MUTUAL LIFE AFRICA

3. International Banking & Currency Management

Exchange-rate movements, sanctions, currency controls, or regulatory directives may affect settlement timelines or values.

7A. Medical Disclosure

This section records the answers given for each covered member when the policy was opened. A tick (✓) means Yes and a cross (×) means No. These answers form the basis of the disclosure requirements in Sections 10 and 13. Where no answer was recorded, the entry shows Not recorded.

Answers recorded on: {date}. Disclosure answers are those given when the policy was opened. A material non-disclosure or misrepresentation is dealt with under Sections 13.2 to 13.4.

8. Benefits & Sums Assured

8.1 Core Benefits

The Funeral Cover Amount and the Life Cover Amount are separate amounts, each paid out separately.

8.2 Fixed Cover Benefits Included as Standard

Repatriation is paid in addition to, and is not deducted from, the Cover Amount. It is not payable for a natural death within the 6-month waiting period (Section 10).

8.3 Optional Riders

• Accidental Death Benefit
• Dread Disease / Critical Illness Benefit
• Hospital Cash Benefit
• Disability Benefit
• Education Fund Benefit

Riders apply only if selected and shown in the Policy Schedule or Rider Annexure.

8.4 Plan Limits

9. Expatriate & International Provisions

9.1 Eligibility

Cover is available to:

• Local residents and citizens;
• Foreign nationals;
• Expatriates;
• Multinational employees;
• Persons with multi-jurisdictional residence, employment, or family arrangements.

No eligibility restriction applies based on South African citizenship or residence.

9.2 Territory of Cover

Cover applies in the country of residence recorded in the Policy Schedule and in any other country approved and covered by Mutual Life Africa in writing, subject to Section 19 (Territorial Limits), sanctions laws, currency controls, and local law.

9.3 Change of Residence

The policyholder must notify Mutual Life Africa within 30 days of any change in country of residence, tax residency, nationality, or permanent address.

Cover is accepted for the country of residence recorded in the Policy Schedule. If the policyholder or a covered member moves to another country, the policy is not active in the new country until Mutual Life Africa has approved it in writing. A death in a country that has not been approved is not covered, because the risk was accepted in the original country and not in the new one. The new country must be an approved and covered country.

9.4 International Claims

Claims may be submitted from any jurisdiction. Documents not in English must be translated by a certified translator. Apostille, consular authentication, or local official certification may be required.

9.5 Tax and Reporting

Policyholders are responsible for their own tax reporting obligations in their country of residence, including FATCA/CRS or equivalent requirements where applicable.

9.6 Sanctions

No benefit is payable where payment would breach applicable sanctions. Benefits may be held or redirected as permitted by law.

10. Waiting Periods

Waiting periods apply per member and restart for newly added members. Waiver or reduction is at Mutual Life Africa’s discretion, including verified transfers from another insurer or replacement policies.

11. Premiums & Payment Terms

International payment methods may include SWIFT, card, online portal, or other approved methods. Premiums are adjusted annually in line with the inflation rate of the country of the policy’s base currency (ZAR: South Africa; GBP: United Kingdom; USD: United States; EUR: European Union), and the Cover Amount is raised proportionally. Premiums may also be adjusted on benefit or member changes. At least 30 days’ written notice is given.

12. Claims Procedure

12.1 Notification and Time Limits

A death must be notified to Mutual Life Africa as soon as it happens. The claimant then has up to 12 months from the date of death to submit all related documents, and any repatriation must be claimed within 12 months of death.

The same 12-month limit runs from diagnosis for critical illness claims and from discharge for hospital cash claims. Claims and documents received after the 12-month limit are not accepted.

12.2 Required Documents

• Completed claim form;
• Certified death certificate;
• Certified ID/passport of deceased;
• Medical cause-of-death report;
• Police/coroner/accident report for accidental death;
• Proof of relationship and banking details.

For international claims: certified English translation, apostille/consular authentication where required, and local official documentation.

12.3 Submission

Claims may be submitted online, by email to claims@mutuallife.africa, by post, or through the servicing agent. Electronic submission is encouraged.

12.4 Acknowledgement

Acknowledgement within 3 business hours during business hours, or by end of next business day otherwise.

13. Claims Investigation & Contestability

13.1 Waiting-Period and Early Claims

No policy benefit, including repatriation, is payable for a natural death within the waiting period in Section 10, and no such claim is investigated or paid. Accidental death is exempt from the waiting period upon police/coroner/official accident confirmation.

A claim is investigated only where a trigger in Section 13.2 applies. An investigation includes verification of medical history, cause of death, prior knowledge of illness, and disclosure.

13.2 Investigation Triggers and Effect

A claim is referred for investigation where any of the following applies:

• The death is not an accidental death and occurs within the first 12 months of the member’s cover start date;
• The death is not an accidental death and the member is under 65 years of age, the retirement age, because a death below that age cannot be regarded as due to old age;
• The cause of death is unknown, undetermined, or awaiting an inquest;
• The cause of death indicates suicide or intentional self-harm within 24 months of cover start, or another Excluded Cause under Section 18;
• The death is from a pre-existing illness or medical condition within 24 months of cover start;
• There are indications of fraud, material misrepresentation, or inconsistent documents.

An investigation freezes only the cash payout. Repatriation and every other policy benefit continue without delay and are not affected by any trigger or investigation. Once the 6-month waiting period has passed, or in the case of accidental death, repatriation is arranged immediately regardless of claim status.

The only exception is fraud or material misrepresentation. Where it is established, both the cash payout and repatriation are stopped.

13.3 Grounds for Decline

A claim may be declined where:

• A pre-existing illness or medical condition that was not disclosed in full from day 1 materially contributed to death, or death from a disclosed pre-existing illness or condition occurs within 24 months of cover start;
• A terminally or critically ill member was knowingly enrolled without disclosure;
• Material misrepresentation was made on the application;
• The cause falls within Section 18 exclusions;
• Fraud is established.

Premiums are not refunded in confirmed fraud or intentional misrepresentation.

13.4 Three-Year Contestability

After 36 months of continuous active cover per member, Mutual Life Africa waives the right to contest on non-disclosure/misrepresentation, subject to:

• Policy active and premiums up to date;
• No Section 18 exclusion;
• No fraud, which may be raised at any time.

The period applies per member and resets on addition of a new member.

13.5 Investigation Timeline

Final assessment is completed within 48 hours of complete documentation. For new policies, flagged-for-review policies and life cover claims, assessment may take up to, but is not limited to, 210 business days. The claimant is given written notice of the outcome. Extensions for complexity or international verification must be notified in writing.

13.6 Active Status and Arrears

Benefits, including repatriation, are payable only on a policy that has an active status and no arrears at the date of death.

The only exception is the death of the policyholder. Where the policyholder dies and the arrears are a result of that death, because a deceased policyholder cannot pay, a premium that is no more than 45 days late is accepted and the claim proceeds despite the arrears. No other exception applies, and the death of any other covered member does not qualify.

14. Claims Service Level Agreement

* New policies, flagged-for-review policies and life cover claims may take up to, but not limited to, 210 business days (Section 13.5).

Business hours are 08:00–17:00 SAST, Monday–Friday, excluding public holidays, unless otherwise stated.

15. Repatriation Services — Fixed Cover Benefit

Repatriation is included as a fixed cover benefit for all covered members from their individual cover start date. It is not an optional rider.

It covers local and international transportation of mortal remains, documentation assistance, preparation/embarking, and coffin/casket or urn, with no monetary limit. Repatriation is arranged immediately on notification of death, regardless of whether the claim is under investigation or a dispute exists. Repatriation becomes active automatically after the 6th month (for accidental death, from day 1) and is not affected by any investigation, which freezes only the cash payout, except where fraud or material misrepresentation is established. Repatriation is stopped only in the cases listed below. The cash benefit may be held pending claim clearance; repatriation services are not withheld.

Repatriation is not covered where the death occurs in a country that is not the registered country of residence or an approved country (Sections 9.2 and 9.3), the death is a natural death within the waiting period, the policy is not active or has arrears (Section 13.6), request is more than 12 months after death, fraud or material misrepresentation is established (Sections 13.2 and 16), or transportation is prohibited by sanctions or law. Excluded causes (Section 18) affect the cash payout only; they do not stop repatriation.

16. Fraud Prevention, AML & CTF

All policies and claims are subject to fraud-prevention, AML, CTF, sanctions, and KYC controls. Proven fraud may result in immediate termination, forfeiture of benefits, no premium refund, criminal prosecution, and reporting to authorities. Policyholders and claimants may be required to provide ID, address, source-of-funds, and beneficial-ownership information.

17. Reinsurance Disclosure

No contractual relationship exists between the policyholder and any reinsurer.

18. General Exclusions

No cash benefit is payable where death arises directly or indirectly from:

• Fraud or material misrepresentation;
• Suicide, intentional self-harm, or intentional self-inflicted injury within 24 months of cover start;
• Criminal or unlawful activity;
• War, invasion, hostilities, or warlike operations;
• Terrorism, except innocent victims where law permits;
• Riot, civil commotion, rebellion, or insurrection;
• Nuclear, chemical, or biological contamination, except accidental exposure at a licensed facility;
• Hazardous activities not disclosed and accepted;
• Pandemic or epidemic declared by the World Health Organization (W.H.O.), except healthcare workers contracting in employment where law/policy permits;
• Cyber-attack, hacking, or digital incident directly causing death;
• Illegal substances or misuse of prescription medication;
• Alcohol intoxication or alcohol-related causes above the legal driving limit of Delaware, USA.

Exclusions apply to the cash payout only and do not affect repatriation, which depends on the waiting period in Section 10 and the conditions in Section 15. Exclusions apply subject to mandatory local law. The claimant bears the burden of proving a covered death; Mutual Life Africa bears the burden of proving an exclusion.

19. Territorial Limits & International Coverage

Cover applies in the country of residence recorded in the Policy Schedule and any additional country approved in writing (Sections 9.2 and 9.3), and is subject to:

• Sanctions laws;
• Currency controls;
• War zones or active armed conflict unless disclosed and accepted;
• Travel advisories: the advisory issued by the member’s own embassy and disclosed to Mutual Life Africa is the advisory that applies, as it stands at the time;
• Jurisdictions where insurance services are prohibited.

International claims may require translation, apostille/consular authentication, and local death registration. Currency-control delays are not SLA breaches. International repatriation is included as a fixed benefit and must comply with export/import and transportation regulations.

20. Data Protection & Confidentiality

Personal data is processed under applicable data-protection laws, including POPIA, GDPR where applicable, and other local laws. Data may be shared with affiliates, reinsurers, service providers, regulators, law enforcement, and fraud databases under appropriate safeguards. International transfers use standard contractual clauses, adequacy decisions, binding corporate rules, or consent where required. Data subjects may access, correct, object, or complain to the relevant authority. Data is retained for legal requirements and at least 5 years after policy termination or final claim.

21. Cancellation & Cooling-Off

The policyholder may cancel within 30 days of cover start if no claim has been made; premiums are refunded in full. After cooling-off, cancellation requires 30 days’ written notice, subject to Section 23. No refund is due after cover has been in force, except overpayment or insurer error. Outstanding credit remains due under Section 24.

22. Payment Default & Policy Status

Status-change notices are sent by email, SMS, and written notice.

Reinstatement from suspension: when a suspended policy is reinstated by clearing all arrears, no claim can be filed within 30 days of the date the arrears were cleared.

Cancelled policies: a cancelled policy may be reinstated, but the reinstated policy is treated as a new policy, with new waiting periods and a new contestability period (Sections 10 and 13.4). A cancelled policy cannot be reinstated in order to file a claim.

23. Underwriting Risk & Right to Cancel

Mutual Life Africa may review, suspend, or cancel a policy where payment history presents unacceptable underwriting risk, including:

• Three or more missed/late payments in a rolling 12 months;
• Recurring grace-period activation;
• Repeated suspension/reinstatement cycles;
• Payment conduct materially increasing risk;
• KYC/AML non-compliance.

Cancellation requires 30 days’ written notice. The decision may be upheld despite representations. No premium refund is due on underwriting-risk cancellation.

24. Credit, Debt & Right of First Claim

Any credit facility, loan, points-based credit, policy-linked credit, or financial accommodation extended by Mutual Life Africa, Mutual Life Global, Mutual Life Pay, African Mutual Capital, or Mutual Africa Pay remains in force despite cancellation, lapse, or suspension of any policy.

Cancellation or lapse does not extinguish debt. Credit and any loans due take priority over all other creditors and claims on the policy proceeds, except obligations mandated by law. Outstanding loans are paid first from the Cover Amount, and any remainder is paid out to the beneficiary. If nothing remains, or the balance outstanding exceeds the Cover Amount, the balance is claimed from the estate. This applies globally.

25. Beneficiary Provisions

Beneficiaries may be primary, contingent, trust, or estate beneficiaries, and may reside in any jurisdiction. A minor beneficiary cannot claim until reaching adulthood; the benefit is held in trust under the applicable trust rules until then. Beneficiary changes require written notice and acknowledgment. If a beneficiary predeceases, the contingent beneficiary receives; otherwise the estate. International payments are subject to exchange control, sanctions, and tax reporting.

26. Dispute Resolution

Complaints should first go to complaints@mutuallife.africa or +27 87 265 8885. Acknowledgment within 3 business days; initial response within 10 business days; final response within 30 business days. Unresolved complaints are escalated internally to arbitration within Mutual Life Africa. If arbitration does not resolve the dispute, either party may take it to court: in South Africa for local policies, in Mauritius for cross-border family policies, and in New York, USA for international policies. Nothing in this Section limits any right under mandatory law to approach the relevant regulator or ombud. Governing law and forum are set out in Sections 4 and 27, subject to mandatory local consumer protections.

27. Governing Law & Jurisdiction

Governing law: The laws of the Republic of South Africa, unless otherwise stated.
Dispute forum: Internal escalation to arbitration within Mutual Life Africa first, then the courts of South Africa for local policies, Mauritius for cross-border family policies, and New York, USA for international policies.

Nothing in this policy excludes mandatory consumer-protection or insurance law in the policyholder’s or claimant’s jurisdiction where it cannot lawfully be excluded.

28. Statutory & Regulatory Disclosures

• Mutual Life Africa operates as a registered insurance brand of Mutual Lifeco Africa.
• Nothing in this policy is financial, tax, or legal advice.
• Mutual Life Africa and Mutual Life Global are not banks; premiums are not deposits and are not deposit-insured.
• USD/EUR benefits are administered by Mutual Life Global; exchange rates, sanctions, or regulatory directives may affect settlement.
• Conflicts of interest are disclosed where they arise.
• Treating-customers-fairly principles apply where required.
• This policy is issued in English; translations are for convenience and English prevails.

29. Definitions

In this policy, the following terms have the meanings given below.