You are on page 1of 11

2015 Policy Schedule

In consideration of and conditional upon the prior payment of the premium, the receipt thereof by or on behalf of
Constantia Insurance Company Limited (the Company) before the inception date or renewal date and subject to the
terms, exceptions, conditions and provisions of the policy, the Company agrees to pay the insured person(s) for an
insured incident occurring during the period of insurance up to the limit of indemnity stated for the insured person(s)
and the benefit as stated in the policy.
Definitions
In this policy all words and expressions signifying the singular shall include the plural and vice versa. Words and
expressions implying the masculine gender shall include the feminine. The following words and expressions shall
have the following meanings:
1. “Accident” means bodily injury caused by violent, accidental and external physical means.
2. “Company” means Constantia Insurance Company Limited.
3. “Chronic condition/Disease” means an illness that is prolonged in duration, does not often resolve
spontaneously, is rarely cured and requires medication.
4. “Co-payment/Deductible” means an upfront payment that is required by a medical scheme for the cost of
certain procedures.
5. “Dread disease” means a disease with a significant impact on lifestyle which incurs high costs and/or causes
significant and permanent residual morbidity.
6. “Dual insurance” means similar cover through another insurer.
7. “Eligible child” means a biological child, legally adopted child or stepchild of a principal insured person or
the spouse who is an eligible child dependant and who is not already insured under this policy or any other
insurance issued by the Company providing similar cover. As soon as such a child ceases to satisfy the
conditions above, such a child will no longer be an eligible child and will therefore no longer be covered under
this policy. This policy will cover child dependants up to and including the age of 27, provided that the
dependant is registered on the medical scheme option of either the principal member or the spouse.
8. “Eligible member” means a member/person who is in a category of paid up members as designated by the
Insured and accepted by the Underwriter as eligible for participation in the insurance provided by this policy
and such other person as the Company may from time to time deem eligible.
9. “Eligible spouse” means the spouse of the principal insured person who is not already insured under this
section or any other policy issued by the Company providing similar cover. For the purpose of the policy
“Eligible spouse” shall include a spouse by common law marriage. Should a principal insured person have
more than one spouse who could qualify as an eligible spouse then that principal insured person must make
an irrevocable nomination of one eligible spouse to whom the benefits provided by this policy, applies. No
benefits will be paid in respect of an eligible spouse if more than one person qualifies as such and no
nomination has been made by the principal insured person. On the death of the principal insured person, the
cover of the eligible spouse under this policy may be continued should such spouse elect to do so within sixty
(60) days of the death of the principal insured person.
10. “Family” means the principal insured person and such person’s eligible spouse provided such spouse is an
insured person but not a principal insured person and such person’s eligible children provided they are
insured persons on the medical scheme option of either the principal member or the spouse.

care or treatment were sought or received. “Medical practitioner” means a legally qualified registered medical practitioner. treatment. 18. mentally impaired or other handicapped persons 12. has not been so diagnosed. but can be reasonably proven by examination of medical history. an eligible spouse or an eligible child of the principal insured person or the insured spouse. treatment and care of insured and sick persons by or under the supervision of a staff of medical practitioners Provides nursing service supervised by registered nurses or nurses with equivalent qualifications. natural cure clinic or similar establishment Is not an institution providing long-term care for the blind. “Medical and surgical procedure and/or operation” means a listed medical procedure involving an incision with instruments. all medical schemes are required to cover a defined set of conditions known as Prescribed Minimum Benefits (PMB). 17. though capable of diagnosis by such evidence. advice or consultation was rendered to an insured person within the period prior to the effective date of coverage. is not other than incidentally. 13. registered clinic or registered associated facility for treatment. The procedure must be paid from the risk benefit (hospital benefit) by the medical scheme. “Insured person” means a principal insured person. “In-hospital/Hospital confinement” means admission to a hospital ward. even though no diagnosis. health hydro. “Illness” means any one somatic illness or disease which manifests itself during the period of insurance and includes premature senile degenerative changes. . “Medical officer” means a legally qualified registered medical practitioner appointed by the Company. 131 of 1998. but not an illness which is of such a nature as to be incapable of diagnosis by objective evidence or which.11. 23. “Insured incident” means any one accident or illness which causes an insured person to be confined to hospital or registered day clinic and undergo certain medical or surgical procedures and/or operations. “Hospital” means any institution in the territory of the Republic of South Africa which in the opinion of the Company meets each of the following criteria:     Have diagnostic and therapeutic facilities for surgical and medical diagnosis. Any injury or sickness shall be considered to be present or manifest if the condition or symptoms exist prior to the effective date of coverage. 22. “Rejection” means non-payment of a medical service/procedure forwarded for reimbursement. or any complications there from which is present or manifests itself. 20. 21. “PMB conditions”: In terms of the Regulations of the Medical Schemes Act (Act no 131 of 1998). “Penalty co-payment” means a stated co-payment that is imposed when medical scheme protocols are not adhered to. 16. performed to repair damage or arrest disease in a living body. 14. 24. 19. “Out-patient” means an insured person who is not hospitalised but who visits a registered hospital. either a mental institution or a convalescent home Is not a place of rest for the aged or a place for drug/substance abuse. “Registered Medical Scheme” means a medical scheme as registered under the Medical Schemes Act No. the Company will agree an appropriate allocation of units in consultation with an independent medical practitioner. In the event of a procedure and/or operation not being listed. 15. deaf. “Pre-existing condition” means any injury or sickness. or for which medical care.

6. Medical scheme exclusions unless the event is otherwise insured. including consultations in doctors rooms at a hospital facility. endoscopic procedures and related surgery and dental procedures A waiting period of ten (10) months upon a new insured person and the insured person’s dependant(s) before such an insured person and/or dependant(s) is entitled to claim for pregnancy and childbirth A waiting period of ten (10) months upon a new insured person and the insured person’s dependant(s) before such an insured person and/or dependant(s) is entitled to claim for a pre-existing medical condition or related surgery GENERAL EXCLUSIONS The Company shall not be liable for hospitalisation. consultation with. 5. an accident or on the diagnosis of a dread disease that may cause substantial psychological damage. where an insured person has not been admitted. “Treatment” means any form of investigation or examination by. Comprehensive and Hospital Optimiser. joint replacements (unless accidental). “Sub-limit” means the limit imposed by a medical scheme for specific in-hospital procedures but excludes overall annual limits. hernia repairs (unless an emergency). 26. “Split/Selective billing”: when a service provider bills separately for the same service and submits one account to the medical scheme and a private account to the insured person. 30. but not applicable to consumable items. cataract surgery. sickness or disease directly or indirectly caused by. or treatment by a registered medical practitioner for the purpose of treating or monitoring an insured person’s medical condition arising out of an insured incident. “Travelling” means travelling in any country other than the Republic of South Africa. “Trauma” means a serious injury or shock to the body due to violence. Auxiliary services / Allied accounts. 2. 3. Co-Evolution 500. 4.25. Accounts paid from day-to-day benefits or from the savings account of a medical scheme. Hospital account shortfalls. bodily injury. 31. “Shortfall” means the difference between the amount charged by a medical practitioner and the payment made by the medical scheme. POLICY WAITING PERIODS AND EXCLUSIONS POLICY WAITING PERIODS The following underwriting applies to all new members:     A general waiting period of three (3) months upon a new insured person and the insured person’s dependant(s) before such an insured person and/or dependant(s) is entitled to claim any benefits A waiting period of six (6) months upon a new insured person and the insured person’s dependant(s) before such an insured person and/or dependant(s) is entitled to claim for tonsillectomy. related to or in consequence of: 1. hysterectomy (except where cancer is diagnosed). myringotomy (grommets). 29. including ward and theatre fees. adenoidectomy. Medical scheme sub-limit benefits excluded on Base 500. 27. but not applicable to: a) Co-payments that are paid from a medical scheme savings account b) Services under the Casualty Benefit and Trauma Counselling Benefit Overall annual hospital limits excluded but not applicable to Hospital Optimiser. 28. “Schedule” means the schedule attaching to and forming part of this policy. but not applicable to: .

attempted suicide or intentional self-injury. strikes and activities of locked out workers or the insured person’s own criminal act b) International or fighter aviation other than as a passenger. but not applicable to: a) Internal prostheses on Elite. 16. 18. . 20. hormone treatment for infertility or contraception. emotional illness. Depression. the equivalent of cosmetic or reconstructive surgery related to or in consequence of cosmetic surgery other than as a result of an event otherwise insured. labour disturbances. Senior 500. Nuclear weapons. 9. Active military. 22. 10. a) Counselling sessions at a registered counsellor or clinical psychologist under the Trauma Counselling Benefit b) In-hospital tariff shortfalls for physiotherapy In hospital dentistry. convalescent home). For the purpose of this exception. whilst on active duty. but not applicable to: a) Tubal ligation and vasectomy on Comprehensive. treatment or surgery for obesity. but not applicable to domestic aviation within the borders of South Africa Claims will only be considered for payment if the relevant Stratum Benefits policy makes provision for the benefit being claimed for. 25. Elite and Corporate Elite Investigations. Drug and alcohol addiction including: a) The taking of any drug or narcotic unless prescribed by and taken in accordance with the instructions of a registered medical practitioner or any illness caused by the use of alcohol b) An event directly attributable to the insured person having an alcohol content exceeding the recognised legal limit or the insured person suffering from alcoholism Expenses incurred for transport charges or for services rendered whilst being transported in any emergency vehicle. combustion shall include any self-sustaining process of nuclear fission. 23. Suicide. Co-payments applied as a result of: a) The voluntary use of a non-designated service provider b) Selective / split billing where a co-payment is charged on doctors accounts Oncology: a) A total exclusion for any pre-diagnosed cancer is applicable to the Oncology Benefit on Comprehensive. 14. ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste resulting from the combustion of nuclear fuel. insanity. Routine physical examinations. 17. Step-down facilities (e. where the medical scheme does not pay from risk (hospital benefit). nuclear material. 27. 15. vessel or aircraft. External prostheses excluded. riots. Participation in: a) Civil commotion. 21. 13. 28.7. 8. mental or mental stress-related conditions. 24. 12. The insured person’s deliberate exposure to exceptional danger except in an attempt to save a human life. Corporate Elite and G Force Cost of mechanical appliances used during surgical procedures and operations. procedures of a purely diagnostic nature or any other examination where there is no objective indication of impairment referred to somatic illness or disease in normal health and laboratory. treatment or surgery for artificial insemination. Co-Evolution 500 and Hospital Optimiser do not provide an Oncology Benefit Prescription and take home medication. applicable to the Oncology Benefit on Elite and Corporate Elite c) Base 500. Tariff shortfalls and overall annual limits on MRI and CT scans. 11. Investigations.g. Senior 500. including: a) Osseointegrated implants b) Maxillofacial surgery unless due to an accident (proof will be required) The Casualty Benefit is not granted where costs incurred are paid by the medical scheme from risk (hospital benefit). Oncology Plus and G Force b) Pre-diagnosed cancer is covered provided the insured person is in remission for 5 years either prior to policy inception or during cover on the Stratum Benefits policy. police and police reservist activities. 26. diagnostic or x-ray examinations. 19. Investigative costs incurred by the insured person to assist in the finalisation of a claim.

Stratum Benefits will honour the shortfall incurred subject to the standard policy terms and conditions. Umbilical. Femoral. when if paid from the risk benefit (hospital benefit) by the insured’s medical scheme.OUTPATIENT PROCEDURES A list below is provided for the recognised out-patient procedures. Epigastric.Spigelian) Ischio-rectal abcess drainage Lymph node biopsy Removal of pins and plates Paediatric surgery orchidopexy Sigmoidoscopy Surgical haemorrhoidectomy ENT surgery Adenoidectomy Antrostomy Direct laryngoscopy Diathermy Frenectomy Grommets Myringotomy Nasal surgery (Turbinectomy and septoplasty) Sinus surgery (FESS) Tonsillectomy (Laser and conventional) Tympanoplasty OBSTETRICS AND GYNAECOLOGY Cauterisation of vaginal warts Cervical cerclage Cervical conization Cervical laser ablation Diagnostic D & C Dilation and curettage Evacuation Eptopic pregnancy (Laparoscopic) Hysteroscopy Incision and drainage of Bartholin’s cyst Marsupialisation of Bartholin’s cyst Phototherapy Tubal ligation (Sterilisation) Vulva/Cone biopsy HYPERBARIC OXYGEN TREATMENT Decompression sickness Chronic osteitis Cardiothoracic surgery (Bronchoscopy) Chemotherapy or radiotherapy for treatment of cancer Hepatobiliary surgery (Needle biopsy of liver) Immunology (Plasmatheresis) Kidney dialysis Malunion of major fractures Neurology (48 Hour later EEG Radio necrosis Serious anaerobic infections Vascular leg ulcers GENERAL MEDICAL CARDIOLOGY Coronary angioplasty Coronary angiogram OPHTHALMOLOGY Cataract removal Pterygium removal Strabismus repair Trabeculectomy GASTROENTEROLOGY Colonoscopy ERCP ORTHOPAEDIC Arthroscopy Bunionectomy . General surgery Acromioplasty shoulder/open Arthrocentesis (Joint injection) Anal dilatation Cystourethroscopy Closure of colostomy Diathermy Excision breast lump Excision mole/lipmoa Ganlionectomy Hernia repairs Hernia (Inguinal.

8. From the age of 28. by way of a completed/detailed claim form. Minimum and maximum entry age may apply and is product specific.1 Following an insured event the claimant shall at his/her own expense: a) As soon as reasonably possible after treatment. provided that the dependant is registered on the medical scheme option of either the principal member or the spouse. the most recent documents must be submitted to Stratum Benefits for assessment. the subject of this condition shall be avoidable f) A claim submitted within but not later than six (6) months from treatment of an insured incident in terms of this policy will prescribe after nine (9) calendar months from the date of occurrence of such insured incident if the claim is not a subject of a then pending court case and if relevant documentation is outstanding g) Should an insured person receive a discount from a medical practitioner. but not later than six (6) months from treatment for such incident b) Provide in writing any such proof or other information as Stratum Benefits may reasonably request c) As often as required. 7. including the results of any blood tests and submit a medical examination on behalf of the Company d) Give Stratum Benefits authorization to obtain medical information on the insured’s behalf relating to the claim e) Where the insured person is not a principal insured person. provided they are registered dependants on the medical scheme option of either the principal member or the spouse. Should it be found that the claimant received a discount and did not notify Stratum Benefits. Children will be accepted as child dependants up to and including the age of 27. Claims 1.GASTROENTEROLOGY Gastroscopy Oesophagoscopy ORTHOPAEDIC Carpal tunnel release Ganglion surgery DIAGNOSTIC RADIOLOGY Angiograms Bronchography Cartoid Cerebral Coronary Myelogram Peripheral UROLOGY Cystoscopy Circumcision Orchidopexy Prostoscopy Prostate biopsy Vasectomy GENERAL CONDITIONS General Memoranda 1. 1. 6. notify the administrator. the principal insured person shall provide or obtain the necessary permission or consent to comply with this condition failing which all benefits in respect of any claims. 3. a child dependant will be regarded as an adult and will therefore be charged an adult dependant rate. provide authority for Stratum Benefits to inspect all current and/or past medical or other information. The table of benefits applies in the territory of the Republic of South Africa. The Company reserves the right to increase client premiums giving (30) thirty days written notice. The entry age for adult dependants is subject to the age criteria of the respective policy. 5. 2. 4. The Company reserves the right to alter the basis on which the benefit is calculated by giving thirty (30) days written notice of any change to the participating employer or individual member. this is seen as enrichment and legal action can be taken . The Stratum Benefits policy extends cover to all dependants as registered on the medical scheme option of either the principal member or the spouse.

Payment runs are restricted to every Friday of every week provided this day is not a public holiday. payment will be made on the next available payment run. Braamfontein. 2017 Tel: (011) 726 8900 Fax: (011) 726 5501 Website Address: www. n) Where the Company rejects or disputes a claim or the quantum of a claim.00) 1. Cramerview. the medical scheme remittance statement. and on approval of a claim.co.h) Any benefit payable in respect of hospital confinement shall only become due at the end of a period of such confinement i) Payments on an account can be made to the principal insured person at the end of a thirty (30) day period at the discretion of Stratum Benefits j) All benefits payable shall be paid to the principal insured person. the claim will be rejected d) No pre-authorizations.osti. the insured person has a further one hundred and eighty (180) days after the expiry of the representation period for the service of summons on the Company. or voids the policy.za Alternatively. quotations or pre-assessments will be done prior to a proposed event as it is first subject to the assessment of the medical scheme . (not exceeding the claimed amount of R800 000. Stratum Benefits will not be held liable to act on behalf of the medical scheme and pay out the portion of the claim m) Provided all relevant documentation is received in order to assess a claim. the insured person has ninety (90) days (the “representation period”) from receipt of the Company’s written notification to dispute the decision of the Company. This must be done in writing to the Company: The Operational Officer Constantia Insurance Company Limited PO Box 3518. 2060 Tel: (011) 686 4200 Fax: (011) 789 8828 Email Address: info@constantiagroup. according to the medical scheme statement and reason codes. Should the registered child dependant not reflect on the latest medical scheme membership certificate. his/her legal representative or directly to the medical practitioner where a discount has been negotiated k) No benefit payable shall carry interest l) Claims are assessed line by line. Where the medical scheme reason code states that a line item has not been covered. confirming the child’s dependency on the principal insured’s medical scheme provided the Stratum Benefits Policy Premium is calculated at a family rate. This is subject to change at the discretion of Stratum Benefits.2 Claim Process a) Claims must first be submitted to your medical scheme for payment b) A fully completed Stratum Benefits claim form.za If the dispute is not satisfactorily resolved in this manner. hospital admittance form and all updated medical practitioner accounts relating to the procedure must be submitted to Stratum Benefits within six (6) months from the treatment date for assessment c) Claims for registered child dependants will be considered upon receiving the medical scheme membership certificate at claim stage.co. the principal insured may contact: The Ombudsman for Short-Term Insurance PO Box 32334.

2. re-submit outstanding premiums for the preceding month inclusive of the next debit order amount due inclusive of an administration fee of R 25. electronic transfers and manual payments are not accepted as premium payment methods k) A premium increase may be implemented effective 1 January of each calendar year 3. the policy will not be active and no claims will be payable . Termination of cover a) The Company. Jurisdiction a) The policy shall be subject to the laws of the Republic of South Africa whose courts shall have sole jurisdiction to the exclusion of the courts of any other country b) Where payment is to be made to or by the Company it shall be made in the currency of the Republic of South Africa (Rand) by the Company’s Head Office 6. any premiums due must be paid in one installment on or before the first (1st) day of the month of the insured’s policy e) A full month’s premium is due in respect of any insured person whose cover commences or ceases during a calendar month if such person enjoyed cover for seven (7) days or more in that particular month f) The Company shall not be obliged to accept premiums tendered to it after inception date or renewal date as the case may be but may do so upon its sole discretion with a reasonable explanation g) Claims will only be assessed provided that the policy is in-force and policy premium is up to date h) Refunds will be considered after an investigation with a reasonable outcome to a maximum of three (3) months i) Bank charges charged by banking institutions for debit order failures will not be refunded j) Credit card accounts. Medical evidence a) Claim payments are subject to the claimant supplying medical reports that may be required by the Company at the claimant’s own expense 5. giving thirty (30) days written notice. Cancellation will be effective the last day of the current month in which the cancellation was received c) Members of a corporate company. Premiums and premium payments a) Premium is due monthly in advance in accordance with the premium payers chosen debit order date b) Upon failure of a debit order Stratum Benefits shall suspend the policy and unless otherwise instructed. may cancel their policy with immediate effect d) Only claims that have a service date prior to the cancellation date will be considered for processing and must be submitted within three (3) months after the cancellation date was effective e) Refunds will be considered after an investigation with a reasonable outcome to a maximum of three (3) months 4. registered with Stratum Benefits as an employer group. may cancel this policy at any time b) Written cancellation of a policy is required by the principal insured (policy holder) and not the account payer. Commencement of cover a) Cover in terms of this policy commences on the first (1st) day of the calendar month for which the premium has been paid b) Should premiums not be received by the Company by the 7th of the month. the policy will be cancelled effective as from the last month for which a successful premium was received d) Subject to the approval of the Company.00 c) Should the debit order fail for any arrear premiums.

360 Oak Avenue.co. 2194 Postal Address: P O Box 3518.: (011) 686 4200 Email Address: maleselam@constantiagroup. 37 of 2002 1. the policy will be cancelled from the requested inception date e) Should the member cancel after the 7 (seven) day cooling off period.co. administration and claims handling is administered for Health & Accident Insurance business b) Ambledown and CICL do not have any shareholding in each other c) Ambledown has in the last twelve (12) months earned more than 30% of its remuneration from CICL . addressed to Astrid Baynes.za 2.za Website Address: www. 2060 E-mail Address: info@cicl. policy documentation. The Company reserves the right to adjust the premiums by giving thirty (30) days written notice to the principle insured person Cover a) Cover shall only be in force provided that the insured person is covered with a registered South African medical scheme b) Proof of marriage certificates for newlyweds need to be submitted to Stratum Benefits within thirty (30) days of marriage to register the spouse or full underwriting will apply c) Proof of birth certificates for newborn babies need to be submitted to Stratum Benefits within thirty (30) days or full underwriting will apply 7.za A written complaint may be lodged with CICL. Randburg.co. underwriting. Disclosure notice to Short Term Insurance policyholders in terms of the Financial Advisory and Intermediary Services (FAIS) Act. Cramerview.c) Backdating of any policy for premiums for more than (2) two months not received will not be permissible d) The principle insured person will be entitled to a seven (7) day cooling off period. Tulbagh. Administrators Details a) Ambledown has an agreement with CICL authorizing Ambledown to act as an Underwriting Manager whereby marketing. where should the principle insured person cancel within such period.constantiagroup. the policy will be cancelled effective the end of the current month and no refund will be granted 5. no. Insurer / Underwriter details Name: Constantia Insurance Company Limited (CICL) Registration No: 1952/001514/06 Telephone No: (011) 686 4200 FSP No: 31111 Facsimile No: (011) 789 8828 Physical Address: Unit 3. Compliance Officer: Malesela Mokonyane: Telephone No. should you not be satisfied with the purchased product. Amendments a) 6.

za PO Box 1862.za a) Stratum Benefits has an agreement with CICL authorizing Stratum Benefits to act as an intermediary whereby marketing. 004/006271/07 0861 262 533 0287 011 463 1600 Ambledown House. how to lodge a complaint or with Stratum Benefits compliance with the FAIS Act. 2191 compliance@ambledown.co. Eton Office Park East. Weltevredenpark.co. Ambledown is not required to have IGF cover Ambledown Financial Services (Pty) Ltd Registration No.: Physical Address: E-mail Address: Postal Address: Website Address: 3.: Facsimile No.stratumbenefits.: 2003/018155/07 Telephone No. 1715 E-mail Address: marco@stratumb.: (032) 946 2921/49 Email Address: danielo@nationalcompliance.: Telephone No. Stratum Benefits is not required to have IGF cover 4.za Product Supplier Name: Stratum Benefits (Pty) Ltd (Stratum) Registration No. service received as part of a general disclosure. please refer the matter to marco@stratumb.co.co. Compliance Officer: National Compliance Telephone No. Ferndale. c/o Sloane & Harrison Streets. 2060 www. Bryanston. Randburg Postal Address: Suite 367 Private bag X09.za Website Address: www. administration and claims handling is administered for Health & Accident insurance business b) Stratum Benefits and CICL do not have any shareholding in each other c) Stratum Benefits has in the last twelve (12) months earned more than 30% of its remuneration from CICL d) Stratum Benefits has both Professional Indemnity and Fidelity Guarantee cover.ambledown. Cramerview. 367 Surrey Avenue.d) Ambledown has both Professional Indemnity and Fidelity Guarantee cover. 2.: 2111 Facsimile No. Name.co.: 086 111 3499 FSP No.: 086 633 3761 Physical Address: Block C.co.: FSP No.za Should you not be satisfied with any aspect of your insurance contract. 3. policy documentation. The Broker You have the right to the following information regarding the broker who must hold a valid license to operate under specific categories of business: 1.za. address and contact details Legal status Whether the services rendered are under supervision .

co. 0081 Telephone No. Whether the broker holds more than 10% of the Insurer’s shares Whether the broker received more than 30% of the total remuneration from the Insurer in the past year Whether the broker holds any form of Professional Indemnity Insurance Details of complaints policy and procedures Details of compliance arrangements The rand amount of fees. Ground Floor.4. 7. 7. 9. 10.: (011) 726-5501 / (012) 348-3447 E-mail Address: info@osti. you will be required to complete a claim form and may also be required to produce documentary proof substantiating your claim. 6. 5.: (012)470 9080 Facsimile No. 5. Block B Postal Address: 473 Lynwood Road.za FAIS Ombudsman Address: Sussex Office Park.co. Braamfontein.co. Ombudsman Details Short-term Insurance Ombudsman Address: P O Box 32334.za Website Address: www.: (012) 348 3477 E-mail Address: info@faisombud. commissions or any valuable consideration payable Contractual arrangements with the Insurer including any restrictions or conditions Premium payment Details of your premium obligations are contained in the Policy’s Schedule of Insurance and include commissions and total amount due.co.za Website Address: www.osti.faisombud. payment dates and payment conditions. 2017 Telephone No. 6. 8.: (011) 726-8900 Facsimile No.za . it may be rejected due to such late notification. Lynwood. If you fail to notify your insurer timeously of your claim. Furthermore. Claim notification procedures Please note that should you have a claim under your policy you are required to notify your insurer whose details appear above of such claim within 180 (one hundred and eighty) days from the date the event (hospital admission) had occurred.