Lifestyle 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.

BACK TO TOP

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.

BACK TO TOP

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.

BACK TO TOP

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.

BACK TO TOP

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.

BACK TO TOP

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.

BACK TO TOP

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.

BACK TO TOP

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 are 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.

BACK TO TOP

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.

Lump sum or monthly benefit

  When you apply for your plan you can choose to have your benefits paid either as a lump sum or as a monthly benefit.

  If you choose the lump sum option we’ll pay the benefit in full in the event of a claim.

  If you choose the monthly benefit option we will pay an annual benefit in monthly instalments until the end of the term for that cover. The amount of your annual benefit will automatically increase each year to help keep pace with inflation. See the ‘Will I be able to increase my cover in the future’ section.

  You cannot switch between options once the plan is in force.

  Please remember that Critical Illness Benefit is not a substitute for Income Protection Insurance.

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. This pays your premiums if you are unable to work due to incapacity.

  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.

  We will not pay out 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.

Increases in cover without medical evidence

  This option applies if your plan is accepted on standard terms. It enables you to increase the amount of your cover on certain special events such as marriage or childbirth, without having to provide us with additional medical information.

  There are also special events on which you can add or increase life cover when life cover you hold elsewhere expires.

  These increases and additions are subject to maximum limits and conditions. See section H of the Terms and Conditions for full details. 

BACK TO TOP