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Product Benefits Summary
- Receiving 100% of sum assured in case of death caused by illness or accident. (1)
- Receiving 100% of sum assured in case of Total and Permanent Disability (TPD) caused by illness or accident. (1)
Product Features Summary
| Insured’s age | From 18 to 60 years old |
| Expired age | 80 years old |
| Sum assured | From $5,000 |
| Policy term | 10 to 20 years |
| Premium payment term | Equal to policy term (10 to 20 years) |
| Premium payment mode | Annually, semi-annually, quarterly and monthly |
Remarks
(1) This policy shall be terminated when the death or Total and Permanent Disability (TPD) benefit is paid.
Product Detail
1. Definitions
“Company” means Sovannaphum Life Assurance Plc. (Life Insurance Company)
“Policy” means life insurance policy which is a legal binding document issued by the Company stipulating major substance and detailed terms and conditions that are agreed between the Company and the Insured in the Insurance Contract.
“Insurance Contract” means the written agreement between the Company and the Insured in which the Company agrees to accept any specific risk, and in return receives premium paid by the Insured. The Insurance Contract consists of the Policy, Life Insurance Certificate, riders, attachments, additional statement, endorsements, or requests for any changes by the Insured approved and signed by the Company, Insurance Application Form, health report by physician and health declaration, which all these documents are considered as the Insurance Contract between the Insured and the Company.
“Insured” means the person identified as Insured in the Life Insurance Certificate or attachment, who would be covered under Insurance Contract.
“Premium” means the amount paid by an Insured to the Company as consideration for the obligations assumed by the Company.
“Life Insurance Certificate” means document issued by the Company to certify the fact that an Insured has purchased insurance from company.
“Policy Effective Date” means the date when the Insurance Contract begins.
“Policy Year” means each period of 1 year after the policy becomes effective or from the anniversary date.
“Accident” means sudden event, caused by external factor with a result that is not the intention or determination of the Insured.
“Injury” means physical injury and is directly caused by an accident and is separated and independent of other causes.
“Beneficiary” means a person who is stated in the Insurance Application Form by the Insured to be a Beneficiary, according to the Insurance Contract, and who would receive the benefits due under this Policy upon the death of Insured.
“Total Permanent Disability (TPD)” refers to the insured suffers from complete loss, permanent paralysis and permanently irrecoverable of:
• Two arms; or
• Two legs; or
• One arm and one leg; or
• Two eyes; or
• One eye and one arm; or
• One leg and one eye.
In this definition, complete loss and permanently irrecoverable of (i) eye(s), means physical loss of eyes or complete blindness, (ii) arm(s), means loss above the wrist, and (iii) leg(s), means loss above the ankle.
In case of permanent paralysis, the Total and Permanent Disability condition must be certified by a registered hospital at provincial level or above no sooner than 180 days and not later than 270 days from the occurrence of the accident or the date the paralysis condition is verified.
In case of complete loss of arm(s) or leg(s) or eye(s), such certification could be carried out at any time.
2. Entirety of Insurance Contract
This Insurance Contract is based on the Company’s belief in the truth and accuracy of the Insured’s statement in the Insurance Application Form, health declaration and any other additional declarations signed by the Insured; and that the premium has been duly paid in full. On this belief, the Company hereby enters into the Insurance Contract and issues the Policy.
In case that the Insured knowingly misrepresents any statement or has known of or should have known of any material facts but fails to disclose any such fact to the Company which might cause any change to the subject to be Insured, the Company reserves the right to charge extra premium or refuse to enter into the Insurance Contract. Any such misrepresentation or failure to disclose material facts to the Company shall render this Insurance Contract voidable. In such a case, the Company may void the contract and deny to pay a contractual claim.
The Company shall not deny any liabilities by relying on any statement other than that made by the Insured in the document stated under the first paragraph of Entirety of Insurance Contract clause in Part 2.
A life insurance agent or broker has no power to correct or amend this insurance policy, or to extend premium payment anniversary date or to disclaim the submission of notice or evidence for claim processing according to the requirements of this Policy. Any amendment to this Policy shall be complete only after the Company accepts such amendment and issues its endorsement.
3. Applicable Law
This policy will be governed by and construed according to the laws of the Kingdom of Cambodia.
4. Currency
It is described under “Currency” in the Life Insurance Certificate.
5. Incontestability of Insurance Contract
Unless stated as otherwise in this Policy, when the policy is in force, the Company shall not contest the entirety of the Insurance Contract after it has been in force for two years from the Policy Effective Date, or if the policy is reinstated, from the date of the last reinstatement, excepted the Insured has no insurable interest, or the misstatement of the Insured’s age as to be outside the normal limit of business of the Company.
6. Rights and Exercise of Rights under the Policy
The rights and the exercise of rights under this policy, unless specifically assigned to any other person, shall be regarded as solely belonging to the Insured.
Any assignment of rights and the exercise of rights in the policy to another person shall be made only on approval by the Company upon delivery of prior written notice.
7. Insurance Application Form
The Insured shall submit an Insurance Application Form to the Company by using of the prescribed Company’s form.
8. Beneficiary under the Policy
The Insured is entitled to specify the Beneficiary and upon the death of the Insured, the Company shall pay any benefits, specified in the policy. If the Insured has not specified a Beneficiary, the benefits will be paid to heir(s) of the Insured.
If only one Beneficiary is specified and the Beneficiary dies before the Insured or at the same time, the Insured must notify the change of Beneficiary to the Company in writing. If the Insured fails or is unable to notify the change of Beneficiary to the Company, when the Insured dies, the Company shall pay benefits to the Insured’s heir(s).
If more than one Beneficiary is specified and one of them dies before the Insured, the Insured must notify the change of Beneficiary or the conditions of benefit payment to the other Beneficiaries who are still alive, to the Company in writing. If the Insured fails or is unable to notify the change of the Beneficiary to the Company, when the Insured dies, the Company shall pay an equal amount of any remaining benefits of the late Beneficiary after debt repayment (if any) to each of the surviving Beneficiaries.
9. Change of Beneficiary
In case the new Beneficiary is the Insured’s parent, spouse or child, the change of the Beneficiary will be effective from the day the Insured expresses such intention by notifying the Company in writing so that the Company will record the change in the policy or issue a policy endorsement. However, the Company will not be liable, if the amount payable under the policy has been paid to the original Beneficiary without its knowledge of the change in Beneficiary from the Insured.
In case the new Beneficiary is not the Insured’s parent, spouse or child, the change of the Beneficiary will be effective on the day the Company approves and records such change in the Policy or issue a Policy endorsement.
10. Intentionally Killed by Beneficiary
If the Insured is killed intentionally by a Beneficiary, the Company’s liability will be limited by returning the total actual paid premium, without interest, to the heir(s) of the Insured who is not a perpetrator, co-perpetrator, initiator or accomplice in the killing.
In case there are more than one beneficiary, if any of the Beneficiary (ies) has not taken part in the intentional murder of the Insured, the Company will pay the pro rata amount of sum assured to the Beneficiary who took no part in the murder of the Insured, after deducting the portion that the murderer should have been entitled thereto. The Company shall not return the entire amount of this portion of premium.
In returning the premium in case of murder by the Beneficiary, the Company shall be entitled to deduct therefrom the debt owed under this policy.
11. Amendment of policy
Any amendments to this policy will be valid only when the Company accepts the said amendment and will be effective when the Company has recorded it in the Policy or issued an endorsement thereto, by the person authorized to act for the Company.
12. Misstatement of Age or Gender
If the Insured has misstated age or gender to the Company, and thereby, the Company collected a lower premium than it would have collected; the amount that the Company must pay hereunder shall be reduced to the value of coverage that such premium could buy. In case the Insured has paid the premium exceeding the rate according to the actual age or gender, the Company will return all excess premiums.
If the Company can prove that at the time of conclusion of the Insurance Contract, the actual age of the Insured is outside the premium limit according to the Company’s general business practices, this Insurance Contract shall be voidable by the Company. In case the Company voids the Insurance Contract, the Company shall return premium after deducting the outstanding obligation (if any) to the Insured or the Beneficiary, whichever the case may be.
13. Premium Payment
The premium payment must be paid before, or on the due date by paying on an annual, semi-annual, quarterly or monthly basis at the Company’s Headquarters or a Branch of the Company or to the agent authorized in writing by the Company or other payment methods according to an agreement between the Insured and the Company. The Company will issue the premium receipt as evidence.
In case where the Company leniently allows the premium to be paid on the premium payment mode except annually, the portion of premium not yet paid to the Company, shall be a debt for which the Company will be entitled to deduct from the benefit payable under the policy.
The Insured can change the mode of payment by submitting a request for the change of the mode of premium payment in writing to the Company. The change will be effective when the Company approves such request.
The payment of premium shall be paid in cash. Any payments of the premium made by a promissory note, check, draft, or by any other means, will be regarded as payment being made only when such instrument has been cashed.
14. Grace Period
If the Insured fails to pay the premium when it falls due, the Company will leniently allow a grace period of 31 days from the due date. During the grace period, the policy is still in force. If the Insured dies or gets total Permanent Disability during the grace period, the Company will deduct the outstanding premium in that policy year from the amount which the Company will pay under this policy without charging interest.
15. Lapsation
If the Insured fails to pay the premium within the grace period under clause 14, this policy will be lapsed, as from the payment due date, except in a case that the policy remains in force by virtue of any other provisions contained in the policy.
16. Policy Cancellation
The Company may cancel this policy by advance notice in writing of not less than 30 days, if it shows obvious evidence that the Insured conducts fraud to make use of the benefits under this policy either for the Insured or others. In such event, the Company shall return 90% (ninety percent) of the remaining premium to the insured after deducting premium for the period that the policy has been in force.
The Insured shall give 10 days, written notice to the Company in advance if the Insured wishes to cancel the insurance before expiry date. Based on reasonable grounds, the Company will refund 90% (ninety percent) of the remaining premium to the Insured after deducting premium for the period that the policy has been in force.
17. Notification of Death and Autopsy
Upon the Insured’s death, the Beneficiary must notify the Company within 30 (thirty) days from the date of the Insured’s death, unless it can be proved that there is a reasonable cause for any delay in notifying the death, or they are not aware of the existence of the Policy. In such case, the Company must be notified within 30 (thirty) days from the day the Beneficiary becomes aware of the existence of the Policy.
The Beneficiary shall provide an official death report or official evidence certifying the death of the Insured to the Company, and upon the Company’s reasonable request, the Beneficiary shall provide any additional documents to the Company at the Beneficiary’s own expense.
The Beneficiary shall consent and cooperate for the autopsy of the Insured when the Company deems it necessary, in compliance with the law and with respect to any applicable religious code.
The Company shall be liable as bound by this Policy when the Beneficiary or the Insured’s party act in compliance with the requirement(s) hereof.
18. Notification of Total Permanent Disability (TPD)
When there is a claim made upon the incurrence of Total Permanent Disability (TPD), the Insured or Insured’s party must notify the Company within 30 days after the day that the disability is diagnosed or the occurrence of the accident and submit the proof of physician’s diagnosis and additional proofs as required by the Company as necessary on their own expenses, unless there is a proof that the Insured has other significant and acceptable reason for the absence but had inform the Company as soon as possible.
The Company has a right to request bodily examination of the Insured as it deems appropriate, during the claim underwriting process.
19. Required Documents for Claim
a. In case of death caused by sickness
1. Completed Death Claim Form
2. Life Insurance Certificate (original copy)
3. Certified copies of Beneficiary’s ID card and family book and also along with the original ones
4. Certified copy of certificate of death and also along with the original one
5. The consent letter of Beneficiary or heir to disclose personal data
6. Medical report from doctor in case of death in the registered hospital or registered clinic
In case of death caused by accident, the above documents are also required with two additional documents as follows:
1. Certified copy of daily record related to the case which is certified by detector
2. Certified copy of Autopsy examination report
b. In case of claim based on Total Permanent Disability (TPD)
1. Completed Claim Request Form of Total Permanent Disability
2. Medical report as determined by the company
3. Life Insurance Certificate (original copy)
4. Certified copy of Insured’s ID card and also along with the original one
20. Exclusions
Death or Total Permanent Disability (TPD) claims resulting directly or indirectly from any of the following shall be excluded:
a. Suicide or attempted suicide, self-inflicted injury, whether sane or insane within two years after the Policy Effective Date or the effective date of any reinstatement of this Policy, whichever is later; or
b. Committing or attempting to commit by the Insured or the Beneficiary a criminal offence; or
c. Using drugs or stimulators, abusively using alcohol or driving vehicles under the influence of alcohol as defined in the current laws and regulations.
If the death or Total Permanent Disability (TPD) claims of the Insured resulting directly or indirectly from the exclusions a to c, the Company will only refund the total actual premium, without interest, to the Beneficiary (ies) or heir(s) of the Insured or the Insured.
In returning the premium or paying the death or Total Permanent Disability (TPD) benefit, the Company is entitled to deduct any outstanding obligations owed under this Policy.
21. Free-Look Period
The Insured has the right, for any reasons, to return this Life Insurance Contract together with the written cancellation request within 21 days after the Company has delivered the Policy. If returned, the Policy will be considered void from the beginning.
The Company shall refund the paid premium, deducting the actual health exam fee, and any debts (if any) is owed to the Company by the Insured. The Company reserves right to charge the operation service fee.
An Insured who already claims any benefits from this Insurance Contract cannot cancel this Policy.
22. Dispute Resolution
In the event of any dispute arising from the Insurance Contract, such dispute shall to be settled amicably between the parties to the dispute based on peaceful negotiation and reconciliation between the disputing parties. If such reconciliation fails to settle the dispute, the dispute parties may bring the case to MEF for mediation before filing a lawsuit to arbitration or a competent court.