SCORPION BRANCHES. Branches continue on back page

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2 SCORPION BRANCHES BELLVILLE Suite 2015, 2nd Floor, Slaney Centre 39 Durban Road, Bellville P O Box 2333, Bellville, 7535, Docex 38, Bellville Tel: , Fax: NELSPRUIT Office , 6th Floor, Talis Towers, 17 Samora Machel Street, Nelspruit P O Box 6887, Nelspruit, 1200 Docex 56, Nelspruit Tel: , Fax: BLOEMFONTEIN 1st Floor, JOE Building, 23 Elizabeth Street, Bloemfontein P O Box 3706, Bloemfontein, Docex 118, Bloemfontein Tel: , Fax: CARLETONVILLE Shop 8B, cnr. Ada and Osmium Streets, Carletonville P O Box 656, Carletonville, Docex 7, Carletonville Tel: , Fax: DURBAN 8th Floor, Aquasky Towers, 275 Anton Lembede Street, Durban P O Box 789, Durban, Docex 352, Durban Tel: , Vax: EAST LONDON 6th Floor, Oxford House, Oxford Street, East London P O Box 1730, East London, 5200 Docex 51, Gasson Centre, East London Tel: , Fax: NEWCASTLE Shop No 4, Misin Centre, Scott Street, Newcastle (Next to Shoprite Centre) P O Box 2912, Newcastle, 2940 Docex 12, Newcastle Tel: , Fax: PIETERMARITZBURG Shop 2, 60 Boshoff Street, cnr. Boom Street, Pietermaritzburg P O Box 3280, Pietermaritzburg, 3200 Docex 103, Pietermaritzburg Tel: , Fax: POLOKWANE 1st Floor, Nedbank Building, 58 Landros Mare Street, Polokwane P O Box 4394, Polokwane, 0700 Docex 28, Polokwane Tel: , Fax: PORT ELIZABETH 1st Floor, Old Mutual Building, Govan Mbeki Avenue, Port Elizabeth P O Box 639, Port Elizabeth, 6000 Docex 161, Port Elizabeth Tel: , Fax: EMALAHLENI (WITBANK) Office No. 1, 3rd Floor, Vusani House, cnr. Arras & President Streets, Witbank P O Box 609, Witbank, 1035 Docex 3, Sentinel, Witbank Tel: , Fax: GERMISTON Shop 2, cnr. Victoria & Library Streets, Germiston P O Box 1795, Germiston, 1400 Docex 348, Germiston Tel: , Fax: JOHANNESBURG 1st Floor, OPH Building, 112 Main Street, cnr. Main & Eloff Streets, Marshalltown, Johannesburg P O Box 411, Newtown, 2113 Docex 348, Johannesburg Tel: , Fax: KEMPTON PARK Suite 4, Perm Plaza, 20 Voortrekker Street, cnr. Wolff Street, Kempton Park P O Box 1765, Kempton Park, 1620 Docex 17, Kempton Park Tel: , Fax: KLERKSDORP OASE Gemeente Building,1st Floor, 36 Leask Street, Klerksdorp, 2571 P O Box 623, Klerksdorp, 2570 Docex 8, Klerksdorp Tel: , Fax: Branches continue on back page PRETORIA Office 801, 8th Floor, Presidia Building, 255 Pretorius Street, cnr. Pretorius & Paul Kruger Streets, Pretoria P O Box 2159, Pretoria, 0001 Docex 367, Pretoria Tel: , Fax: ROODEPOORT Station Square, cnr. Adolphus & Luttig Streets, Roodepoort P O Box 1550, Roodepoort, 1725 Docex 23, Roodepoort Tel: , Fax: RUSTENBURG 1st Floor, 44 Boom Street, Rustenburg P O Box 5775, Rustenburg, 0300 Docex 27, Rustenburg Tel: , Fax: SPRINGS Office 5, The Avenues Shopping Centre, 6th Avenue, Springs P O Box 2285, Springs, 1560 Docex 18, Springs Tel: , Fax:

3 SCORPION FUNERAL PLAN POLICY DOCUMENT A maximum fee of 55% of gross written premium is paid out in commissions. SCORPION FUNERAL PLAN Underwritten by HOLLARD LIFE ASSURANCE COMPANY LIMITED (Reg. No. 1993/001405/06) ( The Company ) specially arranged for SCORPION LEGAL PROTECTION (PTY) LIMITED (Reg. No. 1996/001206/07) ( Scorpion ) Scorpion acts as a non-mandated intermediary HOLLARD LIFE ASSURANCE COMPANY LIMITED 1

4 SCORPION FUNERAL PLAN POLICY WORDING UNDERWRITTEN BY HOLLARD This is your Scorpion Funeral Plan Policy Wording. The Company will accept any eligible person who has bought this Funeral Plan and will, in the event of a valid claim, pay to your estate subject to the terms and conditions of this policy. This document tells you in clear and simple language how the policy works. The name of the insurance company is Hollard Life Assurance Company Limited ( The Company ). Scorpion administers this policy on behalf of The Company. The Company is a registered insurance company and a licensed Financial Services Provider. Scorpion is a licensed of Hollard in terms of this policy. This policy wording as amended from time to time, various administrative forms, application forms, policy schedule, logged conversations pertaining to this policy and agreements supplied by Scorpion shall form the basis of this insurance contract. In the event of any difference between this policy and that of any other documents mentioned above, the provisions of this policy shall prevail. HOW TO GET HOLD OF US To register your family details, please call To communicate with Scorpion in connection with this policy kindly contact: Scorpion Legal Protection, Funeral Claims Division, PO Box 1795, Germiston, 1400 Tel: Fax: or

5 1. BENEFITS waiting periods from the Start Date of cover for the Insured Person as stipulated in this policy. You or an Insured Person and if you do this the policy will be null and void. 1.1 FUNERAL BENEFIT nominated Insured Person s death during the period of insurance. You will complete the details of the insured persons on the application form which you will have to sign. You will need your family member s ID numbers/date of birth to register the details on the application form. The Company will conditions of this policy. 1.2 ADDITIONAL ACCIDENTAL DEATH BENEFIT Company will provide additional cover in the event of the Accidental Death of the Main Insured Person and/or Partner from the Start Date of their cover, as long as all premiums have been paid. There is no Waiting Period for the Additional Accidental In the event of the Accidental Death of the Main Insured Person and/or Partner, during or after the Waiting Period (clause 4.1), then because of paid. If an Insured Person dies after the Start Date as a result of an accident that occurred before the Start schedule. 1.3 BREADWINNER S BENEFIT (IF APPLICABLE) provides cover in the event of the death of the 3

6 Main Insured Person only, during the period of insurance. Waiting Periods from the Start Date of cover in respect of the Main Insured Person as stipulated in this policy. Main Insured Person on this policy subject to the terms and conditions of this policy. The sum insured will be paid in equal monthly instalments for a maximum period of 12 (twelve) months. 2. LIMITATION OF BENEFITS No Main Insured Person or Partner may be covered in terms of one or more Scorpion Funeral Plans where the total cover No Child or Parent may be covered in terms of one or more Scorpion Funeral Plans where the total cover in respect of The Company may increase these limits from time to time. In the event that a claim or claims are submitted for more the amount payable by The Company will be limited to the portion of the premiums paid for cover above the maximum validity of any claim. 3. NOMINATION OF BENEFICIARY OR BENEFICIARIES complete the application form you must indicate or say who Insured Person under this policy as stipulated by you at you. inform Scorpion in writing or telephonically of any change. paid to the following in relation to the Main Insured Person, 4

7 in descending order: The Partner, and if there is no Partner then; Adult Child, and if there is no Adult Child then; Parent, and if there is no Parent then; The estate of the deceased Main Insured Person. 4. SPECIFIC RESTRICTIONS, EXCLUSIONS, PROVISIONS AND CONDITIONS 4.1 WAITING PERIODS The Waiting Periods that are applicable for certain occurs during any applicable Waiting Period. The Waiting Periods in respect of an Insured Person commences on the Start Date of this policy or the date on which the relevant Insured Person becomes entitled to cover in terms of this policy. The Start Date is the date that Scorpion receives Should cover in respect of an Insured Person be terminated and subsequently restarted the Waiting Periods will commence from the date that cover is restarted unless waived in writing by The Company. Should cover in respect of an Insured Person be terminated and subsequently reinstated then from the date that cover is reinstated and unless waived in writing by The Company a Waiting Period of 6 (six) consecutive months and 6 (six) consecutive premium payments will apply to any claim where the cause is either due to natural causes, suicide or Where a Waiting Period was still applicable prior to the policy lapsing and been reinstated, the balance of any such Waiting Period will continue to apply after the reinstatement. of an Insured Person and be added to the policy, the Waiting Periods will apply in respect of the increased cover. There will be no Waiting Period for new born children, as long as he/she is added within 60 (sixty) days of birth and the policy is older than the Waiting Period. No Waiting Period applies for death as a result of an accident. Cover for Accidental Death commences from the Start Date of this policy. 5

8 In the event of an Insured Person dying before the Start Date or dying as a result of an Accident that occurred before the Start Date, there will be no WAITING PERIOD DEATH FROM NATURAL CAUSES o 6 (six) months for Plans A and B; and o 12 (twelve) months for Plans C and D; for the Main Insured Person, Partner and Children Period of 12 (twelve) months for Parents and premium. of an Insured Person due to natural causes during the Waiting Period WAITING PERIOD DEATH FROM SUICIDE A Waiting Period of 24 (twenty four) consecutive (one after the other) months and 24 (twenty four) consecutive premium payments will apply on the death of an Insured Person by suicide, where death is caused directly or indirectly by or arising from or resulting from or contributed to by or traceable to any attempted suicide. 4.2 ELIGIBILITY The Main Insured Person and Partner will be eligible for cover from the date of his/her 18th (eighteenth) birthday, at the application date. Thereafter cover continues for life as long as the monthly premium is paid. The Main Insured Person and Partner will not be eligible to apply for cover from the date of his/her Children of the Main Insured Person are eligible to provided that the Child was not married at the time of death. Cover is extended to the 25th (twenty- student registered at an educational institution or is mentally disabled or is permanently and totally physically disabled (providing that satisfactory proof is submitted to Scorpion in respect of the above). Parents are eligible for cover up to the date of their Thereafter cover continues for life as long as the 6

9 monthly premium is paid. Persons over the age of be covered as a Parent on the Scorpion Funeral Plan. Extended Family Members are eligible for cover at the application date. Thereafter cover continues for life as long as the monthly premium is paid. application are not eligible to be covered as an Extended Family Member on the Scorpion Funeral Plan. 4.3 TERMINATION OF COVER (STOPPING YOUR POLICY) The cover provided by this policy will cease/stop on the earlier of: - You or the Company cancelling this policy and the cover provided; or - If you do not pay the premium every month before the grace period expires; or - Payment of a valid death claim on the life of the Main Insured Person. In the event of death of the Main Insured Person on the Scorpion Funeral Plan, the Main Insured Person s Partner has the option to continue cover by informing Scorpion in writing or telephonically. Scorpion will tell/advise the Main Insured Person s Partner of the monthly premium payable on continuation of cover. 4.4 TERMINATION OF BENEFITS cease on the earlier of: - where the Insured Person was over the age of 18 (eighteen) and not a Child nor an Extended Family Member under the age of 21 (twenty-one) when the Insured s cover commenced: The death of the particular Insured Person, or The non-payment of any premium within 30 (thirty) days of the premium due date, subject to the grace periods; or The policy ceasing. - where the Insured Person was unmarried, under the age of 21 (twenty-one) and not an Extended Family Member when the Insured s cover commenced: birthday, or 7

10 birthday if the Insured Person is an unmarried full-time student registered at a registered educational institution or is mentally disabled or is permanently and totally physically disabled (provided that satisfactory proof is submitted to Hollard in respect of the above), or The Insured Person getting married, or The death of the Insured Person, or The non-payment of any premium within 30 (thirty) days of the premium due date, subject to the grace periods; or The policy ceasing. - where the Insured Person was unmarried, under the age of 21 (twenty-one) and an Extended Family Member when the Insured s cover commenced: birthday, The Insured Person getting married, or The death of the Insured Person, or The non-payment of any premium within 30 (thirty) days of the premium due date, subject to the grace periods; or The policy ceasing. 5. GENERAL RESTRICTIONS, EXCLUSIONS, PROVISIONS AND CONDITIONS 5.1 GENERAL be ceded or transferred to any third party. of the validity of any claim. This policy does not acquire any paid up value or surrender value. 5.2 TERRITORY COVERED Any Insured Person ordinarily resident in the Republic of South Africa will be covered in terms of this policy. Cover is extended to include a visit lasting less than three months outside the territory covered. An Insured Person who is not a South African citizen, a permanent legal resident or who ordinarily resides outside of the Republic of South Africa will not be covered in terms of this policy. 8

11 5.3 CURRENCY AND LAW shall be paid in the Republic of South Africa and in South African Rands only. This policy shall be governed by and interpreted in accordance with South African Law in the courts of the Republic of South Africa. 5.4 CRIMINAL ACTIVITIES The Company shall have no liability whatsoever under this policy where any claim arises from, or is the result of any contravention of any criminal law, whether legislative or at common-law (including fraud), by you or an Insured Person, or by anyone acting on your or an Insured Person s behalf or with your or an Insured Person s consent, or by of such claim, and premiums paid in respect of such policy shall be forfeited, and this policy may be voided or cancelled as from the date of the criminal offence, at The Company s discretion. 5.5 MISREPRESENTATION, MISDESCRIPTION OR NON-DISCLOSURE Misrepresentation, misdescription or nondisclosure of any material fact or circumstances in connection with this policy, a claim or the application for this policy may result in this policy being cancelled, a claim rejected or the policy voided from inception and all your premiums forfeited. result of any misrepresentation, non-disclosure, mis-description or fraudulent action by an Insured under this policy such person will be required to and any costs involved. 5.6 CLERICAL MISTAKE BY SCORPION A clerical mistake by Scorpion shall not invalidate insurance otherwise validly in force, nor continue insurance otherwise not validly in force. 5.7 INSURABLE INTEREST In order for an insurance policy to be valid, you are required to have an insurable interest in the Insured Person Partner, Child, Parent or Extended 9

12 needs to be a recognised relationship between you and the Insured Person and as a result of this event of the death of the Insured Person. Where no insurable interest exists, the policy shall be void from the Start Date of cover. 5.8 PREMIUM PAYMENT DAYS OF GRACE Scorpion will notify you of any non-payment of premium by SMS or letter. It is important that you notify Scorpion if your contact details change. A period of 90 (ninety) days grace is allowed for the payment of each premium due and payable 3 years, the grace period will be extended by 1 (one) month, subject to a maximum grace period of 6 (six) months. force. If any event occurs during the period of grace that results in a valid claim, the unpaid premiums will be deducted from any amount paid out. If any premium is not paid and received by Scorpion or The Company within the grace period from the premium due date, this policy will automatically lapse at midnight on the last day of the preceding period of insurance for which a premium has been paid and all cover will be terminated. The premium grace period does not apply to the policy (THIRTY) DAY POLICY REVIEW PERIOD Where no claim has been instituted in terms of this policy or where no right has accrued to you of the policy, you may, within 30 (thirty) days after having received a policy pack containing your policy documentation, cancel the policy by contacting Scorpion and informing them of the cancellation or notifying Scorpion in writing or telephonically of the cancellation of the policy. All premiums paid during this 30 (thirty) day review period shall be refunded by Scorpion, subject to the deduction of the cost of any cover actually enjoyed by the Insured Persons. 10

13 5.10 NO PREMIUM NO COVER IF YOU DO NOT PAY YOUR PREMIUM YOUR COVER WILL STOP This policy is conditional upon and will only premium. Premiums are due and payable monthly in advance 5.11 PREMIUM PAYMENT Premiums are due on the Premium Due Date and your nominated bank account will be debited on this date. In the event that your Premium Due Date falls on a weekend or public holiday, the nominated bank before or after the weekend or public holiday. If any debit order instruction is not successful on the Premium Due Date because there are then Scorpion may debit the nominated bank funds in the nominated bank account CANCELLATION STOPPING YOUR POLICY You may cancel this policy at any time by giving 30 (thirty) days notice to Scorpion of the cancellation of the policy in writing or telephonically. Scorpion may cancel this policy at any time by giving 30 (thirty) days notice to you of the cancellation of the policy in writing or telephonically. Such cancellation notice shall be accepted from the date of posting such notice. If a premium has been paid for a period beyond the date of cancellation of this policy, the relevant premium will be refunded. The Company is not responsible for any cancellation requested by you, where you do not inform the Insured Persons of such cancellation TERMINATION OF POLICY The policy will cease on the earlier of: - You or Scorpion cancelling this policy and the cover provided; or expired, lapsed; or - The death of the Main Insured Person. 11

14 5.14 CHANGES TO YOUR PREMIUM AND POLICY Scorpion and The Company may increase the premium amount from time to time by giving you 30 (thirty) days written notice of such increase. Scorpion and The Company may amend this policy by way of endorsement, provided that any amendment will not affect the extent of cover already provided and in force in terms of this policy. Scorpion and The Company reserves the right to amend the terms and conditions of this agreement and increase the premium from time to time upon 30 (thirty) days notice by ordinary posted to the Policyholder s last known address or an alternative written address supplied by the Policyholder. Notice to policyholders shall be deemed to be received within 10 (ten) weekdays (excluding public holidays) of the date of posting. If we receive payment of your premium after any to have agreed to the relevant amendment/s or changes in premium. No person or company is authorised to receive premiums from you on behalf of Scorpion, unless such person is in possession of a written authority from Scorpion to do so. Scorpion may charge an administration fee for any amendment you request (including reinstatement of your policy). Scorpion will advise you of the administration fee at the time that you request the amendment. Scorpion may increase the policy fee on an annual 5.15 CHANGES IN YOUR DETAILS THAT YOU SUPPLIED IN YOUR APPLICATION Should there be any changes to the original details supplied by you at the time of application or telephonically on within 30 (thirty) days of such change occurring. If you do not notify Scorpion of such change, The Company reserves the right to reject the claim or to cancel this policy STARTING YOUR POLICY AGAIN If your policy has been cancelled due to nonpayment of premiums, you will be allowed to 12

15 reinstate this policy within a maximum of 3 (three) months from the date that the last premium was clause 5.8 above. Reinstatement of this policy is subject to a written or telephonic instruction by you. On reinstatement, no premiums are payable for the period from the expiry of the grace period to the date of reinstatement. On reinstatement your grace period will start over again, with a minimum of 3 (three) months. On reinstatement no new Waiting Periods will be imposed. However, if the policy was cancelled during the Waiting Period, the remaining Waiting Period will commence from the date of reinstatement. the expiry of the grace period to the date of reinstatement INDULGENCES Non-enforcement or indulgences of any provisions in this policy will not mean that we waive any of our rights or change our obligations under this policy and will not preclude us from enforcing any terms and conditions of this policy CONSENT TO DISCLOSURE OF PRIVATE INFORMATION It is essential for insurance companies to share claims and underwriting information (as well as credit information) in order to enable the fair assessment and underwriting of risks and to reduce the number of fraudulent claims. You hereby waive any right to privacy and consent to the disclosure of any insurance information provided by you or on your behalf for any insurance policy or claim made or lodged by you or on your behalf and you agree to such information being disclosed to any other insurance company, whether on your behalf or on behalf of any person you represent herein. This consent clause will survive the termination for whatever reason of the policy, including the cancellation or lapsing thereof. other sources or databases CONTINUATION OPTION In the event of death of the Policyholder the Main Insured Person s insured Partner has the option 13

16 to continue cover by informing The Company in writing. This continuation option is valid for a period of 3 (three) months after the death of the Policyholder. The continuation option may only be taken up if the Main Insured Person s insured Partner has an insurable interest in each of the Insured Persons whose cover is to be continued. Should the continuation option be taken up, Hollard will advise the Main Insured Person s insured Partner (as applicable) of the monthly premium payable on continuation of cover CONDITION PRECEDENT The Company s liability in terms of this policy is conditional on you, an Insured Person or anyone acting on your behalf, complying with all the terms, conditions and warranties of this policy THE COMPANY S LIABILITY The Company will not be liable to make any payment unless the premium due in terms of this policy has been received, and the applicable documentation, data or medical evidence and satisfactory proof of a claim, as required by Scorpion has been provided to Scorpion at your, appointed Executor s, expense. the event of a valid claim in terms of this policy will be a full and effective discharge by The Company of its liability and obligations in terms of the policy REJECTION OF CLAIM AND TIME BAR If The Company, via Scorpion, declines liability for a claim made in terms of this policy, voids this policy, or if there is a dispute regarding the amount of the claim, representation may be made to The Company within 90 (ninety) days (the representation period ) of the date of your receipt of the letter of rejection or avoidance. Representation must be submitted in writing to: Hollard Life Claims Manager, PO Box 87428, Houghton, 2041 Fax: Alternatively, you may contact: The Ombudsman for Long Term Insurance, Private Bag X45, Claremont 7735 Tel: Fax:

17 If the dispute is not satisfactorily resolved in this manner, legal action may be instituted against The Company for the enforcement of the claim by way of the service of summons against The Company. Summons must be served on The Company within 180 (one hundred and eighty) days of the expiry of in respect of such claim shall be forfeited and no liability can arise in terms of such claim. 6. CLAIM NOTIFICATION PERIOD On the happening of an event, which may result in a claim appointed Executor shall, at their own expense submit the claim to Scorpion. must submit to Scorpion, the full details in writing of the claim as soon as reasonably possible up to a maximum of 180 (one hundred and eighty) days from the date of the event giving rise to the claim. The Company shall in no way whatsoever be liable to pay within the maximum period as stipulated above. 7. DEFINITIONS Unless the contrary appears from the context, the following words and phrases shall have the meanings assigned to them where they appear in this policy: 7.1 POLICYHOLDER OR YOU OR YOUR Policyholder or you or your refers to the person applying for cover on the lives of the Insured Persons. The Policyholder must be the Main Insured Person. 7.2 INSURED PERSONS This policy may provide cover only in respect of a Main Insured Person and a Partner or Child of the Main Insured Person where applied for by you in terms of this policy MAIN INSURED PERSON The person who has been accepted as the Main Insured Person in terms of this policy PARTNER Partner means the person to whom the Main Insured Person is married. If a Main Insured Person is joined in marriage with 2 (two) or more persons then only the Partner whom schedule as a Partner will be covered, subject to the terms and conditions of this policy. Once a nomination has been made, it remains in force for as long as the Main Insured Person is married to his or her Partner or until you notify Scorpion in writing or telephonically of any changes. 15

18 Marriage means: a marriage in terms of statutory law; a union which is recognised as a marriage in terms of any customary or tribal law or under the tenets of any Asiatic religion; or a union where 2 (two) persons are living together as if married (whether in a heterosexual or homosexual partnership), with the commitment of continuing to do so permanently and have been doing so for at least 12 Provided that: if the Partner is added after the start of the policy the waiting periods relating to the Partner will start on the date the Partner was added to this policy. satisfactory proof is submitted to Scorpion regarding the above. A Partner can be covered under the Scorpion Funeral Plan at no additional premium CHILD OR CHILDREN A Child means a Child of the Main Insured Person and/or schedule by you, subject to the terms and conditions of this policy. Once a nomination has been made, it remains in as the Child is unmarried, or until you notify Scorpion in writing or telephonically of a change. Cover will, however, birthday, if the Child is unmarried and a full-time student registered at an educational institution or is mentally retarded or is permanently and totally disabled, provided that satisfactory proof of such status is submitted to Scorpion. A Child means: a Child by birth, including a Child still-born (following 28 weeks of pregnancy and not as a result of any wilful abortion) while the policy is in force, a step-child, or an adopted Child, a Child in respect of whom the Main Insured Person has been appointed as the legal guardian of the Child (in certain special circumstances) and where the Child is not a Child by birth, a step-child, or an adopted Child, provided that satisfactory proof of such status is submitted to Scorpion. A Grandchild means a Child of any of the Main Insured Person s Children or the Main Insured Person s Partner s Children and where both Parents of the Grandchild are deceased or where the Grandchild is a dependant of the Main Insured Person or the Partner, provided that satisfactory proof of such status is submitted to Scorpion. 16

19 You need to inform Scorpion in writing or telephonically of the birth of a Child whom you want covered in terms of this policy. No waiting period in respect of cover will apply (sixty) days of the birth of the Child. Plan at no additional premium. 3 (three) Additional Children may be added to the Scorpion Funeral Plan at an additional monthly premium. A maximum of 8 (eight) children may be covered by the Scorpion Funeral Plan in total PARENT OR PARENTS Parent means a Parent of the Main Insured Person or Main Insured Person s Partner who is nominated as a Parent in tions of this policy. A Parent must be one of the following: Biological father or mother of the Main Insured Person or Partner Adoptive father or mother of the Main Insured Person or Partner Legal guardian of the Main Insured Person or Partner Stepfather or stepmother of the Main Insured Person or Partner Parents can be covered under a Scorpion Funeral Plan for an additional monthly premium per Parent. A maximum of 4 (four) Parents may be covered in terms of the Scorpion Funeral Plan EXTENDED FAMILY MEMBER Extended Family Member means a person who is a Dependant of the Main Insured Person or the Main Insured Person s Partner and whose relationship with the Main Insured Person or the Main Insured Person s Partner can be described by one of the following: Additional Partner, Adult Child, Biological Brother or Biological Sister, Niece or Nephew, Aunt or Uncle. Additional Partner means a Partner of the Main Insured Person. Adult Child means a Child or Grandchild of the Main Insured Person or Main Insured Person s Partner that is over the age of 21 (twenty one) and is a Dependant of the Main Insured Person or Main Insured Person s Partner. 17

20 Biological Brother or Biological Sister means a brother or sister of the Main Insured Person or Main Insured Person s Partner. Niece or Nephew means a Child of a Brother or Sister of the Main Insured Person or Main Insured Person s Partner. Aunt means the sister of a Parent or the female Partner of a brother/sister of a Parent. Uncle means the brother of a Parent or the male Partner of a brother/sister of a Parent. Extended Family Member can be covered under a Scorpion Funeral Plan for an additional monthly premium per Extended Family Member. A maximum of 4 (four) Extended Family Members may be covered by the Scorpion Funeral Plan in total. 7.3 BENEFICIARY OR NOMINATED BENEFICIARY persons who has/have been nominated by you to receive Insured Person. 7.4 ACCIDENTAL DEATH A death will be deemed to be accidental if it was caused solely and directly by a sudden, fortuitous and uncertain event and by violent, external and visible means independently of any other cause. 7.5 START DATE ceived by Scorpion and from which the nominated Insured Persons are covered in terms of this policy. 7.6 PREMIUM DUE DATE Premium Due Date is the day in each month on which the premium is payable to Scorpion to extend the period of insurance. 7.7 PREMIUM DEBIT DATE Premium Debit Date is the date in each month on which Scorpion will debit the premium payer s bank account. 7.8 DEPENDANT on the Main Insured Person or Main Insured Person s Partner at the date of application and immediately prior to the Dependant experiencing a claim event. 8. INTERPRETATION Words importing the singular shall include the plural, and vice versa, words importing the masculine gender shall include the feminine and neuter genders, and vice versa, 18

21 and words importing natural persons shall include legal persons, and vice versa. The clause headings in this policy are inserted for reference purposes only and shall not affect the interpretation of any of the provisions to which they relate. R. W. Smith INFORMATION Note: This section does not form part of the policy and is provided for information purposes only. HOW TO CLAIM STEP 1 In the event of a claim, contact Scorpion on obtain a claim form at any Scorpion Branch. You will also be advised on all additional documentation that is required for the claim to be processed. STEP 2 On receipt of the claim form the claimant must complete all details and sign the claim form. Please ensure that the claim form is read carefully for any additional requirements. In addition the claimant must attach the following documents: In the event of the death of any Life Insured Insured Life. from the undertaker). (you can get this from the undertaker). In the event of the death of a Partner cohabitation or partnership. In the event of the death of a Child o In the case of a Child by birth or a stepchild a copy of o In the case of an illegitimate or adopted child a copy documentary proof, issued by the Department of Child 19

22 Welfare or any other government department charged with the administration of adoptions. o In the case where cover has been extended to a Child s the educational institution concerned that the Child is registered as a student, or in the event that the Child is mentally retarded or is permanently and totally disabled documentary proof from a registered medical practitioner. STEP 3 Fax all the documentation to or Thereafter post the documentation to: Scorpion Legal Protection, Funeral Claims Division, PO Box 1795, Germiston, funeralplan@scorpion.biz SUPPORTING DOCUMENTS TO BE SUBMITTED TO SCORPION You are obligated to furnish Scorpion with such documents as may reasonably be requested and to comply with any reasonable request made by Scorpion. This may be where Scorpion needs documents to assess your claim or needs you to consult with an attorney or other specialist in pursuance of a claim. Failure or refusal to supply the necessary documents or comply with Scorpion s request may result in your claim being repudiated. cepted. Documentation can be faxed so that the claims department can start processing the claim. However, the by Scorpion before payment of the claim can be made. Scorpion shall at all times have the right to inspect all documents relating to the policy and will communicate with regarding any problems with the documentation. You hereby grant power of attorney to Scorpion to obtain from your attorney or public authority or third party any document or information pertaining to a claim. COMPLAINTS PROCEDURE If you have a complaint about this policy: First try and resolve it with Scorpion as stated in the schedule. If the matter cannot be resolved, you can submit a complaint in writing to: Policy Administration, Hollard Life Assurance Company Limited, PO Box 87428, Houghton,

23 Toll Free Number: Fax Number: If the matter is not resolved to your satisfaction by Hollard, you may submit the complaint to the Ombudsman, as detailed earlier in this document. SCORPION S COMPLAINTS POLICY As an authorised Financial Services Provider, Scorpion is committed to providing our members with quality service. Should it happen that an Insured Member does have a complaint, we undertake to: o Resolve complaints in a manner that is fair to our members, our business and staff o To inform all our members of the procedures established for the internal resolution of their complaints. o To ensure easy access to our complaints resolution telephone. o Empower or properly train our staff to deal with complaints. o Deal with complaints in a timely and fair manner, with every complaint receiving proper consideration in a process that is managed appropriately and effectively by the responsible staff member. o Where appropriate, inform members of their right to refer their complaints to the Long-Term Insurance Ombudsman. o Maintain records of all complaints received in terms of the Financial Advisory and Intermediary Services Act, o Implement follow up procedures to: Implement remedial action to prevent similar complaints from occurring Improve services and procedures where necessary in the business or you are not happy about the advice received or did not receive a full copy of our policy document, please contact the consultants in our Quality Management Department on We urge you not to sign any incomplete or blank documents, No person may request or insist that you do so. MATTERS OF IMPORTANCE You must accurately, fully and properly disclose all material facts. All information provided by you or on your with the accuracy of any transaction submitted by anyone on your behalf. 21

24 If you feel that the policy or the manner in which the policy was sold does not meet legal requirements, or if you are not happy about the advice received, please write to: Company Limited, PO Box 87428, Houghton, 2041 Fax Number: You must not sign any incomplete or blank documents. No person may request or insist that you do so. NOMINATION OF BENEFICIARY OR BENEFICIARIES It is suggested that a person over the age of 18 (eighteen) satisfactory proof of Legal Guardianship is submitted to Scorpion) or to the Guardian s Fund. It is therefore Legal Guardian so that payment can be made to the Legal at the time of death of the Main Insured Person. 22

25 IMPORTANT INFORMATION - PLEASE READ CAREFULLY This contains disclosures and other legal requirements, some of which will appear here, and the rest in more detail elsewhere as indicated. (THIS NOTICE DOES NOT FORM PART OF THE INSURANCE CONTRACT) Hollard has appointed Scorpion Legal Protection (Pty) Ltd ( Scorpion ) to sell insurance policies, handle claims and policy administration. Scorpion s FSP reference number is FOR ALL CLAIMS AND ADMINISTRATION MATTERS, PLEASE CONTACT: Scorpion Legal Protection Funeral Claims Division PO Box 1795 Germiston, 1400 Tel Number: Tel Number Administration: Fax Number: or Scorpion acts as an administrator on behalf of The Hollard Life Assurance Company Limited. About the Insurer This policy is underwritten by Hollard Life Assurance Company Limited, a registered long-term insurer Hollard Life Assurance Company Limited, PO Box 87428, Houghton, 2041 Toll Free Number: Fax Number: For all marketing and advice related queries, please contact: Scorpion Tel: Fax: For a detailed claims procedure, please refer to the policy document. About your Financial Services Provider Your Financial Services Provider (FSP) is: Scorpion Legal Protection, (Pty) Ltd (Reg No. 1996/001206/07). Suite 10, Ground level Absa Bank building cnr. Park and Victoria Streets Germiston Or 23

26 PO Box 1795 Germiston, 1400 Tel number: Fax: or Scorpion has Professional Indemnity insurance cover in force. About the Service This is a Funeral Insurance policy. For the complete please refer to the policy document. For your monetary obligations, premium payment obligations, manner and frequency thereof, and the consequences of non-payment of premium please refer to the policy document and schedule of insurance. Details regarding remuneration, commission, fees, incentives paid and who pays it please refer to the policy document. Details of special conditions, exclusions, excesses or restrictions please refer to the policy document. If you have any queries about a claim or this product, please contact: Scorpion Tel: , Fax:

27 Ways to pay your monthly premium: Debit order Stop order (municipal employees only) EasyPay pay points like Pick n Pay and Pep The Post Office Selected Scorpion branches REMEMBER: HERE IS YOUR NEW BARCODED MEMBERSHIP CARD! The easiest way to pay your premiums is by monthly debit order on your bank account or stop order on your salary. Or you can pay at any store with an EasyPay paypoint (such as Shoprite Checkers, Pick n Pay and Pep), the Post Office, or in cash at selected Scorpion branches. HOW TO PAY WITH YOUR NEW CARD SCORPION BRANCHES A) Present your card together with your premium. B) Present your card to the cashier at any Shoprite Checkers, Pick n Pay or Pep outlet together with your premium. C) Present your card to the cashier when you pay your premium. ALWAYS INSIST ON A RECEIPT AS PROOF OF PAYMENT! Any queries call: TO CHANGE YOUR PERSONAL PARTICULARS, SMS CHANGE to R1.50 charged per SMS.

28 SCORPION BRANCHES CONTINUED VEREENIGING Shop 1, Sarbec Place, 19 Beaconsfield Avenue, Vereeniging P O Box 4629, Vereeniging, 1930 Docex 32, Vereeniging Tel: , Fax: WELKOM Shop 9, Charter House, 34 Bok Street, Welkom P O Box 4029, Welkom, 9460 Docex 5, Welkom Tel: , Fax: SCORPION EXPRESS BRANCHES BURGERSFORT Malope Mahlaela Attorneys House No. 132, cnr. Eland & Morone Streets, Burgersfort EMPANGENI 1st Floor, ABSA Building 39 Maxwell Street, Empangeni Tel: GROBLERSDAL Melanie Burger-Fourie Attorney Inc. (MBF Attorneys) 5 Wes Street, Groblersdal KIMBERLEY Fletcher s Attorneys 27 Angel Street, New Park, Kimberley KOKSTAD Maxprop Estate Agents offices 62 Hope Street, Kokstad LADYSMITH Kribashni Naidoo & Associates, 11 Poort Road, Ladysmith MAHIKENG Shop no. 6, Shasons Centre Shippard Street, Mahikeng Tel: MAKHADO (LOUIS TRICHARDT) Coxwell, Steyn, Vise & Naude Inc. 31 Songozwi Street, Louis Trichardt PORT SHEPSTONE PHG Stoppel & Company 3 Bazley Street, Port Shepstone SECUNDA Vos Viljoen & Becker Attorneys VVB Building Horwood Street, Secunda THOHOYANDOU Hammann - Moosa Attorneys Metropolitan Building, Office G/01, Thohoyandou TZANEEN Johan Steyn Attorneys Elita No. 1, cnr. Agatha & Short Streets, Tzaneen VRYHEID Kilian Venter Attorneys 200 Hlobani Street, Vryheid ETIKET/9396/07/2018