Funeral Policy Terms and Conditions

1. INTRODUCTION

These Terms and Conditions govern the Funeral Policy ("Policy") issued/arranged by MGN Legacy ("the Company") to the Principal Member ("the Member").

The Policy provides funeral-related benefits to the Member and the persons listed on the Policy Schedule, subject to:

• these Terms and Conditions;
• the Policy Schedule;
• the applicable benefit limits;
• payment of premiums;
• waiting periods;
• exclusions; and
• applicable South African legislation and regulatory requirements.

Where there is any conflict between the Policy Schedule and these Terms and Conditions, the provisions applicable to the specific regulated product and the final approved policy wording will prevail.

2. DEFINITIONS

For purposes of this Policy:

2.1 "Administrator"

Means the entity appointed to administer the Policy and claims, where applicable.

2.2 "Beneficiary"

Means the person legally entitled to receive the applicable benefit under the Policy.

2.3 "Child"

Means a biological, legally adopted or legally recognized dependent child who meets the eligibility requirements specified in the Policy Schedule.

2.4 "Claim"

Means a formal request for payment or provision of a funeral benefit following the death of an insured person.

2.5 "Commencement Date"

Means the date on which the Policy becomes effective, subject to receipt and acceptance of the application and the applicable premium.

2.6 "Funeral Benefit"

Means the monetary or funeral-service benefit specified in the Policy Schedule.

2.7 "Insured Person"

Means the Principal Member, spouse, child or additional family member accepted for cover.

2.8 "Member"

Means the Principal Member who has entered into the Policy.

2.9 "Premium"

Means the amount payable by the Member to maintain the Policy.

2.10 "Policy Schedule"

Means the document setting out the Member's specific cover, benefits, premiums and insured persons.

2.11 "Waiting Period"

Means the period following commencement of cover during which specified benefits are not payable, subject to the Policy's provisions.

3. ELIGIBILITY

Membership is subject to the eligibility requirements applicable to the selected product.

The Company may require:

• South African identity documentation;
• passport or other acceptable identification;
• date of birth;
• contact details;
• information relating to dependents; and supporting documents
• beneficiary information;
• payment details and Debi check mandate will be mandatory
• any other information reasonably required to administer the Policy.

The Company reserves the right to verify information supplied by the applicant.

4. APPLICATION AND ACCEPTANCE

The applicant must complete the prescribed application form accurately and honestly.

The applicant is responsible for ensuring that all information supplied is:

• complete;
• accurate;
• truthful; and
• not misleading.

The Company or authorized insurer/administrator may reject or defer an application where eligibility requirements are not satisfied.

Cover will only commence once the application has been accepted and the applicable commencement requirements have been met. 6 months waiting period will be applied.

5. POLICY BENEFITS

The benefits available to the Member will be those stated in the Policy Schedule.

Benefits are subject to the maximum amounts and conditions specified in the Policy Schedule.

A cash benefit payout will be calculated at a rate of 16% of the total cover value.

6. FUNERAL SERVICE BENEFIT

Where the Policy provides a funeral-service benefit rather than a cash benefit, the Company will provide funeral services up to the value of the approved benefit. Cash back will be calculated at a 16% rate of the cover value.

The family may select services from the available funeral-service catalogue, subject to the benefit limit.

Where the selected funeral arrangements exceed the available Policy benefit:

The difference will be payable by the family before the additional services are provided.

The family will receive an itemized quotation for all additional services.

7. CASH BENEFIT

Where a cash benefit is provided, payment will be made to the person legally entitled to receive the benefit, subject to verification of the claim and compliance with the applicable policy terms. Cash back will be calculated at a 16% rate of the cover value.

The Company will not make payment to a person who has no lawful entitlement to the benefit.

8. PRINCIPAL MEMBER

The Principal Member is responsible for:

• payment of premiums;
• maintaining accurate policy information;
• notifying the Company of changes;
• ensuring that eligible dependents are correctly recorded;
• providing required documentation; and
• notifying the Company of the death of an insured person.

9. SPOUSE / PARTNER

A spouse or qualifying partner may be covered subject to:

• eligibility requirements;
• applicable age limits;
• required documentation; and
• the applicable premium.

Only one spouse/partner may be covered under a particular category unless the product specifically provides otherwise.

10. CHILDREN

Children may be covered subject to the applicable product rules.

The Policy Schedule will specify:

• qualifying age;
• maximum age of 21;
• benefit amount;
• dependency requirements; and
• applicable waiting periods.

Where a child reaches the maximum qualifying age, the cover may terminate or convert to another available product, subject to the Policy terms.

11. EXTENDED FAMILY MEMBERS

The Policy may allow additional family members to be added for an additional premium.

These may include:

• parents;
• parents-in-law;
• siblings;
• grandparents; and
• other qualifying dependents.

Each additional member is subject to:

• eligibility requirements;
• applicable premiums;
• waiting periods;
• benefit limits; and
• acceptance under the relevant product.

12. PREMIUMS

The Member must pay the premium specified in the Policy Schedule.

Premiums may be payable:

• monthly;
• annually; or
• through another approved payment arrangement.

The Member is responsible for ensuring that sufficient funds are available where payment is made by debit order. The principal member will be required to sign a Debi check mandate for debit order payment options.

13. PREMIUM REVIEW

Premiums may be reviewed from time to time were permitted by the applicable product terms and legislation.

Any change to premiums will be communicated to the Member in accordance with applicable requirements.

The Company will not arbitrarily change an individual Member's premium without following the applicable contractual and regulatory requirements.

14. PAYMENT FAILURE

Where a premium is not successfully collected:

1. The Member will be notified where required.

2. The Member will be given an opportunity to bring the account up to date.

3. The Policy may enter a grace period.

4. If the premium remains unpaid after the applicable grace period, the Policy may lapse in accordance with its terms.

15. GRACE PERIOD

A grace period may be provided for unpaid premiums.

Proposed grace period:

30 days

The exact grace-period provisions will be stated in the final Policy Schedule.

Cover during the grace period will be governed by the applicable policy terms and regulatory requirements.

16. LAPSE

A Policy may lapse where:

• premiums remain unpaid;
• the grace period expires;
• the Member requests cancellation; or
• another termination event specified in the Policy occurs.

A lapsed Policy will not automatically be treated as active.

17. REINSTATEMENT

A lapsed Policy may be reinstated subject to the applicable reinstatement requirements.

These may include:

• payment of outstanding premiums;
• completion of a reinstatement form;
• confirmation of continued eligibility;
• new waiting periods where applicable; and
• approval by the authorized insurer/administrator.

18. WAITING PERIOD

Waiting periods may apply to certain causes of death.

The applicable waiting period will be clearly stated in the Policy Schedule.

Structure:

Natural death: 6 months

Accidental death: subject to the specific product terms and applicable cover provisions.

Suicide: 12 months

The final waiting-period provisions must comply with the approved insurance product and applicable legislation.

19. DEATH DURING THE WAITING PERIOD

Where an insured person dies during a waiting period, the claim will be assessed in accordance with the Policy terms.

Depending on the approved product, the claim may:

• be excluded;
• qualify for an accidental-death benefit;
• qualify for a return of premiums; or
• qualify for another specifically defined benefit.

The applicable outcome will be clearly stated in the final Policy Schedule.

20. ACCIDENTAL DEATH

Where accidental death cover applies, the death must result directly from an unforeseen external event as defined in the Policy.

The Company may request:

• death certificate;
• medical documentation;
• police report;
• post-mortem report; and/or
• other evidence reasonably required to assess the claim.

21. SUICIDE

The Policy will contain a specific suicide provision consistent with applicable South African law and the approved product structure.

The applicable exclusion or waiting period must be clearly disclosed to the Member before or at commencement of cover. 1 waiting period.

22. EXCLUSIONS

Benefits will not be payable where the claim falls within an exclusion specified in the Policy.

Potential exclusions include circumstances such as but are not limited to:

• material misrepresentation;
• fraudulent claims;
• non-disclosure of material information;
• death outside the scope of the insured benefit;
• cover not being active at the date of death;
• benefits claimed for a person who was not covered;
• failure to meet eligibility requirements; and
• other exclusions specifically disclosed in the Policy.

The Company will not rely on undisclosed exclusions.

23. MATERIAL NON-DISCLOSURE

The Member must disclose information required by the application.

If material information was deliberately withheld or misrepresented, the claim and/or Policy may be affected in accordance with applicable law and the approved Policy terms.

The Company will follow the applicable legal and regulatory process before repudiating a claim on grounds of non-disclosure or misrepresentation.

24. FRAUD

Fraudulent activity is strictly prohibited.

Examples include:

• submitting false documentation;
• providing false information;
• attempting to claim for a person who is not insured;
• submitting duplicate claims;
• falsifying death information;
• deliberately concealing material information; or
• assisting another person to submit a fraudulent claim.

Suspected fraud may be investigated and referred to the appropriate authorities where necessary.

25. CLAIM NOTIFICATION

The Company should be notified of a death as soon as reasonably possible.

Recommended notification period:

Within 10 days of death

Late notification may be considered where there is a reasonable explanation.

The Company will not automatically reject a legitimate claim merely because notification was delayed where applicable law or the approved policy terms provide otherwise.

26. CLAIM DOCUMENTATION

The following may be required:

• Completed claim form;
• Principal Member's ID;
• Deceased's ID;
• Death certificate;
• Notification of death;
• Medical documentation where required;
• Police report where applicable;
• Proof of relationship;
• Proof of beneficiary entitlement;
• Policy documentation;
• Proof of premium payment where required; and
• Any other reasonable documentation required to assess the claim.

27. CLAIM ASSESSMENT

Once a claim is received, the Company or authorized administrator will:

1. Verify the Policy;

2. Confirm that premiums are up to date;

3. Confirm the identity of the deceased;

4. Verify the insured person's eligibility;

5. Confirm the applicable benefit;

6. Review waiting periods;

7. Assess exclusions;

8. Review supporting documentation; and

9. Approve, decline or request additional information.

28. CLAIM DECISION

The Member or claimant will be informed of the outcome of the claim.

Where a claim is declined, the claimant should receive an explanation of the applicable reason and information regarding the applicable complaints or dispute process.

29. FUNERAL ARRANGEMENT AUTHORISATION

Once the claim has been approved for a funeral service benefit, the funeral arrangements will be confirmed.

No additional services should be treated as included unless they have been approved under the Policy or agreed separately with the family.

30. UPGRADES

A Member may upgrade the funeral service beyond the Policy benefit.

The additional amount will be payable by the family.

Example:

Policy Benefit: R30,000 Funeral Selected: R38,000 Additional Amount: R8,000

The family must approve the additional cost before the upgrade is provided.

31. TRANSPORTATION

Transportation benefits are subject to the limits stated in the Policy Schedule.

This may include:

• collection;
• hearse;
• local transportation;
• family transportation; and
• repatriation.

Additional kilometers or special transportation requirements may attract additional charges.

32. REPATRIATION

Repatriation may be included as a benefit or offered as an optional rider.

The Policy Schedule must specify:

• geographic area;
• maximum benefit;
• transportation limits;
• documentation requirements;
• cross-border requirements; and
• any exclusions.

Cross-border and international repatriation will be subject to applicable legal and regulatory requirements.

33. CREMATION

Where cremation is selected, the applicable benefit will be limited to the amount specified in the Policy Schedule.

Additional costs may apply for:

• premium urns;
• memorial services;
• venue hire;
• flowers;
• transportation outside the included area; and
• other optional services.

34. CHANGE OF INFORMATION

The Member must notify the Company of changes to:

• address;
• telephone number;
• email address;
• banking information;
• dependents;
• beneficiaries; and
• other relevant policy information.

Changes must be submitted through the prescribed process.

35. ADDITION OF DEPENDANTS

Additional family members may be added subject to:

• eligibility;
• applicable premium;
• waiting periods;
• documentation; and
• acceptance under the product.

The additional dependent will not automatically be covered merely because the Member has requested inclusion.

36. CANCELLATION

The Member may request cancellation of the Policy in accordance with the applicable cancellation provisions.

Cancellation must be submitted through the prescribed process.

The effective cancellation date will be communicated to the Member.

37. TERMINATION BY THE COMPANY / INSURER

The Policy may be terminated in circumstances permitted by the Policy and applicable law, including:

• non-payment;
• fraud;
• material misrepresentation;
• loss of eligibility;
• expiry of the product; or
• other legally permitted circumstances.

Any termination will be communicated in accordance with applicable requirements.

38. REFUNDS

Refunds, where applicable, will be handled according to the final Policy terms and applicable legislation.

Premiums already paid do not automatically create an entitlement to a refund.

39. POLICY TRANSFER

A Policy may not be transferred to another person without written approval where transfer is legally and contractually permitted.

40. BENEFICIARY NOMINATION

Where applicable, the Member may nominate a beneficiary.

The beneficiary nomination must comply with applicable legal and policy requirements.

The Member is responsible for keeping beneficiary information current.

41. POPIA AND CONFIDENTIALITY

The Company will process personal information in accordance with applicable South African data- protection requirements.

Personal information may be processed for purposes including:

• Policy administration;
• identity verification;
• premium collection;
• claims processing;
• fraud prevention;
• regulatory compliance;
• customer communication; and
• provision of funeral services.

The Company will take reasonable steps to protect personal information from unauthorized access, disclosure, alteration or loss.

42. CUSTOMER RESPONSIBILITIES

The Member agrees to:

• provide accurate information;
• pay premiums on time;
• notify the Company of relevant changes;
• keep policy documents safe;
• notify the Company of a death;
• provide required claim documentation; and
• cooperate with reasonable claim verification requirements.

43. COMPANY RESPONSIBILITIES

The Company undertakes to:

• treat customers respectfully;
• provide clear information;
• maintain appropriate records;
• handle claims professionally;
• protect customer information;
• provide agreed funeral services;
• disclose additional costs; and
• deal with complaints fairly.

44. THIRD-PARTY SERVICE PROVIDERS

The Company may use approved third-party service providers, including:

• mortuaries;
• crematoria;
• transport providers;
• florists;
• coffin manufacturers;
• catering companies;
• tombstone suppliers; and
• other funeral-service providers.

The Company remains responsible for the services it has contracted to provide, subject to the applicable agreements and legal requirements.

45. FUNERAL SERVICE QUALITY

The Company will endeavor to provide services professionally and respectfully.

Where a selected service or product is unavailable, the Company may provide an alternative of equivalent or greater value, subject to the Member's approval where appropriate.

46. COMPLAINTS

Customers may submit complaints regarding:

• claims;
• premiums;
• funeral arrangements;
• service delivery;
• staff conduct;
• administration; or
• any other aspect of the Policy.

Complaints should be submitted to:

Complaints Officer: Mmaketi Mangaba Telephone: 0871643632 Email: admin@mgnlegacy.co.za Physical Address: Farm 12, Uitkyk 851KS Nebo Sekhukhune R579, 1059

The Company will acknowledge and handle complaints in accordance with its complaint’s procedure and applicable regulatory requirements.

Where the product is underwritten/administered by a regulated insurer or financial-services provider, the applicable escalation and external dispute-resolution channels will also be made available.

47. DISPUTE RESOLUTION

The Company will first attempt to resolve disputes through its internal complaints process.

Where the dispute cannot be resolved internally, the customer may use the applicable external dispute- resolution or regulatory complaint mechanisms relevant to the product.

The final policy must identify the appropriate South African escalation route for the actual regulated product.

48. CHANGES TO TERMS AND CONDITIONS

The Company may not make material changes to the Policy without following the applicable contractual and regulatory requirements.

Members will be notified of material changes where required.

49. GOVERNING LAW

The Policy shall be governed by the laws of the Republic of South Africa, subject to the applicable regulatory framework governing the specific product.

50. POLICY DOCUMENTATION

The following documents form part of the Member's Policy file, where applicable:

1. Application Form

2. Policy Schedule

3. Terms and Conditions

4. Benefit Schedule

5. Premium Schedule

6. Beneficiary Nomination

7. Amendments/Endorsements

8. Claims documentation

9. Applicable notices and disclosures

51. MEMBER ACKNOWLEDGEMENT

I confirm that:

• I have received the Policy Terms and Conditions;
• I understand the benefits applicable to my selected plan;
• I understand the premium payable;
• I understand the applicable waiting periods;
• I understand the exclusions;
• I understand that additional funeral services may attract additional charges;
• I have provided information that is accurate and complete to the best of my knowledge; and
• I understand the procedure for submitting a claim.

Principal Member: ______________________________

ID Number: ____________________________________

Signature: _____________________________________

Date: _________________________________________

Witness: _______________________________________

Signature: _____________________________________