Terms & Conditions

Acceptance of Application

Insurance is subject to the Insurer accepting, at its own discretion, the application made herein by the applicant & proposed Principal Insured.

Contract Term & Cancellation

The Contract Term of the Policy is monthly, and both the policyholder and the Insurer can cancel the policy within 31 days written notification. Upon renewal of the Policy, no new waiting period will apply, subject to the insured having a previous policy at least 31 days before.

Waiting Periods

A six-month Waiting Period applies to death due to Natural Causes and a twelve-month Waiting Period applies to death due to Suicide, starting from the entry date. The Waiting Period will not apply to accidental death once the first premium is received.

• When a new Life Assured is added to the Policy, all Waiting Periods will apply to the new Life Assured.
• If you increase a benefit, the Waiting Period will apply to the amount by which the benefit is increased.
• Premiums are payable during the Waiting Period for the Benefits.

Accidental Death Cover

Death as a result of an accident has no Waiting Period and is covered from the Acceptance Date of the Policy, provided the first premium is received.

Effective Entry Date

If the first premium is received before the 7th of the month, the effective entry date will be on the first of the current month. If received after the 7th, the effective entry date will be the 1st of the following month.

Replacement of Policies

In the event of the Replacement of Policies, no Waiting Period will be imposed, provided that:

• The Policyholder had a previous policy with another insurer at least 31 (thirty-one) days before entering into this new policy.
• The Policyholder had completed the Waiting Period in respect of the previous policy.
• The policy benefits under the previous policy provided cover in respect of similar risks related to the same lives assured as those covered under this new policy.

Should you not have completed the Waiting Period under the previous policy, a Waiting Period equal to the unexpired balance of the Waiting Period under the previous policy will apply.

Claims Processing

The claim benefit is paid between 48 and 72 hours after all required documents have been received (see Claims Procedure).

Spouse & Dependent Children

Spouse and Dependent Children’s cover are as per the cover page under the Direct Family Plan section and varies according to the plan selected.

Dependent Children Age Limits

Dependent children will be covered until aged 21 last birthday. If the dependent child is a full-time student, he/she will enjoy cover until the age of 25 last birthday.

Extended Family Cover

The Extended Family cover has four different options. Under each option the total cover amount is divided among the total number of extended family members covered to determine each extended member’s cover amount.

Premium Payments & Policy Terms

Cover is afforded on a month-to-month basis. Premiums are payable monthly. A premium received in a particular month provides cover for that month.

• No reserves are built up under the plan, therefore premiums are payable lifelong and there are no surrender values when cover ceases.
• The Policy never becomes paid up and no loans can be made against the Policy.
• Premiums do not decrease if a Life Assured passes away.
• The policy may not be ceded.

Lapsed Policies & Re-instatement

Policies will lapse after 2 consecutive payments were missed and the Policyholder fails to remedy the situation within 15 days from the date the premium becomes due (the grace period).

Notice of outstanding premiums and the lapse of the policy will be sent to the Policyholder. Once the Policy has lapsed, no benefits will be in place.

Re-instatement conditions:

• The Re-instatement Date is not more than 2 (two) months from the Lapse Date.
• The Policyholder had completed the Waiting Period in respect of the lapsed policy.
• The policy benefits under the lapsed policy provided cover in respect of similar risks related to the same lives assured.

Should you not have completed the Waiting Period under the lapsed policy, a Waiting Period equal to the unexpired balance will apply. The remaining Rules, Terms, Conditions and Provisions of the reinstated policy will be the same as the original (lapsed) policy.

Exclusions

Claims will not be paid where such a claim arises from any condition or event directly or indirectly from or traceable to:

• Participation in any act of war, military action, riot or unlawful strike, insurrection, civil commotion, usurpation of power, martial law, terrorism and any usage of nuclear, chemical and biological weapons, device or agent.
• A disease, epidemic, or pandemic.
• An act of government.
• Any act or deed by the Principal Insured deliberately committed in violation of any law, as well as any other insured person under the Policy including but not limited to a minor child, where his/her parent and/or legal guardian knowingly allows such child to participate in any act which constitutes a violation of any law.
• Self-inflicted injury or self-inflicted illness, whether intended or not, or voluntary exposure to danger or obvious risk of injury.

Any injury or disease which is caused partly by the actions or omissions of the insured, but in conjunction with the action or omission of some other party or some other contributory factor, will fall outside the ambit of the above exclusion.

Outstanding Premiums at Claim Stage

Should due premiums not have been paid, any outstanding premiums shall be deducted at claim stage, provided that the policy is still active.

Maximum Cover Per Life Assured

No one life assured may have insurance cover exceeding R30,000 (thirty thousand Rand) with EAP Financial Services (Pty) Ltd. Cover for a life assured in excess of R30,000 (thirty thousand Rand) will require 2 (two) or more application forms to be completed in full.

Right to Reassess

EAP Financial Services (Pty) Ltd reserves the right to reassess the premium, terms, conditions, or provisions together with the Insurer and with its Actuary in order to keep the product actuarially sound in terms of the Insurance Act (18 of 2017) and the Policyholder Protection Rules.

Claim Submission Deadline

Failure to lodge a claim within 6 (six) months of the date of death will render the claim null and void.

Cooling-Off Period

The Principal Insured has the opportunity to cancel this policy (cooling-off period), providing no benefit has been paid or claimed within a period of 31 days after receipt of the policy schedule.