POLICY TERMS, CONDITIONS & BENEFITS OF THE POLICY.
The Application Form, Policy Terms and Conditions, Acceptance notification and Document of Insurance (Policy Schedule) form an insurance contract between “You” the policyholder and “Us” Prudential Life Insurance Ghana Limited (Prudential Life).
Prudential Life will send you an acceptance notification after we review and accept the application. After receiving your first premium, you will receive your Policy Schedule which spells out the benefits of the contract. Please note that until you receive the Acceptance notification and we receive your first premium you are not eligible to any form of benefit.
Please ensure to read the Terms and Conditions and your Policy Schedule which spell out the benefits of this contract.
What This Policy Entails
A. Accumulated Fund
The inflow of cash into the Accumulated Fund is from:
- Investment Premium Payment
The amount put in your investment account is the basic premium paid less policy charges; policy fee, risk premium and other administrative expense.
The money is invested into a portfolio of diversified assets and the value of Your investment account will be determined by the performance of these investments.
The Cash Value of the investment account is the account value of the fund less management charges (2.5% per annum), surrender charge and other regulatory charges which may arise.
The total investment premium allocated to the investment account (fund) is guaranteed at maturity.
- Lump Sum Contribution
To accelerate the growth of your investment account, you can make lump sum contributions to your fund.
Lump sum contributions may be made, with each payment limited to a minimum of GH¢100 and a maximum of GH¢1,000.
The Cash Value of the investment account is the account value of the fund less management charges (2.5% per annum), surrender charge and other regulatory charges which may arise.
The investment account of the policy at maturity is the benefit amount payable. The maturity date of the policy will be the anniversary of the commencement date coinciding with the expiry of the term of the policy that is stated in your policy document.
If you keep the policy in force till the end of the term, we celebrate your achievement by paying out a lump sum of 4% of total investment premiums paid. In calculating this benefit, the total premium does not include the policy fee.
If you terminate the policy before its maturity, the benefit payable is reduced by the surrender penalty. The surrender penalty is a percentage of the investment account value as shown in the table below.
|Policy Year||Surrender penalty,|
|After Year 4||3%|
To illustrate, if you terminate the policy within the first year, you will lose the sum total of the investment premiums paid to date.
Waiver of premium on the death of the policyholder
We will pay premiums on your behalf if death should occur before you attain the age of 60. This benefit will cease on expiration of the term of the policy, attainment of your 65th birthday or encashment of the policy, whichever of these events occur first.
If for any reason, you are unable to continue to pay the investment premiums for the rest of the term of the policy, there is the option to convert it to a Paid-Up policy.
This is on condition that the accumulated value of the fund exceeds GH¢1,500.
A policy that has been made paid-up may be reinstated on the request of the policyholder. Such reinstatement may be effected once during the lifetime of the policy. Upon reinstatement, a six (6) month waiting period will apply to the waiver of premium and the lump sum benefits. The policy fee for Paid-Up policies is GH¢0.50 per month.
Partial Withdrawal Benefit
Yearly partial withdrawal could be made after the first year of the policy coming into force. Withdrawal can only be made once a year and shall not exceed 50% of the accumulated fund.
Waiver of Premium Benefit
We will pay the investment premiums on your behalf if death should occur before you attain the age of 65. This benefit will cease on expiration of the term of the policy, attainment of your 65th birthday or encashment of the policy, whichever of these events occurs first.
This benefit applies if death occurs through an accident within the first six (6) months of the policy. If the policy has an inflation protector, it will cease when this benefit commences.
Lump Sum Benefit
The lump-sum benefit is defined as ten times the annual equivalent of the investment premium at the time of inception. We will pay 100% of the lump sum benefit to your beneficiaries if death should occur before you attain the age of 65.
Double Lump Sum Benefit
We will pay 200% of the lump sum benefit to your beneficiaries in the event that the insured life dies through an accident. The waiting period clause does not apply to this benefit.
Total Permanent Disability (TPD) Benefit
Waiver of premium on TPD of the Policyholder
We will pay the investment premiums on your behalf if you become permanently disabled before the attainment of age 60. This benefit will cease on expiration of the term of the policy, attainment of your 65th birthday or encashment of the policy, whichever of these events occurs first.
If the policy has an inflation protector, it will cease when this benefit commences.
Lump Sum Benefit
If the policyholder is permanently disabled during the term of the policy, we will pay a percentage of the lump sum benefit given that the waiting period is satisfied. The lump-sum payable on TPD is subject to the percentage payouts defined in the table below:
|Percentage of Lump Sum Benefit||Condition|
|100%||Mentally impaired: Suffer from any disease of the mind either due to organic brain disease or psychological disease diagnosed or confirmed by a competent psychiatrist or psychologist.|
|Functional loss of both limbs below the shoulder or hip joint i.e. feet, knees, hands, elbows, wrists or ankles.|
|Loss of ability to hear with both ears through accident or disease (condition must be persistent for a consecutive period of 12 months)|
|Loss of sight (both eyes) due to illness or accident.|
|Bedridden: Being unable to take care of basic daily need without assistance for a long time, for example movement, daily grooming, ablutions need.|
|50%||Functional loss of one limb below the shoulder or hip joint i.e. feet, knees, hands, elbows, wrists or ankles.|
|Loss of sight (one eye) due to illness or accident.|
C. Condition Precedent to Death and Total Permanent Disability Benefits.
D. Waiting Period:
This is a period from policy inception where no benefit is paid. There shall be a waiting period of six (6) months preceding the commencement of these benefits (if applicable): waiver of premium and lump sum payment on death and TPD. Accidental death cover starts immediately.
E. Policy Exclusions
We are not liable to offer the Waiver of Premium benefits or the lump sum benefit under this policy while sane or insane you indulge in any of the following directly or indirectly:
- Participation in dangerous sports and recreational activities like hiking, horse riding, hunting, any speed contest other than that on foot or fighting except in self-defence;
- Suicide, attempted suicide or self-inflicted injury within two (2) years from the inception of the policy.
- Committing or attempting to commit a criminal offence;
- Use of intoxicating drugs and excessive use of alcohol.
- Any involvement in an act of war, terrorist activities, riots, strikes or civil uprising.
- Carriage in a private plane and not as a passenger on a commercial flight (as a fare-paying passenger).
F. Policy Conditions
Commencement of Benefit
After we receive the first premium and the waiting period is satisfied, these benefits can be accessed on the first day of the month following the last day of the waiting period if the policy is active.
In case of accidental death, there is no waiting period.
Premiums are payable monthly, quarterly, bi-annually or annually in advance or before the first day of the due date until cancellation or expiry of the policy.
If the first premium required for the commencement of the policy is not received within six (6) months from the Acceptance Date, your application for insurance will be cancelled.
It is your responsibility to ensure that we receive the premium regularly and at the scheduled date.
You have thirty (30) days from the date of acceptance of the contract to cancel the policy. All premiums paid will be refunded on condition that no form of benefit has been paid to you during this period.
For policies that have exceeded the 30-day period, all risks covered under the policy will cease at the calendar month in which the last premium was received. The effective date of termination of the policy will be the end of the calendar month for which premiums have been received prior to the date that the request was made for the cancellation of the policy.
The policyholder has the sole right to terminate the policy. If the policy is active at the time of death or total permanent disability of the policyholder, the lump sum benefit will be paid out and the waiver of premium benefit will be activated.
The beneficiary can only encash/ terminate the policy if it has lapsed at the time of death of the policyholder.
All cancellations should be communicated directly to us in writing and not third party institutions – Broker, Banks, the accountant or payroll officer of your organisation.
Benefits from this policy will be paid directly to you but in case you pass on, the proceeds will go to the beneficiary (ies) you elected. If the beneficiary is a minor at the time of payment of the benefit, it will be paid to the trustee. If none of the beneficiaries can be contacted, the proceeds of the policy will be payable to your estate.
If you wish to change any of the beneficiaries under the policy or appoint a new trustee, you must do so in writing.
In the event that the trustee dies first or his/her appointment is cancelled, a replacement should be made. Any provision made in the “Last Will and Testament” with regards to the appointment or cancellation of a trustee will not be considered in the payments of the benefits of the policy.
In the absence of a valid trustee, the benefits of the policy will be payable to your estate.
If the premium is not received within four (4) calendar months from the due date, the policy will lapse and the death and TPD benefits will be forfeited. The policy can be re-instated on condition that it has not lapsed for more than one calendar year and that all outstanding premiums are paid with interest.
If the policy is reinstated within the first six months from the date of lapse, no waiting period will apply to the Death and TPD benefits; else a six month waiting period shall apply.
The policy fee for lapsed policies is GH¢0.50 per month
The processing of a claim will start when the policy is active and only after we have received these documents:
- A completed claim form
- The original Policy Schedule.
- Any national identification document that establishes the name and date of birth of the policyholder and / or claimant: Voters’ ID, Driver’s license, Passport Ghana card or NHIS card.
In addition to the above, the following listed documents are also required depending on type of claim:
- A death certificate or medical cause of death or a legal document that confirms the occurrence of the event for which the claim is being made.
- A Police Report in the event of unnatural/accidental death.
Total Permanent Disability Claim
- A letter from the employer confirming that the individual has been off work continuously for six (6) months due to a TPD.
- A doctor’s report confirming diagnosis of TPD from a medical facility registered with the Ghana Health Service.This list is by no means exhaustive. We reserve the right to ask for other documents that can enable us process a claim.
Prudential Life will pay valid claims within five (5) working days upon receipt of all required documents. Total Permanent Disability claims may go beyond 5 working days, as that requires further verification.
G. Policy Exclusions
Premiums and benefits will be paid in the legal currency of the Republic of Ghana.
Prudential Life will contest the validity of the insurance contract with you on the grounds of material misrepresentation in the application/proposal for insurance within two (2) years of the inception of the policy.
A material misrepresentation in an application for life insurance is a misrepresentation that is relevant to the evaluation of the application. The misrepresentation is material when, if the truth had been known, we 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.
Misstatement of Age
The death benefit at the point of claim will be adjusted if the age of any of the covered lives has been misstated.
The amount of the benefit payable will be adjusted to the amount of insurance that the premiums paid would have provided had the insured’s age been stated correctly.
All the lives insured should be permanently resident in Ghana at the time of the application but the insured lives are not prohibited from travelling outside Ghana. No benefits will be paid if you are a permanent resident in a foreign country. We have the sole prerogative to waive this restriction.
We have the right to revise the policy fee annually if necessary.
There is no restriction on the occupation of the lives insured.
Policy loans are not permissible under this contract.
You cannot cede the Policy to another person as collateral for a loan or any kind of business.
Personal Information Collection
We, Prudential Life Insurance Ghana, the Prudential Group and our Business Partners, will use the personal information you provide to us for the following purposes: to communicate with you, to enable us to administer, process and service our products and services for you, to comply with legal or regulatory requirements, to improve our products and services, to carry out checks using third party agencies or publicly available information and keeping your information on record as well as carrying out other internal business administration. For certain products or services, we’ll need to process your sensitive personal information, such as information relating to health.
When mandated by law, we may also pass on your personal information to financial crime prevention agencies and any legal, regulatory or government bodies. Any transfer of your personal information will always be done securely.
As we, the Prudential Group, and some of our Business Partners are global companies, we might need to send your personal information overseas. Any transfer of personal data overseas will be in accordance with applicable local law requirements.
Your personal information will be stored either for as long as you are our customer, or longer if required by law or as is otherwise necessary. It’ll always be kept in line with our data retention policy.
You can request: a copy of your personal information, that we correct anything that’s wrong, or complete any incomplete personal information or that we delete your personal information if it is no longer needed for the purposes set out above or there is no other legal basis for the processing of your personal information.
We, Prudential Life Insurance Ghana and the Prudential Group will send you information by text, email, telephone, post or other means about our products and services.
Prudential Group means any affiliates of Prudential Life Insurance Ghana (including, Prudential Plc, Prudential Africa Holdings Limited and Prudential Corporation Asia).
Business Partners means our service providers, accountants, auditors, IT service and platform providers, intermediaries, reinsurers, investment managers, agents, selected third party financial and insurance product providers and our professional advisers.
Governing Law and Jurisdiction
This insurance contract and the rights and obligations of the parties, including all non-contractual obligations arising under or in connection with this contract, shall be exclusively governed by, and construed and enforced in accordance with the laws of Ghana. The courts of Ghana are to have exclusive jurisdiction to determine any claim, dispute or difference arising under or in connection with this contract.
Compliance with Applicable Laws
You shall at all times during the term of this contract comply with all applicable laws relating to anti-bribery and corruption, sanctions, anti-money laundering and “know your customer” principles and with the provisions of the U.S. Foreign Account Tax Compliance Act as are applicable to You. By reason of the operation of applicable laws, We may be obliged to cancel Your policy, refuse to pay the benefit or return premiums paid under the policy if You fail to comply with applicable laws.
Any of the following means of communicating is acceptable:
- Post using a registered mail service.
- Submitting to any of our Client Service Centres or
- Email to firstname.lastname@example.org
Please note that it is important to keep the proof of transmission.
Kindly refer to the last page of this document for branch details
H. Policy Definitions
|Acceptance Date||Acceptance Date is the date on which We approve your application for a policy.|
|Accident||It is any sudden, unforeseen, unexpected incident caused by violent external and visible means.|
|Accidental Death||Death through unexpected bodily injuries caused by impact and not due to an illness.|
|Accumulated Fund||Proportion of premiums allocated to member’s account plus any additional lump sum payments by the policyholder plus interest allocated less any management or administrative charges.|
|Beneficiary||A person nominated for the benefits specified under this policy.|
|Cancellation||Terminating the contract by formally writing to the Company. Cancellation should not be exercised if possible since it deprives the policyholder from maximum benefiting under the policy.|
|Claim||A claim occurs when an insurable event under the policy occurs before maturity. If the policy is in force until maturity, a claim will be made on the fund value.|
|Issue Date||It is the Start date of your insurance policy, the first day of the month following receipt of the first premium.|
|Investment Premium||Premiums paid into the accumulated fund.|
|Lump Sum Risk Premium||Premiums paid for the Lump Sum Benefit|
|PEP||A person who is or who has been entrusted with prominent public functions and includes the following:
(a) heads of state, ministers and deputy ministers;
(b) members of parliament;
(c) members of the governing bodies of political parties;
(d) justices of supreme courts, of constitutional courts or of any judicial body;
(e) members of the boards of central banks;
(f) ambassadors, charges d’affaires and high-ranking officers in the armed forces;
(g) members of the administrative, management or supervisory bodies of State-owned Enterprises; and
(h) directors and members of the board of an international organisation.
|Family member of a PEP||(a) a spouse, or a person considered to be equivalent to a spouse of a PEP;
(b) children of the PEP and spouses, or persons considered to be equivalent to a spouse of the PEP’s children; and
(c) parents of the PEP.
|Known close associates of a PEP||(a) persons who are known to have joint beneficial ownership of legal entities or legal arrangements, or any other close business relations, with a PEP; and
(b) persons who have sole beneficial ownership of a legal entity or legal arrangement which is known to have been set up for the de facto benefit of a PEP.
|Policyholder||This is the person who takes the policy; owner of the policy.|
|Total Permanent Disability(TPD)||Disability which is total and permanent and persists continuously for at least six (6) months.|
|Waiver of Premium Risk Premium||Premium paid for Waiver of Premium Benefit|
I. Other Policy information
|Age Limits||Minimum age at entry is 18 and maximum is 54 years. Maximum age for cover is age 65.|
|Frequency of Payment||Payment can be made monthly, quarterly, bi-annually or annually.|
|Policy Fee||A policy fee of GH¢0.5 per month will be added to the premiums.|
|Investment Premium||Minimum is GH¢ 100 per month and maximum of GH¢1,000 per month.|