MTN
Y’ello Cover offered in collaboration with MANSARD
INSURANCE is an affordable airtime-based life insurance product. It
is a simple and convenient way to access affordable life protection plan with
your mobile phone and registered MTN number at N15/daily with a benefit plan of
up to N350,000 to cover medical expenses and/or permanent disability benefits
in case of accident. In the event of subscriber’s demise, benefit shall be paid
to a named beneficiary.
BENEFITS/OFFERINGS
ARE BROKEN DOWN INTO:
• Cover for medical expenses in case of
accident - up to 10% of the sum assured and is payable once a year
• Cover for permanent disability arising from
accidents - various categories and is up to 100% of the sum assured. (See
details)
• On the demise of the insured, the total sum
assured of N350,000 becomes payable to the named beneficiary.
PRODUCT DYNAMICS
• Customer eligibility: MTN subscribers
between 18 – 60 years
• Only registered MTN phone numbers are
eligible
• No registration fee
• Premium shall be paid through Airtime
billing
• No opt out fee
• Subscriber policy would be effected once a
subscriber has registered for the cover and paid the first premium
• Subscriber forfeits cover when he ports to
another network
• Only claims arising from an accident are
payable within the first 30 days
• Only claims that occur between 12:00am and
11:59pm of the subsequent day of billing would be covered and deemed payable by
the insurer
• The policy ceases once a demise or total
permanent disability claim is paid
• Claims notification must be done within 30
days of the scheme member’s demise/permanent disability.
• There will be an initial waiting period of
30 days after subscription, to qualify for benefits of total permanent
disability or demise caused by natural causes
(i.e.
this refers to the first 30 days of enrolment into the scheme during which
benefit will be payable in case of demise resulting from accident only. No
cover for demise/total permanent disability resulting from natural causes is
given during the first 30 days).
• Next of Kin/Beneficiary can be changed only
once in 30days
• In case an individual registers more than
one line, the maximum cover shall be two times the specified sum assured for a
maximum of two lines. However, the
beneficiary maybe the same person for the two lines.
• The subscriber must have sufficient credit
balance. Where the subscribers credit balance is insufficient, the subscriber
is notified of suspension of cover and will be asked to top-up the line in
order to be covered again
• If there is no sufficient credit balance on
the customer line for 30 consecutive days, the subscriber will be automatically
opted out of the service
• A policy holder has the sole obligation to
inform his beneficiary or legal adviser of his policy
• Subscribers must accept these Terms and
Conditions of the product prior to subscription
• Where the subscriber’s credit balance is
insufficient, the system will retry to deduct the charge from a customer credit
balance once a day
• Where a subscriber completes the registration
for the insurance cover, a policy number will be sent to the subscriber by SMS.
Access to the customer portal will also be available to a subscriber to update
subscription details & print policy certificate
• Subscribers can cancel their micro-insurance
plan at any time
• Responsibility lies with the subscriber in
the event of phone misuse or fraudulent activity from the subscriber’s MSISDN
with respect to the micro-insurance service
UNDERWRITING
CONSIDERATION
A
Proposer shall be required to complete an e-proposal form using a registered
phone number. The following information would be collected
• Subscriber’s Name
• Subscriber’s Age
• Beneficiary Name
• Phone number
Other
information other than the aforementioned may be requested for at Mansard
Insurance’s discretion. A scheme member can change his beneficiary only once a
month.
MTN TERMS,
BENEFITS AND CONDITIONS
Scope of Cover: The policy
shall provide cover to the insured for medical expenses incurred and permanent
disability arising from an accident and upon demise of the insured.
Claims
processes:
Claims will be paid within five (5) working days from the receipt of all
documentations
Contract: The contract
shall continue as long as premium is paid as at when due.
Benefits: Provided that
all regular premiums under the policy are paid in full as and when due, the
benefit payable upon the demise of the insured shall be an amount equal to his
life assurance benefit (sum assured).
• The policy ceases once a total permanent
disability or demise claim is paid.
• In the event of demise of the assured, the
named beneficiary shall present the following original documents to Mansard
Insurance:
a. Completed claim form
b. Originals of medical certificate of cause
of demise
c Demise registration certificate
d. Burial warrant
e. Clergy certificate
f. Police report (in case of road traffic
accident)
• In the event of a Permanent Disability
claim, the named beneficiary shall present the following original documents to
Mansard Insurance
a. Completed physician certificate by the
doctor who last attended to the subscriber
b. Pictures of the subscriber showing affected
area
c. Police report if the disability is as a
result of accident
d. Completed claim form
• To process an Accidental Medical Allowance
claim, the named beneficiary shall present the following original documents to
Mansard Insurance
a. Completed physician certificate by the doctor
who attended to the subscriber
b. Pictures of the subscriber showing affected
area
c. Police report if the disability is as a
result of accident
d. Completed claim form
• Completed claim form must be submitted to
Mansard Insurance within 14 days of the insured’s demise/total disability.
Premium Terms:
Premiums are payable daily
Premium Payment
Methods:
Premium would be deducted from subscriber’s airtime
Lapsed Policy: If a regular
premium becomes unpaid when due, policy shall lapse without value and the life
assurance benefit under the policy shall cease to be payable.
Nil Surrender
Value:
This policy does not at any time qualify for surrender value. The insured shall
not be entitled to any cash value if the policy is terminated by the insured
any time after commencement.
General
Exclusion:
This policy does not apply to bodily injury whether fatal or non-fatal or
blindness directly or indirectly caused by, arising or resulting from or
traceable to: Intoxication, Hazardous Pastime and Air Travel (other than as a
fare-paying passenger by a regular schedule Airline Service).
Suicide and Act
Contrary To Public Policy: The insurance company shall not be liable to pay
the sum assured under the policy if the demise of the insured occurred as a
result of suicide or the execution of judicial capital punishment.
Active War Risk: It is agreed
and expressly understood that the insurance company shall not be liable should
the insured pass away directly or indirectly from his engaging or taking part
in any naval, military or air force operations or services, or like services of
a national character, any war, invasion or warlike operations (whether war be
declared or not), insurrection, civil commotion, military or usurped power,
martial law, riot or criminal act.
HIV/AIDS,
Related Complex And Any Other Terminal Ailments: It is agreed
and expressly understood that the Insurance cover is being provided on the
condition that the life assured has never been treated for, or had any
indication of Acquired Immune Deficiency Syndrome (AIDS), Aids Related Complex
(ARC), immunological disorder, or had any positive test results indicating
exposure to the Aids virus or any other terminal ailments before subscribing to
the policy. Otherwise the policy will become void and the company shall not be
liable.
Endorsements: No variation in
the terms and conditions of this policy, either by endorsement or otherwise,
shall bind the insurance company in any way unless it be made by a duly
authorized officer of the insurance company.
Valid Discharge: Unless
otherwise stated in the policy or endorsed thereon, the policy and any benefit
there-under belong to the named beneficiary of the insured or his legal
personal representative who alone may give a valid discharge. The sum assured
under the policy shall be payable by the insurance company to the person
entitled to give a valid discharge. A valid Discharge shall consist, on the
delivery to the insurance company of:
a) Proof of such demise, being the production
to the Insurance Company, originals of medical certificate of cause of demise, demise
registration certificate, burial warrant and police report (in case of road
traffic accident)
b) The insurance certificate together with all
necessary documents of title (if any)
c) Written instruction from the person or
persons entitled to give a valid discharge
Cancellation: The Insurance
Company may cancel this policy, where the information provided by the Life
Assured is found to be false and in breach of the principle of utmost good
faith. In such a case, there will be no refund of fees deducted from the
insured’s airtime.
Policy
Termination:
The scheme (and all benefits linked to the scheme) shall be terminated in any
case of fraud committed by scheme member.
Currency and
Law:
All amounts payable in terms of this scheme, either to or by Mansard Insurance,
are payable in the lawful currency of Nigeria. Any question of law arising
under this scheme shall be decided according to the laws of Nigeria.
SCALE
OF BENEFIT FOR PERMANENT DISABILITY % OF LIABILITY
SCALE I
Total
Paralysis 100
Injuries
resulting in being permanently bedridden
100
Any
other injury causing permanent total disablement
From
engaging in or giving attention to profession or occupation of any kind 100
Loss
of two limbs 100
Loss
of both hands or of all fingers and thumbs
100
Total
loss of sight in both eyes 100
SCALE II
Loss
of arm at shoulder 60
Loss
of arm between elbow and shoulder 50
Loss
of arm at elbow 60
Loss
of arm between wrist and elbow 45
Loss
of hand at wrist 45
Loss
of four fingers 50
Loss
of thumb-both phalanges 35
One
phalange 10
Loss
of index finger - 15
Three
phalanges 15
Two
phalanges 10
One
phalange 6
Loss
of middle finger - Three phalanges 10
Two
phalanges 6
One
phalange 4
Loss
of ring finger -
Three
phalanges 6
Two
phalanges 5
One
phalange 3
Loss
of little finger - Three phalanges 5
Two
phalanges 4
One
phalange 3
Loss
of metacarpals - 1st or 2nd (additional) 3rd 4
4th
or 5th (additional) 3
Loss
of leg - at hip 70
Loss
of leg - between hip and knee 50
Loss
of leg - below knee 35
Loss
of foot 40
Loss
of toes - all of one foot 20
great
- both phalanges 10
One
phalange 3 other than great, if
more than one toe lost, each 2
Loss
of sight of one eye 30
Loss
of hearing - one ear 10
Total
loss of hearing 50
Percentage
of Liability is the percentage of the Sum Assured the insurance company will
pay if any of the permanent disability listed above occurs.
• Medical expenses in case of accident: Shall mean the
medical expenses (Including operation fees, cost of medicine, surgical
appliances and hospital or nursing home charges) necessarily incurred and
expended in connection with any injury by accident within the meaning of the
policy; it is a condition precedent to the payment of such medical expenses
that the medical attendant’s detailed account shall, if the Assurer so
requires, be submitted to and approved by the assurer; medical expenses in case
of accident would be paid to the tune of 10% of total sum assured at the
occurrence of an insured peril under this clause and is payable once a year
• Claim will be paid 5 working days after
receipt of all documentation as stated above
It
is further understood that:-
(a) In the event of multiple injuries arising
from one accident, the total compensation payable for Permanent Disablement
shall not in the aggregate exceed the basic compensation under item B (ii)
above.
(b) Permanent total loss of use of part of a
limb shall be treated as loss of that part.
(c) Loss of sight of an eye shall mean total
and irrecoverable loss of all sight rendering the Insured person absolutely
blind in that eye beyond remedy by surgical or other treatment.
(d) Where any bodily injury not specifically
mentioned herein however small is sustained by the Insured person' a percentage
of the permanent disablement will be applied which in the opinion of the
company is consistent with the above scale of fixed percentages of compensation
after necessary consultation with a qualified medical practitioner.