TRANSITION PLUS PLAN TERMS AND CONDITIONS
The Old Mutual Life Assurance Company (Ghana) Limited, (Herein after called "the Company"), hereby agrees with the Policyholder, subject to the payment of the premium, 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.
FRAUD WARNING: Deliberately presenting false information is unlawful. Failure to disclose accurate information may result in non-payment of claim and all benefits under the policy being terminated.
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 all other lives covered i.e. spouse, parents, parents-in-law, stepchildren, children and adopted children of main life 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 amount payable on the death of a life insured.
Premium: The consideration amount required for any proceeds to become payable
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. 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 accepts the signed application form from the Policyholder. 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 premium is in default.
Termination: When the policy is no longer in force.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
The Company declares that the 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.
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) Claims 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 payable (ii) T he legal title of the claimant, and (iii) T he age of the life insured. Benefits payable on the death of any of the other Lives Insured shall be paid to the main life covered/policyholder. On the death of the Policyholder who is also the Life Insured, benefits shall be paid to the nominated beneficiary or his/her authorized representative in our records.On the Death of the Policyholder, provided there is another Life Insured on the policy, ownership of the policy will be transferred to the beneficiary for ownership that has been nominated by the Policyholder in writing to us, to take over the policy on the Policyholder's death 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. Claim form 2. Death Certificate/Medical Certificate of cause of death 3. Identity document of policy holder 4. Original policy document
4. CASH BACK The Policyholder will receive a cash back benefit equal to 10% of the actual premiums paid on the policy in the preceding 3 years. This benefit Is available every 3 years, i.e. on the 3rd, 6 th , 9 th , 12 th and 15 th policy anniversary. The benefit is only payable if the policy is in force.
5. PREMIUM Premiums are payable in advance over a period of 15 years from commencement of the policy, after which the policy becomes paid up. A premium is due on the date of expiry of the previous premium. A grace period of 120 days will be allowed for payment of each renewal premium. If the insured dies during the grace period, the unpaid premium will be deducted from the Sum Insured. 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.
6. 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 twelve (12) months for death due to natural causes for parents and parents in law. All other insured lives shall be subject to six (6) months waiting period. There is no waiting period when death is due to an accident. The waiting period for children transitioning to the adult policy will be waived if the new policy is purchased within one year of turning 18 or 21.
7. ADDITION OF LIVES New lives can be added to a policy at a later date than the cover start date on the initial policy. Added lives will be required to pay premiums for 15 years. New business terms and conditions will apply to these dependents.
8. ELIGIBILITY The policyholder will select the life insured as defined in this policy.
9.AGE LIMITS FOR LIFE INSURED.
Maximum cover per life with the underwriter is GHS 70,000. Cover is available for the whole life. Cover level is selected from pre- determined levels ranging from GHS 5,000 to GHS 70,000. The life cover for children under 15 years of age is 50% of the sum insured up to a maximum of GHS 20, 000. The life cover for children 15-20 years of age is 50% of the sum insured of the policyholder up to a maximum of GHS 25, 000. The selected cover for parents and parents- in- law with ages between 71 – 75 years a maximum sum assured of GHS 40,000 and for ages between 76 – 80 years a maximum sum assured of GHS 20,000. The spouse must be on the same cover level as the main life assured/policyholder.
11. PREMIUM AND COVER GUARANTEES
The premiums and cover are guaranteed for the first two years of the policy. Both premiums and cover may be reviewed after this period. There will be no further guarantee period after the first two years of the policy.
12. 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 two years of policy inception. A material misrepresentation in an application for life insurance is a misrepresentation that is relevant to the insurer's evaluation of th 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.
13. 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.
14. 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.
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.
16. 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.
17. 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.
18. 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 120 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
19. 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.
20. CURRENCY AND JURISDICTION
All payments made to or by the Company shall be payable in the Lawful currency ofGhana and any questions of Law arising under this policy shall be decided according to the Laws of Ghana.
All differences and disputes arising out of this policy shall, in the first place, be settled by negotiation by the parties. Policyholders may also contact the National Insurance Commission in the event of a dispute. Should either party be dissatisfied with the progress of negotiations, the matter shall be referred to a single arbitrator by consensus and the decision of the arbitrator shall be conclusive and binding on all parties subject however to the right of appeal by either party to a court of law. A negotiated settlement or an award or judgment shall be a condition precedent to any liability of action by or against either party.
22.SURRENDER, PAID UP AND LOANS
There is no cash value or surrender value on this policy. However, the policy becomes paid up when the client has completed the 15-year policy paying term for all insured lives. The policy does not allow for policy loans.
23. MEDICAL EXAMINATION
A medical examination is not required to apply.
24. TERMINATION OF THE POLICY
1. On death of all the Lives Insured. 2. No premium paid at the end of the grace period. 3. On the Policyholder's request
25. CHANGES TO COVER
A Policyholder can decrease the level of cover on a policy. There will not be a waiting period on the new cover. The term of premiums previously paid will count towards the 15- year premium payment period. The cash back will recognize the higher premiums paid within the period. Increases in cover / premium can be effected by purchasing an additional Plan or cancelling the current Plan and purchasing a new Plan. If the increase in cover is effected by cancelling the original policy and purchasing a policy with higher cover, the waiting period will apply on the new policy. If the increase in cover is effected by purchasing an additional policy, the waiting period will apply on the additional policy only.
26. EXCEPTIONS & EXCLUSION
This policy does not cover death resulting from: 1. Nuclear activity or radioactivity. 2. Wilful 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 in the first 24 months. 5. Execution of a judicial sentence of death. 6. A life insured traveling 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.
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 email@example.com. 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.