Sanitas Terms and Conditions

Sanitas enables individuals (sponsors), whether resident in Nigeria or abroad, to enrol family members and other persons (beneficiaries) in, and pay health insurance premiums into, State Social Health Insurance Schemes in Nigeria (State Schemes). State Schemes are administered by State Social Health Insurance Agencies (SSHIAs). We work with SSHIAs, payment service providers, accredited healthcare facilities and other authorised partners.

Sanitas is a facilitator. We do not provide medical advice, diagnosis or treatment. We do not underwrite insurance, assess insurance risk or act as an insurer. Coverage, benefits, exclusions and healthcare delivery are determined by the relevant SSHIA and State Scheme.

In these Terms, premium means the amount set by the relevant State Scheme for a beneficiary's coverage, and platform fee means any fee charged by Sanitas for its own services.

To open a sponsor account you must be at least 18 years old and legally able to enter into a binding contract. You must keep your account and beneficiary information accurate, complete and up to date. You may close your account at any time by contacting us or through your account settings; see Section 16 for what happens to existing coverage.

We may ask you to verify your identity or the source of a payment where required by law, including anti-money-laundering and fraud-prevention rules.

You agree to provide accurate, complete and up-to-date information about yourself and your beneficiaries; enrol a beneficiary only where you have their consent or other lawful authority to do so (or, for a child under 18, where you are their parent or legal guardian or have that person's consent), and tell them that their details will be shared with Sanitas and the relevant SSHIA; keep your login details confidential and tell us promptly about any unauthorised access to or misuse of your account; and use the platform lawfully, without fraud, fictitious enrolments, unauthorised payment funds, or interference with its security or operation.

We will clearly show all premiums, platform fees and any currency conversion before you confirm a payment; remit premiums to the relevant SSHIA within 5 business days of receiving cleared funds; submit beneficiaries' enrolment details to the relevant SSHIA and tell you when enrolment is confirmed or rejected; notify you promptly if a payment cannot be remitted or coverage cannot be activated, and refund you in line with Section 8; provide reasonable support with enrolment, coverage and administrative queries; and handle personal data in line with our Privacy Policy and applicable law.

We will provide our services with reasonable care and skill.

Once enrolment is confirmed, the relationship between a beneficiary and the State Scheme is governed by that State Scheme's rules. The relevant SSHIA and its accredited providers are responsible for the benefit package, exclusions, waiting periods, claims handling, the choice and availability of healthcare facilities, and the quality and outcome of care. Licensed healthcare professionals make medical decisions. Sanitas does not control these matters, but we will help you raise coverage problems with the relevant SSHIA.

Premiums are set by the relevant State Scheme. Sanitas does not add any amount to the premium. Our platform fees are set out in our fee schedule, and we may offer promotional pricing, discounts or incentives from time to time in line with applicable law.

Payments are processed by licensed third-party payment service providers, whose own terms may also apply. Premium funds are held by Paystack until remitted to the SSHIA.

If you pay in a currency other than Nigerian Naira, the amount in your currency and the exchange rate used will be shown before you confirm payment, and that is the amount you will be charged, excluding any fees your own bank or card provider may apply. Premiums are remitted to SSHIAs in Naira.

Coverage begins in accordance with the relevant State Scheme's rules once the premium has been remitted and enrolment confirmed, which may include waiting periods or temporary access arrangements. We will tell you the expected start date where the State Scheme makes it available to us.

Coverage lasts for the period set by the State Scheme (for example, 12 months). If you choose automatic renewal, you authorise us and our payment provider to charge the applicable premium and platform fee at each renewal. We will send you a reminder at least 14 days before each renewal, showing the amount due. You can switch off automatic renewal or cancel a renewal at any time before the renewal date through your account settings or by contacting us.

If a renewal payment is not made, the beneficiary's coverage may lapse under the State Scheme's rules. We will notify you before this happens and, where we hold their contact details, the beneficiary.

We will process refunds due from Sanitas within 5 business days of the refund becoming due. Where a refund arises from an error by Sanitas, or from a failed remittance or rejected enrolment, you will receive the full amount originally charged in your original currency. In other cases, refunds of foreign-currency payments may be affected by exchange-rate movements and payment provider charges. Confirm with your payment provider. Refunds from an SSHIA follow that SSHIA's timelines.

If you dispute a charge with your bank (a chargeback), please contact us first, as we can usually resolve payment issues faster.

Beneficiaries are not parties to these Terms and have no payment obligations under them. A beneficiary may contact us directly to ask to be removed from a sponsor's account, to update their information, or to exercise their data protection rights.

We handle personal data as described in our Privacy Policy, which explains what we collect, why, who we share it with (including SSHIAs) and your rights. Where we rely on your consent, for example for marketing, we will ask for it separately.

All content, trademarks, logos, software, designs and materials on the Sanitas platform belong to Isuna or its licensors. You may use them only to access the services for their intended purpose and may not copy, modify or distribute them without our prior written permission.

Sanitas does not provide medical, legal or insurance advice. Apart from our obligations in these Terms, we do not guarantee the benefits, availability or continuity of coverage under any State Scheme, or the availability, quality or outcome of healthcare services, as these depend on the SSHIA, the State Scheme and accredited providers. We aim to keep the platform available but cannot guarantee uninterrupted or error-free access.

Sanitas is not an emergency service and does not provide emergency medical response, ambulance dispatch or crisis intervention. If you or a beneficiary is experiencing a medical emergency, contact local emergency services or go to the nearest appropriate healthcare facility immediately. Do not wait for a response from Sanitas. Our support team can help with enrolment, coverage and administrative matters once immediate medical needs have been addressed.

Nothing in these Terms limits or excludes our liability for premiums we have received but not remitted to the relevant SSHIA or refunded to you; fraud or fraudulent misrepresentation; gross negligence or wilful misconduct; death or personal injury caused by our negligence; or any other liability that cannot be limited or excluded under applicable law, including mandatory consumer protection law.

Subject to the above, we are not liable for indirect or consequential losses, or for losses caused by the acts or omissions of SSHIAs, healthcare providers or other third parties outside our reasonable control. Subject to the above, our total liability to you arising out of or in connection with these Terms is limited to the greater of (a) the platform fees you paid to us in the 12 months before the claim arose and (b) NGN 15,000.

You agree to compensate Isuna and its officers, directors, employees and agents for reasonable losses, costs and expenses (including reasonable legal fees) that they incur as a direct result of your fraud, deliberate misuse of the platform, provision of false information, or breach of these Terms, except to the extent the loss was caused by our own fault.

We may suspend or close your account if you breach these Terms, if required by law or a regulator, or where reasonably necessary to protect the security of the platform or prevent fraud. Except where the law, a regulator or an urgent security or fraud concern prevents us, we will give you notice and the reasons, and an opportunity to resolve the issue first.

If your account is suspended or closed, by you or by us, coverage already paid for and confirmed continues until the end of its current period under the State Scheme's rules, and any premium not yet remitted will be either remitted or refunded to you at your choice. Unless we closed your account because of fraud, any platform fees for services not yet provided will be refunded. Provisions that by their nature should survive termination will survive.

If you are unhappy with our service, please contact us at support@sanitascare.org. We will acknowledge your complaint within 2 business days and aim to resolve it within 15 business days, keeping you informed if it takes longer. Complaints about coverage or healthcare services will be passed to the relevant SSHIA, and we will help you follow them up.

If your complaint is not resolved to your satisfaction, you may contact the Federal Competition and Consumer Protection Commission (FCCPC) or, for data protection matters, the Nigeria Data Protection Commission. The parties may also agree to refer a dispute to mediation before starting court proceedings.

We may update these Terms to reflect changes in our services, the law or the requirements of SSHIAs. We will give you at least 30 days' notice of material changes, including any increase in platform fees, by email or through the platform, unless a shorter period is required by law or a regulator. If you do not agree to the changes, you may close your account before they take effect and Section 16 will apply. Changes will not affect payments you have already made.

Force majeure. We are not responsible for delays or failures caused by events beyond our reasonable control, such as outages of SSHIA or banking systems, network failures, natural disasters or government action. We will tell you promptly and do what we reasonably can to minimise the impact. Any premium affected will be remitted or refunded as soon as possible.

Electronic communications. You agree that we may communicate with you by email, SMS and platform notifications, and that these meet any legal requirement for written communication.

Assignment. You may not transfer your rights under these Terms without our consent. We may transfer our rights and obligations to another organisation, for example following a merger or sale, provided your rights are not reduced.

Severability. If any provision of these Terms is found to be invalid or unenforceable, the remaining provisions continue in full force.

No waiver. If we delay or do not enforce any right, we do not give up that right.

Entire agreement. These Terms, together with our fee schedule and any terms shown to you at the time of payment, form the entire agreement between you and us about your use of Sanitas.

These Terms are governed by the laws of the Federal Republic of Nigeria, and the courts of Nigeria have jurisdiction over any dispute arising out of or in connection with them. If you live outside Nigeria, this does not deprive you of any protection given to you by the mandatory consumer protection laws of your country of residence, or of any right to bring proceedings in your local courts where those laws allow.

For questions about these Terms, please contact:

Email: support@sanitascare.org

Address: Isuna Technologies Limited, 2 Anthony Adegbulugbe Crescent, Kado, Abuja