Description: Curas GapCo Cover pays the charges above the Medical Scheme tariff for associated ser

vices in-hospital and charges in the form of a co-payment or deductible applied for in-hospital admissions and/or the necessity for chemotherapy or radiotherapy for the treatment of cancer on an out-patient basis, and/or the necessity for kidney dialysis on an out-patient basis. Benefits: 1. The maximum benefit payable in terms of this policy shall be R250 000 per insured person per annum and R500 000 per family per annum. 2. Benefits for co-payments or deductible are limited to R30 000 per insured person per annum and R50 000 per family per annum. Exclusions: The Company shall not be liable for hospitalisation due to bodily injury, sickness or disease directly or indirectly caused by related to or in consequence of: Nuclear weapons or nuclear material or by ionising radiation or Par ticipation in: a. Active military duty, police duty, police reser vist duty, civil contamination by radioactivity from any nuclear fuel or from any commotion, labour disturbances, riot, strike or the activities of nuclear waste from the combustion of nuclear fuel. For the purpose locked out workers. of this exception combustion shall include any self-sustaining b. Aviation other than as a passenger. process of nuclear fission. c. Any form of race or speed test (other than on foot Investigations, treatment, surgery for obesity, its consequence or or involving any non-mechanically propelled vehicle vessel craft or cosmetic surgery or surgery directly or indirectly caused by or aircraft). related to or in consequence of cosmetic surgery other than as a No benefits are payable which should be provided by the medical aid result of an insured event otherwise insured. scheme (such as Prescribed Minimum Benefits), this exception Cosmetic surgery shall include surgery for breast reduction or includes ward fees, theatre fees, medicines and other hospital reconstruction unless necessitated as a result of treatment for expenses. cancer. Any procedure not covered or declined by the medical aid scheme. Routine physical or any procedure of a purely diagnostic nature or No benefits shall be payable for an insured event for which the any other examination where there is no objective indication of Insured Person received treatment or advice twelve (12) months impairment in normal health and laboratory diagnostic or X-ray prior to becoming an Insured Person. This exclusion only applies to examinations except in the course of a disability established by prior the first twelve (12) months of an Insured Persons cover. call or attendance of a physician. No benefits shall be payable for pregnancy or childbir th for a period Suicide, attempted suicide or intentional self-injury. of twelve (12) months from inception of this policy. The taking of any drug or narcotic unless prescribed by and taken in Investigations, treatment or surgery for ar tificial insemination or accordance with the instructions of a registered medical practitioner hormone treatment for infer tility. (other than the Insured Person) or any illness caused by the use of Depression, insanity or mental stress or psychotic/psychoneurotic alcohol. disorders. Drug addiction. No benefits shall be payable in the event of fraudulent submission by An event directly attributable to the Insured Person where the the claimant. alcohol content in the blood exceeds the legal level permitted by law. Claims: Following an insured event the Principal Insured Member shall at his - Any claim in terms of this policy will prescribe after twelve (12) own expense: calendar months from the date of occurrence of the insured incident - As soon as possible notify the administrator of any claim in writing if the claim is outstanding and not a subject of a then pending cour t but not later than one hundred and eighty (180) days from treatment case. for such incident. - Any benefit payable in respect of hospital confinement shall only - Supply in writing any such proof or other information as the Company become due at the end of a period of such confinement. However, may reasonably request. payments on account can be made to the Principal Insured Member - As often as required provide authority for the Company to inspect all at the end of a thir ty (30) day period of hospital confinement at the current and/or past medical or other information including the results discretion of the Company. of any blood tests and submit to medical examination on behalf of - All benefits payable shall be paid to the Principal Insured Member and at the expense of the Company. his legal representative whose receipt shall in every case be a full - Where the Insured Member is not a Principal Insured Member the discharge to the Company. Principal Insured Member shall provide or obtain the necessary - No benefit payable shall carry interest. permission or consent to comply with this condition failing which all benefits in respect of any claims subject to this condition shall be avoidable. Waiting Periods: A waiting period of 3 months will be applicable. Mandatory 12 month waiting period for pre-existing conditions. 12 Months waiting period on pregnancy. Monthly Premium: R130.00 per month per family.

GAPCO COVER

E-mail: mail@curaadmin.net Tel: 086 681 3670

DISCLOSURE NOTICE TO SHORT-TERM & LONG-TERM INSURANCE POLICYHOLDERS IN TERMS OF THE FINANCIAL ADVISORY AND INTERMEDIARY SERVICES (FAIS) ACT, NO 37 OF 2002 IMPORTANT - PLEASE READ CAREFULLY - DISCLOSURE AND OTHER LEGAL REQUIREMENTS (This notice does not form par t of the Insurance Policy or any other document)

1. INSURED DETAILS Name: Registration No.: FSP No.: Physical Address: Postal Address: Address:

Should you not be satisfied with the product purchased, you may lodge a written complaint with HGR at:

Hollard Group Risk (HGR), a division of the Hollard Insurance Company Limited 1952/003004/06 Telephone No.: 17698 Facsimile No.: 22 Oxford Road (entrance in Federation Road), Parktown, 2193 PO Box 97419, Houghton, 2041 Website Address:

(011) 351-5000 (011) 351-8010 www.hollard.co.za

The Operational Officer, Hollard Group Risk Telephone No.: (011) 351-2216 A division of the Hollard Insurance Company Limited, E-mail Address: HGRCompliance@hollard.co.za 22 Oxford Road, Parktown, 2193 PO Box 87419, Houghton, 2041 You are entitled to a full copy of the policy on request. You are also entitled to a summary of the policy. If you have not received a summary or a full copy of the wording within 60 days, or you feel that this policy does not meet legal requirements, please write to: Address: The Compliance Officer The Hollard Insurance Company Limited, PO Box 87419, Houghton, 2041 2. UNDERWRITING MANAGER DETAILS Name: Ambledown Risk & Underwriting Managers (Pty) Ltd (Ambledown) Registration No.: 2004/006271/07 Telephone No.: 0861 262 533 FSP No.: 10287 Facsimile No.: 011 463 1600 Physical Address: Ground Floor Right Wing, Worcester House, Eton Office Park, c/o Sloane and Harrison Streets, Bryanston, 2191 Postal Address: PO Box 97419, Houghton, 2041 Website Address: www.ambledown.co.za Should you not be dissatisfied with any aspect of your insurance contract, ser vice received as par t of a general disclosure, how to lodge a complaint or of Ambledowns compliance with the FAIS Act, please refer the matter to info@ambledown.co.za Compliance officer: Moonstone Compliance Telephone No.: (021) 883 8000 a. Ambledown has an agreement with HGR authorising Ambledown to act as an underwriting manager whereby marketing, underwriting, policy documentation administration and claims handling is administered for Health & Accident insurance business. b. Ambledown and HGR do not have any shareholding in each other. c. Ambledown has in the last 12 months not earned more than 30% of its remuneration from HGR. d. Ambledown has both Professional Indemnity and Fidelity Guarantee cover with Etana Insurance. e. Ambledown is not required to have IGF cover. 3. ADMINISTRATORS Name: Registration No.: FSP No.: Physical Address: Postal Address: Cura Administrators (Pty) Ltd 1997/017797/07 26848 829 Rubenstein Drive, Moreletapark, 0044 PO Box 42331, Moreletapark, 0044 Telephone No.: Facsimile No.: Website Address: E-mail Address: 086 155 3553 086 681 3670 www.curaadmin.co.za mail@curaadmin.net

Holds indemnity cover.

1. THE BROKER You have the right to the following information regarding the Broker who must hold a valid licence to operate under specific catagories of business: 1. 2. 3. 4. Name, address and contact details Legal status Whether the ser vice rendered are under super vision Whether the broker holds more than 10% of the Insurers shares and /or 5. Whether the broker received more than 30% of the total remuneration from the Insurer in the past year 6. Whether the broker holds any form of professional indemnity insurance 7. Details of complaints policy and procedures 8. Details of compliance arrangements 9. The Road amount of fees, commissions or any valuable consideration payable. 10. Contractual arrangements with the Insurer including any restrictions or conditions
4. SHORT-TERM INSURANCE OMBUDSMAN DETAILS Shor t-term Insurance Ombudsman Address: PO Box 32334 Braamfontein 2017 Telephone No.: (011) 726 8900 Facsimile No.: (011) 726 5501 E-mail Address: www.osit.co.za 5. LONG-TERM INSURANCE OMBUDSMAN DETAILS Address: Telephone No.: Facsimile No.: E-mail Address: The Ombudsman for Long-Term Insurance Private Bag X45 Claremont, Cape Town 7735 (021) 657 5000 (021) 674 0951 info@ombud.co.za

2. PREMIUM PAYMENT Details of your Premium obligations are contained in the Policys Schedule of Insurance and include Administration Fees, Commissions and Total Amount Due, payment dates and payment conditions. 3. CLAIM NOTAFICATION PROCEDURES Please note that should you have a claim under your policy you are required to notify your insurer, via your broker, of such a claim within 180 (one hundred and eighty) days from the date of happening of the event giving rise to your claim. If you fail to notify your claim timelessly it may be repudiated due to such late notification. Fur thermore, you will be required to complete a claim form and may also be required to produce documentary proof substantiating your claim.

FAIS Ombudsman PO Box 74571 Lynnwood Ridge 0040 0860 324 766 (012) 348 3447 info@faisombud.co.za

FAIS Ombudsman PO Box 74571 Lynnwood Ridge 0040 0860 324 766 (012) 348 3447 info@faisombud.co.za