LifeOne Policy Wording

Transcription

1 LifeOne Policy Wording

2 LifeOne Policy Wording 1. Introducing your Policy 2. What you are insured for 3. Your rights to change your Policy 4. Cigna s obligations and rights 5. Exclusions 6. How to make a claim 7. Policy definitions 1. Introducing your Policy This Policy pays you, as the Policy Owner, a lump sum on the death of the Life Insured or diagnosis of a Terminal Illness for the Life Insured. The Policy is underwritten by Cigna Life Insurance New Zealand Limited (Cigna) who will be responsible for all claims and other matters relating to this Policy. As the Policy Owner it is your responsibility to arrange payment of the premiums from the Premium Start Date and as they become due. All correspondence with you will be sent to the most recent address that Cigna holds for you. If you change your address, it is your responsibility to notify Cigna. Please read all your policy documents including your Policy Summary, this document and your application form carefully as they contain the terms and conditions that apply to your Policy and form the basis of the contract between you and Cigna. Meanings of important words and terms are in Section 7. If you have any questions, please contact us. As a reward for your loyalty, on the 5th anniversary of your Policy Cigna will give you back 10% of your premiums. Full details of Cigna s Premium Pay Back can be found in Section 4. Because it s important you are entirely satisfied with your insurance, Cigna offers a 30 day Free Look Period. If for any reason you want to cancel this Policy, please call our Customer Services team. Any premiums that you have paid will be refunded and Cigna will confirm in writing that the Policy has been cancelled. If you cancel outside this 30 day period, there will be no refund of premiums. All payments made in respect of this policy are in New Zealand currency. This Policy does not have any surrender or cash value.

3 Your duty to be truthful We rely on the information you provide us to issue your Policy and pay any claim. If you re not absolutely truthful or don t notify us of all Material Information in your application and up until the Policy is issued or when you claim, we may cancel your Policy and retain all or some of your premiums. 2. What you are insured for Cigna s Insurance Promise Providing the terms and conditions are met and the premiums are up to date, Cigna will pay you the benefits shown on the Policy Summary and as described here. Life Benefit If the Life Insured dies, Cigna will pay the current Cover Amount to you. Terminal Illness Benefit If the Life Insured is diagnosed with a Terminal Illness, Cigna will pay you an early payment of the current Cover Amount, up to a maximum of $500,000. If Cigna pays a Terminal Illness Benefit equal to the current Cover Amount, the Policy will end and no further premiums will be payable. If the Terminal Illness Benefit paid is less than the current Cover Amount, this will be reduced by the amount paid. The remaining Cover Amount will be payable on the death of the Life Insured and the premiums for the remaining Cover Amount will be adjusted to reflect the reduced cover.

4 3. Your rights to change your Policy Increase your cover You can apply to increase your Cover Amount at any time by completing a new application, which will go through the same process as your original application. The terms and conditions for your additional cover may differ from those for your existing cover. Your existing Cover Amount will continue with your original terms and conditions, unless Material Information was not provided or misrepresented on the earlier application(s). Decrease your cover You can apply to decrease your Cover Amount at any time by writing to Cigna. Cancel your cover You can cancel your Policy anytime. Your cover will stop as soon as you advise us. If you cancel your Policy within the Free Look Period, you will receive a full refund of all the payments you have made. If you cancel your Policy outside the Free Look Period, there will be no refund of premiums. Change the Policy Owner You can transfer the Policy ownership at any time. To do this you need to complete a Change of Policy Ownership form and return it to Cigna. Cigna will need to register the transfer for it to be legally recognised. Reinstate your cover You can apply to Cigna for your Policy to be reinstated if it has been cancelled through unpaid premiums. You may need to provide Cigna with information about the Life Insured s health and lifestyle and reinstatement will be at Cigna s discretion. The terms applying to the reinstated cover may be different to those applying before it was stopped. You will be issued with a new Policy Summary. Register a complaint If you have a complaint please contact Cigna to discuss it. Cigna is a member of the Insurance and Savings Ombudsman scheme which is a free, independent service which can help settle any unresolved disputes you may have. Any dispute or action relating to this Policy will be determined in accordance with New Zealand law. Change your payment method and frequency You can apply to change the method and frequency of premium payments at any time by contacting Cigna.

5 4. Cigna s obligations and rights Guaranteed renewal of your cover Cigna will renew this Policy each year on the Anniversary Date and cover will continue if you do not cancel the Policy and premiums continue to be paid. Premium adjustments Your initial premium payable is shown in your Policy Summary and is based on the Cover Amount. Your premiums will be adjusted on each Anniversary Date as you get older except where the Fixed Premium Period is five years, in which case Cigna will not adjust your premium until the 5th Anniversary Date and then annually after that. Cigna will advise you in writing before your Anniversary Date of any changes to your premium payable for the coming year. After the Fixed Premium Period, Cigna may review and change its premium rates for all LifeOne policies. Cigna will give you 30 days prior written notice of any such change. Inflation adjustments To help keep your cover up to date, Cigna will offer you a yearly increase in the current Cover Amount, up to 10%, on each Anniversary Date. The percentage increase offered will be based on the most recent 12 month increase in the Consumer Price Index (CPI). If your Fixed Premium Period is one year, the first indexation offer will be made on the 1st Anniversary Date and yearly from then on. If your Fixed Premium Period is five years, the first indexation offer will be made on the fifth Anniversary Date and yearly from then on. You do not have to accept an increase but no further increases will be offered once: you have declined three offers; or an offer to increase will lead to the total Cover Amount under the Policy exceeding $1,000,000; or Cigna has been notified of a possible claim under this Policy; or the Anniversary Date after the Life Insured s 65th birthday has been reached. Rewarding your loyalty On the fifth Anniversary Date, Cigna will pay back to you 10% of all the premiums you have paid in the first five years of the Policy. This Premium Pay Back will be subject to: the Policy being active on the 5th Anniversary Date; and no outstanding premiums; and no claim payments made, or claims lodged, against the Policy. The Premium Pay Back in respect of any increase in cover you apply for will be paid on the 5th anniversary of the Premium Start Date of the increase. This Premium Pay Back is only available for increases to the Cover Amount you apply for within the first five years of the Cover Start Date. Stop your Policy Cigna will stop the Policy when any of the following happens: if the premiums are unpaid for three months, cover will end on the date the last premium was paid up to; Cigna pays a Terminal Illness benefit equal to the Cover Amount; Cigna pays out your full Cover Amount; you request Cigna to cancel your Policy.

6 5. Exclusions Cigna will not pay any benefit under this Policy if: you or the Life Insured did not completely and truthfully answer the questions asked when the Policy was issued, increased or reinstated. Cigna may cancel the Policy from the Cover Start Date and keep any premiums paid; or you or the Life Insured failed to provide Cigna with any Material Information before the Policy was issued, increased or reinstated. Cigna may cancel the Policy from the Cover Start Date and keep any premiums paid; or the Life Insured s death is caused or contributed to, directly or indirectly, by suicide, attempted suicide or intentional self injury, whether sane or insane, within 13 months of the Cover Start Date; or the claim is due, directly or indirectly, to War or any act of War, invasion, Terrorism or any acts of Terrorism, act of foreign enemy, hostilities, strike, riot and/or civil commotion, civil war, rebellion, revolution, insurrection, military or usurped power. 6. How to make a claim If you need to make a claim against this Policy, contact Cigna as soon as possible to request a claim form. Cigna will send the claim form within 24 hours of your request. Complete the claim form and return it to Cigna together with any supporting documents requested. Any medical information required to support a claim for a life benefit or Terminal Illness benefit must be: provided by appropriately qualified medical practitioners registered in New Zealand or Australia (or any other country approved by Cigna); and paid for by you. If Cigna requires the Life Insured to undergo any further examinations or tests to confirm that the Life Insured is suffering a Terminal Illness these costs will be met by Cigna. If the Cover Amount has been increased within the 13 months prior to the Life Insured s death from suicide, attempted suicide or intentional self injury, whether sane or insane, Cigna will only pay the Cover Amount that applied prior to the increase.

7 7. Policy definitions The following words and terms appear in the Policy Summary and/or in this document. They are defined as: Anniversary Date means the date 12 months after the Premium Start Date and the same date every year after that. Cover Amount means the amount this Policy pays out. Cover Start Date means the date that the cover began. Free Look Period means a 30 day period starting on the day that Cigna posts or s this Policy. Fixed Premium Period means the period during which the premium for this Policy will not change, starting from the Premium Start Date. Life Insured means the person who is insured under this Policy. Material Information means all the relevant information that Cigna needed in order to decide the terms relating to your Policy. It includes, but is not limited to: information about the Life Insured s health, medical history, occupation and leisure activities. Policy means the terms and conditions applying to this insurance as described in the Policy Document, Policy Summary and your application form. Premium Start Date means the date that the first premium is due. Terminal Illness means an illness that Cigna believes will result in the death of the Life Insured within 12 months of the Policy Owner applying for a Terminal Illness benefit. The illness must commence after the Cover Start Date or the reinstatement date if Cigna reinstates this Policy, and be diagnosed while this Policy is in force. This illness must be supported by written diagnosis and prognosis by two unaffiliated registered medical practitioners. Terrorism means the use or threatened use of force or violence against human life or property, or commission of an act dangerous to human life or property, or commission of an act that interferes with or disrupts an electronic or communication system, undertaken by any person or group, whether or not acting on behalf of or in any connection with any organisation, government, power, authority or military force, when the intent is to intimidate, coerce or harm a government, civilian population or any segment thereof, or to disrupt any segment of the economy. War means any war, whether declared or not, or any warlike activities including use of military force by any sovereign nation to achieve economic, geographic, nationalistic, political, racial or religious ends. Policy Owner means the person(s) initially named as the Policy Owner, or the assignee(s) named on the most recent Change of Policy Ownership form if the Policy has been assigned. The Policy Owner is also referred to as you or your in this document. Policy Summary means the summary sent to you with this document on which details specific to your Policy are listed, or any replacement summary.

8 About Cigna Cigna New Zealand is a leading specialist provider of insurance products and services including life insurance, identity theft protection, funeral insurance, income protection insurance, accidental death insurance and trauma insurance. We ve been operating in New Zealand for more than 85 years, and now protect over 275,000 New Zealanders with our insurance policies. Cigna New Zealand is part of Cigna Corporation, a Fortune 500 company and one of the world s largest publicly-owned companies. A copy of Cigna s latest financial statements is available on request. Cigna Life Insurance New Zealand Limited has an A- (Excellent) financial strength rating which was given by A.M. Best Company Inc on 23 December The rating scale is: Secure Vulnerable A++ A+ Superior B B- Fair A A- Excellent C++ C+ Marginal B++ Good C C- Weak D Poor E Under regulatory Supervision F S In Liquidation Suspended

9 Contact us By phone By for general information about your Policy such as premiums and address changes to register a complaint claims.nz@cigna.com to request a claim form or ask any questions related to a claim By letter Cigna Life Insurance PO Box Manners Street Wellington 6142 By Fax CIG469 12/02/1228/01