North Yorkshire Police Federation Group Insurance Scheme

Transcription

1 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 1 North Yorkshire Police Federation Group Insurance Scheme Effective from 1 January 2015 Member Benefits Serving Member to age 64 inclusive Life Insurance 120,000 Terminal Prognosis Advance on Life Insurance* 20% of sum insured Personal Injury Insurance: Permanent Total Disablement (due to accident) 100,000 Accidental Loss of Use of Limbs/Eyes/Hearing 100,000 Hospitalisation Benefit 28 pn up to 7 nights Temporary Total Disablement excluding first 7 days 28 pw up to 104 weeks Regulation 28 Sick Pay up to 26 weeks 20% scale pay Critical Illness 10,000 Child Critical Illness 2,000 Child Death Grant 2,500 Child Personal Injury Insurance Included Red Arc Plus Family Cover Legal Expenses including ID Theft Protection Included Member & Child Travel Insurance Motor Breakdown Cover (UK and Europe) Member and Partner Mobile Phone Member and Partner CALENDAR MONTHLY PREMIUM Non-Serving Spouse/Cohabiting Partner of Serving Member to age 64 inclusive Life Insurance 60,000 Terminal Prognosis Advance on Life Insurance* 20% of sum insured Personal Injury Insurance Included Critical Illness 10,000 Family Travel Insurance CALENDAR MONTHLY PREMIUM 7.75 *Terminal Prognosis Advance only available for members aged 63 and under PLEASE INFORM THE FEDERATION OFFICE IMMEDIATELY IF THERE ARE ANY CHANGES TO YOUR PERSONAL CIRCUMSTANCES OR ALTERATION TO BENEFICIARY.

2 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 2 Retired Member Benefits Retired Member Life Insurance - aged under 60 50,000 Life Insurance - aged 60 to 64 (inclusive) 25,000 Terminal Prognosis Advance on Life Insurance* 20% of sum insured Personal Injury Insurance: Permanent Total Disablement 30,000 Accidental Loss of Use of Limbs/Eyes/Hearing 30,000 Hospitalisation Benefit 28 pn up to 7 nights Temporary Total Disablement excluding first 7 days 28 pw up to 104 weeks Red Arc Plus Family Cover Legal Expenses including ID Theft Protection Included Member & Child Travel Insurance Motor Breakdown Cover (UK and Europe) Member and Partner Mobile Phone Member and Partner CALENDAR MONTHLY PREMIUM Spouse/Cohabiting Partner of Retired Member Life Insurance - aged under 60 25,000 Life Insurance - aged 60 to 64 (inclusive) 12,500 Terminal Prognosis Advance on Life Insurance* 20% of sum insured Family Personal Injury Insurance Included Family Travel Insurance CALENDAR MONTHLY PREMIUM 9.75 Retired Member Aged 65 to 69 Life Insurance 5,000 Red Arc Assured Family Cover Legal Expenses including ID Theft Protection Included Member & Child Travel Insurance Motor Breakdown Cover (UK and Europe) Member and Partner Mobile Phone Member and Partner CALENDAR MONTHLY PREMIUM Spouse/Cohabiting Partner Aged 65 to 69 of Retired Member Life Insurance 2,500 Family Travel Insurance CALENDAR MONTHLY PREMIUM 9.75 *Terminal Prognosis Advance only available for members aged 63 and under 2 Police Federation Group Insurance Scheme

3 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 3 Important Information Applicable to All Benefits This booklet is a summary only. The benefits are subject to certain exclusions and policy conditions not stated in this booklet; which in the event of a claim will be applicable. The benefits are provided strictly under the terms of insurance policies taken out and owned by the Trustees of the scheme. Membership of this scheme is on a non-advised basis. The Trustees retain the full policy wording detailing all benefits provided. Copies of the policies are available to view upon request. Some policy wordings are available to download via some Smartphones with a QR Scanner, from this document. Subscription to the scheme entitles the member to the benefits provided by the scheme but confers no ownership of any of the underlying policies, which are vested in the Trustees. Any scheme member who attains the age of 65 and is still in the employment of the Force, may continue as a member of the scheme with the benefits applicable to a retired member under the appropriate age category. When the member is no longer eligible under the scheme, Spouse/Partners eligibility also ceases. If you are going on a career break, maternity leave, secondment or are living overseas, you must contact Philip Williams and Company to identify if cover can be maintained. All benefits cease for members and partners upon attaining maximum age of eligibility for the scheme. Applying to Join Serving members and cohabiting partners can apply to join the scheme at any time by completing an application form which contains medical underwriting questions. New recruits may join without the need for medical underwriting. Subscription collection Subscriptions are collected monthly by salary/pension deduction unless alternative arrangements have been agreed. Insurers A list of the insurers is available on request. How to cancel your cover In the event that you need to cancel your cover, please contact the Federation Office. Complaints Procedure The Federation Insurance Scheme is arranged on behalf of the Trustees by Philip Williams and Company who are authorised and regulated by the Financial Conduct Authority registration number The Trustees are responsible for dealing with the insurance broker and organising the Policies. Any complaints about any aspect of the Federation Insurance Scheme should in the first instance be directed to the Trustees. 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 Federation Insurance Scheme please contact the Federation Office on: Telephone Or simply write, giving details of your complaint to: North Yorkshire Police Federation, Police Station, Castlegate, Knaresborough, North Yorkshire HG5 8AR Police Federation Group Insurance Scheme 3

4 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 4 Explanation of Benefits Life Insurance On death of a member or spouse/partner who are covered under the scheme the cash benefit detailed in the current benefits table will be paid. The policy is written in Trust so that if a member dies, the proceeds can be paid, by the Trustees, to the member's dependants quickly free of tax and without having to wait for probate. Members should ensure that they have an up-to-date beneficiary nominated and have lodged the details with the Federation Office, to assist the Trustees in the event of a claim. If a beneficiary aged 63 or under receives a terminal prognosis of 12 months or less, they may apply to the Trustees for an advance of the death benefit of 20% of the relevant sum insured. Child Death Grant This benefit is paid upon the death of a dependent child of a member, aged between 6 months and 17 years. Personal Injury Insurance Insured Persons Category A Any serving member and civilian support staff of North Yorkshire Police Force up to age 65 years. Category B Any retired member and civilian support staff of North Yorkshire Police Force up to age 65 years. Category C Any Partner, aged under 65 years, of an Insured Person described in Category A or B Category D Any Child, aged under 18 or under 22 if in full time education, of an Insured Person described in Category A or B Please note that cover under Category C only applies if the Spouse/Cohabiting Partner option is selected. BENEFIT DESCRIPTION BENEFIT AMOUNT CATEGORY A CATEGORY B CATEGORY C CATEGORY D Death Nil Nil 15,000 7,500* Permanent total disablement 100,000 30,000 15,000 7,500 Loss of one or more limbs 100,000 30,000 15,000 7,500 Loss of sight in one or both eyes 100,000 30,000 15,000 7,500 Loss of hearing in both ears 100,000 30,000 6,000 3,000 Loss of hearing in one ear 25,000 7,500 1, Permanent disabling injuries Nil Nil Up to 15,000 Up to 7,500 Temporary total disablement 28 per week 28 per week Nil Nil Benefit period weeks Deferment period 7 days Hospital confinement 28 per night 28 per night 75 per week per week (Overnight benefit) (immediately following (immediately following the accident) the accident) - Benefit period 7 nights 7 nights 52 weeks 52 weeks Regulation 28 Sick Pay 20% of scale pay Nil Nil Nil - Qualifying period 182 days - Benefit period 183 days * The Benefit Amount for Children under age 16 is 5, Police Federation Group Insurance Scheme

5 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 5 Permanent Total Disablement Means disablement which has lasted for at least 12 months and which in the insurers opinion is beyond hope of recovery and will in all probability continue for the remainder of the member's life, will prevent the member from engaging in or giving attention to business profession or occupation of any and every kind for the remainder of their life. Accidental Loss of Use Benefit Variable Benefits paid in the event of:- - Permanent loss of sight in one or both eyes - Permanent loss of use of one or more limb - Permanent total loss of hearing in one or both ears Hospitalisation Benefit For each consecutive night s stay, up to seven nights in hospital, immediately following an accident this benefit will pay the member the amount listed per night. Temporary Total Disablement (including Post Traumatic Stress Disorder) This benefit will be paid should the member suffer injuries which cause the member to be prevented from carrying out their usual occupation as a result of an accident for up to 104 weeks (excluding the first seven days). Benefit will also be paid under this section if a member suffers Post Traumatic Stress Disorder as a result of attending an incident on police duty. Such Post Traumatic Stress Disorder must be the clear result of an incident that was documented in the police records and be of sufficient severity to prevent the performing of duties. Sick Pay Benefit (Regulation 28 cover) If a member suffers a pay cut under regulations or terms of employment, the benefits illustrated on the scheme benefits table will become payable. Police Federation Group Insurance Scheme 5

6 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 6 Critical Illness The scheme benefits will be payable if a member, member's partner (if additional subscription paid) or their child, aged from 6 months to 17 years, suffers from an insured illness and survives for more than 28 days from the date of diagnosis or surgery. - Alzheimer s disease resulting in permanent symptoms (group C) - Aorta graft surgery for disease (group A) - Bacterial meningitis resulting in permanent symptoms (group C) - Benign brain tumour resulting in permanent symptoms (group B) - Blindness permanent and irreversible (group A&C) - Cancer excluding less advanced cases (group B) - Coma resulting in permanent symptoms (group A&C) - Coronary artery bypass grafts with surgery to divide the breastbone (group A) - Creutzfeldt-Jakob disease (group C) - Deafness permanent and irreversible (group A&C) - Heart attack of specified severity (group A) - Heart valve replacement or repair with surgery to divide the breastbone (group A) - HIV infection/hep B virus contracted from a blood transfusion, physical assault or an incident occurring whist performing Police Duties (group C) - Kidney failure requiring dialysis (group C) - Loss of hands or feet permanent physical severance of 2 or more hands or feet in any combination (group A&C) - Loss of speech permanent and irreversible (group A&C) - Major organ transplant (group A) - Motor neurone disease resulting in permanent symptoms (group C) - Multiple sclerosis with persisting symptoms (group C) - Paralysis of limbs total and irreversible (group A&C) - Parkinson s disease resulting in permanent symptoms (group C) - Severe burns First degree burns covering at least 60% of the total body surface area or Second degree burns covering at least 40% of the total body surface area or Third degree burns covering at least 20% of the total body surface area (group C) - Stroke resulting in permanent symptoms (group A) - Traumatic head injury resulting in permanent symptoms (group A&C) Please refer to the policy wording for full definitions of the illnesses covered. A pre-existing conditions exclusion applies together with other terms and conditions. Critical illness benefit is payable once only in respect of conditions in a common group. Some illnesses may belong to more than one group, as shown in the full policy wording You may be able to download the full policy wording and terms and conditions by scanning the QR code into your mobile phone. 6 Police Federation Group Insurance Scheme

7 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 7 Red Arc Plus A telephone support service which provides Access to a Personal Nurse Adviser for you and your family to provide support in the event of: - Serious Illness - Bereavement - Long Term Disability - Stress - Telephone Support for people when discharged from hospital Your Personal Nurse Adviser will be able to assist with: - Help in understanding the condition and all its implications - Explain options for treatment - Help to prepare for consultants appointment - Explain medical terms in simple everyday language - Help families to cope with consequences of illness - Information and advice on home adaptations/specialist equipment - Source suitable equipment & medical aids - Provide information on entitlements from NHS - Helping you to make as speedy a recovery as possible by providing suitable information and helping to navigate into the appropriate services - Provide good long term management of your condition - Simply a listening ear when you are feeling low, or want to talk to someone who is not emotionally involved At the discretion of the nurse, when clinically necessary in certain circumstances they will be able to authorise third party interventions such as: - Specialist nurse home visit - Specialist counselling - Speech & language therapy The RED ARC service is free of charge and confidential. If you think you may be eligible you should ring RED ARC on in normal business hours. Police Federation Group Insurance Scheme 7

8 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 8 Travel Policy Annual Travel Policy An excess of 50 is applicable for most policy sections. the excess is payable per person, per policy section per insured incident subject to a maximum of 100. Policy provides cover for the subscribing member, and dependant children under 18 years or 22 years if in full-time education, all normally resident with the member. The spouse/partner is only covered if spouse/partner cover is subscribed to. All insured individuals are covered if travelling independently from the member. The maximum duration of any one trip is 60 days. Where a Journey is for a duration longer than 60 days, or 90 days where the appropriate additional premium has been paid, no cover will be applicable for any part of the trip. The total duration of all Journeys undertaken by a Beneficiary must not exceed 180 days during any one Period of Insurance. Winter sports is automatically included but it should be noted that this is not a bespoke winter sports policy and therefore does not provide certain special extensions, e.g. piste closure. The policy covers travel worldwide including the United Kingdom and the cover and benefits provided are comparable with those offered by travel agents and tour operators. Full travel policy details are provided in a separate travel insurance document, which is also being circulated. This should be kept in a safe place and taken when travelling. In the event of medical emergency overseas the 24 hour assistance number is (+44) Policy number 54UK Insurer - ACE European Group Ltd Non-Emergency Claims during office hours Benefit Description Benefit Amount/Limit of Liability Benefit Amount/Limit of Liability United Kingdom Medical Expenses 5,000,000 Not Covered Personal Property 1,500 1,500 Personal Money Valuables Cancellation/Curtailment 3,000 3,000 Missed Departure 500 Not Covered Delayed Departure Abandonment 3,000 3,000 Personal Injury 20,000 20,000 Personal Liability 1,000,000 1,000,000 Legal Expenses 25,000 Not Covered You may be able to download the full policy wording and terms and conditions by scanning the QR code into your mobile phone. 8 Police Federation Group Insurance Scheme

9 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 9 Legal Expenses Some important facts about the Professional Fees policy are summarised below. This summary does not describe all of the terms and conditions of the policy. All references below to the cover provided are contained within the full policy wording. Please note that a full policy wording is available for your inspection at the Federation Office upon request Section of Cover Criminal Prosecution Defence ( 185,000) Personal Injury Residential Protection Peaceful Occupation Consumer Protection Data Protection Uninsured Loss Recovery & Motor Prosecution Defence ( 100,000 but limited to 2,500 in providing representation following the seizure of a vehicle as a result of incorrect information being on the Motor Insurance Database and 5000 for Motor Defence claims) Discrimination Probate Employment Fund Trustee Defence Representation at Public Enquiries Independent Police Complaints Commission Investigations Disciplinary Hearings ( 10,000) Bankruptcy ( 1,000) Education Taxation Identity Theft (claim line ) Assistance (Not applicable) Legal Helpline There is a 24 hour legal helpline and this can be contacted on for initial advice and further instructions in how to make a claim. Please quote scheme number LES/256/0661 Arranged by Legal Insurance Management Ltd. underwritten by Ageas Insurance Ltd. Police Federation Group Insurance Scheme 9

10 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 10 UK and European Motor Breakdown Comprehensive motor breakdown cover for you and your partner including: - Roadside Assistance/Recovery - Home Assist - Alternative Travel - Emergency Overnight Accommodation - Misfuel Assist - Lack of Fuel - Message Service - Caravans & Trailers - Keys - European Assistance How to Make a Claim If the car, motorcycle, or car-derived van you or your partner are travelling in or any caravan or trailer of a proprietary make you are towing which is fitted with a standard towing hitch and does not exceed 7 metres/23 feet suffers a breakdown caused by a mechanical or electrical failure, misfuel, accident, theft, vandalism, fire, or flat tyre which immediately renders the vehicle immobilised, please call our 24 hour Control Centre on or For assistance in mainland Europe please call Please have the name of the covered member, your return telephone number, vehicle registration number and precise location available when requesting assistance numbers are chargeable at a local rate including from mobile telephones. They are usually included in network providers free minute packages. Please program the Control Centre s telephone number in you and your partner s mobile telephones. All use of this service is available for the covered member and their partner. We consider a partner any person married, civil partnered, or cohabiting with the covered member at the time of the incident. Any claim will be validated with the Police Federation, or other such administrative organisation, with costs for any claims from non-eligible persons being the responsibility of the claimant. Cover will apply during the period of insurance and within the territorial limits. There is no age limit to the car, motorcycle, or car-derived van for breakdowns occurring in the UK. A vehicle age limit of 10 years applies outside the UK. Please note Campervans/MotorHomes are excluded. For details and a list of European countries covered please see the full policy wording. You may be able to download the full policy wording and terms and conditions by scanning the QR code into your mobile phone. 10 Police Federation Group Insurance Scheme

11 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 11 Mobile Phone Covered Individuals This cover is provided for: - Subscribing members - Retired members - Partners of serving and retired members This policy provides for you and your partner s mobile phone(s) to be covered against the repair or replacement cost in the event of theft, accidental loss, accidental damage, or breakdown whilst in you or your partner s possession during the period of insurance. Pre-registration of mobile phones is not required, but ownership and age of the phone will need to be evidenced by the relevant proof of purchase. How to Make a Claim If you need to make a claim please contact Brightstar Insurance Services B.V. (UK Branch), Weston Road, Crewe, CW1 6BU. Telephone number Please refer to full policy terms and conditions prior to making a claim. Claim limit(s) An excess of 50 applies for each and every claim. The liability of the insurer in respect of any one claim and in aggregate for any 12 month period will be the replacement cost of the mobile phone and in any event shall not exceed a total claim cost up to a maximum of 1000 including VAT. The maximum liability limit includes cover of up to 750 including VAT for unauthorised data usage for a period of up to 24 hour directly following a valid theft or accidental loss. The mobile phone should be no more than eight years old at the time of the incident as evidenced by the relevant proof of purchase. Upon acceptance of a claim, the insurer may at its discretion replace your mobile phone with a functionally equivalent or better model which maybe a refurbished mobile phone of similar quality. Full policy wording and policy summary can be accessed either by downloading them from the QR reader (you can save a copy using the settings on your phone or tablet), online at or request details by contacting Philip Williams and Company during office hours on Police Federation Group Insurance Scheme 11

12 1570 North Yorkshire PFGIS a-w.qxp_v3 23/01/ :20 Page 12 Claims Procedures Claims should be reported as soon as is practical and if possible within 30 days of the incident/diagnosis. If claims are not reported within 90 days of the date of the incident/diagnosis they may not be met. The onus is on the member to notify a claim and it is not the responsibility of the Federation to make a member aware of their entitlement to claim. For Life, Critical Illness, Accident Benefits and Sickness Benefits please advise the Federation Office on Travel Insurance Policy Number 54UK Emergency Assistance (+44) Non-Emergency Claims Motor Breakdown Cover (UK) Legal Expenses (quote LES/256/0661) Red Arc Plus Mobile Phone Cover Documents can be downloaded by visiting the Group Scheme section of our website or by scanning the above code PWI1570A v3