The policy holder is the main member of a policy and is the person who enjoys the benefits on the policy. Someone else can be the policy payer but they have no rights on the policy, only the main member has.

Yes, Foreign nationals can be covered if they meet the requirements included in the policy wording.

1. All lives covered must be in possession of a valid work/refugee/ residence permit within a valid passport that allows them to live within the country and must normally reside in South Africa to qualify to be added onto the policy
2. The main member and beneficiary must have a South African bank account
3. Benefits will be paid in South African Rands to a South African bank account

1. They can be added to the Single parent, Family funeral  if they are within the qualifying age
2. Still born children of the Main member are covered under the policy.
3. Children under the Single Parent, Family policy will remain as children up until their 21st or 25th* birthday
4. Children qualify to be covered up to 25 years of age if they are unmarried and attending a tertiary institution. As well as if they are physically or mentally disabled.
5. When the child passes the qualifying age (i.e. turn 21 or 25) they must be added as an adult child under the extended family benefit to remain on the policy.

This is the date when the client pays their first premium and cover commences.

HOW IT WORKS

1. As soon as the first premium is paid, all members under the policy are automatically covered for accidental death.
2. When the policy incepts waiting periods for natural causes and suicide will also commence
3. If new benefits or additional members are added to the policy premium will be recalculated and waiting periods and cover for the additional members and benefits will start when the New recalculated total premium is paid.

A policy lapse is when a policy is no longer valid. 

1. A lapse occurs when a customer does not pay their TOTAL premium or makes partial payments of their total premium that adds up to two (2) full premiums.
2. When a policy lapses the policy holder and their member will no longer have cover under their policy.

1. Cover ends for all lives assured
2. The client can elect to keep the policy and  benefits on the policy by reinstating the policy.

If your policy lapses you can come back to us and request that we reinstate your policy with the same benefits or additional benefits. This can be done within 90 days from the last date a premium was received.

When the customer first takes out the policy

• Waiting periods apply when the customer first takes out the policy and pay’s their first premium i.e. incepts the policy
• Cover for death by natural causes for all lives on the policy will start after the policy has been active for 6 months, has finished its waiting period of 6 months depending on the product selected and complete premium received
• Cover for death by suicide for all lives on the policy will start after the policy has been active for 12 months in a row from the policy/ benefit start date and we have received and complete premium received.

There are specific events that are not covered on this policy and if they occur, we will not pay a claim even if the customer is out of their waiting period. These excluded events are stipulated in the policy wording.

In addition to any specific exclusions set out in each benefit section, we will not pay a claim for an insured event because of any of the exclusions listed below:

THE INSURED PERSON WAS NOT ELIGIBLE

We will not pay a claim for an insured person if he was not eligible or did not meet the definition of insured person on his benefit start date.

We will not pay a claim for an insured person if the insured event, or accident leading to the insured event, happened before his benefit start date.

1. On the policy anniversary date premiums and benefits will increase if (if family funeral selected) main insured are under 65
2. As soon as either the main insured or partner turns 65 (on the policy anniversary cycle linked to their 65th birth date) the premium and benefit increases will STOP
3. This also means if main member is OVER 65 at the start date of the policy there will be no premium or benefit increases on the policy.

1. For as long as the main insured is under the age of 65 the premium and benefit increases are compulsory.
2. If the client cannot afford the increases, they must contact us in advance and do one of the following: Reduce cover amounts, remove benefits or remove lives assured on the policy to reduce the premium to what they can afford.

The process of changing or substituting one insurance policy for another by cancelling the current policy. For example, when a client wants to replace their current policy from insurer A or B for the Two Mountains Family plan policy.

WHAT IMPACT DOES IT HAVE?

As the insurer of this policy. it is required that we track all replacement requests from our customers, and inform the current insurer that their policy is being replaced

We will also look at how long the client has had the current the policy for and how much cover they had. This aims to see if we will waiver (i.e. remove) some or all the waiting periods on the Two Mountains Life Series V2 policy the customer must wait out.

REPLACEMENT PROCESS

1. Client must select yes or no if they are replacing a policy on the application form
2. If they select yes to replace the policy, they must be made aware of the following.

• They may pay some charges and fees twice, first on the existing policy and once again on the new policy.
• They may pay higher premiums on the new policy because they are older now or their health situation might have changed.
• There might be differences in premium and benefit increases
• The new   policy   may   have   more   exclusions, restrictions or waiting          This     means     their     policy     may sometimes pay   out   claims   when   your   old   policy   did There may be other things to think about which might change their decision to replace their old policy.
• Because this is non-advice sale, Two Mountain’s agents CANNOT offer advice about the replacement. If they need advice, they must contact a financial advisor
• If they agree to take the Two Mountains Family Plan product and are replacing it with their current policy, we will need them to submit the policy schedule within 31 days at their nearest branch or email to Two Mountains
• If they do not submit within 31 days than normal waiting periods will apply.