A revolution in mortgage protection. Meet Mimi Adviser Guide

Transcription

1 A revolution in mortgage protection Meet Mimi Adviser Guide

2 This guide explains: Page No. Introducing MIMI 2 Section A: Types of cover available 1 Mortgage related cover 3 2 Non-mortgage related cover 6 3 Definition of incapacity 6 Section B: What cover can we provide to your clients? 1 Eligibility 8 2 Minimum and maximum terms 8 3 Minimum and maximum sums assured 8 4 Maximum benefit payable at claim 9 5 Definition of income 9 6 Lives covered 9 7 Premiums 9 Section C Flexibility and dealing with changing circumstances 1 Flexibility 10 2 Guaranteed insurability options 10 Section D Exclusions and limitations 1 Exclusions 12 2 World-wide cover 12 Section E Underwriting 1 Financial underwriting 13 2 Medical evidence and underwriting 13 3 Medical examination or paramedical screening 15 4 Pre-underwriting cover 15 Section F General information 1 IFA-client relationship Our promise to you 16 2 Taxation 16 3 Assignments and trusts 16 4 Premium rates and documentation 16 5 Mortgage Payment Protection Unemployment 16 Section G Critical illnesses defined 17 Section H Occupation rate class guide 24 Liverpool Victoria s Mimi 1

3 Introducing MIMI MIMI is a revolutionary protection plan, designed to pay off your client s residential mortgage on death or critical illness, and to meet their monthly payments in the case of redundancy or disability. It is a flexible policy made up of Life Protection, Critical Illness Protection, Mortgage Payment Protection Health, Integrated Health and Unemployment cover. MIMI is a comprehensive plan, offering your clients complete peace of mind, so that however their lives may change, their mortgage will be protected. Your clients can choose from the full range of options available and change them, or add to them as their circumstances change. The types of cover available are: Life Protection (including terminal illness cover) Stand Alone Critical Illness Protection (three versions available) Combined Life and Critical Illness Protection (three versions available) Stand Alone Mortgage Payment Protection Health Mortgage Payment Protection Integrated Health Mortgage Payment Protection Unemployment Waiver of Premium In addition Life, Critical Illness and Income Protection cover for requirements beyond the mortgage amount can be selected. The following sections give a concise, technical explanation of the Flexible Mortgage Protection Plan MIMI to provide an invaluable reference for you when dealing with your clients. 2 Liverpool Victoria s Mimi

4 Types of cover available A. Types of cover available 1. Mortgage related cover Life Protection The sum assured is payable on death or on diagnosis of a terminal illness within the term of the plan. Terminal illness is defined as an advanced or rapidly progressing incurable illness where, in the opinion of an attending consultant and the Chief Medical Officer of the Company, life expectancy is no greater than 12 months, or the remaining term of the cover if this is less. Level and decreasing cover is available to pay off some or all of the outstanding balance of the mortgage. A decreasing policy will cover a maximum mortgage interest rate of 12% per annum and for these policies we pay a guaranteed minimum benefit regardless of whether a mortgage is in force or not. This is based on a mortgage interest rate of 7.5% per annum. Critical Illness Protection There are three versions of critical illness protection available and these are: 1 Critical Illness Protection including Permanent Total Disability Cover 2 Critical Illness Protection excluding Permanent Total Disability Cover 3 Permanent Total Disability Cover only. Your client may only select one of these versions of critical illness protection and this will apply for both lives for all critical illness benefits in this plan. If they select option 1 we will pay a cash sum if they are diagnosed as having one of 30 defined illnesses and conditions or as being permanently and totally disabled. If they select option 2 we will pay an agreed cash sum if they are diagnosed as having one of the 30 defined illnesses and conditions. If they select option 3, we will pay a cash sum if they are diagnosed as being permanently and totally disabled. See page 15 for definitions of critical illness conditions covered and Permanent Total Disability. There are two different definitions for Permanent Total Disability and the definition used will depend on your client s age and occupation. Up to age 65 either the own occupation or work tasks definition will apply according to their occupation. After age 65, the work tasks definition will apply. Combined Life and Critical Illness Protection can also be chosen and this will make one payment only, either on death or on earlier diagnosis of a critical illness. If Critical Illness Protection is chosen in the plan, the benefit will only be paid if your client survives 14 days after the critical illness is first diagnosed or the surgical procedure takes place. This does not apply to Combined Life and Critical Illness Protection. Level and decreasing Critical Illness and Combined Life and Critical Illness Protection is available to pay off some or all of the outstanding balance of the mortgage. A decreasing policy will cover a maximum mortgage interest rate of 12% per annum and for these policies we pay a guaranteed minimum benefit regardless of whether a mortgage is in force or not. This is based on a mortgage interest rate of 7.5% per annum. All of your clients children aged from 30 days up to their 18th birthday will be covered for 50% of the initial Critical Illness Protection amount up to a maximum of 25,000, for a reduced range of critical illness conditions (the policy document defines eligibility and the cover provided). Liverpool Victoria s Mimi 3

5 List of critical illnesses covered A full explanation of policy conditions and plain English definitions is available in Section G. Alzheimer s disease (including senile and presenile dementia) Angioplasty Aorta graft surgery Aplastic anaemia Bacterial meningitis Benign brain tumour Blindness Cancer Coma Coronary artery bypass surgery Creutzfeldt-Jakob disease Deafness Heart attack Heart valve replacement or repair HIV assault HIV blood transfusion HIV occupation Kidney failure Loss of independent existence Loss of limbs Loss of speech Major organ transplant Motor neurone disease Multiple sclerosis Paralysis/paraplegia Rheumatoid arthritis Stroke Terminal illness Third degree burns Plus Permanent total disability (Note Wordings in respect of core illnesses (shown in bold) and certain additional definitions conform to the ABI Best Practice Note in respect of critical illness.) Buyback option If your client takes out Combined Life and Critical Illness Protection, they may select the buyback option. This will reinstate their life cover in full, 12 months after the date of diagnosis of the critical illness, using rates applicable to their age at the time of reinstatement. A small additional premium will be charged for this option. Mortgage Payment Protection Mortgage Payment Protection Health or Integrated Health and Unemployment cover can be combined to provide cover that meets the ABI/CML baseline criteria for Mortgage Payment Protection Insurance, but with the added benefit of a longer payment period for disability claims. There are three different types of Mortgage Payment Protection: Mortgage Payment Protection Integrated Health This benefit is designed to meet your client s monthly mortgage payments if they are incapacitated for longer than their chosen deferred period (1, 2, 3, 6,12 or 24 months). The definition of incapacity is based on your client s occupation. The definition will change if cover goes beyond age 65. See page 6 for full definitions of incapacity. Parkinson s disease 4 Liverpool Victoria s Mimi

6 It provides a monthly benefit if your client is unable to work due to sickness or accident. It is a cover which makes health protection more affordable by eliminating the overlap between this cover and Critical Illness Protection offering a discount of up to 25% on our ordinary income protection rates. It can therefore only be selected if your client has also selected Critical Illness Protection or Combined Life and Critical Illness Protection for the same life or lives assured. The Mortgage Payment Protection Integrated Health cover will stop, and any benefit payments will cease, if a critical illness claim is paid under the plan. The amount of the Critical Illness or Combined Life and Critical Illness Protection must cover the full amount of the mortgage and the term of the cover must at least equal the term of the Integrated Health cover. The total amount of this benefit must not exceed 140% of the amount of the monthly mortgage payment at the outset of the plan and the term of the cover must not exceed the term of the mortgage. Benefits in excess of 1,500 a month may be limited in relation to your client s income. For further details, see page 9. Mortgage Payment Protection Health This cover is the same as Mortgage Payment Protection Integrated Health except that it is a stand alone insurance against incapacity due to sickness or accident. For this cover to be selected, it is not necessary for any Critical Illness Protection to be included in the plan and the payment of any critical illness claim under the plan will not affect the payment of any Mortgage Payment Protection Health benefits. Your clients can choose between: full cover benefits continue until they have recovered, died or until the end of the term of the cover, if earlier budget cover benefits continue until they have recovered, died or until the end of the term of the cover subject to a maximum of 24 months for any one claim. Once 24 month s benefit has been paid, no further claims are allowed for the same or related condition until your client has been back at work full-time and continuously for at least six months. Mortgage Payment Protection Unemployment For this plan Unemployment is defined as: Your client being the subject of involuntary unemployment and being registered for work at an Employment Service Job Centre and receiving either Job Seeker s Allowance or National Insurance Credits. A regular monthly benefit will be paid for a maximum of 12 months for any one claim and 36 months in total for the period of the agreement if your client becomes involuntarily unemployed for more than their selected deferred period of either 30 or 60 days. The total amount of Unemployment cover must not exceed 140% of the amount of the mortgage repayment at outset, up to a maximum of 1,500 a month. In addition, benefit may not exceed 60% of gross monthly income. For a claim to be paid, your client must have been in continuous permanent employment, or self-employed, for at least 6 months immediately before unemployment occurs. Liverpool Victoria s Mimi 5

7 No claim can be made within the first 60 days of cover if a new mortgage or loan is taken out at the same time, or within 120 days for an existing mortgage. Standard employment related exclusions apply (see page 12). If your client has a fixed term contract with more than 12 months of the term remaining, it will be possible to select Unemployment cover however, a claim will only be paid in particular circumstances. Please refer to the Company for full details. 2. Non-mortgage Related Cover Where cover beyond the mortgage amount is required, Life and Critical Illness Protection are available on the same basis as described on page 3. It is also possible to select Income Protection cover as below. Income protection A regular monthly income will be paid to your client after their chosen deferred period (1, 2, 3, 6,12 or 24 months) if they are incapacitated due to sickness or accident. The definition of incapacity is based on your client s occupation and age when the cover is taken out. Your client can choose to have their cover indexlinked which means that the benefits and premiums will increase each year in line with the Retail Price Index (subject to a maximum of 12% a year during a claim). Your client can choose between: full cover benefits continue until they have recovered, died or until the end of the term of the cover, if earlier budget cover benefits continue until they have recovered, died or until the end of the term of the cover subject to a maximum of 24 months for any one claim. Once 24 months benefit has been paid, no further claims are allowed for the same or related condition until your client has been back at work full-time and continuously for at least six months. Waiver of Premium Your client can include Waiver of Premium which means that if they become incapacitated for longer than their chosen deferred period (1, 2, 3 or 6 months), premiums for all aspects of cover under the MIMI plan will be paid on their behalf. The premiums will continue to be paid while they remain incapacitated, until their plan terminates or until they reach the age of 65, whichever is earliest. Your client can select at outset to extend their cover beyond age 65, in which case the revised definition of incapacity will apply as detailed below. 3. Definition of Incapacity Up to age 65 Incapacitated means that because of sickness or accident your client is totally unable to carry out the essential duties of their normal occupation and they are not doing any other work. Essential duties are those duties which cannot reasonably be omitted without affecting their ability to carry out their normal occupation. If they are unemployed at the start of a period of incapacity, then by incapacity we mean that because of sickness or accident they are unable to go out of doors without help. Some occupations have special definitions of incapacity which will be provided at quotation stage. 6 Liverpool Victoria s Mimi

8 After age 65 For Mortgage Payment Protection Health, Integrated Health and Waiver of Premium covers, a different definition of incapacity will apply after age 65 as follows. Incapacity means that the life assured is unable to carry out at least three of the following activities without the help of another person but with the use of appropriate aids or assistive devices. Walking The ability to walk a distance of 200 metres on flat ground (with the use of a walking stick or other aid if necessary) without stopping. Climbing The ability to walk up or down a flight of 12 stairs (with the use of a handrail) without stopping. Communicating The ability to answer the telephone and take a simple message. Eyesight Having eyesight (after correction by spectacles or contact lenses if necessary) sufficient to read a standard daily newspaper or to pass the standard eyesight test for driving. Dexterity The physical ability to use a pen, pencil or keyboard. Healthcare The ability to make arrangements to see a doctor and take regular medication as prescribed. Financial Independence The ability to recognise the transactional value of money and the handling of routine financial transactions. Bending The ability to bend or kneel to pick up something from the floor and stand up again. Liverpool Victoria s Mimi 7

9 What cover can we provide to your clients? B. What cover can we provide to your clients? 1. Eligibility The plan will only be available to UK residents. It will not be available in the Channel Islands or the Isle of Man. The minimum and maximum attained age at entry and expiry for each type of cover is as follows: Min. Max. Entry Entry Expiry Life Protection Critical Illness Protection Combined Life and Critical Illness Mortgage Payment Protection Health and Integrated Health Mortgage Payment Protection Unemployment Income Protection Waiver of Premium Minimum and maximum terms The minimum term is 5 years and the maximum is 45 years apart from Income Protection which may be longer but which must cease at age 65. All covers except Income Protection may only be written for a fixed term of years. Income Protection may only be written to a specified expiry age between 50 and 65 (or 60 for some occupations). For unemployment cover a fixed term of years can be chosen at outset, although the cover is renewable monthly. 3. Minimum and maximum sums assured For Life Protection and Critical Illness Protection, minimum and maximum limits are not applied. Different sums assured may be effected for Critical Illness Protection and Life Protection. For Income Protection, maximum monthly benefits are based on income before incapacity (see page 9). For Mortgage Payment Protection Health and Integrated Health benefits up to 1,500 per month will not be limited in relation to income. For Income Protection and Mortgage Payment Protection Health and Integrated Health the minimum and maximum benefits for which your client may apply are as follows: Occupation class 1 and per month minimum 6,800 per month maximum 5,200 per month maximum index-linked (Income Protection only) 3,250 per month maximum beyond age 60 1,500 per month maximum beyond age 65 (Mortgage Payment Protection Health or Integrated Health only) Occupation class 3 and per month minimum 3,250 per month maximum 2,600 per month maximum index-linked (Income Protection only) 1,500 per month maximum beyond age 60 (Mortgage Payment Protection Health or Integrated Health only) For Mortgage Payment Protection Unemployment, your client may apply for a minimum of 100 a month and a maximum of 1,500 a month benefit. 8 Liverpool Victoria s Mimi

10 4. Maximum benefit payable at claim In the event of a claim for Mortgage Payment Protection Health or Integrated Health, other insurances which have been taken to cover the mortgage repayment (including any unemployment cover if payable at the same time) will be taken into account. If the total of all such benefits exceeds 140% of the mortgage repayment at outset (or at the start of incapacity if this is higher) then benefit under the plan will be reduced accordingly. In the event of a claim for Mortgage Payment Protection Health or Integrated Health benefits in excess of 1,500 a month, or any claim for Income Protection, benefits will be limited in relation to income, as follows. The maximum benefit payable is 50% of earned income LESS any other sickness and accident insurance including waiver of premium (for net personal pension contributions greater than 10% of relevant earnings) and credit protection insurance. 60% of any ill health or retirement pension 60% of any continuing income from employment 5. Definition of Income For the purpose of calculating maximum benefits, income means gross earned income less any amount allowable against income tax as expenses. 6. Lives covered A combination of single life and joint life covers can be effected for all elements in this plan except Income Protection and Unemployment cover which are available on a single life basis only. Cover is not available on a life of another basis. 7. Premiums There is a 7 per month minimum premium for the plan. Premiums must be paid by direct debit. Premiums for Mortgage Payment Protection Unemployment will be renewable at 30 days notice. For all other covers except Life Protection, your client can choose reviewable or guaranteed premiums. A different choice can be made for different covers within the same plan. Reviewable premiums are guaranteed for the first 5 years but may be reviewed at any time after that. If changed, premium rates may not be changed again for a further 12 months. Premium increases on index-linked Income Protection cover will be proportionate to increases in benefit. PLUS if your client is not eligible to receive State benefits during incapacity, the amount of the basic State Long Term Incapacity Benefit. Liverpool Victoria s Mimi 9

11 Flexibility and dealing with changing circumstances C. Flexibility and dealing with changing circumstances 1. Flexibility The MIMI Plan offers your clients the flexibility to be able to make the following changes to their cover as their requirements change: add or remove an element of cover, for example, adding Life Protection to existing Critical Illness Protection increase or decrease the benefit level on any element of cover if, for instance, they change their mortgage amount extend or shorten the term on any element of cover add a life to the plan if, for example, they marry or switch to a joint life mortgage, or remove a life change from a level cash sum benefit to decreasing benefit or vice versa, or choose a combination of level and decreasing cover, depending on whether the mortgage is repayment, interest only or a mix of both change from reviewable to guaranteed premiums where applicable, or vice versa change deferred period on Mortgage Payment Protection Health, Income Protection or Waiver of Premium cover if, for instance, their sick pay arrangements at work change change the version of Critical Illness Protection change Mortgage Payment Protection Health from full to budget cover, or vice versa change Mortgage Payment Protection Health to Integrated Health and vice versa (subject to certain conditions). Your client will need to provide satisfactory evidence of good health for some alterations listed above. Any alteration will be subject to the rules on minimum premiums, and minimum/maximum ages, terms and sums assured, which apply at the time. The following restrictions apply to the choice of benefits: all covers except Mortgage Payment Protection Unemployment can be taken in isolation, however, an existing plan can continue if all covers other than Unemployment Cover are cancelled unless they are cancelled from inception Critical Illness Protection (sufficient to pay off the full amount of your client s mortgage) is also required where Mortgage Payment Protection Integrated Health cover is selected there are three versions of Critical Illness Protection and the same version will apply to each life and to all critical illness benefits in the plan no more than two lives can be included in a plan, however, your client can take some benefits on a single life basis and others on joint life basis. 2. Guaranteed Insurability Options Unless your client is told otherwise when their application is considered, they will automatically benefit from certain guaranteed insurability options where no medical evidence will be required. Life Protection & Critical Illness Protection up to a maximum age of 50 the individual can 10 Liverpool Victoria s Mimi

12 increase their existing cash sum covers by up to 100% of the original benefit (subject to an overall maximum of 200,000) within three months of: marriage birth or adoption of a child increase of mortgage on moving house or home improvements. Life Protection can also be added to existing stand alone Critical Illness Protection within three months of marriage or birth or adoption of a child. This is available only if the critical illness protection was accepted on standard terms. The increase in cover may not exceed 140% of the increase in mortgage repayment and the total Mortgage Payment Protection cover in force may not exceed 140% of the new monthly mortgage payment. This option may not be taken if the life assured is incapacitated at the time or if we are paying Mortgage Payment Protection benefit. The premium for any increase in cover will be based on the rate which applies for the insured s age at the time. Mortgage Payment Protection Health and Integrated Health up to a maximum age of 50, the individual can increase their existing Mortgage Payment Protection by up to 100% of the original benefit (subject to a maximum of 700 per month) within three months of increasing their mortgage on moving or to undertake home improvements. Liverpool Victoria s Mimi 11

13 Exclusions and limitations D. Exclusions and Limitations 1. Exclusions There are no exclusions for Life Protection, Critical Illness Protection and Waiver of Premium benefits and HIV is the only exclusion for Mortgage Payment Protection Health, Integrated Health and Income Protection. However, we will cover accidental infection with HIV in the course of the insured s normal occupation in the UK, provided certain procedures for infection arising in this way are followed. Your client will not be able to claim unemployment benefits if unemployment occurs or is notified within 120 days of completing the application form (for existing mortgages) or 60 days (for new mortgages) unemployment is voluntary or due to misconduct, fraud or dishonesty they are employed by a family close company unemployment occurs as a result of a strike or labour dispute they refuse any offer of alternative reasonable employment made by the employer they have reached the statutory retirement age for their occupation If your client fails to give adequate proof of status for the claim, then it will not be accepted. 2. World-wide cover Your client is covered if they fall ill or suffer an accident anywhere in the world, although monthly benefit payments are made only while they reside in the UK, North America, Australasia and most countries in Europe. A lump sum for Critical Illness Protection can only be paid if we receive satisfactory evidence of the claim from a medical attendant in one of these areas. For an unemployment cover claim to be payable the policyholder must be resident in the UK. unemployment is a recurrent feature of their occupation they are employed on a temporary basis they are required under their contract of employment to work outside the UK for more than 12 weeks in any 52 week period (other than an assignment by a UK company to work in the EC, or working for the British Armed Forces or in a British Embassy) 12 Liverpool Victoria s Mimi

14 Underwriting E: Underwriting 1. Financial underwriting In all cases we will consider whether the total amount of cover is reasonable to the circumstances of the individual. Life Protection sums assured of 500,000 or less (or 300,000 or less for Critical Illness Protection) can normally be covered without further financial evidence. Those who require a higher amount of lump sum cover will be asked to complete a Personal Cover questionnaire. 2. Medical evidence and underwriting The key for all of these tables can be found on page 14. Life Protection and Permanent Total Disability only cover under Critical Illness Protection Medical evidence requirements, based on sum insured, up to 1m AGE PSR GPR MER HIV ECG Up to , , ,001 SM 300,001 AM 1,000,001 F 1,000, , , ,001 as above , , ,001 as above , , ,001 as above , , ,001 as above , , ,001 Over 65 75, , , ,001 Life Protection Additional medical evidence requirements for sums insured in excess of 1m Sum Insured To age Over 55 1,000,001 *see note below *see note below Exercise ECG** 2,500,000 inc 2,500,001 *see note below Exercise ECG** 5,000,000 inc Fasting Blood Profile Chest X-ray for smokers only Over 5,000,000 MER Recognised Examiner of Consultant status Exercise ECG** Fasting Blood Profile Microscopic Urinalysis Chest X-ray for smokers only *Note Where there is a combination of risk factors (family history of coronary heart disease, smoking, hypertension, high cholesterol or overweight) there might be a need to obtain Exercise ECG and/or Fasting Blood Profile. Refer to Underwriters. **Exercise ECG includes a resting ECG. Liverpool Victoria s Mimi 13

15 Critical Illness Protection Medical Evidence Retirements AGE GPR PSR HIV ME/ECG/PROF XCG/MSU/PFTs Up to , ,001 SM 300, ,001 1,500,001 M/F 500, , ,001 as above 500,001 1,000, , ,001 as above 500,001 1,000, , ,001 as above 350, , , ,001 as above 350, ,001 Over 60 50,001 75,001 N/A 300, ,001 Income Protection and MPP Health and Integrated Health Medical Evidence Retirements Rate Class 1 and 2 ATTAINED AGE GPR PSR MER & PROF ECG Up to 40 1,951 2,817 5,201 N/A* ,734 2,167 5,201 N/A* ,517 1,951 5,201 N/A* ,084 1,517 5,201 5, ,084 5,201 5,201 *ECG not required unless there are coronary risk factors on application eg family history, overweight, smoking, high blood pressure or high cholesterol. Rate Class 3 and 4 ATTAINED AGE GPR PSR MER Up to 40 1,301 1,734 2, ,084 1,517 2, ,301 1, ,084 1,517 Key: HIV SM HIV Test single males (inc separated and divorced) HIV AM/F HIV Test all married males, widowers and females GPR General Practioner s Report PSR Paramedical Screening Report MER Medical Examination Report ECG Resting ECG XCG Exercise ECG (includes a resting ECG) PROF Blood Profile (biochemistry and haematology). PROF to also include a PSA for males. PSA = Prostate Specific Antigen MSU Microscopic Urinalysis PFTs Pulmonary Function Tests (inc peak flow, FEV1 and FVC). FEV1 = Forced Expiratory Volume in 1 second. FVC = Forced Vital Capacity. 14 Liverpool Victoria s Mimi

16 3. Medical examination or paramedical screening Medical examinations will be arranged with doctors from our panel. Applicants are asked to state the most convenient location. Paramedical screening is undertaken by nurses who will visit the applicant at home or at work. The nurse will telephone the applicant to make an appointment. We will write directly to the applicant to ensure that there is no delay. A copy will be sent to you and we will not otherwise communicate with your client. 4. Pre-underwriting cover Full pre-underwriting cover will be available to eligible lives in respect of mortgage related Life Protection and Critical Illness Protection benefits only provided they have asked for immediate cover and enclosed a signed direct debit. The amount of cover will be the amount of cover applied for subject to a maximum of 500,000 for Life Protection or 300,000 for Critical Illness Protection. Eligible lives are those under age 55 at the date the application is received where the applicant has answered no to all the medical questions in the application form (or, in the underwriter's opinion, any disclosure made would not affect the issuing of standard terms or require any further medical evidence). The life assured's height and weight, habits and family history must be acceptable such as not to prompt any further medical evidence, and the occupation must be one which would not attract a rating for Life or Critical Illness Protection. Pre-underwriting cover will end on the earliest of the commencement date of the policy five days after non-standard acceptance terms are sent the date of withdrawal or postponement of the application the date of declinature of the application 30 days after receipt of the application the admission of a claim in respect of this cover. No charge will be made for the period of preunderwriting cover. Premiums will be due with effect from the commencement date of the plan. Pre-underwriting cover is subject to the normal terms regarding validity of cover and the consequences of any failure to give correct answers to the questions in the application form. No claim will be paid under the pre-underwriting cover if the death, injury or permanent total disability of the life assured is as a result of suicide, attempted suicide or self-inflicted injury. Lives who are not eligible for full pre-underwriting cover, or who have applied for non-mortgage related cover, but who have asked for immediate cover and enclosed a signed direct debit, will be covered for accidental or sudden death, in respect of Life Protection benefits only. The death benefit will be equal to the amount of Life Protection cover applied for subject to a maximum of 500,000. We will exclude death caused by or related to any medical condition for which the insured has had tests or treatment in the two years prior to receipt of the application. Death by suicide is also excluded. Accidental or sudden death cover will end on the earliest of the commencement date of the policy 10 days after acceptance terms are offered the date of withdrawal or postponement of the application the date of declinature of the application 60 days after receipt of the application the admission of a claim in respect of this cover. No charge will be made for this cover. Premiums will be due with effect from the date that we assume full risk. Liverpool Victoria s Mimi 15

17 General information F. General information 1. IFA-Client relationship Our promise to you We will not cross-sell to your clients and you can be confident that our data will not be used for any cross-selling purposes. It is important that your clients are aware of the information held by us, so we will return a photocopy of the application when we issue the policy. Other than this service and any ongoing information we have to give, such as for indexlinked updates and options, you will find that we do not approach your clients directly as we feel that the client/adviser relationship should be respected at all times. 2. Taxation Premiums paid by individuals are not allowable as an expense for tax purposes. Benefits paid are free of income and capital gains tax. Life Protection benefit may form part of an estate and be subject to inheritance tax. 3. Assignments and trusts Life and Critical Illness policies within the plan may be assigned or written under trust. Other policies in the plan are not assignable and may not be written under trust. 4. Premium rates and documentation We offer competitive premium rates across the range of our contracts. A same day quotation service is available from our Call Centre, who will also provide application forms, specimen policies and any other associated documentation. In addition, the Company s policies are quoted on the Exchange. 5. Mortgage Payment Protection Unemployment This is provided by Sterling Insurance Company Ltd whose registered office is at Whittaker House, 2 Whittaker Avenue, Richmond-upon-Thames TW9 1EH and which is limited by shares and incorporated in England. Sterling Insurance is a member of the General Insurance Standards Council (GISC). We have arranged this insurance as agent for Sterling Insurance and will keep to the GISC Code of Practice for selling general insurance. If Sterling Insurance stops offering this type of cover, we will do everything possible to find another provider for unemployment benefit. If this has happened, the conditions could be different to those arranged through Sterling Insurance. 16 Liverpool Victoria s Mimi

18 Critical illnesses defined G: Critical illnesses defined Plain English Wherever possible we have given a plain English explanation after the policy condition. This is to aid understanding of the sometimes complex nature of the wordings. The policy condition is always the full definition and all other text is intended as a helpful guide. 1. Alzheimer s disease (including pre-senile and senile dementia) A clinically established diagnosis of Alzheimer s disease (pre-senile dementia) resulting in the inability to perform independently at least three of the following activities of daily living. Transfer and mobility The ability to move from one room to an adjoining room or from one side of a room to another or to get in and out of a bed or chair without requiring physical assistance of another person Continence The ability to voluntarily control bowel and bladder functions such as to maintain personal hygiene Dressing Putting on and taking off all necessary items of clothing without requiring assistance of another person Toileting Getting to and from the toilet, transferring on and off the toilet and associated personal hygiene Eating All tasks of getting food into the body once it has been prepared Alzheimer s disease is a progressive form of dementia associated with degeneration of the brain cells from an unknown cause. 2. Angioplasty The actual undergoing of angioplasty, atherectomy or laser treatment for coronary artery disease to correct significant stenoses of at least 50% in each of two or more coronary arteries, following an unequivocal recommendation by a consultant cardiologist. Angiographic evidence of underlying disease must be provided. When coronary arteries become narrowed they cannot supply enough blood to the heart. To correct this, angioplasty can be used by inflating a fine balloon catheter (a flexible plastic tube which is inserted into the body) in the area of the blocked coronary artery. This forces the walls of the artery apart to improve the blood flow. 'Atherectomy' and 'laser' treatment are variants of angioplasty techniques. You will be able to claim if the treatment is to correct a 50% narrowing of at least two coronary arteries. Single vessel blockage is not covered. 3. Aorta graft surgery Undergoing surgery for disease of the aorta needing excision and surgical replacement of a portion of the diseased aorta with a graft. For this definition aorta means the thoracic and abdominal aorta but not its branches. The aorta is the main artery that supplies oxygenated blood to all other parts of the body. Sometimes, part of the aorta becomes blocked or weak and may need replacing. You will be able to claim if you need surgery to remove and replace part or all of the aorta. Liverpool Victoria s Mimi 17

19 4. Aplastic anaemia Confirmation by a consultant haematologist of a definite diagnosis of complete bone marrow failure necessitating regular blood transfusions. The bone marrow failure must result in anaemia, neutropaenia and thrombocytopaenia. Aplastic anaemia is a severe form of anaemia in which the bone marrow fails to produce any new blood cells. Treatment is usually blood transfusions or bone marrow transplant. Bone marrow transplant is covered separately under the major organ transplant definition. 5. Bacterial meningitis Confirmation by a consultant physician of a definite diagnosis of bacterial meningitis. Other forms of meningitis, including viral meningitis, are specifically excluded. 6. Benign brain tumour A non-malignant tumour in the brain resulting in permanent deficit to the neurological system. Tumours or lesions in the pituitary gland are not covered. We will cover benign brain tumours which have required surgical removal excluding cysts, malformations in, or of, the arteries or veins of the brain, haematomas and tumours in the pituitary gland. A benign tumour is not cancerous because it does not spread to the rest of the body but the pressure from such a tumour can be dangerous in the brain and may cause neurological damage or require surgery. Certain other growths and swellings are excluded because they are not likely to be life threatening. Permanent deficit to the neurological system means definite symptoms of damage to the central nervous system that are expected to last through the life assured's life, irrespective of when the cover ends or the life assured retires. These symptoms include numbness, hyperaesthaesia (increased sensitivity), paralysis, localised weakness, dysarthria (difficulty speaking), aphasia (inability to speak), dysphagia (difficulty swallowing), visual impairment, difficulty walking, incoordination, tremor, seizures, dementia, delirium or coma. It does not include findings on a scan alone without any residual physical or mental symptoms being present. 7. Blindness Total permanent and irreversible loss of all sight in both eyes. 8. Cancer A malignant tumour characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue. The term cancer includes leukaemia and Hodgkin s disease but the following are excluded: all tumours which are histologically described as pre-malignant, as non-invasive or as cancer in situ; all tumours of the prostate unless histologically classified as having a Gleason score greater than 6 or having progressed to at least TNM classification T2NOMO; all forms of lymphoma in the presence of any Human Immunodeficiency Virus; Kaposi s Sarcoma in the presence of any Human Immunodeficiency Virus; any skin cancer other than malignant melanoma. 18 Liverpool Victoria s Mimi

20 A claim can be made if the life assured is diagnosed as suffering from a malignant tumour which has invaded surrounding tissue unless it is one of the excluded tumours above. A microscopic examination of the cells will be required to confirm the claim. 9. Coma A state of unconsciousness with no reaction to external stimuli or internal needs, persisting continuously with the use of life-support systems for a period of at least 96 hours and resulting in permanent neurological deficit. Permanent deficit to the neurological system means definite symptoms of damage to the central nervous system that are expected to last through the life assured's life, irrespective of when the cover ends or the life assured retires. These symptoms include numbness, hyperaesthaesia (increased sensitivity), paralysis, localised weakness, dysarthria (difficulty speaking), aphasia (inability to speak), dysphagia (difficulty swallowing), visual impairment, difficulty walking, incoordination, tremor, seizures, dementia, delirium or coma. It does not include findings on a scan alone without any residual physical or mental symptoms being present. 10. Coronary artery bypass surgery The undergoing of open heart surgery on the advice of a consultant cardiologist to correct narrowing or blockage of one or more coronary arteries with by-pass grafts. When one or more coronary arteries become narrowed or blocked they cannot supply enough blood to the heart muscle. To correct this, coronary artery bypass surgery grafts a vein (usually taken from the thigh) to connect the two sections of artery either side of the blockage. A claim can be made if the life assured undergoes this surgery. Open heart surgery means a heart operation that requires the use of the 'cardiopulmonary bypass' or 'heart-lung machine' as it is also called. It does not include heart surgery performed without cardiopulmonary bypass. Balloon angioplasty, atherectomy or laser relief is covered under a separate definition. 11. Creutzfeldt-Jakob disease Confirmation by a consultant physician of a definite diagnosis of Creutzfeldt-Jakob disease. 12. Deafness Total permanent and irreversible loss of all hearing in both ears. 13. Heart attack The death of a portion of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence of acute myocardial infarction: Typical chest pain; New characteristic electrocardiographic changes; The characteristic rise of cardiac enzymes, troponins or other biochemical markers; Liverpool Victoria s Mimi 19

21 where all of the above shows a definite acute myocardial infarction. Other acute coronary syndromes, including but not limited to angina, are not covered under this definition. Heart attack, also known as myocardial infarction, occurs when part of the heart muscle dies from lack of oxygenated blood. Chest pain is usually felt at the time of the attack and ECG (electrocardiogram) changes will confirm the diagnosis. A damaged heart will also release enzymes into the bloodstream so a blood test will show the heart attack is recent. Angina is not covered by the policy as, although there is chest pain, there is no death of heart muscle. 14. Heart valve replacement or repair Undergoing open heart surgery from medical necessity to replace or repair one or more heart valves. There are four chambers in the heart and the blood flow within the heart and into the arteries is regulated by a series of valves. When a valve is diseased or damaged it may need to be replaced with an artificial one and such an operation will be covered by the policy. 15. HIV assault Infection with Human Immunodeficiency Virus after the commencement date stated in the benefit schedule provided the virus is acquired as a result of physical assault involving involuntary contact with either a hypodermic needle or an infected sharp instrument or sexual assault. The incident must have occurred in the UK and have been reported to the police within 7 days and investigated and documented according to established hospital procedures for dealing with such incidents. The life assured must have undergone a negative HIV test within 7 days of the incident and a further positive HIV test within 12 months. All blood tests must be carried out in the UK. Infection with the Human Immunodeficiency Virus is thought to lead to Acquired Immune Deficiency Syndrome for which there is currently no cure. The body s defence system breaks down leaving the individual open to infections and cancers that are invariably fatal. 16. HIV blood transfusion The life assured being infected by any Human Immunodeficiency Virus provided that the infection is due to a blood transfusion received in the UK after the commencement date stated in the benefit schedule. 17. HIV occupation Infection with Human Immunodeficiency Virus after the commencement date stated in the benefit schedule provided the virus is acquired as a result of accidental exposure during the course of the life assured's normal occupation in the UK involving needlestick injury, injury with a sharp instrument or mucous membrane exposure to blood or blood stained body fluid. The accident must have been reported, investigated and documented according to established hospital procedures for dealing with such incidents. The life assured must have undergone a negative HIV test within 7 days of the accident and a further positive HIV test within 12 months. All blood tests must be carried out in the UK. 18. Kidney failure End stage renal failure presenting as chronic irreversible failure of both kidneys to function, as a result of which either regular renal dialysis or renal transplant is initiated. The kidneys act as filters and remove wastes from the blood. When the kidneys fail to do this, waste builds up in the blood and leads to severe complications. Although it is possible to manage with one kidney, if both kidneys fail completely you will need long-term dialysis or a transplant. 20 Liverpool Victoria s Mimi

22 19. Loss of independent existence Confirmation by a consultant physician of loss of independent existence resulting in a permanent inability to perform at least three of the following activities of daily living either with or without the use of mechanical equipment, special devices or other aids and adaptations in use for disabled persons. For the purpose of this benefit the word 'permanent' shall mean beyond the hope of recovery with current medical knowledge and technology. The activities of daily living are: Transfer and mobility The ability to move from one room to an adjoining room or from one side of a room to another or to get in and out of a bed or chair without requiring physical assistance of another person. Continence The ability to voluntarily control bowel and bladder functions such as to maintain personal hygiene. Dressing Putting on and taking off all necessary items of clothing without requiring assistance of another person. Toileting Getting to and from the toilet, transferring on and off the toilet and associated personal hygiene. Eating All tasks of getting food into the body once it has been prepared. 20. Loss of limbs 21. Loss of speech Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease. 22. Major organ transplant The actual undergoing as a recipient of, or inclusion on an official UK waiting list for, a transplant of a heart, liver, lung, pancreas or bone marrow. Sometimes a major internal organ is so seriously diseased or damaged the only effective treatment is replacement with a healthy one. Kidney transplants are covered under a separate section. 23. Motor neurone disease Confirmation by a consultant neurologist of a definite diagnosis of motor neurone disease. This is a progressive degenerative disease of the nervous system. 24. Multiple sclerosis A definite diagnosis by a consultant neurologist of multiple sclerosis which satisfies all of the following criteria: There must be current impairment of motor sensory function, which must have persisted for a continuous period of at least six months The diagnosis must be confirmed by diagnostic techniques current at the time of the claim. The permanent physical severance of two or more limbs from above the ankle or wrist joint. Liverpool Victoria s Mimi 21

23 This is a progressive disease of the central nervous system where the protective covering (myelin) of the nerve fibres in the brain and spinal cord is destroyed. The severity of the disease and symptoms will depend on the areas of the brain or spinal cord affected. Periods of remission which may last many years between acute phases are characteristic of the disease. 25. Paralysis/paraplegia Total irreversible loss of muscle function or sensation to the whole of any two limbs as a result of injury or disease. The disability must be permanent and supported by appropriate neurological evidence. Paralysis is usually caused by damage to the brain or spinal cord affecting the transmission of messages through the nervous system or by physical injury to the limbs in question. 26. Parkinson s disease Confirmation by a consultant neurologist of a definite diagnosis of Parkinson s disease. A progressive disturbance of voluntary movement characterised by uncontrollable shuffling, unstable rigid gait and tremors. The condition usually runs a slowly progressive course with treatment providing some relief. 27. Rheumatoid arthritis Diagnosis of severe rheumatoid arthritis by a consultant rheumatologist. The diagnosis must confirm the following: morning stiffness swelling and pain in the joints of at least three joint groups, involving the corresponding joints on both sides of the body. One of these groups must be either joints on the fingers or toes, the knuckles of the hand or the wrists small nodular swellings beneath the skin a positive rheumatoid factor test x-ray evidence showing changes to joints typical of rheumatoid arthritis. When the membrane lining joints becomes inflamed, the swelling, pain and restricted movement can be quite severe. The areas usually affected are the hands, wrists and feet. 28. Stroke A cerebrovascular incident resulting in permanent neurological damage. Transient ischaemic attacks are specifically excluded. A stroke is an incident which affects the supply of blood to the brain causing permanent neurological damage such as paralysis or disturbance of speech or vision. Transient Ischaemic Attacks are excluded as they do not cause permanent damage and the symptoms do not last for more than 24 hours. Permanent neurological damage means definite symptoms of damage to the central nervous system that are expected to last through the life assured's life, irrespective of when the cover ends or the life assured retires. These symptoms include numbness, hyperaesthaesia (increased sensitivity), paralysis, localised weakness, dysarthria (difficulty speaking), aphasia (inability to speak), dysphagia (difficulty swallowing), visual impairment, difficulty walking, incoordination, tremor, seizures, dementia, delirium or coma. It does not include findings on a scan alone without any residual physical or mental symptoms being present. 22 Liverpool Victoria s Mimi