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Product Benefits Summary
- Upon death of the life insured member during the coverage period due to sickness or accidental causes, the 100% of sum assured will be payable.
Product Features Summary
| Insured’s age | From … to … years old |
| Expired age | …. years old |
| Sum assured | From $….. |
| Policy term | …. to …. years |
| Premium payment term | Equal to policy term (…. to …..) |
| Premium payment mode | Annually, semi-annually, quarterly and monthly |
Product Detail
Part 1: Definitions
“Company” means the life insurance company as specified in the Life Insurance Certificate (if any).
“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, the Policyholder and the Insured Member which the Company agrees to accept any specific risk, and in return receives premium paid by the Policyholder. The Insurance Contract consists of the Policy, riders, Life Insurance Certificate, attachments, additional statement, endorsements, or requests for any changes 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 Policyholder, Insured Member and the Company.
“Policy Schedule” means the schedule showing details of the Policy issued by the company to accompany this Policy and is considered as part of this agreement.
“Policy Effective Date” means the date when the Insurance Contract begins.
“Policy Anniversary” means a period of one year beginning with the Policy Effective Date or the date otherwise specified in the Policy Schedule.
“Policy Year” means each a period of one year beginning with the Policy Effective Date or subsequent Policy Anniversaries.
“Members” means the persons so defined in the Policy Schedule attached hereto.
“Eligible Members” means Members and Dependents (if any) who, having completed the required waiting Period (if any) and having all the Qualifications as specified in the Policy Schedule attached hereto, are entitled to participate in the insurance plan under this Policy.
“Insured Members” means Eligible Members who, in accordance with the provisions of Part 2 Participation, are participating in the insurance plan under this Policy.
“Entry Date” means the date an Eligible Members become the Insured Members under this Policy.
“Non-contributory Insurance” means an insurance for which the Policyholder pays entirely the premium.
“Contributory Insurance” means an insurance for which the Policyholder pays part of premium and the Insured Members contribute the other or an insurance for which the Insured Members pay entirely the premium.
Part 2: Participation and Termination
1. Participation
1.1 All Eligible Members being covered under this Policy shall have all the Qualifications as specified in the Policy Schedule.
1.2 All Eligible Members on the Policy Effective Date shall be eligible for insurance under this Policy on the Policy Effective Date.
1.3 All Eligible Members (employer and employee) have to be under the National Social Security Fund (NSSF).
1.4 All Eligible Members (employer and employee) must be actively-at-work and in good health before they are qualified to participate.
1.5 Any Eligible Member (employer and employee) who is not actively-at-work on the date s/he would otherwise become eligible for participation hereunder shall not eligible until s/he returns to active service and in good health.
1.6 Dependents who are legally recognized spouse or children (if any) of regular full-time employees of the Policyholder can participate in this policy.
1.7 All dependents must be healthy and no handicap.
1.8 Members not eligible as of the Policy Effective Date and new Members shall become eligible for participation hereunder on the day following the completion of the required Waiting Period and having all the Qualifications as specified in the Policy Schedule.
1.9 Members whose participation has been terminated and who re-apply for participation shall be considered as new Members.
1.10 Every Member who fulfills the conditions necessary to participate as set forth in paragraphs 1.1 to 1.9 above must use their right within the Eligible Period as specified in the Policy Schedule from the date on which s/he becomes eligible. Otherwise, s/he shall be able to start participation only after s/he shall have furnished, at his/her own expense, evidence of his/her insurability satisfactory to the Company.
1.11 Each Eligible Member shall be insured hereunder on the first day on which s/he becomes eligible provided the condition set forth in paragraph 1.10 of this Section has been satisfied and the duly completed enrolment form has be received, unless agreed otherwise, and coverage confirmed by the Company.
2. Member Termination
The insurance hereunder of any Insured Member shall automatically cease on the earliest of the following dates:
2.1 The date on which the Policy is terminated.
2.2 The date on which the Insured Member is dead.
2.3 The Premium Due Date on which the Insured Member, under Contributory Insurance, does not pay the premium
2.4 The last date of the Policy Year on which the Insured Member’s age exceeds that specified in the Policy Schedule
2.5 The date on which the Insured Member is disqualified on any Qualifications as specified in the Policy Schedule.
3. Policy Termination
The insurance hereunder of this Policy shall cease on any of the following cases:
3.1 The Policyholder does not pay the premium within the grace period. This Policy shall be terminated on the day following the expiration of the grace period.
3.2 The Company reserves the right to not renew the Policy on any Policy Anniversary by written notice and this Policy shall be terminated on such Policy Anniversary.
Part 3: Benefit Provisions
1. Insurance Amount
The Company shall pay an amount determined in accordance with the Policy Schedule to the designated beneficiary in the manner herein provided, immediately upon due proof of the death of any Insured Member in a form satisfactory to the Company.
2. Free Cover Limit
Amount of Sum Assured in excess of the Free Cover Limit as stated in the Policy Schedule or as re-determined at any Policy Anniversary may be accepted. All this, the company reserves the right to require evidence of insurability, and the right to decline or stipulate conditions, for accepting any increase in amount of Sum Assured which is in excess of the Free Cover Limit. In the absence of evidence of insurability satisfactory to the Company, the amount of Sum Assured shall be limited to the Free Cover Limit.
Part 4: General Provisions
1. Entirety of Insurance Contract
This Insurance Contract is based on the Company’s belief in the truth and accuracy of the Policy’s holder and the Insured Member’s statement in the Insurance Application Form, the enrolment form of each Insured member, health declaration and any other additional declarations signed by the Insured Member; 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 Member 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 Policy’s holder and the Insured Member in the document stated under the first paragraph of Entirety of Insurance Contract clause in Part 4.
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 completed only after the Company accepts such amendment and issues its endorsement.
2. Applicable Law
This policy will be governed by and construed according to the laws of the Kingdom of Cambodia.
3. Currency
It is described under “Currency” in the Policy Schedule.
4. Incontestability of Insurance Contract
Notwithstanding anything to the contrary stated heretofore in this Policy, this Policy shall be incontestable or unarguable except for non-payment of premium or the Policyholder has no insurable interest on such insurance, after it has been in force for two year from the Policy Effective Date.
The original insurance on any Insured Members or any subsequent additional insurance shall be incontestable or unarguable except for non-payment of premium or the Insured Member declares incorrectly age that it is out of the age limit according to the business practice, after such insurance has been in force during his lifetime for two year from his Entry Date and the date of each subsequent increase of insurance respectively.
5. Enrolment Form
The Policyholder shall furnish to the Company individual enrolment forms for each Insured Member (if any) in the form prescribed by the Company.
6. Individual Certificates
Unless provided otherwise, the Company shall issue to the Policyholder, for delivery to each Insured, an individual certificate (if any) certifying that such Insured Member has insured under the Policy.
7. Data Required
7.1 The Policyholder shall keep a record with respect to each Insured Member under this Policy, showing the Insured Member’s name, sex, age or date of birth, amount of Sum Assured, Entry Date, the date insurance terminated, beneficiary designation, and other pertinent information as may be necessary to carry out the terms of this Policy.
7.2 Clerical error in keeping the records shall not invalidate insurance otherwise validly in force nor continue insurance otherwise validly terminated, but upon the discovery of such error, an equitable adjustment shall be made.
7.3 The Policyholder shall furnish the Company with documents and proofs, which the Company may reasonably require with regard to any matters pertaining to the Policy. All documents furnished to the Policyholder by any persons in connection with the insurance, and other proofs as may have a bearing on the insurance under this Policy, shall be opened for inspection by the Company at all reasonable times.
8. Premium Rate
The Company shall have the right to change the rate at which the premiums shall be calculated:
8.1 On any Policy Anniversary, or
8.2 The date on which conditions, classification, number of Insured Members, sum assured, or risks is changed substantially from the original, and the Company notifies the Policyholder at least 31 days in advance.
In any event, the Company shall issue to the Policyholder the endorsement notifying such change.
9. Premium Adjustments
Premium adjustments (if any) shall be made on the Premium Due Date unless provided otherwise.
10. Premiums Payments
Premiums are payable by the Policyholder in accordance with the Mode of Payment as specified in the Policy Schedule, in advance or on the Premium Due Date, either at the Company’s Headquarters or at the Branch of the company or to an authorized agent of the Company.
The first premium shall be payable at the Policy Effective Date and subsequent premiums shall be due and payable on the Premium Due Dates determined by the Policy Schedule. All this, the Company shall issue an official receipt for the payment of the premium.
If the Company allows to change payment of premium by an installment less than a year, the amount of the premium of the Insured Member who was dead to be paid to the Company and not yet completed a year shall be an indebtedness which the Company shall deduct it against the proceed under the Policy.
11. Grace Period
A grace period of thirty one (31) days following the Premium Due Date shall be allowed for the payment of any premium and not yet paid by the Policyholder, during which period this Policy shall remain in force. If any premium is not paid before the expiration of the grace period, this Policy shall automatically terminate on the day following the expiration of the grace period unless the Policyholder shall written notify in advance to terminate the Policy before such date. The Policyholder shall be liable to the Company for the premium for the time the Policy was in force during the grace period.
12. Renewal Policy
This Policy is issued for the term of one year and can be renewed at the end of each Policy Year that the Company issues an official receipt for the payment of the premium due on the following Policy Anniversary, to be paid by the Policyholder on that date.
13. Notice of Death and Autopsy
Upon the Insured Member’s death, the Policyholder or the Beneficiary must notify the Company within thirty (30) days from the date of the Insured Member’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 thirty (30) days from the day the Policyholder or the Beneficiary becomes aware of the existence of the Policy.
The Policyholder or the Beneficiary shall provide an official death report or official evidence signifying the death of the Insured Member to the Company, and upon the Company’s reasonable request, the Policyholder or the Beneficiary shall provide any additional documents to the Company at the Policyholder or the Beneficiary’s own expense.
The Policyholder or the Beneficiary shall consent and cooperate for the autopsy of the Insured Member 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 Policyholder or Beneficiary or the Insured Member’s party act in compliance with the requirement(s) hereof.
14. Required Documents for Claim
a. In case of death caused by sickness
1. Completed Death Claim Form
2. Group Insurance Certificate (original copy) (if any)
3. Certified copies of Beneficiary’s ID card and family book and also along with the real ones
4. Certified copy of certificate of death and also along with the real one
5. The consent letter of Beneficiary or heir(s) to disclose personal data
6. Medical report from doctor in case of death in the registered hospital or registered clinic
b. In case of death caused by accident, the above documents are also required with two additional documents as follow:
1. Certified copy of daily record related to the case which is certified by detector
2. Certified copy of Autopsy examination report
15. Payment of Benefits
15.1 If the Insured Member is dead, payment of all benefits under this Policy shall be made at the written request of the designated beneficiary or beneficiaries or at the written request of the Policyholder for disbursement in accordance with the terms of the Policy.
15.2 Payment of any benefits to the beneficiaries shall be a valid discharge to the Company and shall release the Company of all claims and demands whatsoever in respect thereto.
16. Beneficiaries
16.1 Each Insured Member shall designate to the Company a beneficiary or beneficiaries to whom the benefits under this Policy shall be payable in the event of death. If the Insured Member is dead, the Company shall pay the benefits in accordance with the terms of this Policy. If such beneficiary or beneficiaries predecease or decease simultaneously with such Insured Member and the Insured Member has not showed an intention to change the beneficiary, the benefits shall be payable to the heir(s) of the Insured Member. But if there are many beneficiaries and some of them predecease or decease simultaneously with the Insured Member, the benefits shall be payable to the beneficiaries who are alive by equals or by proportions as provided by the Insured Member in his enrolment form.
16.2 The Insured Member shall be entitled to change the beneficiary by providing written notice to the Company, such change shall take effect on receipt of such notice and be accepted by the Company.
17. Suicide / Murder
The Company shall not pay any proceed under this Policy if:
17.1 The Insured Member voluntarily committed suicide within two years after the Entry Date. The Company is bound only to return premiums paid in respect of such Insured Member to the Company.
17.2 The beneficiary intentionally killed the Insured Member. The Company is bound only to return premiums paid of that Policy Year in respect of such Insured Member to the Company.
If there are more than one beneficiary, the Company may pay the proportional proceed to the beneficiary or beneficiaries who not taking part in intentionally killing the Insured Member, after deduct the proportion of the one who kills the Insured Member and is not entitled to receive. The Company shall not return all premiums in connection with this proportion.
18. Misstatement
18.1 If the age or date of birth or other relevant facts relating to an Insured Member shall be found to have been misstated and if such misstatement affects the scale of benefits or has anything to do with the terms and conditions of this Policy, the true age and facts shall be used in determining whether insurance is in force under the terms of this Policy and the benefits payable therefrom; and an equitable adjustment of premiums shall be made.
18.2 Where a misstatement of age has caused the Insured Member to be insured hereunder when he is otherwise ineligible for any insurance, or when he would otherwise be disqualified from the insurance, the Company shall return premiums paid in respect of such Insured Member.
19. Dispute Resolution
In the event of any dispute arising from the Insurance Contract, such dispute shall attempt 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 shall be settled by arbitration pursuant or court system.
20. Exclusions
Exclusions for Death Benefits
Death 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 member or the Beneficiaries 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 of Insured Member claims resulting directly or indirectly from the exclusions a to c, the Company will only refund the total actual premiums paid, without interest, to the heir(s) of the Insured.
In returning the premium or paying the death benefit, the Company is entitled to deduct any outstanding obligations owed under this Policy.