Professional Documents
Culture Documents
u a
uneral
ervices
Address: 3 Blombos close, Plattekloof , Cape Town TEL: 076 170 4008 / 082 221 9971/ 021 939 3907 email:
lulafuneral@gmail.com
Underwritten by:
POLICYHOLDER DETAILS
Surname.First Name(s).
TitleI.D. Number...Date of Birth..
Residential
Address...Code...
Cash
DEPENDENTS
FULL NAMES (SURNAME FIRST)
I.D. NUMBER
RELATIONSHIP
1.
Spouse
2.
Child
3.
Child
4.
Child
5.
Child
6.
Child
7.
Child
COVER
PREMIUM
1.
I.D. NUMBER
RELATIONSHIP
2.
3.
4.
R
TOTAL
BENEFICIARY
Title
Full Names
Date of Birth
I.D. Number
Relationship
..
..
Account Holders Signature
..
Policyholders Signature
Date
Fill out the Product Application Form clearly with all required information and Sign
Provide certified copies of all required documents; like: IDs & Birth Certificates
Pay your premiums every month and keep all your receipts in safe place. Your policy will lapse after 45 days from date of last payment if no
premium (s) were paid the policy will lapse and a new waiting period of 6 (six) months will apply.
You will be allocated with Easy Pay reference so you can pay at any Pep Stores, Spar, Shoprite, Post Office, Pick N Pay, Checkers, Boxer Stores,
etc . Keep this card as it will make your life easier.
You must not engage on risk activities like suicide, committing crime, etc. as this will affect your claim
Waiting Period:
Waiting Period means the Waiting Period as set out in the scheme rules of the Client at inception and shall not be less than:
6 Months of continuous cover for all new members joining the Client after the commencement date of this contract.
Accidental death will be covered as from receipt of the first months premium by Mtengwane Funeral Directors.
CLAIM PROCEDURE
The following documents relating to the Assured Lifes death must be provided to AFRICAN UNITY by the client:
Complete BI 1663
An official police report in the case of Accidental Death of the Assured Life;
A medical report in the case of stillborn babies, indicating that the pregnancy reached the 26th (TWENTY SIXTH) week; and
Any such other documentary proof as may be required by the Insurer in the sole discretion of the Insurer.
No claims of whatsoever nature instituted in terms of this Master Policy shall be entertained after the date of cancellation of this Master Policy, unless the
insured event occurred prior to the date of cancellation.
All benefits of the client will be distributed as stated on the policy contact.
NO PREMIUM = NO COVER
IMPORTANT WARNING
Products or Transactions chosen by him meets his needs and requirements. To this end, it is proposed that the Applicant engages the Intermediary or insurer
with regard to the impact of the proposed transaction on his finances, other insurance and insurance Policies or broader investment portfolio. The Applicant
is advised to complete and sign all requisite forms after ensuring that he understands the content thereof. The Applicant is invited to request information, of
any nature whatsoever, whether verbal or written, relative to this Policy. Any concerns regarding the product sold may be addressed to either the long term
insurance Ombudsman or the Registrar of Long term Insurance, whose details are set out below, if the Applicant has concerns regarding the products sold
and/or advice given to him.
DETAILS OF THE UNDERWRITER
ZINMAR CORPORATE CONSULTANTS
appoints:
DETAILS
OF
THE
SERVICES PROVIDER
FINANCIAL
for
long
term
DETAILS
OF
SERVICES BOARD
FINANCIAL
: Funeral IPlan
DECLARATION:
the undersigned
herebyBenefit
declare that
have000
read and understand the terms and
conditions
1: Death Basic
: IR10
Funeral
Plan above.
2: Death Basic Benefit:
R40
per family
R35
R 7 500