Setting up a policy.

You’ll need to decide the eligibility conditions including who can join and when, as well as, the level of benefits you want to provide. 

Number of membersNormally a minimum number of 50 members is needed to first set up the policy.
Who can be coveredMembersChildrenNon-employees
Any employees that satisfy the eligibility conditions set out by the employer.The members children between the ages of six months to 18 years are covered automatically at no extra cost.For an additional cost, the members spouse or registered civil partner.
Maximum benefitMembersChildrenNon-employees
The lower of £500,000 or five times scheme earnings.The lower of £20,000 or 25% of the member’s benefit level.£150,000 or an amount equivalent to the level covering the member, if less.
Conditions covered12 conditions covered as standard.

26 further conditions can be added at an extra cost.

What happens next

Once you’ve accepted our quote and all the information we asked for in the quote has been provided, starting cover is very straightforward.

Step 1

You should:

  • Where cover is already in place elsewhere, please make sure there are no outstanding requirements from our quote, before cancelling with the current insurer.
  • Confirm the assumptions we’ve made in our quote.
  • Let us know the date you’d like cover to start from (cover cannot be backdated).

If you are an employer, you may want to talk to an independent financial adviser.

Step 2

We’ll send you:

  • A confirmation letter, including your policy number and our medical underwriting requirements.
  • A copy of the quote and invoice.
Step 3

You’ll need to send us:

  • A completed proposal form within 14 days.
  • For any members who have previously been medically underwritten, send us a copy of the insurer’s ‘letter of acceptance’ or declaration – switch terms form.
  • The first premium payment within 14 days from the date we agree to provide cover.
Step 4

We’ll provide you with:

  • A policy document.
  • A member’s guide, which gives you information about the policy that you can use on your intranet site to help you promote the benefits of this cover to your employees.

We don’t normally need to know about salary increases during the scheme year, unless the increase takes the benefit over the free limit. Our rate guarantee is normally for two years, and any changes in benefit increases will be swept up at the next renewal date along with new entrants and leavers, depending on the accounting basis chosen.

Rate guarantee

We normally guarantee premium rates for two years (or a period agreed at the quote stage). We won’t be able to guarantee premium rates if:

  • The benefit or membership varies by more than 25% during the policy year.
  • The eligibility conditions are changed.
  • The benefit formula or scheme earnings definition is changed in anyway.
  • A new employer joins the scheme or a participating company leaves it. Let us know immediately if this happens so we can review our rate.

You need to know

We’ll continue to provide cover and pay any valid claims as long as the employee meets the definition of incapacity that is set out in the quote and premiums are paid and the terms are met. Policy terms will be unique to each business and there are some circumstances where we won’t provide cover. More benefits and exclusions can be found in the technical guide.


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Winner for Group Critical Illness Cover at the Cover Excellence Award 2007, 2008, 2010 and 2011.

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