Hollard Generic CoverPlus

Transcription

1 Hollard Generic CoverPlus Policy wording Underwritten by The Hollard Insurance Company Limited (HOLLARD) Registration no: 1952/003004/06 22 Oxford Road Parktown 2193 Tel No: Administered by IUA Business Solutions (IUA) Registration no: 1981/006334/07 P O Box 1800 Umhlanga Rocks 4320 Should you wish to obtain any information in connection with this policy, kindly contact IUA Business Solutions Tel No: Fax No: service@iua.co.za Edition: June 2014

2 2 Contents Introduction... 2 A. Definitions... 3 B. Cover provided... 5 C. Claims conditions... 7 D. General conditions... 7 E. General exclusions General information Introduction This document explains the Shortfall Cover policy. You will notice that some words are Capitalised. These words have a specific meaning and they are explained under the Definitions section. In exchange for receipt of the premium on the Premium Due Date, Hollard Insurance (We) agree to protect the policyholder (You) against any losses from an Insured Event which occurred in the Period of Insurance. Your cover is subject to the terms and conditions contained in this policy or in any subsequent endorsement to it. This policy is subject to various terms, conditions and exclusions which appear elsewhere in this document. The Certificate of Insurance and this policy and any endorsements or amendments together comprise Your insurance contract with Us and should be read together. If there is anything in this policy You do not understand, or any changes need to be made to Your cover, please contact IUA Business Solutions. In the event of any conflict between the provisions of this policy and that of any other document as mentioned above, the provisions of this policy shall prevail.

3 A. Definitions 3 In this policy and in any documentation issued by Us in connection with this policy the following words shall have the meanings set out below: 1. Administrators IUA Business Solutions. 2. Certificate of Insurance Means the schedule containing Your details and the details of the Vehicle, Period of Insurance, premium payable etc. and updated from time to time at Your request. 3. Consequential loss Indirect loss which accompanies an insured loss, such as loss of earnings resulting from a burnt down business that was insured against fire. Consequential losses are not covered by ordinary insurance policies, unless specifically included on payment of additional premium. 4. Credit Provider Means a registered Credit Provider, whose interest in the Vehicle forms the subject matter of the Credit Agreement is noted in this policy. 5. Credit Agreement Means a credit transaction entered into by You with the Credit Provider in respect of The Vehicle (National Credit Act 34 of 2005). 6. Date of Loss Means the date when damage or loss of the Vehicle occurs. This date must fall within the Period of Insurance. 7. Date of Occurrence means for Violation of Conditions claims the date on which You first received notice of the rejection of Your claim in terms of Your Underlying Policy. for Shortfall claims the date on which Your account is credited with the payment from the Underlying Insurer in settlement of Your claim in terms of Your Underlying Policy. 8. Days Means ordinary days, including weekends and public holidays. 9. Ex Gratia Means We pay a non-contractual partial or full settlement of the claim without prejudice when liability under the Underlying Policy is denied. 10. Excess Means an amount to be paid by You in respect of each and every claim in terms of the Underlying Policy. 11. Event Means the event which gave rise to Your claim in terms of the Underlying Policy. 12. First Amount Payable for Violation of Conditions claims - The Excess payable as per Your Underlying Policy - In respect of wrong class of use in terms of the Underlying Policy, an additional 10% of the Market Value. for Shortfall claims Nil

4 4 13. Market Value Means the average of the recommended retail value and trade price of the Vehicle, including its accessories and spare parts as specified in the Certificate of Insurance. This value is determined at the Date of Loss by that month s issue of the Auto Dealer s Guide (by Transunion Auto Information Solutions) and adjusted according to the average Kilometre and Condition Chart contained in the Guide. Where the particular make and model of the Vehicle are not reflected in the Auto Dealer s Guide or Auto Dealer s Guide for Cars Over 10 Years Old or Commercial Vehicle Dealer s Guide then the average value given for the Vehicle by three independent motor industry sources of Our choice will be used as the Market Value of the Vehicle. 14. Maximum Indemnity Means the Sum Insured or the Market Value of the Vehicle, whichever is the lesser, or the Statutory Settlement Balance, whichever is the greater, but limited to a maximum of R Minor Damage Chips, minor dents and light scratches caused by day to day motoring, this is inclusive of windscreen chips and Mag wheel scratches 16. Period of Insurance Means the period stated in the Certificate of Insurance of this policy or any agreed renewal period subject to Our receipt and acceptance of Your premium. 17. Premium Due Date Means the date on which your premium is due and which is indicated on the Certificate of Insurance. 18. Statutory Settlement Balance Means the payment due by You as at the Date of Occurrence which would liquidate Your outstanding liability to the Credit Provider in terms of the Credit Agreement and entitle You to retain the Vehicle unencumbered. The Statutory Settlement Balance does not include arrear instalments, interest or finance charges on such arrear instalments and early settlement penalties. 19. Sum Insured Means the value of the Vehicle specified by You in Your Certificate of Insurance at the time of Your application for this policy. The sum insured is the applicable value of the Vehicle which includes accessories and spare parts (whether factory-fitted or added subsequently) and VAT. This value can be updated by You from time to time. 20. Vehicle Means the vehicle described in the Certificate of Insurance and which may be any of the following: motor vehicles, minibuses (maximum 16 seater), caravans, 4x4 vehicles, 4x2 vehicles, light delivery vehicles, and panel vans, all with a gross vehicle mass of not more than kg; trailers with a carrying capacity of not more than 750 kg; motorcycles. but specifically excluding any vehicle used as a courier service; any vehicle modified for commercial purposes (such as but not limited to emergency and towing vehicles); any vehicle used as an armed reaction vehicle; quad bikes or off road motor cycles. 21. Underlying Policy and Underlying Insurer

5 Means the fully comprehensive enforceable motor vehicle insurance policy (Underlying Policy) entered into by You with any registered domestic insurance company (Underlying Insurer). This policy must cover the Vehicle against and obliges the underlying insurer to pay for all possible motor vehicle risks, including theft and hijacking that occurs at least in the whole of the Republic of South Africa if all the underlying conditions have been fulfilled. 22. We, Us, Our Means the insurer in terms of this insurance policy being The Hollard Insurance Company Limited. Hollard is a registered insurer in terms of the Short-term Insurance Act 53 of 1998, and a licensed Financial Services Provider in terms of the Financial Advisory and Intermediary Services Act 37 of You, Your Means the person or entity named as the Insured in the Certificate of Insurance. 5 B. Cover provided 1. Violation of Conditions of the Underlying Policy Insured Event We will provide cover when the Vehicle is damaged, written off or stolen and a condition of the Underlying Policy is unintentionally violated or not complied with. If the Underlying Insurer rejects your claim during the period of insurance, We will pay the benefit amount as explained below. Benefits We will pay for: Repairable vehicles; the cost of repair of the Vehicle less the First Amount Payable in terms of this policy. Total loss & constructive total loss vehicles (including stolen or hijacked vehicles); the Maximum Indemnity less the First Amount Payable in terms of this policy. Storage and towing; the combined costs of storage and towing to a limit of R1 000 per Event. Specific conditions applicable to violation of conditions We may at Our option repair, replace, reinstate or pay cash in lieu of the amount of damages or use any combination of these methods of indemnity. We reserve the right to require any repair work to be carried out at a repairer of Our choice. In the event of a payment made by Us for a total loss or constructive total loss, any proceeds subsequently recovered from the sale of the Vehicle or its salvage shall be solely Our property. We reserve the right to decide when the Vehicle may be declared a total loss. We shall only be liable to pay one Violation of Conditions claim where the claim arises from Your inadvertent non-payment of a single month s premium in terms of the Underlying Policy and provided that You paid premium for at least 3 consecutive months immediately prior to the month of non-payment and that Your Underlying Policy has not lapsed or been cancelled or voided by reason of Your non-payment. The cover in terms of this section of this policy is limited to Events occurring in the Republic of South Africa or as specified in the Underlying Policy. Specific exceptions applicable to violation of conditions We do not cover loss or damage from: the hiring or selling of the Vehicle to other parties for reward, driving instruction for reward and motor racing, rallies, speed and other contests or while the Vehicle is being used for any

6 purpose in connection with the motor trade other than for the purpose of overhaul, upkeep or repair of the Vehicle; damage to tyres caused by the application of brakes or by road punctures, cuts or bursts; loss of or damage to any sound equipment. civil commotion, labour disturbances, riot, strike; war, invasion or acts of warlike operations; mutiny, military rising, insurrection, rebellion or revolution; any act to overthrow Government by means of fear, terrorism or violence; any act to further any political aim or in protest against any State or Government authority, or for the purpose of inspiring fear in the public section; consequential loss; legal liability caused by ionising radiation or contamination by radio-activity from any nuclear fuel. loss or damage caused directly or indirectly by any Nuclear material (NMA 1975); any occurrence for which a fund has been established - War Damage Insurance and Compensation Act, (No.85 of 1976) or similar Act operative in any of the territories to which this policy applies; to any property (including a computer), legal liability, or consequential loss caused by or contributed to by the failure of any computer. A computer includes any computer, data processing equipment, microchip, integrated circuit or similar device in computer or non-computer equipment or any software, tools, operating system or any computer hardware or peripherals and the information or data electronically or otherwise stored in or on any of the above, whether it be Your property or not. 6 any claim involving asbestos, or any materials containing asbestos in any form or quantity. 2. Shortfall Cover Insured Event This section covers the difference (shortfall) between the lump sum payment (Maximum Indemnity) made by the Underlying Insurer and the Statutory Settlement Balance when Your Vehicle is stolen and not recovered or damaged beyond economical repair and written off. Benefit You will be receiving a benefit amount under this section if the Underlying Insurer settles a claim of the Underlying Policy and a shortfall arises between such lump-sum payment and the Statutory Settlement Balance of the Credit Agreement. We will pay either, the Statutory Settlement Balance (less deduction listed below) or We will pay the Maximum Indemnity, whichever is the lesser. We do not cover and therefore deduct the following amounts from the Statutory Settlement Balance: a) the amount by which the Excess payable by You in terms of the Underlying Policy exceeds R6 000; b) the amount paid by the Underlying Insurer; c) amounts deducted by the Underlying Insurer which are not covered in terms of the Underlying Policy; Example: Items such as but not limited to premium refunds, towing, salvage, storage and release fees may create a short payment from Your Underlying Insurer and is not covered in terms of the shortfall benefit of this policy

7 d) any amount refundable to You in terms of the Credit Agreement on the Date of Loss such as insurance premiums, including short-term, credit life or motor warranty premiums; and e) any further or additional amounts added to the principal debt in terms of the Credit Agreement after its date of commencement, and any finance charges and interest thereon, Specific conditions applicable to shortfall The amount paid by the Underlying Insurer, whether by way of an agreed or Ex Gratia settlement shall be deemed never to be less than the Market Value as defined under the Definitions section of this policy. If the Sum Insured stated in the Certificate of Insurance and the premium paid to Us is incorrect the benefit will be adjusted accordingly. C. Claims conditions When an Event occurs that may result in a claim under this policy, You will at Your own expense be required to do the following for each type of claim: Violation of Conditions Claims Notify Us immediately of the rejection of Your claim in terms of the Underlying Policy and within 30 Days of the Date of Occurrence provide Us with Your written claim form reflecting full details of the claim together with particulars of the Underlying Policy; Attach a copy of the letter of rejection by the Underlying Insurer to Your claim form; Provide Us with such proof, information and affidavits as We may require to process the claim; Be responsible for the First Amount Payable as defined in respect of each and every Event giving rise to a claim; Provide Us with a copy of the claim form in terms of the Underlying Policy claim; Assist Us in any recovery action instituted by Us against any third party responsible for the loss or damage, which action may proceed in Your name, and/or in the identification of the Vehicle stolen and recovered and the prosecution of those responsible, for which assistance We will reimburse You for Your reasonable out-of-pocket expenses; Provide Us with and/or authorise Us to obtain a copy of Your Credit Agreement and a statement of Your account with the Credit Provider reflecting a full transaction history. Shortfall Claims Notify Us immediately that Your claim in terms of Your Underlying Policy has been settled and within 30 Days of the Date of Occurrence, submit to Us full details in writing of Your Shortfall claim by means of a claim form; Provide Us with and/or authorise Us to obtain a copy of Your Credit Agreement or other agreement between Yourself and the Credit Provider, a statement of Your account with the Credit Provider reflecting a full transaction history and a copy of Your credit application; Provide Us with such proof, information and affidavits as We may require to process the claim; Provide Us with a copy of the signed agreement of loss or Ex Gratia agreement or letter accompanying the Ex Gratia payment, whichever is applicable, between You and the Underlying Insurer. 7 D. General conditions The following conditions are applicable to all sections of this policy except as they may be varied by specific conditions or exceptions. 1. Consent to disclosure of private information

8 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. It is important to remember that when You accept Your policy You accept the terms and conditions laid out in the policy. Your acceptance gives Hollard the right to verify that the information You have supplied on Your application form or telephonically is accurate and truthful. The condition above applies to all policyholders. They are intended to protect the company from fraudulent claims, but are, nevertheless, of direct benefit to You. The more the company is able to reduce the number of fraudulent claims, the cheaper the premium Condition precedent to liability We do not cover You unless, The premium has been received by the Administrators by the Premium Due Date; You comply with the Claims Procedures set out in this policy; and There is an Underlying Policy in place at the Date of Loss. 3. Comprehensive Underlying Policy for your Vehicle You must ensure that the Vehicle including its accessories are comprehensively insured for its full Market Value in terms of the Underlying Policy as at the Date of Loss. If the Vehicle is not the subject of an enforceable fully comprehensive Underlying Policy, then this policy does not operate. Ensure that all your Vehicle extras are insured. We will not pay any amounts deducted by the Underlying Insurer for extras (such as tow bars, canopies, mag wheels) which were not specified in Your Underlying Policy. Where the Underlying Policy is unenforceable, cancelled or for any reason is void or invalid or should be treated as such by the Underlying Insurer, or where it is not fully comprehensive, this policy does not operate. Where the Underlying Insurer has rejected liability for a claim in terms of the Underlying Policy and the Underlying Policy has not been cancelled, voided or avoided, but the Underlying Insurer has made You an Ex Gratia payment, any cover in terms of this policy shall be limited to the difference between the Statutory Settlement Balance and the Market Value and the claim shall be dealt with as a Shortfall claim in terms of this policy. 4. Underlying policy You must undertake to obtain a full indemnity from Your Underlying Insurer and institute legal action to enforce Your rights in terms of the Underlying Policy. You must notify Us of the rejection of Your claim in terms of the Underlying Policy within the time specified in this policy, notwithstanding that such claim may be the subject of pending legal action, and advise Us of the status of such legal action from time to time. 5. Rejection of claim and time bar If You dispute Our decision to decline Your claim or cancel the policy, You have 90 Days from the receipt of Our letter, to appeal this decision in writing to Hollard: The Account Manager Hollard Personal Lines: Banks Division P.O. Box Houghton 2041 Tel: (011)

9 Fax Number: (011) address: 9 Alternatively, You may contact: The Ombudsman for Short Term Insurance P.O. Box Braamfontein 2017 Tel: Fax: Sharecall: If Your dispute is not satisfactorily resolved in this manner, You may institute legal action against Hollard for the enforcement of the claim. The summons must be served on Hollard within 180 Days of the expiry of the above mentioned 90 Day period, else all benefits in respect of such claim will be forfeited and no liability can arise in terms of such claim. 6. Fraud If any claim under this or the Underlying Policy is in any way fraudulent or if any fraudulent means are used by You or anyone acting on Your behalf to obtain any benefit under this policy or if any of the Events insured against in terms of this policy are occasioned by Your intentional act or with Your connivance, all benefits under and the premiums paid in terms of this policy shall be forfeited, and the policy shall be void at Our option. 7. Legal jurisdiction This policy is subject to South African law and the jurisdiction of a competent South African court. 8. The Credit Provider's interest The Credit Provider has an interest in this policy if the Insured Property is the subject of a Credit Agreement. If a total loss occurs, payment under this policy will be made first to Your Credit Provider.. The Credit Provider's acceptance of the payment will be an effectual discharge of Our liability for that portion of Your claim. We will pay any balance to You afterwards. 9. Credit agreement termination This policy shall automatically cancel from the date of the termination of the Credit Agreement. You will not be entitled to payment for any benefits whatsoever in terms of this policy. This is an important clause. This policy is designed to operate in tandem with the credit agreement. If for any reason the credit agreement is terminated, cover will automatically cease and you will need to make alternative insurance arrangements. 10. Cancellation and refund of premiums This policy may be cancelled by You or Us at any time on 30 Days written notice. If a premium has been paid for any period beyond the date of cancellation of the policy, Hollard shall refund the relevant premium to You 11. Authority to complete claim form If the Vehicle has been damaged, written-off or stolen during the Period of Insurance and You are unable, refuse, fail or cannot be traced to complete, wholly or partially, a claim form in terms

10 of this policy, a Manager of the Credit Provider shall be and is hereby authorised to complete and sign such claim form to the best of his/her knowledge and belief on Your behalf. 12. Period of grace for premium payments You shall be entitled to a period of 15 Days from the Premium Due Date in which to pay Your Premium. In the case of monthly policies, this period of grace only applies from the second month of the currency of this policy. 13. Prescription We are not liable for any claim under this policy after the lapse of 12 months from the Date of Occurrence unless such claim is the subject of a pending legal action. 14. Amendments or endorsements We may amend or endorse this policy at any time by giving You 30 Days notice in writing at Your last known address. 15. Territorial limits Cover is limited to Events occurring in the territorial limits as specified in Your Underlying Policy. 16. Repatriation costs If the Vehicle is damaged outside the Republic of South Africa, the costs of repatriation will be borne by You. E. General exclusions These exclusions are applicable to all sections of this policy. We do not cover Your losses: if the Underlying Insurer rejects Your claim in terms of the Underlying Policy (except for Violation of Conditions claims); 2. if You cancel your Underlying Policy 3. for liability to any passenger or third party whatsoever for loss, damage or personal injury; 4. to any goods, materials, possessions or property carried in or on the Vehicle; 5. caused whilst the Vehicle is being driven by You or someone else (with Your consent), who is not fully licensed to drive or who is not complying with the laws related o learners; 6. when You, or someone else (with Your consent) is driving the Vehicle while under the influence of alcohol or drugs or when the driver s blood or respiratory system exceeds the statutory alcohol limit. 7. arising out of any contractual liability unless liability would have attached in the absence of such agreement; 8. for consequential loss; 9. for depreciation, wear and tear, mechanical or electrical breakdowns, failures or breakage; 10. if it falls in the scope of any compulsory motor vehicle insurance legislation at the Date of Loss and applicable in any territory covered by this policy, in particular the Road Accidents Fund Act 56 of (This exclusion applies regardless if the applicable legislation fund is unable to provide compensation); 11. to the Vehicle which existed prior to the Event (pre-existing damage), or losses arising from any other Event unrelated to a particular claim, unless such Event is the subject of a valid claim registered separately under this policy; 12. for misrepresentation, non-disclosure or misdescription of any fact or circumstance, whether in connection with: Your Underlying Policy or claim; this policy or claim in terms of this policy; 13. arising where You reside or carry on business outside the Republic of South Africa. In which such case this policy will be void from inception and the premium refunded;

11 14. more than Our rateable proportion of any claim which is covered under another enforceable insurance policy; 15. from permanent or temporary dispossession resulting from detention, confiscation, forfeiture, impounding or requisition legally carried out by customs, police service, crime prevention units or any lawfully constituted officials or authorities. 11 General information Claims If You have a claim, a policy query or require changes on Your policy, please contact our administrators during office hours to obtain a claim form. You will be advised of all additional documentation that is required for the claim to be processed. Initial notification of a claim must be made within 30 days from the date of loss to: IUA Business Solutions P O Box 1800 Umhlanga Rocks 4320 Telephone: Fax No. : service@iua.co.za Complaints procedure If you have a complaint about this policy or You are in any way unhappy with the service you have received, please contact: The Compliance Officer Hollard Insurance P.O. Box Houghton 2041 Tel: (011) Fax Number: (011) address: enquiries@hollard.co.za If Your enquiry or Your dispute is not resolved, You can contact: The FAIS Ombud P.O. Box Lynnwood Ridge 0040 Telephone number: Fax number: info@faisombud.co.za Please take careful note of General Condition 5 of this policy. If this Policy or the manner in which it was sold does not meet legal requirements, please write to: The Hollard Compliance Officer, P O Box 87419, Houghton, 2041, Fax Number The responsibility of the Compliance Officer is primarily to assist and advise Hollard on issues regarding legal compliance and to investigate cases where there is possible non-compliance. For service complaints and claims disputes, please follow the complaints and dispute resolution processes as described above. Important things to remember:

12 12 Do not sign any blank or partially completed application forms Don t be pressurised to buy this policy. Incorrect information supplied, or non-disclosure by You or anyone acting on Your behalf may impact on any claims arising from Your insurance policy.