CREDITCARE BUSINESS Policy Wording

Transcription

1 CREDITCARE BUSINESS Policy Wording

2 CreditCare Business Policy Wording Part A: About this Policy Part B: Definitions Part C: What this Policy covers 1. Temporary Disablement cover in detail 2. Permanent Disablement cover in detail 3. Death cover in detail Part D: Other terms and conditions Part E: Exclusions Part F: How to make a claim

3 Your Policy Important This booklet contains the terms and conditions that apply to the CreditCare Business insurance policy. Together with the original application form and the Policy Schedule, it forms the basis of the contract between each covered Cardholder and the insurer, Cigna Life Insurance New Zealand Limited (Cigna). Please make sure that this Policy meets your requirements and if you have any questions or want further information do not hesitate to contact Cigna directly. If any Cardholder decides that they do not wish to continue with the Policy they must notify Cigna within 30 days of receiving it. Any premiums that have been paid will be refunded and Cigna will confirm in writing that the Policy has been cancelled. If the Policy is cancelled outside this 30 day period there will be no refund of premiums.

4 Part A: About this Policy This Policy is designed to help pay the BNZ Advantage Business Card account when a Cardholder cannot work as the result of an Illness or Injury, or if a Cardholder dies. Providing the premiums continue to be paid, the Policy will continue until the last Cardholder turns 100. However, once a Cardholder turns 65, their cover will be limited to death cover only. The Policy is underwritten by Cigna who will be responsible for all claims and other matters relating to this Policy. Cigna s contact details are on the back page of this booklet. All correspondence will be sent to the most recent address that Cigna holds on record for the Cardholder(s). If the address changes it is the Cardholders responsibility to notify Cigna. Meanings of important and frequently used words and terms are set out under Part B. Who offers this insurance? The Policy is underwritten by Cigna who will be responsible for all claims and other matters relating to this Policy. Bank of New Zealand (BNZ) receives a commission while this Policy remains active. BNZ and its related companies (as defined in the Companies Act 1993) do not guarantee the obligations of Cigna and will not be liable if Cigna refuses to pay a claim.

5 Part B: Definitions The following words and terms appear in the Policy Schedule and in the Policy Wording. They are defined as: Additional Cardholder means a BNZ Advantage Business Card account cardholder who is not liable for any debt incurred on that account. Anniversary Date means the date 12 months after the Cover Start Date and the same date every year after that. Cardholder means each BNZ Advantage Business Card account cardholder named on the Policy Schedule. This excludes Additional Cardholders. Cover Start Date means the date shown on the policy schedule and is the date that the cover began. BNZ Advantage Business Card account means the account shown on the Policy Schedule and is the BNZ Advantage Visa Business Card account maintained for you by BNZ. For the avoidance of doubt, references to BNZ Advantage Visa Business Card account shall (where the context requires) include any such account before 1 May 2015 (even if such account was branded under a different name). Illness means any sickness or disease which first occurs at least 14 days after the Cover Start Date. Injury means any bodily injury, occurring after the Cover Start Date, which is caused by violent, accidental, external and visible means. Paid Employment means a Cardholder is in paid work for a minimum of 20 hours per week, either in Self Employment or for another employer, immediately prior to a claim by that Cardholder. Permanent Disablement means a Cardholder is entirely prevented from engaging in work for 6 months in a row as a

6 result of an Injury or Illness and their disablement will, in all probability, prevent them from working in any occupation for which they are Reasonably Suited for the rest of their normal working life. Cigna s medical advisors must agree that the Cardholder is Permanently Disabled. Policy means the terms and conditions applying to this insurance, as described in the Policy Wording and the Policy Schedule. Pre-existing Condition means any injury, illness or degenerative condition existing or diagnosed or for which the Cardholder should reasonably have received medical advice or treatment at or prior to the Cover Start Date. Reasonably Suited means the type of work a Cardholder would be expected to do because of their education, training or experience. Self Employment means a Cardholder is employed by a business where they or their immediate family have direct or indirect control, or the Cardholder works for themself as a self-employed contractor, sole trader, partner in a partnership, or otherwise for remuneration for a minimum of 20 hours a week. Temporary Disablement means a Cardholder is entirely prevented, for 30 days in a row, as a result of an Injury or Illness, from working in any occupation for which they are Reasonably Suited. Cigna s medical advisors must agree that the Cardholder is Temporarily Disabled. Terrorism means the use or threatened use of force or violence against human life or property, or commission of an act dangerous to human life or property, or commission of an act that interferes with or disrupts an electronic or communication system,

7 undertaken by any person or group, whether or not acting on behalf of or in any connection with any organisation, government power, authority or military force, when the intent is to intimidate, coerce or harm a government, civilian population or any segment thereof, or to disrupt any segment of the economy. Total Debit Balance means the total amount of debt on the BNZ Advantage Business Card account at the date of a Cardholder s Temporary Disablement or Permanent Disablement or the date a Cardholder dies. This amount will exclude any purchase, or transfer or cash advance any Cardholder received when the possibility of an event giving rise to a claim was known, which, in Cigna s opinion, is outside the normal conduct of the BNZ Advantage Business Card account. War means any war whether declared or not, or any warlike activities including the use of military force by any sovereign nation to achieve economic, geographic, nationalistic, political, racial or religious ends. Part C: What this Policy covers Cigna s insurance promise Providing the terms and conditions are met and the premiums are up to date, Cigna will help pay the BNZ Advantage Business Card account if a Cardholder who is in Paid Employment is temporarily or permanently disabled by Injury or Illness, or if a Cardholder dies. From the age of 65 a Cardholder will be covered for the death benefit only (see section 3 over the page). Cigna will pay only one benefit per Cardholder for a Permanent

8 Disablement or death claim. Details of the benefits are set out in sections 1 3 below and in Part D. Important qualifications and exclusions apply to the insurance promise, which are detailed in Parts D, E and F. 1. Temporary Disablement cover in detail How does Temporary Disablement cover work? If a Cardholder is in Paid Employment and becomes Temporarily Disabled, Cigna will, each month, pay BNZ 15% of the Total Debit Balance at the date of disablement. Payments in respect of a Cardholder will be the same amount each month and will continue until: that Cardholder is no longer Temporarily Disabled; or Cigna has made 18 monthly payments or has paid $45,000 for one or more claims due to the same Illness or Injury, or a related cause, whichever is the earlier. How does Temporary Disablement cover work when more than one claim is made? If any Cardholder suffers a relapse of the same Illness or Injury within six months Cigna will treat this as a continuation of the original claim. The maximum number of payments that Cigna will pay is outlined above. A new claim for any Cardholder will only be considered if the Cardholder has returned to Paid Employment for a continuous period of at least six months.

9 If this Policy covers more than one Cardholder and more than one Cardholder is involved in the same accident, then Cigna will pay no more than $45,000 in respect of that accident, regardless of the number of Cardholders. 2. Permanent Disablement cover in detail How does Permanent Disablement cover work? If a Cardholder is in Paid Employment and becomes Permanently Disabled Cigna will pay BNZ the Total Debit Balance at the date he/she was first prevented from engaging in Paid Employment solely as a result of an Injury or Illness. However, the total amount payable under this benefit will be limited to a maximum of $25,000 per Cardholder. Any amount paid under a Temporary Disablement claim from the same cause as the Cardholder s Permanent Disablement will be deducted from the Permanent Disablement benefit. If Cigna pays a Permanent Disablement benefit in respect of a Cardholder then cover under this Policy will stop for that Cardholder. In the case of joint Cardholders, cover will continue for the other Cardholder. 3. Death cover in detail How does death cover work? If a Cardholder dies, Cigna will pay BNZ the Total Debit Balance at the date of death. However, the total amount payable under this benefit will be limited to a maximum of $25,000 per Cardholder. Any amount paid under a Temporary Disablement claim from the same cause as the Cardholder s death will be deducted from the death benefit.

10 If Cigna pays a death benefit in respect of a Cardholder then cover under this Policy will stop for that Cardholder. In the case of joint Cardholders, cover will continue for the other Cardholder. Part D: Other terms and conditions What credit card is covered? The BNZ Advantage Business Card account to which the premium is being charged is covered under this Policy. What if a Cardholder is working less than 20 hours per week or is not working? If a Cardholder is not in Paid Employment, or he/she is working less than 20 hours per week for themself or for another employer, that Cardholder will be covered under the death benefit only. Once that Cardholder starts work in Paid Employment full cover will recommence. Does the Cardholder s age matter? From the age of 65 each Cardholder will be covered for the death benefit only. Cigna will automatically renew the Policy each year on the Anniversary Date. The last renewal will occur on the Anniversary Date prior to the Cardholder reaching 100 years of age. Accounts with more than one Cardholder If more than one person holds a card on the BNZ Advantage Business Card account then each Cardholder is covered by this Policy, provided they are named on the Policy Schedule. The maximum amount that Cigna will pay for Temporary Disablement where more than one Cardholder is involved in the same accident (as specified in Part B) will apply regardless of the number of Cardholders. Premiums The premium payable is shown on the Policy Schedule.

11 The premium is charged monthly to the BNZ Advantage Business Card account and is calculated on the Total Debit Balance as at the closing date of the monthly statement. Payment of the premium ensures cover for the month up to the closing date of the statement. If there is a zero or credit balance at the closing date of the monthly statement then no premium will be payable for that month. Premium changes Cigna may, at any time, review and adjust the premium rates. If the rates are changed, they will apply to all policies, not just this one, and Cigna will write to the Cardholder(s) at least 30 days before the new rates apply to advise of the new premium. Can the BNZ Advantage Business Card account still be used even if a claim has been made? Yes, the BNZ Advantage Business Card account can still be used, but any amounts spent on the card after the date of the event giving rise to any claim will not be covered. When the Policy stops The Policy will stop when any one of the following happens: the BNZ Advantage Business Card account is closed for any reason; or any Cardholder asks Cigna to cancel the Policy; or if the premiums are unpaid; or Cigna cancels all policies and gives 90 days notice in writing. Cover for a Cardholder will stop when one of the following occurs: the Cardholder attains 100 years of age; or Cigna pays a claim for Permanent Disablement or death; or

12 a Cardholder ceases to be a BNZ Advantage Business cardholder. If there is more than one Cardholder covered under this Policy, cover for the remaining insured Cardholders will continue. Policy changes Cigna may, at any time, change any of the conditions and exclusions applying to this Policy. Any such changes will apply to all policies not just this one and Cigna will notify the Cardholder(s) at least 30 days prior to the changes coming into effect. Goods and Services Tax (GST) Under current legislation, the CreditCare Business premium includes GST at the rate of 9.5% of the total premium. This is because a small component of the premium relates to life insurance which is exempt from GST. If legislation relating to GST and this Policy changes, the Cardholder(s) will be notified in writing by Cigna at least 30 days prior to the change coming into effect. Disputes If a Cardholder has a complaint, in the first instance they should contact Cigna to discuss it. This will initiate Cigna s internal complaints resolution process. Refer to the Contacts section for the details. Cigna is a member of the Insurance and Savings Ombudsman

13 scheme which is a free, independent service which can help settle any unresolved disputes. Any dispute or action relating to this Policy will be determined in accordance with New Zealand law. Part E: Exclusions Cigna will not pay a claim if a Cardholder s Temporary Disablement or Permanent Disablement or death is caused by or contributed to by: any Pre-existing Condition within 24 months of the Cover Start Date; any medical treatment or surgical procedure which is not essential for medical reasons and is requested by the Cardholder for psychological, personal or cosmetic reasons; intentionally self-inflicted injury; alcohol or drugs taken by the Cardholder (unless prescribed and taken as prescribed by a registered doctor); any psychiatric, mental or nervous disorder including stress and stress related conditions; backache and related conditions causing disability unless there is a radiologically proven medical abnormality; service in any armed force including any police force of a country; pregnancy, termination of pregnancy, or complications arising from childbirth; War or any act of War, invasion, terrorism or any acts of terrorism, act of foreign enemy, hostilities (whether war be declared or not), strike, riot and/or civil commotion, civil war, rebellion, revolution, insurrection, military or usurped power; Terrorism;

14 any condition which is, or results from, or is a complication of infection with Human Immunodeficiency Virus (HIV), or any variant including Acquired Immune Deficiency Syndrome (AIDS) and AIDS Related Complex (ARC). Part F: How to make a claim If a Cardholder needs to make a claim against this Policy, they should contact Cigna as soon as possible to request a claim form. The claim form will be sent out within 24 hours of the request. The claimant must complete the claim form and return it to Cigna together with any supporting documents that Cigna may reasonably require. Any medical information required to support the claim must be: provided by appropriately qualified medical practitioners registered in New Zealand or Australia (or any other country approved by Cigna); and paid for by the claimant. If Cigna requires the Cardholder to undergo any further examination or tests to confirm that they are disabled then these costs will be met by Cigna.

15 About Cigna Cigna New Zealand is a leading specialist provider of insurance products and services including life insurance, funeral insurance, income protection insurance, accidental death insurance, trauma insurance and travel insurance. We ve been operating in New Zealand for nearly a century, and now protect over 295,000 New Zealanders with our insurance policies. Cigna New Zealand is part of Cigna Corporation, a Fortune 500 company and one of the world s largest publicly-owned companies. A copy of Cigna s latest financial statements is available on request. Cigna Life Insurance New Zealand Limited has an A- (Excellent) financial strength rating which was given by A.M. Best Company Inc. The rating scale is: Secure Vulnerable A++ A+ Superior B B- Fair A A- Excellent C++ C+ Marginal B++ B+ Good C C- Weak For more rating information visit D E F S Poor Under regulatory Supervision In Liquidation Suspended

16 To contact Cigna By phone We re open between 8.00 am and 8.00 pm Monday to Friday. Outside these hours Cardholders can leave a message and we ll call back on the next business day. By contactus.nz@cigna.com for general information about this Policy including premiums, address changes complaintsandquality.nz@cigna.com to register a complaint claims.nz@cigna.com to request a claim form or ask any questions related to a claim By letter Cigna Life Insurance PO Box Manners Street Wellington 6142 By Fax CIG521 08/11/1280/01