British Horse Society and/or BHS Trading Co Ltd and Equestrian Qualifications (GB) Ltd. Members Personal Accident Insurance. Group Policy Wording

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1 British Horse Society and/or BHS Trading Co Ltd and Equestrian Qualifications (GB) Ltd. Members Personal Accident Insurance Group Policy Wording Insurer Information The Policy is underwritten by Millstream Underwriting Ltd, Registration No Registered Office: 145 Leadenhall Street, London, EC3V 4QT on behalf of: Arch Insurance Company (Europe) Limited Registered address; 6 th Floor Plantation Place South, 60 Tower Street, London, EC3R 5AZ Millstream Underwriting Limited is authorised and regulated by the Financial Conduct Authority (FCA). (FCA number ). Their registration can be checked by visiting or by contacting them on Millstream Claims Millstream Personal Accident Claims, Attwood House, Mansfield Business Park, Four Marks, GU34 5PZ Telephone: Page 1

2 Contents Description Page Insurance Agreement 2 Policy Definitions 3 Eligibility 5 Paying Premiums 5 When cover ends 5 Operation of Cover 5 Section 1: Injury 5 A. Death 5 B. Permanent Total Disability 5 C. Permanent Disabling Injury 5 GENERAL EXCLUSIONS 6 GENERAL CONDITIONS 6 CLAIMS PROVISIONS 7 COMPLAINTS PROCEDURES 8 CUSTOMER SERVICES 8 FINANCIAL SERVICES COMPENSATION SCHEME 8 DATA PROTECTION 8 DETAILS ABOUT OUR REGULATOR 8 Insurance Agreement This Policy is a contract of insurance and is the basis upon which all claims will be considered. Please read the Policy carefully to ensure that it is in accordance with Your requirements and that You fully understand its terms and exclusions and limitations. The Policy, the information You have provided and/or the application form and any declaration You have made and the Schedule should be read together to form the contract of insurance between You the Insured and Us, Millstream Underwriting Limited. This is a legal contract. You must tell Us about any changes which affect Your insurance and which have occurred either since the Policy started or since the last renewal date. If You are not sure whether certain facts are relevant, please contact your insurance adviser. If You do not tell us about relevant changes, Your Policy may not either cover You fully, or may be invalidated. Page 2

3 Policy Definitions Accident A sudden external unforeseen and identifiable event and the word accidental shall be constructed accordingly. If an Insured Person suffers Bodily Injury as a result of unavoidable exposure to the elements We will consider it as having been caused by an Accident. Accumulation Limit The maximum aggregate amount the Insurer will pay in respect of Insured Persons for all claims arising from one event source or original cause Annual Salary Means the gross salary paid to an Insured Person not including bonuses Body The head excluding the Face, trunk, legs and arms. Burns Full thickness third degree Burns resulting in a permanent scar Benefit Period The maximum period for which a Benefit is payable such period commencing at the date the Insured Person first became disabled and ending no later that the stated number of days or weeks thereafter (allowing for any excess periods applied) Bodily Injury Injury which is caused by an Accident and which within 24 months from the date of such Accident shall result in the death or disablement of the Insured Person Child/Children Children, Stepchildren and legally adopted children of the Insured Person and their Partner, and children for whom the Insured Person or their Partner are the Parent or Legal Guardian. To be covered under this Policy Child/Children must be; A. Aged over 30 days B. Under 18 years of age or 23 years of age and in full time education C. Dependant on the Insured Person or their Partner Coma Means a continuous unrousable state Convalescence An Insured Person s necessary convalescence, under the regular care and advice of a Qualified Medical Practitioner Day A period of 24 consecutive hours Declarations The information supplied by the Insured confirming up to date Insured Person information and Premium due to Us Deferment Period The period specified in the Schedule of Benefits when cover does not apply Excess Period The period specified in the Schedule of Benefits at the commencement of each and every period of disablement for which no benefit shall be payable Event Means all losses arising from one single unusual, unexpected and sudden event occurring at a specified time and place Face The area bordered by the natural hairline surrounding the forehead, the front of the ears and the lower jaw Hospitalisation Being admitted as an inpatient to an institution which has accommodation for resident patients and the facilities for diagnosis, surgery and treatment. It does not include a convalescence home, an extended care facility, a geriatric home, a long term nursing or rehabilitation centre Injury Medical Expenses Reasonable costs necessarily incurred for hospital, ambulance, surgery and treatment costs following an Accident Page 3

4 Insured The Person, Group, Company or Organisation named in The Schedule Insured Person Any person or categories of persons described under this heading in The Schedule Insurer Arch Insurance Company (Europe) Limited. Loss of Hearing: Total and permanent loss of hearing in both ears to the extent that the hearing loss is greater than 95 decibels across all frequencies using a pure tone audiogram. Loss of Limb: In the case of a leg: a. Loss by permanent physical severance at or above the ankle or b. Permanent and total loss of use of a complete foot or leg In the case of an arm: a. Loss by permanent physical severance of the four fingers at or above the meta carpo phalangeal joints (where the fingers join the palm of the hand) or b. Permanent and total loss of use of a complete arm or hand Loss of Sight Permanent and total loss of sight: a. In both eyes if the Insured Person s name is added to the Register of Blind Persons on the authority of a fully qualified ophthalmic specialist b. In one eye if the degree of sight remaining after correction is 3/60 or less on the Snellen Scale (seeing at 3 feet what the Insured Person should normally see at 60 feet). and We are satisfied that the condition is permanent and without expectation of recovery. Loss of Speech Permanent total and irrecoverable loss of speech Maximum Benefit Any One Person and/or Maximum Limit any one Life Shall mean the maximum amount payable in respect of any one Insured Person for all claims arising from one Event Paraplegia Permanent and total paralysis of the two lower limbs, bladder and rectum Partner Spouse, civil partner or co-habitee of either sex with which the Insured Person has been living with for at least 3 months Permanent Total Disablement Total and absolute disablement caused other than by Quadriplegia, Paraplegia, Loss of Limb, Loss of Sight in one or both eyes, Loss of Speech or Loss of Hearing in both ears which stops the; A. Insured Person from engaging in their usual occupation B. A Partner or Child from performing or giving attention to any gainful occupation for which they where able by way of training or education or experience Premium The amount specified in The Schedule in respect of the specified Period of Insurance Period of Insurance From the Effective Date to the Expiry Date specified in The Schedule Permanently Resident Resident in the first instance for at least 3 months and at least 40 weeks thereafter Policy Shall mean the contract of insurance Quadriplegia The permanent and total paralysis of the lower two limbs and two upper limbs Qualified Medical Practitioner A doctor or specialist registered or licensed to practice medicine under the laws of the country in which they practice who is neither; A. The Insured Person or B. A relative of such Insured Persons unless approved by Us Rehabilitation Expenses Counselling, therapy and re-training expenses for returning to work Page 4

5 Temporary Total Disablement Temporary total disablement which entirely prevents an Insured Person from engaging in their usual occupation Terrorism 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 ethical purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public in fear United Kingdom England, Scotland, Wales, the Channel Island, Isle of Man and Northern Ireland War Armed conflict between nations, invasion, act of foreign enemy, civil war and military or usurped power We/Us/Our Millstream Underwriting Limited on Behalf of Arch Insurance (Europe) Ltd You/Your Means any Insured Person Eligibility There will be no insurance under the Policy unless the following are met; A. The Insured Person is an existing gold, founder, full, life or junior member of the British Horse Society B. The Insured Person must be Permanently Resident in the United Kingdom Paying Premiums The Insured will arrange for the payment of the Premium to Us. When an Insured Persons cover ends Cover will terminate under the Policy on the occurrence of the following events; A. At the Expiry Date of the Period of Insurance B. When an Insured Person terminates their membership to the British Horse Society Operation of Cover In return for You having paid or agreed to pay the Premium We will pay the amount shown in the Schedule in the event of an Insured Person described in the Schedule sustaining Accidental Bodily Injury during the Period of Insurance and within the Operative Time which independently of any other cause results in any of the benefits listed below to the extent of and subject to the terms contained in or endorsed to the Policy. Section 1: Injury A. Death; Where injury results in death We will pay the amount specified in The Schedule B. Permanent Total Disability; Where injury results in Permanent Total Disability We will pay the amount specified in The Schedule C. Permanent Disabling Injury Where an Accident results in a Permanent Disabling Injury We will pay the amount shown in The Schedule. For a Permanent Disability not listed in The Schedule the benefit payable will be based on Our medical assessment of the degree of disability in relation to the scale shown in The Schedule Page 5

6 General Exclusions We will not be liable under this Policy for any loss relating to the following; 1. Terrorism It is agreed that, regardless of any contributory cause (s) this insurance does not cover any claim (s) in any way caused or contributed to by any act of Terrorism involving the use or release or the threat thereof any nuclear weapon or devise or chemical or biological agent 2. Nuclear reaction, radiation and contamination This Policy does not cover claims in any way caused or contributed to by nuclear reaction, nuclear radiation or radioactive contamination 3. War Not withstanding any provision to the contrary within this Policy or any endorsement thereto it is agreed that this insurance does not cover claims in any way caused or contributed to by War, whether War be declared or not, hostilities or any act of War or civil War when the Insured Person is taking an active part therein or in the Insured Person s country of domicile 4. Suicide or self inflicted injury Suicide, attempted suicide or deliberate selfinflicted injury by the Insured Person regardless of the state of mental health 5. Repetitive strain injury Repetitive strain injury or related syndromes or any gradually operating cause 6. Illegal acts Illegal acts of the Insured Person 7. Aggregate limits Any claim in excess of the Aggregate Limits or Event limits detailed on The Schedule 8. Illness or disease Any illness or disease not directly resulting from a Bodily Injury 9. Bacterial or viral infection Any bacterial or viral infection directly resulting from a Bodily Injury 10. Air Travel The Insured Person taking part in any form of air sports or air travel other than as a fare paying passenger 11. Armed Forces If the Insured Person is a full time member of the armed forces or reserve forces, cover will only apply to recreational riding and not activities associated with the Insured Person s occupation or profession General Conditions 1. Any circumstances which are likely to give rise to a loss under this Policy should be notified to Millstream Claims as soon as reasonably possible. 2. The Insurer will not be liable under sections B, C, D and E should the Insured Person s death occur within 13 weeks of the Accident 3. As soon as is practically possible after the occurrence of an Accident which may be the subject to a claim under this Policy, the Insured Person must; i. Give notice to the Insurer and supply, without cost to the Insurer, such certificates and evidence which thereafter may be reasonably required ii. Place themselves under the care of a Qualified Medical Practitioner 4. The Insurer may cancel the Policy at any time subject to 30 days notice by recorded delivery letter to the Insured s last known address 5. If any claim is in any respect fraudulent or if fraudulent means or devices are used by the Insured Person or anyone acting on their behalf to obtain a benefit under this Policy, all benefits for that Insured Person shall be forfeited Page 6

7 6. The receipt of final payment by the Insured Person or his/her personal representatives shall discharge the Insurer of its liability under this Policy 7. The Insured and the Insurer have agreed that this Policy will be governed by the law of England and Wales who s courts alone will have jurisdiction on the dispute hereunder 8. The Policy, Schedule and any endorsement attached thereto will be read as one document 9. If any differences shall arise as to the amount to be paid under this Policy (Liability being otherwise admitted) such a difference shall be referred to an arbitrator to be appointed by the parties in accordance with the statutory provisions for the time, being in force in England and Wales. The place of arbitration shall be London and the language of the arbitration shall be English. Where any difference is by this condition to be referred to arbitration the making of an award shall be a condition precedent to any right of action against the Company 10. We are required to notify You that other taxes or costs may exist which are not imposed or charged by Us 11. We reserve the right to make changes, add Policy terms and/or change the premiums for legal, regulator or taxation purposes Claims On the happening of an occurrence likely to give rise to a claim under this Policy notice will be given to Millstream Claims as soon as reasonably possible using the following contact details; Millstream Personal Accident Claims, Attwood House, Mansfield Business Park, Four Marks, GU34 5PZ Telephone: The Insured Person shall at their own expense furnish Us with such certificated, information and evidence as We may require in the form prescribed by Us. We shall be allowed at Our own expense, upon reasonable notice to the Insured Person, to request a medical examination of the Insured Persons as appropriate. If You make a statement to support Your claim that is misleading or is found to be incorrect, Your claim will be rejected and Your cover may be cancelled. Any amounts already paid must be repaid to Us We will deal with claims based on the level of cover applicable to the Insured Person immediately before the Accident Page 7

8 Complaints Any issue arising in a complaint under this Policy should be made to; The Managing Director, Millstream Underwriting Limited, 145 Leadenhall Street, London, EC3V 4QT If the Insured Person remains dissatisfied after Our final response the Insured Person can approach the Financial Ombudsman Service at the following: The Financial Ombudsman Service, South Quay Plaza, 183 Marsh Wall, London, E14 9SR Telephone: Fax: The existence of these complaints procedures does not affect your statutory rights relating to this Policy Customer Services Should you require any assistance or guidance with this Policy please contact Millstream Underwriting Limited quoting your name and policy number; Postal Address: London Road, Hadleigh, Essex, SS7 2DD Telephone: Financial Services Compensation Scheme Data Protection The information provided by or on behalf of the Insured Person at the time of taking out the Policy will be used by Us or Our service providers for the purpose of Customer Service and Claims Management purposes only. It may also be used for the purpose of fraud prevention including passing details to the authorities and other insurers. We may monitor and/or record data and communication sent to or made with Us for the purposes of Customer Service and Claims Management. Data will only be kept for so long as it is appropriate Details about our Regulator This Policy is underwritten by Millstream Underwriting Limited on behalf of Arch Insurance Company (Europe) Limited. Millstream Underwriting Limited (FCA Firm Ref: ) is authorised and regulated by the Financial Conduct Authority (FCA). Arch Insurance Company (Europe) Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Registered in England and Wales number Registered office: 6th Floor, Plantation Place South, 60 Great Tower Street, London EC3R 5AZ Their registration can be checked with the FCA by visiting or by contacting them on Millstream Underwriting Limited will act on behalf of Arch Insurance Company (Europe) Limited with respect to the receipt of customer money and for the purpose of settling claims and handling premium refunds. In the event that the Insurer is unable to pay a claim You may be entitled to compensation from the Financial Services Compensation Scheme. Their contact details are; Financial Services Compensation Scheme, 10th Floor, Beaufort House, 15 St Botolph Street, London EC3A 7QU. Fax: Page 8

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