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Terms and Conditions

LEGAL EXPENSES POLICY

Whereas the Insured has applied to Genric Insurance Company Limited “the Insurer” for this insurance and agrees that any proposal / application or other information supplied by the Insured or on their behalf for the insurance shall be the basis of this Contract of Insurance, the Insurer agrees to indemnify the Insured subject to the terms, exclusions and conditions of this policy

INSURING CLAUSE

In consideration of the payment of the premium by or on behalf of the Insured, Genric Insurance Company Limited (the Insurer) agrees to provide the Benefits to the Insured arising out of the Insured Matters which occur and are notified to MY LAWYER during the period of insurance.

DEFINITIONS

Insured shall mean - the Principal Member (the person who has taken out this policy) and his/her life partner/spouse and five of his/her/their dependent biological or legally adopted children under the age of 25 years who are unmarried, full time students and financially dependent on the Principal Member. If not married, only a partner who is engaged in a relationship of living together with the Principal Member as life partner will be entitled to Legal Services. Legal Services will only be provided to those family members nominated by the Principal Member. In the event of a dispute arising between the Principal Member and one of his immediate family members, MY LAWYER will only be liable to provide Legal Services to the Principal member. The Principal Member must forward to MY LAWYER, by fax, sms or e-mail message, the names and birth dates of his immediate family within 3 months from date of receipt of this policy. It is the responsibility of the Principal Member to update these family details.

My Lawyer shall mean My Lawyer Legal Assistance (Pty) Ltd Reg. No. 2011/113599/07 trading as MY LAWYER.

Benefits shall mean the Legal Services provided by My Lawyer and / or appointed legal practitioners on behalf of the Insurer to the Insured.

Legal Services shall mean the proceedings and / or services provided by My Lawyer and / or appointed legal practitioners arising from any of the Insured Matters

Insured Matters shall mean:

Legal Advice

The insured have access to a 24-hour legal service centre to obtain legal advice and standard legal documents.

Legal Assistance

Subject to the terms of this policy, the Insured shall be entitled to our 24-hour legal advice and legal representation and litigation services in any legally instituted court or tribunal, pertaining to the following matters:

  1. Civil claims instituted by the Insured (regarding matters set out in this service schedule)
  2. Civil claims instituted against the Insured (regarding matters set out in this service schedule)
  3. Civil Marriages
  4. Lobola Marriages. Services will be provided only in respect of marriages that came into effect after the 3-month waiting period.
  5. Religious and Customary Marriages. Services will provided only in respect of marriages that came into effect after the 3-month waiting period
  6. Divorces - Uncontested
  7. Divorces - Contested
  8. Amendment of Divorce Orders
  9. Enforcement of Divorce Orders
  10. Maintenance – Application for
  11. Enforcement of Maintenance Orders
  12. Amendment of Maintenance Orders
  13. Failure to pay maintenance – Representation in
  14. Maintenance arrears – Recovery of
  15. Prenuptial agreements
  16. Living together as life partners
  17. Custody of Children
  18. Visitation rights
  19. Paternity(excluding the medical test procedure)
  20. Family violence
  21. Guardianship
  22. Protection orders (excluding disputes between the Insured and immediate family members, spouse or life partner)
  23. Adoptions
  24. Disciplinary Hearings Assistance and Representation
  25. Lodgement of grievances at workplace
  26. Internal Appeals
  27. CCMA Assistance and Representation
  28. Arbitration
  29. Criminal matters – all criminal offences
  30. Bail applications
  31. Bail payments up to R5 000 per incident per family member. MY LAWYER will conduct a bail application and pay bail money / furnish a guarantee on behalf of the Insured in an amount not exceeding  R5000 (Five Thousand Rand) per Insured per incident. The bail assistance service under this policy will only be provided in respect of a first bail application related to every specific incident.
  32. Mal-practice by doctors
  33. Negligence in hospitals
  34. Disputes with insurance and medical aid companies
  35. Child abuse
  36. Children’s rights
  37. School related legal disputes
  38. Lease agreements - this benefit is limited to tenants only
  39. Damage to immovable property
  40. Unlawful arrest by SAPS and Metro Police
  41. Consumer related legal problems
  42. Defective goods
  43. Personal and bodily injuries
  44. Problems with the neighbours
  45. Sexual harassment
  46. Disputes with service providers
  47. Homeowner legal problems – limited to primary residence of insured
  48. Building disputes – limited to primary residence of insured
  49. Surety
  50. Contracts
  51. Guarantees and warranties
  52. Poor craftsmanship
  53. Defamation of character
  54. Legal disputes regarding Tax
  55. Registration of companies – limited to 2 Companies per annum
  56. Status of persons (Curator’s appointment) The event and/or condition that forms the ground for person’s change in status must have happened or developed after the 3-month waiting period
  57. Urgent applications
  58. Interdicts
  59. Appeals and review proceedings in criminal cases
  60. Rescission of civil judgement
  61. Wills – limited to advice and drafting of
  62. Trusts
  63. Legal disputes regarding financial services
  64. ID Theft
  65. Debt related legal problems
  66. Garnishee Orders
  67. Blacklisting – Removal of your name from the Credit Bureau list
  68. Unlawful blacklisting
  69. Legal problems with Local Authorities
  70. Criminal prosecution relating to motor vehicle Accidents
  71. RAF (Road Accident Fund) Claims
  72. Traffic Offences where the fine exceeds R1 500 - Bail services as set out in services 30 and 31 above will only be provided following an arrest after the commission of a traffic offence. In respect of any drug or alcohol related offences or in  the event of an arrest as a result of failure to appear in court no bail services will be provided
  73. Drunken driving
  74. Reckless or  Negligent driving
  75. Culpable Homicide as a result of an accident
  76. Guarantees and warranties
  77. Purchase contracts
  78. Financing agreements
  79. Insurance related matters
  80. Auctions
  81. Repossessions
  82. Pothole damages
  83. Other damage to your vehicle due to bad road conditions
  84. Problems with panel beaters
  85. Problems with tow-in companies

Additional value adding services (Costs for the Insured’s account at discount rates):

  1. Negotiating discount on attorney’s transfer fees of up to 30% when purchasing/selling immovable property if one of the attorneys on the My Lawyer network is appointed as the transferring attorney
  2. Winding up of deceased estates. My Lawyer will negotiate a special rate on executor’s fees if one of the attorneys on the My Lawyer network is involved in the winding up of a deceased Insured’s estate

CONDITIONS

  1. Limit of Liability
    The liability of the Insurer in respect of any services, proceeding or series of services and proceedings arising from one original cause for any Insured Matter shall not exceed R200 000.

  2. Premiums
    The Principal Member shall pay by debit order to MY LAWYER (on behalf of the Insurer), a monthly premium of R109, including VAT, on the Due Date. For the purposes of this policy the Due Date shall mean the Inception Date and the 1st of every month after the Inception Date provided that with effect from the second month of the currency of this policy My Lawyer shall in the event of non payment double debit the account on the next Due Date.  If the premium remains unpaid after this second debit the policy will be cancelled from the last day of the month in which the premium was received and no further Benefits will be provided or payable to the Insured. The Principal Member hereby requests and authorises the withdrawal of the premium as indicated herein against his / her bank account and to debit his / her account with the amount equivalent to the monthly premium and continuing until cancelled by him / her in writing. All such debits against his / her account shall be treated as though he / she has signed and done them personally. If, in the event of payment from his / her bank account, such payment day falls on a Sunday or recognized South African public holiday, the payment day will automatically be the preceding or next ordinary business day. Further, if there are insufficient funds in his / her nominated bank account, the debit order system may track his / her account and re-present the instruction for payment as soon as sufficient funds are available in his / her account. The Insurer shall not be obliged to accept any premium tendered after the second unpaid debit but may do so on terms that he, at its sole discretion may determine.

  3. Waiting Period
    This policy commences on the inception date and receipt of the 1st premium and from such date the Insured is immediately entitled to legal advice. An Insured may utilize the Legal Services as frequently as required, provided that the service shall be rendered to such Insured on Insured Matters pertaining to personal capacity. Legal representation and litigation services are only available after three months continuous and uninterrupted duration of this policy and in respect of divorce matters only after six months continuous and uninterrupted duration of this policy, and only in matters where the cause or grounds of the demand for services and or benefits under this policy arose after the expiration of the two mentioned periods, respectively, as set out above. With regard to any legal disputes in respect of agreements, of whatever nature, only agreements that came into effect after the said 3-month period will be entertained under this policy. In matters where MY LAWYER is providing litigation and representation services in terms of this policy on behalf of an Insured, and such Insured instructs MY LAWYER to stop its assistance in that matter before finalization thereof, then the Insurer will not be liable to provide further litigation or representation services in that same matter.

  4. Cancellation
    This policy may be cancelled at any time by the Principal Member by giving notice in writing to MY LAWYER acting on behalf of the Insurer in which event an Insured’s rights to the Benefits in terms of this policy will immediately terminate on the date of such cancellation. The Insurer may give the Principal Member 30 days written notice to cancel or terminate this policy in which event an Insured’s rights to any further Benefits under this policy will immediately terminate on the date of such cancellation or termination. The Benefits already incurred and payable for the completion of pending and/or partly provided Legal Services in respect of an Insured Matter occurring before such cancellation or termination shall be payable by the Insurer. In the event of cancellation and/or termination by the Principal Member, an Insured will have no claim or right to any Legal Service provided under this policy or the completion of pending and/or partly provided Legal Services.

  5. Policy Changes/ Amendments
    The Insurer or MY LAWYER may, at its sole discretion, amend the premium, Benefits and any of the terms of this policy by giving thirty days notice of such changes to the Principal Member at his/her postal address or via fax, sms or e-mail message.

  6. Claims

    1. On the occurrence of an Insured Matter which may result in a claim under this policy, the Principal Member shall at his/her own expense give notice thereof to My Lawyer as soon as reasonably possible and submit to My Lawyer  all details they may reasonably require.

    2. On receipt of notification of an Insured Matter MY LAWYER, at its sole discretion and subject to the terms of this policy, will determine the nature, extent and procedures of all Legal Services covered in terms of this policy and the Insurer will be entitled to conduct such Legal Services using the appointed legal resources and practitioners of My Lawyer or those appointed by My Lawyer. Only attorneys or legal practitioners appointed by MY LAWYER will be entitled to render service to any Insured and the Insured authorises MY LAWYER, in terms of this policy, to appoint such persons. Only MY LAWYER may terminate the mandate of such appointed attorneys or practitioners. The Insurer or MY LAWYER will not be liable for any fees directly or indirectly incurred by any Insured or for payment of bail monies where such Insured of his/her own accord contracted the services of a legal practitioner or attorney or consultant and MY LAWYER will not, at any stage of such proceedings, take over any such cases.

    3. The Insured grants power of attorney to MY LAWYER to obtain any document or information pertaining to the provision of Legal Service. All or any privilege that emanates between the Insured and the appointed attorneys or legal practitioners or consultants, will include MY LAWYER. The Insured authorises MY LAWYER to have access to and receive copies of all privileged documents or information. The Insured further authorises MY LAWYER and/or the appointed attorneys or legal practitioners or consultants to exchange privileged documents and information in order to provide Legal Services to the Insured and waives all his/her rights in respect of privilege with regard to such information and documents.

    4. The Insured may not make any confessions or admissions or accept liability in any matter in respect of which the Legal Services are provided, prior to consulting with My Lawyer or its appointed legal practitioner. Any statements made by the Insured without prior consultation with My Lawyer or its appointed legal practitioner prior to making of such statements, shall not be binding on the Insurer or My Lawyer and the appointed legal practitioner, and the Insured irrevocably indemnifies the Insurer, My Lawyer and the appointed legal practitioner of any liability of whatever nature resultant to such statements.

    5. If the Insured takes any legal steps in any matter without the notice and approval thereof by the Insurer or MY LAWYER, or does not accept the advice of MY LAWYER, or appoints his/her own attorney, or uses alternative legal products, and/or, in the sole opinion of MY LAWYER or its appointed legal practitioner, regarding any matter to be adjudicated in terms of this policy, there is no reasonable prospect of success, or where, in the sole opinion of MY LAWYER, a reasonable settlement offer is submitted by the opponent and is rejected by the Insured, the Insurer or My Lawyer in these instances will not be liable to provide or render any further services under this policy.

    6. All Legal Services are provided at the sole discretion of MY LAWYER and subject to the terms of this policy and any of the services may be provided on a contingency basis. Where the My Lawyer appointed attorney conducts a matter on a contingency fee basis and the Insured, at any stage of the proceedings regarding such matter, terminates this policy and / or the services of that attorney, the Insured will be liable for the attorneys fees on a scale attorney client and it is agreed that the amount as set out in the attorney’s taxed account will be a liquid amount for purposes of summary judgement in this regard.

    7. Where costs are awarded or settled in the favour of the Insured, the Insurer has the right to off-set such awarded/settled costs against any Benefits paid.

    8. No claim shall be payable and the Insured shall not be entitled to any benefit under this policy if the Insured does not comply with any of these Claim conditions.

    9. If the Insurer rejects any claim in terms of the policy the Principal Member has 90 days from the date of such rejection letter to dispute this decision with the Insurer. If the dispute is not satisfactorily resolved and the Principal Member has not commenced legal action within 6 six months after this period, all Benefits afforded under this policy in respect of any such claim shall be forfeited.

  7. Jurisdiction
    Legal Services are provided only in respect of matters that fall within the Jurisdiction of South African Courts and where South African Law applies.

  8. Misrepresentation, misdescription or non-disclosure in any material particular shall render the policy voidable and the Insured shall forfeit any Benefit payable in terms of this policy.

  9. This document, together with proof of payment of premium, constitutes an alternative to a tax invoice, debit note or credit note as contemplated in sections 20(7) and 21(5) of the Value Added Tax Act N0 89 0f 1991. All sums insured and premiums are inclusive of VAT at 14%. Excess is not subject to VAT. Genric Insurance VAT number: 4190226169.

EXCEPTIONS

  1. This policy excludes:
    1. The payment of any fine, penalty, tax, levy, any witness fee, any costs pertaining to expert witnesses and expert witness reports, travelling or subsistence costs, any payment or reimbursement of money to the Insured of whatever nature, including costs and expenses in respect of services under this policy provided on a contingency fee basis.

    2. Any costs awarded by way of court order and costs granted in legal proceedings to the Insured’s opponent and/or any other party by court/forum order.

    3. Insured Matters that occurred outside the borders of Republic of South Africa.

    4. Litigation and representation services regarding Insured Matters which occurred before the inception date of this policy or within the Waiting Periods.

    5. Matters related to the Insured’s business trade or profession.

    6. Matters related to the professional sporting activities of the Insured

    7. Any Matters relating to:

      1. Debt review, counselling or rehabilitation
      2. Insolvencies and administration of estates
      3. Investment and pension/provident fund disputes
      4. Citizenship related legal matters
      5. Water and electricity account matters
      6. Loss of or damage to any vehicle as a result of an accident
      7. Matters related to the service and / or repair of a vehicle
      8. Application of rules by Body Corporates or Home Owners Associations
      9. Matters that fall within the jurisdiction of the small claims Court
      10. Conveyancing of property
      11. Matters related to contracts and or transactions with telecommunication service providers
      12. Matters related SABC licences
      13. E-toll
      14. Adoptions in respect of blood relatives of the Insured
      15. Custody of children born out of wedlock
      16. Matters adjudicated in the Land Claims Court
      17. Constitutional Court proceedings
      18. Any act or activity pertaining to political activity / riot, civil commotion, labour riot / strike / lockout or public disorder
      19. Labour matters, the cause or grounds of which originate during the Insured’s membership of a Trade Union
      20. All matters not specifically included in the definition of Insured Matters
      21. Ionising radiation or contamination by radioactivity from an irradiated nuclear fuel or any nuclear waste from the combustion of nuclear fuel
      22. The radioactive, toxic, explosive or other hazardous properties of any nuclear assembly or nuclear component thereof
      23. War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, riot, rebellion, revolution, insurrection, military or usurped power, or confiscation or nationalisation or compulsory purchase, requisition, destruction of or restrictions or controls placed on or damage to property by or under the order of any government or public or local authority.
    8. Legal services that are purely administrative of nature.

    9. Events or circumstances which had commenced or occurred before the inception of this policy.

    10. This policy of insurance and all actions whether actual or contemplated brought against the Insurer and / or My Lawyer by the Insured.

    11. Legal proceedings brought by or contemplated against Insureds by other Insureds where the parties to the proceedings are members of the same household

    12. Any claim which is false or fraudulent

    13. Any claim where the claimant acts without the consent of the Insurer or My Lawyer or contrary to or in a manner different from the advice of MY LAWYER.

  2. The Insurer and My Lawyer does not provide sureties of whatever kind. In the event of a court order for costs in favour of an Insured, that amount of costs is payable immediately and on demand to My Lawyer and it is further agreed that the amount as set out in the court order will be a liquid amount for purposes of summary judgement.

  3. The Insurer or MY LAWYER will not be held liable for the provision of any Benefits or Legal Services incurred:

    1. prior to written confirmation of the Insurer or MY LAWYER that the claim has been accepted
    2. where the Insured fails to give proper instructions and in due time to the Insurer or MY LAWYER or the legal practitioners appointed by MY LAWYER
    3. My Lawyer will not be liable for payment of any legal expenses relating to any matter if a claim is not received by us within 60 days :
      of the occurrence of the facts of that particular matter; or
      of the date when the Insured became aware of such facts.
    4. where the Insured is responsible for anything which in the reasonable opinion of the Insurer or MY LAWYER  prejudices his/her prospects of success in the prosecution, defence or settlement of the proceedings and in general the handling of his/her claim;
    5. Where the Insured take legal steps, of whatever nature, without the notice and approval thereof by My Lawyer;
    6. Where the Insured misrepresented any facts or did not disclose to the Insurer or My Lawyer all information relevant to his/her claim and / or this policy.

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