Investec Life
General Terms & Conditions
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1. The Insurer
The Insurer that offers the insurance to you is Investec Life Limited. Wherever the words “we”, “us” or “our” are used in your policy and the Benefits that you have chosen, these words mean Investec Life Limited.
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2. The Policy
Your Policy contract contains one Benefit or a number of Benefits that you have chosen.
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3. General Terms and Conditions
These terms and conditions are the General Terms and Conditions applicable to all the Benefits that you have chosen which are set out in your Policy Summary in your Welcome Pack.
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4. Benefits
In addition to these General Terms and Conditions that apply to all of the specific Benefits that you have chosen, the particular Terms and Conditions that apply to each specific Benefit that you have chosen are called the Benefit Terms and Conditions. For each Benefit these are set out in a document headed with the name of the Benefit. These Benefit Terms and Conditions must be read in conjunction with these General Terms and Conditions.
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5. Other documents that form part of your Policy Contract
The electronic quotation that we issued to you and which you accepted, the electronic application form that you completed and all other documents that we specify, whether electronic, in writing or voice recorded, will also form part of your contract with us.
These documents may include for example underwriting questions and answers, advice record/s and telephonic discussions and e-mail communications between you and us.
The information you have provided to us forms the basis upon which we are willing to insure you. Any errors and omissions in the information you have provided could result in us not paying a claim.
Please make sure that all the information and details that you provided to us have been correctly recorded. If there are any errors or if you need to update any of the information and details you provided, please advise us immediately.
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6. What the words “include” and “including” mean
When we use the word “includes” or “including” in your policy contract, followed by a number of examples, or when we simply set out a list of examples, these examples are not all inclusive. The examples do not limit us to only the information or factors depicted by the examples.
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7. Policyholder
This is you, the person or institution that owns your policy.
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8. Life and Lives Covered
This is the person on whose life event cover under the Benefit becomes payable. This is you or other people such as members of your family and your business partner or business associate. In order for us to provide cover in respect of a Life Covered under a Benefit we will need to make sure that there is what is known as an insurable interest. This means there must be a recognised relationship between you as the Policyholder and the Life Covered and that because of this relationship, either you, or a member of your family, or your business partner or business associate, or a business entity in which you are involved, would suffer a financial loss should an Insured Event occur to the Life Covered.
In each of the documents which describe your Benefits we will explain what we mean by an Insured Event.
The Life/Lives Covered in respect of each of your Benefits are indicated in your Policy Summary.
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9. Premium Payer
This is the person or institution who pays the premiums. Please remember that you, as the Policyholder, are liable for the premiums, even though you may have chosen another person or institution to actually attend to the premium payment.
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10. Policy Anniversary
This is the date one year after the Cover Start Date of the first Benefit that you have chosen. It will be the same date for all the Benefits in your policy.
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11. Cover Amount
This is the sum insured or level of income insured under each Benefit.
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12. Benefit Amount
This is the amount that we approve to be paid out in respect of a Benefit after the occurrence of an Insured Event.
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13. Cover Start Date
Your Cover Start Date is reflected in the Policy Summary.
Should you later have a Benefit or Benefits added to your Policy, that Benefit/s will have its own Cover Start Date which will be reflected on the Policy Summary that we will make available to you at the time.
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14. Premium
The amount of the Premium that you have to pay us each month for the cover that we provide in respect of each Benefit, as well as the total monthly Premium that you have to pay for all the Benefits, is set out in the Policy Summary. Your Premium depends on the Benefits you have chosen, the Cover Amount in respect of each Benefit and the information you have provided us.
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15. Underwriting and Changes in Personal Circumstances
Upfront we may have asked you appropriate and relevant medical and lifestyle questions and may have also received medical test information. Once you or the Life Covered have gone through this underwriting, you may be able to increase your cover without further or with limited further underwriting during a specified future period.
This is not a guarantee that we will in the future insure you for a certain new amount or type of cover or insure you at all. What it does do is provide flexibility to you as a client if your health and lifestyle remain unchanged or improve in the future. This flexibility remains within the discretion of Investec Life.
Amongst other key information that we may have asked you to provide include your age, gender, occupation, hobbies, whether you engage in risky sports or activities and your smoker status. These form part of the basis upon which we are willing to insure you and have an effect on the premium that you will have to pay.
By way of an example, if you inform us that you are an airline pilot, we will take this fact into account when calculating your premium. We may however ask you for further information such as whether you have any flying hobbies and whether amongst these hobbies is flying experimental aircraft. We consider this hobby more risky than piloting an airliner and this fact could have an effect on your premium.
Should significant changes in your or any Life Covered’s personal circumstance take place after entering into this policy, please let us know immediately as these changes could affect your policy in a material way and affect the payment of claims. These are related to issues regarding your lifestyle, smoker status, travel (or relocation) abroad, occupation, career and work duties. If in doubt, rather contact us to clarify whether it is relevant or not.
You would need to inform us of the following changes for any Life Covered:
Occupation, work duties or career
You must inform us if you have changed your occupation, career or work duties. For example, if you change from being a surgeon to working as an executive at a pharmaceutical company, stop being a commercial pilot, or change from being entirely office bound to visiting clients daily.Travel and/or living abroad – you must inform us in advance if:
- You will be outside South Africa (for any purposes) for more than 90 consecutive days
- You are going to work or live abroad
- You visit (for any purpose) any countries under international sanctions, or
- You visit any country that is experiencing internal conflict or civil war
Smoking
You must inform us if your smoker status changes.You do not have to tell us about the following issues:
Hobbies or risky activities
We do not require you to inform us should you start participating in risky activities. (You should inform us if you stop participating in risky activities, as this could reduce your premiums)
Health changesThe basis of this policy is that you have made full and honest disclosure about your health and personal information. You do not have to inform us of changes in health, medical history, medical conditions and family medical history unless you are:
- Increasing the cover amount
- Increasing the annual cover increase percentage
- Restarting a benefit that was previously lapsed or cancelled
- Buying a new benefit
What we have said above in regard to informing us of any changes applies to all Lives Covered under your policy.
When you advise us of these changes, we may review your Premium, apply different Terms and Conditions to your Benefit, or cancel your Benefit.
If you do not inform us of these changes, we may decline a claim under a Benefit and we may cancel a Benefit.
To allow us to better manage the risk of insuring the Lives Covered under your policy, the Lives Covered have also given us (or any organisation we deem appropriate) permission to gather or to share health, medical, lifestyle and other information that may be required to assess their risk under this policy on an ongoing basis, including at claims stage. Any ongoing health information will not be used to re-underwrite your current policy (unless you are making changes as stated above under “Health changes”).
- You will be outside South Africa (for any purposes) for more than 90 consecutive days
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16. Cover and Premium Flexibility
You may be able to increase a Benefit’s Cover Amount without further or with limited further underwriting during a specified future period after the initial underwriting and where on an ongoing basis, we are able to gather health, medical, lifestyle and other information concerning a Life Covered.
To permit such cover flexibility we also provide you with flexibility in our premium structure such that the Premium you pay is a fair and accurate reflection of each individual that is covered under a Benefit.
- Whenever cover is changed, your Premium changes in accordance with the new level of cover. The premium charged for the month that the Cover Amount is changed will be pro-rated.
Where further underwriting (including questionnaires and medical tests) is required for a cover increase, we may apply new Terms and Conditions to the increased portion of the Cover Amount. The Premium for the increased portion of cover will reflect any new information on the Life Covered.
- Whenever cover is changed, your Premium changes in accordance with the new level of cover. The premium charged for the month that the Cover Amount is changed will be pro-rated.
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17. Premium Review and Guarantees
We will review your premiums on all the Benefits at every Policy Anniversary for each Life Covered taking into account fairness between different groups of Lives Covered and changes in our long term view on risks we insure against.
In our illustrations, we assume a CPI rate of 5.5% each year, even though the actual CPI rate will fluctuate each year in the future.
All illustrated values of your monthly premium are expected future values, however these are not guaranteed. This means that if the future conditions are expected to materially change, your monthly premiums may also change.
At each Policy Anniversary Date our review will look at the following assumptions relating to:
- Our expectation of future claims
- Our expectation of future investment returns on premium income
- Our expectation of future expenses inflation
- The incidence of taxation on life insurance
- The cost of reinsurance
In reviewing our assumptions, we will analyse our insurance experience for similar policies, industry insurance experience, expert opinions regarding future inflation and the impact of future medical and lifestyle changes.
We will compare the assumptions that are applicable at the time of the review with those previously used and, by reference to that comparison, use a fair and reasonable method of calculating any change in your Premium.
Your Premium may therefore increase or decrease at each review due to the revised assumptions. There is no limit to the increase or decrease that may apply.
It is important to note that these annual changes in Premium will not depend on your individual circumstances, for example your health, at the time of the review.
Any change in your premium will take effect from the relevant Policy Anniversary Date and we will advise you at least 30 days before we make any change. If we advise you of an increase to your Premium due to a review, you may choose to continue paying the previous amount but reduce your Cover Amount. To do this, please advise us at least ten (10) days before your Policy Anniversary. Your reduced Cover Amount will apply from the Policy Anniversary Date.
- Our expectation of future claims
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18. Premium Collection Date
The date that you select for the Policy’s Premium to be collected is indicated in the Policy Summary. This is the Premium Collection Date.
Premiums can only be paid by way of debit order. We will debit your bank account with the Premium on the Premium Collection Date.
The first Premium Collection Date is indicated in the Policy Summary.
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19. Non Payment of Premiums
If there is a failed premium collection, we will raise a double debit order at the following Premium Collection Date.
By way of example, if your policy’s Premium Collection Date is the 25th of every month and there is a failed premium collection on the 25th of March, then we will raise a double debit order on the 25th of April.
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20. Lapse
If a second debit order fails and the policy is accordingly two Premiums in arrears, your Policy will automatically lapse at the end of that month. This means you have a grace period of two (2) months of missed premiums before your Policy is lapsed.
In the above example, if the Premium Collection on the 25th of April also fails, then your policy will lapse on the 30th of April.
During a grace period the Lives Covered in the Benefit/Benefits for which a Premium has not been received by us will continue to be fully covered in respect of Insured Events that happen during this period.
It is important to remember that once your policy has lapsed there will be no cover and no Premium collection until, and if, your Policy is restarted.
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21. Policy Restart
Once your policy has lapsed you can ask us to restart a Benefit or Benefits. We may do this without a change in the terms of your cover provided that you have requested the restart within three months after the policy was lapsed, and you have confirmed by way of a health questionnaire that the Life Covered’s state of health has not changed.
In the above example the Policy was lapsed on the 30th of April. You may apply for a restart before or on the 31st of July.
We may request further underwriting requirements (including questionnaires and medical tests where necessary) when you apply for a restart. After the health questionnaire and/or submission of the further underwriting requirements, we may apply new Terms and Conditions to the Policy from the Restart Date. The Restart Date will be reflected on the new Policy Summary that we will make available to you at the time.
The Benefit/s that have lapsed will remain in lapse status until the Restart Date. Any waiting Periods applicable prior to lapse will restart on the Restart Date.
In each of the documents which describe your benefits we explain what we mean by waiting Periods applicable to that Benefit.
As there will be no Cover from policy lapse until the Restart Date, arrear premiums are not payable in order to restart a Benefit/s.
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22. Cool-off and cancellation
If you are not satisfied or not happy with the choices that you have made you may cancel a Benefit or Benefits. We will refund you all Premiums received in respect of that Benefit or Benefits in the event that:
- You cancel such Benefit or Benefits within the first 30 (thirty) days of us issuing your Policy documents,
- You have not already claimed or we have not paid you a Benefit Amount, and
- An Insured Event has not already occurred.
You can still cancel a Benefit or Benefits after the 30 days are up, however we will not refund any Premiums to you.
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23. Annual Cover Increase
You may have chosen to include an Annual Cover Increase for each Benefit in your policy. Annual Cover Increases are applied at Policy Anniversary.
If you have chosen CPI as your Annual Cover Increase, this will be the Consumer Price Index (CPI) headline rate as published by Statistics South Africa three months before the Policy Anniversary.
If Statistics South Africa publishes a CPI of more than 10% in a particular year, your Cover will only increase by 10% the following year.If Statistics South Africa publishes a negative CPI in a particular year, your Benefits will remain the same the following year.
If you have chosen an Annual Cover Increase, your Premiums in respect of each Benefit will be adjusted annually to reflect your new amount of cover. This is apart from the Premium Review which takes place at every Policy Anniversary.
You may at any time ask us to decrease or remove the Annual Cover Increase that you have chosen. You may also be able to increase the Annual Cover Increase that you have chosen, but may be subject further underwriting.
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24. Cession
You may cede a Benefit, or all your Benefits, to another person or to an institution. You may do this by way of a security cession or an outright cession. An outright cession results in a change of ownership of the Benefit namely the person or institution to whom or to which you cede the benefit will become the owner of the Benefit. When you cede your Benefit or policy by way of a security cession, for example to secure a loan provided to you by another person or institution, the person or institution to whom you cede your Benefit or policy will be paid out first in accordance with the cession. If, after payment in accordance with the cession, there is any amount of money remaining in your Benefits, these will be paid in accordance with your policy.
We will only regard a cession as valid when you have notified us of the cession in accordance with the secure process specified by us which may include telephone and online access, and we have accepted and recorded the cession.
If there is an Insured Event, in order for us to make payment in terms of a cession, the cession must have been recorded and accepted by us before the happening of the Insured Event. A cession amount cannot be greater than a Benefit’s Cover amount.
A cessionary is the person or institution to whom you cede your Benefit whether by way of a security cession or an outright cession. That person or institution receives transfer of the Policy Benefits from you.
If you have nominated a beneficiary and we have accepted and recorded your beneficiary nomination, we will suspend the Beneficiary nomination in the case of a security cession for as long as the security cession remains recorded in our records. In the case of an outright cession the Beneficiary nomination accepted and recorded by us will be cancelled immediately when we accept and record an outright cession.
If you are married in community of property you may not cede any Benefit without first obtaining the written consent of your spouse. In such a case, we will not accept and record a cession without this consent.
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25. Cash Value
Your policy does not have a cash value. This is also known as a surrender value. If the policy is cancelled or lapsed, no money will be paid out. You cannot borrow any money from us under this policy. It may be used as security for a loan from another person or institution.
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26. Currency
Premiums, Benefit Payout and any other cash flows are payable in South African Rand to, and from, the Head Office of Investec Life Limited at 100 Grayston Drive, Sandown, Sandton, Johannesburg.
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27. Language
The language applicable to your policy and all documentation and information in connection therewith will be English.
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28. Applicable Law
South African Law will apply to your policy and any legal issues will be decided in accordance with South African Law.
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29. Exclusions that apply to all of your Benefits
No part of the Cover Amount in respect of any of your Benefits will be paid by us if an Insured Event in respect of the Benefit is due to an excluded event below.
- In the case of the Insured Event being the death of a Life Covered, if the death is due to, or hastened by, his or her own act (including suicide) in the first twenty four (24) months after:
- Cover Start Date of the Benefit,
- Voluntary Cover Increase Date of the Benefit, but this will only apply to the increased portion of the cover,
- Restart Date after an earlier lapse.
This exclusion is irrespective of whether, at the time of the act, the Life Covered is sane or insane. - In the case of the Insured Event involving disability / impairment or illness of a Life Covered, if the disability or illness of the Life Covered is due to, or hastened by, his or her own act, including elective cosmetic surgery or attempted suicide, irrespective of whether, at the time of the act, the Life Covered is sane or insane.
- If the Life Covered commits or attempts to commit any criminal acts.
- If the Life Covered wilfully and actively participates in war (whether war has been declared or not), invasion, act of foreign enemy, hostilities or war–like operations (whether war has been declared or not), civil war, riots, strikes, military or usurped power, military uprising, martial law, rebellion, revolution, insurrection or terrorism.
- If you visit (for any purpose) any countries under international sanctions or those that are experiencing internal conflict or civil war.
- Intentional and negligent consumption of alcohol, poison or drugs and narcotics unless prescribed by a medical practitioner or the Life Covered being affected (temporarily or otherwise) by alcohol or drugs other than as prescribed by a medical practitioner.
The Life Covered drives a motor vehicle whilst under the influence of alcohol, or under the influence of drugs having a narcotic effect or where the blood alcohol levels of the Life Covered exceed the legal limit.
- If you fail to disclose information honestly to us.
- If we cannot obtain enough medical evidence from your dependants or your treating doctor in order to fulfil our criteria for making a Benefit Payment.
A claim payout in respect of any of your Benefits will be reduced if you or the Life Covered failed to disclose information honestly about existing insurance policies and this resulted in over-insurance.
- In the case of the Insured Event being the death of a Life Covered, if the death is due to, or hastened by, his or her own act (including suicide) in the first twenty four (24) months after:
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30. Suicide Exclusion on Replacement Policies
A Replacement Policy is where an existing insurance policy with an Insurer A, is discontinued and replaced by a new policy with another Insurer B.
There are specific rules which an advisor, agent or broker must explain and discuss with you, or which must be made available and fully explained on-line, before you enter into a Replacement Policy.
At claim stage we may waive, or reduce the twenty four (24) month Suicide Exclusion applicable on a new Benefit where your Investec Policy is replacing an existing policy with another Insurer, if
- The new cover amount is lower or equal to the previous policy’s cover amount;
- The previous policy was active and uninterrupted for more than twenty four (24) months when it was replaced by the Investec Policy;
- The previous policy was underwritten by a Republic of South Africa registered insurance company; and
- We have satisfactory proof of the details of the replaced policy.
- The new cover amount is lower or equal to the previous policy’s cover amount;
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31. Fraud
If you, or a claimant submits a claim on a Benefit and we determine that such claim is based on fraud we will be entitled to reject such claim on the grounds of fraud. If this happens we will be entitled to cancel your Policy and no Benefit will be payable (and any benefits already paid may be claimed back). The Premiums received prior to cancellation will not be refunded.
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32. Sanctions
We are bound to comply with United Nations Resolutions, the Trade and Economic Sanctions Laws and Regulations of the European Union, United Kingdom and United States of America. As a result, we will not be able to provide any cover, nor will we be liable to pay any claim or provide any benefit to the extent that such cover, payment of claim, or benefit would expose us to any sanction, prohibition or restriction under United Nations Resolutions, or the Trade or Economic Sanctions Laws or Regulations of the European Union, United Kingdom or United States of America.
For example if you visit or work in a country that is on the international sanctions lists maintained by the above mentioned bodies or should you personally be listed on one of these sanctions lists then the above condition applies.
Apart from what we set out above, South African Law will apply to your Policy and any legal issues will be decided in accordance with South African Law.
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33. Changes we may make to your Policy
We may make any reasonable changes to your Policy and Benefit Terms and Conditions. We will advise you of any such change no later than 30 (thirty) days prior to the change we make.
This is to enable us to objectively adapt your Policy if changed circumstances warrant this. For example we may adopt new claims definitions and assessment techniques where it helps us in the objective assessment and treatment of claims.
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34. When will your Policy end
Your Policy will end immediately if:
- You cancel the Policy; or
- We cancel the Policy for any of the reasons set out in these General Terms and Conditions; or
- The duration of all your Benefits end; or
- We pay all your Benefits; or
- You die; or
- Your Policy lapses and is not Restarted; or
- We consider this necessary in order for us to comply with applicable laws or to prevent, stop or avoid criminal, fraudulent or other undesirable activity or even the suspicion thereof.
- You cancel the Policy; or