Sickness and accident protection cover (Prestige level only)
Please call the claims department on 01270 588555 before you make a claim. Your Prestige-level contributions are covered for up to 12 months when you or your partner (if they are covered) are continuously off work for at least30 days due to one of the following:
• Sickness
• Accidental injury
Sickness and accident protection cover only applies if you or your partner (if they are covered):
• have completed a qualifying period of 13 weeks
• are in full-time employment and between the ages of16 and 64
• are not aware of any medical treatment or advice you are due to receive, and
• are in good health.
If you suffer a disability, we will pay 1/30th of your monthly contribution, after the first 30 days of your disability, for each consecutive day you are disabled. We will refund benefit every 30 days during your disability, up to a maximum of 12 payments for any one claim.
By ‘disability’, we mean being totally prevented from carrying out your normal job or work as a result of an accidental bodily injury or sickness, as confirmed by a registered medical practitioner, that takes place after the start date. ‘Normal job or work’ means paid work of at least 16 hours a week that you carry out immediately before the start of your disability, and any similar job that you may reasonably be expected to carry out.
We will not pay disability benefit for any period you are disabled after you have reached the age of 65 (or your retirement date, if earlier).
When we assess the maximum benefit period, we will treat periods of disability resulting from the same cause as being the same period of disability, as long as they are not separated by at least three calendar months before you return to work.
Exclusions to sickness and accident protection cover
An exclusion period of 30 days applies to all claims.
We will not pay any amount where the disability happens within the 13-week qualifying period.
We will not pay for any period of disability caused by any physical or mental disorder, any chronic (severe) illness, or any recurring or continuing disease which you had received treatment or advice for before your cover began.
We will not pay for any period of disability that a registered medical practitioner has not provided medical evidence for. You must pay all the costs involved in getting medical evidence.
We will not pay for any period of disability caused by the following:
• War
• Attempted suicide
• You deliberately injuring yourself
• You being under the influence of alcohol or drugs (other than drugs taken under medical supervision, but not for treating a drug addiction)
• Pregnancy, childbirth or any complication connected to these
• A mental disorder, unless it is investigated and diagnosed by a consultant
• HIV (human immunodeficiency virus) or any HIV-related illness, including acquired immune deficiency syndrome (AIDS)
• Cosmetic surgery
• A pandemic disease
