OPTION SELECTION
Terms and Conditions*
Cover is limited to the Policyholder and maximum of 4 Dependants in total.
Dependants are:
Either an Adult or Child who is dependent upon the
Policyholder for access to the benefits available within this policy.
Adult: A person over the age of 21 (twenty-one), except for a
full-time student over the age of 21 (twenty-one) who is dependent on the
Policyholder and approved by Us as eligible for membership of this policy.
Child: A Child is a person under the age of 21 (twenty-one),
who is considered to be the Immediate Family of the Policyholder eligible for membership in
terms of this policy. Cover as a Child can be extended to the age of 27
(twenty-seven) if they are full-time students. Documented proof of full-time studies is required
annually.
Immediate Family: The Immediate Family is a defined
group of relations, whether over or under the age of 21 (twenty-one) and
determines which members of a Policyholder's family may join this policy.
The definition extends to those connected to the Policyholder in the
following manner:
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By birth, adoption, stepchildren or grandchildren or any
other child who has been placed in the custody of the
Policyholder and in respect of whom the Policyholder is
liable for care and support.
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Parents/stepparents, grandparents in respect of whom the
Policyholder is liable for care and support.
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Siblings, including half-siblings in respect of whom the
Policyholder is liable for care and support.
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A Spouse of a Policyholder as defined in this policy.
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Any other relative, who at the Insurers discretion,
qualifies for membership under this policy.
Spouse: A person who is a signifcant other, partner or non-marital partner of
that the principal member:
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In a marriage or customary union recognised in terms of the laws of the
Republic; or
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In a union recognised as a marriage in accordance with the tenets of any
religion; or
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In a same sex or heterosexual union which the Underwriter is satisfied is
intended to be permanent.
option one is only selected
Please refer to the terms and conditions in Policy Wording.
Adult Dependant or 1st Child Dependant
PRINCIPAL INSURED / POLICYHOLDER DETAILS
SPECIFIC HEALTH QUESTIONS*
NOMINATED BENEFICIARY (Related to Accidental Death Benefit)