Article 1: Definitions
The following terms explain the definitions mentioned in this document and any additional appendices to it:
The company: AROPE Life Insurance – Egypt.
Insurance Application Form: It is the form in which the “insurance benefits” are requested according to the basic policy and other additional benefits that the insurance applicant signs and attaches to the policy, which form an integral part of the policy.
Additional appendices: They are the appendices of the additional coverage on the insurance application or added later, the premiums of which are paid by the insured after the approval by the Insurance company, as specified in the attached additional appendices referred to in the table of benefits and the special specifications, which form an integral part of the policy.
Insurance policy: It is the basic insurance document with its general and private terms, table of benefits, special specifications, and appendices attached to it, if any, and the underwriting within this policy
Table of benefits and special specifications: It is a document attached to the policy and forms an integral part of it, and it shows the information about the owner of the policy, the insured, the date of inception and expiration of the policy … etc, insurance coverage, and others.
Insurance starting date: It is the date on which the insurance coverage takes effect under the policy, as mentioned in the table of benefits and special specifications.
Issuing date: It is the date of issuance of the policy, as specified in the table of benefits and specifications for each policy.
Insurance expiry date: It is the date on which the policy’s validity period expires and any additional appendices attached to it, as specified in the table of benefits and special specifications table.
Policyholder: The person or legal person who applies for this policy as indicated in the insurance application, unless it is changed later. The policy owner can be an uninsured person.
The insured: is the person who issued the insurance coverage for his life according to this policy and whose name is mentioned in the insurance application and in the table of benefits and the special specifications.
Beneficiary: Any individual, individuals or legal person who is entitled to have the compensation in the event of the death of the insured under this policy, whose name is specified in the insurance application or the table of benefits and specifications, or in any subsequent amendment to the date of issuance of the policy based on the request of the owner of the policy and approved by the Insurance company.
Sum Insured: It is the amount included in the Insurance policy in the event of the death of the insured and shown in the table of benefits and specifications of the policy.
Net Installment: It is the installment that must be paid to the Insurance company and mentioned in the table of benefits and specifications of the policy according to the time frequency mentioned in the table of benefits and specifications before adding the stamps, taxes and fees due on it.
The insurance period: as specified in the table of benefits and specifications of the policy.
Article 2 – Subject
Under this policy and after paying the premiums, AROPE Life Insurance – Egypt, and in the event of the insured’s death due to illness, accident or any other cause, except for the exceptions mentioned in this policy, to pay to the beneficiary \ beneficiaries the amount shown in the table of benefits in this policy, on the date of death of the policyholder. The validity of the policy is a condition.
Article 3- Basis of the insurance policy
1/3 – The insurance application, data and declarations submitted by the policyholder and / or the insured, which were filled out completely and decently and signed. In addition, the medical report, or any other documents submitted for the company, it constitutes the basis for issuing the insurance policy and all forms an integral and complementary part of it.
2/3 – With the exception of what may be expressly stated, this document is subject to all laws in force or that may be issued in the future in the Arab Republic of Egypt, as well as to the general and special conditions and the table of benefits and specifications of the document.
3/3 The Insurance company is only bound by the official documents approved by it, and the company’s obligations are specified in what is included in the policy and in the amendments it issues, and any amendment in this policy is not considered liable to be adhered to the company unless it was issued and approved by the company’s management.
3/4 The policyholder is responsible for the correctness of the information and declarations submitted to the company by the policyholder or the insured, which are taken into consideration when making a decision regarding this insurance by the company as described in the above paragraph.
3/5 In the event that the policyholder and / or the insured discovers mistakes in the policy, he must inform the company immediately and within a period of one week from the date of issuance, as a maximum, in writing about this mistake for correction.
Article 4- Proof of age
If it appears, when submitting the insured’s birth document, that there is a mistake in calculating the age, and the result of collection is less than the premium of the real age at the time of the issuance of the policy, the insurance premium will be reduced to the premium that should have been paid. If the opposite occurred and the collected premium was greater than the premium that had to be paid for the real age of the sum insured mentioned in the table of benefits and specifications, the collected amounts would be refunded in excess without any interest being calculated on them. Provided that the insurance becomes null if it is proven that the real age at the beginning of the insurance exceeded the maximum age that the company would accept upon accepting the insurance, and the company is not obligated to pay in this case only the net premiums paid without calculating any interest on it after deducting the premium of the first two years.
Article 5 – Insurance coverage and the impermissibility of a dispute
1/5 – The policyholder and / or the insured shall notify the Insurance company in writing of any change that may occur to his place of residence, work or profession, which enables the Insurance company to reconsider the risk assessment and increase the premium if necessary. The insurer also has the right to cancel the policy t if the aforementioned changes are (For his place of residence, work or profession) are among the risks that cannot be covered by insurance. In the event that the change is within the appropriate framework in assessing the risk, then the insurer shall issue an annex to the document according to which the amendments are determined and the excess insurance premium, if any, shall be collected.
2/5 – The insurance policy and the additional supplements, if any, remain valid and the dispute will not be accepted after the expiration of a period of three years since the beginning of the insurance, except in cases of a fraud, i.e. if it appears that the policyholder and / or the insured intentionally concealed information and data or neglected to disclose concrete facts. It may affect the Insurance company’s decision to accept or reject insurance, or he deliberately and in bad faith made false, false and incorrect declarations and information about his health condition, work, place of residence or travel abroad. In this case, all the rights of the policyholder and the insured, and everyone who has the right to claim the benefits of insurance under this policy, which are considered legally canceled, shall be forfeited, and the premiums paid for it become an acquired right of the Insurance company.
Article 6 – Risks Excluded
This policy does not cover death directly or indirectly resulting from the following cases:
1 / 6 – Suicide or self-destruction within two years of policy inception.
2/6 – Willful killing, in this case, the company shall be discharged from its obligations if the policyholder intentionally caused the death of the insured. So, if the death occurred based on his instigation, and if the death was deliberately caused by one of the beneficiaries, or it occurred, at his instigation, the beneficiary’s right to insurance is forfeited.
3/6 – Environmental pollution as a result of nuclear weapons, radiation, or the radioactivity of nuclear fuel or nuclear waste. Resulting from combustion or any other processes of a nuclear, biological or chemical nature that may lead to pollution.
4/6 – Execution of the insured in implementation of a court ruling.
5/6 – The insured is addicted to all kinds of drugs, such as morphine, cocaine, etc., sedative pills, hallucinogens, or other similar substances, or alcoholism.
6/6 – Using any means of air transportation, unless he is as a passenger on board for the scheduled commercial airlines.
7/6 – Participation in the attempt to form an atom, nuclear fission, radiative power, or the use of explosive materials.
8/6 – HIV infection (AIDS).
9/6 – The insured practicing in any form for the following games or hobbies: mountain climbing, aerial games or Air flight, scuba diving and combat sports. Or similar games or hobbies which are classified as dangerous.
10/6 – Playing dangerous games such as riding motorcycles, races, betting and other matches.
11/6 The actual participation of the insured in foreign or civil war, invasion and hostilities by a foreign country, declaration or continuation of martial law or state of siege, establishment of military rule and / or insurrection, rebellion, revolution, civil unrest and popular and military movements and uprisings and political, the use of weapons and ammunition of various kinds, military machinery and equipment, actions and operations by armed persons affiliated with or not affiliated with organizations or political, military or paramilitary parties and / or subject to the authority of realistic or legitimate authorities who are self-employed or for others. Terrorist acts of all kinds are acts of looting accompanying or resulting from the above.
12/6 – The death resulting from the insured having committed an act in contravention of the law, meaning the law of the country in which the death occurred.
13/6 – Carrying out military activities and actions such as maneuvers and training during active military service and / or during conscription.
In the event of death resulting from one of these excluded risks, the Insurance company does not pay any amount to the right-holders and beneficiaries, and the insurance ends with that.
Article 7 – validity of insurance
1/7 – The validity of the insurance coverage depends on the policyholder and / or the insured receiving the policy and signing the receipt copy and paying the first installment in full, provided that the health condition of the insured has not undergone any change since the date of submitting the insurance application until the date of issuance of the policy.
2/7 – The validity of the policy ends with the expiry of its period, and the insurance will also expire in the event of its dissolution or cancellation for any legal reason or upon the request of the policyholder and / or the insured.
Article 8 – Insurance Premiums
Clause 1 Payment of installments
1- The insurance premiums are payable on the dates specified in the table of benefits and specifications of the policy at the head office of the company or in one of its branches or one of the collectors approved by the company against an official receipt approved by the company’s management. Under no circumstances may any payment be made to any unauthorized person, except by virtue of an official receipt approved by the company’s management. It is also possible to withdraw the installment from the balance of the policyholder in one of the banks approved by the company by means of an official letter addressed to the bank and a copy of it in the company. This book cannot be canceled without informing the company officially, and it will be applied after one month from the date on which the company is notified.
2- The company can grant a grace period of thirty (30) days, except for the first installment, from the due date to pay each installment that is due, and if the death of the insured occurs during the grace period, the premium supplementing the insurance year shall be deducted from the amount of insurance to be paid.
Clause 2 withholding installments
If the thirty days period (grace period) referred to in Paragraph 2 of Clause No. 1 above has expired without being fulfilled payment of the due installment the company sends a registered letter to policyholder and / or the insured requesting him to pay the premium within fifteen (15) days from the date of this letter.
It is expressly agreed upon:
1- These dangers replace every official claim, warning or notification of any kind and produce its full effects.
2- The post office receipt is sufficient to prove that the letter was sent, the date it was sent, and what was brought with it.
3- The address to which the company sends the registered letter is the address stated in the insurance request under the item (correspondence address) and registered in the table specification table unless the company has notified in writing the address of the policyholder and / or the new insured.
4- If it happened that despite sending the above-mentioned registered letter, the installment was not paid until the end of the period specified in it, the policy is considered canceled on its own and without the need for a warning, and the installments paid remain an acquired right of the company. However, the company sends the policyholder and / or the insured with a registered letter notifying him of the cancellation of the policy and the annexes that complement it, if any.
Article 9 – Beneficiaries
1- The policyholder and / or the insured has the right to appoint one or more beneficiaries, to whom the insurance amount will be disbursed according to the percentage mentioned in the policy specification table in the event of the death of the insured, and the policyholder and after the insured’s written consent also has the right to change the beneficiary at any time during the validity period of the policy provided that this is done with a written request submitted to the company, and upon the approval of the company, an annex is issued to the document specifying the change of the beneficiary or the amendment of the granted percentage of the sum insured. Any addition, change, or amendment to the insurance policy will not be effective, except after the company approves it and issues an appendix to the policy proving this and it must bear the company’s official seal and signature.
2- In the event of the death of the beneficiary before the insured and he was the only beneficiary, the policyholder and / or the insured can appoint a new beneficiary during the validity period of the policy. And every request to change the beneficiary must be notified in writing to the head office of the company, and the appendix issued by the company to change the beneficiary takes effect immediately upon its signature with the knowledge of the policyholder and / or the insured and the company’s approval of this request and the issuance of a duly signed official supplement, provided that it does not contradict the laws in the Arab Republic of Egypt. If a new beneficiary is not appointed with the knowledge of the policyholder and / or the insured, all the rights arising from this policy will be transferred to the inheritors of the insured lawful if there is only one beneficiary or if there is more than one beneficiary, then the insurance amount is paid to the living beneficiaries according to the percentages mentioned in table of features and specifications.
3- In the event that several beneficiaries of the policy are appointed, the death of one of them will proportionally increase the shares of the others.
4- If the insured dies as a result of an intentional act by one of the beneficiaries or at his instigation, then the insured loses his right to the sum of the insurance, which remains due to be paid to the rest of the beneficiaries or to the heirs of the legitimate insured in the event that there is only one beneficiary.
Article 10 – Reduction, Liquidation, and Sharing of Profits
This policy has no reduction or liquidation value and has no right to share in the profits. It is a temporary fixed life insurance policy with a fixed insurance amount and a variable insurance premium according to the age of the insured.
Article 11 – Requirements for payment of compensation
In the event of the death of the insured, the beneficiary / or the beneficiaries identified in the policy on the date of death shall notify the company as soon as possible, and the beneficiary must, in order to prove his rights, provide the company with the following:
1- The original document and its supplementary annexes, if any, and the receipt of the last paid installment.
2- Proof of birth of the insured: If it appears that the age of the insured mentioned in the policy is less than the real age, then the amount paid will be equivalent to the amount that would have been paid in the case of applying the premium paid for the real age.
3- Death certificate of the insured.
4- A medical report from the last doctor who treated the insured in addition to all the medical reports and results of the diagnostic examinations and treatments that had been performed for the insured person before death.
5- Fulfill the form prepared by the company to file a claim.
6- An official copy of the police report, the prosecution’s decision, and the forensic doctor’s report in the event of death in an accident.
7- Any other documents that the company deems necessary to present in order to fulfill the procedures for disbursing the compensation amount.
8- The company has the right to conduct investigations or collect information by representatives or doctors appointed by it to verify the causes of death, whenever it deems it necessary.
Article 12 – Entitlement to benefits and proof of rights
In the event that all the documents necessary for the payment of the compensation due under this document are completed, the company shall pay the sum insured mentioned in the table of benefits and specifications of the policy within the terms of the chosen insurance program within fifteen working days from the date of completing all the documents, and this amount shall be paid without delay interest at the head office of the company.
Article 13 – Loss of the right to claim insurance and to file lawsuits
The right to claim any of the rights arising from this policy will be lost, if the holders do not demand or the beneficiaries present to the company the required documents after three years from the date of death or the occurrence of the incident. Unless they proved to the concerned parties that they did not know of the death except at a later date, so that the three-year period begins.
Article 14 – Settlement of the security amount
The company deducts all the debit amounts due on this policy before paying any sums to the beneficiaries or the insured according to the coverage subscribed to in the table of benefits and specifications of the policy.
Article 15- Cancellation of the policy
The policyholder has the right to request the cancellation of the policy, and this is only possible on the anniversary of the policy, according to an official letter from the policyholder and with the approval of the insured and signed by the insured, and the policyholder is directed to the company in addition to the main document with all additional annexes or modifications, if any. Then the policy will be canceled and the company does not claim the policyholder or the insured for the due installment for the next year.
The company has the right to cancel the policy in the event of non-payment of the insurance premium as mentioned in the above paragraph, or in the event of a false statement and false and incorrect information provided by the policyholder and the insured, and then all the premiums paid for this policy remain an acquired right of the company.
Article 16 – Address of correspondence
1- The correspondence addressed to the company by the policyholder and / or the insured is not considered unless it is received at the head office of the company, and it is expressly agreed that no insurance broker, agent, sales representative or customer service employee has the authority to make any amendment in the insurance policy is binding on the company or accepting statements, data and obligations in the name of the company or on its behalf, or making a change or amendment to the premium or the policy, extending the grace period, or waiving any of the company’s rights and requirements.
2- The company shall not be bound by the correspondence received from the policyholder and / or the insured except from the date of receiving these correspondences and recording them in the registration documents prepared for that.
3- The address to which the company’s correspondence is directed to the policyholder and / or the insured is the address stated in the insurance application under the item (correspondence address) and indicated in the table of benefits and specifications of the policy. All correspondence sent to this address is considered valid unless notified by the policyholder and / or the insured. The company must change the address in writing and issued an attachment to that, then sending the correspondence to the address of the new policyholder. It is agreed that the policyholder is the person responsible for notifying the company immediately of any change in the correspondence address.
Article 17 – Stamps, Taxes and Fees
The policyholder and / or the insured or the beneficiary shall bear all royalties, taxes and fees of whatever kind, whenever a law, decree, decisions, regulations or orders is issued to which they are now or in the future subject to all documents related to the insurance policy and all payments arising from it unless legally stipulated for unlike that.
Article 18 – Competent courts
It is expressly agreed that this policy is subject to the laws in the Arab Republic of Egypt, and that every dispute arises in connection with this policy for the interpretation of its conditions or for the implementation of its provisions, the competence in its view is the competent Egyptian courts in whose jurisdiction the head office of the company is located.
Arbitration clause
Every dispute that arises between the parties to this policy, whether in relation to the interpretation of its provisions or the application of its terms, may be resorted to (based on their agreement) to the provisions of Law No. 27 of 1994 issuing the arbitration law in civil and commercial matters.
AROPE Life Insurance Company