—The premium amount may vary due to annual increases, costs incurred where debit orders are returned unpaid, or other additional amounts due on an ad hoc basis, allowed or specified in the insurance contract (referred to as "the Agreement").
—I acknowledge that a pro-rata premium may be debited based on or within 48(forty-eight) hours from the inception date of coverage, and this amount will be confirmed via an SMS sent to the mobile number provided in my application.
—I authorise Old Mutual Alternative Risk Transfer Insure Limited to draw against the above account the amount necessary for payment of the monthly premium every month until the agreement is cancelled in writing by either party.
—I accept that if the debit date falls on a weekend or public holiday, we will be debited on the following working day.
—I am the authorised signatory on the above banking account and authorised to apply for insurance on behalf of the company.
—I declare that I have applied for device insurance cover.
—I am aware of the premium payable and that the premium will be deducted in the cover month via monthly debit order by Old Mutual Alternative Risk Transfer Insure Limited.
—I understand that failure to pay the monthly premium will result in cover lapsing.
—I confirm that I am in possession of the device/s stated in the schedule.
—I acknowledge that cancelling this payment authorisation does not constitute the cancellation of the agreement unless explicitly stated otherwise in the agreement.
—I acknowledge and consent that this authority may be ceded or assigned to a third party if the agreement is also ceded or assigned to that third party and I am notified accordingly.
—I understand that this declaration forms part of the policy of insurance.
YOUR MONTHLY BANK DEBIT ORDER REFERENCE WILL INCLUDE YOUR POLICY NUMBER AND ISTOREINS.
