The Old Mutual Life Assurance Company (Ghana) Limited, (Herein after called "the Company"), hereby agrees with the Policyholder, subject to the provision of items required and cash benefit, to pay the sum insured in accordance with the terms and provisions of this policy if the Life Insured dies while this policy is in force. Ekyire Asem also offers the Policyholder a choice of adding a Hospital Cash Benefit. For the Policyholders who choose to purchase the optional Hospital Cash Benefit, the terms and provisions of the additional Hospital Cash benefit are available below.
FRAUD WARNING: Deliberately presenting false information is unlawful. Failure to disclose accurate information may result in non-provision of required items and all benefits under the policy being terminated.
DEFINITIONS
When we use the following words, this is what we mean:
The Life Insured: This is the person whose life has been insured in this policy. This includes the main life covered and any family members (i.e. spouse, child, parent or parent-in-law) as reflected in the application form.
You, Your, Policyholder: The owner of this contract who is the main life covered, as shown in the application form, unless changed as provided for in this contract.
We, Our, Us: The Old Mutual Life Assurance Company Limited herein after called the Company.
Age: The life insured's age at their last birthday.
Sum Insured: The guaranteed items required and cash benefit payable on the death of a life insured.
Premium: The sum of money that must be paid before any proceeds can be considered earned. The sum of money that the policyholder has paid for each and every life that is insured under the policy. To enable Old Mutual to provide any proceeds or benefits resulting from the covered risk, the items required, and cash benefit must be provided as at the time it is due.
Beneficiary/ Trustee: The person named in our records to receive the death benefit after the Policyholder/main life dies.
Effective Date or Policy Date: The effective date of coverage under this policy and the date from which policy anniversaries, policy years, policy months and premium due dates are determined subject to answering a simple medical questionnaire (if there is one). It is the date when the company receives the completed application form and the premium for the policy
Acceptance Date: The Acceptance date will be the date on which the underwriter receives the policyholder online application form inclusive of data consent acceptance and policy terms & condition acceptance. On this date therefore all acceptance criteria have been met and the underwriter has received all required documentation from the Policyholder. The acceptance date may be before the effective date or after the effective date. However, if after the effective date, the Acceptance date must happen no more than 30 days after the effective date of the policy.
Lapse: The state of a policy where the cover has stopped because the policyholder has premium in default. In this state, due to the policyholder's failure to pay monthly premiums, He / She is no longer under cover.
Termination: When the policy is no longer in force.
Policy Anniversary: The same day and month as your policy date for each succeeding year policy remains in force.
Hospital Cash Benefit: The is an optional benefit and it is only available to the main member (policyholder) on the digital funeral policy. The policy provides some cash relief for hospitalization if the policyholder opts for the Hospital Cash Benefit. For the Policyholders who choose to purchase the optional Hospital Cash Benefit, the terms and provisions of this additional Hospital Cash Benefit are available below.
GENERAL CONDITIONS
1. CONTRACT
The Company declares that the digital application form and the terms and conditions set forth in this policy, form the contract between the Company and the Policyholder named in the application form and it is further declared that any endorsements made on this policy are to be deemed to modify the contract between the Company and the Policyholder as from the date of such endorsement unless otherwise provided.
This is an annually renewable contract. The one-year contract term end at the policy anniversary. At the policy anniversary, there is a one-month revival period to renew without new business conditions (waiting period). If renewed after the one month, a new policy will be issued and waiting periods will apply. There will be no cover during the one-month renewal period, i.e. during the time the policy is still in the ‘expired’ state and still awaiting renewal.
Termination of contract happens on the first of the following events:
- the policyholder as the premium payer and life insured dies,
- the life insured has reached the termination age of cover provided of the policy,
- if the policy lapses due to the premiums not being paid,
- the premium payer as the life insured does not renew,
- on the Policyholder's request,
- on full hospital cash claim of up to 90 days in aggregate for main life, the hospitalization benefit cover is no longer available.
2. FREEDOM FROM RESTRICTIONS
This policy is absolutely free from all restrictions as regards foreign travel and occupation unless otherwise stipulated. Only persons who are ordinarily resident in Ghana can take out a policy. No life cover benefits will be paid for any life assured who is a permanent resident in a foreign country.
3. CLAIMS
a) Item to be provided and cash benefit are payable upon receipt of proof satisfactory to the directors of the company with regard to:
(i) The occurrence of the event on which the Sum Insured is to be provided
(ii) The legal title of the claimant, and
(iii) The age of the life insured.
Benefits to be provided on the death of any of the other Lives Insured shall be given to the main life covered/policyholder.
On the death of the Policyholder who is also the Life Insured, benefits shall be provided to the nominated beneficiary or his/her authorized representative in our records.
As soon as practicable, but no later than one year after the death of a Life Insured, written notifications shall be given to the Company informing the Company of the death of the Life Insured. This requirement shall be a condition precedent to any liability of the Company to make any payment under this policy. An official death Certificate/Medical Certificate of cause of death (relating to the Life Insured) shall constitute proof of death. The following documents are required in the event of a death claim:
1) Digital claim form
2) Scanned copy of Death Certificate and or Medical Certificate of cause of death
3) Identity document of policy holder
4) Any other document relevant to the claim
5) If beneficiary is a minor a softcopy of an affidavit is required
6) For the Hospital Cash Benefit; the terms and provisions of the additional Hospital Cash benefit are available below
4. CLAIMS - HOSPITAL CASH BENEFIT
The is an optional benefit (rider) made available only to the main member) policyholder) on the Digital Funeral Policy and it provide some cash relief for hospitalization if and only if the policyholder opts for the Hospital Cash Benefit. The hospital cash benefit is also annually renewable and will be aligned with the contract term of the Digital Funeral Plan. The Hospital Cash Benefit is an optional benefit, and the relevant terms and provisions of this additional Hospital Cash Benefit are available below.
5. CASH BACK
The Policyholder will receive a cash back benefit equal to 5% of the actual premiums paid at the policy anniversary provided the policy is still in force and no claim is made.
6. PREMIUM
Premiums are payable monthly, and the policy has an annual renewable term. A premium is due on the date of expiry of the previous premium. A grace period of 90 days will be allowed for payment of each renewal premium.
If the renewal premium is not paid within the grace period and with the insured still being alive then the insurance shall cease forthwith and without any obligation whatsoever of the Company towards the Policyholder. The policyholder may then obtain cover by purchasing a new policy and will be subject to a new waiting period.
If the insured dies after the waiting period but within any grace period, any unpaid premium will be deducted from the Sum Insured benefit and the balance paid to the beneficiary.
7. WAITING PERIOD
Waiting period refers to a period in months from the effective date during which benefits under this policy shall not be paid if the claim is caused by natural death or illness. There will be a waiting period of three (3) months for death due to natural causes for policyholders and selected family members. There is no waiting period when death is due to an accident.
8. ADDITION OF LIVES
The policy allows for any two additional family members (i.e. spouse, child, parent or parent-in-law) to be insured together with the main member. No new lives can be added to a policy at a later date than the cover start date on the initial policy. However, additional lives can be added at policy renewal.
9. ELIGIBILITY
The policyholder will select the life insured as defined in this policy.
10. AGE LIMITS FOR LIFE INSURED
11. COVER
Maximum cover per life with the underwriter is GHS 20,000. Cover is available whiles policy is in force. Cover level is selected from pre- determined levels ranging from GHS 2,000 to GHS 20,000.
12. PREMIUM AND COVER GUARANTEES
The premiums and cover are guaranteed on annual basis. Both premiums and cover may be reviewed after this period.
13. INCONTESTABILITY CLAUSE
Old Mutual Life Assurance may contest the validity of the insurance contract on the grounds of a material misrepresentation in the application/proposal for insurance within the year of policy inception. A material misrepresentation in an application for life insurance is a misrepresentation that is relevant to the insurer's evaluation of the proposed insured. The misrepresentation is material when, if the truth had been known, the insurer would not have issued the policy or would have issued the policy on a different basis, such as a higher premium or a lower face amount.
14. MIS-STATEMENT OF AGE
If it be found that the age of a Life Insured has been understated in the proposal, any Sum Insured thereto will be reduced to the amounts which premiums paid would have secured. In calculating such reduced amounts, the term of the policy and of the premium payments will be deemed to be the same as those specified in the schedule. If it be found that the Age has been overstated the excess premium paid will be refunded without interest.
15. FRAUD OR MIS-STATEMENT
Any fraud or mis-statement of a material fact by an insured, either in the Application or Proposal Form on which the insurance is based or in relation to any claim hereunder shall render this policy null and void in so far as it relates to the insured and all claims hereunder shall be forfeited.
16. CESSIONS
Except as provided in this policy, ownership may not be ceded. Benefits under this policy cannot be assigned as collateral security. The Company accepts no responsibility arising from a private treaty or any other arrangement.
17. COOLING OFF PERIOD
The Policyholder has the right to cancel this policy within 30 days of commencement. All premiums paid will be returned provided that no insured event has happened.
18. CANCELLATION CLAUSE
After completion of the 30-day cool off period the Policyholder may still give notice to cancel the policy. No premiums will be returned.
19. GRACE PERIOD
If the full premium due is not received by the due date, the policyholder will enter the grace period on the due date. There is a grace period of 90 days available. If a full premium due payment in respect of the oldest missed premium due is received by the end of the grace period, the policy continues as active.
20. LAPSE CLAUSE
If the renewal premium is not paid within the grace period and with the insured still being alive then the insurance shall cease forthwith and without any obligation whatsoever of the Company towards the policyholder. The policyholder may then obtain cover by purchasing a new policy.
21. CURRENCY AND JURISDICTION
All payments made to or by the Company shall be payable in the Lawful currency of Ghana and any questions of Law arising under this policy shall be decided according to the Laws of Ghana.
22. DISPUTES
The Parties shall use all reasonable efforts to resolve any disputes amicably. Where amicable settlement of any dispute arising from this Agreement is impossible within fourteen (14) days, the policyholder may contact the National Insurance Commission for the resolution of the disputes. Should either party be dissatisfied with the decision of the National Insurance Commission, the Parties may by consensus refer the dispute to the Ghana Arbitration Centre for resolution through arbitration in accordance with the Alternative Dispute Resolution Act, 2010 (ACT 798).
23. SURRENDER, PAID UP AND LOANS
There is no cash value or surrender value on this policy. The policy does not allow for paid up.
24. MEDICAL EXAMINATION
A medical examination is not required to apply.
25. TERMINATION OF THE POLICY
- On the death of all the Lives Insured.
- No premium is paid at the end of the grace period.
- On the Policyholder's request.
- On not renewing the policy at the end of the 1year term.
26. CHANGES TO COVER
Changes to beneficiary and other life covered (family member) will be allowed only at policy renewal.
Other changes including the cover amount cannot be amended once a purchase is complete. A Policyholder wishing to make changes will have to wait until the current cover ends should they wish to change the level of cover. A new premium rate would apply subsequently.
27. EXCEPTIONS & EXCLUSION
This policy does not cover death resulting from:
1) Nuclear activity or radioactivity.
2) Willful exposure to danger by the life insured except in an attempt to save human life.
3) War, enemy hostilities, commotion, insurrection, revolution, military seizure of power or the usurping of power or any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the government de jure or de facto or to the influencing of terrorism or violence.
4) Suicide.
5) Execution of a judicial sentence of death.
6) A life insured travelling in or alighting from an aircraft other than as a fare paying passenger or an aircraft licensed for the carriage of passengers piloted by a pilot holding a commercial pilot’s license and operated by a regular airline or recognized charter service.
7) Hospitalization as a result of riot, private flying, hazardous sports or any illegal acts where the Insured Person was directly involved.
8) Non-compliance to medical treatment.
DECLARATION
In witness to the above, The Old Mutual Life Company (GHANA) Limited has caused this Policy to be executed as of the policy date Signed on behalf of the Old Mutual Life Company (GHANA) Limited
For compliments or complaints about Old Mutual, please visit any Old Mutual Office or branch or email customerservice@oldmutual.com.gh. If matter remains unresolved, you can visit the National Insurance Commission (NIC) at National Insurance Commission: No 67 Independence Ave Insurance Place P.O. Box CT 3456 Cantonments, Accra.