Policy Terms and Conditions

Policy Terms and Conditions

  1. Eligibility for Coverage
    • All application forms must be fully and accurately completed for the member and their dependents, including full names, dates of birth, and identification document numbers.
  2. Dependent Children Limit
    • A maximum of 6 children can be classified as dependents.
    • Children under 21 years (or 26 years if a full-time student) are eligible.
  3. Coverage for Disabled Children
    • Mentally disabled, permanently disabled, and totally disabled children are covered until their death or as long as the principal member remains enrolled in the scheme.
  4. Spousal Coverage
    • The scheme recognizes common-law, civil, and tribal marriages.
    • Only one spouse can be listed as a dependent, provided they are legally or traditionally married to the member.
  5. Accidental Death Coverage
    • Coverage takes effect immediately after the first premium is received.
  6. Claims Submission Deadline
    • Claims must be submitted to Legacy Guard Brokers within 12 months of the death of an assured. Late submissions will not be considered.
  7. Claims Settlement Process
    • Claims will be settled upon receipt of certified documents, including:
      • Death certificate
      • Copies of the deceased’s and claimant’s IDs
      • Underwriter’s Insurance Certificate
      • Any other required documentation
  8. Surviving Spouse as Principal Member
    • If the principal member dies, the surviving spouse can apply to become the new Principal Member by notifying Legacy Guard Brokers in writing.
  9. Suicide Clause
    • No benefit will be paid for deaths resulting from suicide or attempted suicide within:
      • 12 months from policy inception, or
      • 2 years of reinstating a lapsed policy.
  10. Exclusions from Coverage
    Death benefits will not be paid if caused by:
    • 10.1 Terrorism, war, civil unrest, or military conflicts.
    • 10.2 Radioactive contamination, nuclear, biological, or chemical weapons.
    • 10.3 Suicide (unless all policy conditions are met).
    • 10.4 Self-injury, alcohol/drug influence, or insanity (unless medically prescribed).
    • 10.5 Involvement in unlawful activities by the member or dependents.
    • 10.6 Divorced spouses (coverage ceases immediately upon divorce).
  11. Waiting Period for New Members
    • A 6-month waiting period applies to all new members from the policy start date.
  12. Waiting Period for Extended Family
    • Extended family members are subject to a 6-month waiting period, regardless of age.
  13. Definition of Extended Family
    • Includes parents, parents-in-law, and other blood relatives specified by the Principal Member.
  14. Coverage Limits
    • The scheme covers the Principal Member + 15 dependents (spouse, children, and extended family).
    • Child Benefit Payout Structure – In the event of the Principal Member’s death, dependent children will receive a portion of the cover amount based on age:
  15. Age Restrictions for Extended Family
    • Maximum age for extended family: 84 years at joining.
    • Member Plus Groups may include:
      • Up to 4 parents/parents-in-law/grandparents (<84 years).
      • Up to 4 other dependents (<64 years), including uncles, aunts, siblings, and cousins.
  16. Premium Payment Responsibility
    • The Principal Member must ensure monthly premiums are paid on time and in full.
  17. Policy Lapse Conditions
    • Failure to pay 3 consecutive premiums (or arrears equal to 3x premiums) will result in policy lapse.
  18. Required Claim Documents
    Submit the following to claims@legacyguard.co.za:
    • 18.1 Completed Death Claim Notification Form.
    • 18.2 Original death certificate (SAPS-certified).
    • 18.3 Computerized death certificate (no abridged copies).
    • 18.4 Certified copies of IDs (deceased, claimant, and third-party if applicable).
    • 18.5 Beneficiary’s certified ID.
    • 18.6 Certified BI-1663 form (SAPS).
    • 18.7 Bank details & statement of payee/beneficiary.
    • 18.8 Police statement (for unnatural deaths).
    • 18.9 Medical report (stillborns after 26 weeks).
    • 18.10 Marriage certificate (if no spouse listed).
    • 18.11 Proof of children (if none listed).
  19. Additional Documentation
    • Legacy Guard Brokers may request extra documents (e.g., medical records, proof of relationship) depending on the claim.
  20. Common-Law/Religious Marriage Claims
    • Claims for such spouses only valid if they were listed as dependents or added via amendment form before death.
  21. Benefit Payment
    • Valid claims will be paid to the designated beneficiary listed on the policy.
  22. Claims Deadline Reminder
    • Claims must be submitted within 12 months of death; late claims are void.
  23. Fraud & Misrepresentation
    • Legacy Guard Brokers reserves the right to cancel policies and forfeit premiums if fraud is detected. Legal action may follow.
  24. Policy Cancellation by Member
    • Members may cancel within 30 days of policy receipt by submitting a written request.
  25. Cancellation Conditions
    • Cancellation only allowed if no claims were paid or events occurred. Risk cover costs may be deducted.
  26. Refund on Cancellation
    • Premiums will be refunded minus costs incurred during the coverage period.
  27. Complaint Procedure
    • Contact customer service with:
      • 27.1 Policy number
      • 27.2 ID number
      • 27.3 Nature of enquiry
  28. Unresolved Complaints
    • Escalate to the underwriter if unresolved.
  29. Ombudsman Escalation
    • Further disputes may be referred to:
      • FAIS Ombudsman
        • Tel: (012) 470-9080
      • Ombudsman for Long-Term Insurance
        • Tel: (021) 657-5000

Contact Information

  • Legacy Guard Brokers
    • Address: 1st Floor, Liberty Life Building, 21 Aurora Drive, Umhlanga Ridge, 4301
    • Tel: 084 540 1500
    • Email: info@legacyguard.co.za
  • SAFRICAN
  • Rand Mutual Assurance (RMA)
    • Address: RMA House, 6 Wierda Road West, Sandton, Johannesburg, 2196
    • Claims & General Enquiries: 0861 762 526
    • Email: info@rma.co.za