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BIMA PERSONAL ACCIDENT INSURANCE POLICY

Whereas the Insured Person by a proposal which shall be the basis of the contract and be held as incorporated herein has applied to the Company for the insurance hereinafter contained and has paid or agreed to pay the first premium as consideration for such insurance.

Now this policy witnesses that subject to the terms conditions and exceptions contained herein or endorsed hereon, if at any time during the period of insurance, if the Insured Person shall sustain any Bodily Injury caused by Accident as defined herein, the Company will pay to the Insured Person or in the event of his death, to his Beneficiary, if surviving, otherwise to the estate of the Insured Person the Benefit stated in the Policy Schedule attached hereto

DEFINITIONS

  • ACCIDENT means a sudden, unexpected, unusual, specific event, which occurs at an identifiable time and place.
  • ACCIDENT PROTECTION PLAN means one of the personal accident insurance covers under this Insurance Policy.
  • ALFALAH refers to the COMPANY, the INSURER, or Alfalah Insurance Company Limited
  • APPLICANT means the individual who applies for an Accident Protection Plan under this Policy.
  • BENEFICIARY is defined as Beneficiary in the application or the person substituted as such.
  • INSURANCE BENEFIT(S) are amounts payable in the event of an idemnifiable claim and as detailed in the Schedule of Insurance Benefits attached hereinafter.
  • BIMA refers to Milvik Mobile Pakistan.
  • BODILY INJURY means Bodily Injury which is
    • sustained by the Insured Person during the period of insurance and;
    • caused by external, violent and visible means and;
    • is solely and independently of any other cause, except illness directly resulting from, or medical or surgical treatment rendered necessary by such Bodily Injury, occasions the death or Disablement of the Insured Person within twelve calendar months from the date of the Accident by which such Bodily Injury is caused.
  • The COMPANY is stated as Alfalah Insurance Company Limited.
  • ELIGIBLE APPLICANT means an Applicant who meets the eligibility criteria set forth in this Policy.
  • END USER PRICE means the amount to be charged to the Subscriber for getting the Insurance Policy and it shall include the Premium, Jazz’s Consideration and any applicable taxes on the telco services involved in the provision of Insurance Services.
  • HOSPITAL is defined as "Any institution in Pakistan that has been registered as a hospital with the local authorities and is under the supervision of a registered and qualified medical doctor."
  • INSURANCE COVER means the amount which shall be paid by Alfalah to the Beneficiary or the Insured as per the terms and conditions of the Insurance Policy.
  • INSURANCE POLICY means this insurance policy setting out the terms and conditions on which insurance coverage is granted to a Subscriber.
  • INSURANCE SERVICES shall mean the insurance services to be provided to Jazz Customers.
  • The INSURED or INSURED PERSON means any Jazz Telecom subscriber who opt to purchase policy.
  • The INSURER is stated as Alfalah Insurance Company Limited.
  • MSISDN shall mean Mobile Subscriber Integrated Services Digital Network Number.
  • PERMANENT DISABLEMENT means TOTAL OR PARTIAL PERMANENT DISABLEMENT as defined hereunder
    • TOTAL AND PERMANENT DISBLEMENT means the Insured Member has established to the satisfaction of Insurer that the Insured Member has been incapacitated by Injury to such an extent as to render the Insured Member unable ever to engage in or work for reward in any occupation or work (on a temporary basis, part-time basis or full-time basis) which the Insured Member is capable of performing by reason of his or her education, training or experience.
    • PERMANENT PARTIAL DISABLEMENT means all those bodily injuries which result in reducing the insured person’s ability to work as defined in the Table of Insurance Benefits.
  • PREMIUM means the premium payable by an Insured Member to Insurer in relation to the Insurance Policy.
  • SUBSCRIBER means those Jazz Customers who subscribe for the Insurance Services to get this Insurance Policy.
  • JAZZ refers to 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, IBC Building, F-8 Markaz, Islamabad, Pakistan.
  • JAZZ CUSTOMERS shall mean the customers of Jazz using Jazz’s System.
  • JAZZ SYSTEMS means Jazz’s GSM mobile cellular system.
  • JAZZ PAYMENT TERMS means Jazz’s payment terms published at jazz.com.pk , as revised from time to time.

EXCLUSIONS

Payment of claims is subject to exclusions, as outlined below. The Personal Accident Insurance Cover shall not cover any Death or Permanent Disability which is caused by, or resulting, directly or indirectly, wholly or partly, from any of the following factors:

  • Suicide or any attempt thereat (sane or insane).
  • Kidnapping for ransom.
  • To any death or injury sustained whilst the Insured is under the influence (temporarily or otherwise) of intoxicants, alcohol or drugs.
  • 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
  • kidnapping for ransom

GENERAL PROVISIONS

1. Eligibility & Enrolment

Applicants are eligible to apply for an Accident Protection Plan under the Policy if Applicants meet ALL the criteria set out below:

  1. 1. Eligible Applicants shall include individual pre-paid and post-paid Jazz Customers. It is understood and agreed between the Parties that only one (1) person shall be insured per pre-paid or post-paid telecommunication connection.
  2. 2. All Eligible Applicants shall be natural persons. Corporations, partnerships and businesses shall not be eligible for coverage under the Personal Accident Policy.
  3. 3. All Eligible Applicants shall be a minimum of eighteen (18) years of age and a maximum of sixty four (64) years of age at the time of registration.
  4. 4. If the Applicant wishes to apply for and subscribe to an Accident Protection Plan under this Insurance Policy, the Applicant will be required during the registration process to:
    1. I. acknowledge that the Applicant has read and understood the terms of the Policy and the Jazz Payment Terms;
    2. II. confirm that the Applicant meets the eligibility criteria set out in General Provision 1 of the policy;
    3. III. confirm the Accident Protection Plan that the Applicant wishes to apply for;
    4. IV. authorize Jazz to make 30 daily deductions each month from the prepaid account and
    1. a) the Insurance Benefits payable are subject to the Applicant’s confirmations being true and correct; and
    2. b) if the Applicant’s confirmation is untrue or incorrect, no Insurance Benefits will be payable and the End User Price the Subscriber paid will not be refunded.

2. Mistake in Age

The Company shall only pay Insurance Benefits based on the disclosed age of the Insured. With the onus on the customer for incorrect disclosure the Company shall not be liable to pay any benefit under this Policy in that particular case.

3. Intentional False Statements Of The Insured

In the event of any concealment or misrepresentation the Personal Accident Policy shall become null and void with respect to the relevant Insured.

4. Notice Of Claims

the Company shall be notified of the occurrence of Death of the Insured or the Permanent Disablement of the Insured as soon as possible, but not later than 180 (one hundred & eighty) days from the date of Death or occurrence of Permanent Disablement after which it shall be treated as time‑barred and the Company shall not be bound to pay the Claim.

For each Claim reported, the Company shall obtain:

From the Claimant:

In case of Death:

A notice of death, which could be a legal death certificate, a certificate of attending physician, containing his registration number and mentioning actual cause of death, and proof of the personal identity of the Insured, which could be the official personal identity data.

In case of Permanent Disablement:

Medical report containing the degree of Disablement certified by the surgeon.

In case of Permanent Disablement, unnatural or unusual death, Insurer may require any other document it reasonably deems necessary before approving a claim under the Policy.

1) The Company" shall process and pay genuine and approved claims on receipt of required documents from the Claimant within three (3) working days.

2) If there is a dispute, suspected fraudulent activity on the claim or a unique situation which requires further clarification, the payment period can be extended but shall not exceed ten (10) working days, or as long as the dispute takes to resolve in the legal system.

5. Termination Of Individual Insurance

The insurance of an Insured shall automatically terminate at the earliest time below:

1) Upon payment on Death or
2) Upon settlement of the Insured of the amount of insurance, including in the event of early termination of such relationship; or
3) Upon cancellation or withdrawal of subscription by Jazz of the contract/relationship with the Insured, whatever the reason may be, or
4) In case of non-payment of the individual End User Price for the Insurance Policy.

6. Participation Requirement/Process

Interested customers shall participate through an electronic enrolment process, assisted by a call center or field agent, or by submitting information electronically via their handset, in two phases:

1st Phase:
Name of the Customer:
Age or CNIC Number:
Name of the Beneficiary:
Relationship to Customer:
Insurance Benefits selected by Customer:

2nd phase:
Once the customer has answered the questions in the 1st Phase, the customer shall receive an SMS on for or on behalf of the Company and shall be asked to dial a short code, or send an SMS to a particular number to confirm registration. Alternatively, the Customer may offer his verbal consent over an official recorded channel managed by BIMA to a BIMA agent. This confirmation serves as digital signature for the Personal Accident Insurance Cover. After receiving positive response, the customer shall be enrolled under the Personal Accident Policy.

7. Arbitration

All differences arising out of this policy shall be referred to the decision of an arbitrator to be appointed in writing by the parties in difference or if they cannot agree upon a single arbitrator to the decision of two arbitrators one to be appointed in writing by each of the parties within one calendar month after having been required in writing so to do by either of parties or incase the arbitrators do not agree of an umpire appointed in writing by the arbitrators before entering upon the reference. The umpire shall sit with the arbitrators and preside at their meetings and the making of an award shall be a condition precedent to any right of action against the Company. If the Company shall disclaim liability to the Insured Person for any claim hereunder and such claim shall not within twelve calendar months from the date of such disclaimer have been referred to arbitrator under the provisions herein contained then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder. Notwithstanding stated above, dispute resolution forums given under the Insurance Ordinance, 2000, such as the Insurance Ombudsman, Small Disputes Resolution Committee and the Insurance Tribunals, shall prevail in the order of precedence, and over the seat of Arbitration.

8. Compliance with Policy Provisions

Failure to comply with any of the provisions contained in the policy shall invalidate all claims hereunder.

9. Insurance Benefits

The Company hereby agrees to pay the following benefit subject to the terms and conditions provided under the Personal Accident Policy as defined hereunder.

If an Insured dies or is permanently disabled due to an Accident as defined herein, on a twenty four (24)-hour worldwide basis, the Company will, upon receipt of due proof in writing of the Death or Permanent Disablement of the insured, pay the Insured or Beneficiary as the case may be the sum assured, according to their Insurance Cover level as described in this Insurance Benefits Section of the Policy Wording, as full and final settlement of Death or Permanent Disablement Claim in respect of the deceased/disabled Insured.

Benefit:

The amount of benefit received by the Insured or the Beneficiary in the event of the accidental Death or Total and Permanent Disablement of the Insured will be according to the amount of premium paid and subject to the terms and conditions of the product.

Terms and conditions of this cover are as follows:

For pre-paid accounts, if the Applicant pays less than the monthly Premium due in the preceding calendar month, a proportionately reduced amount of insurance benefit will be provided based on the following thresholds for the different insurance policies:

1. Only One (1) policy per applicant
2. A Claim must be intimated to the Company within one hundred & eighty (180) days from the date of occurrence of the Death or Permanent Disablement
3. Payment of claims is subject to exclusions, as outlined in the Exclusions section of this contract
4. In the event of partial pay-out following Permanent Disablement due to Accident, the Company shall permit renewal of the insurance offer on a case-by case basis, and inform the registered subscriber accordingly. The following actions shall be taken depending on the decision of renewal or non-renewal:
5. On non-renewal: The insurance policy shall be terminated, and all airtime deduction or billing shall be discontinued; any amount deducted or billed after the occurrence of the accident is nonrefundable.
6. On renewal: the insurance policy shall continue on auto-renewal, and all airtime deduction or billing will continue to apply in subsequent calendar month

The Personal Accident Insurance Cover is extended to one (1) person per Warid subscriber who is a successful Applicant for the Personal Accident Insurance Cover. Each Applicant is allowed to select the level of maximum insurance benefit at the point of Enrolment.

Monthly Price

Daily

Method of Payment

Level of Maximum Insurance Benefits provided

43.80

1.46

Prepaid balance

PKR 200,000

87.60

2.92

Prepaid balance

PKR 400,000

218.70

7.29

Prepaid balance

PKR 1,000,000

437.10

14.57

Prepaid balance

PKR 2,000,000

For pre-paid accounts, if the Applicant pays less than the monthly Premium due in the preceding calendar month, a proportionately reduced amount of insurance benefit will be provided based on the following thresholds for the different insurance policies:

PKR 200,000 POLICY

 

Amount of End User Price paid in calendar month (PKR)

Insurance cover in following calendar month (PKR)

43.80

200,000

42.34

193,333

40.88

186,667

39.42

180,000

37.96

173,333

36.50

166,667

35.04

160,000

33.58

153,333

32.12

146,667

30.66

140,000

29.20

133,333

27.74

126,667

26.28

120,000

24.82

113,333

23.36

106,667

21.90

100,000

20.44

93,333

18.98

86,667

17.52

80,000

16.06

73,333

14.60

66,667

13.14

60,000

11.68

53,333

10.22

46,667

8.76

40,000

7.30

33,333

5.84

26,667

4.38

20,000

2.92

13,333

1.46

6,667

0

Nil


PKR 400,000 policy

 

Amount of End User Price paid in calendar month (PKR)

Insurance cover in following calendar month (PKR)

87.60

400,000

84.68

386,667

81.76

373,333

78.84

360,000

75.92

346,667

73

333,333

70.08

320,000

67.16

306,667

64.24

293,333

61.32

280,000

58.40

266,667

55.48

253,333

52.56

240,000

49.64

226,667

46.72

213,333

43.80

200,000

40.88

186,667

37.96

173,333

35.04

160,000

32.12

146,667

29.20

133,333

26.28

120,000

23.36

106,667

20.44

93,333

17.52

80,000

14.60

66,667

11.68

53,333

8.76

40,000

5.84

26,667

2.92

13,333

0

Nil


PKR 1,000,000 policy

 

Amount of End User Price paid in calendar month (PKR)

Insurance cover in following calendar month (PKR)

218.70

1,000,000

211.41

966,667

204.12

933,333

196.83

900,000

189.54

866,667

182.25

833,333

174.96

800,000

167.67

766,667

160.38

733,333

153.09

700,000

145.80

633,333

138.51

633,333

131.22

600,000

123.93

566,667

116.64

533,333

109.35

500,000

102.06

466,667

94.77

433,333

87.48

400,000

80.19

366,667

72.90

333,333

65.61

300,000

58.32

266,667

51.03

233,333

72.90

333,333

65.61

300,000

58.32

266,667

51.03

233,333

43.74

200,000

36.45

166,667

29.16

133,333

21.87

100,000

14.58

66,667

7.29

33,333

0

Nil


PKR 2,000,000 policy

 

Amount of End User Price paid in calendar month (PKR)

Insurance cover in following calendar month (PKR)

437.10

2,000,000

422.53

1,933,333

407.96

1,866,667

393.39

1,800,000

378.82

1,733,333

364.25

1,666,667

349.68

1,600,000

335.11

1,533,333

320.54

1,466,667

305.97

1,400,000

291.40

1,333,333

276.83

1,266,667

262.26

1,200,000

247.69

1,133,333

233.12

1,066,667

218.55

1,000,000

203.98

933,333

189.41

866,667

174.84

800,000

160.27

733,333

145.70

666,667

131.13

600,000

116.56

533,333

101.99

466,667

87.42

400,000

72.85

333,333

58.28

266,667

43.71

200,000

29.14

133,333

14.57

66,667

0

nil


Death / Total Permanent Disablement

% of maximum insurance benefit paid

Accidental Death

100%

Amputation or Loss of use of two limbs

100%

Amputation or Loss of use of both hands, or of all fingers and both thumbs

100%

Total paralysis or Injuries resulting in being Permanently bedridden or Disablement

100%

Total insanity

100%

Total and irrevocable loss of all sight in both eyes

100%


PERMANENT PARTIAL DISABLEMENT

% of maximum insurance benefit paid

Amputation or Loss of use of a limb

50%

Amputation or Loss of use of four fingers and thumb on one hand

50%

Total and irrevocable loss of all sight in one eye

50%

Total Loss of hearing or speech

50%

Burns – 3rd degree covering more than 9% of body

50%


- In addition to the Personal Accident Insurance Cover, the Insured is entitled to cover for each night spent in hospital (hospitalization) due to an Accident. For each night spent in hospital, the Insured is eligible for the greater of (i) PKR 500, or (ii) 0.25% of the monthly sum insured, according to the Insurance Cover level as described in the Insurance Benefits Section of the Policy Wording above. For example, if the customer is deducted PKR 60+taxes and receives PKR 400,000 of monthly Personal Accident Insurance Cover, and the Insured is hospitalized due to an accident for 2 nights but not permanently disabled, the Insured will receive PKR 2000 of cover. This additional cover is paid out for a maximum of 30 nights in a given year. The Insured cannot claim both Personal Accident Insurance Cover and this additional cover for the same incident.

- This additional cover is subject to the same terms and conditions as the Personal Accident cover meaning for example that: no cover will be provided if the Insured is not receiving any cover in the present month or if the Insured is ineligible because the Insured fails to meet the criteria or is in hospital due to an exclusion or in hospital for any other reason other than an Accident.

- In addition to the Personal Accident Insurance Cover, the Beneficiary is entitled to a one-off funeral expense in case of death of the Insured for any reason. The funeral expense depends on the End User Price paid the month preceding the month of death.

  • If any amount between PKR 1.46 and PKR 36.50 User Price has been paid the relevant month, the Beneficiary is entitled to PKR 25,000 in funeral expense.
  • For every incremental PKR 1.46 above PKR 36.50 paid of the End User Price the relevant month, the Insured is entitled to an additional PKR 1,000 in funeral expense.
    • Example 1: if PKR 37.96 has been paid of End User Price the relevant month, the Beneficiary is entitled to PKR 26,000 in funeral expense.
    • Example 2: if PKR 1.46 has been paid of End User Price the relevant month, the Beneficiary is entitled to PKR 25,000 in funeral expense.

Funeral cover will be given in case death is caused by any event, including if it is caused by any of the excluded event (mentioned in the Exclusions)

However, no cover will be provided if the Insured is not eligible for any cover in the present month due to not having paid End User Price, or, if the Insured is ineligible because the Insured fails to meet the eligibility criteria.

The Personal Accident Insurance Cover and this additional one-off funeral cover can be claimed for the same event."

ACKNOWLEDGEMENT OF THE CUSTOMER
(POLICY TERMS AND CONDITIONS SHALL REMAIN SUBJECT TO THE FOLLOWING)

Bima is the Insurance broker who has been authorized by Alfalah Insurance Company Limited to bind cover on behalf of Insurer within the terms and conditions of this Insurance Policy. To cease daily deductions, the Subscriber must deregister the Subscriber's Accident Protection Plan by contacting Bima. Otherwise, Jazz will continue making daily deductions for so long as the Subscriber's prepaid account has a positive credit balance.

In the event that the Subscriber, as an Insured Member, subscribe to more than one (1) Accident Protection Plan under the Insurance Policy (including through different Jazz mobile accounts):

1. The Subscriber's maximum benefit shall be the maximum benefit offered by only one of the Accident Protection Plans that the Subscriber has subscribed to;

2. Our maximum liability to the Subscriber or the Subscriber's beneficiary shall be the higher of the two Accident Protection Plans that the Subscriber subscribed to;

After becoming the Subscriber in the Insurance Service, Jazz Subscriber permits Jazz to share his details and information available with Jazz and as sought by Alfalah Insurance and Bima or any other entity authorized by Alfalah Insurance in this regard, for inter alia processing of the Policy, storing and processing data across countries, and more effectively providing the Insurance Service and payment of Insurance Cover; Jazz Customer/Subscriber agrees and acknowledges that he or his legal heirs shall not hold Jazz responsible for any consequences of sharing such information;

Fraud or abuse relating to Re-Load/Re-Charge may result in forfeiture/cancellation of the Policy, suspension of Jazz Services of the Customer/Subscriber and termination of his Connection; and While availing the Insurance Service the Subscriber shall not respond to any calls/SMSs directing to make/send calls/SMSs to any other number/short code or which are regarding award of any prize (whether money or in kind) in lieu of balance transfer or any call. Ignorance of this clause by Jazz Customer/Subscriber shall not accrue any liabilities/responsibilities on Alfalah Insurance or Jazz including but not limited to liability/responsibility towards any loss occurred to the Jazz Customer/Subscriber

Jazz, Alfalah, or Bima may amend these Terms and Conditions at any time. The Subscriber shall be informed through an SMS or any other manner in accordance with the relevant laws that these Terms and Conditions are amended. Such SMS or information through any other manner (as mentioned above) shall contain a link to such amended Terms and Conditions, and if the Subscriber shall continue to pay for the Insurance Cover it shall be the acceptance of the Subscriber to the amended Terms and Conditions.

Jazz, Bima, and Alfalah may jointly amend the Service Charges from time to time at their discretion in accordance with the applicable laws and regulations of Pakistan Telecommunication Authority ("PTA"). The acceptance of these Terms and Conditions of the Subscriber shall also be the acceptance with the End User Price to be charged to provide the Insurance Policy;

Alfalah, Jazz, and Bima have the complete authority to stop offering the Accident Protection Plan or Policy at any time at their discretion.

The Subscriber acknowledges that these Terms and Conditions are in addition to the terms and conditions accepted by the Subscriber at the time of availing Jazz's cellular services (which includes the terms and conditions of CSAF and the terms and conditions received in the SIM Jacket). However in case of conflict between these Terms and Conditions and terms and conditions of CSAF, these Terms and Conditions shall prevail to the extent of subject matter of these Terms and Conditions.

The domestic laws of the Islamic Republic of Pakistan shall govern the Insurance Policy and the Courts of the Islamic Republic of Pakistan shall have jurisdiction in any dispute arising hereunder.

If any provision of the Insurance policy is found by any court or administrative body of competent jurisdiction to be invalid or unenforceable, such invalidity or unenforceability will not affect the other provisions of the Insurance policy which will remain in full force and effect.

This policy has been especially created to provide protection for those Jazz Customers who successfully apply for that protection and who pay the appropriate Premium. Accordingly, notices to the Subscriber may be provided by:

SMS to the Subscriber's prepaid mobile service (from which daily deductions are made);If a notice is made by SMS, the notice is deemed to be received on the day the SMS is sent. If a notice is placed on a website, the notice is deemed to be received on the day the notice is placed notification placed on Jazz.com.pk or on the Insurer's website at http://www.alfalahinsurance.com/ ; or on www.milvikpakistan.com by publication in a major newspaper in the Islamic Republic of Pakistan.

 
 
Abu Dhabi Group is represented in Pakistan by the following entities:
   
 
Copyright 2018, All Rights Reserved - Alfalah Insurance Company Limited - Powered by Alfalah Insurance IT Team Last Updated on 22/11/2018