Loan payment protection insurance
Policy wording (Certificate of Insurance)
1. Introduction
1.1. This document outlines the details of the Choices Loan
Protection Insurance policy. The policy provides cover if
You become Incapacitated or Unemployed. However, You are only
covered as long as You meet the conditions of eligibility
described below and You have paid the required Premium for
the level of cover You have chosen.
1.2. Facilities are available for customers with hearing
difficulties. Copies of this policy can be made available,
on request, in alternative media forms as required under the
Disability Discrimination Act 1995.
1.3. Please read this document carefully and make sure You
are eligible and that You know what the policy does and does
not cover. If You have any questions please contact the Administrator
at the following address: Adminicle Ltd, Callidus House, Cirencester
Business Park, Love Lane, Cirencester GL7 1XD, or Telephone
01285 886600.
1.4. The maximum Monthly Benefit payable for Loan Protection
under this policy is £1000 or Your Loan Payment, whichever
is the lesser. Please check Your policy schedule to ensure
the Monthly Benefit amounts You have chosen are correct.
1.5. If You have requested joint cover under the policy please
note that:
1.5.1. Each Insured’s cover is limited to a percentage
of the Monthly Benefit. The schedule, which is part of the
policy, shows the percentages of the Monthly Benefit, which
We will pay to each Insured in the event of a claim.
1.5.2. The higher earner can choose the higher percentage
of the Monthly Benefit. If the other Joint Insured becomes
the higher earner before the End Date, please write to the
Administrator at the above address. If no claim is in the
process of being validated or paid, the percentages may
be changed. Should a claim be made retrospectively, the
benefit percentages will be applied dependent on the date
of claim.
1.5.3. After the Start Date there can be no addition or
substitution of Joint Insured’s.
1.5.4. All terms and conditions relate to each individual
when joint cover is required.
1.6. If You transfer Your cover from an existing insurer,
We will waive the initial exclusion period for Unemployment,
provided Your previous insurance has been in force for at
least six months and You have never made a claim under Your
previous insurance.
1.7. We will pay Monthly Benefits directly to Your Lender.
We only pay You one type of benefit (Incapacity, or Unemployment)
at a time.
1.8. Certain words and phrases have special meanings. These
are explained in the Definitions section of this document.
Certain exclusions also apply please see the individual benefit
sections.
2. Insurance Contract
2.1. The policy is a legal contract between You and Us. The
application form, policy terms and conditions, the schedule,
and any endorsement make up the policy and You should read
them together. The policy is based on the information You
give Us when You fill out Your application form.
2.2. You are allowed a choice of law for this policy but
unless We agree otherwise English law will apply.
2.3. The insurers are Bankers Insurance Company Limited,
which is a member company of Assurant Solutions whose registered
office is: 117-119 Whitby Road, Slough, Berkshire, SL1 3DR,
England.
3. Eligibility
3.1. You are covered under the policy if on the Start Date:
3.1.1. You are at least 18 and under 65 years of age; and
3.1.2. You are actively Working (i.e. not off sick) or
away from Work on statutory maternity, paternity or adoption
leave; and
3.1.3. You are Working when You apply and have been for
at least 6 months immediately before the Start Date; and
3.1.4. You are named on the application form; and
3.1.5. We have accepted Your application; and
3.1.6. You have a Loan Agreement in force; and
3.1.7. You are a permanent resident in the UK.
3.2. If You are a Contract Worker and Employed under a fixed
term contract of Employment, You must meet the conditions
above at the Start Date and We will only consider Your cover
under the Unemployment section in accordance with the definition
of Work.
3.3. If You reduce the time You are Working to less than
16 hours a week, please tell Us. Your protection under the
policy is based on Your Employment.
3.4. You are not covered for any Pre-Existing Medical Conditions,
any Chronic Condition, or Unemployment before the Start Date,
which may cause You to claim for Incapacity, or Unemployment.
We may still insure You but We will not pay benefits directly
relating to any claim which We consider You were aware of
before the Start Date.
4. Definitions
Wherever the following words appear in this document they
will have the following meanings:
4.1. Accident/Accidental - A sudden identifiable violent
external event that happens by chance and which could not
be expected.
4.2. Administrator - Adminicle Ltd, Callidus House, Cirencester
Business Park, Love Lane, Cirencester GL7 1XD, or Telephone
01285 886600.
4.3. Certified - The Doctor/employer must confirm the document
is a true copy of the original and state their name, the date
and stamp it with their surgery/company stamp.
4.4. Choices - Choices Insurance TABICL House, 1 Rectory
Close, The Green, Tadley, Hampshire RG26 3PHTelephone: 0118
981 0203, Fax: 0118 981 5439 or email: enquiries@choices-insurance.co.uk.
4.5. Chronic Condition - A Condition that occurs prior to
the Start Date and that continues indefinitely, or cannot
be cured or eradicated and that recurs or requires treatment.
4.6. Condition - Any illness, injury, disease, sickness or
medical condition You have, including any related illness,
injury, disease, sickness or medical condition, or any associated
symptoms.
4.7. Contract Worker - A person who is Employed on a fixed
term contract of Employment as defined in Work.
4.8. Control - the power of a person (in relation to a company)
to exercise direct or indirect control over that company’s
affairs including but not limited to, owning the greater part
of the share capital or voting rights of that company or by
powers given to that person in any recognised document.
4.9. Doctor - A registered medical practitioner, practising
in the UK. This does not include You or Your relatives except
when diagnosing a Pre-Existing Medical Condition.
4.10. End Date - The date Your cover ends as set out in Section
10 - When Cover Ends.
4.11. Employment, Employed - undertaking any Work (including
Self-Employed work) of at least 16 hours a week.
4.12. Exclusion period - The period immediately after the
Start Date during which You will not be able to make a claim.
The period during which You are unable to claim is during
the first 60 days from the Start Date in respect of Unemployment
benefit. This is irrespective of when Employment actually
ends.
4.13. Hospital - Means a government controlled hospital,
a National Health Service hospital or a private hospital but
will not apply to any long-term nursing homes or geriatric
unit or any such facilities.
4.14. Incapacity, Incapacitated - A Condition, which stops
You from doing Your Work or any similar job. It must also
stop You from doing any other Work which Your experience,
education or training reasonably qualifies You to do. In addition,
if You are Self-Employed, an Incapacity must stop You from
helping, managing, receiving any money from or carrying out
any part of the day-to-day running of a business.
4.15. Incident Date - the date You die, or become Incapacitated
or Unemployed.
4.16. Insured, Joint Insured - The person(s) named on the
schedule and covered by the policy.
4.17. Lender – the entity to whom You are contracted
to make monthly repayments under Your Loan Agreement.
4.18. Loan Agreement - the loan granted by Your Lender to
You and to which this policy relates.
4.19. Loan Payment - the amount You pay each month as specified
in Your Loan Agreement
4.20. Misconduct - Means being dismissed from Your Employment
as a result of, but not limited to, theft, fraud, alcohol
abuse, sex offences, harassment and/or discriminatory behaviour.
4.21. Monthly Benefit - The amount shown in the policy schedule
for Loan Protection Insurance payable to You for a maximum
of 12 months, on a monthly basis in arrears, if You are unable
Work due to Incapacity or involuntary Unemployment.
4.22. Monthly Premium - the amount of Premium You must pay
every month as set out in Your policy schedule. If you are
in receipt of Monthly Benefits under this policy You must
continue to pay the Monthly Premium as it falls due in order
to ensure continuous cover under this certificate.
4.23. Partnership - An association of two or more people
who agree to share in the profits and losses of a business.
Members of a partnership are called partners.
4.24. Payment - the amount You must repay each month as specified
in Your Loan Agreement
4.25. Payment in Lieu of Notice - means either of the following:
4.25.1. Any payment You receive relating to the notice period
Your employer should have given You under the terms of Your
contract of Employment or letter of appointment; or
4.25.2. Any part of a compensation payment made for loss
of office (including any part of a payment made under a compromise
agreement and/or redundancy package) whether this directly
or indirectly relates to the notice period Your employer should
have given You under the terms of Your contract of Employment
or letter of appointment, or not.
4.26. Permanently Retire - You have stopped Working and You
have no intention to return to Work.
4.27. Pre-Existing Medical Condition - A Condition whether
diagnosed or not, which You knew about or in our reasonable
opinion should have known about, or for which You received
Treatment, prior to the Start Date.
4.28. Premium - the amount You must pay every month for cover
under this policy, as documented on Your policy schedule.
If You are in receipt of Monthly Benefits under this policy
You must continue to pay the Premium as it falls due in order
to ensure continuous cover under this certificate.
4.29. Salary - the amounts shown on Your payslips from Your
employer, received in the 12 months prior to the Start Date,
or in the event of claim, the claim incident date, if later.
If Self-Employed, this will mean the monthly average of Your
annual income received in the 12 months prior to the Start
Date, or in the event of claim, the claims incident date,
if later and as declared on Your self assessment return for
the previous tax year, confirmed by the Inland Revenue. For
Joint Insured’s the combined Salary of both applicants
will be considered as defined.
4.30. Self-Employed - You are
4.30.1. helping with, managing or carrying on a business
in the UK and are liable to pay tax under Schedule D Case,
l, ll, lV or V of the Income and Corporations Taxes Act
1988;
4.30.2. a partner in a partnership;
4.30.3. a person who exercises direct or indirect Control
over a company (not necessarily the majority shareholder
or holder of the majority voting rights);
4.30.4. Working for a company and in any way connected
with a person who has Control over that company (for example,
You are one of his or her family).
4.31. Start Date - The date Your cover commenced with Us
as shown in the policy schedule.
4.32. Treatment - Receiving advice or undergoing examinations
or consultations or receiving medication or long-term monitoring
from a Doctor.
4.33. UK - England, Scotland, Wales, Northern Ireland, the
Channel Islands and the Isle of Man.
4.34. Unemployment, Unemployed - Being out of Work and registered
as Unemployed with Your local Job Centre Plus office or the
Department of Health and Social Security in Northern Ireland.
You must be available for and actively looking for a Work
and able to provide third party documentation as requested
to support this each month. We will not consider You as Unemployed
for any day You receive Payment in Lieu of Notice.
4.35. We, Us, Our - Bankers Insurance Company Limited and
(a member company of Assurant Solutions).
4.36. Work or Working - Permanent Employment or Self-Employment
for 16 hours or more each week or on statutory maternity leave,
adoption leave, parental leave or paternity leave from such
Employment. You must also be paying the correct National Insurance
Contributions. If You are Employed under a fixed term contract
of Employment We will consider Your cover under the Unemployment
section in accordance with the following:
4.36.1. If at the Start Date You have been Working for
the same Employer for at least six months and Your contract
has been renewed at least once, We will consider a claim
only if Your current contract is terminated prior to its
expiry date. Monthly Benefit will only be paid until that
contract would have expired.
4.36.2. However, if at the Start Date You have been Working
for the same Employer for at least two years and if You
have an annual contract, which has been renewed at least
once and has at least six months remaining on Your contract,
We will consider any claim as if You had been in permanent
Employment.
4.37. You, Your - The person(s) named on the schedule and
covered by the policy.
5. Incapacity Benefits
5.1. If You are Working and become Incapacitated for at least
30 days in a row, We will pay You one Monthly Benefit.
5.2. To make a claim for Incapacity benefit, You must see
Your Doctor. We will treat the first day of Your Incapacity
as the day Your Doctor confirms You cannot Work. However,
if You complete Your Employer’s Self-Certification Form
for the first 7 days of Incapacity You will be classified
as Incapacitated for those 7 days. You must continue to be
treated by Your Doctor for the first 30 days of Your Incapacity.
At the end of this, and every 30 day period after that, You
must give the Administrator a Doctor's certificate confirming
Your Incapacity. We will be unable to pay any claim for any
period when a Doctor does not confirm Your Incapacity. Payment
in respect of valid claims will be made at the end of each
full 30 day period, upon receipt of all relevant information.
5.3. We will continue to pay one Monthly Benefit for each
complete and continuous 30 day period that You remain Incapacitated
until:
5.3.1. the End Date; or
5.3.2. You are no longer Incapacitated; or
5.3.3. We have paid a maximum of 12 Monthly Benefits; or
5.3.4. until the amount You still owe under Your Loan Agreement
at the date of Your Incapacity (excluding any arrears) has
been paid; or
5.3.5. the final repayment date; or
5.3.6. if You are a Contract Worker and Your Contract would
have expired, as defined in Work
whichever is the earlier.
5.4. If Your Incapacity (after the initial 30 day period)
is less than 30 days, We will pay 1/30th of one Monthly Benefit
for each day You are Incapacitated.
5.5. Exclusions for Incapacity cover are defined in Sections
6 and 9.
6. Incapacity Benefit Exclusions
You will not receive Incapacity benefit for any claim, which
is caused by, or resulting from:
6.1. a Pre-Existing Medical Condition; but You will be entitled
to benefit if You have not suffered from that Condition for
two years before the first date You became unable to Work.
You have not suffered from a Condition if throughout that
two year period You:
6.1.1. have not consulted a Doctor for that Condition,
and
6.1.2. have not received Treatment for that Condition,
and
6.1.3. have been free of symptoms of that Condition.
6.2. any physical or mental Condition which You knew of or
should reasonably have known about at the Start Date, or which
You asked or received treatment or counselling for from any
Doctor before the Start Date;
6.3. suicide, attempted suicide or self-inflicted injuries;
6.4. any Chronic Condition;
6.5. alcohol or drugs, unless they are prescribed for treatment
(other than for addiction) by a Doctor;
6.6. Human Immunodeficiency Virus (HIV) and/or HIV related
illness including Acquired Immune Deficiency Syndrome (AIDS)
and/or mutant derivatives or variations thereof however caused;
6.7. backache and related conditions howsoever caused unless
You have medical documents (for example, a MRI scan or X-rays)
as evidence of a diagnosed medical condition;
6.8. psychiatric illness or mental disorders including depression,
bereavement, stress, or stress related conditions unless diagnosed
by a consultant who is a member or the Royal College of Psychiatrists
and is recognised by that Royal College as being a consultant;
6.9. geriatric care, medical operations or treatments which
are not medically necessary, including cosmetic or beauty
treatment unless this is the result of an accident where Your
Doctor recommends You have cosmetic treatment;
6.10. pregnancy, childbirth, miscarriage, abortion or any
related conditions unless this is a result from complications
which are diagnosed as such by a Doctor, or consultant, who
specialises in obstetrics;
In addition You will not receive Incapacity benefit:
6.11. for any period when Your Incapacity is not confirmed
by a Doctor;
6.12. unless You are in receipt of statutory sick pay from
Your Employer or short term incapacity
benefit from the Job Centre Plus;
6.13. for any period where You are in receipt of Your Salary;
6.14. if You are receiving Unemployment benefit;
6.15. if any Exclusions detailed in Section 8 or 9 apply.
7. Involuntary Unemployment Benefit
7.1. If You are Working and become Unemployed for at least
30 days in a row, We will pay You one Monthly Benefit. If
You were Employed and You need to make a claim for Unemployment
benefit You must register at Your local Job Centre Plus office
within 15 days of the date Your Employer confirms You last
Worked or the date Your Payment in Lieu of Notice expires,
whichever is the later. If You were Self-Employed and You
need to make a claim for Unemployment benefit, You must register
with the Job Centre Plus within 15 days of the date Your business
permanently ceased trading and in addition Your business must:
7.1.1. have stopped trading and/or be in the process of
being wound up and You must have filed closing accounts
with the Inland Revenue;
7.1.2. be put into the hands of an insolvency practitioner;
or
7.1.3. be a partnership which has been or is in the process
of being dissolved and You must have filed closing accounts
with the Inland Revenue.
7.2. At the end of the first 30 day period of Unemployment,
and every 30 day period after that, You must give the Administrator
a copy of the Jobseekers Agreement and ABI1 Form from Your
local Job Centre Plus office confirming Your Unemployment.
Payment in respect of valid claims will be made at the end
of each full 30 day period, upon receipt of all relevant information.
7.3. We will continue to pay one Monthly Benefit for each
complete and continuous 30 day period that You remain Unemployed
until:
7.3.1. the End Date; or
7.3.2. You are no longer Unemployed; or
7.3.3. We have paid a maximum of 12 Monthly Benefits ;
or
7.3.4. until the amount You still owe under Your Loan Agreement
at the date of Your Unemployment (excluding any arrears)
has been paid; or
7.3.5. the final repayment date; or
7.3.6. if You are a Contract Worker and Your contract would
have expired, as defined in Work
whichever is the earlier.
7.4. If Your Unemployment (after the initial 30 day period)
is less than 30 days, We will pay 1/30th of one Monthly Benefit
for each day You are Unemployed.
7.5. If You are receiving Unemployment benefit and want to
start temporary Work which will continue for less than 6 months,
please let Us have details in writing before You start this
Work. We will not pay for the period You are not Unemployed.
However, when the temporary Work finishes, Your Unemployment
claim may continue and We will treat this as one continuous
claim. The most We will pay for this continuous claim is the
maximum number of Monthly Benefit payments selected.
8. Unemployment Benefit Exclusions
You will not receive Unemployment benefits in the following
circumstances:
8.1. If You were not in continuous Work for 6 months immediately
before Your Employment ended (if You were not in Work for
2 weeks or less, We will not count this as a break in Your
Employment);
8.2. Unemployment caused or resulting from Your Employment
ending within the Exclusion periods;
8.3. You being told, or made aware either before the Start
Date or within the Exclusion period that Your Employment will
end. This is irrespective of when Employment actually ends;
8.4. Unemployment which is normal or seasonal in Your line
of Work;
8.5. Unemployment which You knew of, or should reasonably
have known of, on the Start Date;
8.6. Misconduct which contributes or leads to Your dismissal;
8.7. any wilful act by You;
8.8. dismissal due to the inability to pass a probationary
period or perform any elements of Your job;
8.9. resignation, voluntary Unemployment or voluntary redundancy;
8.10. if You are Employed on a specific project, including
any temporary assignment and this project finishes;
8.11. if Your Employment ends as a result of the expiry of
an apprenticeship or training contract;
8.12. if You are Self-Employed and Your business temporarily
stops trading;
8.13. if You are a Contract Worker, Your contract would have
expired;
8.14. if You are Self-Employed and You can not give Us evidence
that Your business:
8.14.1. has permanently stopped trading and/or being in
the process of being wound up; or
8.14.2. has been put into the hands of a company dealing
with insolvency; or
8.14.3. is a partnership which has been dissolved or is
in the process of being dissolved.
8.15. for any period for which You have received or are entitled
to receive Payment in Lieu of Notice.
8.16. if You are receiving Incapacity benefit.
8.17. If You become Unemployed as a result of any condition
in Section 6 or if any Exclusions detailed in Section 9 apply.
9. General Exclusions
9.1. In addition to Sections 6 and 8, You will not receive
any benefits for Unemployment or Incapacity which is caused
by or resulting from:
9.1.1. taking part in, attempting, or acting as an accessory
to, any crime;
9.1.2. taking part in a strike, labour dispute, industrial
action or lock-out;
9.1.3. radioactive contamination, war, invasion, act of
foreign enemy hostilities (whether war be declared or not),
civil war, rebellion, revolution, insurrection, riots, civil
commotion, military or usurped power.
9.2. If You are Working outside the UK, unless You are:
9.2.1. Working for the British Armed Forces or as a civil
servant in a British Embassy or
consulate; or
9.2.2. Working for an Employer that is a UK registered
company who assigns You to Work in
the European Union on the same terms and conditions; or
9.2.3. Working on a specific project for less than 30 days
outside the UK and were actually
outside the UK for less than 30 days.
10. When Cover Ends
The policy will end automatically and all Monthly Benefits
will stop:
10.1. if You die; or
10.2. when You reach 65 years of age or Permanently Retire
if earlier (You must tell Us as soon as possible); or
10.3. when You cancel the policy; or
10.4. when Your Loan Agreement ends for whatever reason;
or
10.5. on the date You stop paying the monthly Premium; or
10.6. on the 90th day after We cancel coverage; or
10.7. if You are no longer resident in the UK;
whichever is earlier.
10.8. If You cancel the policy or cover ends for any reasons
detailed above and You wish to reinstate at a later date,
a new policy will be issued, subject to the eligibility criteria.
Cover will not be backdated and new exclusion/waiting periods
will apply from the new Start Date.
10.9. If Joint Insured’s are covered by this policy
and one of the Insured reaches the age of 65 or Permanently
Retires before then, that person will no longer be covered.
If You tell Us about this, in the event of a valid claim,
the remaining Insured will be entitled to claim the total
value of the Monthly Benefit.
11. Multiple Claims
11.1. You can make more than one claim for Incapacity or
Unemployment benefit subject to the re-qualification periods
detailed below:
11.1.1. The most We will pay for any one Condition resulting
in an Incapacity claim on this policy, is a maximum of 12
Monthly Benefits as shown on Your policy schedule.
11.1.2. You must return to Work for at least one month
before You can claim Incapacity for an unrelated Condition
or for at least six months before You can make another claim
for Incapacity for a related Condition.
11.1.3. If You return to Work for less than six months
and You need to make an Incapacity claim for the same Condition,
We will treat this as the same claim, providing You have
not received the maximum Monthly Benefit for that Incapacity.
11.2. You must return to Work continuously for at least six
months before You can make another claim for Unemployment
benefit. However, periods of Unemployment separated by six
consecutive months or less shall be treated as one continuous
claim provided You have not received the maximum number of
Monthly Benefits available.
12. General Conditions & Cancellations
12.1. If a claim is fraudulent, fraud is suspected in any
respect, or any false information is supplied in relation
to Your policy or claim, all benefits under this policy will
be forfeited and You may be liable to criminal prosecution.
We may demand You repay any benefits We have already paid
You. We will keep the Premium You have paid Us. We may also
prosecute You.
12.2. You can cancel the policy by writing to Us. If You
do this within the first 30 days of the Start Date and as
long as You have not made a claim, We will give You a full
refund of any Premiums You have paid.
12.3. We may cancel the policy at any time by giving You
90 days written notice at Your last known address. We may
also change the terms and conditions of the policy and the
Premium amount. We will give You 30 days written notice of
any change. The notice should be attached to the policy.
12.4. You cannot transfer Your right or interest in the policy
to any other person. The policy will not have any value at
the End Date or if it is cancelled.
12.5. If You cancel the policy no further Premium will be
collected and no refund of Premium will be made.
12.6. No refund of Premium will be made if You have made,
or attempted to make a claim, or Your Loan Agreement ends
for any reason.
12.7. Cancellations will not be backdated for any reason.
12.8. Only changes formally made by Us and advised to You
in writing are accepted as terms under this policy. No other
parties have any jurisdiction to change or agree any different
terms.
12.9. If Your circumstances change at any time during this
policy term, please notify the Administrator immediately in
writing. If You do not do so Your policy may be affected.
The following are some examples of circumstances that You
must tell Us about:
12.9.1. You are named on the policy and You choose to give
up Work; or
12.9.2. You Permanently Retire, irrespective of the reason,
from Work; or
12.9.3. You change the nature of Your Work.
12.10. If You need to change Your policy You may be required
to complete either a policy amendment form or a new application
form, dependant upon Your circumstances.
13. How to Claim
13.1. If You need to make a claim, You should contact the
Administrator at; Adminicle Ltd, Callidus House, Cirencester
Business Park, Love Lane, Cirencester GL7 1XD, or Telephone
01285 886600.
13.2. Please fill in the claim form and return it to the
Administrator who will process Your claim on Our behalf. The
Administrator should receive the claim form within 120 days
of the Incident Date. If You do not do this, Your benefit
may be affected. The Administrator may allow longer to claim
if You ask. The Administrator will give You information to
help You fill in Your claim form and tell You what details
are required.
13.3. When You make a claim, You must give the Administrator
all the evidence that is required to prove Your claim. You
will have to pay any costs involved in doing this. You must
give the Administrator this evidence in the way that is asked.
You must also agree to any medical examination, which will
be arranged and paid for by Us. Your past Employers may also
be contacted.
13.4. Any payment of benefit under the policy may, in some
circumstances, affect Your entitlement to Job Seekers Allowance
(and possibly other state benefits). Your local Job Centre
Plus office will be able to provide You with further information.
14. Change of Claim
14.1. If You are receiving Monthly Benefits because You are
Incapacitated and You become Unemployed You must write to
the Administrator straight away. We will continue to pay Your
Incapacity benefit while it remains valid. If You are still
Unemployed once a Doctor says You are fit to return to Work,
You must tell the Administrator and they will ask You to fill
in an Unemployment claim form for consideration.
14.2. If You are receiving Monthly Benefits because You are
Unemployed and You become Incapacitated You must write to
the Administrator straight away. You will no longer be eligible
to claim Unemployment benefit and You will have to fill in
a claim form for consideration under Incapacity benefit.
14.3. If You are not fit for Work and cannot meet, or continue
to meet, Our conditions to claim for Incapacity benefit and
You become Unemployed You may fill in an Unemployment claim
form for consideration.
14.4. We will only pay You one type of benefit (Incapacity
or Unemployment) at a time. If You change Your claim, the
most We will pay for Your Incapacity and Unemployment claims
together is 12 times the Monthly Benefit.
14.5. If You are receiving Monthly Benefit for Incapacity
and the Condition for which you are claiming changes, You
must advise the Administrator immediately and Your claim will
be re-considered in respect of the new Condition. The maximum
number of Monthly Benefits payable for any combination of
Conditions suffered consecutively will be 12 times the Monthly
Benefit.
15. Customer Care
We care about the service We provide to You and We make every
effort to maintain the highest possible standards. If You
have any questions about the policy please ask the Administrator.
Please have this document available so that Your enquiry is
dealt with speedily.
16. Complaints Procedure
Although We set ourselves high standards, if We do not meet
Your expectations and You are dissatisfied in some way We
would like to know. If You follow the guidelines below, Your
complaint will be dealt with in the most efficient way possible.
Step 1.
Please contact the Administrator’s Customer Services
Department: Adminicle Ltd, Callidus House, Cirencester Business
Park, Love Lane, Cirencester GL7 1XD. Telephone 01285 886600.
Please give or quote Your certificate number, noted on Your
policy schedule, so that they can deal with Your enquiry quickly.
Step 2.
If You are not satisfied with the way Your complaint has been
dealt with please contact or write to the Operations Director,
Assurant Solutions, 117-119 Whitby Road, Slough, Berkshire
SL1 3DR. Telephone 0870 152 6000.
Step 3.
If You are not satisfied with the way We have dealt with Your
complaint You can ask the Financial Ombudsman Service to review
Your case. You can contact them at the following address:
South Quay Plaza, 183 Marsh Wall, London E14 9SR. Telephone
0845 080 1800.
17. Assignment
The Benefits of this contract may not be assigned to a third
party.
18. Data Protection
18.1. We are committed to maintaining the personal data that
You provide in accordance with the requirements of data protection
legislation. Our Privacy Statement below gives further information
about this.
18.2. Assurant Solutions, its other related entities, and
carefully selected third parties may use Your personal data
to keep You informed about insurance products, services and
special offers that may be of interest to You. If You do not
wish Your personal information to be used in this way please
write to Us.
19. Notice to Customers
19.1. You are advised that any telephone calls made to Our
administration and claims handling units may be monitored
or recorded. This is to monitor the accuracy of information
provided by Our customers and Our own staff. It may also be
used to provide additional training to Our staff or to prove
that Our procedures comply with legal requirements. Both the
Administrator’s and Our staff are aware that conversations
can be monitored and recorded.
19.2. If We are unable to meet Our liabilities, You may be
entitled to compensation from the Financial Services Compensation
Scheme who can be contacted at: 7th floor Lloyds Chambers,
Portsoken Street, London, E1 8BN.The first £2,000 of
an insurance claim or policy is covered in full through the
FSCS, plus 90% of the balance.
19.3. Bankers Insurance Company Limited are authorised and
regulated by the Financial Services Authority. Ref 202735
19.4. Adminicle Ltd are authorised and regulated by the Financial
Services Authority: Ref 305375.
19.5. Choices are authorised and regulated by the Financial
Services Authority: Ref 304443.
19.6. You can check these details at the FSA Register at
http://www.fsa.gov.uk/register/ or by calling 0845 606 9966.
20. Privacy Statement
20.1. Your data controller:
20.1.1. For the purposes of the Data Protection Act 1998,
the data controller in respect of any personal information
provided is Assurant Solutions.
20.1.2. You may be assured that Assurant Solutions will
treat all personal data as confidential and will not use
or process it other than for legitimate purposes. Steps
will be taken to ensure that the information is accurate,
kept up to date and not kept for longer than is necessary.
Measures will also be taken to safeguard against unauthorised
or unlawful processing and accidental loss or destruction
or damage to the data.
20.2. Uses made of your personal information:
20.2.1. The personal information that You provide us will
be used for a number of different purposes including:
20.2.2. to manage and administer Your policy;
20.2.3. to assess Your application or subsequent claim(s)
including: conducting credit checks and fraud background
checks; and approaching former employers, the Department
of Employment and the Department of Social Security;
20.2.4. to offer You insurance products and services (except
where you have asked us not to do so) and to help us develop
new ones;
20.2.5. to contact You with details of changes to the products
You have bought;
20.2.6. for internal analysis and research;
20.2.7. to comply with legal or regulatory requirements;
and
20.2.8. to identify You when You contact us.
20.3. We may use external third parties to process Your personal
information on Our behalf in accordance with these purposes.
20.4. Sharing of Your personal information:
20.4.1. Unless You have asked us not to do so, Your personal
information provided may be shared with other organisations:
so You can receive, either in writing or by telephone, details
of other products and services which may be of interest
to You; and in order for us to comply with any legal or
regulatory requirements. In addition, We may share your
personal information with Our related companies to Assurant
Solutions for the purposes set out in this Privacy Statement.
20.5. Sensitive personal data:
20.5.1. To the extent that You provide sensitive personal
data, We (and our related companies) may also process such
sensitive personal data, both manually and by electronic
means, for the same purposes described in this Privacy Statement.
Sensitive personal data includes information as to Your
physical or mental health or condition; or the commission
or alleged commission of any offence by You.
20.6. Business changes:
20.6.1. If We, or a related company, undergoes a reorganisation
or is sold to a third party, the personal information provided
to Us may be transferred to that reorganised entity or third
party and used for the purposes set out in this Privacy
Statement.
20.7. Overseas transfers:
20.7.1. We may transfer Your personal information to countries
located outside the European Economic Area (the EEA). This
may happen when Our servers, suppliers and/or service providers
are based outside of the EEA. The data protection laws and
other laws of these countries may not be as comprehensive
as those that apply within the EEA - in these instances
We will take steps to ensure that Your privacy rights are
respected. Details of the countries relevant to You will
be provided to You upon request.
20.8. Access to/correction of Your information:
20.8.1. With limited exceptions, You have the right to
ask for a copy of the information that We hold about You.
There may be a charge for this. If any of the information
that we hold about You is incorrect, please tell Us at Assurant
Solutions, 117-119 Whitby Road, Slough, SL1 3DR. and We
will amend as necessary.
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