Mortgage Protection
Options
Life and Critical Illness Benefits - Your Questions
Answered
What is Life
Benefit?
What is not
covered by Life Benefit?
What is
Critical Illness Benefit?
Which
critical illnesses are covered?
How do we
measure total permanent disability?
What is not
covered by Critical Illness benefit?
What is
Combined Life and Critical Illness Benefit?
What
is not covered by Combined Benefit?
What options
do I have for these benefits?
Life Benefit
What is Life Benefit?
It
is a benefit that is designed to pay out if you die.
In
addition we will pay out if you’re diagnosed as terminally ill more
than 12 months before your life cover ends.
A
terminal illness is an illness which, in the opinion of a
specialist consultant and with the agreement of our Chief Medical
Officer, is likely to lead to your death within 12 months.
If
we pay out for either of these events this benefit will end.
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What is not covered by Life
Benefit?
We
will not pay if you die after the expiry date for your cover, or
you’re diagnosed as terminally ill but do not die in the 12 months
before your cover ends.
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Critical Illness Benefit
What is Critical Illness
Benefit?
It
is a benefit that is designed to pay out if, during your cover
term, you’re diagnosed as having one of a defined list of critical
illnesses and you survive for at least 30 days.
We
will also pay out if, during your cover term, you’re diagnosed with
a total permanent disability and you survive for at least six
months.
If
we pay out for either of these events this benefit will end.
In
order to pay out, the diagnosis must meet our plan definition
either for total permanent disability or for one of the critical
illnesses shown on our list.
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Which critical illnesses are
covered?
Here is a complete list of the critical illnesses we
cover.
Alzheimer’s disease before
age 60 - resulting in permanent symptoms
Aorta graft surgery -
for disease
Benign brain tumour -
resulting in permanent symptoms
Blindness - permanent
and irreversible
Cancer - excluding
less advanced cases
Coma - resulting in
permanent symptoms
Coronary artery by-pass
grafts - with surgery to divide the breastbone
Deafness - permanent
and irreversible
Heart attack - of
specified severity
Heart valve replacement or
repair - with surgery to divide the breastbone
HIV as a result of an
assault - caught in the UK
HIV as a result of a blood
transfusion - caught in the UK
HIV through duties in
eligible occupations - (the emergency services, the medical
profession or the armed forces) caught in the UK
Kidney failure -
requiring dialysis
Loss of hands or feet
- permanent physical severance
Loss of speech -
permanent and irreversible
Major organ transplant
Motor Neurone disease
- resulting in permanent symptoms
Multiple Sclerosis -
with persisting symptoms
Paralysis of limbs -
total and irreversible
Parkinson’s disease before
age 60 - resulting in permanent symptoms
Stroke - resulting in
permanent symptoms
Third degree burns -
covering 20% of the body's surface area
Traumatic head injury
- resulting in permanent symptoms
Please remember that these headings are only a guide to what is
covered and for the full definitions of the illnesses covered, and
the circumstances in which you can claim, you should refer to the
Definitions section in our Terms and
Conditions. These definitions typically use medical terms to
describe the illnesses but in some cases the cover may be limited.
For example:
some types of cancer are
not covered,
to make a claim for some
illnesses you need to have permanent symptoms.
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How do we measure total permanent
disability?
We
measure total permanent disability by assessing your ability to
perform any three of the following activities, without the
assistance of another person or the use of special equipment:
washing or bathing so as
to maintain personal hygiene;
putting on and taking off
all necessary items of clothing;
moving from one room to
another or getting in or out of bed or a chair;
getting food or drink into
the body once it has been prepared and made available;
getting on and off the
toilet and maintaining personal hygiene following the use of
it;
controlling bowel or
bladder function.
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What is not covered by Critical
Illness benefit?
You are not covered if the cause of the claim results from alcohol
or drug abuse, HIV/AIDS (except where specifically included under
our plan definition), self inflicted injury or war and civil
commotion.
We
will not pay if you die, or if your cover ceases, within 30 days of
the diagnosis of critical illness or within six months of the
diagnosis of total permanent disability.
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Combined Life and Critical Illness
Benefit
What is Combined Life and Critical
Illness Benefit?
It
is a benefit which will pay out on the first of the following
events:
you die,
you are diagnosed with a
terminal illness more than 12 months before your cover ends,
you are diagnosed as
having one of a defined list of critical illnesses and you survive
for at least 30 days,
you are diagnosed with a
total permanent disability and survive for at least six months.
In
order to pay out on a diagnosis, your illness or injury must meet
our plan definition either for terminal illness, total permanent
disability or for one of the critical illnesses shown on our
list.
If
we pay out for any one of these events this benefit will end.
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What is not covered by Combined Life
and Critical Illness Benefit?
We
will not pay if you die after the expiry date for your cover, or
you’re diagnosed as terminally ill but do not die in the 12 months
before your cover ends.
We
will not pay for critical illness if your cover period ends within
30 days of the diagnosis of critical illness or within six months
of the diagnosis of total permanent disability.
We
will not pay out for critical illness if the cause of the claim
results from alcohol or drug abuse, HIV/AIDS (except where
specifically included under our plan definition), self inflicted
injury or war and civil commotion.
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What options do I have for these
benefits?
Length of your cover
When you apply for your plan you choose how much cover
you want and how long you want it to last.
The minimum term is 5 years and you must be aged under 60 at
the start of your plan.
You should ensure that the term of your cover is long enough to
cover the term of your mortgage.
Level or decreasing cover
Depending on the way you are repaying your mortgage you can choose
to have your cover on a level or a decreasing basis.
If
you choose level cover the amount of your benefit(s) will remain
the same throughout the term of your Plan. You should normally
consider this option if you have an interest only mortgage.
If
you choose decreasing cover the amount of your benefit(s) will
reduce each year during the term of your Plan. You should normally
consider this option if you are repaying your mortgage by regular
instalments over the loan period. The amount of your benefit is
calculated to be always equal to the outstanding amount under a
standard repayment mortgage. This calculation assumes that your
mortgage interest rate does not average over 12% a year.
Waiver Of Premium
If you are not in a high risk occupation you can
choose to have Waiver Of Premium cover when you apply for your
Plan.
If
you choose this cover, we’ll pay your premiums after 6 months of
incapacity and continue to pay them until the first of these
events:
you recover and are no
longer incapacitated,
your 65th birthday,
your cover ends,
you die.
Please see the Definitions section of
our Terms and Conditions for
our definition of incapacity.
You are not covered for Waiver Of Premiums if the cause of the
claim results from alcohol or drug abuse, criminal acts, flying on
a non-commercial basis, hazardous sports and pastimes, HIV/AIDS,
living abroad (defined as outside of Australia, Canada, the
European Union, New Zealand, Switzerland or the USA for more than
13 consecutive weeks in any 12 months), self-inflicted injury,
unreasonable failure to follow medical advice, or war and civil
commotion.
Single or joint life
Depending on your needs you can apply for the plan to cover you
alone, or you and another person.
If
the plan covers two people it will only pay out once for each
benefit for which you are covered. This would be when the first of
you becomes eligible for that benefit.
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