Hifazat Kamil Plan is underwritten and distributed by EFU Life
EFU Life is a leading life insurance company and is part of largest insurance group in Pakistan which provides insurance coverage to millions of Pakistanis.
Jazz Telecom is facilitating this offering but shall not be responsible for any grievance of the Jazz Customer relating to Hifazat Kamil Plan and EFU Life Insurance’s performance of its obligation.
1.DEFINITIONS
Hifazat Kamil PLAN means a term assurance product which provides a guaranteed level of life insurance protection against death, accidental permanent total disability alongwith Telehealth Services.
ACCIDENT means accidental bodily injury which is caused solely by violent, external and accidental means resulting directly and independently of all other causes.
AUTHORIZED REPRESENTATIVE means an official of the Company who has been authorized by the Company to transact business on behalf of the Company under this Policy.
COMPANY means EFU Life Assurance Limited
ELIGIBLE PERSON means customers of the Group Policy Holder, male or female Pakistani nationals, who is eligible for insurance cover under this policy in accordance with Clause 2 of these provisions and conditions.
COMMENCEMENT DATE means the date on which the cover becomes effective which will be from 00:01 hours on the 1st day of next month following the date on which the premium is paid after acceptance of the application by the Member.
GROUP POLICY HOLDER means Pakistan Mobile Communications Limited or Jazz.
ENROLLMENT DATE means the date on which the Member was initially enrolled under this Policy.
ENROLLMENT MONTHIVERSARY DATE means a period of one month of the date on which an Insured Person was initially enrolled under this Policy.
CORPORATE INSURANCE AGENT means Hello Doctor (Private) Limited responsible for providing Telehealth services , enrolling and servicing customers.
MOBILE NETWORK OPERATOR means Pakistan Mobile Communications Limited, a company duly incorporated and registered under the Companies Ordinance 1984 of Pakistan and having its registered office at 1-A Kohistan Road, DHQ-1 F-8 Markaz, Islamabad, Pakistan.
MEMBER means an Eligible Person who is to be included in this policy after giving his valid documented or recorded consent to purchase this insurance and pay required premium amount.
NOMINEE means a person or persons appointed by the Member (under the provisions of the Insurance Ordinance 2000) to receive the benefits payable under the policy.
POLICY TERM means the period of one month beginning from the first day of a calendar month and ending on the last day of same calendar month.
RENEWAL DATE means any subsequent monthiversary of the Commencement Date.
RENEWAL ENROLLMENT means Re-enrolment of the Member into this Policy upon payment of premium on Renewal Date.
SICKNESS means sickness or disease contracted for the first time after the Commencement Date or Renewal Date.
Words importing the singular number include the plural number and vice versa and words of masculine gender shall include the feminine unless the context otherwise requires.
2.ELIGIBILITY
The eligible persons for this Policy are the present and future customers of the Group Policy Holder who are within the Eligibility Age range i.e. 18 to 66 years and have given their valid consent to opt for insurance cover under this policy. Any Member shall not be eligible for multiple enrollments at a single point in time.
3.EFFECTIVE DATE OF INDIVIDUAL ASSURANCE
Member will become eligible from 1st day of next calendar month following the date on which the premium is paid after acceptance of the application by the Member.
4.EVIDENCE OF AGE
Evidence of age of a Member satisfactory to the Company will be required before any benefit in respect of him/her is paid under this Policy and if after commencement of the insurance cover hereunder the date of birth of any Member is found to have been incorrectly notified to the Company, the Company shall notify the Group Policyholder of the adjustment to be made under this Policy in respect of such incorrect notification. No benefit whatsoever shall be payable under the Policy if the correct age of the Member is found to be more than maximum eligibility age of 66 years.
5.AMOUNT & CALCULATION OF PREMIUM
Premiums under this Policy are payable by the Group Policy Holder at such office/ offices of the Company as the Company may designate in writing to the Group Policy Holder from time to time. The Company may authorize the Corporate Insurance Agent to collect premium from the Group Policy Holder on its behalf. Such authorization will be in writing and provided to the Group Policy Holder. Premiums are due by the 1st of each calendar month for all such eligible Members, who are to be covered as per the terms and conditions of the Policy. At the time of initial enrollment of the Member and at each subsequent Renewal Enrollment, the Group Policy Holder will calculate the monthly premium as per the following table:
| Plan Category | Monthly Premium (PKR) | Daily Premium (PKR) |
|---|---|---|
| SILVER | 94.5 | 3.15 |
| GOLD | 132 | 4.4 |
| PLATINUM | 179.4 | 5.98 |
The coverage will start from the 1st day of the next month. Where full premium for an insured Member is not paid any benefit amount will be adjusted on Pro rata basis as per the variant wise table below.
Silver Plan
| Amount of End User Price paid in calendar month (PKR) | Education Continuation Benefit (12 Months) |
Income Continuation Benefit (12 Months) |
Accidental Death Benefit (Lump sum) |
Telehealth Subscription |
|---|---|---|---|---|
| Nil | Nil | Nil | Nil | Nil |
| 3.15 | 66.67 | 333.33 | 8,333.33 | Unlimited per month for family |
| 6.3 | 133.33 | 666.67 | 16,666.67 | Unlimited per month for family |
| 9.45 | 200 | 1,000.00 | 25,000.00 | Unlimited per month for family |
| 12.6 | 266.67 | 1,333.33 | 33,333.33 | Unlimited per month for family |
| 15.75 | 333.33 | 1,666.67 | 41,666.67 | Unlimited per month for family |
| 18.9 | 400 | 2,000.00 | 50,000.00 | Unlimited per month for family |
| 22.05 | 466.67 | 2,333.33 | 58,333.33 | Unlimited per month for family |
| 25.2 | 533.33 | 2,666.67 | 66,666.67 | Unlimited per month for family |
| 28.35 | 600 | 3,000.00 | 75,000.00 | Unlimited per month for family |
| 31.5 | 666.67 | 3,333.33 | 83,333.33 | Unlimited per month for family |
| 34.65 | 733.33 | 3,666.67 | 91,666.67 | Unlimited per month for family |
| 37.8 | 800 | 4,000.00 | 100,000.00 | Unlimited per month for family |
| 40.95 | 866.67 | 4,333.33 | 108,333.33 | Unlimited per month for family |
| 44.1 | 933.33 | 4,666.67 | 116,666.67 | Unlimited per month for family |
| 47.25 | 1,000.00 | 5,000.00 | 125,000.00 | Unlimited per month for family |
| 50.4 | 1,066.67 | 5,333.33 | 133,333.33 | Unlimited per month for family |
| 53.55 | 1,133.33 | 5,666.67 | 141,666.67 | Unlimited per month for family |
| 56.7 | 1,200.00 | 6,000.00 | 150,000.00 | Unlimited per month for family |
| 59.85 | 1,266.67 | 6,333.33 | 158,333.33 | Unlimited per month for family |
| 63 | 1,333.33 | 6,666.67 | 166,666.67 | Unlimited per month for family |
| 66.15 | 1,400.00 | 7,000.00 | 175,000.00 | Unlimited per month for family |
| 69.3 | 1,466.67 | 7,333.33 | 183,333.33 | Unlimited per month for family |
| 72.45 | 1,533.33 | 7,666.67 | 191,666.67 | Unlimited per month for family |
| 75.6 | 1,600.00 | 8,000.00 | 200,000.00 | Unlimited per month for family |
| 78.75 | 1,666.67 | 8,333.33 | 208,333.33 | Unlimited per month for family |
| 81.9 | 1,733.33 | 8,666.67 | 216,666.67 | Unlimited per month for family |
| 85.05 | 1,800.00 | 9,000.00 | 225,000.00 | Unlimited per month for family |
| 88.2 | 1,866.67 | 9,333.33 | 233,333.33 | Unlimited per month for family |
| 91.35 | 1,933.33 | 9,666.67 | 241,666.67 | Unlimited per month for family |
| 94.5 | 2,000.00 | 10,000.00 | 250,000.00 | Unlimited per month for family |
Gold Plan
| Amount of End User Price paid in calendar month (PKR) | Education Continuation Benefit (12 Months) |
Income Continuation Benefit (12 Months) |
Accidental Death Benefit (Lump sum) |
Telehealth Subscription |
|---|---|---|---|---|
| Nil | Nil | Nil | Nil | Nil |
| 4.4 | 100 | 500 | 11,666.67 | Unlimited per month for family |
| 8.8 | 200 | 1,000.00 | 23,333.33 | Unlimited per month for family |
| 13.2 | 300 | 1,500.00 | 35,000.00 | Unlimited per month for family |
| 17.6 | 400 | 2,000.00 | 46,666.67 | Unlimited per month for family |
| 22 | 500 | 2,500.00 | 58,333.33 | Unlimited per month for family |
| 26.4 | 600 | 3,000.00 | 70,000.00 | Unlimited per month for family |
| 30.8 | 700 | 3,500.00 | 81,666.67 | Unlimited per month for family |
| 35.2 | 800 | 4,000.00 | 93,333.33 | Unlimited per month for family |
| 39.6 | 900 | 4,500.00 | 105,000.00 | Unlimited per month for family |
| 44 | 1,000.00 | 5,000.00 | 116,666.67 | Unlimited per month for family |
| 48.4 | 1,100.00 | 5,500.00 | 128,333.33 | Unlimited per month for family |
| 52.8 | 1,200.00 | 6,000.00 | 140,000.00 | Unlimited per month for family |
| 57.2 | 1,300.00 | 6,500.00 | 151,666.67 | Unlimited per month for family |
| 61.6 | 1,400.00 | 7,000.00 | 163,333.33 | Unlimited per month for family |
| 66 | 1,500.00 | 7,500.00 | 175,000.00 | Unlimited per month for family |
| 70.4 | 1,600.00 | 8,000.00 | 186,666.67 | Unlimited per month for family |
| 74.8 | 1,700.00 | 8,500.00 | 198,333.33 | Unlimited per month for family |
| 79.2 | 1,800.00 | 9,000.00 | 210,000.00 | Unlimited per month for family |
| 83.6 | 1,900.00 | 9,500.00 | 221,666.67 | Unlimited per month for family |
| 88 | 2,000.00 | 10,000.00 | 233,333.33 | Unlimited per month for family |
| 92.4 | 2,100.00 | 10,500.00 | 245,000.00 | Unlimited per month for family |
| 96.8 | 2,200.00 | 11,000.00 | 256,666.67 | Unlimited per month for family |
| 101.2 | 2,300.00 | 11,500.00 | 268,333.33 | Unlimited per month for family |
| 105.6 | 2,400.00 | 12,000.00 | 280,000.00 | Unlimited per month for family |
| 110 | 2,500.00 | 12,500.00 | 291,666.67 | Unlimited per month for family |
| 114.4 | 2,600.00 | 13,000.00 | 303,333.33 | Unlimited per month for family |
| 118.8 | 2,700.00 | 13,500.00 | 315,000.00 | Unlimited per month for family |
| 123.2 | 2,800.00 | 14,000.00 | 326,666.67 | Unlimited per month for family |
| 127.6 | 2,900.00 | 14,500.00 | 338,333.33 | Unlimited per month for family |
| 132 | 3,000.00 | 15,000.00 | 350,000.00 | Unlimited per month for family |
Platinum Plan
| Amount of End User Price paid in calendar month (PKR) | Education Continuation Benefit (12 Months) |
Income Continuation Benefit (12 Months) |
Accidental Death Benefit (Lump sum) |
Telehealth Subscription |
|---|---|---|---|---|
| Nil | Nil | Nil | Nil | Nil |
| 5.98 | 166.67 | 666.67 | 16,666.67 | Unlimited per month for family |
| 11.96 | 333.33 | 1,333.33 | 33,333.33 | Unlimited per month for family |
| 17.94 | 500 | 2,000.00 | 50,000.00 | Unlimited per month for family |
| 23.92 | 666.67 | 2,666.67 | 66,666.67 | Unlimited per month for family |
| 29.9 | 833.33 | 3,333.33 | 83,333.33 | Unlimited per month for family |
| 35.88 | 1,000.00 | 4,000.00 | 100,000.00 | Unlimited per month for family |
| 41.86 | 1,166.67 | 4,666.67 | 116,666.67 | Unlimited per month for family |
| 47.84 | 1,333.33 | 5,333.33 | 133,333.33 | Unlimited per month for family |
| 53.82 | 1,500.00 | 6,000.00 | 150,000.00 | Unlimited per month for family |
| 59.8 | 1,666.67 | 6,666.67 | 166,666.67 | Unlimited per month for family |
| 65.78 | 1,833.33 | 7,333.33 | 183,333.33 | Unlimited per month for family |
| 71.76 | 2,000.00 | 8,000.00 | 200,000.00 | Unlimited per month for family |
| 77.74 | 2,166.67 | 8,666.67 | 216,666.67 | Unlimited per month for family |
| 83.72 | 2,333.33 | 9,333.33 | 233,333.33 | Unlimited per month for family |
| 89.7 | 2,500.00 | 10,000.00 | 250,000.00 | Unlimited per month for family |
| 95.68 | 2,666.67 | 10,666.67 | 266,666.67 | Unlimited per month for family |
| 101.66 | 2,833.33 | 11,333.33 | 283,333.33 | Unlimited per month for family |
| 107.64 | 3,000.00 | 12,000.00 | 300,000.00 | Unlimited per month for family |
| 113.62 | 3,166.67 | 12,666.67 | 316,666.67 | Unlimited per month for family |
| 119.6 | 3,333.33 | 13,333.33 | 333,333.33 | Unlimited per month for family |
| 125.58 | 3,500.00 | 14,000.00 | 350,000.00 | Unlimited per month for family |
| 131.56 | 3,666.67 | 14,666.67 | 366,666.67 | Unlimited per month for family |
| 137.54 | 3,833.33 | 15,333.33 | 383,333.33 | Unlimited per month for family |
| 143.52 | 4,000.00 | 16,000.00 | 400,000.00 | Unlimited per month for family |
| 149.5 | 4,166.67 | 16,666.67 | 416,666.67 | Unlimited per month for family |
| 155.48 | 4,333.33 | 17,333.33 | 433,333.33 | Unlimited per month for family |
| 161.46 | 4,500.00 | 18,000.00 | 450,000.00 | Unlimited per month for family |
| 167.44 | 4,666.67 | 18,666.67 | 466,666.67 | Unlimited per month for family |
| 173.42 | 4,833.33 | 19,333.33 | 483,333.33 | Unlimited per month for family |
| 179.4 | 5,000.00 | 20,000.00 | 500,000.00 | Unlimited per month for family |
6.BENEFITS
Upon receipt of due proof in writing that the Member has, whilst the Policy is in full force and effect, suffered any of the event(s) set out below, the Company, subject to the exclusions set out below and the terms and conditions contained herein, shall pay the following Benefits.
DEATH BENEFIT:
On death of the Member, whilst the Policy is in full force and effect, the amount of benefit payable shall be d
etermined according to the Plan Category chosen by the Member from the table given hereunder:
| Plan Category | Monthly Education Continuation Benefit for 12 months (PKR) |
Monthly Income Continuation Benefit for 12 months (PKR) |
|---|---|---|
| SILVER | 2,000 | 10,000 |
| GOLD | 3,000 | 15,000 |
| PLATINUM | 5,000 | 20,000 |
ADDITIONAL ACCIDENTAL DEATH BENEFIT:
If the Member dies as a result of injuries caused solely by violent, external and accidental means and there is evidence of a visible contusion or wound on exterior of the body except in the case of drowning or of an internal injury revealed by an autopsy, and that such death occurred within 90 days of the accident solely as a result of the same injury and not as an indirect result of any fit, physical defect, illness or disorder, the Company, upon receipt of and due investigation of the claim, will pay an amount shown in the Table of Death Risk below, in addition to any benefits under the Policy.
| Plan Category | Sum Assured (PKR) |
|---|---|
| SILVER | 250,000 |
| GOLD | 350,000 |
| PLATINUM | 500,000 |
ACCIDENTAL PERMANENT TOTAL DISABILITY BENEFIT:
If the Member whilst the Policy is in full force has sustained injuries caused solely by violent external and accidental means and within 90 days of the accident suffers the losses set out in the Table of Benefits of Accidental Disability solely as a result of the same injuries, the Company, upon receipt of and due investigation of the claim, will pay an amount depending on the type of loss as provided in the Table of benefits of Accidental Disability below.
| S.No. | Description of Injuries | Percentage of Sum Covered |
|---|---|---|
| 1 | Loss of both hands or amputation at higher sites | 100% |
| 2 | Loss of hand and a foot | 100% |
| 3 | Double amputation through leg or thigh; or amputation through leg or thigh on one side and loss of other foot | 100% |
| 4 | Loss of sight to such an extent as to render the claimant unable to perform any work for which eye-sight is essential | 100% |
| 5 | Absolute deafness | 100% |
7.CESSATION OF MEMBERSHIP
Insurance Cover shall cease on any of the following:
a) Member’s death or total disability.
b) Member having attained the age of 66 years.
c) Non-payment of premium by the Member when due.
d) Any other date on which the Member ceases to be eligible for insurance cover for any fraudulent or criminal reason affecting the insurance cover hereunder. Decision of the court shall be final in such cases.
8.EXCLUSIONS
No benefit will be paid if the death or disability of the Member results directly, wholly or partly, as a result of or related to:
a) Intentional self-inflicted injury or its attempt, murder, suicide and violation of law;
b) War, strikes, riots, civil commotion and any natural or man-made perils (including chemical, nuclear, biological, and radiological) that results in the declaration of a state of emergency on a local or national level;
9.ASSIGNMENT
The insurance cover provided for under this Policy and the benefits payable hereunder are not assignable.
10.CLAIMS
In case of any claim under the benefit(s) covered against in this policy, the same shall be notified to the Company. The Member or the Nominee at its own expense, shall furnish all information necessary to determine whether the Benefit Claimed is payable or not to the Member or the Nominee.
Written notice of claim must be presented to and received at the Main Office of the Company within three hundred and sixty five (365) days after the date of event giving rise to the claim. Otherwise the claim shall be invalid.
Company, upon receipt of such notice, will furnish forms for filing proof of Claim. The forms along with astandard claim requirements quoted by the Company must be completed and returned to within fifteen (15) days from claim notification date for which the claim is made. Such forms may include, but not limited to, the following documents.
a) Copy of Death certificate issued by NADRA / Union Council
b) Copy of CNIC of claimant and nominee and deceased member
c) Claimant Statement Form
d) Attending Physician’s Statement Form/Report
e) Police & MLO Report (in case of accidental causes)
f) Hospital Death Certificate
g) Past Medical records
h) Disability claim forms
i) Past medical records
j) Treatment record giving dates of admission and discharge, diagnosis and treatment given
k) Medical Certificate issued by treating doctor
l) Any other document deemed to be necessary for claim assessment and finalization
The insurance cover effected hereunder shall carry no paid-up or surrender value.
Claim will be processed by the Company following the submission of the claim documents to the Company or an entity authorized by the Company.
11.RENEWAL PRIVILEGE
This Policy is issued for the period shown in the Policy Schedule and may be renewed by the Member on subsequent Renewal Date subject to the conditions hereof. Renewal will be affected by the payment of the required premium when due.
12.CHANGE OF OWNERSHIP
If the business of the Group Policy Holder is transferred to or succeeded by any person or corporation then, subject to the consent of the Company, the payment of premium under this Policy may at the option of such person or corporation be continued in which case such person or corporation shall as from the date of such transfer or succession take the place of and be treated for all purposes of this Policy as being the Group Policy Holder hereof.
13.TERMINATION OF THIS POLICY
The Company reserves the right to terminate the Policy by giving 90 days’ notice. It is
clarified that any termination shall not affect the obligations of Group Policy Holder and Company assumed at any time prior
to the effective date of termination. Further, the Company reserves the right to give the Group Policy Holder three months’ written notice to add,
alter or repeal the terms and conditions of the Policy hereof.
Notwithstanding anything to the contrary in this Policy, the termination of this Policy shall have the following effect:
a) No individual enrollment shall be entertained under this Policy after the time of termination.
14.LAW
The policy is governed by and interpreted according to the laws of Islamic Republic of Pakistan.
15.STATUTORY FUND
Under the provisions of the Insurance Ordinance 2000 this policy and any additional benefits shall be referable to the Conventional Business Statutory Fund of the Company. The Company may by endorsement to the Policy change the Statutory Fund(s) to which the policy and any additional benefits are referable.