Money that would be paid to you if you were to make a successful claim under a plan.
Critical Illness, is a life-threatening condition, which is generally strictly defined. Most critical illness policies provide for the payment of a lump sum benefit if the policyholder is diagnosed as suffering from one of a number of specified terminal illnesses.
Date of Expiry
The date a cover ends. The date of expiry of individual covers is shown on the plan schedule.
A plan account that decreases in value over the life of the plan. It decreases in the same way as a repayment mortgage that has a 10% annual equivalent interest rate. If the plan is fixed term, you can choose to have a decreasing account. If you have disability cover, you can also choose for it to decrease in the same way.
The period during which an insured person must be ill or disabled before a plan will pay any benefit.
Disability cover pays one or more lump sums if you were to become disabled because of an accident or illness. You can be covered for several different categories of disability, from temporary disability that stops you working in the short term, to severe disability that affects you for the rest of your life.
Family Income Cover
Family Income Cover pays a regular monthly benefit for a fixed period of time if you die or are diagnosed with a terminal illness. If you have selected Family Income Cover that provides a benefit on diagnosis of a serious illness, a benefit will also be paid if you are diagnosed with an illness that is covered by your chosen plan whilst meeting the provider’s definition of the illness.
The term of a cover is how long the cover lasts. A fixed term has a defined date of expiry.
Guaranteed Insurability Options
This allows for you to increase certain covers when particular events happen in your life, without giving your provider any further information about your health.
Income protection Cover
Income protection cover pays you a regular income if you become incapacitated and cannot work, as long as the incapacity meets the definitions of your provider.
Joint Life Second Death
Life Cover where your provider pays the benefit when the last of the persons covered passes away or is diagnosed with a terminal illness.
Key Person Protection
Key Person Protection is a business insuring itself against the financial loss it would suffer if a key person in their business died or were diagnosed with a specified critical illness if chosen, during the length of the policy.
Life assured or insured is the person(s) whose life is covered in the contract by the provider.
The full-time occupation that you had immediately before the start of the illness or injury (or incapacity in terms of Income Protection Cover).
Personal Health Insurance (PHI)
Insurance against loss by illness or bodily injury. Health insurance provides coverage for medicine, visits to the doctor or emergency room, hospital stays and other medical expenses. Policies differ in what they cover, limits of coverage and the options for treatment available to the policyholder. Health insurance can be directly purchased by an individual, or it may be provided through an employer.
Personal Medical Insurance (PMI)
A type of insurance coverage that pays for medical and surgical expenses incurred by the insured person.
The owner of the plan.
A document that shows:
The cover(s) in the plan
The amount of each cover
The premium for each cover
The date of expiry of each cover, unless the cover is whole of life
Any special conditions.
Pre-existing Medical Condition
A medical condition (whether or not a diagnosis was made or any symptoms were evident) which existed before any of these dates, as appropriate:
The start date of the plan and relevant covers
The relevant child reaching the age of one month (only for Optional Serious Illness Cover for Children, Core Serious Illness Cover for Children, Family Income Cover and Education Cover)
The legal adoption of the relevant child (only for Optional Serious Illness Cover for Children, Core Serious Illness Cover for Children, Family Income Cover and Education Cover)
The date that the plan is reinstated following non-payment of plan premiums
Relevant Life Plan
A term assurance plan available to employers to provide an individual death in service benefit for an employee. It is designed to pay a lump sum if the employee dies whilst employed during the length of the policy.
A definite diagnosis by the attending Consultant of an illness that satisfies both of the following:
The illness has no known cure or has progressed to the point where it cannot be cured
In the opinion of the attending Consultant, the illness is expected to lead to death within 12 months.
The process that provider’s use to assess your application to include or make alterations to a cover. Underwriting can lead to:
Accepting of the application
Rejection of the application
Amendment of one or more terms
Waiver of Premium
Waiver of Premium, is a clause within an insurance policy that waives the policyholder’s obligation to pay any further premiums should he/she become seriously ill or disabled, so the waiver of premium allows people to benefit from an insurance policy, even when they cannot work.
Whole of Life
The term of a cover that lasts from the covers start date to the death of the insured person for the joint life first death or the death of both persons covered for joint life second death.