Family Cover by Momo Terms and Conditions

1. “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
2. “Hospital” means a hospital registered with the Uganda Medical and Dental Practitioners Council as published on http://www.umdpc.com/registers.php.
3. “Policyholder” means the individual who is the user and owner of the MTN Uganda mobile number who successfully registered for FAMILY COVER. The Policyholder will always be the life insured. The Policyholder will be the recipient of the MyHospital insurance benefits.
4. “Family Member” means the selected Family Members who have been successfully registered on the policy and where premiums have been paid. You can register your Spouse and/or your Children on the policy. 
5. “Children” means a biological child, legally adopted child, stepchild or child where You are the legal guardian who is under the age of 21 (twenty-one) years old.
6. “Spouse” means a marriage concluded in accordance with the applicable indigenous law as well as a union concluded between parties married in accordance with the doctrines of any recognised religion or tradition.
7. “Next of Kin“ means the natural person entitled to the insurance benefits in respect of MyLife.
8. “Premium“ means the amount payable in advance by the Policyholder for the FAMILY COVER policy.
9. “Subscriber” means a natural person that owns an MTN Uganda mobile number, which is used only on a prepaid basis.
10. “MyLife” means the insurance cover for the death of the Policyholder.
11. “MyHospital” means the insurance cover for the Accidental Hospitalisation or Illness Hospitalisation of the Policyholder. The cover is limited to treatment received in a the 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.
12. “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.
13. “Accidental Hospitalisation” means at least 1 (one) overnight stay in Hospital which in our sole discretion is necessary and appropriate to treat to an Accidental Injury.
14. “Illness Hospitalisation” means at least a 2 (two) night stay in Hospital which in our sole discretion is necessary and appropriate to treat to an illness.
15. “MyBonus” means a reward, equivalent to 10% of the Premiums paid by the Policyholder, which will be made available to the Policyholder every 12 months provided that the FAMILY COVER Policy has remined active for 12 consecutive months and no claim payments have been made. 
16. “Waiting Period” for the Policyholder means a 1 (one) month period during which only claims due to an Accident will be paid. For Family Members added to the Policy, it means a 3 (three) month period during which only claims due to an Accident will be paid.
17. “Cooling-off period” means a period within which a policyholder has a right to cancel the contract without giving any reason and without the payment of any fee or penalty.
18. SANLAM Life Uganda is the Underwriter of the Family Cover product

1. The Policyholder and registered Family Members will be covered for both the MyLife and the MyHospital benefit following successful registration and following the receipt of Premium by SANLAM Life Uganda. 
2. The registered Family Members can be a Spouse or Child of the Policyholder who is between the age of 1 and 65 years. A Family Member can only be covered under 1 (one) Family Cover policy.
3. During registration, the Policyholder will select a Benefit and corresponding Premium amount. The Premium amount will be deducted from the MTN MoMo wallet. 
4. The Policyholder will have the option to purchase cover by paying a Premium in advance for 3 (three),  6 (six) or 12 (twelve) months or by paying a monthly Premium which will be automatically deducted from their MoMo wallet each month. 
5. The Policy is renewable monthly and the Policyholder must pay a Premium each month for cover to continue. Where a Policyholder has selected to pay in advance, the cover term will depend on the number of months the Policyholder has paid a Premium for. 
6. SANLAM Life Uganda reserves the right to adjust Premium(s) at a 1 (one) days’ notice.
7. In the case where a Policyholder is found to be registered for FAMILY COVER 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 for FAMILY COVER.
8. Where you have registered for multiple Insurance products distributed by MTN MoMo, the maximum payout for 1 event on any 1 insured is UGX 5,000,000 for MyLife Benefit, and UGX 2,500,000 for MyHospital Benefit.  
9. SANLAM Life Uganda reserves the right to increase or decrease the maximum policy cover levels without notification to the Policyholder.
10. The maximum cover amount will be applied at the point of Premium payment and we reserve the right to restrict/decline the allocation of cover.
11. SANLAM Life Uganda reserves the right to adjust Premium(s) at a 1 (one) days’ notice.
12. 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.
13. 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.
14. Cover under the MyLife policy shall be deemed to have ceased upon payment of the MyLife Benefit
15. For the policyholder, a 1-month waiting period applies to the Policy in which only death and hospitalisation due to accident is payable. The Waiting Period will apply on: 

1. 1. Commencement of the first policy; or
   2. Reinstatement of the policy after 90 days from expiry of last cover. 

For registered Family Members, a 3-month waiting period applies to the policy during which only death and hospitalisation due to accident is payable. This Waiting Period will apply on: 

1. 1. Commencement of the first policy; or 
   2. Reinstatement of the policy after 90 days from expiry of last cover; or 
   3. Change of a registered Family Member. /

1. A Subscriber shall be eligible for Family Cover if the Subscriber:
   1. Is between the age of 18 (eighteen) and 65 (sixty five) years of age when registering for the policy; and
   2. is a resident in Uganda;
2. MTN MoMo reserves the right to offer benefits for a limited duration or on a campaign basis to selected groups of customers from time to time

1. 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).
2. Sanlam Life Uganda shall verify the eligibility of all claims and may request documentary proof of identification as well as proof of the Insured Event.
3. Sanlam Life Uganda reserves the right to route the claimant, the person initiating and driving the claims process, to a claims repudiation process if required.
4. In validating a claim, the Policyholder acknowledges that Sanlam Life Uganda might require personal information relating to the Policyholder or the insured from a third party. The Policyholder hereby irrevocably authorizes and consents for Sanlam Life Uganda to request on behalf of the Policyholder, any personal information from MTN MoMo 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;
5. In the event that the time of admission to a Hospital is more than 24 hours from the time of accident/trauma event, Sanlam Life Uganda reserves the right to scrutinise and reject the claim if it believes that it was not an Accidental Hospitalisation.
6. 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.
7. Claims will NOT be paid under the following circumstances if:
   1. 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
   2. the Policyholder or Claimant commits fraud or attempts to commit fraud against Sanlam Life Uganda when claiming benefits under the policy;
   3. Sanlam Life Uganda is not notified within the minimum required time after the claim event occurred;
   4. 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;
   5. 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.
   6. the Hospitalisation leading to the claim resulted from self-inflicted injury, abuse of alcohol or illegal narcotics, pregnancy or childbirth, mental and emotional conditions, and cosmetic and elective surgery or experimental surgery.
8. 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.
9. If the Next of Kin (beneficiary) is deceased, cannot be located within a reasonable period of time or no beneficiary has been designated, Sanlam Life Uganda reserves the right to pay the benefit to any individual deemed to have an insurable interest in the insured. 
10. 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 claim shall remain within the sole discretion of the Underwriter SANLAM LIFE Uganda)
11. Dial *165*7*2#, select option 1 (Cover by MoMo), then select Option 2 “Claim”.  Then select option 1 “Make a claim” and follow the steps. and follow the prompts or capture your information online on the make a claim page located on: https://ug.coverbymomo.com/submit-claim  or Visit the nearest MTN service Center for assistance for assistance.

1. The policy will terminate if the Policyholder has not paid the Premium due. If a Premium is missed, the Policyholder will have 30 days to pay the Premium. If there is a valid claim during this time, any outstanding premium will be deducted from the claim amount. If the Policyholder fails to pay the Premium during this 30-day period then the insurance cover will cease and any non-used MyBonus shall be forfeited.
2. The policyholder may cancel the contract within the 30-day cooling-off period, without providing any reason and without incurring any fees or penalties.
3. Where a policy is cancelled after the cooling-off period, no refund of Premium(s) shall be made. All policy cover yet to expire shall be terminated with immediate effect and non-used MyBonus shall be forfeited.
4. The right to cool-off shall not apply where the policyholder or a beneficiary has made a claim under the contract.

1. Following the termination of your policy a reinstatement period of 180 days will be available, During the first 90 days of this period, manual reinstatements may be made – however, auto-reinstatement will be attempted on each of the 180 days. 
2. Auto-Reinstatement – Following the expiry of your cover and failure to successfully pay the premium due on the next collection date, an auto reinstatement process will commence for a period of 180 days. On each of the 180 days a collection attempt will be made for the full premium due.
3. Manual Reinstatement – A customer can manually reinstate their policy within the first 90 days of the reinstatement period.
4. On reinstatement within the first 90 days of the reinstatement period no new waiting periods will apply to all benefits purchased by the policyholder, no new waiting periods will also apply to all covered family members.
5. On reinstatement between 90 and 180 days of the reinstatement period, new waiting periods will apply to all benefits purchased by the policyholder, new waiting periods will also apply to all covered family members.
6. Should the policyholder want to purchase benefits provided by the Family Cover product after the expiry of the reinstatement period, a new policy will be issued and new waiting periods as per the terms and conditions of the policy issued at that point in time.

1. If you have a complaint, dispute or compliments regarding this policy you should first visit the nearest MTN Service Center or, call 100.  We will make every effort to resolve disputes promptly and fairly. If the issue remains unresolved, you may escalate the matter to the Insurance Regulatory Authority of Uganda (IRA).

1. The policy cover shall be governed and construed in accordance with the Laws of Uganda.
2. Sanlam Life Uganda 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 Life Uganda shall be forfeited.
3. The policy cover cannot be sold or exchanged for cash.
4. 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.

1. In order for us to offer our services to you and administer this policy MTN MoMo must collect, process and store your personal information which may include special personal medical information about you and your beneficiaries and MTN MoMo may be required to disclose this information to 3rd parties. MTN MoMo might also require personal information relating to you from a third party. 
2. You hereby authorize and consent for MTN MoMo 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.
3. For more information on specific categories of information and how MTN MoMo will use your information please visit our Privacy Statement on the MTN MoMo website.
4. By accepting these Terms and Conditions you here you consent to the processing of your information includes MTN MoMo, MTN and SANLAM Life Uganda exporting your personal information outside of the borders of Uganda to the extent lawful and for its intended purpose.

1. Enquiries on product, service and claims can be referred to the help option on the USSD menu or the MTN Call Centre Helpline which will be available to answer generic questions: 100.
2. Policyholders may also refer to the section on Frequently Asked Question (FAQs) on the MTN MoMo website: https://www.mtn.co.ug/momo/my-family-cover-by-momo/