DISCLOSURE NOTICE IN TERMS OF SECTION 4 TO 7 OF THE GENERAL CODE OF CONDUCT OF THE FINANCIAL ADVISORY AND INTERMEDIARY SERVICES (FAIS) ACT, NO 37 OF 2002
Please read carefully
This notice does not form part of the Insurance Contract or any other document. It does however contain information which is in your interest. This notice is provided at the inception of each policy.
YOUR INTERMEDIARY
You have the right to the following information regarding the Broker, as indicated in your Policy’s Schedule of Insurance, who must hold a valid license to operate under specific categories of business:
Name, address and contact details
Financial Services Provider License number
Legal status
Whether the services rendered are under supervision
Whether the broker holds more than 10% of the Insurer’s shares and/or
Whether the broker received more than 30% of the total remuneration from the Insurer in the past year
Whether the broker holds any form of professional indemnity insurance
Details of complaints policy and procedures
Details of compliance arrangements
The Rand amount of fees, commissions or any valuable consideration payable
Contractual arrangements with the Insurer including any restrictions or conditions
YOUR ADMINISTRATOR
Name: Cura Administrators (Pty) Ltd
Financial Services Provider License No:26848
Postal Address:
PO Box 42331
Moreleta Park
0044
Physical Address:
829 Rubenstein Drive
Moreleta Park
Pretoria
0044
Telephone No:
(086) 155 3553
Facsimile No:
(086) 681 3670
FSP Licence Category: Category 1 Short-Term: Personal Lines, Long-Term: Category A, Long-Term: Category B1 and B2. Licensed to offer both Intermediary Services and Advice.
The administrator did not receive more than 30% of the total remuneration from the Insurer in the past year.
YOUR UNDERWRITING MANAGER
Name: Ambledown Financial Services (Pty) Ltd
Financial Services Provider License No:10287
Postal Address:
PO Box 1862
Cramerview
2060
Physical Address:
Ambledown House
Eton Office Park East
c/o Sloane & Harrison Streets
Bryanston
Telephone No:
(086) 126 2533
Facsimile No:
(011) 463 1600
YOUR INSURER (THE RISK CARRIER WITH WHOM YOUR POLICY IS PLACED)
Name: Constantia Insurance Company Limited
Financial Services Provider License No: 31111
Postal Address:
PO Box 3518
Cramerview
2060
Physical Address:
Unit 3 Tulbagh
360 Oak Avenue
Randburg
2191
Telephone No:
(011) 686 4200
Facsimile No:
(011) 789 8828
Compliance Officer: Adv Christiene Brummer
E-mail: Christieneb@constantiagroup.co.za
FSP Licence Category: Category 1 Short-Term, Personal and Commercial Lines and Participatory interests in Collective Investment Schemes. Licensed to offer both Intermediary Services and Advice.
5.YOUR POLICY, PREMIUMS AND FEES
Refer to your Policy Schedule for your Policy, Premiums and Fees
6.CLAIMS PROCEDURE
Full details of the specific claims procedure that you should follow are stated in the insurance policy wording.
On the occurrence of any event, which may result in a claim or possible claim under the policy, please notify Cura Administrators (Pty) Ltd in writing or telephonically within 180 days of the Insured Event occurring. (Late notification could result in rejection of the claim.)
7.LODGING A COMPLAINT
In the case of dissatisfaction with services received, you have the right to lodge a complaint through
Complaints Officer : Mr Rudolph Ackermann
Physical Address : 829 Rubenstein Drive, Moreleta Park, Pretoria, 0044
Postal Address : PO Box 42331, Moreleta Park, Pretoria, 0044
Telephone : 086 115 3553
E-mail : rudolph@curaadmin.net
A full Complaints Resolution Policy may be requested from the Compliance Officer as per details below.
In the case of dissatisfaction with services received, you have the right to lodge a complaint with Constantia Insurance Company Limited through
Complaints Officer : Mrs Astrid Baynes
Physical Address : Unit 2 Tulbagh, 360 Oak Avenue, Randburg
Postal Address : PO Box 3158, Cramerview, 2060
Telephone : (011) 686 4200
E-mail : complaints@constantiagroup.co.za
8.CONFLICT OF INTEREST REQUIREMENTS
Cura Administrators (Pty) Ltd has established a Conflict of Interest Management Policy which is available on request from our Compliance Officer.
In order to meet regulatory requirements, financial or immaterial expenditure by and to our staff are monitored.
Where potential Conflicts of Interest have been identified which do not have a direct impact on you, the insured, internal structures are in place to manage and control such circumstances.
9.THE ADMINISTRATOR’S COMPLIANCE OFFICER
Compliance Officer : Mr Trevor Laubscher
Physical Address : 25 Quantum Street, Technopark, Stellenbosch
Postal Address : PO Box 12662, Die Boord, Stellenbosch, 7613
Telephone : (021) 883 8000
E-mail : TLaubscher@moonstonecompliance.co.za
10.PARTICULARS OF THE SHORT-TERM INSURANCE OMBUDSMAN
Postal Address :
PO Box 32334
Braamfontein
2017
Telephone Number : (011) 726 8900
Sharecall Number : (086) 072 6890
Facsimile Number : (011) 726 5501
E-mail : info@osti.co.za
The Ombudsman is available to advise you in the event of claims problems which are not satisfactorily resolved by the Insurer.
11.PARTICULARS OF OMBUD FOR FINANCIAL SERVICE PROVIDERS (FAIS OMBUD)
Postal Address :
PO Box 74571
Lynnwood Ridge
0040
Telephone Number : (012) 470 9080; (012) 762 5000
Facsimile Number : (012) 348 3447; (086) 764 1422
E-mail : info@faisombud.co.za
Should you not receive satisfaction in respect of a complaint lodged with the insurer (other than regarding the settlement of a claim), you may contact the FAIS Ombud.
12.PARTICULARS OF THE REGISTRAR OF SHORT – TERM INSURANCE
Postal Address :
P O Box 356555
Menlo Park
0102
Telephone Number : 012 428 8000
Facsimile Number : 012 347 0221
13.SHARING OF INFORMATION
The sharing of information for underwriting and claims purposes (including credit information) is in the public's interest as it enables the insurer to underwrite policies and assess risks fairly and to reduce the incidence of fraudulent claims with a view to limiting premiums.
When you accept this policy you waive any person you may represent and/or your rights to privacy with regards to underwriting or claims information (including credit information) that you or any person you represent provide or that is provided by any other person on your behalf or on behalf of any person you represent in respect of any insurance policy or claim made or lodged by you.
You further confirm that you have purchased this product of your own free will and I was in no way forced or incentivised to purchase this product.
14.WARNING
Do not sign any blank or partially completed application form.
Complete all forms in ink.
Keep all documents handed to you.
Make notes as to what is said to you.
Don’t be pressurized to buy the product.
Misrepresentation, incorrect or non-disclosure by you of relevant facts may impact on any claims arising from your contract of insurance.
You, the client, must disclose all material facts accurately, fully, truthfully and properly.
The underlying policy has no cooling off rights. Your premium must be paid for cover to take effect.
OTHER MATTERS OF IMPORTANCE
No person may request or induce you to waive your rights as set out in this disclosure notice or any other rights confirmed by the Short Term Insurance Act and/or the Financial Advisory and Intermediary Services Act.
Failure to provide all correct and full material information may influence an insurer in respect of any claim arising under your contract of insurance.
You will be informed of any material changes to the information referred to in paragraph 1 and 2.
Your insurance may only be cancelled on 30 days prior notice which may be provided either directly to you or to your broker.
You are entitled to request a copy of the master policy free of charge.
You are entitled to a 15 day period of grace after the due date for the payment of your premium. (this period of grace applies from the second month on monthly policies only)
By entering into this Insurance contract you acknowledge that the sharing of credit, claims and underwriting information by Insurers is essential to enable the insurance industry to assess risk fairly and to reduce the incidence of fraudulent claims as this is in the public interest and is aimed at limiting premiums.
The application, certificate of insurance and the policy wording must be read as one document.
A polygraph or any lie detector test may be required in the event of a claim. The failure of such test may not be the sole reason for repudiating a claim.
16.USE OF YOUR PERSONAL INFORMATION
When you enter into this policy, you will be giving us your personal information that may be protected by data protection legislation, including but not only, the Protection of Personal Information Act, 2013 (POPI). We will take all reasonable steps to protect your personal information.
You authorise us to:
Process your personal information to:
Communicate information to you that you ask us for.
Provide you with insurance services.
Verify the information you have given us against any source of database.
Compile non-personal statistical information about you.
Transmit your personal information to any affiliate, subsidiary or re-insurer so that we can provide insurance services to you and to enable us to further our legitimate interests including statistical analysis, re-insurance and credit control.
Transmit your personal information to any third party service provider that we may appoint to perform functions relating to your policy on our behalf.
You acknowledge that this consent clause will remain in force even if your policy is cancelled or lapsed.
