MoMo
My Cover by MoMo
Welcome to MyCover by MoMo. MyCover by MoMo is a Life policy offered to the MTN subscriber and underwritten by SANLAM Life Uganda (Plot 15 Princess Anne Drive, Bugolobi, Kampala), on the terms and conditions set out below (“T&Cs”).
Definitions
- “Accidental Hospitalisation” means at least 1 (one) overnight stay in Hospital which in Sanlam’s sole discretion is necessary and appropriate to treat to an Accidental Injury.
- “Accidental Injury” means a physical injury to the Insured’s body as a direct result of an accidental violent external and visible force such as a road accident, fire or violence.
- “Hospital” means a hospital registered with the Uganda Medical and Dental Practitioners Council as published on http://www.umdpc.com/registers.php.
- “Insured Event” means, in respect of MyHospital, the Policyholder’s Hospitalisation or, in respect of MyLife, the Policyholder passing away, subject to the Terms and Conditions.
- “Illness Hospitalisation” means at least a 2 (two) night stay in Hospital which in Sanlam’s sole discretion is necessary and appropriate to treat to an illness.
- “MyLife” means the insurance cover for the death of the Policyholder.
- “Next of Kin” means the natural person nominated by the Policyholder who is entitled to the insurance benefits in respect of MyLife.
- “MyHospital” means the insurance cover for the Accidental Hospitalisation or Illness Hospitalisation of the Policyholder, depending on the benefit selected. The cover is limited to treatment received in a Hospital by a medical practitioner who has been licensed by the Uganda Medical and Dental Practitioners Council to practice at the time of the treatment, as published on the annual practicing licenced register http://www.umdpc.com/registers.php.
- “Policyholder” means the individual who is the user and owner of the MTN Uganda mobile number who successfully registered for MyCover by MoMo. The Policyholder will always be the life insured.
- “Premium” means the amount payable in advance by the Policyholder for the MyCover by MoMo policy to become effective.
- “Subscriber” means a natural person that owns an MTN Uganda mobile number, which is used only on a prepaid basis.
- “Waiting Period” means a period of time during which insurance cover commences, but Sanlam will not pay any benefits for the duration of such waiting period specified in the policy, and the premiums remain payable.
- SANLAM Life Uganda is the Underwriter of the MyCover by MoMo product
Premium & Cover Received
- The MyCover by MoMo Policy provides the Policyholder with MyLife and MyHospital benefit.
- The cover will commence following successful registration and following the receipt of Premium.
- The Policyholder will select a Premium amount which will be collected as follows, via MTN MoMo:
- The Policyholder will be required to pay the Premium due before cover commences and may purchase cover for 1 (one) month, 3 (three), 6 (six) or 12 (twelve) months.
- At the end of the selected cover term, the premium will automatically be collected for the next cover term to ensure that the Policyholder continues to enjoy cover provided by this policy.
- If a Premium is not received for a period of 90 days after all cover has expired, the policy will terminate.
- The maximum cover amount will be applied at the point of Premium payment.
- SANLAM Life Uganda reserves the right to restrict/decline the allocation of cover.
- SANLAM Life Uganda reserves the right to adjust Premium(s) at a 1 (one) days’ notice.
- SANLAM Life Uganda reserves the right to increase or decrease the maximum policy cover levels without notification to the Policyholder.
- In the case where a Policyholder is found to be registered for MyCover by MoMo on more than one mobile number, the maximum pay out for 1 (one) event on any 1 (one) life insured will be the maximum cover level.
- The benefits on a policy are linked to a mobile number and cannot be transferred to another mobile number where the Policyholder changes mobile numbers.
- Cover under the MyLife policy shall be deemed to have ceased upon payment of the MyLife Benefit.
Waiting Periods
- A 3-month waiting period applies to the Illness Hospitalisation covered by the MyHospital benefit.
- A 7-day waiting period applies to death due to natural causes covered by the MyLife benefit.
Eligibility Criteria
- A Subscriber shall be eligible for a MyCover by MoMo policy if:
- Is between the age of 18 (eighteen) and 65 (sixty-five) years of age when registering for the policy; and
- is a permanent resident in Uganda.
- SANLAM Life Uganda reserves the right to offer benefits for a limited duration or on a campaign basis to selected groups of customers from time to time.
Claims Submission
- Claims must be submitted within 30 (thirty) full consecutive days from the date of death (in the case of a MyLife claim) or the date of the hospital admission (in the case of a MyHospital claim).
- Sanlam shall verify the eligibility of all claims and may request documentary proof of identification as well as proof of the Insured Event.
- Sanlam reserves the right to route the claimant, the person initiating and driving the claims process, to a claims repudiation process if required.
- In validating a claim, the Policyholder acknowledges that Sanlam might require personal information relating to the Policyholder or the insured from a third party. The Policyholder hereby irrevocably authorizes and consents for Sanlam to request on behalf of the Policyholder, any personal information from MTN Uganda, a Hospital, a medical practitioner or any other third party that might be potentially relevant to an Insured Event for the purposes of assessing your claim.
- In the event that the time of admission to a Hospital is more than 24 hours from the time of accident/trauma event, Sanlam reserves the right to scrutinise and reject the claim if it believes that it was not an Accidental Hospitalisation.
- The frequency of MyHospital claims is limited to 3 (three) claims per 12 (twelve) month rolling period, subject to a minimum period of 30 (thirty) days between claimable Insured Events.
- For MyLife or MyHospital cover to pay out, cover must have been bought prior to the accident/trauma event date resulting in admission to a hospital for the hospital benefit, and cover must have been bought prior to the date of death for the life benefit. The claim amount shall therefore be the applicable cover amount accumulated as on the day before the claim event date.
- Claims will NOT be paid under the following circumstances if:
- any material information in any relevant document (such as the death certificate) is incorrect or incomplete, or if any other relevant material information is withheld.
- the Policyholder or Claimant commits fraud or attempts to commit fraud against Sanlam when claiming benefits under the policy.
- Sanlam is not notified within the minimum required time after the claim event occurred.
- the claim was caused, directly or indirectly, by active participation in war, invasion, acts of foreign enemies, hostilities, warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power.
- the treatment in the Hospital did not comply with the procedures and clinical guidelines prescribed in the Uganda clinical Guidelines 2016 as published from time-to-time by the Republic of Uganda Ministry of Health Board, was not considered to be medically necessary or could have been provided at a lower level of medical care.
- the Hospitalisation leading to the claim resulted from self-inflicted injury, abuse of alcohol or illegal narcotics, pregnancy or childbirth, dental and optical conditions, mental and emotional conditions, and cosmetic and elective surgery.
- If a claim is in any respect fraudulent, intentionally exaggerated or misrepresented in any manner, all benefits under the policy shall be forfeited and SANLAM Life Uganda may terminate the policy without the obligation to refund any of the premiums already paid under the policy.
- If the Next of Kin (beneficiary) is deceased, cannot be located within a reasonable period of time or has not been nominated, Sanlam shall in its sole discretion be entitled to pay the benefit to any person that is of an insurable interest to the Insured.
- The acceptance and processing of a claim does not in any way imply that a claim has been approved for payment. This decision to admit or repudiate a clam shall remain within the sole discretion of SANLAM LIFE Uganda.
- To initiate a claim, WhatsApp your medical documents to (256) 077 95 95 481. Remember to include your Mobile number on the documents you are sending. Or visit the nearest MTN service Center for assistance.
Policy Termination and Reinstatement
- The policy will terminate when the Policyholder turns 70 (seventy) years old or upon death, if earlier.
- A Policyholder can cancel the policy at any time. However, no refund of Premium(s) shall be made, all policy cover yet to expire will apply until the cover purchased expires.
- A Policyholder can reinstate the policy at any time by registering for a new MyCover by MoMo policy with all relevant Terms and Conditions of a new policy applicable.
Complaints
For complaints or compliments please call 100.
Laws Applicable
- The policy cover shall be governed and construed in accordance with the Laws of Uganda.
- Sanlam shall be free from all obligations under this policy if at any time it is found that there has been wilful or fraudulent misrepresentation by the Policyholder, in which all monies paid to (or payable by) Sanlam shall be forfeited.
- The policy cover cannot be sold or exchanged for cash.
- This policy shall not attain any surrender or loan value and therefore no benefits can be paid unless the Insured Event on which the benefit amount is payable has occurred.
Data Sharing
- In order for us to offer our services to you and administer this policy MTN must collect, process and store your personal information which may include special personal medical information about you and your beneficiaries and MTN may be required to disclose this information to 3rd parties. MTN might also require personal information relating to you from a third party.
- You hereby authorize and consent for Sanlam as Underwriter to request on your behalf, any personal information from MTN, a Hospital, a medical practitioner, health care professional or any other third party that might be relevant for the purposes of administering this policy inclusive of assessing and processing your claim.
- For more information on specific categories of information and how MTN and Sanlam will use your information please visit their Privacy Statement on their website.
- Processing of your information includes MTN and SANLAM Life Uganda exporting your personal information outside of the borders of Uganda to the extent lawful and for its intended purpose.
Additional Information
- Enquiries on product, service and claims can be referred to: www.mtn.co.ug or the following MTN Call Centre Helpline which will be available to answer generic questions: 100.
- Policyholders may also refer to the section on Frequently Asked Question (FAQs) on the website: www.mtn.co.ug .