cover my life Peace of mind when it matters most

Transcription

1 Membership Guide To make a claim call or advice@cover-my-life.co.uk cover my life Peace of mind when it matters most Terms & Conditions: All claims must be validated in accordance with claims procedure. By becoming a member of this Payplan Membership Scheme you are not entering into an Insurance contract. You can leave the scheme at your discretion. Payplan Limited is a limited company registered in England, Register No Registered office: Kempton House, Dysart Road, Grantham, Lincolnshire, NG31 7LE. Cover my Payments and Cover my Life are absolute discretionary membership schemes not insurance contracts. Consumer Credit licence Number Payplan and the Payplan logo are trademarks of Totemic Ltd Version 2 April 2013

2 Contents 02 Welcome 03 Benefits of Cover My Life 03 What happens if I die 04 Cover My Life summary 06 General questions and further details Please remember, should your circumstances change, particularly in relation to your residency, you need to contact us immediately so that we can confirm whether changes in your circumstances will affect your membership Eligibility Frequently asked questions Data protection Law Fraud 09 General conditions 11 General exclusions 13 Definitions 16 Contact

3 At Payplan, we re committed to doing everything possible to make your repayment plan successful including preventing your family from possibly inheriting your debt, if you should die before the end of the plan. Cover My Life is a non-insurance membership scheme that will provide peace of mind that should you die before the end of your Debt Management Plan, a one-off payment of up to 20,000 will go towards clearing your debts before anything is taken from your assets. If you don t have any assets or you owe less than 20,000 at the time of your death, any surplus will be paid to your estate, which can simply be used to cover funeral costs or to make sure there is something left for your next of kin. If your next of kin need to make a claim, you can be sure that we ll deal with it quickly, fairly and efficiently. Important things to remember Payplan has absolute discretion whether or not any creditor of the member and/or the estate will receive a benefit and has absolute discretion as to the amount of benefit. It is important that you read the General Exclusions as set out in this guide. All benefit claims must be validated in accordance with the claims procedure. By becoming a member of Payplan Cover My Life scheme, you are not entering an insurance contract. Benefits of Cover My Life By joining Payplan s Cover My Life scheme and including a payment for Cover My Life into your planned payment to Payplan, you become a member. As a member, you are eligible for the benefits payable in accordance with this scheme, provided you meet the set criteria within this guide. Your monthly contribution to the Cover My Life scheme will be taken from the planned payment you make to Payplan - this is the payment used by Payplan to pay all of your creditors their agreed payment. The membership benefit is 20,000 for each eligible member s life, payable direct to the member s creditors via the Payplan distribution system. Should there be any residue, this may be paid in accordance with the membership terms to the member s Estate. The Cover My Life scheme is designed only for the benefit of Payplan Ltd clients. What happens if I die You need to make your next of kin aware that you are a member of this Cover My Life Scheme. In the event of your death, your next of kin will need to complete a claim form and send your original birth and death certificates to us in order for a claim to be considered. Once received, we may request a copy of your medical records from your doctor in order to establish if the cause of death was connected to a pre-existing medical condition. If the claim is agreed, and you were in a joint DMP, we will negotiate settlements of those debts in your sole name first, followed by any joint debts and finally those of your partner if your partner has sole debts. Unless there is a will, any residual monies once all of your creditors have received settlement will be distributed to the persons entitled to issue a receipt, being Administrators or Executors of the Estate. To make a claim or find answers to queries call

4 Cover My Life summary (membership benefit scheme) Type of Membership Cover My Life is a non-insurance membership scheme that provides a one-off payment of 20,000 towards your debts in the event of your death. This is payable direct to your creditors via the Payplan distribution system. Should there be any residue, it may be paid in accordance with the membership terms to your Estate. Payplan has absolute discretion as to whether creditors will receive any benefit and the level of any benefit to be paid to creditors. Am I eligible? You are eligible to join Payplan s Cover My Life scheme if: - You are over 18 but under 65 years of age (you can become a member up to the age of 64 years and one month) - You are entering into, or are currently in, a Payplan DMP - You are resident in the UK - We have accepted your application - You have paid the monthly contribution to become a member Membership benefit shall not include death from a any illness, disease, condition or accident which occurred before the start date as any condition deemed to be preexisting is not covered by this scheme. What is the benefit to me? In the unfortunate event of your death, 20,000 will be paid to your creditors (subject to claim acceptance). Should there be any residue, it will be paid in accordance with the membership terms to your Estate. When do I become a member? You become a member when your first payment has been received by us and has cleared. How much does it cost? The cost is per annum per member (paid in regular intervals from surplus income). What is the maximum benefit payable? The benefit payable in the event of a successful claim is 20,000 per member. How is benefit claimed? If a claim needs to be made, your next of kin must notify Payplan Membership Services on as soon as possible. However, a claim cannot be made within the first 60 days of membership. Who is the benefit paid to? Benefits are paid direct to the creditors in your Payplan Debt Management Plan. Payplan has absolute discretion as to whether or not a creditor of the member of the scheme will receive any benefit and the amount of any benefit that may be paid to the creditor. All benefit claims must be validated in accordance with the claims procedure. By becoming a member of the Payplan Cover My Life scheme you are not entering an insurance contract. Key exclusions The following are the main exclusions but please see pages of the Membership Guide for details of all of the exclusions that apply to this scheme:- - Your death is caused by any condition/s which existed prior to your membership start date. - Your death is related to having a BMI in excess of 37 - HIV/Aids whether contracted before or during your membership - You die within the initial exclusion period (60 days) of becoming a member - You move away from the UK and are no longer a UK resident - You commit suicide - Your death is related to alcohol or drug abuse General exclusions - Nuclear, chemical, biological terrorism - Civil unrest, war and terrorism, earthquake - Pandemics/Epidemics Contract duration Your membership of the scheme starts and your first contribution is collected when you make your payment to us for your DMP. The initial exclusion period will commence upon receipt of your first payment. Your membership will end at the earliest of the following events:- - You die - You are no longer resident in the UK - You default on your contributions to the scheme - You cancel your membership - You reach the age of 65 - Your DMP agreement finishes or reaches its end date. What happens if I die? Before making any payment to your creditors or your Estate, whoever you elect will need to provide us with satisfactory proof of your death including: a) The death certificate b) The birth certificate, and c) Any other information that may be required. All claims should be notified to Payplan Membership Services on What should I do if I want to complain? Please telephone Payplan Membership Services on or write to:- Payplan Membership Services Complaints Officer Kempton House Dysart Road Grantham Lincolnshire NG31 7LE What if I change my mind? You can cancel your membership at any time. However, if you change your mind within 30 days of us receiving your first payment, we will issue you with a full refund. You must telephone in order to cancel your membership. Who can I call if I want more information? If you have any further questions regarding the Payplan Cover My Life scheme, you can telephone Payplan Membership Services on

5 General questions & further details about my membership Who is eligible You can join if, on the start date: You are over 18 but under 65 years of age (you can become a member up to the age of 64 years and one month) You are entering into, or are currently in, a Payplan DMP You are resident in the UK We have accepted your application You have paid the monthly contribution to become a member. You must make us aware of any illness, disease, condition or accident which occurred before the start date as any condition deemed to be pre-existing is not covered by this scheme. What if I change my mind? If you change your mind and wish to cancel your membership, you can do so within 30 days of the start date or receipt of your member s guide (whichever is first). We will refund any monthly contribution you may have paid. No refund of the monthly contribution will be made where a claim has been paid out under Payplan s Cover My Life scheme. When does my membership start? Your membership starts as soon as your payment has cleared. However, you are unable to claim until you have been a member for 60 days (Initial Exclusion Period) or more which begins once your first payment has cleared. How much does Cover My Life membership scheme cost? Your monthly contribution to Cover My Life will be taken from the planned payment you make to Payplan every month. The remainder of your planned payment will be used to pay your creditors their agreed payment. The cost is 5.00 per person per month to provide 20,000 of membership benefit. Upon your death, this is payable to your remaining creditors via the Payplan distribution system as long as death was not caused by a pre-existing medical condition or was not related to any exclusions of the scheme (see pages for full details). What if I miss a payment? Please be reassured that your membership will NOT end automatically if you fail to pay your monthly contribution. You will be notified of your first missed payment. If payment is still not received, you will be given reasonable notice before we cancel your membership. Should you wish to cancel your membership, please tell us or we will continue to deduct contributions which are non-refundable. We reserve the right to withdraw membership or refuse a valid claim for benefit should any monthly contribution not be met within 30 days of its due date. What if I decide to cancel my membership? To cancel your membership, you will need to call us on We will cancel Payplan Cover My Life with effect from the date when your next monthly contribution is payable. No pro-rata fees will be refunded, only full monthly payments. Any refunds will be paid into your DMP and not directly to you. What if my circumstances change? You need to telephone us immediately so that we can confirm whether changes in your circumstances will affect your membership. It is particularly important to let us know if there are any changes to your residency in the UK. We do recommend that you review your personal circumstances regularly to ensure that this membership is still relevant to your needs. If you are unsure about what constitutes a change in circumstances, please call us on Do I need to renew my membership every year? You will continue to be a member of the scheme unless you tell us you want to cancel membership. Otherwise it will only cease if: 1) You reach the age of 65 2) You die 3) Your DMP agreement finishes or reaches its end date 4) You are no longer resident in the United Kingdom 5) You default on your contributions to the scheme. 6 7

6 IMPORTANT INFORMATION Data protection The information you have given us will only be used for the purposes of processing your Payplan Cover My Life scheme including administration and handling. We comply with the principles laid down in the Data Protection Act whilst processing your information. We will process and store your information in a clear, secure, fair, accurate and appropriate manner and will not sell it or pass it on to anyone at all without your permission, as mentioned below and we will only keep the information for as long as necessary, whilst maintaining your rights as an individual. It is important that we have up to date information so please do let us know straight away about any changes in your circumstances. Please make sure you provide any information likely to influence the acceptance and assessment of Payplan Cover My Life scheme. If you have doubts as to whether information is important or relevant, tell us anyway. Failure to disclose relevant information may invalidate membership of the Cover My Life scheme. If you give us false or inaccurate information and we suspect or identify fraud we will record this and may also pass this information to fraud prevention agencies and other organisations involved in crime and fraud prevention. To ensure Payplan Cover My Life scheme operates effectively and to protect your interests, we may disclose your personal data to other parties such as solicitors, loss adjusters, insurers, etc. If necessary, we may contact other parties requesting sensitive personal data this might include doctors, hospitals, consultants, employers, etc. We will only contact these parties to enable us to obtain sufficient information to effectively administer the scheme, but we won t do this without your prior consent. Law If you are a resident of the European Union, then the parties completing this contract are free to choose the law applicable to this contract. However, unless it is specifically agreed to the contrary, the scheme shall be subject to English law. Fraud If you have given false information to us on or before the start date, on your claim for benefit form or in connection with Payplan s Cover My Life scheme, or any claim for benefit made, we may cancel your membership immediately. We may demand you repay any benefits we have already paid you and we may also take steps to prosecute you. We will keep the monthly fee you have paid us. General conditions 1. This scheme and any written statement of medical or other information made by you make up the membership terms and conditions between us and you. 2. No evidence of health will be required. Notwithstanding this waiver of evidence of health, the scheme shall not include death from a condition or causes (whether mental or physical) which existed prior to the issue of this membership nor does it include death directly related to having a BMI in excess of 37, suicide, drugs, alcohol, HIV/AIDS or any circumstance covered in general exclusions (see pages for full details). 3. Payplan has absolute discretion as to whether or not benefit will be paid to the member s creditors and/or Estate and as to the amount of benefit. 4. Before making any payment in respect of the scheme, Payplan Membership Services shall be supplied with satisfactory proof of: - a) The date and circumstances of the event on which the benefit in respect of a member s life will become payable b) The original death certificate for the member c) The original birth certificate for the member d) Completion of a claim form e) Any other information that may be required f) Any residual sums available after settlements are made to creditors will be made to the member s Estate. 5. If a claim is agreed, we will only negotiate settlements for debts already included in your DMP. 6. A claim decision will not be made upon the receipt of an interim death certificate. Where applicable, we will wait for the outcome of any inquest or enquiry into the death and a final death certificate before confirming whether a claim is agreed. 7. The following circumstances are excluded from this scheme whether they are directly caused by, indirectly caused by, a result from or connected to the cause of death, damage, cost or expense. This also applies to any action which attempts to control, prevent and suppress the cause of death. 8 9

7 8. The membership benefit provided in respect of a member s life shall immediately cease: a) on the death of the member b) on the attainment of age 65 c) on being discharged as a member of the scheme d) on the member becoming a resident outside of the UK e) on the member s DMP agreement finishing or reaching its end date 9. You may not transfer or assign your rights or interest in this scheme to any other person. Payplan s Cover My Life scheme does not have any value at the end date nor does it acquire any surrender value during the period of membership. 10. In accordance with Section 1(a) and Section 1(b) of the Contracts (Rights of Third Parties) Act 1999, nothing in this scheme is intended to describe a directly enforceable benefit for any member or third party. 11. Cancellation Rights: A member can cancel his/her membership to the scheme within the first 30 days of the start date by written notice sent to Payplan Membership Services at the address stated on page 16. A member can telephone us to request membership is cancelled on Benefits under Payplan Cover My Life are non-taxable, although this may change in line with any amendments to legislation. In this event, we will deduct from any benefit any sums which by law we are required to deduct. 13. We reserve the right to amend the terms of the monthly contribution paid into this scheme by giving you notice of our intention to do so as follows: 90 days notice - to withdraw, terminate or cancel the membership 30 days notice - to vary the membership terms provided, alter the monthly contribution rates (other than any statutory tax changes) charged during the period of membership. General exclusions We will not pay any benefit if: 1. Your death is caused by any condition/s which existed prior to your membership start date. 2. You have moved outside of the UK and are no longer a UK resident. In this event, membership will automatically cease. You must advise us if you move outside of the UK as any monthly contributions paid after the date you moved will not be refunded if you are late advising us. 3. Death arising from the misuse of alcohol or drugs. 4. HIV (Human Immunodeficiency Virus) and/or any HIV related illness including AIDS (Acquired Immune Deficiency Syndrome), even if contracted after the start date of your membership. 5. You have a BMI of 37 or over and your death was related to this fact. 6. You die within the initial exclusion period of the first 60 days of becoming a member of the scheme. 7. The following circumstances are excluded from this scheme whether they are directly caused by, indirectly caused by, a result from or connected to the cause of death, damage, cost or expense. This also applies to any action which attempts to control, prevent and suppress the cause of death. a. war, invasion, acts of foreign enemies, hostilities (whether war is declared or not), civil war, rebellion, revolution, insurrection, military or usurped power, riot or civil commotion. b. any act of terrorism. (For the purpose of this section an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear). c. Nuclear disaster, radioactive contamination whether arising directly or indirectly and/or release of nuclear or atomic energy. d. Ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. e. The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component

8 f. Any outbreak of a pandemic or epidemic of a contagious disease that spreads rapidly and widely. Where this has been deemed to have ended but germs are still in circulation, death arising from this will still be considered an exclusion. h. If we conclude that cause of death, damage, cost or expense is not covered by the scheme because of the exclusions, it is the responsibility of the member or the member s next of kin to prove otherwise. 8. If the cause of death, damage, cost or expense is directly or indirectly linked, connected to or arises from the following circumstances which are connected with any act of nuclear, chemical or biological terrorism (as defined below), they are excluded from this scheme. a. Nuclear, chemical, biological terrorism shall mean the use of any nuclear weapon or device or the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical agent and/or biological agent during the period of membership by any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed or political, religious or ideological purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public in fear. b. Chemical agent shall mean any compound which, when suitably disseminated, produces incapacitating, damaging or lethal effects on people, animals, plants or material property. c. Biological agent shall mean any pathogenic (disease producing) micro-organism(s) and/ or biologically produced toxin(s) (including genetically modified organisms and chemically synthesised toxins) which cause illness and/or death in humans, animals or plants. d. If we conclude that cause of death is not covered by the scheme because of the exclusions, it is the responsibility of the member or the member s next of kin to prove otherwise. 9. The scheme does not cover death if the member commits suicide or dies as a result of their own actions whether they were considered sane or insane. Definitions Wherever the following words and phrases appear in this Membership Guide or the Membership Confirmation they will always have the same meaning, as shown below: BMI - Body Mass Index (BMI) which is a measurement of your weight against your height. In the UK, people with a BMI between 25 and 30 are categorised as overweight, and those with an index above 30 are categorised as obese. People with a BMI of 40 or more are described as morbidly obese. Consultant - A medical specialist who is a member of a college and recognised by that college to be a consultant. This does not include you or your relatives. Cover My Life - An absolute discretionary non-insurance scheme to provide a benefit payment in accordance with the conditions and terms set out within this guide. Creditors - The companies/people to whom you owe money and who you are repaying via a DMP. Debt Management Plan (DMP) - The informal agreement you have in place with your creditors arranged by Payplan in order to pay your creditors. Doctor - A medical practitioner practising in the United Kingdom, being a fully registered person under the Medical Act 1983, other than you, your spouse or any of your relatives. End Date - The earliest of the following to occur: a) You die b) You are no longer resident in the United Kingdom. c) You default on your monthly contribution to Cover My Life scheme d) Your DMP agreement finishes or reaches its end date e) You reach the age of 65. Epidemic - A widespread occurrence of an infectious disease in a community at a particular time: eg, a flu epidemic, a sudden, widespread occurrence of an undesirable phenomenon. Estate - All of the member s possessions, including the property, left upon death. Hospital - A government controlled hospital, a National Health Service hospital or a private hospital but does not apply to any long-term nursing home or geriatric unit or any such facility. Initial Exclusion Period - The 60 days immediately following the start date of your membership to this scheme when you cannot make a claim

9 Member/s - An individual or couple who have joined Payplan Cover My Life scheme and in this wording refers only to members of Cover My Life. Membership Confirmation - The document supplied to members outlining the terms and conditions of your membership. Membership Cost per annum (payable by 12 instalments of 5.00), non-refundable except where cancellation right is exercised. Monthly Contribution - The amount you pay to be a member of the Payplan Cover My Life scheme as set out on your Membership Confirmation. Next of Kin - Where no Will exists, we will follow the rules of intestacy should there be surplus funds once all debts have been settled. Pandemic - An epidemic that spreads over a very wide area, such as a whole country or continent. Payplan - Payplan Ltd Payplan Cover My Life - An optional and absolute discretionary non-insurance scheme which provides membership benefits in accordance with the conditions and terms set out within this guide. Settlement/s - The Payplan Settlement team will negotiate settlements of all outstanding debts included in your DMP at the time of your death. Where you are part of a joint DMP, debts will be negotiated in the following way: 1. Debts in your sole name will be negotiated in the first instance, then providing there is further provision. 2. Debts in joint names will be negotiated, then providing there is further provision 3. Debts in your partner s name will be negotiated, then providing there is further provision 4. Residual funds will be paid to your Estate/Next of Kin. Start Date - The date membership commences on your Membership Confirmation, after you have made your first/next payment into your DMP and that payment has cleared. UK - United Kingdom, Channel Islands and the Isle of Man. We or Us or Our - Payplan Membership Services. You or Your or Yourself - the person or persons named on your Membership Confirmation. Payplan Membership Services - The department responsible for the administration of the Payplan Cover My Life scheme. Period of Membership - The period between the membership start date and the end date for which the correct fee has been paid. Planned Payment - The amount of money you have left every month once you have paid all of your essential bills e.g. mortgage, rent, utilities. Pre-Existing Medical Condition - Any sickness, condition or accident of which you were aware and for which you received treatment or advice (including regular or routine examination or consultations to monitor the condition) prior to the membership start date. Scheme - A non-insurance absolute discretionary membership benefits scheme, to provide a benefit payment in accordance with the conditions and terms set out in this guide

10 Notes who do I contact about this For general queries relating to Payplan Cover My Life: contact us at the address below by letter, telephone or Payplan Membership Services Kempton House Dysart Road Grantham Lincolnshire NG31 7LE Tel: advice@cover-my-life.co.uk Customer satisfaction If you have a complaint related to this scheme, please contact the Complaints Officer in writing at the address below: Complaints Officer Payplan Membership Services Kempton House Dysart Road Grantham Lincolnshire NG31 7LE In your letter, please quote your ID Number so that your enquiry or complaint may be dealt with promptly. If you are still not satisfied with the way that your enquiry or complaint has been dealt with, you may contact The Compliance Manager, also at the above address. A full copy of the complaint procedure is available on request