Critical Illness Insurance

Disability income benefit (sickness, accident or disability)

This benefit will give you a monthly income if, because of sickness, an accident or disability, you are, in the insurer's reasonable opinion, unable to work or do a number of work tasks. They may automatically include premium payment benefit (sickness, accident or disability) if you choose this benefit.

When you take out this benefit, you decide which of the following definitions you want the insurance company to use to assess a claim. If you are not in paid work or you are a house-person you can only choose the work tasks definition.

You also choose the level of cover that you want.

However, the  insurance company may impose limits

These limits also take into account all other permanent health insurance and accident, sickness and unemployment plans that you may have with other providers.

When you take out your benefit, you can choose the deferred period you want: four, 13, 26 or 52 weeks.

The deferred period is the period during which an insured person must be ill or disabled before the insurance company will pay any benefit. With a longer deferred period your premiums are lower.

As insurers may also include premium payment benefit (sickness, accident or disability), the deferred period for this benefit will be the same as the deferred period you choose for disability income benefit (sickness, accident or disability), unless you show otherwise on your Application Form.

Insurers will ask you to fill in a claim form when you make a claim. This will ask you for details of your condition and of any income that you receive, for example from other income protection plans. Insurers may also need medical information as evidence.

Insurers will pay your benefit until the first of the following events happens:

• > In our reasonable opinion, you recover

• > You reach the end of your benefit term

• > You die.

The maximum age at the end of the benefit term is 65 and your benefit will end on the benefit anniversary after you reach age 65 (or the first life to reach 65 if you choose a joint-life benefit).

The annual amount of disability income benefit will be restricted to 50% of your pre-disability annual salary or earned income. This amount may be reduced if you continue to receive income from employment when we pay the benefit or if you are receiving income from other private disability benefits.

If when insurers accept your claim, there is medical evidence to certify that there is no possibility of recovery, we may, as an alternative to the payment of monthly disability income benefit, convert your income benefit to a one-off lump-sum benefit. Once this payment has been made, the disability income benefit will cease.

If you return to work on reduced hours or to a lower paid job after insurers have accepted a disability claim, they may continue to pay a benefit to you at a reduced rate taking account of the salary or earned income you will be receiving from employment.

If you have a renewable disability income benefit and a claim is in payment when your benefit is due for renewal, insurers may allow you to renew your benefit in the normal way and your claim will continue subject to their standard claims procedures set out in the Policy.

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