Product exclusions

We never offer an exclusion on Life Cover unless your client specifically requests it. This is because we prefer to offer the most comprehensive cover available in the first instance.

Exclusions

• If we apply an additional premium, for example a hazardous activity, your client can request to have the risk excluded from the plan, rather than pay the additional premium.
• Exclusions under Life Cover can only be applied for hazardous activity risks, but not medical risks.
• We can offer an exclusion on all Life Cover products even if the policy is required to protect a loan.
• There is a maximum of one exclusion per life, and a maximum of two exclusions per contract in the case of a Joint Life policy.

Maximum rating

The maximum rating we will normally apply is 400% extra mortality loading.

Countries where a claim can be made

Life Cover claims can be made from anywhere in the world. We will pay a claim as long as we can verify that it is valid.

Exclusions

There is a maximum of two exclusions for a single life application, and three for a Joint life application. This is regardless of whether the exclusions are on the Critical Illness Cover or the Total and Permanent Disability (TPD) elements of the cover. However, we do not allow more than one TPD exclusion for each life.

Maximum rating

The maximum rating is 100% extra mortality loading.

Countries where a claim can be made

The life insured, or relevant child is covered if they are resident in the United Kingdom, any part of the countries that form the European Union, USA, Canada, Australia, New Zealand, the Isle of Man or the Channel Islands. We will also accept a claim from other countries if we can confirm the claim is valid. We will act reasonably when reviewing evidence to support the validity of a claim.

Your client must have been registered with a UK GP for two years to be able to apply for our Income Protection products.

Financial underwriting

Financial underwriting is done at the claim stage (except for Key Person Income Protection, which is financially underwritten at both the application and claim stages).

Exclusions

We can apply an exclusion for mental illness and spine injury with a reduction in premium of:

• 5% for a full exclusion
• 3% for a partial exclusion
• There is a maximum of two exclusions permitted per life

Special terms

Special terms are available for NHS dentists, doctors, midwives, nurses, and surgeons. These terms are not available on:

• Low Start Income Protection
• Executive Income Protection
• Key Person Income Protection

Overseas travel and residency

The policy remains in force if your client resides in, or travels to, any of the following countries after the policy has been issued, provided that they are a UK resident at the time the application is made:

• Any part of the European Union
• United States of America (USA)
• Canada
• Australia
• New Zealand
• Isle of Man
• Channel Islands

The monthly benefit will be paid for up to 6 months if your client is residing or travelling for up to 12 consecutive months outside of these countries.

We wouldn’t normally offer Income Protection plans to anyone who is residing overseas at the start of the policy.

Countries where a claim can be made

Clients can make a claim on this policy if they reside in or travel to any part of the countries that form part of the European Union, USA, Canada, Australia, New Zealand, the Isle of Man or the Channel Islands, or they reside or travel for up to 12 consecutive months in any other part of the world. However, the monthly benefit for incapacity provided by this policy will only be payable for up to six calendar months while the client is outside the countries listed above

Per mille ratings affect the premium differently on Family and Personal Income Plan cases, compared to normal term assurance contracts.

If a pre-sales enquiry for the plan contract indicates a per mille rating, we recommend you speak to our Protection Customer Services for an indicative rated quote.

Total and Permanent Disability (TPD) pays out the sum insured if the client becomes totally and permanently debilitated, under one of the following two definitions (and with no prospect of improvement at any time):

• Own Occupation – unable to do their own occupation ever again
• Specified Work Tasks – unable to do three specified work tasks ever again

The nature of the applicant’s occupation (for example admin or manual) will determine which TPD definition will be considered at application stage.

The product’s policy booklet will tell you which definition applies.

For joint life plans, only one definition of disability will apply to both lives if both clients are in gainful employment. This will be shown on their personal quote.

See pages 21-22 of the Product Profiles document for more information on definitions.

The life insured can claim for Waiver of Premium if they reside or travel within the European Union or travel outside of the European Union for no more than three consecutive months in any 12 months.

If the life insured travels outside of the European Union for more than three consecutive months in any 12 months we will act reasonably when assessing whether the life insured meets the definition of incapacity.

Overseas travel and residency questions form part of our standard application process.

If the application is accepted by us, then the policy documentation states how we would assess any future overseas travel or change in residency.

The terms and conditions governing residency and travel vary between different products and have changed over time, so any existing customer should refer to their individual policy document for full information.

Any payments from claims can only be made to a UK bank account.

Residency and travel