· ACCIDENTAL DEATH BENEFIT refers to a Member dying 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.
· COMMENCEMENT DATE shall be the date this policy takes effect.
· COVERED MEMBER means an Eligible Member who is included in this Policy.
· EFFECTIVE DATE & TIME OF THE POLICYmeans the date and time on which the cover becomes effective which will be from 00:01 hours on the Commencement Date or the date following the date on which the Contribution is paid after acceptance of the application for group family takaful, whichever is later.
· ELIGIBLE MEMBERmeans an Individual to Be Covered who is eligible for family takaful benefit under this policy.
· GROUP FAMILY PARTICIPANTS’ TAKAFUL FUNDmeans the collective fund hereinafter referred to as GFPTF under the Window Takaful Operator Waqf Fund in to which all Group Family Takaful Contributions for Takaful Death Benefits as well as Takaful Additional Benefits are pooled. The benefits of GFPTF belong to the Participants with certain conditions for their mutual help and GFPTF is managed by the Window Takaful Operator as Wakeel under the Islamic Concept of Wakalah.
· INDIVIDUAL TO BE COVEREDmeans a cardholder of the Participant.
· NON-CONTRIBUTORY TAKAFULmeans Takaful coverage for which contribution is solely paid by the Participant.
· PARTICIPANT means the Policyholder also described as an Organization in this case Qaumica.
· PERMANENT DISABILITY means inability of the member to engage in any occupation for which he is reasonably qualified by education, training, and experience. Benefit will become payable 6monthsafter the onset of disability due to an accident.
· POLICY YEAR means the period of one year or a shorter period beginning from the Commencement Date or any Renewal Date.
· RENEWAL DATE means the date one year after Commencement Date and each subsequent date.
· TAKAFUL CONTRIBUTIONmeans periodic contributions paid into the Group Family Participants Takaful Fund for Takaful Death Benefit as well as Takaful Supplementary Benefits (if any).
Words importing the singular number include the plural number and vice versa and words of masculine gender shall include the feminine unless the context is specified otherwise.
2. Event upon which the Sum Covered is to become payable: Accidental Death or Disability due to an accident of a Member
Eligible Enrollment Age:18 to 60 years nearest birthday.
4. Eligible Coverage Age: 18 to 61 years nearest birthday.
5. Individual Sum Covered:
· For Individuals
o Sum Covered of Rs. 500,000
· For Corporate Companies & Industries
o Sum Covered of Rs. 300,000
· For Student Segment
o Sum Covered of Rs. 100,000 per parent/guardian up to a maximum of two children per parent/guardian.
o Maximum Sum Covered Per Individual: Up to Rs. 200,000
The members eligible for family takaful benefit are the present and future cardholders of the Participant who have fulfilled all the requirements set out by the Participant for subscribing under its discount card membership scheme and are within the Eligibility Age range defined in the Participant's Specific Schedule.
7. Effective Date of Individual Takaful Family Coverage
Subject to the participation requirements as set out in clause 8 hereof, each Eligible Member’s coverage will not become effective until the coverage has been approved by the Window Takaful Operator in writing.
8. Participation Requirements
In order to establish and continue this Policy it is agreed that the Participation percentage of Eligible Members specified by the Window Takaful Operator from time to time, shall be included under this Policy.
9. Particulars to Be Furnished:
The Participant shall furnish the Window Takaful Operator with the names and ages of all Members, Member's CNIC & their Date of Birth, Membership Number, details of the date on which new Members join the scheme, details of the date on which Members leave the scheme, details of benefit and benefit increases and with all other information necessary to determine the benefits and Contributions under this Policy.
Such particulars shall, unless otherwise agreed by the Window Takaful Operator in writing, be furnished on the Commencement Date and daily thereafter in the format specified by the Window Takaful Operator from time to time.
10. Evidence of Age:
Evidence of age of a Covered Member satisfactory to the Window Takaful Operator will be required before any benefit in respect of him is paid under this policy and if after commencement of the Takaful Family Benefit hereunder the date of birth of any Covered Member is found to have been incorrectly notified to the Window Takaful Operator, the Window Takaful Operator shall notify the Participant 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 Covered Member is found to be more than maximum eligibility enrollment age.
If the Covered Member dies by means of any accidental causes, then the Window Takaful Operator will, upon receipt of and due investigation of the Claim, arrange to pay the following benefit:
a) Accidental Death Benefit
If the Covered 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 Window Takaful Operator will, upon receipt of and due investigation of the Claim, arrange to pay the Sum Assured.
b) Permanent Disability
Permanent Total Disability means inability of the member to engage in any occupation for which he is reasonably qualified by education, training, and experience. Benefit will become payable 06 months after the onset of disability.
12. Cessation of Membership:
A Covered Member shall cease to be a Covered Member on:
a) The date of his death or disability;
b) The date on which he exceeds the maximum Eligibility Age;
c) Nonpayment of Takaful Contribution when due;
d) Cancellation or termination or cessation of Member’s subscription by the Participant;
e) Any other date on which he ceases to be eligible for family takaful benefit for any fraudulent or criminal reason affecting the coverage hereunder. Decision of the court shall be final in such cases;
No benefit is payable under this Policy if death or disability of the Member results directly or indirectly, wholly or partly as a result of:
(a) Intentional self-inflicted injury, suicide, murder, assault, assassination and injury sustained through fire arm, participation in any criminal act or violation of law.
(b) Atomic energy explosions of any nature whatsoever, war, invasion, act of foreign enemy, hostilities (whether war be declared or not), armed or unarmed truce, civil war, mutiny, rebellion, revolution, insurrection by military or usurped power, riot or civil commotion, an illegal organization or an industrial dispute.
(c) Participating in exercises or operations while serving with either of the armed or paramilitary forces or while performing any form of police duty or travelling in war inflicted areas.
The Participant shall keep a record of the Members containing, for each Member, the essential particulars of the Family Takaful Benefit. This Policy gives the Window Takaful Operator, by its duly authorized representative, the right at reasonable times to inspect all books and records of the Participant relating to the Family Takaful Cover effected hereunder.
The Participant shall notify the Window Takaful Operator of the death of any Member and furnish the Window Takaful Operator, at its own expense, with all information necessary to determine whether the Sum Covered is payable in respect of that Member and the amount of the Individual Sum Covered. Upon satisfaction, the GFPTF managed by the Window Takaful Operator shall pay the Individual Sum Covered to the Participant.
16. Renewal Privilege:
Renewal of the Policy is automatically effected by the payment of the required Contribution when due.
This Policy shall be governed by the Laws of Islamic Republic of Pakistan subject to the principles of Shariah as interpreted by Shariah Advisor of the Window Takaful Operator.
18. Statutory Fund:
Under the provisions of the Insurance Ordinance 2000 and Takaful
Rules 2012, this policy and any additional benefits shall referable to the
Family Takaful Protection Business Statutory Fund of the Window Takaful
Operator. The Window Takaful Operator may by endorsement to the Policy change
the Statutory Fund(s) to which the policy and any additional benefits are