The Insurer, Enterprise Life Assurance Company Limited, undertakes to compensate you, the Insured, with the amount(s) as specified in respect of the benefits as specified in respect of the benefits stipulated below, subject to the payment of the required premium, the receipt thereof by or on behalf of the Insurer and the compliance with the terms and conditions of the Policy. It is noted that cover is in force from the date of receipt of the first premium and that a claim may be payable if The Insured’s account is current. The Policy, as it may be amended from time to time, the various application forms, certificates, declarations, authorisations and agreements shall form the basis of the insurance contract. AFB, is the duly authorised and appointed intermediary of The Insurer. No employee or contractor of AFB is authorised to offer advice on the selection of insurance policy or to compare it to any other insurance policy or lead you towards the choice of any particular insurance policy. The rules and conditions of this Customer Protection Policy are consistent with the provisions of The Insurance Act.
1. Nature and scope of policy – The Customer Protection Policy has been designed to provide protection (death, disability, dread disease and retrenchment benefits) in respect of your Loan agreement. This Policy is non-participating and does not acquire cash value and cannot be surrendered for cash.
2. Eligible Person – Any person, who enters into a valid Loan agreement with AFB, is eligible for cover, subject to the minimum entry age of 18 years on their next birthday and the maximum entry age of 65 years on their next birthday.
3. Sum Insured – The outstanding debt in terms of the Loan agreement on the date of the happening of the insured event.
4.1. Death Benefit – In the event of the Insured’s death, before the age of 70 years, the outstanding balance shall be paid in full to AFB.
4.2. Permanent Disability Benefit – In the event of the Insured being totally disabled, before the age of 70 years, and the disability cannot be cured or treated and prevents the Insured from earning an income by continuing with his/her own or similar occupation in keeping with his/her training, education or ability, the outstanding balance shall be paid in full to The Company. For example, The Insured shall be deemed to have suffered permanent disability upon the permanent loss of use of both eyes, feet or hands.
4.3. Temporary Disability Benefit – In the event, and before the age of 70 years, the Insured suffers a medically certified temporary disability which prevents the Insured from earning his/her normal income from his/her own or similar occupation, the Insurer shall pay to The Company the monthly instalment or a proportion thereof if The Insured only suffers partial loss of income, for a maximum period of 6 months or until recovery, whichever happens first.
4.4. Retrenchment Benefit – In the event, and before the age of 70 years, the Insured is retrenched or made redundant by the Employer, at any time during the term of the employment agreement due to the new technology, reorganisation, liquidation or staff reductions which resulted in the Insured not earning any income, the Insurer shall pay to the monthly instalments for a maximum period of 6 months. This benefit is available only once during the term of cover.
4.5. Dread Disease – In the event of the Insured suffering from any of the following dread diseases, and before the age of 70 years, the outstanding balance shall be paid in full to The Company: heart attack, stroke, cancer, renal failure, paraplegia, blindness, surgery for coronary heart disease, surgery for a disease of the aorta, replacement of heart valve, an organ transplant, coma or major burns. The above conditions must be medically certified and supported by evidence acceptable to the Insurer. This benefit is subject to a 3 month waiting period from the date the policy commences.
5. Term of cover – Cover for this policy and all benefits become effective the date the Loan agreement becomes binding, and shall not extend beyond the age of 70. Should the debt be terminated or settled before the full term, this policy will terminate automatically. Cover will also terminate on payment of a death, dread disease or permanent disability claim.
6. Specific exclusions – The Insurer shall not pay a claim in respect of any condition or event arising directly or indirectly from, contributed to or traceable to or involvement in any: a) criminal activity; b) any condition, disability, illness, bodily injury, defect or the insured’s ill health that existed prior to or on the date of application for this policy; c) suicide, a suicide attempt or intended self-injury for the first 24 (twenty four) months of cover; d) driving whilst the concentration of alcohol in the insured’s blood exceeds the statutory limit in force or whilst the insured is under the influence of a drug having a narcotic effect unless prescribed by a duly qualified and registered medical practitioner; e) any participation in hazardous sports for example, aviation sport, paragliding, underwater diving, hang gliding, big game hunting, spear fishing, rock climbing, motor boat racing, motor racing, cycle racing, mountaineering, skydiving/parachuting, skiing, para-sailing, go-carting, drag racing, rally driving or bungi-jumping; f) war, riot, radioactive contamination, nucleus incidents or similar risks; g) refusing medical treatment as recommended by The Insured’s own medical practitioner.
No Retrenchment benefit is payable if:
a. a death, permanent disability or dread disease claim was paid;
b. the Insured has not taken reasonable steps in finding work and/or the Insured is currently receiving any earnings in excess of 75% of previous gross salary;
c. the Insured is self-employed, employment is seasonal or unemployment is a regular feature of his/her work;
d. the Insured comes to the end of a fixed-term contract, finishes the job he/she was specially employed to do, resigns, retires, accepts voluntary retrenchment or comes to the end of, or termination of, a work contract;
e. the Insured is a partner in a partnership, or a director of a company, or employed by a family-owned business;
f. the Insured loses his/her job because of theft, fraud, dishonesty, misconduct, illegal strikes which he/she took part in or as a result of any lock-out by the employer;
g. the Insured is retrenched within the first 3 (three) months of entering into the Loan Agreement;
h. the Insured knew or had reason to believe they might lose their job at the inception of the Loan Agreement.
7. Premiums – The monthly premium payable is specified in Part A of the Loan Agreement with AFB. The premiums are reviewable by The Insurer and any changes are subject to 1 (one) month’s written notice. At the election of The Insurer, failure to pay the agreed premium will result in the termination of the policy. The premium is payable and included in the monthly Loan instalment. The premium will be payable for the period of the insurance cover and whilst The Insured has an outstanding balance. This policy does not acquire any paid up value or surrender value.
Should you wish to communicate with The Insurer in connection with this policy kindly contact:
Enterprise Life Assurance Company Limited: Client Services: No.11 High Street, Accra, Ghana Tel: +233 21 666847/9, Fax: +233 21 666186
8. Cancellation – The Insurer or AFB may cancel this policy at any time by giving 30 (thirty) days’ notice in writing to the Insured at their last known electronic contact address. Such cancellation shall commence on AFB’s written approval of cancellation of the policy. If a premium has been paid for any period beyond the date of the cancellation of this policy, the total amount will be refunded to the Insured by The Insurer. If for any reason whatsoever the above- mentioned policy is cancelled before the outstanding balance is settled by The Insured, the Insured will be required to replace it with a paid up policy of equal benefit which meets with the approval of AFB & which is ceded as security to AFB. Prior written approval of AFB is required should The Insured wish to cancel the above- mentioned policy. Failure to comply with this requirement will be considered a breach of the Loan agreement and which will result in the outstanding balance being payable immediately on demand by AFB.
9. Misrepresentation, Misdescription, or non-disclosure – of any material fact or circumstances or any fraudulent actions which may relate to the acceptance of your proposal for insurance or in connection with a claim submitted in terms of this policy shall render this policy and/or the claim voidable. In the event that a benefit is paid to the Insured as a result of any misrepresentation, non-disclosure, misdescription or fraudulent action by the Insured, or anyone acting on the Insured’s behalf, the Insured shall be obliged to repay or return the benefit he/she has received under this policy and The Insurer shall be entitled to take legal action against the Insured to recover the benefit or any costs involved.
10. Rejection of claim – Time Bar clause. If The Insurer declines liability for a claim made in terms of this policy, representation may be made to The Insurer within 90 (ninety) days of the rejection letter or cancellation letter. Thereafter, action must be instituted against The Insurer for the enforcement of the claim by way of service of summons against The Insurer within 180 (one hundred and eighty) days, failing which all benefits in respect of such claim shall be forfeited and no liability can arise in terms of such claim.
11. Claims notification – Every claim should be delivered to or faxed to AFB, within 120 days to the following address:
AFB (GHANA) PLC: Client Services: Cocoshe House, off Agostino Neto Road, Airport City, Accra, Ghana
Tel: +233 3022 41030, Fax: +233 302 241 081, Email: email@example.com.
The Insurer will at all times have the right to inspect the Loan agreement and all other documents relating to the Loan agreement and the policy and to communicate to The
Insured any problems regarding the documentation.
12. How to claim – On the happening of any event, which may result in a claim in terms of this policy the Insured or Executor shall, at their own expense or AFB:
12.1. Submit to AFB full details in writing of any claim, as soon as reasonably possible up to a maximum of 180 days (one hundred and eighty) of the event giving rise to the claim. The Insurer shall in no way whatsoever be liable to pay any benefit if the full details of any claim is not received within the maximum period stipulated.
12.2. Furnish AFB with such proof, information, sworn declarations/affidavits, and/or documentation of whatsoever nature, which AFB may require to process the claim.
12.3. Please note that only original documentation will be accepted, copies of documentation need to be certified.
12.4. On receipt of the claim form you will be asked to complete all details, provide all documentation as requested and sign the claim form.
13. Fraud – If any fraudulent means or devices are used by the Insured, or anyone acting on behalf of the Insured, to obtain any benefit in terms of this policy or if any accident, loss, damage, liability, injury, disability, illness or termination of employment is occasioned by any Wilful act on the part of the Insured or with his/her connivance, all benefits and premiums paid in terms of this policy shall be forfeited.
14. Cession – It is recorded that, in terms of this cession, the Insured assigns and transfers all his rights, title and interest in this policy to and in favour of AFB as security for the outstanding debt by the Insured owed to AFB. This cession supersedes and cancels any other beneficiary nomination made by the Insured.
15. Complaints procedure for the Insured’s benefit – The Insurer undertakes to settle all valid claims as quickly as possible. However, it is in the public’s best interest to verify the validity of any claim and to investigate the appropriate aspects thereof. As such there may be instances where a delay could occur.
If you have any complaint about this policy or you are in any way unhappy with the service you have received, please ask to speak to the manager of the relevant department at AFB. If the matter cannot be resolved this way, then please contact:
The Insurer’s Compliance Officer: Osman Tankari
Tel: +233 30 268 9945/43/40 or +233 24 463 4057, Fax: +233 30 267 7073, Email: firstname.lastname@example.org.
The function of the Compliance Officer is to ensure that legislative requirements are met, in particular those relating to disclosure as described in the Policyholder Protection rules, and to facilitate the resolution of disputes arising between the parties involved in the insurance contract. Service complaints will be forwarded to the senior management for further attention. Compliance with this procedure does not affect your legal rights.