3. NOMINATION OF BENEFICIARY OR BENEFICIARIES

• You may nominate a person as the Beneficiary in terms of this policy. The Beneficiary is the person who will receive the benefits if you die. When you speak to the agents or complete the application form you must indicate or say who the beneficiary is. In the event of the death of any other Insured Person under this policy as stipulated by you at inception of this policy, the benefit will be paid directly to you.
• If you want to change your nominated Beneficiary, you must inform Scorpion in writing or telephonically of any change.
• If no beneficiary is nominated and there is a valid claim on the death of the Main Insured Person the benefit will be paid to the following in relation to the Main Insured Person, 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.

3. NOMINATION OF BENEFICIARY OR BENEFICIARIES

• You may nominate a person as the Beneficiary in terms of this policy. The Beneficiary is the person who will receive the benefits if you die. When you speak to the agents or complete the application form you must indicate or say who the beneficiary is. In the event of the death of any other Insured Person under this policy as stipulated by you at inception of this policy, the benefit will be paid directly to you.
• If you want to change your nominated Beneficiary, you must inform Scorpion in writing or telephonically of any change.
• A beneficiary will have no interests or rights in the policy during the lifetime of the Main Insured Person.
• Nominations in a will or any other testamentary instrument that the Main Insured Person agreed to, shall not affect any existing beneficiary nomination that we have recorded
• If the beneficiary is under the age of 18, Hollard will pay the benefit to the legal guardian or the trust.
• If no beneficiary is nominated and there is a valid claim on the death of the Main Insured Person the benefit will be paid to the following in relation to the Main Insured Person, 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.

4.1.1 WAITING PERIOD – DEATH FROM NATURAL CAUSES

• The Benefits are subject to a Waiting Period of: -6 (six) months for Plans A and B and
  -12 (twelve) months for Plans C and D;
  for the Main Insured Person, Partner and Children from receipt of the first premium.
• The Funeral Benefit is subject to a Waiting Period of 12 (twelve) months for Parents and Extended Family Members, from receipt of the first premium.
• No Benefits are payable in respect of the death of an Insured Person due to natural causes during the Waiting Period.

4.1.1 WAITING PERIOD – DEATH FROM NATURAL CAUSES

• The Benefits are subject to a Waiting Period of 6 (six) months for Plans A, B, C and D for the Main Insured Person, Partner and Children from receipt of the first premium.
• The Funeral Benefit is subject to a Waiting Period of 6 (six) months for Parents and Extended Family Members, from receipt of the first premium.
• No Benefits are payable in respect of the death of an Insured Person due to natural causes during the Waiting Period.

4.1.2 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.
• No Benefits are payable in respect of the death of an Insured Person due to suicide during the Waiting Period.

4.1.2 WAITING PERIOD – DEATH FROM SUICIDE

• A Waiting Period of 12 (twelve) consecutive (one after the other) months and 12 (twelve) 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.
• No Benefits are payable in respect of the death of an Insured Person due to suicide during the Waiting Period.

5.10 NO PREMIUM NO COVER – IF YOU DO NOT PAY YOUR PREMIUM YOUR COVER WILL STOP

• Premiums are due and payable monthly in advance on each monthly anniversary of the first premium.

5.10 NO PREMIUM NO COVER – IF YOU DO NOT PAY YOUR PREMIUM YOUR COVER WILL STOP

• Premiums are due and payable monthly in arrears on each monthly anniversary of the first premium.

5.14 CHANGES TO YOUR PREMIUM AND POLICY

• Scorpion and Hollard 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.

5.14 CHANGES TO YOUR PREMIUM AND POLICY

• Scorpion and Hollard may increase the premium amount from time to time by giving you 31 (thirty-one) days’ written notice of such increase.
• Scorpion and Hollard 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.
  However, we will not change the terms and conditions of this policy during the first 12 months after your policy start date unless: -
  - There are reasonable grounds to change the terms and conditions that are determined by the actuarial department of Hollard or
  - The change of the policy terms and conditions will be to your benefit.

5.18 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 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 content clause will survive the termination for whatever reason of the policy, including the cancellation or lapsing thereof.
• The information provided may be verified against other sources or databases.

5.18 CONSENT TO DISCLOSURE OF PRIVATE INFORMATION

• We care about the privacy, security and online safety of your personal information and we take responsibility to protect this information. Below is a summary of how we deal with your personal information.
• Processing your personal information: We have to collect and process some of your personal information to provide you with our products and services as required by insurance, tax and other legislation.
• Sharing your personal information: We will share your personal information with other insurers, industry bodies, credit agencies and service providers. This includes information about your insurance, claims and premium payments. We do this to assess claims, prevent fraud and to conduct surveys. We may also share your personal information to trace you or your beneficiaries for any unclaimed benefits. You can check if unclaimed benefits are due to you by searching the central database on the Financial Sector Conduct Authority’s website – www.fsca.co.za
• Protecting your personal information: We take every reasonable precaution to protect your personal information from theft, unauthorised access and disruption of services.
• You, acknowledge that the sharing of claims and underwriting information (including credit information) by insurers is essential to enable the insurance industry to underwrite policies and assess risks fairly and to reduce the incidence of fraudulent claims;
• in the public interest and with a view to limiting premiums, consent to such information being disclosed to any other insurance company or its agent; and
• also consent to the disclosure of any information relevant to any insurance claims concerning you or any insured person you represent.

Did not exist previously.

5.19 ANTI-MONEY LAUNDERING

• We are required by anti-money laundering legislation to obtain specific information from you and certain related parties, to enable us to establish and verify your and related parties’ identity.
• Related parties include, but is not limited to, the owner of the policy, premium payer, a claimant, a beneficiary, the employer in a group scheme, the main member and beneficiaries in a group scheme.
• You understand that different information will be required depending on the type of client and related party and we may require supporting documentation.
• This requirement applies when we receive the application for insurance cover, on an ongoing basis while the policy is in force and when a claim is made under the policy.
• You and related parties agree to co-operate fully with us and to provide us with all such information and documentation requested as soon as possible or within a timeframe that will be communicated to you.
• You understand that if we do not receive the information and documentation requested from you or from a related party within a reasonable time, we may be unable to provide you with insurance cover or pay a claim, and in terms of the anti-money laundering legislation we will be required to cancel your policy, and any other existing policies thereafter.
• You consent to the processing of your personal information and to the disclosure of your personal information to any regulatory body, tax authority, or to comply with anti-money laundering legislation.
• You consent to us conducting ongoing monitoring of your transactions and activities related to your business relationship with us, as required by anti-money laundering legislation, and understand that we are not required to disclose our monitoring activities to you.
• If we are unable, for whatever reason, to conduct ongoing monitoring of your transactions and activities we may be unable to provide you with insurance cover and we may have to cancel your existing policies.
• We will therefore be unable to process a claim before the claimant has provided us with the required information and documents for us to establish and verify their identity.

5.21 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, or if applicable the Nominated Beneficiary’s or the appointed Executor’s, expense.
• Payment by Scorpion of the benefits provided in the event of a valid claim in terms of this policy will be a full and effective discharge by Hollard of its liability and obligations in terms of the policy.

5.22 HOLLARD’S LIABILITY

• Hollard will not be liable to make any payment unless the premium due in terms of this policy has been received.
• Hollard will not be liable to make any payment subject to the verification of the validity of any claim, and the submission of the applicable documentation, data or medical evidence and satisfactory proof of a claim, as required by Scorpion has been provided to Scorpion at your, or if applicable the Nominated Beneficiary’s or the appointed Executor’s, expense.
• Payment by Scorpion of the benefits provided in the event of a valid claim in terms of this policy will be a full and effective discharge by Hollard of its liability and obligations in terms of the policy.

5.23. Rejection of Claim and Time Bar

Representation must be submitted in writing to:
Hollard Life Claims Manager, PO Box 87419, Houghton, 2041
Fax: 011 351 8013

• Alternatively, you may contact:

The Ombudsman for Long Term Insurance
Private Bag X45, Claremont 7735
Tel: 021 657 5000.
Fax: 021 674 0951.

5.23. Rejection of Claim and Time Bar

Claims queries
Hollard Funeral Claims Manager
PO Box 87419, Houghton, 2041
Fax: 011 351 8013. Tel: 0860 333 664
Email: Directfuneral@hollard.co.za

Customer Service queries
Hollard Funeral Customer Service Manager
PO Box 87419, Houghton, 2041
Fax: 011 351 8013. Tel: 0860 333 118
Email: Customerservice@hollard.co.za

• Alternatively, you may contact:

The Ombudsman for Long Term Insurance
Private Bag X45, Claremont 7735
Fax: 021 674 0951. Tel: 021 657 5000.
Email: info@ombud.co.za

Did not exist previously.

6. CLAIM NOTIFICATION PERIOD

If you do not follow the steps above, or you do not send the information requested by Scorpion within the time you have been given, the claim will not be successful.

7.2 INSURED PERSONS

This policy may provide cover on/in respect of a Main Insured Person and a Partner or Child of the Main Insured Person or parent of the Main Insured Person where applied for by you in terms of this policy.

7.2 INSURED PERSONS

This policy may provide cover in respect of a Main Insured Person and a Partner or Child of the Main Insured Person or parent of the Main Insured Person or Main Insured Person’s partner or an Extended Family Member where applied for by you in terms of this policy.

HOW TO CLAIM

STEP 1
In the event of a claim, contact Scorpion on 0861 333 333 during office hours to obtain a claim form. You can also 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

• A certified copy of the ID document of the deceased Insured Life.
• A certified copy of the death certificate (you can get this from the undertaker).
• The BI-1663 Certificate - Notification/Register of Death (you can get this from the undertaker).

In the event of the death of a Partner

• A certified copy of the marriage certificate or any other official documentary proof, or an affidavit confirming the cohabitation or partnership.

In the event of the death of a Child

• In the case of a Child by birth or a stepchild – a copy of the birth certificate.
• In the case of an illegitimate or adopted child – a copy of the birth certificate and affidavit and/or any official documentary proof, issued by the Department of Child Welfare or any other government department charged with the administration of adoptions.
• In the case where cover has been extended to a Child's 25th (twenty-fifth) birthday – documentary proof from 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 a registered medical practitioner.

STEP 3
Fax all the documentation to 086 646 7420 or 011 388 4481
Thereafter post the documentation to:
Scorpion Legal Protection, Funeral Claims Division, PO Box 1795, Germiston, 1400.
Email: funeralplan@scorpion.biz

HOW TO CLAIM
FOLLOW THE STEPS BELOW for all death claims.

STEP 1
Inform Scorpion of the death and obtain a death claim form.

To report the death and to obtain the death claim form:

• Call our contact centre on 0861 333 333; or
• Visit any one of our nationwide branches; or
• Download the form from our website at www.scorpion.biz
• Email: funeral@scorpion.biz

STEP 2
Collect required documents.

You need to collect the required documents as stated in the death claim form.

STEP 3
Complete the death claim form.

Please complete all the details required on both pages.
Incomplete details may cause a delay in the processing of the death claim benefit.

STEP 4
Submit the death claim form and documentation.

You need to submit the completed death claim form and required documents to:
Scorpion Funeral Claims Department:
Email: funeral@scorpion.biz or Fax: 086 646 7420
Should you have any questions with regard to the completion of the death claim form, please contact your nearest Scorpion branch or call our contact centre on 0861 333 333.

STEP 5
Scorpion will assess the death claim.

Scorpion will assess the death claim to ensure that the claim form has been completed properly and that all the documents have been received. If there are missing documents the claims handler will advise you.

STEP 6
Payment will be made.

Payment will be made within 48 hours for a death claim that is valid and approved, and we have received all the required information and documentation stated below.

Complaints Procedure

If you If you have a complaint about this policy:

• First try and resolve it with Scorpion as stated in the information provided to you with your Policy Benefit schedule.
• If the matter cannot be resolved, you can lodge a complaint in writing to:
  Policy Administration, Hollard Life Assurance Company Limited.
  PO Box 87428, Houghton, 2041

Complaints Procedure

If you have a complaint about this policy:

• First try and resolve it with Scorpion as stated in the information provided to you with your Policy Benefit schedule.
• If the matter cannot be resolved, you may lodge a complaint with Hollard Life Assurance Company Limited. Hollard’s complaints policy and procedures can be found at www.hollard.co.za, alternatively you may contact Hollard’s complaints department and the Compliance Officer at:
  Complaints email: mycomplaint@hollard.co.za
  Compliance email: compliance@hollard.co.za
  
• Complain to Hollard’s Office of the Internal Adjudicator (OIA)
  If you are still unhappy with the Hollard complaints department’s outcome after their review, you may email Hollard’s independent OIA. The OIA will provide an independent, objective and fair investigation of your complaint. Please send all your documentation to:
  Email: lifeoia@hollard.co.za, Tel: 011 351 5652. Fax: 011 351 0801.
• 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.