Accidental means bodily injury caused solely or directly by sudden and unexpected external, violent and visible means.

Administration Fee refers to a percentage deducted from the Sum Assured which covers the claims administration costs. This percentage deduction may change from time-to-time.

Application Date means the date on which the Policy was recorded by Clientèle Life.

Child means an unmarried dependant child, step-child, illegitimate child or adopted child (legally or by custom) of the Life Assured and includes a child who is over 21 (twenty-one) and becomes dependant on the Life Assured by reason of mental or physical incapacity during the currency of the Policy. This definition further includes a grandchild being the child of any of the Life Assured’s children where both child’s parents are deceased or the child is a dependant of the Life Assured and satisfactory proof of dependency is submitted to the Insurer. A dependant child that has attained the age of 18 years or 21 years, if a full time student, shall no longer be covered under this policy. Proof will be requested at claim stage.

Commencement Date means the first day of the month during which the first Premium is paid.

Cooling Off Period The Policy Owner will have a 30 (thirty) day cooling off period from the date of receipt of the Policy Document in order to read over the Policy conditions and to cancel the Policy if unsatisfied. Any Premium deducted in this period will be refunded in full should the Policy be cancelled during this period.

Currency means the period from the Commencement or Reinstatement Date whilst due Premiums are paid.

Illness means sickness or disease contracted and commencing during the Currency of the Policy.

Life Assured means those person(s) stated as such in the Schedule.

Main Policy means the Policy outlined in this policy document and excludes any rider or supplementary benefits outlined in a separate policy document or schedule.

Policy Owner refers to the person to whom the Policy belongs and shall be the initial payer of Premiums unless The Company is advised otherwise in writing. 

Premium - means the regular monthly contractual payment made by a policyholder in return for an undertaking by the Company to provide policy benefits as specified in this insurance policy.

Spouse means the person married (by law, customary law or common law) to the main Life Assured and named as such in the Schedule.

Survival Period means a period of 14 (fourteen) days which the Insured Person survives without the use of life support after being diagnosed with Cancer.

Terminal Illness is as a disease or illness which, in the opinion of The Company, will result in the death of the Insured Life within a period of 12 (twelve) months following the date of payment of this Benefit.

Accident means a sudden, uncertain and unexpected event which is caused solely and directly by violent, external, physical and visible means and independently of any other cause, excluding any events that are traceable to psychiatric trauma and the Insured Person's state of mental or physical health prior to the event.

Accidental Permanent and Total Disablement means disablement, due to an accident, where an Insured Person is unable to carry out the functions of any occupation or an Insured Person who suffered total and permanent loss of one of the following due to an accident: sight in both eyes; ability to speak; loss of use of a combination of any 2 (two) limbs (hand, foot, leg, arm) provided that they are not part of the same limb; loss of use of both feet (ankle or below); or both legs (above the knee, including the knee and below); loss of the use of both hands (below the wrist); or both arms (above the elbow, including the elbow and below).

Administration Fee refers to a percentage deduction from the Sum Assured which covers the claims administration costs. This percentage deduction may change from time-to-time.

Application Date means the date on which this Policy was recorded by Clientèle Life.

Beneficiary is the natural person nominated by the Policy Owner to receive the Life Cover Benefit in the event of death.

Child means an unmarried dependent child, step-child, illegitimate child or adopted child (legally or by custom) of the Insured Person and includes a child who is over 21 (twenty-one) and dependent on the Insured Person by reason of mental or physical incapacity.

 

This definition further includes a grandchild being the child of any of the Insured Person's children where both child's parents are deceased or the child is a dependent of the Insured Person and satisfactory proof of dependency is submitted to the Insurer.

 

A dependent child that has attained the age of 18 (eighteen) years shall no longer be covered under this Policy, unless enrolled as a full time student at a registered tertiary institution until a maximum age of 21 (twenty-one). Proof will be requested at claim stage.

Commencement Date means the first day of the month during which the first Premium is paid.

Currency means the period from the Commencement or Reinstatement Date (whichever occurred last) whilst due Premiums are paid.

Insured Person means the person(s) named as such in the Policy Schedule who is/are a resident(s) of the RSA (Republic of South Africa) residing in the RSA and in possession of a valid RSA identity document.

Illness means sickness or disease contracted and commencing during the Currency of this Policy.

Physician means a medical practitioner duly qualified, registered, licensed and practicing within the scope of his/her license pursuant to the laws of South Africa. Physician shall not include a relative by blood or marriage of such an Insured Person unless approved by the Company.

Policy Owner shall be the person named as such in the Policy Schedule and is the initial payer of this Policy unless the Company is advised otherwise in writing.

Pre-Existing Medical Condition means Sickness contracted and commencing or Bodily Injury sustained by an Insured Person for which he or she has or should reasonably have received relevant medical treatment or advice by a Physician, prior to such an Insured Person's initial Commencement or Reinstatement Date of Insurance under this Policy (whichever occurred last), including but is not limited to, any physical or mental defect, disease, infirmity or condition which existed prior to the initial Commencement or Reinstatement Date of this Policy (whichever occurred last).

Main Policy Premium means the regular monthly contractual payment made by a policyholder in return for an undertaking by the Company to provide Policy Benefits as specified in this Insurance Policy.

 

This specifically excludes the Premium covering any additional rider benefits where a separate Policy Schedule of Benefit Terms and Conditions are provided.

Spouse means the person married (whether by civil, customary, tribal or religious union) to the Insured Person and named as such in the Policy Schedule. Cover is limited to one nominated spouse where a person has more than one.

Survival Period means a period of 14 (fourteen) days which the Insured Person survives without the use of life support after being diagnosed with a Dread Disease.

Waiting Period means 6 (six) months or (depending on the plan chosen) following the Commencement or Reinstatement Date (whichever occurred last) during which the Insured Person is not covered under this Policy for the Dread Disease and Cancer Benefit.

 

If this Policy is reinstated, then the Waiting Period and Cash Back Period will recommence again from the Reinstatement Date.

Heart Attack – being the death of a portion of the heart muscle as a result of inadequate blood supply to the relevant area. The diagnosis shall be based on the following 3 (three) criteria:

Stroke – any cerebrovascular incident producing an abrupt onset of neurological consequence lasting more than 24 (twenty-four) hours, including infarction and ischaemia of the brain tissue, haemorrhage or embolisation from an extracranial source. Evidence of permanent neurological deficit must be produced at the earliest 6 (six) weeks after the event and no claims can be admitted earlier. The following are specifically excluded:

 

Cancer – a disease including breast cancer in situ manifested by the presence of a malignant tumour positively diagnosed with histological confirmation characterised by the uncontrolled growth and spread of malignant cells, and the invasion of tissue. The following are specifically excluded:

 

Renal Failure – end stage renal failure presenting as chronic irreversible failure of both kidneys to function as a result of which regular renal dialysis is instituted.

Major Organ Transplant – the human to human organ transplant from a donor to the Insured Person of one or more of the following organs: heart, lung, liver, pancreas, small bowel, kidney or bone marrow.