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Death Benefits procedure guide
This booklet must be fully completed prior to submission.
>> 3
Contents
Introduction 4
Benefits paid by the Fund 5
– Overview 5
– Dependants/nominated beneficiaries 5
– Payment of benefits 8
– Deductions from the Fund Death Benefit 8
Benefits paid by BPSA 9
– Ex-gratia payment 9
– BPSA Group Life Assurance Benefit 9
– Voluntary Group Personal Accident Insurance cover 10
– Shares 10
– Deductions from benefits paid by BPSA 10
Process to be followed on the death of an employee 11
Annexures: 12
– Annexure A – Extracts from the Pension Funds Act, 1956 12
– Annexure B – Death Benefit checklist – documents required 13
– Annexure C – Dependants’ background information 15
– Annexure D – Alexander Forbes notification of death 21
– Annexure E – Capital Alliance notification of member’s death (re-insured) 24
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Introduction
BPSA Provident Fund
The Board of Trustees of the BPSA Provident Fund has the task of distributing Death Benefits
payable by the Fund to the dependants and nominees of deceased members. This
includes both the Life Assurance Benefit paid by the Fund and the members’ Fund Credits
(i.e. contributions inclusive of investment returns).
In the majority of cases, the Trustees have no personal knowledge of the deceased or
his/her circumstances. They rely on information supplied by the Human Resource Manager/
Consultant and the Beneficiary Nomination Form. The gathering and collating of the informa-
tion on the dependants and nominees is vital to ensure the fair and equitable distribution of
the Death Benefits. The allocation must be in terms of 37C of the Pension Funds Act (refer to
the separate summary of this portion of the legislation in Annexure A).
The Board of Trustees of the BPSA Provident Fund has established a Death Benefits Sub-
Committee to review the information provided by the Human Resource Manager to ensure
that all the relevant information has been provided in the required format. The information
is used to draft a recommendation for the equitable allocation of the Death Benefit for
approval by the Board of Trustees. The Fund’s administrator informs the deceased member’s
dependants/beneficiaries of the decision taken by the Board of Trustees regarding the
allocation of the Fund benefit.
The Sub-Committee consists of the following people:
• Principal Officer of the BPSA Provident Fund;
• Trustees;
• Alexander Forbes consultant; and a
• Relevant Human Resource Manager.
The Board of Trustees appoints the Chairman of the Sub-Committee.
The Sub-Committee meets as soon as all the information per case has been provided by the
Human Resource Manager.
BPSA
In addition to the Death Benefits paid by the Fund, BPSA pays a number of other death
benefits to dependants on the death of an employee or retiree. The amount of these
benefits is usually significant. The reporting line manager/Human Resource Manager is
required to inform the Principal Officer of the death of an employee and member of the
BPSA Provident Fund to ensure the timeous payment of these benefits. These are described
in more detail in this document.
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Benefits paid by the Fund
Overview
In the event of the member’s death before
the normal retirement age (age 60 or 65 in
respect of ECM members), the following benefits
are paid to the member’s dependants and/or
nominated beneficiaries:
• the member’s Fund Credit (i.e. contributions and
investment returns), and
• 16% of the member’s fund salary at the date of
death multiplied by the total years of service
(years of service to date of death plus potential
years of service to normal retirement age).
Fund salary is defined as either:
• the member’s basic annual salary including a 13th
cheque (if applicable), or
• 70% of the member’s annual Total Cost of Employ-
ment package.
In the event of the member’s death in service after
his normal retirement age (age 60 or 65), only the
Fund Credit is payable.
The apportionment of Death Benefits from the BPSA
Provident Fund is governed by s37C of the Pension
Funds Act. An extract of this section of the Act and
the definition of dependant is attached for ease of
reference. Another factor that the Board of Trustees
has to consider in apportioning Death Benefits is the
view of the Pension Funds Adjudicator as expressed
in the determinations.
The Board of Trustees is required to identify and make
a reasonable attempt to trace all the deceased
member’s dependants within a twelve-month period
following the death of the member. The Board of
Trustees may only apportion the benefits once they
are aware of all known dependants.
Dependants/nominated beneficiaries
In identifying potential dependants, the Trustees are
required to consider the following:
Spouse:
• civil law;
• party to a customary union according to Black law
and custom (may include more than one spouse);
• party to a union recognised as a marriage under
another religion; and or
• permanent life partner.
Child (minor and major):
• member’s child;
• posthumous child;
• adopted child;
• illegitimate child; and
• excluding stepchildren and foster children (factual
dependants only).
A person in respect of whom the member would
have become legally liable for maintenance, had
the member not died.
Parents and grandparents:
• if they are unable to support themselves and the
deceased member had the means to do so; and
• proof that they would have become dependent
on the member at a future date.
Ex-spouse:
• Voluntary maintenance or in terms of an Order of
Divorce and Agreement; and or
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• note that a liability to pay medical aid contribu-
tions is also classified as maintenance in terms of
the Divorce Act.
With regard to nominated beneficiaries, the Trustees
are required to consider the following:
• If the nomination was made prior to 30 June
1989, it is not valid. In this instance, only pay to
dependants.
• Nominations must be in writing and may be
contained in the Will of the deceased. A nomi-
nation may be ignored when the Trustees need
to achieve an equitable distribution amongst
dependants.
• An estate cannot be a nominated beneficiary.
• Only a natural person may be nominated e.g.
members are not permitted to nominate charities
in terms of the allocation of their Fund benefit but
may do so in their Will.
• If nominees only, can only pay to them if the
estate is solvent. A letter from the Executor of the
estate confirming this is required.
If there are no dependants or nominated benefi-
ciaries, the Trustees are required to pay the benefit
into the deceased member’s estate. The benefit is
then dealt with in terms of the deceased member’s
Will. If the member did not have a valid Will, the laws
of Intestate succession will apply.
In apportioning the Death Benefit, the Board of
Trustees is required to take the following factors into
account:
• all potential dependants;
• all nominated beneficiaries;
• ages of dependants;
• extent of dependency of dependants;
• relationship of dependants with the deceased;
• wishes of the deceased as reflected on a valid
nomination form ;
• wishes of the deceased as reflected in the last Will
and Testament;
• financial affairs of the dependants, including
future earning potential;
• whether there is a Maintenance Order/agree-
ment;
• whether an ex-spouse has remarried;
• whether the deceased was financially solvent; and or
• whether an investigation has been made to trace
all dependants, irrespective of whether or not
they have been included in the nomination form.
The Board of Trustees requires the following docu-
mentation that will prove dependency and sub-
stantiate the above factors:
• Notification of Death;
• Nomination of Beneficiary Form;
• Original certified copy of death certificate;
• If available, a copy of the Will – this could provide
insight into the nature of the relationship between
the deceased and the dependants;
• If there are no dependants or nominated
beneficiaries, details of the deceased’s estate,
name ofthe Executor, whether the estate is
solvent or not;
• Proof of prior claim by employer;
• Address and contact details of all dependants
and nominated beneficiaries; and
• Banking details on bank letterhead of all
nominated beneficiaries to whom benefits will be
paid.
>> 7
If there is a spouse/partner:
• Original certified copy of marriage certificate:
civil/customary. In the case of a customary union,
a letter from the chief is not adequate.
• Original certified copy of identity document.
• Proof of income and financial position of each
spouse/partner.
• Confirmation that the deceased and spouse were
living together at date of death. If not, why not?
• If permanent life partner, an affidavit to sub-
stantiate that there was a common household,
the duration of the common household, plus proof
of dependency such as joint banking account,
joint ownership of house. Proof of income earned
by spouse/partner.
If there is an ex-spouse:
• original certified copy of Maintenance Order/
Divorce Order and agreement;
• proof of payment by deceased;
• original certified copy of identity document;
• details of ex-spouse’s monthly income;
• whether ex-spouse has remarried; and
• if a customary union, whether it has been dis-
solved. If yes, proof is required.
If spouse deceased:
• Original certified copy of death certificate of
spouse.
Children (minor and major):
• original certified copies of birth certificates;
• original certified copies of identity documents;
• proof of schooling;
• confirmation as to whom is supporting and looking
after the children;
• whether the children lived with the deceased;
• proof of income of children;
• details of the extent of monthly monetary support
required by the children;
• proof of disability;
• details of guardians appointed to minor children;
and
• proof of income of person/guardian looking after
children.
Grandchildren:
• original certified copies of birth certificates;
• proof of schooling;
• who is supporting and looking after the grand-
children;
• whether the grandchildren lived with the de-
ceased; and
• proof of financial support.
Other dependants:
• relationship to the deceased;
• nature of their dependency on the member prior
to death;
• details of their monthly income; and
• original certified copies of identity documents.
Nominated Beneficiaries:
• name of nominated beneficiaries;
• relationship to deceased;
• original certified copies of identity documents;
and
• details/relationship of person verifying information
of nominated beneficiaries.
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Payment of benefits
If the benefit is paid as a lump sum, a portion is tax-
free and the balance is taxed according to the
following sliding scale:
Rand amount of benefit Rate of tax applied
R0 - R300 000 tax-free
R300 000 - R600 000 18%
R600 000 - R900 000 27%
R900 001 and above 36%
Alexander Forbes applies for the tax directive,
deducts the tax from the lump sum and issues the
IRP5 to the dependants(nominated beneficiaries)
who have recieved a portion of the death benefit.
.
If the benefit is paid as a pension, the pension is
taxed as income (i.e. marginal tax rates apply). An
annuity is purchased from a registered financial
services provider of choice and a net pension is paid
to the dependants.
If the benefit is paid into a Beneficiary Fund, the
amount is not taxed on transfer into the Fund.
Payments made from the Fund will be taxable in the
hands of the beneficiaries.
Deductions from the Fund Death Benefit
In terms of s37D of the Pension Funds Act, only the
following deductions may be made from a benefit
payable to a member or a dependant of a member:
• A loan granted to the member by the Fund
for the purposes of financing housing or home
improvements.
• An amount for which the Fund or the Employer is
liable under a guarantee provided in respect of a
housing loan granted by a financial institution, for
example a bank.
• Compensation (including legal costs recoverable
from the member) in respect of damage caused
to the employer as a result of theft, misconduct,
fraud or dishonesty of a member and in respect
of which:
– the member has admitted liability in writing to
the employer; or
– the employer has obtained a Court Judgment.
There has been a ruling from the Pension Funds
Adjudicator that allows the Fund to withhold
payment of a benefit for a reasonable period
of time in circumstances such as this to enable
the employer to institute legal proceedings. The
employer must institute criminal proceedings
and make a claim for damages as well. The
Fund may only withhold the amount equal to
the loss suffered by the employer and not the
entire benefit.
For this purpose, the member will be deemed to
have elected his benefit in the form of a lump sum
to the extent permitted in terms of the Income Tax
Legislation but not greater than the claim by the
employer or the Fund. The amount of any prior claim
will be limited to an amount not exceeding the
amount which in terms of Income Tax Legislation may
be taken as a lump sum.
Note• The administrator will not deduct any amounts
from member’s benefits unless they arespecifically provided for above.
• It is not possible for an employee to “sign-over” his benefits to the employer becausethe Pension Funds Act clearly states that nobenefit or right under the Fund may be ceded,pledged or assigned nor may a benefitbe subject to any form of attachment orexecution. An acknowledgement of debt forany debt other than a debt detailed abovecould be viewed as an attempt to cedebenefits and will not be entertained by theadministrators.
>> 9
Benefits paid by BPSA
Human Resource Services are required to finalise
the calculation of all the benefits payable by BPSA
and must ensure timeous payment to dependants/
nominated beneficiaries/deceased’s estate. Human
Resource Services are required to communicate the
payment details to the involved parties.
Ex-Gratia payment
In the event of an employee dying in service, an
immediate ex-gratia payment of two months basic
salary/pensionable salary is made to the spouse,
appointed guardian or appointed nominee. This
payment is intended to assist the family in paying for
immediate expenses and to sustain them until the
Death Benefits from the BPSA Provident Fund have
been allocated and the BPSA Group Life payments
become available.
The ex-gratia payment is paid tax-free and is usually
paid to the deceased’s spouse, appointed guardian
or appointed nominee. If none exists, payment is
usually made to the deceased’s estate. However,
as this is a discretionary benefit, the employer is
required to take any extraordinary circumstances
into account when deciding to whom to make
payment. Preference is given to individuals who
bear the cost of the funeral arrangements and
where proof of this can be supplied.
The following documentation is required in order to
finalise the payment:
• original certified copy of death certificate; and
• nomination of beneficiary form.
BPSA Group Life Assurance Benefit
The BP Southern Africa (Pty) Ltd Group Life Assur-
ance Plan is underwritten by Old Mutual (Policy No
1 850 499).
On the death of an employee, a lump sum of twice
annual basic salary/pensionable salary is paid to BP
Southern Africa (Pty) Ltd.
In respect of an employee who is not in receipt of
a Total Cost of Employment (TCoE) remuneration
package and is entitled to a thirteenth cheque,
twice annual salary will equate to their last monthly
basic salary X 26. In respect of an employee who
is not in receipt of a TCoE remuneration package
and is not entitled to a thirteenth cheque, twice
annual salary will equal last monthly basic salary
X 24. All employees in receipt of a TCoE remunera-
tion package are entitled to twice annual pension-
able earnings (i.e. monthly pensionable earnings
X 24).
The payment of the Group Life Assurance Benefit is
tax-free. The insurer pays BPSA the total amount and
in turn BPSA effects payment in accordance with
the nomination of beneficiary form. This is a separate
nomination form to the Beneficiary Nomination
Form completed by the member in respect of Fund
benefits. If no form exists or if the nomination is invalid,
the benefit is paid into the deceased’s estate.
The following documentation is required in order to
finalise the payment:
• original certified copy of death certificate; and
• nomination of beneficiary form.
In addition to the above, an accident benefit of 2 X
annual pensionable salary is also payable under the
policy if the employee’s death was as a result of an
accident. The deceased is covered, irrespective of
whether or not he/she was on business at the time
of the accident. BPSA pays a further 1 X annual
pensionable salary as an accident benefit. The total
accident benefit therefore amounts to 3 X annual
pensionable salary.
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Voluntary Group Personal Accident Insurance
cover
If an employee who opted for this cover dies and
the employee’s death is as a result of an accident,
the lump sum as selected by the employee on the
application form will become payable.
The payment of the benefit is tax-free and it is paid to
the deceased’s estate.
The following documentation is required in order to
finalise the payment:
• claim form;
• original certified copy of death certificate;
• original certified copy of the identity document of
the deceased;
• original certified copy of the identity document of
the policyholder;
• Road Traffic Collision Report (if death was due to a
motor vehicle accident);
• Post Mortem report with Blood Alcohol test report;
• Inquest Report and/or Court Proceeding report;
and
• Letter of appointment of the Executor of the
Estate.
Shares
If the employee had BP shares, these are transferred
to “Estate late …”. The Executor of the estate decides
whether the shares are to be retained, sold, part
retained or part sold. Dividends are paid into the
estate for shares that are retained. If it is decided
upon to sell the shares, the proceeds are paid to the
estate.
Dividends are tax-free but must be declared in
annual tax returns. Capital Gains Tax is payable on
the proceeds from the sale of shares and must also
be declared in tax returns. The transfer of shares into
the beneficiary’s name is tax-free.
The following documentation is required in order to
finalise the payment:
• Letter of appointment of the Executor of the
Estate;
• Instruction letter from Executor of the Estate; and
• bank details of the Estate.
Deductions from benefits paid by BPSA
All debts owing to BPSA that are not permitted to be
deducted from the Fund benefit can be deducted
from the non-retirement fund benefits paid by BPSA.
>> 11
Process to be followed on the death of an employee
Death of a BPSA Provident Fund member
Human Resource Manager to notify the Principal Officer (PO) of the death of the employee and member of the Fund
PO ensures that Human Resource Services are aware of the death in order to initiate the BPSA Group Life Cover claim
Human Resource Manager supplies completed Death Benefit Guide to to the PO for final assessment
The PO may request additional information from the Human Resource Manager depending on the specific dependants/beneficiary circumstances
Sub-comm not happy and requests more information
If in order:PO drafts family tree
Death Benefit Sub-Comm meeting scheduled at which HR Manager
must be present
Sub-Comm happy and formulates a recommendation
Submitted to the Board of Trustees for approval Board is not happy – wants additional information
Happy and approve allocation of the Death Benefit
Resolution signed and Alexander Forbes makes payment
If not in order:
The entire process will take a minimum of six months to complete.
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Annexure A Extracts from the Pension Funds Act, 1956
s37C(1) of the Act reads as follows:
Notwithstanding anything to the contrary contained in
any law or in the rules of a registered fund, any benefit
payable by such fund, upon the death of a member
shall, subject to a pledge in accordance with s19 (5)
(will be) (I) and subject to the provisions of s37 A (3)
and 37 D, not form part of the assets in the estate of
such members, but will be dealt with in the following
manner:
• If the Fund within twelve months of the death of the
member becomes aware of or traces a dependant
or dependants of the member, the benefit shall be
paid to such dependant or dependants as may be
deemed equitable by the Board, to one of such
dependents or in such proportions to some or all of
such dependants;
• If the Fund does not become aware of or cannot
trace any dependant of the member within twelve
months of the death of the member, and the
member has designated in writing to the Fund a
nominee who is not a dependant of the member, to
receive the benefit or such portion of the benefit as
is specified by the member in writing to the Fund, the
benefit or such portion of the benefit shall be paid
to such nominee: Provided that where the aggre-
gate amount of the debts in his estate exceeds
the aggregate amount of the assets in his estate,
so much of the benefit as is equal to the difference
between such aggregate amount of debts and
such aggregate amount of assets shall be paid into
the estate and the balance of such benefit or the
balance of such portion of the benefit as specified
by the member in writing to the Fund shall be paid
to the nominee.
– If the member has a dependant and the member
has also designated in writing to the Fund a
nominee to receive the benefit or such portion
of the benefit as is specified by the member
in writing to the Fund, the Fund shall within
twelve months of the death of such member
pay the benefit or such portion thereof to such
dependant or nominee in such proportions as
the board may deem equitable: Provided that
this paragraph shall only apply to the designation
of a nominee made on or after 30 June 1989:
Provided further that in respect of a designation
made on or after the said date, this paragraph
shall not prohibit a Fund from paying the benefit,
either to a dependant or nominee contemplated
in this paragraph or, if there is more than one such
dependant or nominee, in proportions to any or
all of those dependants and nominees.
• If the Fund does not become aware of or cannot
trace any dependant of the member within twelve
months of the death of the member and if the
member has not designated a nominee or if the
member has designated a nominee to receive a
portion of the benefit in writing to the Fund, the
benefit or the remaining portion of the benefit after
payment to the designated nominee, shall be paid
into the estate of the member or, if no inventory in
respect of the member has been received by the
Master of the Supreme Court in terms of s9 of the
Estates Act, 1965 (Act No. 66 of 1965), into the
Guardian’s Fund.
A “dependant” is defined in the Act as follows:
• a person in respect of whom the member is legally
liable for maintenance;
• a person in respect of whom the member is not
legally liable for maintenance, if such person –
– was, in the opinion of the board, upon death of
the member in fact dependent on the member
for maintenance;
– is the spouse of the member, including a party to
a customary union according to Black law and
custom or to a union recognised as a marriage
under the tenets of any Asiatic religion;
– is a child of the member, including a posthumous
child, an adopted child and an illegitimate child;
• a person in respect of whom the member would
have become legally liable for maintenance, had
the member not died.
>> 13
Annexure B Death Benefit checklist – documents required
All documents must be original certified copies.
Dependants✓ where
applicable
Notification of Death
• Inform Alexander Forbes of the death of the member by completing the Death Notification Formand sending it to Human Resource Services within one month of the death of the employee.
• Inform the Principal Officer of the Fund of the death of the member via email:
• Inform Ms Doreanne Bastiaan and Ms Michelle Bartnicke of the death.
Nomination of Beneficiary Form
• Obtain the Fund’s Beneficiary Nomination Form
• Obtain the nomination form completed by the employee in respect of the benefits paid by BPSA.
• Original certified copy of death certificate.
• If the member died in a motor vehicle accident, supply
– Inquest (two copies)
– Post Mortem (two copies)
• Copy of Last Will and Testament.
• Prior Claim supporting documents including acknowledgement of debt by member to enablespecified deductions to be made from the Fund Death Benefit.
• Letters from banks confirming banking details of dependants/beneficiaries.
Married Member
• Original certified copy of marriage certificate.
• Proof of customary union.
• Affidavit in respect of common law relationship/same sex partner regarding their union and theirextent of dependency on the member.
• Original certified copies of identity documents.
• Proof of financial dependency in the form of an affidavit (if applicable).
• Proof of income.
Divorced Member
• Maintenance Order/Divorce Order and Agreement/Proof of termination of common law orcustomary union.
• Original certified copy of identity document.
• Proof of financial dependency in the form of an affidavit (if applicable).
• Proof of income.
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Annexure B Death Benefit checklist continued
Widowed Member✓ where
applicable
• Original certified copy of death certificate of spouse.
Children (Major & Minor)
• Original certified copies of birth certificates.
• Original certified copies of identity documents.
• Proof of schooling/student.
• Proof of disability.
• Proof of income of guardian.
• Proof of extent of dependency of child – in the form of an affidavit.
• Proof of appointment as guardian.
Guardian/caregiver details
• Refer to the list of questions within the table.
Grandchildren
• Original certified copies of birth certificates.
• Original certified copies of identity documents.
• Proof of schooling/student.
• Proof of disability.
• Proof of financial support in the form of an affidavit.
• Proof of income of child.
Other Factual Dependants
• Original certified copies of identity documents.
• Proof of financial support provided to them by the member prior to death – in the form of an
affidavit.
Nominated Beneficiaries
• Original certified copies of identity documents.
>> 15
Annexure C Dependants’ background information
Member details
Name
Global ID
Date of death
Cause of death (per death certificate)
If unnatural cause, is there an investigation underway?
Are any of the dependants implicated?
BP business unit
Member’s date of birth
Member’s age at date of death
Fund membership start date
Years of service
Monthly basic salary/pensionable salary at date of death
Monthly banked earnings after tax (net pay)
Death Benefit provided by the BPSA Provident Fund
*Total Death Benefit at date of death
(i.e. life assurance plus Fund Credit)
*Life Assurance benefit
*Fund Credit
*Please obtain from Alexander Forbes
Family information
Legal spouse’s details
Date of marriage
Spouse’s name
Spouse’s date of birth
Spouse’s age at member’s date of death
Was spouse living with the member prior to death?
If not, please provide details.
Postal address to be used for future correspondence
Contact telephone number
Spouse’s income from employment (gross and net
amounts. Provide copy of payslip)
If spouse is not employed, state prospects of employment.
Details of spouse’s extent of dependency at date of
member’s death (provide affidavit confirming the details)
SAPROVIDENT FUND
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16 >>
Annexure C Dependants’ background information continued
Children’s details
Children’s names and dates of birth (indicate whether they
are natural or adopted children of the deceased member
and spouse or step children of one of these parties)
Children’s age/s at member’s date of death
Children’s extent of dependency at member’s date of
death (provide affidavit confirming the details)
Who is taking care of the child/children?
Name of legal guardian if not the spouse
State if the children were living with the deceased.
If not, why not
Specify any special circumstance i.e. is the child disabled
or requiring special schooling or care?
State if the child/ren are students or if they are employed
Total spouse’s and children’s extent of dependency at member’s date of death
Person to be regarded as a spouse in terms of Rules (e.g. customary/traditional spouse/common law spouse/same sex partner)
Name
Relationship
Date of birth
Spouse’s age at member’s date of death
If spouse is not employed state prospects of employment
Extent of dependency at date of death
(provide affidavit noting the details)
Details of the children of this “spouse” and the deceased
Children’s names and dates of birth
Children’s age at member’s date of death
Children’s monthly income needs
Name of legal guardian if not the spouse
Specify any special circumstances i.e. is the child disabled
or requiring special schooling or care?
Children’s extent of dependency at member’s date of
death (provide affidavit confirming the details)
State if the child/ren are students or if they are employed
Specify occupation and income of major child/ren
Total spouse’s and children’s extent of dependency at member’s date of death
R
R
>> 17
Details of ex-spouse if previously divorced
Name
Date of divorce
Details of maintenance, if applicable (provide original
certified copy of Maintenance Order)
Details of minor child/ren’s guardian or caregiver if not the spouse
What is the guardian’s highest level of education?
Does the guardian have any experience regarding the
investment of funds?
Does the guardian use the services of an investment or
financial adviser etc?
Is the guardian currently employed? If not, when last
was he/she employed?
Does the guardian run his/her own business? (specify)
What does the guardian earn and is this a regular income?
Does the guardian own any assets (e.g. house, car,
investments etc (specify)
Does the guardian have his/her own banking account
and if yes, for how long has he/she operated this account?
What is the guardian’s state of health?
Monthly household income and expenditure
Please provide the detail below as it pertains to the surviving dependants – i.e. spouse, children, partner, girlfriends/
boyfriends etc. This information is vitally important in establishing their needs and dependency on the deceased
prior to death.
Income
Net monthly/weekly salary R
Income from informal trading R
Own business R
Old age pension R
Investments/annuities R
Total income R
Annexure C Dependants’ background information continued
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18 >>
Expenses
Bond/Rent R
Electricity and water R
Telephone R
Cell phone R
Food and toiletries R
School fees and after care per month R
School clothing pm / pa (specify) R
School sundries and extra curricular activities R
Clothing R
Car repayments R
Petrol R
Car repairs R
Loan repayments R
Domestic services R
Insurance (short and long term) R
Entertainment R
Maintenance R
Accounts (HP, clothing etc) R
Holiday expenses R
Other R
Total expenses R
Any other person who may have been regarded as having been dependent on the deceased (e.g. surviving elderly parents)
Name
Relationship
Date of birth
Person’s age on death of member
Reason for dependency
Extent of dependency at date of death
(provide affidavit confirming the details)
Annexure C Dependants’ background information continued
>> 19
Annexure C Dependants’ background information continued
SAPROVIDENT FUND
Estate
If no dependants, is the estate solvent?
Is there a valid Will?
Who is the executor of the estate?
Contact details of the executor Name
Telephone
Are there any insurance policies paid outside the estate? If yes, to whom, what is the value of the benefit to be paid and who is the life assurer?
Name of the Fund/Retirement annuity/other policies Beneficiary Rand value of benefit
Medical aid dependants
If the deceased was a member of the BP Medical Aid Society, please provide details of all registered dependants
Name
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
Beneficiary nomination form information
Attach the most recent beneficiary nomination made to the Fund.
Member’s wishes regarding payment of Death Benefit
Attach supporting documentation e.g. member’s Will if applicable and/or documentation from deceased’s financial adviser.
Beneficiary nomination form. Provide the date it was signed.
Last Will and Testament. Provide the date it was signed.
Name and contact details of family financial adviser.
SAPROVIDENT FUND
20 >>
Fund housing loan facility
Balance owing
Property
Amount of outstanding bond
Was the property owned by the deceased?
Does the spouse/family wish the Death Benefit to be
applied to settle the outstanding bond?
Payment of benefits from BPSA (Pty) Ltd
Ex-Gratia 2 times monthly basic/pensionable salary
BP Group Life cover of either 24 or 26 times monthly
basic salary
Leave pay
Pro-rata bonus (i.e. 13th cheque) if applicable
Last gross monthly salary
Last net monthly salary (i.e. take-home pay after all
deductions incl tax)
Voluntary Personal Accident insurance
Group Personal Accident of three times annual basic salary
Performance bonus (VPP)
Please provide any additional comments/observations that would assist the Board of Trustees in the equitable allocation of benefits.
Human Resource Manager
Date
Annexure C Dependants’ background information continued
>> 21
Member’s particulars (please complete in full)
Member’s surname
Member’s first names
Member’s maiden name
ID / Passport number Date of birth
Country of issue
Residential address Unit number Complex
Street number Street/Farm name
Suburb City/Town
Country Code
Postal address
Code
Employee number Date of employment
Date of death Date of last contribution
Cause of death (if known) Accidental Not accidental
Annual salary on which death benefit is based R ,
Period of employment outside
RSA prior to death Completed years From To
Income tax number
Revenue office
Non-completion of these will result in a delay in the settlement of this claim.
Documentation to be attached (certified copies required)
Member’s proof of age Member’s death certificate Proof of age for dependant children
Trustee’s disposal resolution* Member’s marriage certificate Proof of age for spouse
Nomination of beneficiary form
* The claim form needs to be lodged as soon as possible. If the disposal instructions are not available, they should follow later.
Are you aware of any Divorce or Maintenance Court Order issued affecting the payment of Fund Benefits?
Yes No If yes, please provide a copy of the Court Order.
Indebtedness to employer to be recovered from benefits (deductions as per s37D of the Pension Funds Act)
Deductions as per s37D of the Pension Funds Act R ,
The section provides two instances when a fund may deduct amounts from a member’s benefit. These are:
• When the member owes the fund or his employer money for an 1. outstanding housing loan given by the fund or the employer or
where the fund or employer provided a guarantee for a housing loan taken by the member and the guarantee is enforced.
• In the event of an employer suffering loss due to an employee’s theft, dishonesty, fraud or misconduct, where the employee has
admitted liability in writing or a court judgement has been obtained. In such instances, a copy of the court order or the member’s
admission of liability for the loss must be attached.
Annexure D Notification of death
Alexander Forbes Financial Services (Pty) Ltd.Reg No. 1969/018487/07 l FAIS licence No. 1177 l Operations and Administration
Alexander Forbes , Block A, Boulevard Office Park, Searle Street, Woodstock 7925 PO Box 253, Cape Town 8000 l Tel : +27 (21) 401 9300 l Fax : +27 (21) 415 5580
Name of Retirement SchemeBP Southern Africa Provident Fund
Name of Employer/PaypointBPSA
22 >>
Important notes on death claims:
• Alexander Forbes / the insurer must be notified of the death of a member within three months of the death of the member.
• All documentation in support of the claim must be provided to Alexander Forbes / the insurer within twelve months of the death of
a member.
The above timeframes are guidelines only. The timeframes specific to this Fund may be shorter than those mentioned above as it is
dependent on the terms & conditions reflected in the fund’s policy document. Failure to meet the applicable timeframes will result in
the repudiation of the claim i.e. no insured benefit will be payable.
In terms of legislation, any benefit which is due and which has not been paid within 24 months from the date it first became due in terms
of the rules of the fund will become an “unclaimed benefit” and may be transferred to an unclaimed benefit fund.
Details of advance payment (if required)
Please note that if an advance payment is to be made we will require either that a Trustee signs the claim form or that a separate
letter, signed by a Trustee, accompanies the claim form as authorisation to make the advance.
Beneficiary’s surname
Beneficiary’s first names
ID / Passport number Date of birth
Relationship to deceased
Amount required R ,
Payment instructions
Please note:
Ensure that the bank account details supplied is in respect of the spouse’s/beneficiary’s own account.
Beneficiary’s banking details (If more than one beneficiary, please show banking details and postal addresses on separate page)
Account holder’s name
Account number
Branch code Type of account Current Savings
Name of bank
Name of branch
Beneficiary’s
residential address
Code
Beneficiary’s
postal address
Code
Telephone number at Cell
which beneficiary can be contacted
Beneficiary’s email address
Annexure D Notification of death continued
>> 23
Trustee’s authorisation of advance payment
Signature Trustee’s name Date
(please print)
Employer’s declaration
It is hereby confirmed and warranted that the;
• information contained herein is correct and, in particular, that the beneficiary’s banking details provided above have been
confirmed as correct;
• the Employer has provided the beneficiary with the contact details for the Investment Advice Centre.
The Employer hereby unconditionally absolves the Fund and Alexander Forbes and as necessary indemnifies and keeps indemnified
the Fund and Alexander Forbes from and against all and any loss, damage, costs and expenses which the beneficiaries, or any other
person whatsoever, may sustain or incur, either directly or indirectly as a result of Alexander Forbes, on behalf of the Fund, relying on and
using any information supplied by the Employer.
Employer’s stamp Authorised signature
Name (Print)
Designation
Contact number Date
Copyright in this material is expressly reserved and this form and all attachments (where applicable) remains the exclusive property of Alexander Forbes. This form and all attachments (where applicable) may not be copied, stored, retrieved or in any way reproduced without the express written permission of Alexander Forbes. Breach of copyright is a serious offence and can lead to litigation. | 5289
Annexure D Notification of death continued
24 >>
Tick where applicable ✔ Please use a black pen and block letters
Scheme name Scheme number
Member’s details
Employer
Member surname
First name(s)
ID number
Membership number Payroll number
Date of death Date of birth
Member’s salary at date of death
Was the member at work on the date that he/she became eligible for membership? Yes No
If not, state reason for absence
State if actively at work on date of death Yes No
If not, state date when last at work and reason for subsequent absence
Payment details
We hereby authorise Capital Alliance Group Risk to pay the benefit into the following account
Name of bank
Branch Branch number/code
Account holder’s name
Account number
Account type Savings account Cheque Account Transmission account
Note: We require proof of your banking details (cancelled cheque or bank statement confirming the account holder’s full name(s),
account number and branch code).
Supporting documents
a) Death certificate b) Supporting documentation required for payment details
c) Proof of age of member (ID) d) Any other documentation as requested by Capital Alliance Group Risk
e) Copy of payslip 1 month prior to death
Annexure E Notification of member’s death (re-insured)
CAPITAL ALLIANCE LIFE LIMITED
Reg No. 1969/008/87/06 Libridge Building, 25 Ameshof Street, Braamfontein 2001 l PO Box 31750, Braamfontein 2017Tel: +27 (11) 408 3911 l Fax: +27 (11) 408 5348
D D M M Y Y Y Y D D M M Y Y Y Y
>> 25
Authorisation and discharge
We hereby certify that the information contained herein is correct, and Capital Alliance Group Risk is hereby authorised to make a payment as stated in the Payment details section.
We agree that payment as stated in the Payment details section, shall constitute good and effectual settlement and shall be a full and final discharge to Capital Alliance Group Risk of its own liability in terms of the fund.
Remarks
Authorised signatory Designation
Date
Annexure E Notification of member’s death (re-insured) continued
Employer’s stamp
D D M M Y Y Y Y
Indemnity Statement I This guide was produced by OMAC Actuaries & Consultants on behalf of the BPSA Provident Fund, BP Southern Africa (Pty) Ltd, Portswood Ridge, Dock Road. V&A Waterfront, Cape Town 8001. It represents an overview of the topics currently under discussion. While every effort has been made to ensure that the information in this guide is correct, the BPSA Management Board take no responsibility for any loss or damage suffered by any person as a result of their reliance on the information contained herein. Reference to “the Scheme” or “your Scheme” refers to the BPSA Provident Fund.
Contact details
Tel. 021 408 2734 l Fax. 021 408 2494Email. [email protected] Box 6006, Roggebaai 8012
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