Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover

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1 Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover FLIP/4569/Mar15 This policy summary gives you important information about the Friends Life Individual Protection Critical Illness with Life Cover to help you decide whether this cover is right for you. You should read this summary carefully and keep it in a safe place afterwards. This policy summary does not contain the full terms and conditions and exclusions of cover. You can find these in the Critical Illness with Life Cover membership handbook, and please also refer to your registration certificate, which will be issued when your membership commences. Please ask us if you would like to see copies of these documents. If you decide to buy this cover it will form part of your Friends Life membership. The provider of this product is Friends Life and Pensions Limited. What is Friends Life Individual Protection Critical Illness with Life Cover? The purpose of this cover is to pay a lump sum, or annual benefit should Family Income Benefit be selected, if a person covered by the membership dies or suffers a terminal illness or suffers or undergoes one of the specified critical illnesses or operations included in the membership. This is the main benefit of the cover. The cover will only pay the main benefit once. This is covered in full detail in the What you are covered for section of the Critical Illness with Life Cover membership handbook. What are the features and benefits of the Friends Life Individual Protection Critical Illness with Life Cover? You can select cover for either: you alone; you and another person; one or two people not including you. The maximum amount of benefit is 3,000,000 for a personal membership and 5,000,000 for a business membership. The cover includes terminal illness cover which means the main benefit will be paid if a consultant diagnoses you with an illness that you are expected to die from within 12 months.

2 Policy Summary of Friends Life Individual Protection Critical Illness with Life Cover FLIP/4569/Mar15 This policy summary gives you important information about the Friends Life Individual Protection Critical Illness with Life Cover to help you decide whether this cover is right for you. You should read this summary carefully and keep it in a safe place afterwards. This policy summary does not contain the full terms and conditions and exclusions of cover. You can find these in the Critical Illness with Life Cover membership handbook, and please also refer to your registration certificate, which will be issued when your membership commences. Please ask us if you would like to see copies of these documents. If you decide to buy this cover it will form part of your Friends Life membership. The provider of this product is Friends Life and Pensions Limited. What is Friends Life Individual Protection Critical Illness with Life Cover? The purpose of this cover is to pay a lump sum, or annual benefit should Family Income Benefit be selected, if a person covered by the membership dies or suffers a terminal illness or suffers or undergoes one of the specified critical illnesses or operations included in the membership. This is the main benefit of the cover. The cover will only pay the main benefit once. This is covered in full detail in the What you are covered for section of the Critical Illness with Life Cover membership handbook. What are the features and benefits of the Friends Life Individual Protection Critical Illness with Life Cover? You can select cover for either: you alone; you and another person; one or two people not including you. The maximum amount of benefit is 3,000,000 for a personal membership and 5,000,000 for a business membership. The cover includes terminal illness cover which means the main benefit will be paid if a consultant diagnoses you with an illness that you are expected to die from within 12 months.

3 Policy Summary - Friends Life Individual Protection Critical Illness with Life Cover Types of cover You can choose from: Level term cover This covers you for a fixed lump sum for a set period of time which you select when you take out the membership. Mortgage protection term cover This covers you for a set period and the cover reduces each month in the same way as the outstanding amount on a repayment mortgage with an interest rate of eight per cent a year. Family income benefit cover Family income benefit cover operates in the same way as level term cover, but does not pay a lump sum payment. Instead, the benefit is paid in annual instalments. These would be paid for each year remaining in the term of your membership. Renewable term cover Renewable term cover provides protection for five or ten years with the option to renew without underwriting at the end of the term. Further information about these types of cover is available in the Your membership section of the Critical Illness with Life Premium options There are two premium options available to choose from: guaranteed premiums reviewable premiums. Guaranteed premiums will not change. Reviewable premiums may change on every fifth anniversary of the start of your membership. If you select renewable term cover your premiums will be reassessed at each renewal. The amount of premium you pay will depend on the options you select. Further information about the premiums is available in the Premium options section of the Critical Illness with Life There is an extra cost, on top of the initial premium, if you choose any of the following options: Fracture cover pays up to 2,100 per year of cover if you suffer one of a list of 18 specified fractures. Global Treatment allows you to access treatment outside the UK if you or your child is diagnosed with one of a number of specified serious illnesses or requires one of a list of medical procedures. Premium waiver we will waive your premium if, due to illness or incapacity, you meet the definition applicable to you in the Critical Illness with Life Cover membership handbook Reinstatement allows you to take out a new cover with a reduced list of critical illnesses following a successful claim on the main benefit. Total permanent disability we will pay the main benefit if you meet the definition applicable to you for total permanent disability in the Critical Illness with Life cover membership handbook. Further information about these options is available in the Additional options section of the Critical Illness with Life Further information about the Global Treatment additional option can be found in the Global Treatment Terms and Conditions. Replacement cover If you have joint cover and a successful claim is made on the main benefit, the person who was not the subject of the claim can take out a new cover. This is not subject to additional underwriting. Further information about this option is available in the How to make a claim section of the Critical Illness with Life Cover membership handbook. Additional options Indexation allows the main benefit to increase by either three per cent, five per cent, Retail Price Index or Average Weekly Earnings on each anniversary of the cover. Increasing the benefit will also result in the premium rising. 2

4 Critical illnesses covered The full definitions of the critical illnesses and the circumstances in which you can claim are shown in the What you are covered for and Critical illness definitions sections of the Critical Illness with Life Cover membership handbook. Conditions covered: Aorta graft surgery Aplastic anaemia of specified severity Bacterial meningitis resulting in permanent Benign brain tumour with permanent or undergoing defined treatments Benign spinal cord tumour resulting in permanent Blindness permanent and irreversible Cancer excluding less advanced cases Cardiac arrest with the insertion of a defibrillator Cardiomyopathy of specified severity Chronic rheumatoid arthritis Coma resulting in permanent Coronary artery by-pass grafts Crohn s disease of specified severity Creutzfeldt-Jakob disease resulting in permanent Deafness permanent and irreversible Dementia including Alzheimer s disease resulting in permanent Diabetes mellitus type 1 first diagnosis over age 40 and requiring permanent insulin injections Heart attack of specified severity Heart valve replacement or repair HIV infection caught from a blood transfusion, a physical assault or at work in an eligible occupation Kidney failure requiring permanent dialysis Liver failure Loss of hand or foot permanent physical severance Loss of independence Loss of speech permanent and irreversible Major organ transplant from another donor Motor neurone disease resulting in permanent Multiple sclerosis of specified severity Open heart surgery Paralysis of limb total and irreversible Parkinson s disease resulting in permanent Progressive supranuclear palsy resulting in permanent Respiratory failure severe lung disease of specified severity Stroke of specified severity Systemic lupus erythematosus (SLE) of specified severity Third degree burns covering 20 per cent of the body s surface area or 20 per cent of the surface area of the face Traumatic brain injury resulting in permanent Terminal illness Ulcerative colitis treated with total colectomy. Additional payment conditions We will pay you a number of smaller benefits if you suffer any of the conditions listed below. The benefit paid will be the lower of 25,000 or 25 per cent of the main benefit. To find out more about each condition, please refer to the What you are covered for and Additional payment definitions sections of the Critical Illness with Life Cover membership handbook. The conditions are: Cerebral aneurysm with surgical repair Cerebral arteriovenous malformation with surgical repair Coronary angioplasty Crohn s disease treated with surgical intestinal resection Less advanced cancers of named sites and specific severity Non-malignant pituitary adenoma with specified treatment Removal of one or more lobe(s) of the lung for disease or trauma Severe hearing loss - permanent and irreversible Significant visual loss - permanent and irreversible. 3

5 Acceleration payment benefit You are eligible for an advance payment if you are on the relevant NHS waiting list for the hospital where your surgical treatment will take place and you meet the following definitions: aorta graft surgery coronary artery by-pass grafts heart valve replacement or repair open heart surgery. Your advance payment would be the lower of 25,000 or 25 per cent of the main benefit. As it is an advance, this amount is deducted from your main benefit. Further information can be found in the Acceleration payment benefit for specified surgical treatments section of the Critical Illness with Life Childcover benefit Children up to age 18, or age 21 if not in full time employment can be covered under your membership at no extra charge. Children will be covered for all illnesses and operations specified in the main cover and additional payment conditions, except diabetes mellitus type 1. Children will not be covered for death. The cover includes additional child specific conditions: cerebral palsy cystic fibrosis hydrocephalus treated with insertion of a shunt muscular dystrophy spina bifida of specified severity. Childcover benefit also provides the following: Children s intensive care benefit Child funeral benefit. Childcover benefit is the lower of 25,000 or 50 per cent of the benefit unless the child suffers one of the additional payment conditions then the childcover benefit will be the lower of 25,000 or 25 per cent of the benefit. It is payable once per child. Child funeral benefit pays a maximum of 5,000. Further information regarding this benefit is available in the What you are covered for section of the Critical Illness with Life How long does the Individual Protection Critical Illness with Life Cover last? The cover can last from between 5 and 40 years, although it must end before you reach 70. You must be between 18 and 59 years of age when you apply and be permanently resident in the UK or the Channel Isles (which means Jersey and Guernsey only). Your cover will end if: you stop paying your premiums the main benefit is paid your cover reaches the end of its term. What doesn t this plan cover you for? We will not pay the main benefit, any additional payment conditions, childcover benefit, premium waiver or total permanent disability in the following circumstances: if you do not answer all of our questions truthfully and accurately at the time you apply for your cover and when you claim. Full details can be found in the What you are not covered for section of the Critical Illness with Life your claim is excluded by any special condition which will have been agreed with you at the time you applied your claim, other than for death or terminal illness, results directly or indirectly from a self-inflicted injury your claim results from an operation which was not medically necessary or was not carried out by someone who was suitably qualified to do the operation. Additional terms apply to total permanent disability and premium waiver options which can be found in the Additional options section of the Critical Illness with Life Cover membership handbook. We will not pay childcover benefit in the additional following circumstances: the first arose, the underlying condition was first diagnosed or either parent received counselling or medical advice in relation to the condition before: the commencement date your legal adoption or legal guardianship of the child. the condition is caused by intentional harm inflicted on the child by you. 4

6 Policy Summary - Friends Life Individual Protection Critical Illness with Life Cover Additional terms apply to childcover benefit which can be found in the Childcover benefit section of the Critical Illness with Life We will not pay child funeral benefit in the additional following circumstances: the child dies before reaching 30 days old the cause of death first arose before: the commencement date your legal adoption or legal guardianship of the child the death is brought about by intentional harm inflicted on the eligible child by you. We will not pay fracture cover claims in the following circumstance: if you have multiple fractures, we will only pay one of your choosing. Additional terms apply to fracture cover which can be found in the Additional options section of the Critical Illness with Life We will not pay Global Treatment claims in the following circumstances: Any treatment that is not arranged by Best Doctors as a result of the claim process set out in the Making a claim section of the Global Treatment Terms and Conditions. Any medical expenses incurred within the UK. Any treatment for your child if the first arose, the underlying condition was first diagnosed or either parent received counselling or medical advice in relation to the condition before the start date, the legal adoption or legal guardianship of the child. Additional terms and claims processes apply to Global Treatment which can be found in the Global Treatment Terms and Conditions. Should I review my Individual Protection Critical Illness with Life Cover? You should regularly review your cover to make sure that it meets your demands and needs. Changing your mind? You can cancel your membership at any time. If you change your mind about taking out this cover within 30 days; of the day when your membership starts, or the day when you receive your membership handbook and your registration certificate you will receive a full refund of the premiums you have paid. If you pay your premium annually and you cancel after 30 days then we will give you a pro-rata refund. Please see the Your rights to cancellation section in the Critical Illness Cover with Life Cover membership handbook. How to claim If you need to make a claim, please contact us using the details below as soon as you can. We may need to access your medical records to consider a claim. You can call us on or write to us at: Friends Life Individual Protection Claims department PO Box 569 Friends Life Centre Bristol BS43 9FE. Getting in touch Remember your financial adviser will normally be your first point of contact. If you have any questions you can: Call us on Calls may be recorded and may be monitored Or write to us at: Friends Life Individual Protection PO Box 569 Friends Life Centre Bristol BS34 9FE. 5

7 How to complain Please contact our Customer Relations Team using the contact details in the Getting in touch section of this document. To see our procedures for dealing with complaints, please ask for our We Listen leaflet. If you are not satisfied with our response you can contact: Financial Ombudsman Service Exchange Tower London E14 9SR. Telephone: or Website: Law and language Both you and we have the right to choose the choice of law in relation to the membership. We have chosen for the membership to be governed by the laws of England and Wales, which will apply unless your membership documents or terms and conditions show otherwise. Your membership documents, terms and conditions and all other communications will be in English. This document is available in other formats. If you would like a Braille, large print or audio version of this document, please contact us. Making a complaint won t affect your legal rights. Compensation If a financial adviser recommends this plan, you have a legal right to compensation if the Financial Ombudsman Service decides it wasn t suitable for your needs at the time. We are covered by the Financial Services Compensation Scheme (FSCS). If we cannot meet our obligations you may be entitled to compensation under the scheme. For this type of plan, the scheme covers at least 90 per cent of the claim. In the first instance the scheme would seek to continue your cover with an alternative provider. For further information see Alternatively, you can contact the FSCS on or Friends Life and Pensions Limited An incorporated company limited by shares and registered in England and Wales, number Registered office: Pixham End, Dorking, Surrey RH4 1QA. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Telephone calls may be recorded. Friends Life is a registered trade mark of the Friends Life group. FLIP/4569/Mar UNI

8 Policy Summary - Friends Life Individual Protection Critical Illness with Life Cover Types of cover You can choose from: Level term cover This covers you for a fixed lump sum for a set period of time which you select when you take out the membership. Mortgage protection term cover This covers you for a set period and the cover reduces each month in the same way as the outstanding amount on a repayment mortgage with an interest rate of eight per cent a year. Family income benefit cover Family income benefit cover operates in the same way as level term cover, but does not pay a lump sum payment. Instead, the benefit is paid in annual instalments. These would be paid for each year remaining in the term of your membership. Renewable term cover Renewable term cover provides protection for five or ten years with the option to renew without underwriting at the end of the term. Further information about these types of cover is available in the Your membership section of the Critical Illness with Life Premium options There are two premium options available to choose from: guaranteed premiums reviewable premiums. Guaranteed premiums will not change. Reviewable premiums may change on every fifth anniversary of the start of your membership. If you select renewable term cover your premiums will be reassessed at each renewal. The amount of premium you pay will depend on the options you select. Further information about the premiums is available in the Premium options section of the Critical Illness with Life There is an extra cost, on top of the initial premium, if you choose any of the following options: Fracture cover pays up to 2,100 per year of cover if you suffer one of a list of 18 specified fractures. Global Treatment allows you to access treatment outside the UK if you or your child is diagnosed with one of a number of specified serious illnesses or requires one of a list of medical procedures. Premium waiver we will waive your premium if, due to illness or incapacity, you meet the definition applicable to you in the Critical Illness with Life Cover membership handbook Reinstatement allows you to take out a new cover with a reduced list of critical illnesses following a successful claim on the main benefit. Total permanent disability we will pay the main benefit if you meet the definition applicable to you for total permanent disability in the Critical Illness with Life cover membership handbook. Further information about these options is available in the Additional options section of the Critical Illness with Life Further information about the Global Treatment additional option can be found in the Global Treatment Terms and Conditions. Replacement cover If you have joint cover and a successful claim is made on the main benefit, the person who was not the subject of the claim can take out a new cover. This is not subject to additional underwriting. Further information about this option is available in the How to make a claim section of the Critical Illness with Life Cover membership handbook. Additional options Indexation allows the main benefit to increase by either three per cent, five per cent, Retail Price Index or Average Weekly Earnings on each anniversary of the cover. Increasing the benefit will also result in the premium rising. 2

9 Critical illnesses covered The full definitions of the critical illnesses and the circumstances in which you can claim are shown in the What you are covered for and Critical illness definitions sections of the Critical Illness with Life Cover membership handbook. Conditions covered: Aorta graft surgery Aplastic anaemia of specified severity Bacterial meningitis resulting in permanent Benign brain tumour with permanent or undergoing defined treatments Benign spinal cord tumour resulting in permanent Blindness permanent and irreversible Cancer excluding less advanced cases Cardiac arrest with the insertion of a defibrillator Cardiomyopathy of specified severity Chronic rheumatoid arthritis Coma resulting in permanent Coronary artery by-pass grafts Crohn s disease of specified severity Creutzfeldt-Jakob disease resulting in permanent Deafness permanent and irreversible Dementia including Alzheimer s disease resulting in permanent Diabetes mellitus type 1 first diagnosis over age 40 and requiring permanent insulin injections Heart attack of specified severity Heart valve replacement or repair HIV infection caught from a blood transfusion, a physical assault or at work in an eligible occupation Kidney failure requiring permanent dialysis Liver failure Loss of hand or foot permanent physical severance Loss of independence Loss of speech permanent and irreversible Major organ transplant from another donor Motor neurone disease resulting in permanent Multiple sclerosis of specified severity Open heart surgery Paralysis of limb total and irreversible Parkinson s disease resulting in permanent Progressive supranuclear palsy resulting in permanent Respiratory failure severe lung disease of specified severity Stroke of specified severity Systemic lupus erythematosus (SLE) of specified severity Third degree burns covering 20 per cent of the body s surface area or 20 per cent of the surface area of the face Traumatic brain injury resulting in permanent Terminal illness Ulcerative colitis treated with total colectomy. Additional payment conditions We will pay you a number of smaller benefits if you suffer any of the conditions listed below. The benefit paid will be the lower of 25,000 or 25 per cent of the main benefit. To find out more about each condition, please refer to the What you are covered for and Additional payment definitions sections of the Critical Illness with Life Cover membership handbook. The conditions are: Cerebral aneurysm with surgical repair Cerebral arteriovenous malformation with surgical repair Coronary angioplasty Crohn s disease treated with surgical intestinal resection Less advanced cancers of named sites and specific severity Non-malignant pituitary adenoma with specified treatment Removal of one or more lobe(s) of the lung for disease or trauma Severe hearing loss - permanent and irreversible Significant visual loss - permanent and irreversible. 3

10 Acceleration payment benefit You are eligible for an advance payment if you are on the relevant NHS waiting list for the hospital where your surgical treatment will take place and you meet the following definitions: aorta graft surgery coronary artery by-pass grafts heart valve replacement or repair open heart surgery. Your advance payment would be the lower of 25,000 or 25 per cent of the main benefit. As it is an advance, this amount is deducted from your main benefit. Further information can be found in the Acceleration payment benefit for specified surgical treatments section of the Critical Illness with Life Childcover benefit Children up to age 18, or age 21 if not in full time employment can be covered under your membership at no extra charge. Children will be covered for all illnesses and operations specified in the main cover and additional payment conditions, except diabetes mellitus type 1. Children will not be covered for death. The cover includes additional child specific conditions: cerebral palsy cystic fibrosis hydrocephalus treated with insertion of a shunt muscular dystrophy spina bifida of specified severity. Childcover benefit also provides the following: Children s intensive care benefit Child funeral benefit. Childcover benefit is the lower of 25,000 or 50 per cent of the benefit unless the child suffers one of the additional payment conditions then the childcover benefit will be the lower of 25,000 or 25 per cent of the benefit. It is payable once per child. Child funeral benefit pays a maximum of 5,000. Further information regarding this benefit is available in the What you are covered for section of the Critical Illness with Life How long does the Individual Protection Critical Illness with Life Cover last? The cover can last from between 5 and 40 years, although it must end before you reach 70. You must be between 18 and 59 years of age when you apply and be permanently resident in the UK or the Channel Isles (which means Jersey and Guernsey only). Your cover will end if: you stop paying your premiums the main benefit is paid your cover reaches the end of its term. What doesn t this plan cover you for? We will not pay the main benefit, any additional payment conditions, childcover benefit, premium waiver or total permanent disability in the following circumstances: if you do not answer all of our questions truthfully and accurately at the time you apply for your cover and when you claim. Full details can be found in the What you are not covered for section of the Critical Illness with Life your claim is excluded by any special condition which will have been agreed with you at the time you applied your claim, other than for death or terminal illness, results directly or indirectly from a self-inflicted injury your claim results from an operation which was not medically necessary or was not carried out by someone who was suitably qualified to do the operation. Additional terms apply to total permanent disability and premium waiver options which can be found in the Additional options section of the Critical Illness with Life Cover membership handbook. We will not pay childcover benefit in the additional following circumstances: the first arose, the underlying condition was first diagnosed or either parent received counselling or medical advice in relation to the condition before: the commencement date your legal adoption or legal guardianship of the child. the condition is caused by intentional harm inflicted on the child by you. 4

11 Policy Summary - Friends Life Individual Protection Critical Illness with Life Cover Additional terms apply to childcover benefit which can be found in the Childcover benefit section of the Critical Illness with Life We will not pay child funeral benefit in the additional following circumstances: the child dies before reaching 30 days old the cause of death first arose before: the commencement date your legal adoption or legal guardianship of the child the death is brought about by intentional harm inflicted on the eligible child by you. We will not pay fracture cover claims in the following circumstance: if you have multiple fractures, we will only pay one of your choosing. Additional terms apply to fracture cover which can be found in the Additional options section of the Critical Illness with Life We will not pay Global Treatment claims in the following circumstances: Any treatment that is not arranged by Best Doctors as a result of the claim process set out in the Making a claim section of the Global Treatment Terms and Conditions. Any medical expenses incurred within the UK. Any treatment for your child if the first arose, the underlying condition was first diagnosed or either parent received counselling or medical advice in relation to the condition before the start date, the legal adoption or legal guardianship of the child. Additional terms and claims processes apply to Global Treatment which can be found in the Global Treatment Terms and Conditions. Should I review my Individual Protection Critical Illness with Life Cover? You should regularly review your cover to make sure that it meets your demands and needs. Changing your mind? You can cancel your membership at any time. If you change your mind about taking out this cover within 30 days; of the day when your membership starts, or the day when you receive your membership handbook and your registration certificate you will receive a full refund of the premiums you have paid. If you pay your premium annually and you cancel after 30 days then we will give you a pro-rata refund. Please see the Your rights to cancellation section in the Critical Illness Cover with Life Cover membership handbook. How to claim If you need to make a claim, please contact us using the details below as soon as you can. We may need to access your medical records to consider a claim. You can call us on or write to us at: Friends Life Individual Protection Claims department PO Box 569 Friends Life Centre Bristol BS43 9FE. Getting in touch Remember your financial adviser will normally be your first point of contact. If you have any questions you can: Call us on Calls may be recorded and may be monitored Or write to us at: Friends Life Individual Protection PO Box 569 Friends Life Centre Bristol BS34 9FE. 5

12 How to complain Please contact our Customer Relations Team using the contact details in the Getting in touch section of this document. To see our procedures for dealing with complaints, please ask for our We Listen leaflet. If you are not satisfied with our response you can contact: Financial Ombudsman Service Exchange Tower London E14 9SR. Telephone: or Website: Law and language Both you and we have the right to choose the choice of law in relation to the membership. We have chosen for the membership to be governed by the laws of England and Wales, which will apply unless your membership documents or terms and conditions show otherwise. Your membership documents, terms and conditions and all other communications will be in English. This document is available in other formats. If you would like a Braille, large print or audio version of this document, please contact us. Making a complaint won t affect your legal rights. Compensation If a financial adviser recommends this plan, you have a legal right to compensation if the Financial Ombudsman Service decides it wasn t suitable for your needs at the time. We are covered by the Financial Services Compensation Scheme (FSCS). If we cannot meet our obligations you may be entitled to compensation under the scheme. For this type of plan, the scheme covers at least 90 per cent of the claim. In the first instance the scheme would seek to continue your cover with an alternative provider. For further information see Alternatively, you can contact the FSCS on or Friends Life and Pensions Limited An incorporated company limited by shares and registered in England and Wales, number Registered office: Pixham End, Dorking, Surrey RH4 1QA. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Telephone calls may be recorded. Friends Life is a registered trade mark of the Friends Life group. FLIP/4569/Mar UNI

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