Ruler & Regulations

1. HOSPITALISATION:

All bona fide hospitalisations, as determined by your board, will be paid on behalf of a fully paid member.Hospitalisation must be at a hospital in South Africa and not foreign based, unless prior authorization is obtained from the board.This includes Hospital, Doctors, Radiology, Laboratory accounts and other service providers all expenses from date of admission to date of discharge will be met.Your responsibility to ensure that accounts are received by the office.Members responsibility to ensure best rates are charged by all service providers. We will endeavour to negotiate better rates when able.We will only pay valid invoices and statements. No part-time /scribbled accounts will be entertained.Benefits will be suspended if subscriptions are not fully paid or if 2 months debit orders are returned.Members duty to ensure that payments are effected on due date.All fraudulent claims will be rejected and membership terminated forthwith with loss of benefits and funds as of immediate effect.

2. ADDITIONS:

Some day care procedures, including gastroscope, colonoscopy, CT scans, MRI Scans, renal dialysis and other specialised procedures as determined by your board. (As long as total limit is not exceeded)Wisdom teeth extractions.Any other specialised treatments as agreed by your board

3. EXCLUSIONS:

All dental procedures.Cosmetic Surgery.Circumcisions.Infertility Treatments.Any other treatments as determined by your board.All chronic medication.

4. MEMBERS MUST SIGN A DEBIT ORDER

5. WAITING PERIOD:

6 months for general hospitalisation.12 months for maternity

6. MEMBERSHIP:

Needs to apply for him/her self and any other dependants in writing.Members duty to inform office in writing concerning additions and/or deletions of members.Dependants must be under 21 years. Any dependant over 21 years must a student (proof to be submitted).All married dependants, irrespective of age cannot be dependants. No claims will be paid for such a claim despite subscriptions being current.It is your duty to ensure that the correct amounts are paid for each dependant. Accounts will be rejected in totality if the wrong amounts are paid for a dependant.If anyone does not qualify as a dependant, or the dependants status has changed, such accounts will be rejected despite you paying the subscriptions.The board reserves the right to reject any application without providing any reason.

7. TERMINATION:

Cannot resign/terminate membership if monies are owing to the fund. No partial withdrawals of funds allowed.Written notice of termination to be given. Funds will be paid out 3 months from written receipt of written notice. When you terminate a dependant, no reimbursement is allowed for the dependant. All funds will accrue to the Principal Member.

8. RE-APPLY:

Ex-member will only be accepted back once the money paid out to him plus any administrative penalty imposed is repaid, either in full or monthly.

9. DIVIDENDS:

Dividends, as determined by the board will accrue to members account. Dividends will not be paid out to member, but accumulates in his account.All surpluses, as determined by the board will be allocated to the POWER FUND.

10. SCHEDULE OF BENEFITS AND CHARGES:

This schedule relates to all charges and benefits that the member will enjoy. The fees will vary from time to time as determined by your board.

11. POWER FUND LEVY:

This levy, as determined by the board will be transferred to the POWER FUND. See Schedule of Benefits.The board may transfer any surpluses as needed to this fund.This fund does not belong to any particular member. He has no right in its funds on termination of membership.

12. MARKETING AND ADMINISTRATION FEES:

See current schedule of Benefits/Charges.

13. CLAIMS PROCESSING FEES:

See current schedule of Benefits/Charges

14. TERMINATION LEVY:

See current schedule of Benefits/Charges

15. UNPAID SUBSCRIPTIONS:

See current schedule of Benefits/Charges

16. BENEFITS:

Benefits apply to family unit.Benefits are not per year but are overall limitsSee current schedule of Benefits/Charges

17. PREMIUM RATES:

The board will be entitled to levy a premium rate for high risk members as determined by their health, usage and age. The minimum rate will be R500 per month.

18. SUSPENSIONS:

No claims will be paid during a members suspension.

20. DISPUTE:

All disputes will be referred to the Jamiatul Ulama based in FORDSBURG and their ruling will be final and binding.

21. CHANGE OF OPTION:

One may only change from one option to another at the beginning of a calendar year and with the permission of the board requesting change in writing.The board has the option of insisting that a member chooses the higher option depending on risk profile.

22. PREFERRED SUPPLIER AGREEMENTS:

In the event that ROSHMED enters into an preferred supplier agreement, the member will be expected to use the preferred supplier, if available in your area, as this will be the amount that will be paid out.See table for current preferred suppliers.

22. BOARDS DISCRETION:

Your board will be entitled to change any rule and regulation, subscriptions fees and benefits as and when the need may arise as long as any rule is not contrary to nay Islamic Ruling.

23. INVESTMENT HOSPITAL SCHEME:Roshmed Power is an Investment Hopsital Scheme and not a traditional hospital plan or medical aid. Your contributions to it do not qualify as medical fund contributions with SARS.

ALL RIGHTS RESERVED ROSHMED HOSPITAL INVESTMENT SCHEME 2011 ©

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