Kent Police Federation

Transcription

1 Kent Police Federation Personal Accident & Sickness, Critical Illness Benefit Scheme Effective from 1 January 2015

2 Summary of cover Kent Police Federation offers this scheme for Kent Police Officers. The scheme is administered on behalf of the Federation by Police Mutual. Benefits summaries attached Personal Accident and Sick Pay Critical Illness Who is covered? Any Serving member of Kent Police Federation who is paying contributions into the scheme by salary deduction (see code PAI on your payslip). Claims Claim forms can be obtained from your Federation office. Accident (including Unsociable Hours Benefit and Dependant Care costs) must be notified as soon as possible and in any case within 6 months from the date of the accident/incident Sickness/Half Pay Benefit must be notified within 6 months of pay being cut Claims for Court Award Compensation must be made within eighteen months of the award being made Critical Illness - claims should be notified within 90 days following diagnosis Who can join? How much does it cost? To join, you must have been actively at work, not on recuperative duties, in the eight weeks prior to making your application. Membership is open to any Serving Officer of Kent Police who is contributing to the Federation s voluntary fund, Superintendent s Association or ACPO. The premium is 6.20 per month. New recruit applicants are covered free of charge until they complete their first year of service, so long as they have signed to join the scheme on induction to the Force. How do I join? Contact the Federation Office at 66 & 67 Queen Elizabeth Square, Sutton Road, Maidstone, Kent, ME15 9BZ or call them on When does the cover end? Cover ceases if premiums stop for any reason or on retirement. You and Police Mutual The scheme aims to meet the demands and needs of a Member who require critical illness, personal accident and sickness insurance. You should ensure the cover is adequate for your needs. Police Mutual offer members of Kent Police this group scheme only. You will not receive advice or a recommendation from us and we will not charge you a fee for our services.

3 Personal Accident and Sickness Benefits Summary Sickness benefit per month whilst on Half/nil pay for up to 78 weeks Temporary Total Disablement (TTD) from usual occupation up to 104 weeks excluding first 7 days Hospitalisation unplanned (inc an accident) Hospitalisation planned 3 night excess 196 per week 42 a week 40 per night up to 90 nights 40 per night up to 7 nights Court award compensation (max per award) 500 Other Accident Benefits Permanent disablement from performing an occupation of any and every kind 48,000 Quadriplegia an additional payment of 25,000 Occupationally acquired HIV 24,000 Loss of limb, eye, speech or hearing (in both ears) 24,000 Loss of hearing in one ear 6,000 Coma benefit If remains in a permanent unconscious state Unsociable Hours Benefit 2 weeks excess Payable for 24 weeks Dependant Care Costs 25 per day up to 365 days 7.5% of basic scale pay (up to agreed maximums) 15ph max 200 per claim 1,000pa Other benefits apply for loss of fingers, toes and the like, as a result of an accident contact Police Mutual for more details. Dental Benefits Any accidental dental injury worldwide cover Up to 2,500 Emergency dental treatment for immediate pain relief, per incident, initial visit only Hospital cash maximum of 20 nights, if an inpatient having dental treatment (under care of dental or maxillofacial consultant care) Up to 200 in the UK Up to 400 rest of world 50 per night, Dentist call out fees to cover the cost of 100 an emergency Dental Call-Out where the dentist has had to reopen their practice outside working hours

4 Accident & Sickness Benefits Effective from 1st January 2015 Significant Features and Benefits Personal Accident and Sickness Insurance provides you with protection by paying lump sum benefits in the event of permanent injury or disablement, or regular weekly benefits in the event of sickness or temporary disablement caused by an accident or sickness. 24 hour worldwide cover, on or off duty Significant or unusual exclusions or limitation Where a pre-existing condition has contributed towards permanent disablement, the insurers reserve the right to negotiate a settlement for a reduced sum, to reflect the extent to which this condition has affected the claim. The main exclusions are for claims resulting from: The Insured Person taking part in aviation (other than travelling as a passenger) unless in the course of police duties, riding or driving in any kind of race or professional sport. Attempted suicide or intentionally inflicted self-injury or sickness Any claim where the incident occurred after the Insured Person s 65th birthday. War (whether declared or not), civil war, rebellion, revolution, insurrection, or civil commotion Main Conditions relating to benefit payments Payments are not normally made under more than one of the core benefits in respect of the same accident or sickness or the same period of disablement for the same insured person. Payments for Permanent Disablment shall only be payable upon certification by a qualified registered medical practitioner and not before the expiry of 52 consecutive weeks of disablement. Payment for Temporary Total Disablement following an accident shall be made at the end of the period of disablement Payment for Temporary Total Disablement following sickness shall be made either: at the end of the period of disablement, or at the insured person s request, at 4 weekly intervals in arrears subject to medical or other information required by the insurer The maximum amount payable in respect of Unsociable Hours Benefit shall be: 60 per week for Constables 75 per week for Sergeants 95 per week for Inspectors and Chief Inspectors The above is only a summary of the policy s terms and conditions. For further clarification, a full policy wording is available upon request.

5 Critical Illness Benefits Summary Effective from 1st January 2015 Benefit payable upon diagnosis of an insured critical illness: 10,000 WHAT CRITICAL ILLNESSES ARE COVERED? Alzheimer s Disease resulting in permanent symptoms Aorta Graft Surgery for disease Aplastic Anaemia with permanent bone marrow failure Bacterial Meningitis resulting in permanent symptoms Benign Brain Tumour resulting in permanent symptoms Blindness permanent and irreversible Cancer excluding less advanced cases Cardiomyopathy Chronic Lung disease Coma resulting in permanent symptoms Coronary Artery By-Pass Grafts with surgery to divide the breastbone Creutzfeld-Jakob Disease Deafness Dementia/Pre Senile Dementia Encephalitis resulting in permanent neurological deficit with persisting clinical symptoms Heart Attack of specified severity Heart Valve Replacement or Repair with surgery to divide the breastbone HIV and Blood Transfusion caught in the EU from a blood transfusion or at work Kidney Failure requiring dialysis Liver failure Loss of Hands or Feet the permanent physical severance of two or more limbs Loss of Speech Permanent and irreversible Major Organ Transplant Motor Neurone Disease resulting in permanent symptoms Multiple Sclerosis with persisting symptoms Paralysis of Limbs total and irreversible Parkinson s Disease resulting in Permanent symptoms Permanent Total Disability Primary Pulmonary Hypertension Progressive Supranuclear Palsy resulting in Permanent symptoms Rheumatoid Arthritis resulting in a loss of the ability to do specified physical activities Severe Burns Stroke resulting in Permanent symptoms Terminal Illness Traumatic Head Injury Critical illness cover pays out a lump sum if you are diagnosed with an insured illness that meets the policy definition, and you then survive for at least 28 days. The policy places the insured illnesses into groups; a member can claim once for conditions in a common group. Other than in the bona fide execution of police duty, no benefit shall be payable if a claim occurs directly or indirectly from: war (whether declared or not) other than civil war or any act incidental thereto, whilst the participant is engaged as a passenger, or otherwise, in aeronautics (other than as a fare-paying passenger) or underwater operations, any breach of the law by the participant, misuse of alcohol or drugs Taking part in any Hazardous Pursuit For further clarification on the conditions and exclusions the full policy wording is available upon request.

6 Regulatory Information This is a summary of the personal accident & sickness and critical illness scheme. The full terms and conditions are contained in policies issued by the insurers and available on request. The Critical Illness benefits are underwritten by The Ancient Order of Foresters Friendly Society Ltd. The Accident & Sickness section is underwritten by UK General Insurance Ltd on behalf of UK General Insurance (Ireland) Ltd. The scheme is administered by Police Mutual which is a trading name of PMGI Ltd. They are Kent Federation s appointed insurance brokers for this scheme and are regulated by the Financial Conduct Authority (FCA registration number ). Scheme terms and conditions may vary from time to time with the agreement of the Secretary of the Kent Police Federation. Complaints In the first instance, please raise any complaint with: Police Mutual, 3 Meridian Office Park, Osborn Way, Hook, Hampshire, RG27 9HY Telephone: Complaints which cannot be settled can be referred to Financial Ombudsman Service: South Quay Plaza, 183 Marsh Wall, London, E14 9RS Telephone: Financial Services Compensation Scheme In the unlikely event that the Insurers are unable to meet their liabilities, you may be able to claim compensation from the Financial Services Compensation Scheme (FSCS) Further Information on this case be obtained from the FCA or the FSCS..