Supporting Information
Everything you need to know is right here: terms and conditions, disclosures, queries, and complaints.
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DEFINITIONS
Unless the contrary appears from the context, the following words and phrases shall have the meanings assigned to them where they appear in this Addendum and the Master Policy
Master Policy
“Master Policy” means the Black Cygnet Life Bond Protection Endurance Policy, and Death Benefit document to which this Addendum is attached.
Claim Payable Date
“The Claim Payable Date” means the date on which a valid claim becomes payable as a result of a ClaimCondition, and is equal to Claim Condition Date plus any Deferred Period (if applicable).
Claim Condition
“Claim Condition”means an illness or bodily injury covered under clause2.1 of this Addendum.
Claim Condition Date
“Claim Condition Date” means the date on which the Claim Condition occurs, in the case of injury, or the Life Assured is finally diagnosed, in the case of illness.
Deferred Period
“Deferred Period”means the period, starting on the Claim Condition Date, for which a Claim Condition must endure continuously in order for a benefit under this Addendum to become payable.
Instalment Benefit
“Instalment Benefit”means the regular monthly instalment as stipulated in the Policy Schedule. If the actual monthly instalment of the Mortgage Loan exceeds the amount stipulated in the Policy Schedule at any time during the Period of Insurance, it is the Life Assured’s responsibility to increase the relevant benefit amount – for which the Life Assured might be charged an increased premium.
Income Benefit
“Income Benefit”means the benefit to which the Instalment Benefit converts interms of clause 2.7.
Total and Permanent Disability
“Total and Permanent Disability” means medically certified total disability as a result of illness, injury or disease and which cannot be cured or treated, and which prevents the Life Assured from earning an income by following his/her own occupation, or any other for which he/she is suited in terms of training, education and experience. A Life Assured shall also be deemed to have suffered total and permanent disability upon the loss or loss of use of both hands, both feet (and one of each) or both eyes. If the Life Assured was not permanently employed for a period of at least 6 (six) consecutive months before the onset of disability, total and permanent disability shall be restricted to meaning the loss or loss of use of both hands, both feet (or one of each) or both eyes.
Waiting Periods
“Waiting Periods” means the periods, starting on the Commencement of Insurance, and any increase to the Sum Assured or benefit amount, during which the occurrence of a claim does not result in a benefit under this Addendum becoming payable. For the purpose of this definition “occurrence of a claim” means the earlier of any of the following events:
- The Life Assured is finally diagnosed with the illness, injury or disease;
- The Life Assured becomes aware that they have contracted the illness, disease or suffered the injury;
- The actual occurrence of the illness, injury or disease.
1. APPLICATION OF THIS ADDENDUM
1.1. The terms of the Master Policy shall apply to this Addendum.
1.2. The Benefits under this Addendum shall only apply if this option has been selected in the Policy Schedule and the relevant premium paid.
2. PERMANENT DISABILITY BENEFIT
2.1. Where a Permanent Disability Benefit has been selected, OMART will pay:
2.1.1. 24 monthly payments from the Claim Condition Date in the form of the monthly Instalment Benefits if, before the policy anniversary immediately prior to the Life Assured’s 65th birthday the Life Assured is prevented by illness or bodily injury from performing his own occupation for more than 90 consecutive days, and while the Life Assured is so prevented from performing, and;
2.1.2. after the above 24 monthly Instalment Benefit payments have been paid, and provided that the Life Assured has suffered Total and Permanent Disability, then the Life Assured shall be paid the Sum Assured.
2.2. Proof of employment and occupation, to the satisfaction of OMART, will be required before a claim will be considered. Where immediately prior to the onset of a Claim Condition the claimant is unemployed, a claim will only be considered where the Life Assured has suffered permanent loss of use of both hands or both feet (or one of each) or both eyes or permanent confinement to a wheel chair, or any other disability which OMART in its sole discretion may deem to be equivalent.
2.3. Should the Life Assured change occupation or duties from that stated in the Application he must notify OMART immediately and OMART reserves the right to charge an additional premium should, in its opinion, the new occupation or duties be of a more hazardous nature. The Permanent Disability Benefit is voidable at the instance of OMART should the Life Assured fail to give notice of any change of occupation or duties.
2.4. The premiums due under the Master Policy and this Addendum will be waived while benefits are being paid under this Addendum. If the benefits cease for any reason whatsoever(including but not limited to the Life Assured reaching the age of 65), then the waiver will fall away and the Life Assured must commence paying premiums again in respect of the Master Policy and other relevantBenefits.
2.5. On admission of a claim, if the Claim Payable Date is reached, Instalment Benefits that fell due after the Claim Condition Date will be paid, subject to the provisions of this Addendum.All instalments will be paid on the same date that the monthly instalments are due for the Mortgage Loan and will be paid into the Mortgage Loan account, unless the Mortgage Loan is no longer in place, in which case it will be paid to the Life Assured.
2.6. Pregnancy or confinement due to the birth of a child shall not mean illness or bodily injury for the purpose of this benefit.
2.7. In the event the Life Assured is no longer liable under the Mortgage Loan then the Instalment Benefit shall convert to an income benefit, which amount will be the equivalent of the monthly instalment as stipulated in the Policy Schedule. Any reference in this Addendum to the Instalment Benefit shall, where applicable, be deemed to include a reference to the Income Benefit.
2.8. Termination Of Benefit: The Permanent Disability Benefit will cease on the earlier of:
2.8.1. the payment in full of all benefits under this Addendum;
2.8.2. the recovery, in the opinion of OMART, during the 24 months period in clause 2.1.1 of the Life Assured sufficiently to perform his own occupation;
2.8.3. the death of the Life Assured;
2.8.4. the Life Assured reaches the age of 65.
2.8.5. any other event in terms of which the Policy would terminate as set out in the Master Policy.
3. DEFERRED PERIOD
The Deferred Period applicable to this Benefit shall be 90 days.
4. WAITING PERIODS
The Waiting Periods for this Benefit shall be:
- From Commencement of Insurance - 30 days;
- In the case of an increase as contemplated in clause 10.1.1 of the Master Policy – 30 days;
- In the case of an increase as contemplated in clause 10.1.2 of the Master Policy – 180 days, as referred to in clause 10.4 of the Master Policy.
5. EXCLUSIONS
In addition to the Exclusions stipulated in the Master Policy OMART will not be obliged to make payment in respect of any illness or bodily injury arising directly or indirectly from or traceable to:
5.1. Psychological Disorders and Psychiatric Illnesses No benefit will be admitted if the claim results directly or indirectly from any of the following:
5.1.1. depression or dysthymia, whether as an episode or disorder, or as part of the symptom complex of another psychiatric diagnosis;
5.1.2. post-traumatic stress disorder;
5.1.3. fibromyalgia;
5.1.4. chronic fatigue syndrome and its synonyms;
5.1.5. In respect of mental illness or symptoms:
- caused by an identifiable organic disorder, or
- of a psychotic nature not caused by chemical dependency.
5.2. Back, Neck and Spinal Conditions
No benefit will be admitted if the claim involves back, neck or spinal conditions or disorders, which are not listed below.
- Paraplegia
- Quadriplegia
- Malignant tumours of the spine or vertebral column
- Failed back syndrome after multiple spinal surgeries
- Fractures of the spine
- Auto-immune conditions affecting the spine
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DEFINITIONS
Unless the contrary appears from the context, the following words and phrases shall have the meanings assigned to them where they appear in this Addendum and the Master Policy:
Master Policy
“Master Policy” means the Black Cygnet Life Bond Protection Endurance Policy, and Death Benefit document to which this Addendum is attached.
Claim Payable Date
“The Claim Payable Date” means the date on which a valid claim becomes payable as a result of a Claim Condition, and is equal to Claim Condition Date plus any Deferred Period (if applicable).
Claim Condition
“Claim Condition” means an illness or bodily injury covered under clause 2.1 of this Addendum.
Claim Condition Date
“Claim Condition Date” means the date on which the Claim Condition occurs, in the case of injury, or the Life Assured is finally diagnosed, in the case of illness.
Deferred Period
“Deferred Period” means the period, starting on the Claim Condition Date, for which a Claim Condition must endure continuously in order for a benefit under this Addendum to become payable.
Instalment Benefit
“Instalment Benefit”means the regular fixed monthly instalment as stipulated in the Policy Schedule.If the actual monthly instalment of the Mortgage Loan exceeds the amount stipulated in the Policy Schedule at any time during the Period of Insurance, it is the Life Assured’s responsibility to increase the relevant benefit amount – for which the Life Assured might be charged an increased premium.
Income Benefit
“Income Benefit”means the benefit to which the Instalment Benefit converts in terms of clause 2.7.
Waiting Periods
“Waiting Periods” means the periods, starting on the Commencement of Insurance, and any increase to the Sum Assured or benefit amount, during which the occurrence of a claim does not result in a benefit under this Addendum becoming payable. For the purpose of this definition “occurrence of a claim” means the earlier of any of the following events:
- The Life Assured is finally diagnosed with the illness or bodily injury;
- The Life Assured becomes aware that they have contracted the illness or suffered bodily injury;
- The actual occurrence of the illness or bodily injury.
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DEFINITIONS
Unless the contrary appears from the context, the following words and phrases shall have the meanings assigned to them where they appear in this Addendum and the Master Policy:
Master Policy
“Master Policy” means the Black Cygnet Life Bond Protection Endurance Policy, and Death Benefit document to which this Addendum is attached.
Claim Payable Date
“The Claim Payable Date” means the date on which a valid claim becomes payable as a result of a Claim Condition, and is equal to Claim Condition Date plus any Deferred Period (if applicable).
Claim Condition
“Claim Condition” means an illness or bodily injury covered under clause 2.1 of this Addendum.
Claim Condition Date
“Claim Condition Date” means the date on which the Claim Condition occurs, in the case of injury, or the Life Assured is finally diagnosed, in the case of illness.
Deferred Period
“Deferred Period” means the period, starting on the Claim Condition Date, for which a Claim Condition must endure continuously in order for a benefit under this Addendum to become payable.
Instalment Benefit
“Instalment Benefit”means the regular fixed monthly instalment as stipulated in the Policy Schedule.If the actual monthly instalment of the Mortgage Loan exceeds the amount stipulated in the Policy Schedule at any time during the Period of Insurance, it is the Life Assured’s responsibility to increase the relevant benefit amount – for which the Life Assured might be charged an increased premium.
Income Benefit
“Income Benefit”means the benefit to which the Instalment Benefit converts in terms of clause 2.7.
Waiting Periods
“Waiting Periods” means the periods, starting on the Commencement of Insurance, and any increase to the Sum Assured or benefit amount, during which the occurrence of a claim does not result in a benefit under this Addendum becoming payable. For the purpose of this definition “occurrence of a claim” means the earlier of any of the following events:
- The Life Assured is finally diagnosed with the illness or bodily injury;
- The Life Assured becomes aware that they have contracted the illness or suffered bodily injury;
- The actual occurrence of the illness or bodily injury.
Download PDF here
DEFINITIONS
Unless the contrary appears from the context, the following words and phrases shall have the meanings assigned to them where they appear in this Addendum and the Master Policy:
Master Policy
“Master Policy” means the Black Cygnet Life Bond Protection Endurance Policy, and Death Benefit document to which this Addendum is attached.
Claim Payable Date
“The Claim Payable Date” means the date on which a valid claim becomes payable as a result of a Claim Event, and is equal to Claim Event Date plus any Deferred Period (if applicable).Claim Event
“Claim Event” means an event of retrenchment covered under clause 2.2 of this Addendum.
Claim Event Date
“Claim Event Date” means the date on which the Life Assured ceases to earn an income, having regard to the Life Assured’s last date of active service and employment record as determined by OMART.
Deferred Period
“Deferred Period” means the period, starting on the Claim Event Date, for which a Claim Event must endure continuously in order for a benefit under this Addendum to become payable.
Instalment Benefit
“Instalment Benefit” means the regular fixed monthly instalment as stipulated in the Policy Schedule. If the actual monthly instalment of the Mortgage Loan exceeds the amount stipulated in the Policy Schedule at any time during the Period of Insurance, it is the Life Assured’s responsibility to increase the relevant benefit amount – for which the Life Assured might be charged an increased premium.
Income Benefit
“Income Benefit” means the benefit to which the Instalment Benefit converts in terms of clause 2.2.
Retrenchment
“Retrenchment” means the involuntary termination of the Life Assured’s full- time or part-time permanent employment with their employer in respect of a permanent employee or the early termination of his contract with their employer in respect of a contract worker:
- due to, or in anticipation of business conditions or any other business decision of the employer that results in redundancy of full- time or part-time permanent employees or contract workers; or
- due to the introduction of new technology or re-organisation of their employer’s business or company closure. Satisfactory evidence that the employer is embarking on a legitimate retrenchment processor company closure will be required as part of the claims assessment process.
Waiting Periods
“Waiting Periods”means the periods, starting on the Commencement of Insurance, and any increase to the Sum Assured or benefit amount, during which the occurrence of a claim does not result in a benefit under this Addendum becoming payable. For the purpose of this definition “occurrence of a claim” means the earlier of any of the following events:
- The Life Assured is retrenched;
- The Life Assured is notified of a possible, or actual retrenchment;
- An indication of a potential retrenchment under general or specific notification.
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DEFINITIONS
Unless the contrary appears from the context, the following words and phrases shall have the meanings assigned to them where they appear in this document and the Master Policy:
Accident
“Accident” means a sudden, fortuitous and uncertain event which is caused solely and directly by violent, external, physical and visible means independently of any other cause, and not deliberately by the Life Assured himself or herself.
Blindness
“Blindness” means the total, permanent and irreversible loss of all sight in both eyes as a result of sickness or Accident, resulting in a sharpness of vision of 3/60 or worse in the better eye when measured with the use of visual aids. Diagnosis has to be confirmed by an ophthalmologist and not be correctable by surgery.
Cancer
“Cancer” means a malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant tumour includes all solid cancers, and blood cancers. For solid cancers, you are covered for any serious cancer that must be classified as least Stage 4 cancer, as staged by the American Joint Association (AJCC) for cancer i.e. cancers that have metastasized, (spread to other organs or throughout the body). Exclusions for solid cancers:
- All tumours of the prostate up to TNM classification T4N0M0
- All non-melanoma skin cancers For Blood cancers, you are covered for any serious blood cancers as detailed below, on the applicable staging systems:
- Acute Myeloid Leukemia;
- Chronic Lymphocytic Leukemia, stage III or IV on the Rai classification;
- Chronic Myeloid Leukemia (requiring bone marrow transplant);
- Acute Lymphocytic Leukemia
- Hodgkins/Non Hodgkins lymphoma Stage IV on Ann Arbor classification system;
- Multiple Myeloma Stage III on the Durie-Salmon Scale. Hairy cell Leukemia is excluded.
Claim Payable Date
“The Claim Payable Date” means the date on which a valid claim becomes payable as a result of a Claim Condition, and is equal to Claim Condition Date plus any Deferred Period (if applicable).
Claim Condition
“Claim Condition” means an illness or bodily injury covered under clause 2.1 of this Addendum.
Claim Condition Date
“Claim Condition Date”means the date on which the Claim Condition occurs, in the case of injury, or the Life Assured is finally diagnosed, in the case of illness, or the date on which the procedure required by the relevant Dread Disease definition is performed, as approved by OMART.
Coma
“Coma” means a state of unconsciousness, defined by a Glasgow Scale score of 8 or less, that necessitates the use of a ventilator for a continuous period of at least 96 hours and results in permanent neurological deficit, persisting for at least 3 months. A coma which is medically induced or results directly from alcohol or drug abuse is excluded.;
- The Life Assured is notified of a possible, or actual retrenchment;
- An indication of a potential retrenchment under general or specific notification
Coronary Artery Bypass Graft
“Coronary Artery Bypass Graft” means the undergoing of surgery to correct the narrowing of, or blockage to, three or more coronary arteries by means of a bypass graft. Realisation of the bypass surgery has to be confirmed by a cardio thoracic surgeon. Excluded are:
- Angioplasty;
- Keyhole surgery; and
- Any other intra-arterial procedures.
Deferred Period
“Deferred Period” means the period, starting on the Claim Condition Date, for which a Claim Condition must endure continuously in order for a benefit under this Addendum to become payable.
Heart Attack
“Heart Attack” means the death of the heart muscle, due to inadequate blood supply, as evidenced by at least two of the following criteria:
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You can have comfort in knowing that Black Cygnet Life( Pty) Ltd (Black Cygnet Life) is governed by the Financial Advisory and Intermediary Services Act (FAIS Act) and is an Authorized Financial Services Provider. For your security, here is some important information regarding the financial services that we have offered you:
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If you have any questions regarding the sale and product information received in terms of this policy, please contact Black Cygnet Life. Contact details are displayed below:
Nature of Enquiry
General Enquiries
- Policy Information
- Policy Changes
- Product Information
Contact Details
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: clientservices@blackcygnetlife.co.za
Company Address
Black Cygnet Life (Broker)
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
OMART has outsourced the administration of the Bond Protection Endurance Policy to Black Cygnet Life. Please find the relevant contact details below for policy administration and claims enquiries:
Nature of Enquiry
General Enquiries (policy administration)
Company Address
Black Cygnet Life (Administration)
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
Contact Details
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: clientservices@blackcygnetlife.co.za
Claims Notifications and Enquiries
Black Cygnet Life (Claims)
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: claims@blackcygnet.co.za
Please find the relevant contact details below for our product supplier and licensed life insurer
Nature of Enquiry
General enquiries regarding the product supplier
Company Address
Old Mutual Alternative Risk Transfer Limited (OMART) (Product Supplier)
Mutualpark
Pinelands
Cape Town
8001
Contact Details
Telephone: 021 821 4921
Email: OMARTADM@oldmutual.com
Nature of Compliant
Financial Service Sales
Company Address
Black Cygnet Life (Broker)
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
Contact Details
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: complaints@blackcygnetlife.co.za
Policy Administration Claims
Black Cygnet Life (Administration)
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: complaints@blackcygnet.co.za
Should your complaint not be resolved to your satisfaction, please feel free to contact the relevant Compliance Officers below:
Nature of Compliant
Financial Service Sales
Black Cygnet Life Compliance Officer
Company Address
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
Contact Details
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: complaints@blackcygnetlife.co.za
Policy Administration Claims
Black Cygnet Life Compliance Officer
Office 104, First Floor
The Boulevard Umhlanga,
19 Park Lane Parkside,
Umhlanga Rocks, 4319
Telephone: 087 232 7014
Fax number: 087 232 7013
Email: complaints@blackcygnet.co.za
OMART Complaints Compliance
Old Mutual Alternative Risk Transfer Limited (OMART) (Product Supplier) Mutualpark, Pinelands, Cape Town, 8001
Telephone: 010 055 7701
Email: OMARTComplaints@oldmutual.com Email: OMARTCompliance@oldmutual.com
If your complaints are not resolved, OMART supports the resolution of unresolved disputes through the National Financial Ombudsman (NFO). The contact details for the NFO who oversee the insurance industry are:
Nature of Compliant
Complaints in respect of claims or other matters not resolved satisfactorily
Company Address
Old Mutual Alternative Risk Transfer Limited (OMART) (Product Supplier) Mutualpark, Pinelands, Cape Town, 8001
Contact Details
Old Mutual Office of Internal Arbitration Telephone: 021 509 1770
Fax: 021 504 7700
Email: arbitrator@oldmutual.com
Complaints in respect of product and claims not resolved satisfactorily by OMART Internal Arbitrator
NFO Ombud Office
JHB: 110 Oxford Road, Houghton Estate, Illovo, Johannesburg, 2198 or
CPT: Claremont Central Building, 06th Floor, 6 Vineyard Road, Claremont, 7708
Telephone: 086 080 0900
Email: info@nfosa.co.za
FAIS complaints (relating to financial service provided)
FAIS Ombud Office
PO Box 41
Menlyn Park
Pretoria 0063
Telephone: 0860 OMBUDS 086 066 2837
Fax: 021 674 0951
Email: info@ombud.co.za
Give us a call on 087 232 7014 or email us clientservices@blackcygnet.co.za