana satu (1) peristiwa yang berikut: pada ketika Orang yang Diinsuranskan memulakan perkhidmatan ketenteraan sepenuh masa; atau 2.2. pada ketika bayaran premium insurans Orang yang Diinsuranskan diberhentikan untuk sebarang sebab; atau 2.3. pada akhir Tempoh Penangguhan sebagaimana tertakluk di Peruntukan 4.6 di bawah; atau 2.4. pada tarikh tamat Sijil Insurans melainkan diperbaharui oleh Kami. 3. PERUNTUKAN TUNTUTAN 3.1. NOTIS TUNTUTAN Notis tuntutan bertulis hendaklah diberikan kepada Kami dalam masa tiga puluh (30) hari dari tarikh kematian Orang yang Diinsuranskan. Kegagalan untuk memberikan notis dalam tempoh masa yang ditetapkan tidak akan membatalkan apa-apa tuntutan sekiranya telah ditunjukkan bahawa notis sedemikian tidak boleh secara munasabah diberikan lebih awal dan bahawa notis telah diberikan sebaik sahaja ia menjadi munasabah untuk diberikan. Notis sedemikian dengan butiran yang mencukupi untuk mengenal pasti identiti Orang yang Diinsuranskan akan dianggap sebagai notis kepada Kami BUKTI TUNTUTAN Bukti bertulis untuk menyokong sesuatu tuntutan harus dikemukakan kepada Kami di pejabat Kami dalam masa sembilan puluh (90) hari dari tarikh kematian Orang yang Diinsuranskan. 3.3 ARAHAN BAYARAN TUNTUTAN Oleh kerana Pemegang Polisi hanyalah pentadbir Polisi ini, Pemegang Polisi dengan ini bersetuju dan tidak boleh batal mengarahkan bahawa semua manfaat yang kena dibayar di bawah Polisi ini akan dibuat kepada: 4. PERUNTUKAN AM orang yang dinamakan oleh Orang tang Diinsuranskan secara bertulis kepada Kami menggunakan borang yang ditetapkan kami; atau sekiranya Orang yang Diinsuranskan tidak memberi arahan untuk membayar mana-mana orang, Kami akan membayar kepada: (a) wasi atau pentadbir sah harta pusaka Orang Yang Diinsuranskan; atau (b) di mana Kami berpuas hati bahawa tiada pelaksana atau pentadbir harta pusaka Hayat Yang Diinsuranskan, Kami boleh membayar manfaat kepada suami, anak atau ibu bapa yang Diinsuranskan mengikut Seksyen 6 Akta Pengagihan 1958; dan (c) di mana tidak ada pasangan, anak atau ibu bapa, Kami boleh membayar faedah tanpa memerlukan pemberian probet atau surat pentadbiran atau perintah edaran kepada seseorang yang memenuhi Kami sebagai penanggung insurans yang orang yang menuntut berhak kepada harta Orang yang Diinsuranskan di bawah kehendaknya atau mempunyai persetujuan dari semua penerima yang sah untuk menjadi pentadbir harta pusaka Orang yang Diinsuranskan Pemegang Polisi dan Orang yang Diinsuranskan bersetuju bahawa faedah yang dibayar mengikut Peruntukan 3.3 ini dianggap telah dibayar dengan sewajarnya dan Kami sebagai penanggung insurans akan dilepaskan daripada liabiliti berkenaan dengan faedah yang dibayar sedemikian walau apa pun ketiadaan atau ketidaksahihan atau apa-apa kecacatan dalam pemberian probet atau surat pentadbiran atau perintah edaran atau mana-mana dokumen lain yang mempunyai kesan yang sama PINDAAN Kami berhak menyemak terma dan peruntukan dalam Sijil Insurans dengan memberi notis bertulis tiga (3) bulan sebelumnya. Notis ini akan dihantar melalui pos ke alamat Anda mengikut rekod Kami. Sebarang perubahan akan dikuatkuasakan pada ulang tahun Sijil Insurans yang akan datang. Sebarang perubahan hanya sah jika diluluskan oleh pegawai Kami yang diberi kuasa dan telah diluluskan. Level 29, Menara Allianz Sentral Page 1 of 3
5 4.2. SERAHAN HAK Penyerahan hak ke atas Sijil Insurans ini adalah tidak dibenarkan MATAWANG BAYARAN Semua amaun perlu dibayar oleh Anda atau Pemegang Polisi kepada Kami atau oleh Kami selaras dengan Sijil Insurans ini perlu dibayar dalam mata wang Malaysia NOTIS Setiap notis atau komunikasi kepada Kami hendaklah secara bertulis dan dihantar kepada Kami. Tiada apa-apa perubahan dalam terma Lampiran ini atau mana-mana pengesahan mengenainya, akan diadakan sah melainkan yang sama ditandatangani atau ditandatangani oleh wakil kami yang diberi kuasa PENYERTAAN DALAM LEBIHAN BOLEH DIBAHAGI Ini adalah Polisi Tidak Menyertai dan tidak turut-serta dalam Lebihan Boleh Dibahagi daripada perniagaan insurans hayat Kami BAYARAN PREMIUM Pembayaran premium yang perlu dibayar akan dibuat oleh Pemegang Polisi kepada Kami. Tempoh penangguhan tiga puluh satu (31) hari dari tarikh tamat tempohnya akan dibenarkan untuk membayar setiap premium, dalam tempoh mana Sijil Insurans ini akan berkuatkuasa (dirujuk sebagai "Tempoh Penangguhan" dalam Polisi). Jika, apabila tamatnya tempoh penangguhan, apa-apa premium yang belum dibayar masih belum dibayar, Sijil Insurans ini akan ditamatkan TEMPOH PERLINDUNGAN DAN PEMBAHARUAN Sijil Insurans akan berkuatkuasa pada tarikh yang dinyatakan di dalam Jadual Sijil Insurans atau dalam pemberitahuan yang dihantar kepada Anda yang akan menjadi Tarikh Berkuatkuasa Individu Tempoh perlindungan Sijil Insurans ini adalah tiga (3) bulan CUKAI BERKENAAN Sekiranya sebarang cukai barangan dan perkhidmatan, cukai nilai tambah atau sebarang cukai yang serupa dan sebarang duti, cukai, levi, atau apa-apa jua impos (dirujuk secara kolektif sebagai Cukai Berkenaan ) yang diperkenalkan oleh sebarang pihak berkuasa dan perlu dibayar di bawah undang-undang Malaysia yang berkaitan dengan pembekalan sebarang barangan dan/atau perkhidmatan yang dibuat atau dianggap telah dibuat di bawah Polisi ini, Kami berhak mengenakan sebarang Cukai Berkenaan yang dibenarkan oleh undang-undang Malaysia. Cukai Berkenaan yang perlu dibayar akan dibayar sebagai tambahan kepada premium dan caj-caj lain yang berkenaan. Semua peruntukan dalam Polisi ini mengenai pembayaran premium dan keingkaran akan turut digunapakai dengan Cukai Berkenaan PENCEGAHAN PENGUBAHAN WANG HARAM, PENCEGAHAN PEMBIAYAAN KEGANASAN DAN HASIL DARIPADA AKTIVITI HARAM 2001 Sekiranya kami menerima arahan daripada pihak berkuasa yang berkenaan untuk membekukan atau menyita wang yang diterima sebagai premium atau wang yang boleh dibayar berkaitan dengan Polisi ini seperti dinyatakan di bawah Akta Pencegahan Pengubahan Wang Haram dan Pencegahan Pembiayaan Keganasan 2001 atau apa-apa perundangan yang sama atau sekiranya kami menemui atau mempunyai keraguan yang munasabah bahawa Polisi ini dieksplotasi untuk aktiviti pengubahan wang haram dan/atau untuk membiayai keganasan, kami berhak untuk menamatkan Polisi ini dengan serta merta. Kami akan menguruskan premium yang telah dibayar dan kesemua manfaat/jumlah bayaran berkaitan dengan Polisi ini dengan apa-apa cara yang kami rasakan sesuai, termasuk tetapi tidak terhad kepada menyerahkannya kepada pihak berkuasa yang berkenaan. 5. DEFINISI Apabila digunakan di dalam Lampiran ini: Umur bermaksud umur harijadi terdekat Orang yang Diinsuranskan. Sijil Insurans bermaksud sijil, yang menjadi sebahagian daripada Skim ini, yang Orang yang Diinsuranskan akan menerima sebagai bukti perlindungannya. Orang yang Layak bermaksud individu yang berhak menyertai Skim ini, yang merupakan Pelanggan Celcom yang berumur antara lapan belas (18) hingga lima puluh (50) tahun, pada harijadi terdekat. Orang yang Diinsuranskan bermaksud Orang yang Layak yang disenaraikan atau dihuraikan di dalam Sijil Insurans atau dengan pengesahan yang diterima oleh Kami di bawah Skim ini yang perlindungan insurans di bawah Sijil Insurans berkuatkuasa. Tarikh Berkuatkuasa Individu bermaksud tarikh berkuatkuasa perlindungan Orang Yang Diinsuranskan seperti yang dinyatakan di dalam Sijil Insurans atau pemberitahuan yang dihantar kepada Anda. Level 29, Menara Allianz Sentral Page 2 of 3
6 Tidak Menyertai bermaksud Polisi ini tidak turut-serta dalam Lebihan Boleh Dibahagi daripada perniagaan insurans hayat Kami. Polisi bermaksud Skim ini, apa-apa pengendorsan, lampiran atau jadual, apa-apa pindaan kepada mereka yang ditandatangani oleh wakil kami yang diberi kuasa dan permohonan Pemegang Polisi. Polisi ini akan menjadi sebahagian daripada keseluruhan kontrak undang-undang antara Pemegang Polisi dan Kami. Pemegang Polisi bermaksud Milvik Malaysia Sdn Bhd. Skim bermaksud Group Term Life Assurance Scheme. Jumlah Manfaat bermaksud jumlah yang perlu dibayar oleh Kami seperti dinyatakan dalam Sijil Insurans. Kami bermaksud Allianz Life Insurance Malaysia Berhad. Anda bermaksud Orang yang Diinsuranskan. BAHAGIAN LAIN MUKA SURAT INI SENGAJA DIBIARKAN KOSONG. Level 29, Menara Allianz Sentral Page 3 of 3
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