Overview

When Life gives you a Rainy day, all you need is an umbrella.
As an employer a rainy day for your company could be the Loss / Permanent Disability or Critical Illness of your employee(s) or their spouse(s).

An umbrella policy helps you fill the void left by your standard primary policies. Umbrella insurance policy is the extra liability insurance as the primary role is to cover liabilities that the existing policy can't/don't cover.

This solution is a simple, cost effective employee benefits solution that provides cover to small and medium sized registered groups/employers/organizations “clients”. The solution covers the employees in the event of death, disability or critical illness.

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Benefits

Benefits Platinum Gold Silver
Death (All causes) Factor of

Salary

Factor of

Salary

Factor of

Salary

Permanent Total Disability (All causes) Stand Alone Stand Alone Accelerated
Critical Illness Stand Alone Stand Alone Accelerated
Funeral (All causes) Stand Alone Stand Alone Accelerated
Spouses Funeral (All causes) Stand Alone N/A N/A
Death (Accidental, Occupational,24hr) Factor of

Salary

N/A N/A
Permanent Total Disability (Accidental, Occupational,24hr) Stand Alone N/A N/A
Temporary Total Disability (Accidental, Occupational,24hr) 52 weeks N/A N/A
Medical Reimbursement (Accidental, Occupational,24hr) Ksh100,000 N/A N/A

 

SCOPE OF COVER
a) For the death & PTD benefit, this is measured as a factor of annual salary, ranging from 1 times to 5 times, at the client’s discretion.
b) As per market practice, the Critical Illness benefit will be 30% of the Death Benefit, with a limit of KShs. 6M for the platinum option, and KShs. 3M for the Gold & Silver options.
c) The funeral benefit limit is KShs. 100,000 for all options.

Benefits

The employees/members of the group/company/organization.

Compensation to the beneficiaries of the employees/members of the group, in the event of death, disability, Critical Illness or injury of the employee/member.

A multiple of the annual salary of the insured, dependent of the defined limits.

Death Benefit
Upon the death of the insured during the term of the policy, the sum assured shall be paid to the beneficiaries.

Critical Illness
30% of the Sum assured subject to a maximum of Kshs. 3,000,000 for The Silver & Gold option, and Kshs. 6,000,000 for the Platinum option. The critical illnesses are as defined in the master policy document.

Disability (All causes)
Upon 100% disability of the insured during the term of the policy, the full sum assured shall be paid to the beneficiary.

Last Expense
Upon the death of an insured during the term of the policy, an amount of KShs. 100,000 shall be paid to the insured’s beneficiary within 48 hours.

Disability (Accidental & Occupational Causes)
Dependent on the degree of disability of the insured during the term of the policy, the awarded sum assured shall be paid to the beneficiary.

Medical Reimbursement “MER” (Accidental & Occupational Causes)
Compensation for utilization of one’s medical cover for any accidental cases.

The client shall give notice of claim to Metcannon within three (3) months of the occurrence of an insured event and furnish satisfactory proof to The Insurer. The client should notify Metcannon of all claims within 24hours from the date they received the information.

 No restriction of cover once issued

The Insurer shall not pay the death benefit in respect of an ELIGIBLE MEMBER if the death was caused, directly or indirectly by:

(i). 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;

(ii)   (a) the use of nuclear, biological or chemical weapons, or any radioactive contamination; or

(b)   Attacks on or sabotage of facilities (including, but not limited to, nuclear power plants, reprocessing plants, final repository sites and research reactors) and storage depots, which lead to the release of radioactivity or nuclear, biological or chemical warfare agents,

Irrespective of whether any of the aforesaid has been performed with the specific use of information technology.

Kshs.5 million Any member with cover above this limit will be required to undergo medical tests to facilitate issuance of acceptance terms.

How do I get Started?

COVER REQUIREMENTS
a) Completion of the acceptance letter.
b) Provision of the client’s data, i.e. full names, gender, salaries and dates of birth & ID no’s.
c) Settlement of Premium annually in advance

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How do I Make a Claim

CLAIMS PROCESS

a) Notification of the claim as per the above benefits within the stipulated timelines by the client.

b) Metropolitan Cannon shall respond with a request for the required documentation for review & record

c) Once all documentation is provided and the premiums are up to date, Metropolitan Cannon will settle the claim within the stipulated timelines

Claims
  • Process death claims within 5 working days of receipt of all documentation.
  • Process Last expense within 48 hours of receipt of all documentation.
  • Process disability, critical illness & MER claims within 5 working days of receipt of documentation.

CLAIMS DOCUMENTATION (Applies to all benefits)

The following documents will be required to facilitate processing of a claim;

  • Original Death Certificate for certification and return
  • A copy of National ID or an original surrender certificate from registrar of persons.
  • A Police Abstract if death was accidental, say Road Traffic, murder etc.
  •  A medical report from our appointed medical Doctor in case of critical illness benefit.