Group Insurance Scheme Summary of Benefits

Transcription

1 The Group Insurance Scheme is arranged by Roland Smith Ltd Insurance Brokers on behalf of the Dyfed Powys Police Federation. Apart from the specifically negotiated Group Insurance Scheme Roland Smith also manage the House and Motor Insurance Schemes which have been exclusively arranged for Serving and Retired Members of the Federation as well as Police Staff. In addition they also offer help and advice on any insurance matters including Life Assurance, Mortgages and a full pre-retirement service. AREAS OF EXPERTISE Special Schemes Motor Household Group Life Legal Expenses Travel Critical Illness Vehicle Rescue Permanent Health Commercial Insurance Fire Theft Trade Packages Marine Goods in Transit Professional Indemnity Personal Insurance Motor Household Travel GAP* Home Appliance Breakdown Vehicle Breakdown Temporary Replacement Vehicle For more information on this or any other matter please phone or write to: Roland Smith Ltd India Buildings Brunswick Street Liverpool L2 0XH Financial Services Pensions Investments Life Assurance Mortgages Protection Inheritance Tax Private Medical Long Term Care Insurance Products Investment Products Retirement Planning Making the most of your money Maximising returns and minimising risk Individual solutions. GAP If your car is written off, 1 or 3 years. Cover for any shortfall, of up to 25,000, between the insurance offer and the retail value of your vehicle (according to Glass s Guide) on the day you purchased your policy. Example premium at January 2011 car cost up to 20,000 cover 10,000 deficit for 3 years for a total cost of only or per month for 10 months total. Cover can be purchased for cars you already own (up to 7 years old) RS0103F MAR 2011 DYFED POWYS POLICE FEDERATION Group Insurance Scheme Summary of Benefits Effective from 1st April 2011 THIS SCHEME IS OPEN TO ALL SERVING POLICE OFFICERS AND SUPPORT STAFF WHO ARE SUBSCRIBING MEMBERS OF THE DYFED POWYS POLICE FEDERATION Dyfed Powys Police Federation is an Appointed Representative of Roland Smith Limited, 1st Floor, India Buildings, Brunswick Street, Liverpool L2 0XH which is authorised and regulated by the Financial Services Authority. 12

2 Group Insurance is payable monthly and costs: Serving Officer Spouse of a Serving Officer 3.75 Retired Officer Spouse of a Retired Officer 4.95 All of the above premiums are monthly And will be deducted directly from your pay. Taxation - Any tax, interest or penalties you may have to pay HM Revenue & Customs - Any claim where you have not taken every reasonable care to act according to tax legislation, or missed a legal deadline, or where fraud is suspected. Employment - Any claim in respect of your activities as a serving Police Officer - Any claim in respect of your activities outside of serving as a Police Officer unless the relevant Chief Constable has approved the activity. Personal Injury - Any claim by a serving Police Officer unless the claim is one alleging negligence by a clinical or medical practitioner and the expected damages do not exceed 1,000 and legal proceedings are not funded by the Police Federation or the Chief Constable. Peaceful Occupation - Any dispute relating to the letting or subletting of or a licence to occupy the home or any lease tenancy or rental dispute. Consumer Contract - A contract of insurance dispute relating solely to quantum or a dispute arising from or relating to a contract entered into prior to the inception of the policy. Data, Protection, Discrimination - Any Serving Police Officer of ACPO or Superintending rank in respect of any claim arising from an on duty decision and Representation at Public Enquiries. Uninsured Loss Recovery - Any accident relating to on duty police work Tenancy Disputes - Any dispute relating to the non payment of rent Identity Theft - Any claims where identity theft is related to the Beneficiary s business, profession or trade, or whether the claim relates to fraud, dishonesty or criminal activity conducted by the Beneficiary or someone acting in collusion with the Beneficiary. Initial Representation - Any matter where the federation has not given its explicit approval. Disciplinary - Any legal expenses for representing you at a disciplinary hearing that is or should be funded by Dyfed Powys Police Federation With regards to the telephone legal advice that we are able to provide under the policy we will not be obliged to correspond, negotiate or otherwise deal on an Insured Person s behalf with any third party. We also will not provide assistance on matters relating to a dispute under this policy between an Insured Person and us, the Insurer, their servants or agents. 2 11

3 10 Personal injury actions in pursuing damages following an injury or accident to you or a member of your family that was not your fault. Pursuit of legal proceedings following any event causing loss of or damage to your home Pursuit or defence of an alleged infringement of your legal rights or an alleged infringement by you with regards to the legal rights of another person relating to the occupation of your home Consumer contract agreements such as a dispute over your experience of a package holiday or the purchase of a new fridge freezer Pursuit of Legal Proceedings to recover uninsured losses incurred as a result of a motor accident causing loss or damage to your vehicle Legal Expenses incurred in the pursuit of legal proceedings by you in respect of a probate dispute involving the will of your parents, grandparents, children, step-children or adopted children. Costs up to 25,000 incurred by you in order to regain occupation of your home or compensation as a result of a private landlord unlawfully evicting you. Your defence against prosecution brought by a financial institution as a result of an unauthorised person using a means of identification belonging to you without your knowledge. Initial representation costs up to a limit of 500 for interviews at a police station after your arrest. Legal expenses up to a limit of 5,000 for representing you at a Misconduct Tribunal Panel, Chief Constables Review or the Police Appeals Tribunal providing that Dyfed Powys Police Federation have given their explicit approval Under the Legal Expenses Insurance the limit of indemnity for any one claim is 50,000 unless otherwise stated Summary of General Policy Exclusions We will not pay for: Cases without reasonable prospect of success Legal expenses arising from your intentional wrongdoing Disputes that you were aware of when you applied for Dyfed Powys Federation Legal Expenses Insurance Cases reported to us more than 6 months after their occurrence. Any costs incurred without our written consent Matters which are covered under other insurances e.g. household, car insurances Defamation actions Disputes between you and/or members of your family Fines or any other penalties In respect of consumer contract disputes the amount in dispute must exceed 50 Principal Exclusions Relating to Individual Sections Criminal Prosecution Defence - Any prosecution arising from actual or alleged rape, sexual assault, murder, attempted murder possession of or dealing in illegal drugs, unless you are subsequently acquitted - Any Serving Police Officer of ACPO or Superintending rank in respect of any claim arising from an on duty decision. - Any claim relating to use of a motor vehicle, your duties as a police officer or where you do not instruct a solicitor in accordance with the terms of your Legal Aid entitlement. Motor Prosecution Defence - Any claim relating to your duties as a police officer, parking offences or where you do not have the appropriate licences and paperwork required by law. Dear Member Group Insurance Rules and Important Information This document contains details of all the component parts of the Group Insurance. However, it is important you understand a number of important facts about this cover: 1. The cost of this cover is per pay period, deducted direct from pay plus 3.75 per pay period if the partner option is taken up. 2. We are not able to advise anybody individually about the suitability of this cover for their own personal circumstances. Therefore this contract is sold to you on a Non- Advised basis. 3. To be eligible for the cover you must be a subscribing member of Dyfed Powys Police Federation or are a member of the Police Staff, Superintendents Association or ACPO. Retired members of these organisations are also eligible to continue some parts of the cover. 4. If you leave the Force, stop subscribing to the Federation, or resign from the Police Service cover will cease immediately. You should bear this in mind if it is your intention to use the Life cover to protect your mortgage. If you were to leave the Force at some time in the future you may then find it difficult or expensive to obtain alternative Life cover, especially if you are not in good health. 5. If you are put onto nil pay, take a career break or take maternity leave you must contact the Federation Office immediately you become aware that this will happen. This is because your premiums are deducted from your salary and in any of these cases there will be no salary to deduct from. In some cases cover can be continued but special arrangements will need to be made. 6. If you are seconded overseas please let the Federation Office know in advance so that they can confirm if any or what parts of the cover can be maintained. 7. The Life cover is written in Trust as this is the best way to ensure the money is paid quickly, without any implications for inheritance or other taxes. This means you cannot assign this policy to any person or company. In the event of death the Trustees will meet and decide who the deceased would have wanted the money to go to. If you want to you can give them an indication of who that would be by completing a Beneficiary Nomination Form. Please note that if you are insuring your partner they should also complete a form. 8. You should check your salary slip periodically to ensure the deductions for this cover are continuing to be made. 9. If you need any part of the cover explaining please ring the Broker, Roland Smith Limited on and ask for the Group Insurance Department. 10.When travelling please make certain you take the Travel Insurance Policy and up to date Schedule with you. If you haven t got a copy then please contact the Federation Office and they will either send or you a copy (which may involve a small administrative charge). 11.This Policy is arranged by the Federation and is based on the historical needs of Federation Members with due regard to changes in Regulations. It is an annually renewable contract and the Federation retain the right to vary the cover and price according to the best interests of the majority. This could mean that covers may be reduced or removed altogether. 3

4 12. Dyfed Powys Police Federation is an Appointed Representative of Roland Smith Limited 1 st Floor India Buildings Brunswick Street Liverpool, which is Authorised and Regulated by the Financial Services Authority. A charge of.91p per member per month is included in the price of the Group Insurance to cover the Administration and Regulation costs incurred in the management of the Scheme. 13. Please remember that all Insurance Policies have exclusions, limitations and things you must do for cover to be valid and in force when you need it. Please take the time to read the Policy Documents to ensure you are aware of the cover before you have a claim otherwise it may be too late. 14.Prior to the end of any contract of insurance we will write to you with the terms of the renewal of the policy. If we have changed the Scheme Insurer you will be informed at that time, when you will be able to decide if you wish to continue with the contract with the new Insurer. 15.Where the document refers to partner this definition includes same sex partners. However, there must be some form of shared financial commitment to the partnership, e.g. joint mortgage, joint bank account or joint rent agreement. In addition the relationship must have been permanent for at least 12 months prior to cover commencing. COMPLAINTS PROCEDURE The Group Insurance Scheme is arranged on behalf of the Federation by Roland Smith Ltd, Insurance Brokers. Roland Smith Ltd, authorised and regulated by the Financial Services Authority (FSA), as are the Insurers who underwrite the Group Policies. All regulated business have to handle business in a particular way and deal with complaints in accordance with the FSA rules. However, although it is you, The Member who is the ultimate buyer of the cover, we, your Federation are responsible for dealing with Roland Smith and organising the Policies. Indeed we are even involved in parts of the administration of the Cover and will on occasions advise Members on different aspects of the various Policies. In view of this it has been agreed with Roland Smith Ltd that any complaints about any aspect of the Group Insurance Scheme should in the first instance be directed to the Federation. We will then investigate any complaint, identify the appropriate person to speak to and then either resolve the matter with that organisation and the Member or arrange for the appropriate organisation to resolve it directly with the Member. Therefore if you have any complaints about the Group Insurance Scheme please write, giving details of your complaint to: 4 The Secretary Dyfed Powys Police Federation Federation Office P O Box 99 Llangunnor, Carmarthen SA31 2PF.LEGAL EXPENSES INSURANCE This policy provides a full telephone legal advice service for any legal matters and will also provide cover for Legal costs arising out of the following: A The Defence of Criminal Prosecutions including motoring offences (not parking) B The Defence or pursuit of Civil claims in respect of Goods or Services bought or sold C The pursuit of motor uninsured loss recovery D Employment disputes involving any Insured person other than the subscribing officer E Personal Injury Claims for spouse/partner or family. (NB Federated Officers are covered to pursue Personal Injury Claims by the Police Federation in certain circumstances F Pursuit or defence of claims relating to the peaceful occupation of the home G Pursuit of claims for damage to personal property H Defence of claims brought under the Data Protection Act I Defence of claims brought under the Sexual Discrimination or Race Relations Acts LIMIT PER CLAIM 50,000 PERSONS COVERED: (a) The subscribing Officer (b) His or her spouse/permanent partner (c) Children under 21 if normally resident with subscribing Officer (d) Parents of the Officer or spouse/partner if normally resident with subscribing officer To obtain advice or make a claim, please telephone First Assist on and quote Reference Number A more comprehensive policy wording is available should you require it. Please contact the Federation Office Insurer: First Assist What are the significant features and benefits of this policy? The Legal Expenses Insurance provides cover for you for legal fees incurred in a wide range of personal legal disputes. Some examples of disputes that could be covered under the policy are: Defending you against prosecution in a court of criminal jurisdiction Legal costs for your defence of proceedings brought against you as a result of a breach of road traffic regulations relating to your vehicle. We will also cover legal costs up to 2,500 in representing you following the seizure of your vehicle by the police as a result of incorrect information being held about you to the Motor Insurance Database. Taxation disputes where HM Revenue & Customs may investigate your personal tax affairs in a full enquiry and you need to employ the services of an accountant to represent you. Defending an allegation of an act or omission occurring as a result of your being a trustee of a fund set by your employer Legal Expenses incurred in respect of your representation at a public enquiry ordered by a District Auditor Representation of civilian staff that are members of the federation in an investigation set up by the Independent Police Complaints Commission Costs of defending you against alleged infringements of the Race Relations Act 1976 or Sex Discrimination Act Employment disputes between a family member and their employer over unfair dismissal, sex or race discrimination at work or breaches of their existing employment contract. 9

5 HALF PAY INSURANCE In the event of any Serving Officer who is a Member of the Scheme being off work as a result of accident or sickness and reduced to Half Pay, for a qualifying period of more than 6 months in any 12 month period, a benefit of per week will be payable. This weekly benefit will be paid for a maximum of 26 weeks after the qualifying period. Payment will cease before 26 weeks if the Member returns to work, returns to full pay or leaves the Force. The policy provides cover for you against accidental bodily injury or sickness which results in disablement entirely preventing you from following your usual occupation and where your pay is reduced for a qualifying period of more than 6 months in any 12 month period in accordance with Police Pay Regulations. A benefit of 100 per week will be payable for a maximum of 26 weeks after the qualifying period. Payment will cease before 26 weeks if the Member returns to work, returns to full pay or leaves the Force. The Policy excludes: Policy Conditions: Hazardous Pursuits Self-inflicted injuries Pregnancy and childbirth War Risks Claims after the member has already received 26 weeks benefit unless they have resumed full police duties for 6 months in a 12 month period after the last claim finished. Cover ceases if you to be a serving member of Dyfed Powys Police, or you stop paying your premiums, or at your 65th birthday, whichever is earlier. You must tell us of any secondment outside the European Union or career break as this may affect your cover. Any weekly benefit paid must be refunded if the member is reinstated back onto full pay. Claims must be notified within 60 days of the date the member s pay is reduced to half pay. The member must be permanently resident in the United Kingdom. LIFE INSURANCE The Scheme is open to all Serving and Retired Officers and Support Staff. Serving Officers and Support Staff who join the Scheme at the first opportunity can do so WITHOUT EVIDENCE OF HEALTH. Officers who wait will have to complete a Medical Questionnaire. The same situation applies to Spouse cover. In the event of Death, the Federation Office will require a Death Certificate or Coroners Report to provide to Insurers. Officers who are about to retire and want to continue cover must contact the Federation Office before retirement as they need to complete a simple Health Declaration. Spouse cover can also be continued in retirement but the Spouse must have been covered during the member s service and cannot be added after retirement. Provided that is approved by Insurers, cover in retirement is assured. The following Benefits apply: All Serving Officers 100,000 All Serving Police Staff 100,000 Retired Officers:- From Retirement Age to Age 59 years 60,000 From Age 60 years to Age 64 years 30,000 Spouse of a Serving Officer or Police Staff 50,000 Spouse of a Retired Officer under Age 60 years 40,000 Spouse of a Retired Officer aged 60 years to 64 years 20,000 Insurer: Lloyds Insurer: Aviva 8 5

6 TRAVEL INSURANCE The Policy contains Terms and Conditions that cannot be shortened and still retain their sense and validity. Therefore we will not attempt to do anything other than outline the salient points of the cover in this document. Please read the Policy, it is important that you understand all the Conditions, Limits and particularly the Exclusions. When you go on Holiday take a copy of the Policy and Schedule with you so that you know what to do if you need to make a claim. Cover applies to you and your spouse or permanent partner if you are both under 65 at the date the trip commences. It also includes all dependant children who are under 21 (at the date the trip commences) and in full-time education but only when travelling with the member or their partner. The Policy only covers trips of up to 30 days duration. It is possible this can be extended but you must do so in advance by speaking to our Brokers, Roland Smith Ltd. The Policy covers world-wide destinations, including UK. However, for cover to apply to UK Travel the holiday must include either an overnight stay and/or a flight. A 35 excess applies to most claims. All the other limits for Medical Expenses, Baggage, Valuables, Cash etc are shown in the enclosed Policy. For advice on cover, or to arrange extensions, please contact our Brokers, Roland Smith Ltd, on and ask for Dyfed Powys Police Travel Insurer: Aviva PERSONAL ACCIDENT INSURANCE The policy pays out if a Member suffers an Actual Bodily Injury resulting in one or more of the conditions shown in the Schedule of Benefits. The sum paid out is always a percentage of the Sum Insured which is: It is not possible to give full details of the Policy cover in this document but the most important conditions and exclusions are: This policy excludes: 1. Hazardous Pursuits 2. Wilfully self-inflicted injury 3. Pregnancy childbirth 4. War, whether declared or not You must report any bodily injury that may give rise to a claim to the Federation office within 6 months of the accident occurring. The Policy only covers Members resident in the UK. If you move and reside abroad permanently you must advise the Federation Office as the Policy can be extended to cover you whilst living abroad, on payment of an additional premium. Please note this cover only applies to Serving Officers and Support Staff and ceases on retirement from the Force. Insurer: Aviva Maximum Benefit 90,000 Accidental bodily injury resulting in: 1 Total and irrecoverable loss of all sight in one or both eyes rendering the Insured person absolutely blind in the eye or eyes beyond remedy by surgical or other treatment 2 Total loss by physical severance or complete and irrecoverable loss of use of : Percentage of the Maximum Benefit (a) either one or both hands and/or one or both feet 100 Left Right (b) one thumb (c) one forefinger (d) any other finger (e) one big toe (f) any other toe Permanent disablement as described below (a) permanent total disablement (other than loss of sight or limbs) entirely preventing the Insured Person from engaging in or giving attention to any and every profession or occupation. (b) complete and incurable (i) paralysis (ii) insanity SCHEDULE OF BEBEFITS (c) complete and irrecoverable loss of hearing (i) in one ear (ii) in both ears (d) complete and irrecoverable loss of speech (e) permanent and total loss of use of shoulder or elbow (f) permanent and total loss of use of wrist (g) permanent and total loss of use of hip, knee or ankle (h) shortening of either one or both legs by at least 5 centimetres (i) loss of osseous substance of the skull in all its thickness: - surface of at least 6 square centimetres - surface of at least 3 sq centimetres but under 6 sq centimetres - surface of less than 3 square centimetres (j) removal of lower jaw by surgical operation (k) fractured leg or knee cap with established non-union (l) Permanent total loss of lens of one eye All occurring within 24 months of bodily injury from which the claim arises 4 Sickness resulting in total and irrecoverable loss of all sight (a) in one eye (b) in both eyes as a result of disease originating during the currency of the policy and occurring while the policy is in force or within 12 months after the expiry date. 100 RS0739A Jul