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)
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 assu
red, 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.
Be the first to comment