Short-Term Insurance Act, 1998 (Act No. 53 of 1998)Policyholder Protection RulesPolicyholder Protection Rules (Short-Term Insurance), 2017Chapter 1 : Interpretation2. Definitions |
| 2.1 | In these rules "the Act" means the Short-term Insurance Act, 1998 (Act No. 53 of 1998), including the Regulations promulgated under section 70 of the Act, and any word or expression to which a meaning has been assigned in the Act bears, subject to context, that meaning unless otherwise defined, and— |
means any communication published through any medium and in any form, by itself or together with any other communication, which is intended to create interest by the public in the business, policies or related services of an insurer, or to persuade the public (or a part thereof) to transact in relation to a policy or related service of the insurer in any manner, but which does not purport to provide detailed information to or for a specific policyholder regarding a specific policy or related service;
[Definition inserted by rule 4(a) of Notice No. 996, GG 41928, dated 28 September 2018]
has the meaning assigned to it in the FAIS Act;
[Definition substituted by rule 4(b) of Notice No. 996, GG 41928, dated 28 September 2018]
in respect of a—
| (a) | registered insurer, means— |
| (i) | a person nominated by the policyholder as the person in respect of whom the insurer should meet policy benefits; or |
| (ii) | in the case of a group scheme, a person nominated by the group scheme or member of the group scheme or otherwise determined in accordance with the rules of that group scheme as the person in respect of whom the insurer should meet policy benefits |
| (b) | licensed insurer, has the meaning assigned to it in Schedule 2 of the Insurance Act; |
[Definition substituted by rule 4(c) of Notice No. 996, GG 41928, dated 28 September 2018]
means any day excluding a Saturday, Sunday or public holiday;
[Definition inserted by rule 4(d) of Notice No. 996, GG 41928, dated 28 September 2018]
means, unless the context indicates otherwise, a demand for policy benefits by a person in relation to a policy, irrespective of whether or not the person's demand is valid;
means a person who makes a claim;
in respect of a—
| (a) | registered insurer, means credit insurance as defined in the National Credit Act; |
| (b) | licensed insurer, means one or more policies written under the Consumer Credit class of non-life insurance business as set out in Table 2 of Schedule 2 of the Insurance Act; |
[Definition substituted by rule 4(e) of Notice No. 996, GG 41928, dated 28 September 2018]
in respect of a registered insurer, has the meaning assigned to it in the National Credit Act;
[Definition substituted by rule 4(f) of Notice No. 996, GG 41928, dated 28 September 2018]
means amounts payable or borne by policyholders in the event of claims or losses under a policy;
means a loss or risk event not covered under a policy;
means a policy entered into before the date on which the relevant rule takes effect;
means the Financial Advisory and Intermediary Services Act, 2002 (Act No. 37 of 2002);
in respect of a—
| (a) | registered insurer, means a scheme or arrangement which provides for the entering into of one or more policies, in terms of which two or more persons without an insurable interest in each other, for the purposes of the scheme, are the lives insured; |
| (b) | a licensed insurer, means a policy with a group as defined in Schedule 2 of the Insurance Act; |
[Definition substituted by rule 4(g) of Notice No. 996, GG 41928, dated 28 September 2018]
means a short-term insurer;
means an independent intermediary or a representative, respectively;
[Definition deleted by rule 4(h) of Notice No. 996, GG 41928, dated 28 September 2018];
means any benefit (including a so-called cash- or premium-back bonus) that is directly or indirectly provided or made available to a policyholder by an insurer or an associate of the insurer, which benefit is wholly or partially contingent upon—
| (a) | the policy or policies of that policyholder with that insurer remaining in place; |
| (b) | the policyholder increasing any policy benefit to be provided under a policy; or |
| (c) | the policyholder entering into any other policy or policy benefit or utilising any related services offered by that insurer or its associate; |
"mandatory credit life insurance"
in respect of a registered insurer, means credit life insurance contemplated in section 106(1)(b) of the National Credit Act;
[Definition substituted by rule 4(i) of Notice No. 996, GG 41928, dated 28 September 2018]
"member of a group scheme"
means—
| (a) | a person who participates in a group scheme to insure him or herself; or |
| (b) | a person who participates in a group scheme to insure the lives of one or more other persons in which the first-mentioned person has an insurable interest; |
"National Credit Act"
means the National Credit Act, 2005 (Act No. 34 of 2005);
means a policy entered into on or after the date on which the relevant rule takes effect;
has the meaning assigned to it in the—
| (a) | Financial Services Ombud Schemes Act, 2004 (Act No. 37 of 2004) up until such time as such Act is repealed through Schedule 4 of the Financial Sector Regulation Act; and |
| (b) | Financial Sector Regulation Act, 2017 (Act No. 9 of 2017) from the date on which such Act repeals the Financial Services Ombud Schemes Act, 2004 (Act No. 37 of 2004) through Schedule 4 of such Act; |
[Definition substituted by rule 4(j) of Notice No. 996, GG 41928, dated 28 September 2018]
in respect of a registered insurer, means credit life insurance contemplated in section 106(3) of the National Credit Act;
[Definition substituted by rule 4(k) of Notice No. 996, GG 41928, dated 28 September 2018]
means an outsourcing arrangement as defined in section 1 of the Financial Sector Regulation Act, and includes rendering services under a binder agreement, but excludes rendering services as intermediary, and "outsourced" has a corresponding meaning;
[Definition substituted by rule 4(l) of Notice No. 996, GG 41928, dated 28 September 2018]
"plain language"
means communication that—
| (a) | is clear and easy to understand; |
| (b) | avoids uncertainty or confusion; and |
| (c) | is adequate and appropriate in the circumstances, |
taking into account the factually established or reasonably assumed level of knowledge of the person or average persons at whom the communication is targeted;
means a short-term policy where the policyholder is a—
| (a) | natural person; or |
| (b) | a juristic person, whose asset value or annual turnover is less than the threshold value as determined by the Minister of the Department of Trade and Industry in terms of section 6(1) of the Consumer Protection Act, 2008 (Act No. 68 of 2008); |
means a person who—
| (a) | has applied to or otherwise approached an insurer, an intermediary, or a group scheme to become a member of a group scheme; |
| (b) | has been solicited by an insurer, an intermediary, or a group scheme to become a member of a group scheme; or |
| (c) | has received advertising, as defined in rule 10, in relation to any group scheme; |
means a person who—
| (a) | has applied to or otherwise approached an insurer or an intermediary to become a policyholder; |
| (b) | has been solicited by an insurer or an intermediary to become a policyholder; or |
| (c) | has received advertising, as defined in rule 10, in relation to any policy or related service of an insurer; |
means the Regulations made under the Short-term Insurance Act, 1998, promulgated by GN R. 1493 of 27 November 1998 and amended from time to time;
means any service or benefit provided or made available by an insurer or any associate of that insurer, together with or in connection with any policy or policy benefit, and includes a loyalty benefit and a no-claim bonus;
in relation to a claim means any action by which an insurer rejects or refuses to pay a claim or any part of a claim, for any reason, and includes instances where a claimant lodges a claim—
| (a) | in respect of a loss event or risk not covered by a policy; and |
| (b) | in respect of a loss event or risk covered by a policy, but the premium or premiums payable in respect of that policy are not paid |
[Definition inserted by rule 4(m) of Notice No. 996, GG 41928, dated 28 September 2018]
has the meaning assigned to it in the Insurance Act;
[Definition inserted by rule 4(n) of Notice No. 996, GG 41928, dated 28 September 2018]
means any person (whether or not that person is the agent of the insurer) with whom an insurer has an arrangement relating to the marketing, distribution, administration or provision of policies or related services;
means any act that results in a change to—
| (a) | the premium; |
| (b) | any term; |
| (c) | any condition; |
| (d) | any policy benefit; |
| (e) | any exclusion; or |
| (f) | the duration of a policy, |
excluding any explicit pre-determined or determinable variation stated or provided for in the policy, and "variation of an existing policy" and "varying" has a corresponding meaning;
means a period during which a policyholder is not entitled to policy benefits;
refers to the marketing of or offering of a specific policy of an insurer under the brand of another person who is not the insurer in terms of an arrangement between the insurer and that other person; and
includes any communication by any appropriate electronic medium that is accurately and readily reducible to written or printed form; and "written" has a corresponding meaning.
| 2.2 | Despite section 2.1, the meaning assigned to "enter into" in the Regulations shall not have such meaning for purposes of these Rules and the grammatical meaning of this term will not apply. |