PERSONAL INSURANCE PROPOSAL
   
THE PROPOSER

 
Title Initials
Name Surname
Date of Birth ID Number
Passport Number (if non SA Resident) Postal Address
Code
Contact Details  
Work Home
Fax Cell
Email
 
PAYMENT OPTIONS AND BANKING DETAILS
Premium Payment Method Annually   Monthly debit order
If paying monthly, date for debiting of premiums 1st   7th   15th
Debit Order Account
Bank
Branch
Branch Code
Account Number
Account Type Cheque Transmission Savings
Account Holders Name
Account Holders Signature
 
GENERAL INFORMATION (Applicable to all sections)
Inception date of this insurance
Physical address of your private residence
Residence 1 Residence 2
Code Code

The following to be completed if cover is required for for Household Contents, Buildings or All Risks Section.
Type of Residence Residence 1 Residence 2
Smallholding / Farm Yes No Yes No
Detached House Yes No Yes No
Granny Flat Yes No Yes No
Residential Complex Yes No Yes No
Apartment / Flat - Ground, first or second floor Yes No Yes No
Apartment / Flat - Above Second Floor Yes No Yes No
CONSTRUCTION
Are the Dwelling(s) built with walls of brick, stone or concrete and roofed with slate, tiles, concrete, asbestos or metal? Yes No
If No, specify the construction Walls
  Roof
If the roof is constructed of thatch, is an SABS lightning conductor installed? Yes No
Are the Outbuilding(s) built with walls of brick, stone or concrete and roofed with slate, tiles, concrete, asbestos or metal? Yes No
If No, specify the construction Walls
  Roof
If the roof is constructed of thatch, is an SABS lightning conductor installed? Yes No
PLEASE NOTE
In respect of Dwellings roofed with thatch it is a requirement that an SABS lightning conductor is installed. It is
also a requirement that a minimum of one 3kg CO2 or 4.5kg Dry Powder Fire Extinguisher be installed in both the kitchen and
the garage. If the Dwelling is more than one storey, a further extinguisher is required to be installed on the upstairs landing.
 
OCCUPATION
Will the residence be left unoccupied
For more than 7 consecutive days within the first 30 days? Yes No Yes No
During working hours? Yes No Yes No
For more than a total of 60 consecutive days In a 12 month period? Yes No Yes No
Is the residence a Holiday Home? Yes No Yes No
Is the Dwelling undergoing alterations? Yes No Yes No
Will the residence be hired or let out or used as a commune? Yes No Yes No
If yes, provide details
 
The Property insured in terms of this policy includes business goods and equipment which are Your property or for which You
are responsible whilst contained in the Dwelling(s) or Outbuilding(s) at the risk address up to an amount of fifty thousand
Rand (R50, 000) or 30% of the sum insured under this section, whichever is the lesser.
     
Do you conduct any business activities from your home? Yes No Yes No
If Yes, provide details of nature of business
Details of type of stock and equipment
Value of stock and equipment
SECURITY
Are there burglar bars on all ground, first and second floor opening and louvre windows and including windows of flats that are on a common passageway? Yes No N\A Yes No N\A
Are there security gates on all external glass panelled Doors? Yes No N\A Yes No N\A
Are there security gates on all external sliding doors? Yes No N\A Yes No N\A
Are there locking devices in addition to the frame lock on all external sliding doors? Yes No N\A Yes No N\A
Is the perimeter of your property walled/fenced with a wall or steel fence of at least 1.8m in height? Yes No N\A Yes No N\A
Is the Dwelling protected with a SAIDSA approved Burglar Alarm System linked to a 24-hour control room with armed response which is made fully operational when the Dwelling is unoccupied? Yes No Yes No
If yes, please advise name of service provider
Are there any of the following within 1km radius?
Informal Settlement Yes No Yes No
Are there any of the following adjacent or within the immediate vicinity of the risk address?
Taxi Rank Yes No Yes No
Vacant Ground / Park / Sports Facilities Yes No Yes No
HIGH SECURITY LIVING
Does the dwelling comply with the following requirements? Yes No Yes No
 
Property is fully walled with an electrified fence a minimum of 1.8 meters in height and 24 hour manned security with
supervised entry and exit from the property.
 
HOUSEHOLD CONTENTS                    
Do you require this insurance? Yes No  
 
The Inventory form included in this proposal can assist you in determining the correct sum insured.
     
Type of Residence Residence 1 Residence 2
Sum Insured in respect of household goods and personal effects (Insure for new Replacement Costs)
Cover Required Yes Limited Yes Limited
PLEASE NOTE
Limited Cover excludes any loss or damage caused by theft or attempted theft and various extensions covered by Full cover.
Optional Cover    
Accidental Damage - Household goods excl personal effects (Extended Cover) Yes No Yes No
See attached annexure for details below
If you want to increase the sum insured from 10% of the Household Contents sum insured, please specify sum insured required
     
Waiver of Basic First Amount Payable
 See details below		 Yes No Yes No
 
Waiver of First Amount Payable
The Basic First Amount Payable as stated in the Schedule will be waived. Any other First Amounts Payable remain applicable
This optional cover is included automatically without additional premium if the insured is 65 years of age or older.
     
Voluntary First Amount Payable
See details below		 Yes No Yes No
 
Voluntary First Amount Payable
In order to reduce your premium you may agree to pay the first 10% of each claim with a minimum of R5,000. This First Amount
Payable is in addition to any Compulsory First Amount Payable.
   
BUILDINGS                                  
Do you require this insurance?                  Yes No
 
Sum Insured (Include buildings, Outbuildings and other structures for Replacement Value).
       
Residence 1 Residence 2
PLEASE NOTE

Sum Insured should include additional costs which may be required for

    • Demolishing the Dwelling, removing debris of such Dwelling from the site and erecting hoardings required for building
      operations.

    • Architects, quantity surveyors and consulting engineers fees and local authorities scrutiny fees.

    • Compliance with the requirements of any public authority following loss or damage to the Dwelling by an Insured Event.
Is the Dwelling bonded? Yes No Yes No
If Yes, name of bond holder
 
OPTIONAL COVER (Tick options required)
Accidental Damage (Extended Cover) Yes No Yes No
See details below in attached annexure
     
Subsidence and Landslip (Extended Cover) Yes No Yes No
See details below in attached annexure
     
Waiver of Basic First Amount Payable Yes No Yes No
See details below   
 
Waiver of First Amount Payable
 
The Basic First Amount Payable as stated in the Schedule will be waived. Any other First Amounts Payable remain applicable.
 
This optional cover is included automatically without additional premium if the insured is 65 years of age or older.
     
Voluntary First Amount Payable Yes No Yes No
See details below
 
Voluntary First Amount Payable
In order to reduce your premium you may agree to pay the first 10% of each claim with a minimum of R5,000. This First Amount Payable is in addition to any Compulsory First Amount Payable.
   
ALL RISKS (WORLDWIDE)                                    
Do you require this insurance?                Yes No  
UNSPECIFIED PROPERTY means

    – Clothing.

    – Personal effects normally worn or designed to be carried on or about the person.

    – Personal equipment normally worn or used by the person for participating in sporting activities (but excluding
       damage to sporting equipment occurring during the course of use).

Property specifically excluded under Unspecified Property are

    1.1 more than twenty five percent ( 25%) of the sum insured stated in the All Risks Section per item, pair or set.

    1.2 vehicle sound equipment, compact disc (CDs), digital video discs (DVDs), cassette tapes, ipods, MP3 players, GPS, tracking
     devices, cell phones or any other hand-held electronic device or cameras.

    1.3 sunglasses, contact lenses, stamp/coin collections, contents of caravans, pedal cycles, tools, camping equipment, golf clubs.
     
Unspecified property Sum insured (Min R10, 000)
 
SPECIFIED PROPERTY
Cell phones – please include IMEI Number (can be obtained by dialling *#06# on your cell phone.)
  Please print item description and include a make and model where applicable. Replacement value
 
   
   
Is cover on any of the items to be restricted to whilst contained in a safe bank deposit? Yes No
If yes, please advise as reduced rates will apply .  
PLEASE NOTE

Jewellery Safe Clause

Any item, pair or set of jewellery including watches that has a value greater than twenty five thousand Rand (R25, 000) must
be kept in a securely locked wall or floor-mounted safe whilst not in use failing which We will not pay more than ten thousand
Rand (R10, 000) per item, pair or set.

Jewellery Certificate

No article of jewellery, gold, silver, platinum, precious or semi-precious stones or watches shall be deemed to be valued at more
than two thousand five hundred Rand (R2500) unless You provide us with a valuation certificate from a registered jeweller.
   
ELECTRONIC EQUIPMENT                          
Do you require this insurance?                 Yes No      
  Hardware Software  
Make, Model & Serial No Sum insured Sum insured Is item portable e.g. laptop / notebook
Yes No
 
OPTIONAL COVER (Tick options required)
Reinstatement of data -
See details below in attached annexure.		 Yes No
If Yes, please state sum insured required.    
       
MOTOR CAR / LIGHT DELIVERY VEHICLE                    
Do you require this insurance?                 Yes No
 
A copy of the licence/registration papers must be attached for each Vehicle for which cover is required.
  Vehicle 1 Vehicle 2
Make and Model
Year of Manufacture
Vehicle registration number
Engine Number
VIN Number
Name and Surname of the registered owner
Name and Surname of usual driver
Relationship of the usual driver to you
Date of birth of usual driver
ID number (or Passport No if not SA citizen) of usual driver
Year in which licence of the usual driver was first obtained
Does the usual driver have a (minimum 3 year) Degree /diploma? Yes No Yes No
If Yes, specify degree /diploma
Does the usual driver or any person who may drive the vehicle suffer from defective vision, hearing or from any physical or mental infirmity? Yes No Yes No
If Yes, provide details
Has the usual driver or any person who to your knowledge will drive the vehicle had a conviction or paid an admission of guilt fine for a driving offence in
the past 3 years or is there any prosecution pending?		 Yes No Yes No
If Yes, provide details
Retail value (excluding extras and non standard factory fitted  extras)
Do you want to include Vehicle extras? (e.g. alloy wheels) Yes No Yes No
If Yes, give details & prices of extras.
Do you want to include any non standard factory fitted items (e.g. sound equipment). Yes No Yes No
If Yes, give details of extras Make, Model & value to be included
Has the vehicle been modified to alter the performance level Yes No Yes No
If Yes, provide details
Is the Vehicle a rebuild (Code 3) Yes No Yes No
Cover Required Comprehensive
Third Party Fire & Theft
Third Party Only 		Comprehensive
Third Party Fire & Theft
Third Party Only
Class of Use

    
Use 1 (Motor Vehicles, Light delivery Vehicles and Motorcycles) Yes No Yes No
 
The vehicle may only be used for social, domestic, pleasure purposes and traveling to and from Your place of employment, excluding business or professional purposes, commercial traveling, hiring, carriage of passengers for hire, carriage of fare paying passengers, driving instruction or towing for reward, racing, speed or other contests, rallies, trials or use for any purpose in connection with the motor trade.
     
Use 2 (Motor Vehicles only) Yes No Yes No
 
The vehicle may only be used for social, domestic, pleasure, business and professional purposes including commercial traveling but excluding hiring, carriage of passengers for hire, carriage of fare-paying passengers, driving instruction or towing for reward, racing, speed or other contests, rallies, trials or use for any purpose in connection with the motor trade.
     
Use 3 (Light Delivery Vehicles and Motor Cycles only) Yes No Yes No
 
The vehicle may only be used for social, domestic, pleasure, business and professional purposes including commercial traveling but excluding hiring, carriage of passengers for hire, carriage of fare-paying passengers, driving instruction or towing for reward, racing, speed or other contests, rallies, trials or use for any purpose in connection with the motor trade.
 
The term ‘motor trade’ does not include periods when the Vehicle is in the custody or control of any member of the motor trade for the purpose of its maintenance or repair.
     
Are you entitled to a no-claim bonus or claim free group? Yes No Yes No
If Yes, state number of years
Is the vehicle fitted with a Security System installed by the vehicle manufacturers (VSS compliant)? Yes No Yes No

Is the vehicle fitted with a VESA APPROVED		   
Immobiliser
If yes specify level of immobilliser 		Yes No Yes No
Gearlock Yes No Yes No
Tracking and recovery device
If yes specify type 		Yes No
Yes No
If Yes, attach a copy of the certificate from the service provider
Is the vehicle kept in a locked garage / or behind locked dates overnight? Yes No Yes No
If No, where is it kept?
Does the vehicle or the windscreen have existing damage Yes No Yes No
If Yes, provide details
Is the vehicle subject to a finance agreement Yes No Yes No
If Yes, state the finance house
    
OPTIONAL COVER AVALABLE FOR COMPREHENSIVE INSURANCE (Tick options required)
Waiver of First Amount Payable
See details below (not applicable to persons under 25 years of age)		 Yes No Yes No
 
Waiver of First Amount Payable
The Basic Theft / Hijack and Single Vehicle Accident First Amounts payable will be waived. Any other First Amounts Payable remain applicable.
     
Car Hire Extension – Extended Cover
Details below

 Yes No Yes No
If Yes, number of days required 14 30 14 30
If Yes, hire of car or LDV Car LDV Car LDV
 
Car Hire Extension – Extended Cover – Applicable to Comprehensive Cover Only
( This extension is automatically included for Comprehensive policies )
See attached annexure for details.
     
Voluntary First Amount Payable Yes No Yes No
 
In order to reduce your premium you may agree to pay an additional First Amount Payable of 5% of cost of claim with a minimum of R2000. This Voluntary First Amount Payable is in addition to any Compulsory First Amount Payable.
     
Credit Shortfall (Limited to 20% of retail value)
See attached annexure for details.		 Yes No Yes No
 
 
MOTOR CYCLE                                                                    
Do you require this insurance? Yes No  
A copy of the licence/registration papers must be attached for each Motor Cycle for which cover is required.
     
  MOTOR CYCLE 1 MOTOR CYCLE 2
Registration Number
Make and Model
Year of manufacture
Engine Number
VIN Number
Name and Surname of registered owner
Name and Surname of usual driver
Relationship of the usual driver to you
Date of birth of usual driver
ID number (or Passport No if not SA citizen) of usual driver
Year in which licence of the usual driver was first obtained
Does the usual driver have a (minimum 3 year) Degree /diploma? Yes No Yes No
If Yes, specify degree /diploma
Does the usual driver or any person who may drive the vehicle suffer from defective vision, hearing or from any physical or mental infirmity? Yes No Yes No
If Yes, provide details
Has the usual driver or any person who to your knowledge will drive the vehicle had a conviction or paid an admission of guilt fine for a driving offence in the past 3 years or is there any prosecution pending? Yes No Yes No
If Yes, provide details
Retail value (excluding extras and non standard factory fitted extras)
Has the vehicle been modified to alter the performance level Yes No Yes No
If Yes, provide details
Cover required Comprehensive
Third Party Fire & Theft
Third Party Only 		Comprehensive
Third Party Fire & Theft
Third Party Only
Use 1 Yes No Yes No
The vehicle may only be used for social, domestic, pleasure purposes and traveling to and from Your place of employment,
excluding business or professional purposes, commercial traveling, hiring, carriage of passengers for hire, carriage of fa repaying
passengers, driving instruction or towing for reward, racing, speed or other contests, rallies, trials or use for any
purpose in connection with the motor trade.
Use 2 Yes No Yes No
The vehicle may only be used for social, domestic, pleasure, business and professional purposes including commercial
traveling but excluding hiring, carriage of passengers for hire, carriage of fare-paying passengers, driving instruction or towing
for reward, racing, speed or other contests, rallies, trials or use for any purpose in connection with the motor trade.
 
The term ‘motor trade’ does not include periods when the Vehicle is in the custody or control of any member of the motor trade for the purpose of its maintenance or repair.
     
Is the motor cycle a 2 wheel cycle? Yes No Yes No
If No, provide details
Is the motor cycle registered for road use? Yes No Yes No
Does the motor cycle have existing damage? Yes No Yes No
If Yes, provide details
Are you entitled to a no-claim bonus or claim free group? Yes No Yes No
If Yes, state number of years
Is the motor cycle kept in a locked garage / or behind locked dates overnight? Yes No Yes No
If No, where is it kept
Is the motor cycle subject to a finance agreement? Yes No Yes No
If Yes, state the finance house
OPTIONAL COVER AVAILABLE FOR COMPREHENSIVE COVER Yes No Yes No
Voluntary First Amount Payable Yes No Yes No
 
In order to reduce your premium you may agree to pay an additional First Amount Payable of 10% of cost of claim with a minimum
of R1000. This Voluntary First Amount Payable is in addition to any Compulsory First Amount Payable in order to reduce your premium you may agree to pay an additional First Amount Payable of 10% of cost of claim with a minimum of R1000. This Voluntary First Amount Payable is in addition to any Compulsory First Amount Payable.
     
Credit Shortfall (Limited to 20% of retail value)
See attached annexure for details		 Yes No Yes No
 
Waiver of First Amount Payable
See details below (not applicable to persons under 25 years of age)		 Yes No Yes No
 
Waiver of First Amount Payable
The Basic First Amounts payable will be waived. Any other First Amounts Payable remain applicable.
 
TRAILER / CARAVAN                                                    
Do you require this insurance? Yes No  
Name and Surname of registered owner  
Retail Value  
Registration Number  
Make and Model  
Year of manufacture  
VIN Number  
Is the trailer/caravan kept in a locked garage / or behind locked dates overnight? Yes No 
If No, provide details  
Does the trailer/caravan have existing damage? Yes No  
If Yes, provide details  
Is the trailer / caravan subject to a finance agreement? Yes No  
If Yes, state the finance house  
PLEASE NOTE – Cover excludes contents. Contents may be insured under the All Risks Section
 
PERSONAL LIABILITY                                        
  Do you require this insurance? Yes No  
Included automatically for Limit of Liability of R 10,000,000 if Household Contents or Buildings Section included.
     
OPTIONAL COVER (Tick options required) Residence 1 Residence 2
Business Liability R1,000,000 (See Annexure) Yes No Yes No
     
PERSONAL ACCIDENT                                        
Do you require this insurance? Yes No  
 
Death and Permanent Disablement benefits included automatically for R50, 000 for You and Your Partner as named in the ...?. You may select to increase this amount.
 
Persons to be insured (We cannot offer this cover to persons over the age of 70).
     
Name and Gender Male Female Male Female
Occupation
ID Number
Relationship to You
Optional Benefits required
Increased Death (Compulsory Benefit)
Permanent Disablement (cannot exceed the Death Benefit)
Temporary Total Disablement (Max 104 weeks) per week
Medical Expenses
Has any person to be insured suffer from defective vision or hearing or from any physical or mental infirmity? Yes No Yes No
If Yes, provide details
Do you wish to nominate a beneficiary? Yes No Yes No
If Yes, state name and ID number
     
WATER CRAFT                                                
Do you require this insurance? Yes No  
If Yes, please complete separate proposal.
     
LEGAL COSTS                                                     
Do you require this insurance? Yes No  
Limit of Liability of R 10,000
Do you want to increase this limit to R50, 000?		 Yes No  
Are you aware of the existence of any circumstances likely to give rise to the payment of legal fees or expenses? Yes No
If Yes. provide details
     
Enroute™ In-Car Insurance     
Do you require this insurance? Yes No  

Cover is on a specified vehicle basis and provides Death, PTD, TTD, Medical Expenses and Trauma cover for the occupants of the vehicle.  There is cover automatically for 5 occupants of the vehicle including the driver, however cover for additional passengers can be purchased.

     
Compendium Assist                          
Do you require this insurance? Yes No  

This benefit provides Roadside Assistance from the AA as well as a maximum of 2 call outs per year for emergency home assistance.

     
Paintless Dent Removal           
Do you require this insurance? Yes No  
PDR is an innovative service that removes small dents from your car quickly and cost-effectively.
 

Service excludes: accident damage where bodywork and paintwork require traditional panel beating and/or body part replacement; hail damage; general scratches requiring partial or total re-spray. These damages must be claimed for under your vehicle's insurance policy. Offer does not extend to commercial vehicles.
     
Vehicle Registration Number  
     
Funeral Benefit                          
Do you require this insurance? Yes No  

We will pay a cash benefit as stated below following the death of:-

  • The Insured ,the Insured’s spouse, the Insured’s children, the children of the Insured’s spouse.
  • A domestic employee employed and registered by the Insured or the Insured’s spouse.

Benefit payable

Any person fourteen (14) years of age or older          – R10,000
Any person under the age of fourteen (14 )                 – R7,500

Provided that
  • This benefit is not applicable to any domestic employee over the age of sixty five (65) years or any other person over the age of seventy five (75) years.
  • Unmarried children will be covered until they reach the age of twenty one (21) years.
  • Unmarried children aged twenty one (21) years to twenty four (24) years who are full time students at a recognized educational institution will be covered subject to proof being received from such educational institution.
  • This benefit is not applicable to children not living with the Insured unless the Insured or spouse is legally responsible for such child or children.
  • Cover only applies to persons residing in South Africa.
 
DECLARATION
1 What is the name of your employer?  
2 What is the nature of their business?  
3 In what capacity are you employed?  
4 Have you previously been insured? Yes No  
If Yes, supply the policy number and names of insurance companies
   
5 Have you or any member of your household had any application for insurance declined or insurance cancelled or renewal refused or not invited or had special conditions imposed ?

 Yes No
   
If Yes, provide details
during the past 3 years have you or any member of your household been involved in a motor accident or suffered any other losses (for example – a burglary, or lost a camera etc)?
 Yes No
 
If Yes, please give the amount of the loss and describe what happened. Also give the names of the insurance companies and policy numbers if you were insured at the time. Claims repudiated must be mentioned.
 
   
been involved in any civil or criminal litigation in the past 3 years or have you had a civil judgment against you? Yes No
If Yes, provide details  
 

DECLARATION

I warrant that the answers given are true, and I do not know of any material facts, even though specific questions about them have not been asked, that should be communicated to the Insurer.

Sharing of insurance information

To enable the insurers to underwrite risk fairly, I consent to the insurers verifying and sharIng policy information with insurers
and other institutions as well as accessing credit information held by other institutions.

If you are unable to sign this declaration without qualification, please give your reasons here.

I warrant that the answers given are true, and I do not know of any material facts, even though specific questions about them
have not been asked, that should be communicated to the Insurer.
     
CONTRACT OF APPOINTMENT
     
BETWEEN COMPENDIUM INSURANCE GROUP (PTY) LTD AND
     
This document contains the following:
  1. Disclosure Notice
  2. Statement of Terms of Business
  3. Complaints Procedure
     
DISCLOSURE NOTICE
INFORMATION ABOUT THE INTERMEDIARY  
Compendium Insurance Group (Pty) Ltd (referred hereafter as “Compendium”) is a registered Financial Services Provider under licence numbers 10409 and 10405, is a member of the Financial Intermediaries Association and possesses an Intermediaries Guarantee Facility, as well as Professional Indemnity cover. We also have Directors’ and Officers’ Liability and Fidelity Guarantee Cover.
     
Compendium’s contact details
2nd Floor, Compendium House
5 The Crescent, Westway Office Park
Westville
Kwa-Zulu Natal
South Africa
     
Tel: 031 2426 800
Fax: 031 2426 850
E-mail: info@cig.co.za
Website: www.cig.co.za
     
Legal status:    
Private Company with limited liability.    
     
IN THE INTERESTS OF DISCLOSURE

Compendium Investment Holdings (Pty) Ltd is the major shareholder of Compendium. The Hollard Insurance Company has a 30% equity stake in Compendium Investment Holdings (Pty) Ltd.

Cignet Administration Services (Pty) Ltd is a subsidiary of Compendium Investment Holdings (Pty) Ltd and receives remuneration for various administrative duties performed on behalf of several Insurance Companies.

The ultimate decision in regard to your policy / policies, premiums and claims is made by your Insurer. They are subject to the ruling by the Registrar of Short Term insurers and the Short Term Insurance Ombudsman.

Compendium does not receive more than 30% of its revenue from any one Insurer.
     
COMPENDIUM UNDERTAKES TO:
  • Deliver services honestly and with diligence.
  • Protect the Client’s insurance interests.
  • Communicate information that is clear, factually correct and not misleading.
  • Manage conflicts of interests and disclose the same to the Client.
  • Provide information that allows the Client to make an informed decision.
  • Deal with Client information in a confidential manner.
     
COMPENDIUM WILL:
  • Explain the scope of cover, the costs involved as well as any significant restrictions, exclusions or conditions that
    may apply.
  • Arrange cover in accordance with the Client’s instructions, disclose details of the participating Insurers and provide
    the Client with a policy together with all related documentation.
  • Ensure that premiums received from the Client, in terms of cover provided by the policy, are paid over to Insurers.
  • Provide the Client with guidance on instituting a claim under the provisions of the policy, manage the claim and
    update the Client on the progress.
  • Upon receipt of the Insurers claim's settlements, make payment to the client on behalf of the Insurer.
  • Disclose commission and fee earnings flowing from the Client’s insurances.
     
AS THE CLIENT, I UNDERTAKE TO:
  • Disclose all material information when obtaining cover. (Information is deemed “material” if it could affect the
    Insurer’s assessment of the risk). Insurers have the right to void the policy and reject claims should any information
    deemed material be omitted or misrepresented.
  • Accept ultimate responsibility for the accuracy of the information submitted to Compendium or the Insurers, and
    shall have no claim against Compendium for any damage, financial or otherwise, arising from the failure to submit
    information deemed to be material, including belated submissions.
  • Notify Compendium of any changes to my / our risk profile or business throughout the term of the policy.
  • Submit all instructions to Compendium in writing. Oral communication must be followed up with a written
    instruction.
  • Complete a proposal form and / or risk questionnaire where required by Compendium and / or the Insurer.
  • Pay premiums on time in accordance with the payment terms, remembering that non-payment or late payment
    may result in the prejudicing of a claim.
  • Report incidents, which may give rise to a claim, to Compendium.
  • Act in good faith at all times.
     
HOW TO INSTITUTE A COMPLAINT

Any complaint must be reported to the Compendium Complaints Department. Compendium undertakes to
investigate the complaint fully and register it in their complaints register. Contact:

Compendium Complaints Department
PO Box 2800
Westway Office Park
3635
Email: complaints@cig.co.za
     

If the matter is not satisfactorily resolved by the Compendium Complaints Department, you can then contact the Ombud:

Short Term Insurance Ombudsman
PO Box 74571
Lynwood Ridge
0040

Tel: 012 470 9080
Fax: 012 3483 447
E-mail: info@osti.co.za

If you have a complaint regarding our services as brokers, contact:

Financial Advisory and Intermediary Services (FAIS)
Ombudsman
PO Box 74571
Lynwood Ridge
0040

Tel: 012 470 9080
Fax: 012 3483 447
Email: info@faisombud.co.za
     
Signed by (full name)
at on this day of 20
Signature
     
ANNEXURE

 

Accidental Damage (Extended Cover)

This extension is automatically included for a sum insured equal to 10% of the Household Contents sum insured. The limit any one
item is 25% of the sum insured for this extension.

We will indemnify You for loss of, or damage to Household Goods whilst inside Your Dwelling at the risk address but excluding;

1.1 loss or damage.

1.1.1 that is payable under any other section of this Policy.

1.1.2 due to depreciation or gradual causes such as wear and tear, rust, mildew, corrosion and decay.

1.1.3 caused by moths or vermin or Your domestic pets or a cleaning, repairing or restoration process of or to the Insured Property.

1.2 damage to glass, glassware or other brittle articles (other than jewellery, camera, fixed glass or television sets) due to
       cracking or scratching unless caused by theft or attempted theft or fire.

1.3 the cost of reproduction or repair of data

1.4 mechanical, electrical/electronic breakdown of any item of electronic equipment unless otherwise stated in the Schedule.

1.5 damage to musical instruments by scratching, bruising, breakage of strings or reeds and splitting of skins.

1.6 damage to firearms.

1.7 damage to video or audiotapes, cell phones, CDs, DVDs and other recording media and computer software.

1.8 damage caused by over winding of clocks or mechanical apparatus.

1.9 loss or damage following confiscation or detention by any process of law.

1.10 consequential loss of any nature.

1.11 the First Amount Payable as stated in the Schedule.

1.12 more than twenty five percent (25%) of the sum insured for this extension in respect of any one item.

The amount We pay in respect of any claim under this extension shall not exceed the amount stated in the Schedule. Any Claim Free Group You have earned will not be affected by any claim that We settle in terms of this extension.

Accidental Damage (Extended Cover)

We will indemnify You for loss of, or damage to the insured property at the risk address but excluding;

1.1 loss or damage.

1.1.1 that is payable under any other section of this Policy.;

1.1.2 due to depreciation or gradual causes such as wear and tear, rust, mildew, corrosion and decay.

1.1.3 caused by moths or vermin or Your domestic pets or a cleaning, repairing or restoration process of or to the insured
          property.

1.1.4 mechanical, electrical/electronic breakdown of any item of electronic equipment unless otherwise stated in the Schedule.

1.1.5 loss or damage following confiscation or detention by any process of law.

1.1.6 consequential loss of any nature.

1.1.7 due to an electrical power surge.

1.2 the First Amount Payable as stated in the Schedule.

1.3 more than twenty five percent (25%) of the sum insured for this extension in respect of any one item.

The amount We pay in respect of any claim under this extension shall not exceed the amount stated in the Schedule.

Subsidence and Landslip (Extended Cover)

This optional cover is included automatically given unless risk address is situated in certain geographical areas (Dolomite Areas).

2.1 This section is extended to include loss of or damage to the dwelling caused by subsidence or landslip of the land
       supporting the dwelling or heave thereof provided that such loss or damage is not caused by or does not arise from.

2.1.1 normal settlement, shrinkage or expansion of the land supporting the Dwelling.

2.1.2 alterations, additions or repairs to the Dwelling.

2.1.3 the compaction of infill.

2.1.4 defective or faulty design, materials or workmanship.

2.1.5 excavations other than mining operations.

2.1.6 removal or weakening of support to the Dwelling.

2.2 We will not be liable for.

2.2.1 loss of or damage to septic or conservancy tanks, drains, water courses unless the Dwelling is damaged at the same
          time by the same event.

2.2.2 consequential loss whatsoever.

2.2.3 damage existing at commencement of cover.

2.3 You will be responsible for the first five percent (5%) of the claim minimum two thousand five hundred Rand (R2,500) of
       each and every occurrence giving rise to a claim.

2.4 if required You must give proof that the loss or damage being claimed for was caused by subsidence, landslip or heave.

Reinstatement of data

We will indemnify You for all costs and expenses necessarily incurred in the reinstatement of data and or programmes recorded on data - carrying media that is lost as a result of accidental erasure;

Provided that such costs and expenses are:

2.1 not caused by programme errors, viruses, incorrect entry or the inadvertent cancellation or corruption of data.

2.2 subject to the limit stated in the Schedule for any occurrence or series of occurrences arising out of one event.

Car Hire Extension – Extended Cover – Applicable to Comprehensive Cover Only

( This extension is automatically included for Comprehensive policies )

If You claim for an accident not insured in terms of COVER PROVIDED COMPREHENSIVE 14 Car Hire extension – Limited cover
(applicable to comprehensive cover only) causing damage to the insured Vehicle We will pay for the hiring of another Vehicle;
provided that:

1.1 We arrange for the hire of the Vehicle.

1.2 the car hire will only commence once the completed claim form and supporting documents have been received and a claim admitted in terms of this extension.

1.3 The engine capacity of the hired vehicle will not exceed one thousand six hundred (1600) cubic centimetres.

1.4 the car hire is on an unlimited mileage basis but will exclude the cost of fuel and / or lubricants and /or maintenance. You must pay the hirers any fuel deposit they may require..

1.5 You have complied with all the provisions of this Policy.

1.6 The maximum number of days for which You are entitled to car hire is the number of days reflected in the Schedule for this
Extension.

Credit Shortfall Clause

If any insured Vehicle is financed and is:

1.1 stolen and not recovered.

1.2 damaged and uneconomical to repair.

we will pay the outstanding finance charges, excluding any residual amount recorded in the finance agreement, calculated to
the month in which the claim is settled.

less:

1.3 any arrear installments or rentals including interest thereon.

1.4 all refunds of premiums for cancellation of insurance cover relating to the insured Vehicle.

1.5 all other refunds or recoveries obtainable.

1.6 all amounts paid in advance of when due.

provided that We will only pay up to the maximum value stated in the Schedule less the First Amount payable stated in the
Schedule.

Credit Shortfall Clause

If any insured Vehicle is financed and is:

1.1 stolen and not recovered.

1.2 damaged and uneconomical to repair.

we will pay the outstanding finance charges, excluding any residual amount recorded in the finance agreement, calculated to the month in which the claim is settled.

less:

1.3 any arrear installments or rentals including interest thereon.

1.4 all refunds of premiums for cancellation of insurance cover relating to the insured Vehicle.

1.5 all other refunds or recoveries obtainable.

1.6 all amounts paid in advance of when due.

provided that We will only pay up to the maximum value stated in the Schedule less the First Amount payable stated in the Schedule.