Expect to understand your Prime Life Insurance
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- Annabelle Davidson
- 8 years ago
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1 Expect to understand your Prime Life Insurance POLICY WORDING Prime Life Insurance Contents 1. Introducing your policy 2. What you re covered for 3. What you re not covered for 4. Changes you can make to your policy 5. How to make a claim 6. What you can expect from us 7. How to register a complaint 8. Policy definitions 9. About Cigna 10. Cigna s Financial Strength 11. Privacy policy 12. Contact us 15/02/1520/01 CIG630 DATE 01/15 GADGET 8038
2 1. Introducing your policy This policy is designed to pay the cover amount upon the death of the life insured. This will be paid to the policy owner unless there is a nominated beneficiary. Your 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. 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. Some of the words are in bold in this policy wording, e.g. we and you, these are defined in Section 8. Policy definitions. If you have any questions about your policy, please contact us on the TSB Bank - Cigna Insurance Helpline ( if you are calling from outside New Zealand). Who is covered under this policy? You are covered if you are: Named as a life insured on the policy summary; and Aged between 55 and 85 (inclusive) at the cover start date. The policy owner is responsible for arranging payment of the premiums from the cover start date and as they become due. All correspondence with you will be sent to the most recent address that we hold for you. If you change your address, it is your responsibility to notify us. This is important as we will send you updates and notices about your policy. Because it s important you are entirely satisfied with your insurance, we offer a 30 day free look period. If for any reason you want to cancel this policy please call our Customer Services team on Any premiums that you have paid will be refunded and we will confirm in writing that your policy has been cancelled. If you cancel outside this 30 day free look period there will be no refund of premiums. All payments for this policy are in New Zealand currency. This policy does not have any surrender or cash value. Your duty to be truthful We rely on the information you give us to cover you and pay any claims. If you don t give us all the information we ask for or any other material information during your application process or when you change your policy later on, we may decline your claim, cancel your policy from the date you purchased it, and/or keep all or some of your premiums. If you give us false or incorrect information in support of a claim we may decline your claim and/or cancel your policy. 2. What you re covered for Cigna s insurance promise We promise to pay the policy owner or the nominated beneficiary the benefit(s) shown in your policy summary as long as the terms and conditions are met and the premiums are up to date. If the nominated beneficiary is deceased at the time we pay a claim the benefit(s) will be paid to the policy owner. If the policy owner is also deceased the claim proceeds will be paid to the policy owner s estate. 1 2
3 Once a benefit has been paid, we cannot dictate how the proceeds are used. Funeral Benefit If a life insured dies at any time after the cover start date, as a direct result of an accidental injury, or 24 or more months after the cover start date, as a result of any other cause, we will pay the cover amount shown in your policy summary. Return of Premium Benefit If the life insured dies within 24 months of the cover start date (except as a direct result of accidental injury) we will only refund the premiums paid. Increase to the Funeral Benefit If the cover amount is increased: 13 months before the life insured(s) death from suicide, attempted suicide or intentional self-injury, whether sane or insane, we will only pay the cover amount that applied before the increase and refund all premiums paid for the increase portion of the cover amount; or 24 months before the life insured(s) death (as a result of any cause other than accidental injury) we will only pay the cover amount that applied before the increase and refund all premiums paid for the increased portion of the cover amount. Limit of Cover A life insured cannot be covered by more than one Prime Life policy. If this happens, we will consider the life insured to be covered under the first policy issued and the premiums will be refunded for the other policy. If you are not a permanent resident of New Zealand at the time that this policy started, we may cancel your policy and refund any premiums paid. 3. What you re not covered for We will not pay any benefit for this policy if: 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. 4. Changes you can make to your policy Cancellation of cover You can cancel your policy at any time. Your cover will stop as soon as you advise us. If you cancel your policy within the free look period we will refund all premium payments you have made. If you cancel your policy after the free look period there will be no refund of premiums. Changing your payment method and frequency You can apply to change the method and frequency of premium payments at any time by contacting us. Changes to Nominated Beneficiaries The policy owner(s) can change beneficiaries at any time by completing a nominated beneficiary form and sending it to us. A change to the nominated beneficiary will be active from the date we receive your nominated beneficiary form. 3 4
4 5. How to make a claim If you need to make a claim on this policy, please contact us. We will send you a claim form within 24 hours of your request. The claim form needs to be completed by the nominated beneficiary or the representative(s) of the life insured(s) estate and returned to us together with any supporting documents we request. Any medical information required to support a claim 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 the remaining policy owner or nominated beneficiary. 6. What you can expect from us Renewal of cover after age 76 From the anniversary date after the 76th birthday of the life insured, we will renew your policy every year and cover will continue until your policy ends. Changes to your premiums Your initial premium payable is shown in your policy summary and is payable up to the premium stop date. Where a joint policy is issued, a discounted premium rate will apply for each life insured. On the death of one life insured, this discounted rate will continue to be applied to the remaining life insured. Cigna may change the premiums payable. Cigna will provide notification in writing to the policy owner(s) at least 30 days before any change takes effect. This notice will be sent to the most recent contact details Cigna has on record for the policy owner(s). Policy Changes We can change the insured events and exclusions of this policy if it is reasonably necessary to protect our legitimate business interests. For example (but not limited to): if changes in the law or its interpretation occur after the cover start date and we reasonably believe that those changes will affect our tax liability, or how the policy works, or the amount of benefit payable if claims experience across all Prime Life insurance policies arranged by TSB Bank, becomes significantly adverse. In such case we can change the provisions of the policy or benefits in whatever way we reasonably decide is necessary to protect our legitimate business interests. You will be given at least thirty days written notice in advance of any such change. When your policy will end Your policy will end when any one of the following happens: if the premiums are unpaid for 3 months in a row, cover will end on the date the last premium was paid up to; you ask us to cancel your policy; or we pay a claim. 7. How to register a complaint If you have a complaint we are happy to discuss it. Please contact us on the TSB Bank Cigna Insurance Helpline on (or if you are calling from outside New Zealand), or us on complaintsandquality.nz@cigna.com. Our Customer Service team will do their best to resolve your issue straight away. However, if they can t sort out the issue, our dedicated Customer Resolution Consultants will personally take on your case. 5 6
5 Also, Cigna is a member of the Insurance and Savings Ombudsman (ISO) scheme, a free, independent service which can help settle any dispute you are unable to resolve with us. Any dispute or action relating to your policy will be determined in accordance with New Zealand law. ISO contact details Post PO Box , Wellington 6143 Phone info@iombudsman.org.nz Website 8. Policy definitions The following words and terms appear in the policy summary and/or in this document. They are defined as: Accidental injury means any injury, resulting solely, directly and independently of all other causes from an accident caused by external, violent and visible means while your policy is active. 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 your 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 we post or this policy to you. Life insured means the person(s) who are insured under this policy. Nominated beneficiary means the person(s) named by the policy owner(s) to be the recipient of a benefit payable under this policy. The nominated beneficiary must be aged 16 or over at the date that they are nominated. If your policy is issued in joint names, the surviving life insured will be considered by us to be the nominated beneficiary unless otherwise specified. Policy means the terms and conditions applying to this insurance as described in the policy wording, policy summary and your application form. Policy owner(s) means the person(s) initially named as the policy owner(s), or the assignee(s) named on the most recent form if your policy has been assigned. The policy owner(s) 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. Premium start date means the date that the first premium is due. Premium stop date means the date that the last premium is due. We, us, or our means Cigna Life Insurance New Zealand Limited (Cigna), the insurer of your policy. You or your means the life insured(s) named on the policy summary. 9. 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, trauma insurance and travel insurance. 7 8
6 We ve been operating in New Zealand for more than 90 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 publiclyowned companies. A copy of Cigna s latest financial statements is available on request. We are required under the Insurance (Prudential Supervision) Act 2010 to establish a statutory fund. The statutory fund relevant to your policy is Cigna s Statutory Fund Number One. 11. Privacy Any details you provide will be held securely by us for the purpose of providing you with quotations and information about TSB Bank products and services. Your details will never be disclosed to third parties, except for purposes of setting up and administering any policy you wish to take out. From time to time, TSB Bank may contact you with information about products and services, which TSB Bank feels may be of interest to you. Under the Privacy Act 1993 you have the right of access to and correction of personal information provided by you. If you would prefer not to be contacted about these products please call the TSB Bank Cigna Insurance Helpline on Cigna s Financial Strength Cigna Life Insurance New Zealand Limited has an A- (Excellent) financial strength rating which was given by A.M. Best Company Inc. The rating scale is: Secure Vulnerable A++, A+ Superior B, B- Fair A, A- Excellent C++, C+ Marginal B++, B+ Good C, C- Weak D Poor E Under regulatory Supervision 12. Contact us Cigna Life Insurance New Zealand Limited Phone Fax contactus.nz@cigna.com For general information about your policy, including premiums, address changes etc. claims.nz@cigna.com To request a claim form or ask any questions related to a claim Postal address Cigna Life Insurance P O Box Wellington 6142 F S In Liquidation Suspended For more rating information visit
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