Short-Term Insurance Act, 1998 (Act No. 53 of 1998)

Policyholder Protection Rules

Policyholder Protection Rules (Short-Term Insurance), 2017

Chapter 3 : Products

Rule 2A : Microinsurance Product Standards

2A.7 Exclusions

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2A.7.1 A microinsurance policy in respect of which the aggregate value of the policy benefits is R120 000 or less may not impose any exclusions or conditions limiting the liability of the microinsurer, other than exclusions or conditions relating to—
(a) unlawful conduct, provided that such exclusions may only be applied or relied on if there is a direct link between the cause of the loss and the unlawful conduct;
(b) special risks referred to in the Conversion of the SASRIA Act, 1998 (Act No. 134 of 1998);
(c) the condition of any asset insured at inception of the policy, other than exclusions relating to the wear and tear of the asset;
(d) the maintenance and usage of the insured asset under a policy that insures against unforeseen mechanical or electrical component failure;
(e) consequential loss; or
(f) any combination of (a) to (e).

 

2A.7.2 A microinsurance policy in respect of which the aggregate value of the policy benefits exceeds R120 000 may impose exclusions or conditions, in addition to those set out in rule 2A.7.1(a) to (f), limiting the liability of the microinsurer if the microinsurer is able to demonstrate that such exclusions or conditions will—
(a) not unreasonably erode the value of the benefits under the policy, taking into account the nature of the policy benefits;
(b) continue to render the policy being suitable for targeted policyholders; and
(c) not compromise the consistent delivery of fair outcomes to the policyholders or members.

 

[Rule 2A.7 inserted by rule 6(b) of Notice No. 996, GG 41928, dated 28 September 2018]