CLAIM PROCEDURE FACT SHEET
Effective October 2012
S A F R I C A N
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Description:
Safrican / Bolokanani must be informed immediately upon the death of any life insured under the On the Go Funeral Benefit Plan.
A Death Claim Notification Form, together with all the necessary supporting documents substantiating the claim, must
be submitted to Safrican within 6 (six) months from the date of death. Failure to do so will result in the benefit being
forfeited.
As it is Safrican’s policy to settle claims promptly, we request the claimant’s co-operation in forwarding the correct and relevant
documents timeously to prevent any unnecessary delays in the processing of the claim.
Documents must be clearly certified by the police or a commissioner of oaths
Documentation
Claims will only be considered upon receipt of all the
necessary documents substantiating the claim,
satisfactory to Safrican’s requirements.
Documents to be submitted:
Claim Notification Form
A fully completed Claim Notification Form, providing the
correct policy number and name of the Principal
Member and of the Deceased. This must be stamped
and signed by the Policyholder (where applicable).
Instructions for payment to the beneficiary must be
clearly shown.
The undertaker’s details should be completed.
Proof of Death
Original computer produced or faxed certified copy of
the Death Certificate (Bl – 5).
or
Original or faxed certified copy of an Unabridged Death
Certificate (BI – 18).
or
Original or faxed certified copy of Abridged Death
Certificate (Bl – 20) in respect of stillborn, together
with supporting medical documents.
and
A copy of the Notification of death (BI-1663)
In the case where the cause of death has been refelected
as Unnatural Causes on the Proof of Death, a Police
Report must be submitted together with the claim
documentation in order for Safrican to assess the nature of
the incident.
Faxed copies of Proofs of Death must be clearly certified.
Documents certified by a Commissioner of Oaths must
clearly reflect the name, signature, organisation, date,
address and telephone number of the Commissioner of
Oaths on the documents.
Documentation submitted other than that requested on this
Claim Procedure Fact Sheet or requested by Safrican, will
not be accepted.
Affidavits are not acceptable.
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In addition to the Claim Notification Form and Proof of
Death, the following supporting documents must be
presented:
(i) Death of a Principal Member
Certified copy of Principal Member’s Identity
Document if a South African citizen, or certified copy of
Principal Member’s Passport if a foreign national
Copy of Principal Member’s payslip for the pay period
immediately prior to death or month in which the death
occurred (Employer Plans only).
Copy of Principal Member’s application form.
Copy of the beneficiary’s bank statement reflecting
Bank name, account number and account holder’s
details
(ii) Death of a Spouse
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Certified copy of deceased’s Identity Document if a
South African citizen, or certified copy of deceased’s
Passport if a foreign national.
Certified copy of Principal Member’s Identity
Document if a South African citizen, or certified copy
of Principal Member’s Passport if a foreign national
Copy of Principal Member’s payslip for pay period
immediately prior to death or the month in which the
death occurred (Employer Plans only).
Principal Member’s application form.
Copy of the beneficiary’s bank statement reflecting
Bank name, account number and account holders
details.
Certified copy of Marriage Certificate.
Copy of any 2 (two) or more of the following documents in
cases where there is no Marriage Certificate or in the case
where the surname of the Spouse differs from that of the
Principal Member:
Marriage Certificate (for cases of surname diference).
Letter from Tribal Chief, signed and stamped.
Company Beneficiary Nomination Form. The
document must have been completed at least 6 (six)
months prior to death (Employer Plans only).
Letter proving customary and/or common law marriage
from the Department of Home Affairs (not an affidavit).
Medical Aid card reflecting dependants details.
Any legal policy document where the Spouse has been
nominated at least 6 (six) months prior to death.
(iii) Death of a Eligible Child:
Certified copy of deceased’s Identity Document if a
South African citizen, or certified copy of deceased’s
Passport if a foreign national.
Certified copy of Principal Member’s Identity Document
if a South African citizen, or certified copy of Principal
Member’s Passport if a foreign national.
Copy of Principal Member’s payslip for pay period
immediately prior to death or the month in which the
death occurred (Employer Plans only).
Copy of Principal Member’s Application Form.
Copy of the beneficiary’s bank statement reflecting
Bank name, account number and account holders
details.
In addition, where the surname of the Elligible Child differs
from that of the Principal Member, 2 (two) of the following
documents will be required:
Full Birth Certificate reflecting both parent’s details ( BI-
19).
Adoption papers.
Baptismal Certificate reflecting both parents’ details (for
Elligible Children age 5 years and younger).
Marriage Certificate and Birth Registration in respect of
stepchildren.
Medical Aid Membership card reflecting the Eligible
Child’s details.
In addition:
If the child has attained age 22 (twenty two) years but has not
yet attained age 26 (twenty six) years and is a FULL-TIME
student, the following must be submitted:
Confirmation satisfactory to Safrican (e.g. last academic
report), from a recognised educational institution, to
confirm full-time study at the time the death occurred.
Part-time and correspondence students are not covered.
If the child is mentally retarded or totally and permanently
disabled (as determined by Safrican), before age 22 years,
and is unable to care for themselves, any 1 (one) of the
following must be submitted:
Confirmation satisfactory to Safrican of State Disability
Grant.
Medical Aid application of Principal Member.
Medical Report.
(iv) Death of a Stillborn Child:
Proof of existence must be submitted by way of any 1 (one)
of the following:
Clinical records (Road to Health Chart)
Medical records
Antenatal records
Proof of relationship of the Stillborn Child to the Principal
Member must be submitted by way of any 1 (one) of the
following:
Certified copies of Identity Documents of both parents if
South African citizens, or certified copy of Passports of
both parents if foreign nationals
Medical Aid card of the Principal Member.
Company Beneficiary Nomination Form.
Affidavits from both parents with certified copies of their ID
documentation (only in case of stillbirths where no Home
Affairs documentation is available).
Copy of the beneficiary’s bank statement reflecting Bank
name, account number and account holders details.
(v) Death of Extended Family:
Certified copy of Principal Member’s Identity Document if
a South African citizen or certified copy of Principal
Member’s Passport if a foreign national.
Certified copy of deceased’s Identity Document if a South
African citizen, or certified copy of deceased’s Passport if
a foreign national.
Copy of Principal Member’s payslip for pay period
immediately prior to death or the month in which the death
occurred (Employer Plans only).
Certified Copy of Extended Family application form (must
have been submitted to Safrican at inception of the policy
or when the Principal Member joined the plan).
Copy of Principal Member’s Application Form.
Copy of the beneficiary’s bank statement reflecting Bank
name, account number and account holders details.
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(vi) Death of a Domestic Assistant:
Certified copy of Principal Member’s Identity Document
if a South African citizen, or certified copy of Principal
Member’s Passport if a foreign national
Certified copy of deceased’s Identity Document if a
South African citizen, or certified copy of deceased’s
Passport if a foreign national
Certified copy of Principal Member’s payslip for pay
period immediately prior to death or the month in which
the death occurred (Employer Plans only).
Certified Copy of Domestic Assistant’s Application Form
(must have been submitted to Safrican at inception of
the policy or when the Principal Member joined the
plan).
Copy of the beneficiary’s bank statement reflecting Bank
name, account number and account holders details.
IMPORTANT:
Application Forms:
All Principal Members must submit Application Forms to
Safrican for record purposes at inception of any policy or
when joining a scheme.
Extended Family Benefit Application Forms must be
submitted where applicable. In the event that Application
Forms were not submitted to Safrican, the benefit may be
forfeited.
Paid-up Benefits for dependants (if applicable):
A certified copy of the Marriage Certificate and Identity
Document of the surviving Spouse, together with a
certifed copy of the Birth Certificates and/or Identity
Documents for the dependants, must be attached to the
Claim Notification Form at claim stage.
Insurable Interest
Please note that all persons insured under the policy must be
related to the principal member and/or policy payer, and the
principal member and/or policy payer must have an insurable
interest in all insured persons under the policy.
Procedure
Substantiating a Claim
Once all the documents have been received, claims
procedures are followed whereby Safrican confirms the
validity of the claim:
Premiums must have been paid up to date. Should a
Principal Member have underpaid his / her premium,
the benefit payable in respect of a claim, will, at
Safrican’s discretion, be reduced in proportion to the
underpayment, or the premium may be refunded and
no claim liability admitted.
All the terms and conditions relating to the Plan must
have been met.
All required documents must have been received by
Safrican within the 6 (six) month period from the
date of death.
Provided ALL the necessary documentation and information
pertaining to the claim have been submitted and the
premiums are up to date, Safrican will endeavour to settle
such claims within 48 (forty eight) hours of receipt of ALL of
the claim and supporting documents.
Pending Claims
On receipt of a claim, a checklist procedure is followed. If
relevant information or any document is found to be
outstanding, a ‘Pending' status will only apply until the
6 (six) month notification period has elapsed. This status and
outstanding requirements will be communicated to the
claimant in writing. It is important that the outstanding
documents be furnished within 6 (six) months from the
date of death in order to enable processing of the claim.
Delay or failure to comply with these requirements will result
in the benefit being forfeited.
Settlement of Claims
To facilitate the settlement of a claim, it is important to
indicate the preferred method of payment.
By Cheque:
Indicate on the Claim Notification Form to whom the
cheque must be made payable, whether it is to be
collected, and by whom, together with this person’s
identity r document. If the cheque is to be posted, the
postal addr ess must be provided. The claimant shall
bear the risk of postage in such cases.
It is important that the Beneficiary presents their
Identity Document (if a South African citizen) or
Passport (if a foreign national) when collecting a
cheque from any of the Safrican offices. Drivers’
Licence Cards will not be accepted.
Electronic Funds Transfer (EFT):
If by way of EFT directly into the Policyholder or
beneficiary’s bank account, the following information
must be provided:
Certified copy of beneficiary’s Identity Document if a
South African citizen, or certified copy of
beneficiary’s Passport if a foreign national
Name of Bank
Branch Code
Name of account holder
Bank account number.
Benefits are payable directly to the Policyholder /
Principal Member of the Plan or his/her beneficiary as
instructed on the Claim Notification Form.
Ancillary benefits
S A F R I C A N
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Paid-up Benefits (if applicable)
In respect of a death claim for any person covered under
Paid-up Benefits, the Paid-up Certificate will be issued
after all documentation have been received by Safrican.
These must be received by Safrican within 6 (six) months
of the date of death for Paid-up Benefit on Death, and
within 3 (three) months of the date of disability or
retirement for Paid-up Benefit on Disability or Retirement.
A certified copy of the Marriage Certificate and Identity
Document of the surviving Spouse, together with a
certifed copy of the Birth Certificates and/or Identity
Documents for the dependants, must be attached to the
Claim Notification Form at claim stage.
Memorial Benefit (if applicable)
On the first anniversary date of the death of a Principal
Member or Spouse, the Memorial Benefit becomes
payable.
The Benefit is only payable to the deceased’s next of
kin, who must be able to provide proof of their relation to
the Principal Member or Spouse.
It is important that when the Death Claim is submitted,
that the settlement details are correct and will have been
given to the beneficiary to present on due date as
reflected on the Memorial Certificate.
If this Benefit is not claimed within 3 (three) months of
the anniversary of the date of death, as reflected on the
Memorial Certificate, the Benefit will be forfeited.
Accidental Death Benefit (if applicable)
In respect of an Accidental Death Benefit claim, together
with the documentation as required for the category of a
Principal Member and/or Spouse, a medical report from a
medical specialist and/or a police report must be
submitted to Safrican. The report must clearly indicate
how, when and where the bodily injury was sustained.
Incapacitation Benefit (if applicable)
A Claim Notification Form reflecting the claimants
details, as well as, payment details must be submitted
to Safrican within 6 (six) months of the occurrence
of the event.
A medical report from a medical specialist,
Workman’s Compensation Claim Assessment and/or
a police report must be submitted to Safrican. The
report must clearly indicate how, when and where the
bodily injury was sustained.
Foreign Death Certificates
Should the deceased be a South African Citizen (or
possess a S.A. Identity number) and die in a foreign
country, we would require a South African Death
Certificate.
Safrican / Bolokanani reserves the right to request
further documentation or information as it may deem
necessary to accurately assess the claim.
Safrican Insurance Company Limited
Reg No. 1935/007463/06
An authorised Financial Services Provider
FSP No. 15123
www.safrican.co.za
Should you require assistance with claims, kindly contact
Bolokanani on:
Head Office:
PO Box 14284 Farrarmere, 1518
26 Edward Street, Westdene, Benoni, 1501
Tel: (011) 420 2200 / 0860 104 851 / Fax: (011) 420 2230
e-mail: info@bolokanani.com
Bolokanani Brokers & Consultants (Pty) Ltd
Reg No. 1997/022480/07
An authorised Financial Services Provider
FSP No. 25288 - www.bolokanani.com