Eligibility
| To be eligible for cover you must be first named on the agreement, over 18 and less than 70 years of age. | |
| For accident and sickness, unemployment and carer cover insurance you must be under 65, in employment or self-employed other than temporary work and you must not be absent due to sickness or injury. | |
| For hospitalisation insurance you must be 65 or over but under 70 or have retired from work and do not intend to seek any other work at this time. | |
| If you are absent from work due to sickness or injury on the start date of the term of cover your cover will start when you return to work, provided that this is within 30 days of the start date of the term of cover. | |
| If at the start date of the term of cover you are retired from work or over 65 but under 70, or, during the period of insurance you permanently retire from work or reach the age of 65, you will not be eligible for accident and sickness, unemployment or carer cover insurance benefits but will be eligible for life and hospitalisation insurance benefits. |
The insurer will pay the outstanding balance (less any arrears) if you die, up to a maximum of £25,000. The maximum aggregate benefit is £25,000 for all life claims.
Accident and Sickness Insurance
The insurer will pay an amount equal to 3% of the outstanding balance or £10, whichever is the greater (less any arrears), at the date of your disability up to a maximum of £1,200 per month if you are unable to work due to accident or sickness. You will be eligible for a monthly benefit to be paid after you have been disabled for a continuous period of 30 days. Further monthly benefits will become payable for each complete 30 days you are disabled until you return to work or the outstanding balance has been paid whichever occurs first. The maximum aggregate benefit is £1,200 per month.
Unemployment Insurance
The insurer will pay an amount equal to 3% of the outstanding balance or £10, whichever is the greater (less any arrears), at the date of notification of your unemployment up to a maximum of £1,200 per month if you suffer involuntary unemployment. You will be eligible for a monthly benefit to be paid after you have been unemployed for a continuous period of 30 days. Further monthly benefits will become payable for each complete 30 days you are unemployed until you return to work, 12 monthly payments have been made or the outstanding balance has been paid whichever occurs first. The maximum aggregate benefit is £1,200 per month.
Hospitalisation Insurance
Benefit under the hospitalisation insurance part of the policy is not available to you if you are eligible for cover under the accident and sickness, unemployment or carer cover insurance part of the policy. The insurer will pay an amount equal to 3% of the outstanding balance or £10, whichever is the greater (less any arrears), at the date you are confined to hospital up to a maximum of £1,200 per month. You will be eligible for a monthly benefit to be paid after you have been confined to hospital for a continuous period of 5 days. If you are already being paid benefit under the accident and sickness insurance part of the policy and your claim changes from accident and sickness to hospitalisation they will pay 1/30th of the monthly benefit for each day you are confined to hospital up to a maximum of £1,200 per month. They will continue to pay 1/30th of the monthly benefit for each day you are confined to hospital until you are no longer confined to hospital or the outstanding balance has been paid, whichever occurs first. The maximum aggregate benefit is £1,200 per month. The maximum aggregate benefit for all accident and sickness and hospitalisation claims is £28,800.
Carer Cover Insurance
If your work ceases due to the need for you to become a carer for a relative, the insurer will pay an amount equal to 12 x the monthly benefit (equivalent to 3% of the outstanding balance or £10, whichever is the greater, at the date you become a carer up to a maximum of £1,200 per month) or the remaining monthly payments due until the policy end date (whichever is the lesser).
Once a payment has been made under this part of the policy the carer cover part of the policy ceases. The maximum aggregate benefit is £1,200 per month. The total maximum aggregate benefit for all carer cover claims is £14,400.
(4) Significant Exclusions
Disability or hospitalisation resulting from a pre-existing medical condition, backache or related conditions unless radiological evidence is available, mental or nervous disorders (e.g. depression) or stress-related conditions unless you are under the care of, and receiving treatment from, a consultant Psychiatrist. Unemployment that is voluntary or results from your misconduct, unemployment that you are aware of at the start of cover or that occurs within the first 90 days of cover. Unemployment that results from the non-renewal of a fixed-term contract within 180 days of the start date. Unemployment that results from the expiry of a fixed-term contract unless you have been employed for 12 consecutive months and your contract has been renewed at least once, or you have been employed by the same employer on a permanent basis, but were transferred to a fixed-term contract, without a break in employment. If you are self-employed your business must have ceased to trade as a direct result of being unable to pay its debts when due and have declared this to the Inland Revenue. The insurer will not pay benefit if your work ceases for reasons not associated with becoming a carer, or if the sickness, disease, condition or injury of the person being cared for existed before the start date of cover or the community care assessment does not confirm that your relative requires a carer.
This insurance is underwritten by St Andrews Life Assurance plc and St Andrews Insurance plc.collapse
