CASE STUDY- SHORT TERM INSURANCE

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CASE STUDY- SHORT TERM INSURANCE

MOOSTONE FINAL EXTERNAL INTEGRATED SUMMATIVE

ASSESSMENT- EISA OCCUPATIONAL CERTIFICATE: INSURANCE

CLAIMS ADMINISTRATOR (CLAIMS ASSESSOR)

SAQA ID: 99668 CREDIT: 131 DATE: ... ... 2019

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This Policy will provide cover for Insured Journeys that commence after the inception date appearing on the Policy Schedule. Cover will commence when the Insured Person leaves the Point of Departure and will auto-matically cease when he returns to the Point of Departure. Cancellation coverage will take effect one day after the issue date as stated on the Policy Schedule and once the required premium is received by us. Motor Hijack cover will take effect one day after the issue date as stated on the Policy Schedule and once the required premium is received by us. For Frequent Flyer Plans, cover will terminate on the Insured Person’s return to the Point of Departure and recommence on his next Insured Journey. The maximum period for any Insured Journey on a Frequent Flyer Plan is restricted to 90 days. Cover on the Frequent Flyer will terminate completely on the expiry date of this policy.

Except for Motor Hijack cover, this Policy does not apply to events that occur after the expiration date shown on the Policy Schedule, or if the Insured Person returns to the Point of Departure from his Insured Journey before this date. Motor Hijack cover will expire 365 days after the issue date as stated on the Policy Schedule. This Policy cannot be cancelled once an Insured Journey has commenced or after the expiry date of the In-sured Journey.

The Policy period cannot be in excess of 12 months.

Premium payments

The Insured Person is liable for the premium and the premium is payable in advance and the Company shall not be liable for any claim arising under this Policy that occurs prior to receipt of the premium. The Company shall not be obliged to accept premium tendered to it or to any intermediary after such date, but may do so upon such terms as in its sole discretion may determine. The Company reserves the right to ask for proof of payment of premium at any time. Such proof must be to the Company’s satisfaction.

Maximum amount payable

1. No Insured Person shall be entitled to recover a benefit exceeding 100% of the sum for an Insured Event as reflected in the Schedule of Benefits.

2. If two or more travel policies issued by the Company or another company apply to the same claim, the maximum amount payable by KBG under all such policies shall not exceed the limit of liability of whichever of such policies has the highest applicable limit of liability. Nothing contained herein shall be construed to increase the limit of liability of this Policy.

3. Subject to any limitations in respect of cover found in the Short Term Insurance Act 53 of 1998, Children accompanying the Insured Person on an identical travel itinerary qualify to share cover with the Insured Person. A maximum of 5 Children per Insured Person can be covered when Benefits are shared. This will apply on an Individual or Family Plan. The Spouse will have full cover on a Family Plan.

4. The maximum amount payable in the event of death or Permanent Total Disablement of a child will be 20% of the Benefit, or in respect of death that amount which is legislated at the Date of Loss, whichever is the lesser.

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CANCELLATION/TERMINATION

Cancellation

1. Provided that no claims have been initiated, the Insured Person may only cancel this Policy before the date of departure stated on the Travel Insurance Certificate. No cancellations will be accepted after the depar-ture date shown on the Travel Insurance Certificate.

2. This Policy may be cancelled by the Company by sending the Insured Person 15 days written notice to his last known address and in which case the Company will refund a pro-rata premium for the unexpired policy period.

Termination

This Policy will terminate on the earliest of the following dates: 1. on the date the Policy is cancelled; or

2. the date of the Insured Person’s return to the Point of Departure; or

3. the date that the Insured Person reaches the maximum age for the cover selected; or

4. the expiry date appearing on the Travel Insurance Certificate unless there is an automatic extension as described under the General Conditions applying to this Policy.

DEFINITIONS

Accident means a sudden unexpected and specific event which occurs at an identifiable time and place, result-ing in Injury.

Accidental Loss means the Insured Person mislaying or misplacing their Baggage resulting in a loss of pos-session.

Baggage means luggage, Personal Effects and travel documents (travel tickets, passports and visas) taken by an

Insured Person on an Insured Journey.

Beneficiary means the person or persons nominated by the Insured Person.

Children means the Insured Person’s dependant children who are not in full-time employment and who are be-tween the ages of 3 months up to and including the age of 18 years (or under the age of 25 years provided they are in full-time education), unmarried, not pregnant, without children and primarily dependent on the Insured Person for maintenance and support.

Company means KBG Insurance Limited.

Damage means physical damage to Baggage which lowers the value. Date of Loss means:

1. For Illness, the first date of diagnosis or the date the Insured Person first became aware of the Illness – whichever occurs earlier;

2. For Injury, the date of the Accident;

3. For all other Sections, the date of the Insured Event.

Day means a period of 24 consecutive hours including the day of admission but excluding the day of dis-charge.

Electronic Equipment shall mean any computer equipment system or software or any product, equipment, system or machinery connected to or operated by means of a micro or data processor chip.

Emergency Medical Expenses means all Reasonable and Customary Charges which at the sole discretion of KGB are deemed medically necessary for Illness or Injury on a local journey.

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Excess means the first amount, or period, of each and every loss payable by the Insured Person.

Hazardous Pursuits means any activity which introduces or increases the possibility of a loss or which may influence the extent of a loss including but not limited to sports activities.

Hospital means a legally constituted establishment which operates pursuant to the laws of the country in which it is based and which meets the following requirements:

1. It operates primarily for the reception, medical care and treatment of sick, ailing or injured persons on a resident in-patient basis;

2. It admits resident in-patients only under the supervision of a Medical Practitioner;

3. It maintains organised facilities for the medical diagnosis and treatment of such persons and provides (where appropriate) facilities for major surgery within the confines of the establishment or facilities con-trolled by the establishment;

4. It provides a full-time nursing service by or under the supervision of a staff of nurses;

5. it is not a day clinic, health hydro or nature clinic, a mental institution, an institution confined primarily to the treatment of psychiatric disease, the psychiatric department of a hospital, a place for the treatment of chemical dependency, an establishment or a special unit of a hospital used primarily as a place for treat-ment of drug addicts or alcoholics, a hospice, a frail care centre, a rest home or nursing, convalescent, rehabilitation, assisted living or extended care facility.

Illness means any fortuitous sickness or disease contracted, commencing or first manifesting itself during an Insured Journey.

Inbound Journey means an Insured Journey commencing from the Point of Departure outside the territorial limits of the Republic of South Africa to the destination inside the territorial limits of the Republic of South Africa including the return journey to the Point of Departure.

Insured Event means an event stated in the Schedule of Benefits.

Insured Person means any person whose name appears on the policy schedule and in respect of whom premi-um has been paid.

Local Journey means an Insured Journey which commences at the time when the Insured Person departs from the Point of Departure to travel in a direct, timeous and uninterrupted manner to a destination within the terri-torial limits of the Republic of South Africa that is more than 100 kilometers away from the Point of Departure and it includes the return journey to the Point of Departure.

Medical Expenses means all Reasonable and Customary Charges for Illness or Injury on an International Journey resulting in hospitalisation, surgical or other diagnostic or remedial treatment given or prescribed by a Medical Practitioner.

Medical Practitioner means a person registered with a current, legal licence to practise medicine, but excludes an Insured Person or a member of any Insured Person’s immediate family.

Medical Treatment means a Medical Practitioner’s medical advice, treatment, consultations and prescribed or repeat maintenance medication.

Permanent Total Disablement means total and absolute disablement which entirely prevents the Insured Per-son from engaging in or giving attention to his usual or any occupation for which he is qualified or has received specialised training and which will in all probability be lasting and continuous for his lifetime.

Personal Effects means spectacles, dentures, purses, wallets, cosmetics and other personal effects normally worn or carried on the person.

Point of Departure In respect of a Local Journey means the Insured Person’s usual place of residence or from which an Insured Person leaves to travel in a direct, timeous and uninterrupted manner;

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Pre-Existing Medical Conditions means any condition giving rise to a claim for which, within the 12 consecu-tive months prior to the Effecconsecu-tive Date of Coverage, the Insured Person:

1. Has consulted a Medical Practitioner or specialist; or 2. Has received Medical Treatment or advice; or

3. The manifestation of symptoms would have caused a reasonable person to seek advice.

Relative means a Spouse, parent, parent-in-law, grandparent, step-parent, Children, grandchild, brother, brother-in-law, sister, sister-brother-in-law, daughter-brother-in-law, son-brother-in-law, fiancée, fiancé, half-brother, half-sister, aunt, uncle, niece or nephew of the Insured Person.

Spouse means the husband, wife, partner in a same sex partnership or any de facto partner with whom the Insured Person has permanently and continuously lived in the same household in a relationship which is not casual or impermanent for a period longer than 6 consecutive months. Only one Spouse shall be eligible for cover.

Theft means wrongfully taking property from an Insured Person without their wilful consent.

GENERAL EXCLUSIONS APPLYING TO THE ENTIRE POLICY

We will not pay for any claim arising from:

a. Your participation in motor cycling except as a driver or passenger of a motor cycle or quad bike with an engine capacity of 200cc or less, provided that You or the driver hold a current legal motor cycle driver’s licence;

b. Your participation in underwater diving involving the use of any artificial breathing apparatus, unless You hold a valid open water diving certificate or are diving under the supervision of a qualified instructor; c. Your participation in any Hazardous, Competitive or Professional Sport or Activity, other than cover

provided under Section 08: Sports Extension, at an additional premium. The following are excluded entirely – aerobatic flying, BMX racing, Cape Epic, cave diving, cliff diving, free diving, hang gliding, horse racing, hunting, microlite flying, motor vehicle and/or motor bike and/or quad bike racing, muay thai, paragliding, parachuting, rock climbing, sky diving, sky surfing, tow-in surfing, white water rafting class 6;

d. search and rescue;

e. consequential loss, loss of enjoyment or financial loss or expense not specifically covered in this policy; f. You travelling against medical advice or You travelling with the intention of obtaining medical treatment

abroad;

g. psychiatric, psychological or emotional illness of any kind, suicide, attempted suicide, deliberate selfinjury, insanity, depression, stress, the effect of excessive use of alcohol or drugs or any similar syndrome;

h. the following conditions if You are Human Immunodeficiency Virus (H.I.V.) positive or have Acquired Im-mune Deficiency Syndrome (A.I.D.S.):

• Kaposi’s Sarcoma • PneumoCystis Jirovecii • Tuberculosis

• Cytomegalovirus (C.M.V.) • Cryptococcal Meningitis

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i. flying or air travel of any kind other than

2. on a flight arranged by the Assistance Company or;

3. flying as a passenger in any fully licensed passenger carrying aircraft, but not as a member of the crew during the course of Your employment, and not for the purpose of undertaking any trade or technical operation therein;

j. medical expenses relating to childbirth and/or a child born whilst on a Local Journey;

k. Manual Work in connection with a business or a trade, including any person who is contracted or employed to drive a commercial vehicle;

l. any unlawful conduct committed by You or You not being honest and frank with all answers, statements and submissions made in connection with any claim or the purchase of this policy;

m. Your wilful exposure to or active participation in war, invasion, act of foreign enemy, hostilities (wheth-er war be declared or not), Riot, Civil Commotion, civil war, rebellion, revolution, insurrection, military or usurped power or any foreseeable act of any person acting on behalf of or in connection with any organisa-tion with activities towards the overthrow by force of any Government (whether with legal authority or not) or any foreseeable act of Terrorism or violence;

CONDITIONS APPLYING TO THE ENTIRE POLICY

It is a condition precedent to liability that: a. You are fit and healthy to travel;

b. if You are travelling on a sea faring vessel the Assistance company will endeavour to provide emergency services from the nearest port or harbour;

c. the following sporting activities are automatically included, for leisure purposes only abseiling, athletics, archery, badminton, bare foot water skiing, basketball, body boarding, bowls, canoeing, combat rifle shoot-ing, cricket, cyclshoot-ing, dancshoot-ing, darts, dressage, elephant ridshoot-ing, fencshoot-ing, fishshoot-ing, go karting with an engine capacity of 200cc or less, golf, gymnastics, hiking, hockey, hot air ballooning, horse riding, ice hockey, ice skating, jet skiing with an engine capacity of 500cc or less, ju jitsu, judo, karate, kayaking, kick boxing, kite skiing, kite boarding, kite surfing, kung fu, martial arts, mountain biking,

mountaineering up to 3 500m, netball, parasailing, polo cross, power lifting, pistol shooting, roller blading, rowing, running, rugby, sailing, snorkelling, soccer, soft ball, squash, surfing, swimming, table tennis, tennis, tenpin bowling, trekking, volleyball, wake boarding, water polo, water skiing, white water rafting (class 1,2 and 3), wind surfing. A sports extension is required for any of the aforementioned sports if You are partici-pating for Competitive and/or Professional purposes;

d. claims must be notified promptly and submitted no later than 60 days after the date of the incident.

The costs of submitting claims and obtaining supporting documentation as We may require shall be borne by You;

e. You must observe all of the policy conditions insofar as they relate to anything to be done by You;

f. We may at Our expense and in Your name, pursue any actions available to obtain a claim recovery and You must provide Us with relevant details of any other applicable insurance or cover;

g. if any claim under this policy is covered by any other policy or policies of insurance or credit card insurance or statutory insurance or medical aid scheme or medical insurance, the cover provided by this policy will be deemed to be in excess of the cover already provided by any of the afore mentioned policies or benefits. This condition does not apply to Accidental Death and Permanent Total Disablement claims (Section 04); h. Accompanied Children share in the Limit of Liability of their parent however the maximum liability per

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i. under no circumstances will any payment on this policy exceed the Limit of Liability in respect of the par-ticular benefit as stated in the Schedule of Insurance;

j. We reserve the right to commence or take legal proceedings in Your name for the settlement or defence of any claim or to prosecute any other party to recover compensation (including legal costs) in respect of any cover provided by this insurance. Any amount recovered shall belong to Us;

k. where You are insured by more than one policy issued by Us, Our maximum payment will never be more than the maximum Limit of Liability as stated on the policy with the highest benefits;

l. in all cases the monetary limits shown in the policy are deemed to be South African Rand;

m. You reimburse Us within 30 days of receiving a written request to defray any expense for which We are not responsible;

SECTION 01: MEDICAL RELATED EXPENSES

01.1 MEDICAL TRANSPORTATION, REPATRIATION AND EVACUATION

If You require medical transportation as determined, agreed and arranged by the Assistance Company, We will pay for Your transfer to the nearest most appropriate medical facility to obtain necessary treatment and / or repatriation to Your Residence.

01.2 BURIAL, CREMATION OR RETURN OF MORTAL REMAINS

In the event of Your death, We will pay the reasonable costs in respect of funeral, burial or cremation where Your death occurred and/or the reasonable costs of returning Your body or ashes to Your Residence. 01.3 DAILY HOSPITAL CASH BENEFIT

If whilst on a Local Journey You are hospitalised for 24 consecutive hours or more, We will pay You a daily inconvenience benefit for each complete 24 consecutive hours You remain in hospital, up to a maximum of 30 consecutive days.

SECTION 01: EXCLUSIONS

a. pregnancy or childbirth from the 1st day of the 26th week of pregnancy;

b. treatment that Your medical advisors are aware will arise during the Local Journey or where a medical advisor has advised against travel;

c. vascular, cardiovascular or cerebrovascular conditions if You are over the age of 69 years;

d. medical transportation, repatriation and/or evacuation that is not specified by a medical practitioner ap-pointed by Us as immediately necessary;

e. Cardiovascular, vascular, cerebrovascular or cardio respiratory or hypertensive conditions; if you have received medical advice and / or treatment (including medication) for hypertension in the six months prior to departure or where you have attained an age of 69 years.”

SECTION 01: CONDITIONS

a. You must obtain Our or the Assistance Company’s prior authorisation before incurring any expenses over R10 000. If prior authorisation is not obtained, cover will be limited to what We would have paid had We been able to instruct Our preferred suppliers..

SECTION 02: ADDITIONAL TRAVEL EXPENSES

02.1 LOCAL JOURNEY CANCELLATION

If You cancel Your Local Journey prior to departure as a result of:

a. unexpected death or sudden illness or injury of You, Your Travelling Companion, a member of Your Imme-diate Family or Business Associate or person with whom You had intended to stay and as deemed neces-sary by a medical practitioner appointed by Us;

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b. Traumatic Event within 14 days prior to departure; then We will pay for, or reimburse You the non-refundable portions of travel or accommodation arrangements paid by You or for which You are legally liable.

02.2 LOCAL JOURNEY CURTAILMENT

If Your Local Journey is curtailed or extended as a result of:

a. unexpected death or sudden illness or injury of You, Your Travelling Companion, a member of Your Immedi-ate Family or Business AssociImmedi-ate and as deemed necessary by a medical practitioner appointed by Us; b. Traumatic Event;

then We will pay for or reimburse You the non-refundable portions of travel or accommodation arrange-ments paid by You or for which You are legally liable and the reasonable additional travel and accommoda-tion expenses (three star accommodaaccommoda-tion and economy class travel expenses) incurred by You to return to Your Place of Residence.

02.3 CAR HIRE

If as a result of an accident, theft or mechanical breakdown to Your vehicle while You are on Your Local Jour-ney, We will pay You up to the limit as shown on Your Schedule of Insurance, to hire a vehicle, allowing You to continue Your Local Journey and/or return to Your Residence.

SECTION 02: CONDITIONS

a. In the event of mechanical breakdown, Your vehicle must not be older than 5 years from date of manufac-ture.

b. If a claim under this section is covered by another policy or policies of insurance, this benefit will be deemed to be in excess of the cover already provided.

SECTION 02: EXCLUSIONS

a. disinclination to proceed or financial circumstances or government prohibition;

b. the inability of any tour operator or wholesaler to complete arrangements for a group due to a deficiency in the number of persons required to commence or complete any part of the tour;

c. default of any transport, or accommodation provider, travel agency or tour operator, or any person acting as an agent of Yours;

d. consequential loss;

e. pregnancy or childbirth from the 1st day of the 26th week of pregnancy; 03: LUGGAGE THEFT

If Your luggage, clothing or Personal Effects are stolen We will indemnify You subject to the following: 1. There is a limit of 25% of the insured sum for any single item of luggage or Personal Effects; 2. A camera, its lenses and fittings and the camera case shall be deemed to be a single item;

3. a mobile phone / satellite phone and its fittings (including photographic fittings) shall be deemed to be a single item and is limited to R1 000;

4. Spectacles, sunglasses, contact lenses are limited to R1 000 per pair; 5. Golf clubs and golf equipment shall be deemed to be a single item; 6. Jewellery and its attachment shall be deemed a single item;

7. A laptop and accessories, including but not limited to battery charger, adapter and case, shall be deemed to be a single item.

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8. Tablet Personal Computer and accessories, including but not limited to battery charger, adapter, external keyboard and case, shall be deemed to be a single item.

SECTION 03: EXCLUSIONS

a. delay, detention, destruction or confiscation by customs officials or other authorities; b. Your contractual obligations resulting from a mobile or satellite phone;

c. theft of a mobile or satellite phone and its fittings unless personally carried with You;

d. theft from an unattended vehicle unless such property is securely locked in a boot and entry to the vehicle is gained by visible, forcible and violent means;

e. theft of bonds, stamps, negotiable instruments, manuscripts, deeds, securities of any kind or bullion; f. any loss that has not been reported to the police or transport carrier immediately and a written police or

irregularity report obtained.

SECTION 03: CONDITIONS

a. You must always exercise reasonable care for the safety, security and supervision of property at all times and must not leave property in an unattended public place, unlocked building or unattended unlocked vehi-cle;

b. You must take all reasonable precautions to minimise any loss and not abandon any damaged property; c. You must always attempt to make a recovery from the airline and never leave an airport unless You have

reported the loss to the carrier and a written report obtained;

d. You must immediately report all losses attributable to theft to the local police authorities in the area where the loss occurred, and provide Us with a written acknowledgement of the report contained;

e. All jewellery, cash and documents must be carried on You or locked in a safety deposit box;

f. Any electronic equipment (including but not limited to cameras, cellular phones, satellite phones, naviga-tion systems, laptops, tablet personal computers and/or eReaders) must accompany You as hand / cabin baggage;

SECTION 04: ACCIDENTAL DEATH AND PERMANENT TOTAL DISABLEMENT

If You suffer bodily injury by accidental, external, violent and visible means which directly and independently of any other cause, results within twelve months in Death or Permanent Total Disablement (as detailed in the schedule below) We will pay the appropriate compensation to You, Your estate or nominated beneficiary in accordance with the Schedule of Benefits below.

If You suffer an injury or die as a direct result of exposure to the elements, resulting from a mishap to the con-veyance in which You are travelling, We will pay the appropriate compensation to You, Your estate or nominat-ed beneficiary.

If You disappear and it is reasonable for Us to believe that You may have died due to accidental bodily injury, We will pay the appropriate compensation to Your estate or nominated beneficiary. Payment is conditional upon a waiting period of 12 months and receipt of a Presumption of Death order from the Court and the per-son/s to whom such sum is to be paid have signed an undertaking to refund such sum to Us if You are subse-quently found to be alive.

SCHEDULE OF BENEFITS Percentage of Limit of Liability 1. Death 100%

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2.1 Loss by physical separation or permanent total loss of use at or above the wrist or ankle of one or more limbs - 100%

2.2 Total, permanent and irrecoverable loss of hearing in both ears - 100% 2.3 Total, permanent and irrecoverable loss of hearing in one ear - 50% 2.4 Total, permanent and irrecoverable loss of sight in both eyes - 100% 2.5 Total, permanent and irrecoverable loss of sight in one eye - 50% 2.6 Permanent and total loss of speech - 100%

SECTION 04: EXCLUSIONS

We will not pay for any claim resulting from: a. travel in any single engine aircraft;

b. travel in any helicopter unless when utilised as a connecting flight by a scheduled airline.

SECTION 04: CONDITIONS

a. Permanent total loss of use of a limb shall be treated as loss of a limb.

b. In the event of compensation becoming payable under more than one benefit, the total amount payable shall not exceed 100% of the Limit of Liability for each Insured person.

c. In the event of travel in any chartered aircraft with more than 20 seats, the Limit of Liability is restricted to 25% in respect of each Insured person.

d. In the event of the death of a minor child, the limit of compensation is subject to the amount legislated by law at the time of the death.

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KBG INSURANCE COMPANY

Personal Travel Insurance

Policy Schedule

Policy number: TVI 09687 Name and address of Insured

Louis van Niekerk 56 Rankdoring Avenue, Randpark Ridge

Randburg, Johannesburg, 2197

Phone number: 011 036 5231 Cell:082 569 1687 Email: [email protected]

Period of insurance From: 21.10.2015 – To: 02.11.2015

Type of Insurance Family Plan

Name of Insured person(s) Mr Louis van Niekerk – ID No 4504237062081 Mrs Amelia van Niekerk – ID No 5011127021085

Journey: International Travel Schedule of benefits

Insured event Sum insured Monthly premium

Medical expenses R375 000 R 900 Accidental death and burial expenses R500 000 R 1 050 Loss of documents R10 000 Included

Loss of baggage R100 000 R425

Baggage delay R5 000 Included

Flight delay R10 000 Included

Car rental protection R100 000 R425

TOTAL R2 800

Standard Excess: R1000 per loss

Conditions - This policy provides cover for travel period of between 1 and 180 days. Claim notification clause

“In the event of any occurrence which may give rise to a claim under this Policy, the Insured shall, as soon as possible, give notice thereof to the Company, in writing, with full details and as far as practicable there shall not be any alteration or repair until the Company have had an opportunity of inspecting”.

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KBG INSURANCE COMPANY

Travel Insurance

Premium Schedule

Policy number: TVI 09687 Name and address of Insured

Louis van Niekerk 56 Rankdoring Avenue, Randpark Ridge

Randburg, Johannesburg, 2197

Phone number: 011 036 5231 Cell:082 569 1687 Email: [email protected]

Date of inception 21.10.2015

Period of insurance From: 21.10.2015 To: 02.11.2015

Type of Travel Insurance Family Plan

Date paid Premium

due Premium paid Status

14 October

2015 R 2,800.00 R 2,800.00 Paid

Thank you for taking your travel insurance with our company.

Kindly take note of our International Call Centre contact numbers, should you need to contact us in an emergency. We wish you a safe journey.

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KBG INSURANCE COMPANY

Travel Insurance

Claim Form

Type of claim

Death/ Personal accident 

Medical  Travel delay  Baggage/cash/documents  

Cancellation & Curtailment  Personal Liability 

Notes:

1. All supporting documentation must be submitted together with this form in order to avoid unneces-sary delays.

2. For all claims relating to loss or theft, please provide a carrier and/or police report. 3. Please supply a copy of your Policy Receipt.

4. Please supply a copy of your Air Ticket.

SECTION 1 – INSURED PERSON

Surname: Van Niekerk

First Names: Louis Age: 70 years Physical address: 56 Rankdoring Avenue, Randpark Ridge

Randburg, Johannesburg Code: 2197 Email address: [email protected]

Tel. No. Business: ( N/A ) Tel. No. Residence: ( 011 036 5231)

ID No: 4504237062081 Travel Dates: 21/10/ 2015 to 02/11/2015 1. Date of Loss/Theft : 2 November 2015

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SECTION 2 – DEATH/PERSONAL ACCIDENT N/A Description of accident:

N/A

The following documentation is required in order to substantiate your claim: 1. Certified copies of the abridged and final death certificate

2. A certified copy of the Post Mortem Report

3. A certified copy of the FULL Inquest Report including all witness statements pertaining thereto 4. The police accident report if death was due to a motor accident

5. The police station and reference number if death is the subject of a criminal investigation 6. Copies of any newspaper clippings, eye-witness statements or incident reports that may be avail-able

SECTION 3 – MEDICAL CLAIMS

1. Describe the circumstances leading to the medical claim

I had a mild heart failure on the 29th_{of October during my holiday in Mauritius. This required}

urgent medical attention hence I had to quickly see a Doctor and get attended to as well. The Doctor also administered some medical drugs on me. I had to pay all this from my pocket. 2. Did you consult a Medical Practitioner? Yes   No 

3. Have you ever received treatment for this or a related illness? Yes  No  

This was the first of its kind.

4. Have you submitted a medical report and any medical receipts for the expenses incurred? Yes   No 

The report is attached.

5. How much are you claiming as medical expenses in total? R37 500.00

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SECTION 4 – BAGGAGE, CASH AND TRAVEL DOCUMENTS

1. Describe how the Delay/Loss/Theft/Damage occurred:

On my way back home from our holiday in Mauritius on the 2nd_{of November, my laptop was}

stolen at the airport while we were waiting for our flight back to Johannesburg. The laptop was on the seat next to me in the waiting area of the airport and when I got up to board the flight, it had disappeared.

2. Carrier/Policeto whom Loss/Theft/Damage reported: When and where: 02.11.2019 – Mauritius Airport Police If NOT reported, give reason why not: N/A

3. Are you the sole owner of the goods Lost/Stolen/Damaged? Yes

4. In respect of Baggage that is Lost/Stolen/Damaged by an Air Carrier, have you lodged a claim with the respective Air Carrier? N/A

If YES, please state where and at which office:

Have you received compensation from the Air Carrier? Yes  No x

If YES, please state the amount compensated: R 5. List the items that were lost and their insured values

Item description Value

Dell Latitude 7390 Professional Series Note-book - Intel Kaby Lake Core I7-8650U Quad Core 1.9GHZ

R31 776.00

SECTION 5 – TRAVEL DELAY N/A

1. Nature of delay: 2. Date and time of delay: 3. Duration of delay:

4. In the event of Strike/Derangement of the aircraft or sea vessel: Where did the Strike/Derangement take place?

Duration of Strike/Derangement:

(Letter from Carrier confirming Strike/Derangement is required)

5. Did you receive any form of Compensation or Alternative Travel Arrangements from the Carrier? Please give details:

DECLARATION AND AUTHORITY

I/We declare that the above information is true and correct in every respect and that the signing of this claim form also constitutes written authority for the Company to inspect or investigate any Medical Records or Details relevant to this claim. I/We further declare that I am/we are aware that any misrepresentation and/or non-disclosure in respect of information provided herein shall render my/ our claim null and void.

CASE STUDY- SHORT TERM INSURANCE