Group Scheme (Masakhane) Application

Masakhane Application Form Explained

1. PERSONAL DETAILS:

Complete ALL of the Main Member and Spouse’s details.
(Remember that the Spouse and the Main Member should be married. Either legally, traditionally, or common law Husband and Wife.)

2. EXTENDED FAMILY MEMBERS:

Depending on which Plan you choose (Plan A, Plan B or Plan C) give your extended Family Members details.

• PLAN A – UP TO 4 ADULTS FOR THE MENTIONED PRICE
• PLAN B – UP TO 6 ADULTS FOR THE MENTIONED PRICE
• PLAN C – UP TO 8 ADULTS FOR THE MENTIONED PRICE

Extra members can be added, but at an additional fee.

3. CHILDREN:

IMPORTANT!!!! The children you add, must be the Main Member and Spouse’s own children ONLY!!

• PLAN A – UP TO 10 CHILDREN
• PLAN B – UP TO 10 CHILDREN
• PLAN C – UP TO 15 CHILDREN

4. PRICING AND SIGNATURE:

• Choose your plan, sign the form where it says, “Signature of Main Member” and write the date.
• At “Signature of Representative”, a HlalaNathi representative will sign here.

5. POINT NO. 5, HLALANATHI TO COMPLETE.

6. PLEASE READ POINT 6!!

Group Scheme Terms and Conditions

1. Premiums must be paid on or before the 7th of each month.
2. Premiums that are not paid by the 7th of each month will show as arrears.
3. If there is an arrears amount on your society, no claim will be paid out.
4. If your society is in arrears for more than 2 months, you will have to join again and a new joining fee will have to be paid, and the society will go into a 6 month waiting period.
5. The 6 months waiting period is six full calendar months.
6. In the event of material information regarding the assurance risk and related statistics, subsequently becoming available prior to our liability for such risk commencing on or thereafter, we have the right to withdraw the quotation on conditions and / or revise it and / or cancel it from inception.
7. The date from which this guarantee is effective will be determined by HlalaNathi Funerals cc after all necessary documentation has taken place and the first premium has been paid. Submitting the book as proof, is not starting the claim process.
8. All funeral services will be conducted by HlalaNathi Funerals cc.
9. HlalaNathi Funerals cc may amend any of the premium rates, terms and conditions of this insurance by giving 30 days written notice of such changes to the insured.
10. There are no surrender values attached to this policy.
11. Suicide will not be covered during the first two years of membership.