POLICY CONDITIONS PC009 January 2014 Mortgage Protection

Transcription

1 POLICY CONDITIONS PC009 January 2014 Mortgage Protection Policy number <<xxxxxxxx>> Part 1 Part 2 Part 3 Part 4 Part 5 Appendix 1 Contract basis and definitions Paying your premiums Main benefits Contents General exclusions and claims procedure General conditions Schedule of benefits Introduction These conditions and your policy schedule set out the details of your contract with us. Please read them carefully. To help you understand these conditions we have divided them into several sections and have included brief notes at the start of each section. These notes do not form part of your contract with us but they will help you to understand the policy. Where notes do not cover all eventualities the implications should be construed using the detailed explanations within the policy conditions. If after going through the conditions you have any questions, please contact us. We will be happy to help. Part 1 Contract basis and definitions This section sets out the basis of the contract between you and us and also defines some terms used elsewhere in these conditions. 1. Basis of the Policy The policy consists of the Policy Schedule and these Conditions and is evidence of the contract which has been issued on the basis of the assessment by Friends First Life Assurance Company Limited (Friends First) of the details provided on the Proposal Form and other information furnished verbally or otherwise, together with any medical evidence obtained from any Medical Practitioner or Consultant attended by the Life Assured at any time for treatment or advice. We reserve the right to declare the policy void from inception in the event that we become aware of any non-disclosure or misrepresentation of any relevant personal information either at the time of proposal, the period of time between submission of proposal and posting of the policy by Friends First, or at the time of and in the course of making and receiving a claim for benefit. 2. Definitions In these conditions the following words and phrases will have the following meanings: Proposal The Proposal signed and dated by the Life Assured and the policy holder, together with any subsequent information provided by, and accepted verbally or otherwise from, the Life Assured or the Life Assureds agent. We, our, us, Friends First Friends First Life Assurance Company Limited. You, your The person, people or company entitled to a payment under this policy. This will usually be the policyholder as shown in the policy schedule but can also refer to the trustees of the policy or the administrator of the policyholder s estate. The Actuary Our Appointed Actuary or any other actuary he or she appoints for the purpose of this policy. Child, children Any natural or legally adopted children of a Life Assured. Children s Life Cover, Specified Illness cover and Hospital Cash cover applies to children between the ages of 30 days and 18 years, or 21 years if in full time education Mortgage The original loan you took out for the property stated on the application form for which this policy is intended as collateral. 3. Sum assured If you chose the Guaranteed Mortgage Repayment option at outset, then in the event of a valid death or Specified Illness claim we will pay an amount equal to the outstanding balance of your mortgage under the following circumstances. the initial sum assured was equal to your original mortgage amount; you have not increased the mortgage or extended the term of the loan; you have paid all payments due under your mortgage; and the loan has remained on a principal and interest basis. If you have not met these conditions we will pay the minimum benefit due, as calculated in Table 1 of Appendix 1. If the minimum benefit shown in Appendix 1 is larger than the balance on the mortgage, we will pay the minimum benefit. If you did not choose the Guaranteed Mortgage Repayment Option then in the event of a valid death or Specified Illness claim we will pay the Benefit due, as calculated in Table 2. This amount may not be sufficient to repay your mortgage in full. The Benefits in Table 2 have been calculated on the assumption that mortgage interest rates do not exceed 6% throughout the mortgage term. Part 2 Paying your premiums This section describes how premiums are paid under your policy and what happens if premiums are missed or stopped altogether. 4. Premiums Your policy schedule sets out how often you must pay your regular premiums. If you pay premiums once a year (annual premiums), the first is due on the policy start date. Premiums are then due on each anniversary of that date. If you do not pay annual premiums, you must pay them by direct debit starting on the policy start date. Notwithstanding the above paragraph, it is the responsibility of the policyholder(s) to ensure that all

2 premiums due under this policy are paid. Failure to pay premiums can result in a loss of the policy benefits. 5. If you do not pay your premiums If you miss a payment we will allow you 30 days to pay. If you do not pay within 30 days we will cancel your policy. If we cancel your policy you can apply to reinstate it within 6 months of the date of cancellation. To do this you must pay all outstanding premiums and provide us with whatever evidence we require to show the current state of health of the life or lives assured or any other information or evidence we may ask for. Part 3 Main benefits This section describes the main benefits available under the Mortgage Protection Plan. Your policy schedule will show which benefits apply to your policy. If you are covered for Specified Illness benefit, please remember that you will only be eligible to claim under this benefit if you meet the exact definitions of the illnesses listed below. For example, although fibro-adenoma can be referred to as a form of breast cancer, it is actually a relatively harmless benign cancer and so is not covered. There are also illnesses, which although very serious, are not covered as a Specified Illness under this policy. Epilepsy would be an example of such an illness. Please ask if you would like more information on the illnesses covered. 6. Benefit The main benefits provided under the Mortgage Protection Plan are Life Cover, or Life Cover with Accelerated Specified Illness Cover. Your policy schedule will show: which of these benefits apply to your policy; What the sum assured is in respect of each Life Assured; and When each benefit will be paid. If at any time the total of all main benefits sums assured is 0, this policy will cease immediately. If this is a dual life policy and at any time the total of all main sums assured for a Life Assured is 0, all benefits, including all additional benefits, for that Life Assured will cease immediately. The policy may, however, remain in force for the other Life Assured. 7. Life Cover This benefit guarantees to repay the outstanding principal of the mortgage loan on death, in line with Condition 3 (Sum assured). Once we have paid a Life Cover sum assured we will reduce that sum assured to Specified Illness benefit This benefit will only apply if Specified Illness is listed as an insured event on your policy schedule. To qualify for Specified Illness benefit, a Life Assured must be diagnosed by a consultant physician in a major private or public hospital in Ireland or the United Kingdom as suffering from any of the illnesses defined below. Our Chief Medical Officer must verify the diagnosis of any Specified Illness. The full payment Specified Illnesses covered are: Alzheimer s disease resulting in permanent symptoms A definite diagnosis of Alzheimer s disease by a Consultant Neurologist, Psychiatrist or Geriatrician. There must be permanent clinical loss of the ability to do all of the following: Remember; Reason; and Perceive, understand, express and give effect to ideas. Other types of dementia. Aorta Graft Surgery for disease or traumatic injury The undergoing of surgery to the aorta with excision and surgical replacement of a portion of the aorta with a graft. The term aorta means the thoracic and abdominal aorta but not its branches. Any other surgical procedure, for example the insertion of stents or endovascular repair. Aplastic Anaemia - of specified severity A definite diagnosis by a Consultant Haematologist of permanent bone marrow failure which results in anaemia, neutropenia and thrombocytopenia requiring treatment with at least one of the following: Blood transfusion Marrow stimulating agents Immunosuppressive agents Bone marrow transplant All other forms of anaemia are specifically excluded. Bacterial Meningitis - resulting in permanent symptoms Bacterial Meningitis causing inflammation of the membranes of the brain or spinal cord resulting in permanent neurological deficit with persisting clinical symptoms*. The diagnosis must be confirmed by a Consultant Neurologist. All other forms of meningitis including viral meningitis are not covered. Balloon Valvuloplasty to correct heart valve abnormalities The insertion, on the advice of a Consultant Cardiologist, of a balloon catheter through the orifice of one of the valves of the heart, and the inflation of the balloon to relieve valvular abnormalities. Benign brain tumour resulting in permanent symptoms or surgical removal via craniotomy A non-malignant tumour or cyst in the brain, cranial nerves or meninges within the skull, resulting in either of the following: permanent neurological deficit with persisting clinical symptoms*, or Full or partial removal of the tumour by craniotomy (surgical opening of the skull) Tumours in the pituitary gland. Angiomas. Benign Spinal Cord Tumour resulting in permanent symptoms or requiring surgery A non-malignant tumour of the spinal canal or spinal cord, causing pressure and/or interfering with the function of the spinal cord, which requires invasive surgery or stereotatic radiosurgery or which results in permanent neurological deficit with persisting clinical symptoms*

3 The diagnosis must be made by a Consultant Neurologist or Neurosurgeon and must be supported by CT, MRI or histopathological evidence. Angiomas are specifically excluded. The requirement for permanent neurological deficit will be waived if the benign spinal cord tumour is removed by invasive surgery or treated by stereotatic radiosurgery. Blindness permanent and irreversible Permanent and irreversible loss of sight to the extent that even when tested with the use of visual aids, vision is measured at 3/60 or worse in the better eye using a Snellen eye chart. Brain injury due to hypoxia / anoxia resulting in permanent symptoms Death of brain tissue due to reduced oxygen supply resulting in permanent neurological deficit with persisting clinical symptoms. For the above definition the following are not covered: - Sickness or injury as a result of drug or alcohol misuse or other self-inflicted means. - Children under the age of 90 days. Cancer excluding less advanced cases Any malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant tumour includes leukaemia, lymphoma and sarcoma. All cancers which are histologically classified as any of the following: o - pre-malignant; o - non-invasive; o - cancer in situ; o - having either borderline malignancy; or o - having low malignant potential. All tumours of the prostate unless histologically classified as having a Gleason score greater than 6 or having progressed to at least clinical TNM classification T2N0M0. Chronic lymphocytic leukaemia unless histologically classified as having progressed to at least Binet Stage A. Any skin cancer other than malignant melanoma that has been histologically classified as having caused invasion beyond the epidermis (outer layer of skin). Explanation of the TNM system The three elements in the system relate to the primary tumour (T), the regional lymph nodes (N) and metastases (M) where the severity of each condition increases as each scale ascends to the maximum. Once the tumour is T2 in size (large but restricted to the prostate) we pay out, it does not matter if there is lymph node involvement or distant metastasis, (distant spread of the disease). Scales of 0-4 are applied for T, 0-3 for N and 0-1 for M. A brief summary follows: Primary Tumour (T) o Tis carcinoma in situ o T0 no evidence of primary tumour o T1 small size, restricted to organ of origin o T2-4 increasing size/local invasion Regional Lymph Nodes o N0 no nodal metastases o N1-3 increasing degrees of nodal metastases Distant Metastasis o M0- no distant metastases o M1 distant metastases present Cardiac Arrest with insertion of a defibrillator Sudden loss of heart function with interruption of blood circulation around the body resulting in unconsciousness and resulting in either of the following devices being surgically implanted: Implantable Cardioverter-Defibrillator (ICD); or Cardiac Resynchronization Therapy with Defibrillator (CRT-D). For the above definition the following are not covered: Insertion of a pacemaker Insertion of a defibrillator without cardiac arrest Cardiac arrest secondary to illegal drug abuse. Cardiomyopathy - of specified severity A definite diagnosis by a Consultant Cardiologist of cardiomyopathy. There must be clinical impairment of heart function resulting in the permanent loss of ability to perform physical activities to at least Class III of the New York Heart Association classification of functional capacity. The diagnosis should be supported by current echocardiogram or cardiac MRI showing abnormalities consistent with the diagnosis of cardiomyopathy. For the purpose of this definition, NYHA Class III is heart disease resulting in marked limitation of physical activities where less than ordinary activity causes fatigue, palpitation, breathlessness or chest pain. All other forms of heart disease, heart enlargement and myocarditis are specifically excluded, as is cardiomyopathy directly related to alcohol or drug abuse. Chronic Lung Disease requiring long term oxygen therapy Confirmation by a Consultant Physician of chronic lung disease which is evidenced by all of the following: The need for daily oxygen therapy for a minimum of 15 hours per day for a minimum period of 6 months; FEV1 being less than 40% of normal; Vital Capacity less than 50% of normal. Chronic Pancreatitis A definite diagnosis of Chronic Pancreatitis by a consultant gastroenterologist. The diagnosis must be evidenced by the following: Calcification of the pancreas Malabsorption due to failure of secretion of pancreatic enzymes Chronic inflammation of the pancreas as shown by Endoscopic Retrograde Cholangiopancreatography (ERCP) or Magnetic Resonance Cholepancreatography (MRCP) Pancreatic duct dilation, beading and stricture For the above definition the following are not covered: Chronic pancreatitis secondary to alcohol or drug abuse Acute pancreatitis Coma resulting in permanent symptoms

4 A state of unconsciousness with no reaction to external stimuli or internal needs which: requires the use of life support systems; and results in permanent neurological deficit with persisting clinical symptoms*. For the above definition, the following is not covered: Coma secondary to alcohol or drug abuse. Coronary artery surgery The undergoing of surgery on the advice of a Consultant Cardiologist to correct narrowing or blockage of one or more coronary arteries with by-pass grafts. Balloon angioplasty; Atherectomy; Rotablation; Insertion of stents; and Laser treatment Crohn s disease of specified severity A definite diagnosis by a consultant gastroenterologist of Crohn s disease with fistula formation and intestinal strictures. There must have been two or more resections of the small or large intestine on separate occasions. There must also be evidence of continued inflammation with on-going symptoms, despite optimal therapy with diet restriction, medication use and surgical interventions. Creutzfeldt-Jakob Disease resulting in permanent symptoms Confirmation by a Consultant Neurologist of a definite diagnosis of Creutzfeldt-Jakob disease resulting in permanent neurological deficit with persisting clinical symptoms*. Deafness permanent and irreversible Permanent and irreversible loss of hearing to the extent that the loss is greater than 95 decibels across all frequencies in the better ear using a pure tone audiogram. Encephalitis resulting in permanent symptoms A definite diagnosis by a Consultant Neurologist of encephalitis resulting in permanent neurological deficit with persisting clinical symptoms* Encephalitis in the presence of HIV infection is specifically excluded. Heart attack of specified severity Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence of acute myocardial infarction: New characteristic electrocardiographic changes. The characteristic rise of cardiac enzymes or Troponins recorded at the following levels or higher; o o - Troponin T > 1.0 ng/ml - AccuTnI > 0.5 ng/ml or equivalent threshold with other Troponin I methods. The evidence must show a definite acute myocardial infarction. Other acute coronary syndromes including but not limited to angina. Heart structural repair with surgery to divide the breastbone The undergoing of heart surgery requiring median sternotomy (surgery to divide the breastbone) on the advice of a Consultant Cardiologist, to correct any structural abnormality of the heart. Heart valve replacement or repair The undergoing of surgery on the advice of a Consultant Cardiologist to replace or repair one or more heart valves. HIV infection Occupational / Assault / Transfusion Infection by Human Immunodeficiency Virus resulting from: a blood transfusion given as part of medical treatment; or a physical assault; or artificial insemination or in-vitro fertilisation given as part of medical treatment; or an incident occurring during the course of performing normal duties of employment after the start of the policy and satisfying all of the following: The incident must have been reported to appropriate authorities and have been investigated in accordance with the established procedures Where HIV infection is contracted through a physical assault or as a result of an incident occurring during the course of performing normal duties of employment, the incident must be supported by a negative HIV antibody test taken within 5 days of the incident. There must be a further HIV test within 12 months confirming the presence of HIV or antibodies to the virus. The incident causing infection must have occurred in countries that were members of the European Union on 1st January 2011, Australia, Canada, New Zealand, Norway, Switzerland or the United States of America. For the above definition, the following is not covered: HIV infection resulting from any other means, including sexual activity or drug misuse Intensive Care requiring mechanical ventilation for ten consecutive days Any sickness or injury resulting in the Life Insured requiring continuous mechanical ventilation by means of tracheal intubation for ten consecutive days (24 hours per day) or more in an intensive care unit in an Irish or United Kingdom Hospital For the above definition the following are not covered: Sickness or injury as a result of drug or alcohol misuse or other self inflicted means. Children under the age of 90 days. Kidney failure requiring dialysis Chronic and end stage failure of both kidneys to function, as a result of which regular dialysis is necessary. Liver Failure End stage liver failure due to cirrhosis and resulting in all of the following: Permanent jaundice Ascites Encephalopathy Liver disorder secondary to alcohol or drug misuse is excluded.

5 Loss of hands or feet permanent physical severance Permanent physical severance of any combination of one or more hands or feet at or above the wrist or ankle joints. Loss of Independent Existence permanent and irreversible Permanent and irreversible loss of the ability to function independently which is defined as follows: Being permanently unable to fulfil at least three of the following activities unassisted by another person: The ability to walk 100 metres on the flat The ability to get in & out of a standard motor vehicle The ability to put on, take off, secure & unfasten all necessary garments, and any braces, artificial limbs or other surgical appliances The ability to wash in the bath or shower (including getting into and out of the bath & shower) such that an adequate level of personal hygiene can be maintained The ability to climb a flight of 12 stairs without the assistance of special aids The ability to manage bowel & bladder functions such that an adequate level of personal hygiene can be maintained OR: Suffering from severe & permanent intellectual impairment which must Result from organic disease or trauma, and Be measured by the use of recognised standardised tests, and Have deteriorated to the extent that requires the need for continual supervision & assistance of another person throughout the day. We will not pay any benefit unless the Loss of Independent Existence has continued without interruption for six months in a row (the qualifying period) or for any longer period we may reasonably decide to be sure that the Loss of Independent Existence is permanent. In making its assessment of any claim, Friends First will consider evidence from all the claimant s treating consultants, the treatment options available, and the likelihood of recovery. In addition, Friends First may require an Independent Medical Assessment by a Consultant or other health professional. The diagnosis must be confirmed to the satisfaction of our Chief Medical Officer and by a consultant physician, neurologist or geriatrician of a major hospital in Ireland or the UK. Loss of speech permanent and irreversible Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease. Major organ transplant The undergoing as a recipient of a transplant of bone marrow or of a complete heart, kidney, liver, lung, or pancreas, or inclusion on an official irish or UK waiting list for such a procedure. For the above definition, the following is not covered: Transplant of any other organs, parts of organs, tissues or cells. Motor neurone disease resulting in permanent symptoms A definite diagnosis of motor neurone disease by a Consultant Neurologist. There must be permanent clinical impairment of motor function. Multiple sclerosis with persisting symptoms A definite diagnosis of Multiple Sclerosis by a Consultant Neurologist. There must be current clinical impairment of motor or sensory function, which must have persisted for a continuous period of at least 6 months. Multiple system atrophy resulting in permanent symptoms A definite diagnosis of multiple system atrophy confirmed by a Consultant Neurologist. There must be evidence of permanent clinical impairment of either: motor function with associated rigidity of movement; or the ability to coordinate muscle movement; or bladder control & postural hypotension Neuromyelitis optica (Devic's disease) with persisting symptoms A definite diagnosis of Neuromyelitis Optica by a Consultant Neurologist. There must be current clinical impairment of motor or sensory function, which must have persisted for a continuous period of at least 3 months. Paralysis of One Limb total and irreversible Total and irreversible loss of muscle function to the whole of any one limb. Parkinson's disease resulting in permanent symptoms A definite diagnosis of Idiopathic Parkinson s disease by a Consultant Neurologist. There must also be permanent clinical impairment that includes bradykinesia (slowness of movement) and at least one of the following: Tremor; or Muscle rigidity; or Postural instability. Parkinsonian syndromes including but not limited to those caused by alcohol or drugs. Parkinson Plus Syndromes A definite diagnosis by a Consultant Neurologist of one of the following Parkinson Plus syndromes: Multiple System Atrophy Progressive Supranuclear Palsy Parkinsonism-Dementia-Amyotrophic lateral sclerosis complex Corticobasal Ganglionic degeneration Diffuse Lewy Body disease There must also be permanent clinical impairment of at least one of the following: Motor function; or Eye movement disorder; or Postural instability; or Dementia Peripheral Vascular Disease with bypass surgery A definite diagnosis of peripheral vascular disease, due to atherosclerosis or Buerger s disease, with objective evidence from an ultrasound of obstruction in the arteries which results in by-pass graft surgery to an artery. For this definition the following is not covered: Angioplasty

6 Pneumonectomy removal of a complete lung The undergoing of surgery on the advice of a Consultant Physician of an Irish or United Kingdom Hospital to remove an entire lung for disease or traumatic injury. For the above definition the following are not covered: Removal of a lobe of the lungs (lobectomy); Lung resection or incision. Pre-Senile Dementia before age 65 resulting in permanent symptoms A definite diagnosis of dementia by a consultant neurologist, psychiatrist or geriatrician. There must be permanent clinical loss of the ability to do all of the following: Remember; Reason; and Perceive, understand, express & give effect to ideas. Dementia directly related to alcohol or drug abuse is specifically excluded. Primary Pulmonary Hypertension of specified severity A definite diagnosis by a Consultant Cardiologist of Primary Pulmonary Hypertension. There must be clinical impairment of heart function resulting in the permanent loss of ability to perform physical activities to at least Class III of the New York Heart Association classification of functional capacity. For the purpose of this definition, NYHA Class III is heart disease resulting in marked limitation of physical activities where less than ordinary activity causes fatigue, palpitation, breathlessness or chest pain. Pulmonary hypertension secondary to any other known cause is specifically excluded. Progressive Supranuclear Palsy A definite diagnosis by a Consultant Neurologist of Progressive Supranuclear Palsy. There must be permanent clinical impairment of motor function, eye movement disorder, rigidity of movement & postural instability. Pulmonary Artery Surgery with surgery to divide the breastbone The actual undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the advice of a Consultant Cardiothoracic Surgeon for a disease of the pulmonary artery to excise & replace the diseased artery with a graft. Rheumatoid Arthritis - of specified severity Severe Rheumatoid Arthritis affecting three or more of the following joint areas: hands, wrists, elbows, neck, knees, ankles, and toes, to the extent that there is permanent and irreversible loss of the ability to fulfil at least three of the activities of daily living listed in the Loss of Independent Existence definition. Stroke resulting in permanent symptoms Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in permanent neurological deficit with persisting clinical symptoms*. Transient ischaemic attack. Traumatic injury to brain tissue or blood vessels. Systemic Lupus Erythematosus of specified severity A definite diagnosis of systemic lupus erythematosus by a Consultant Rheumatologist where either of the following are also present: Severe kidney involvement with SLE as evidenced by: Permanent impaired renal function with a glomerular filtration rate (GFR) below 30ml/min; and Abnormal urinalysis showing proteinuria or haematuria. OR Severe Central Nervous System involvement with SLE as evidenced by: Permanent deficit of the neurological system as evidenced by at least any one of the following symptoms which must be present on clinical examination and expected to last for the remainder of the claimant s life paralysis, localised weakness dysarthria (difficulty with speech) aphasia (inability to speak), dysphagia (difficulty in swallowing), difficulty in walking, lack of coordination, severe dementia where the Life Assured needs constant supervision or permanent coma. For the purposes of this definition seizures, headaches, fatigue, lethargy or any symptoms of psychological or psychiatric origin will not be accepted as evidence of permanent deficit of the neurological system. Third degree burns covering 20% of the body s surface area, or 50% of the surface area of the face Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and covering at least 20% of the body s surface area or affecting at least 20% of the head and neck, or 50% of the face, which for the purposes of this definition, includes the forehead and ears. Traumatic head injury resulting in permanent symptoms Death of brain tissue due to traumatic injury resulting in permanent neurological deficit with persisting clinical symptoms*. For the purpose of the above definitions, Permanent Neurological Deficit with Persisting Clinical Symptoms is defined as follows: Symptoms of dysfunction in the nervous system that are present on clinical examination and expected to last throughout the insured person s life. Symptoms that are covered include numbness, hyperaesthesia (increased sensitivity), paralysis, localised weakness, dysarthria (difficulty with speech), aphasia (inability to speak), dysphagia (difficulty in swallowing), visual impairment, difficulty in walking, lack of co-ordination, tremor, seizures, dementia, delirium, and coma. The following are not covered: An abnormality seen on brain or other scans without definite related clinical symptoms Neurological signs occurring without symptomatic abnormality e.g. brisk reflexes without other symptoms Symptoms or psychological or psychiatric origin NOTE: We will not pay Specified Illness benefit in the circumstances described in Condition 11 of these conditions (General exclusions).

7 9. Supplementary Specified Illness Benefit Payments (automatic where Specified Illness is selected) This is an automatic additional benefit that only applies to a life assured if the plan schedule shows that the life assured has Specified Illness benefit. (a) We will make a partial payment for Specified Illness cover if the life assured is diagnosed as having one of the Specified Illnesses listed below, on a date after the start date and before the expiry date of the Specified Illness cover benefit. The amount we will pay is: 15,000; or Half the amount of Specified Illness cover the life assured has; whichever is lower. For children, the payment per life assured on the plan is the lesser of 7,500 or half of the Specified Illness benefit amount for that life assured. (b) If you make a claim for a partial payment benefit and you are able to fulfil any of the main benefit definitions, then you will be paid the main benefit sum assured only. No partial payment benefit will be made and your contract will cease from the point the main benefit becomes payable. (c) The total amount we will pay for partial payment benefit will not exceed the full Specified Illness benefit as shown on your schedule. (d) If an admissible claim for a related full payment Specified Illness condition arises (i.e. occurrence of the illness or the undergoing of surgery) within 30 days of the occurrence of the illness or the undergoing of surgery for a partial payment Specified Illness, the full benefit will be paid less the amount previously paid under the partial payment definition. If such a claim arises after 30 days, any admissible claim for a related full payment Specified Illness condition will be assessed and paid independently. If the partial payment was for Serious Accident cover, regardless of the period involved, an admissible claim for a related full payment Specified Illness condition will always be subject to the deduction of the partial payment amount previously paid. Examples of conditions where the 30 day rule may apply are (this list is not exhaustive): Brain abscess drained via craniotomy Benign brain tumour / Stroke Carcinoma in Situ, Oesophagus - invasive cancer Oesophagus Carotid artery stenosis Stroke / Heart Attack Cerebral aneurysm- Stroke / Heart attack Coronary Artery Angioplasty - Heart attack / Coronary artery bypass surgery / Stroke Crohns Disease partial payment- Crohns Disease full payment Ductal Carcinoma in Situ, Breast - invasive breast cancer Liver resection - Cancer of liver and major organ transplant Low Level Prostate Cancer - >=T2 Prostate Cancer Peripheral Vascular Disease, treated with angioplasty Peripheral Vascular Disease, treated with bypass / heart attack / stroke. Pituitary tumour- Invasive cancer Single lobectomy Pneumonectomy / Major organ transplant Significant Visual impairment Blindness Surgical Removal of one eye Blindness Third degree burns partial payment Third degree burns full payment (e) Only one claim can be made for each of the Partial payment specified illnesses defined below. (f) We will not pay any benefit under this section if a life assured dies within 14 days of a diagnosis as described in (a). (g) All the normal plan terms and conditions apply to these partial payments. Conditions covered under the supplementary Specified Illness benefit are: Brain abscess drained via craniotomy The undergoing of the surgical drainage of an intracerebral abscess within the brain tissue through a craniotomy by a Consultant Neurosurgeon. There must be evidence of an intracerebral abscess on CT or MRI imaging. Carcinoma in Situ Oesophagus, treated by specific surgery A definite diagnosis of a carcinoma in situ of the oesophagus, which has been treated surgically by removal of a portion or all of the oesophagus. A carcinoma in situ is a malignancy that has not invaded the basement membrane but shows cytologic characteristics of cancer. Histological evidence will be required. Treatment by any other method is specifically excluded. Carotid Artery Stenosis treated by Endarterectomy or Angioplasty The undergoing of endarterectomy or therapeutic angioplasty with or without stent to correct symptomatic stenosis involving at least 70% narrowing or blockage of the carotid artery. Angiographic evidence will be required. Cerebral aneurysm with surgery or radiotherapy The undergoing of any of the following procedures in order to treat a cerebral aneurysm: Craniotomy (surgical opening of the skull), or Endovascular treatment using coils or other materials (embolisation), or Stereotactic radiotherapy For the above definition, the following is not covered: Cerebral arteriovenous malformation Cerebral arteriovenous malformation treated by craniotomy or endovascular repair The undergoing of surgical treatment via Craniotomy (surgical opening of the skull) by a Consultant Neurosurgeon of a cerebral AV fistula or malformation. Or the undergoing of endovascular treatment by a Consultant Neurosurgeon or Radiologist using coils to cause thrombosis of a cerebral AV fistula or malformation. Intracranial aneurysm is specifically excluded. Coronary Artery Angioplasty of specified severity The undergoing of coronary artery angioplasty, atherectomy, laser treatment or stent insertion on the advice of a consultant cardiologist to correct: Narrowing or blockages of at least 70%, confirmed by angiographic evidence, or Narrowing or blockages where there is a fractional flow reserve ratio of <0.8.

8 Provided the above requirements are met, we will make the following payments, subject to an overall total payment of 15,000 under this definition. 7,500 on completion of coronary artery angioplasty, atherectomy, rotablation, laser treatment and/or insertion of stent(s) in one coronary artery. An additional 7,500 will be paid if the life assured undergoes a further coronary artery angioplasty, atherectomy, laser treatment or stent insertion provided it is not performed on the same coronary artery or its branches. 15,000 will be paid if the life assured undergoes coronary artery angioplasty, atherectomy, laser treatment or stent insertion in 2 or more coronary arteries, where no previous claim has been made under this definition. Crohn s disease treated with surgical intestinal resection We will make a limited payment if a life assured is diagnosed with Crohn s disease and has undergone partial surgical resection of the small or large intestine. A definite diagnosis of Crohn s disease must be confirmed by a consultant gastroenterologist or by histological confirmation. Other types of inflammatory bowel disease Intestinal biopsy Ductal Carcinoma in situ Breast, treated by surgery A definite diagnosis of a ductal carcinoma in situ (DCIS) of the breast, which has been removed surgically by mastectomy, partial mastectomy, segmentectomy or lumpectomy. A carcinoma in situ is a malignancy that has not invaded the basement membrane but shows cytologic characteristics of cancer. Histological evidence will be required. Prophylactic mastectomy at the request of the life assured, where no DCIS is found to be present, is specifically excluded. Implantable Cardioverter Defibrillator (ICD) for primary prevention of sudden cardiac death The undergoing of inserting an Implantable Cardioverter-Defibrillator (ICD) on the advice of a Consultant Cardiologist for primary prevention of sudden death due to abnormal heart rhythm. For the above definition, the following is not covered: Insertion of a pacemaker Liver Resection The undergoing of a partial hepatectomy (liver resection) on the advice of a specialist surgeon in gastroenterology and hepatology. For this definition the following are not covered: Surgery relating to liver disease resulting from alcohol or drug abuse Surgery for liver donation (as a donor) Liver biopsy Low level prostate cancer with Gleason score between 2 and 6 and with specific treatment A definite diagnosis of prostate cancer which has been histologically classified as having a Gleason score between 2 and 6 inclusive, provided: The tumour has progressed to at least clinical TNM classification T1N0M0; and The client has undergone treatment by prostatectomy, external beam or interstitial implant radiotherapy Treatment with cryotherapy, transurethral resection of the prostate, experimental treatments or hormone therapy, are all specifically excluded. Peripheral vascular disease with angioplasty The undergoing of balloon angioplasty, atherectomy, laser treatment or stent insertion on the advice of a cardiologist or vascular surgeon to correct at least 70% narrowing or blockage to an artery of the legs. Angiographic evidence will be required. Pituitary Tumour A definite diagnosis of a non-malignant tumour in the pituitary gland resulting in either of the following: Permanent neurological deficit with persisting clinical symptoms*; or Treatment of the tumour by surgery or stereotactic radiosurgery For the above definition the following are not covered: Where symptoms of pituitary tumour are absent with on-going medical treatment Tumours in the brain Serious Accident Cover A serious accident means an accident resulting in severe physical injury where the life assured is immediately admitted to hospital for at least 28 consecutive days to receive medical treatment. For the purposes of this definition a Serious Accident means injury resulting solely and directly from unforeseen, external, violent and visible means, and independent of any other cause. A Life Assured may only claim once under this cover. An accident as a result of any of the following is specifically excluded under this cover: Armed forces, hazardous pursuits, drug and alcohol, and self inflicted injury. Single Lobectomy the removal of a complete lobe of a lung The undergoing of medically essential surgery to remove a complete lobe of a lung for disease or traumatic injury. Partial removal of a lobe of the lungs (segmental or wedge resection) Any other form of lung surgery Significant Visual Impairment Permanent and irreversible reduction in the sight of both eyes to the extent that even when tested with the use of visual aids, vision is measured at 6/36 or worse in the better eye using a Snellen eye chart, while wearing any corrective glasses or contact lens. Surgical removal of one eye Surgical removal of a complete eyeball for disease or trauma Syringomyelia or Syringobulbia treated by surgery A definite diagnosis of Syringomyelia or Syringobulbia by a Consultant Neurologist of an Irish or United Kingdom Hospital, which has been surgically treated. This includes surgical insertion of a permanent drainage shunt. Third Degree Burns covering 5% to 19% of the body's surface area or 25% to 49% of the face s surface area Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and covering at least 5% and less than 20% of the body s surface area, or affecting between 5% and 20% of the head and neck, or between 25% and 50% of the surface area of the face, which for the purpose of this definition, includes the forehead and the ears

9 Ulcerative Colitis with total colectomy A definite diagnosis by histological confirmation by a consultant gastroenterologist of ulcerative colitis treated with total colectomy (removal of the whole bowel). Other types of inflammatory bowel disease Partial removal of the colon Part 4 Additional benefits This section describes the additional benefits which may apply to your policy. 10. Additional Benefits The additional benefits provided under the Mortgage Protection contract are Advance payment of Specified Illness Benefit, Overseas Surgery benefit, Terminal Illness Benefit, Accidental Death benefit, children s life cover, and children s Specified Illness benefit. Some of these additional benefits are automatically included in your policy where a specific main benefit has been chosen, and some of these additional benefits are optional. Your policy schedule will show which of the optional additional benefits apply to your policy. Terminal Illness benefit (automatic where Life Cover or Specified Illness is selected) A life assured is diagnosed as having a terminal illness if the attending consultant gives a definite diagnosis that, our Chief Medical Officer agrees, satisfies both of the following: The illness has either no known cure or has progressed to the point where it cannot be cured; and In the opinion of the attending consultant that the illness is expected to lead to death within 12 months. We will pay the following: If you have Life or accelerated Serious Illness cover, we will pay out the full Life benefit (or Life component benefit on accelerated Serious Illness). If you have specified illness cover only, we will pay the lower of 15,000 or half the specified illness cover. Accidental Death benefit (automatic on all applications for Life Cover) We will pay the Life Cover benefit (to a maximum of 150,000) on accidental death between the time the fully completed and signed application form (or, if submitted online, a completed and signed declaration) is received by us (together with a completed direct debit mandate), and the earlier of the following: The day of the underwriting decision if we are declining or postponing cover The date of commencement of the policy if the Life Assured accepts the terms from Friends First 30 days from the date we receive the application The day the Life Assured withdraws their application For the purposes of this definition, Accidental Death means death caused solely and directly by external trauma, as a result of an accident caused by unforeseen, violent, visible, and external means, and independently of any other cause. The following restrictions apply: The benefit payable is subject to the lesser of the life sum assured and 150,000 The benefit is subject to a maximum entry age of 55 Suicide or intentional self-inflicted injury causing death are excluded This benefit only applies to applications for Life Cover Death must occur as a result of external trauma in an accident occurring after the date of application for this policy We will only pay once under Accidental Death Benefit in respect of any Life Assured, regardless of the number of Life Cover policies or applications for Life Cover a person has with Friends First. An accident as a result of any of the following is specifically excluded under this cover: Armed forces, hazardous pursuits, drug and alcohol, and self inflicted injury. If there are concurrent applications with other Life Offices for the same benefit, we will reduce any payout under this benefit by the amount paid out from other offices. Advance payment of Specified Illness Benefit (automatic where Specified Illness cover is selected) We will pay 30,000 or 50% of the Specified Illness sum assured (whichever is the lesser) in advance in the following circumstances: If a consultant physician confirms in writing that a Life Assured needs aorta surgery, coronary artery surgery, heart valve and structural surgery or a major organ transplant; and We receive confirmation that the Life Assured is on the official waiting list of a public or private hospital in Ireland or the United Kingdom. If a Life Assured receives an advance payment, we will reduce the accelerated Specified Illness and Life Cover sums assured for that Life Assured by the amount of that advance payment. Overseas surgery benefit (automatic where Specified Illness cover is selected) This benefit is payable only if Specified Illness has been selected as a benefit on your policy. We will pay you 7,000 in addition to your Specified Illness benefit if a consultant physician or surgeon confirms to us that a Life Assured, or child between 1 and 18 years of age, requires an immediately necessary surgical procedure or operation, arising from one of the Specified Illnesses for which he or she is covered, which cannot be performed in any hospital in Ireland. We will pay this benefit when the surgery has been completed. This benefit will only be paid once on each plan. Children s Life Cover (automatic where Life Cover is selected) This benefit only applies if referred to in your policy schedule. It will stop if all life cover sums assured are reduced to 0. The benefit for each child will be 5,000 or 10% of the total of all life cover sums assured, whichever is lower. We will only pay benefit once for each child regardless of the number of policies you own.

10 The following are excluded under this cover: Congenital conditions Any condition which the parent or guardian knew to exist prior to the child being 30 days old, or the date of adoption Any condition that existed before the cover for the child started whether symptoms were present or not. Children s Specified Illness benefit (automatic where Specified Illness cover is selected) This only applies if Specified Illness is shown as an insured event on your policy schedule. The benefit will be 20,000 or 50% of the total of all Specified Illness sum assured, whichever is lower. To qualify for benefit the child must survive for 14 days after being diagnosed as suffering from any of the Specified Illnesses listed in Condition 8 and 9 (Full payment Specified Illness benefit and Supplementary Specified Illness benefit) but not including Loss of Independent Existence benefit. We will only pay benefit once for each child regardless of the number of policies you own. The following are excluded under this cover: Congenital conditions Any condition which the parent or guardian knew to exist prior to the child being 30 days old, or the date of adoption Any condition that existed before the cover for the child started whether symptoms were present or not. Part 5 General exclusions and claims procedures As with all insurance policies, there are situations for which you are not covered. Please read the following information carefully. This section also explains the claims procedures and sets out the claim process. 11. General exclusions The following exclusions apply in addition to any exclusions mentioned in the details of each benefit. We will not pay any benefit except Life Cover if a Life Assured is outside the territorial limits for more than three months in any calendar year. The territorial limits are the member states of the EU on the policy start date, the United States of America, Canada, New Zealand, Australia, Norway, Switzerland, Japan, South Africa, Singapore and Iceland. In the event of death by intentional self inflicted injury, life cover shall be limited as follows: Where the death occurs before the first anniversary of the start date (of the original policy), then life cover or any increase in life cover within one year of death shall not become payable. Where the death occurs on or after the first anniversary of the start date (of the original policy), then any increases in life cover within one year of death shall not become payable. However, if you have assigned your life cover to cover your mortgage, we will pay out the life cover sum assured as defined above. We will not pay benefit for Loss of Independent Existence, blindness, coma, heart attack, kidney failure, major organ transplant or paralysis if the claim is either directly or indirectly the result of drug or alcohol abuse or abusing other dangerous substances. We will not pay benefit for Loss of Independent Existence, blindness, coma, loss of limbs or paralysis if the claim is either directly or indirectly the result of the Life Assured deliberately neglecting his or health by failing to get or follow medical advice, or of a deliberate self-inflicted injury. We will not pay benefit for Loss of Independent Existence if a Life Assured is shown to be HIV positive or if a claim is either directly or indirectly the result of: war (whether declared or not) or by you actively taking part in a riot or civil commotion; or the Life Assured taking part in abseiling, bobsleighing, boxing, hang-gliding, scuba-diving, any type of equestrian event, motor or motorcycle sports, mountaineering, rock climbing, pot-holing and caving, parachuting, power-boat racing or flying other than as a fare paying passenger on a regular public airline. 12. Reporting claims You must write to our head office (Friends First Life Assurance Company, Friends First House, Cherrywood Business Park, Loughlinstown, Dublin 18) and tell us if you want to make a claim under this cover. The latest date by which you must tell us depends on the type of claim you are making. Specified Illness You must write to us within 3 months of the date of diagnosis of any Specified Illness. Loss of Independent Existence You must write to us within three months of the date of the start of the disability. If you do not do this we will postpone the start of the qualifying period. The qualifying period will start no earlier than one month before you actually notify us. You must notify us in writing at the end of the qualifying period. 13. Payment of claims Before we can consider making a payment under this policy we must receive the policy document and proof of: the event giving rise to the claim; the right the person claiming payment has to the proceeds of the policy; the date of birth of the life or lives assured; claim form signed by the legal owner(s); policy documentation; if you are claiming children s Specified Illness benefit, you must also provide proof that the child is your natural or legally adopted child; and any other documentation that we may require in order to satisfy ourselves as to the validity of the claim and claimants. We may also need more information or proof as shown in the examples below. Our Chief Medical Officer may want proof that a claim was as a result of an insured event. This proof may include medical reports or examination by a medical officer appointed by us. We may ask you to have a blood test to show that you are not HIV positive.

11 Proof of residency may also be required. If at any time you or anyone acting for you gives us false information in connection with this policy, including the answers given to the questions on the application form and any other evidence given to us, we will consider your policy to be invalid and you will not be entitled to any benefit. You will also have to return any benefits you have already received. We will pay any benefit due under this policy to you, your executors or the administrators of your estate. If we do not pay within 2 months of the date benefit becomes payable we will also pay interest. The interest will be based on a relevant market rate from the end of the 2 month period until the actual date we pay. Part 5 General conditions This section sets out the general legal conditions that govern this policy. 14. Converted Policies If this policy has been set up under a conversion option from a previous Friends First policy and if a valid retrospective Specified Illness claim is made under that previous policy after the commencement date of this policy, then all Specified Illness benefits under this policy shall be made invalid from inception. In addition, if the Specified Illness benefit is Accelerated cover, the Life Cover sum assured on this policy will reduce by the amount of the Specified Illness benefit paid. 15. Law and currency The policy is governed in accordance with the Laws of Ireland. All money paid to or by us must be paid through our registered office in the currency of Ireland. If we pay or accept payment at any other place or in any other currency, it does not mean that we have cancelled this condition. 16. Payment of premiums It is the responsibility of the policyholder to ensure that all premiums are paid. The non payment of premiums, for whatever reason, may result in a loss of benefit under this policy. Please note that the onus is on the policyholder to ensure that all applicable premiums are paid by their respective due dates. 17. Cancellation of this policy by Friends First This policy may be cancelled or amended by Friends First, if, at any time, any of the following happens: a) it becomes impossible or impracticable to continue providing any of the benefits under this policy due to changes in the law or other circumstances beyond our control; b) the tax treatment of Friends First or this policy is changed; c) you are or become ineligible to effect or maintain this policy; d) the Government introduces additional levies or duties on this policy; e) an amendment is to the benefit of the Policyholder. If we need to cancel or amend this policy we will write to you and explain the reasons for our actions and inform you of your options. 18. Government Premium Levy From 1st August 2009 all Premiums/Contributions paid are subject to a Government levy. This levy will be collected from the Policy/Policyholder in a manner determined by the Company. Should the nature or amount of the levy change during the term of the Policy then we will amend your policy to ensure that the levy continues to be appropriately collected. 19. General Notice or instruction must be given to Friends First in writing. Instructions should be sent or delivered to our registered office together with any other documents or information required. Notice or instruction by way of electronic communication may be accepted purely at the discretion of Friends First Life Assurance Company. Instructions may be accepted by us other than in writing at our discretion. Such instructions will be confirmed by us in writing to the address we hold on our records at that time. Such confirmation, once posted, shall constitute a valid instruction. The failure by Friends First to insist on the strict performance of any covenant or duty of a Life Assured, or to pursue any remedy available to it under these Policy Conditions or otherwise, shall not constitute a waiver or breach of that remedy. If at any time we discover that you have told us the wrong age of a Life Assured, we will adjust the benefits under the policy to such amount as the Actuary considers would have been the amount available if we had known the correct age at the start of the policy. Notice must be given to us at our registered office in the event of you transferring or assigning this policy to anyone else. Should the basis of taxation or other applicable law change we will make the appropriate changes to the terms of the policy. 20. Complaints If you need further information, or for any reason are unhappy with either the policy or the service you have received, you should first contact your broker/advisor or Friends First directly. If you do not receive satisfaction and wish to make a formal complaint, you should write, quoting your policy number, to the Friends First Customer Relations Manager. Your complaint will then be referred to the relevant area in the organisation who will reply to you as soon as possible. If agreement cannot be reached, the complaint can be referred to the Financial Services Ombudsman s Bureau, 3rd Floor, Lincoln House, Lincoln Place, Dublin 2. Lo-Call: All communications from Friends First, including these conditions and your policy documents, will be in the English Language. Friends First Life Assurance Company Ltd. is regulated by the Central Bank of Ireland.

12 Appendix 1 Mortgage Protection Plan - Schedule of benefits 1. Schedule of minimum benefit by term Table 1 on the next page shows the minimum amount we will pay under a HomeProtector Plan, where the mortgage term is as shown in the policy schedule. This table applies where the Guaranteed Mortgage Repayment option was selected at outset (8% option). 2. Schedule of benefit by term Table 2 on the next page shows the factors which you should use to multiply by your initial sum assured to show the amount we will pay under a HomeProtector Plan where the mortgage term is as shown in the policy schedule. This table applies where the Guaranteed Mortgage Repayment option was not selected at outset (6% option)

13 3. Table 1 Mortgage Term - 8% mortgage interest rate assumed Year of assurance 10 yrs 11 yrs 12 yrs 13 yrs 14 yrs 15 yrs 16 yrs 17 yrs 18 yrs 19yrs 20yrs 21yrs 22yrs 23yrs 24yrs 25yrs 26yrs 27yrs 28yrs 29yrs 30yrs 31 yrs 32 yrs 33yrs 34yrs 35yrs 1 st nd rd th th th th th th th th th th th th th th th th th st nd rd th th th th th th th st nd rd th th

14 4. Table 2 Mortgage Term - 6% mortgage interest rate assumed Year of assurance