Loan protection insurance policy wording

(example wording cont.)

Unemployment cover under this certificate of insurance will depend on your employment status

Employed (not including company directors, secretaries or their relatives or contract workers); If you are working, we will insure you if you are dismissed.

Employed company directors, secretaries or their relatives
If you own more than 10% of the issued share capital of the business you are working for, or you are a relative of a company director or company secretary who owns more than 10% of the issued share capital of the business you are working for, you will be insured if that business stops trading.

Employed contract workers
If you have been working on a renewable fixed-term contract with the same employer for less than two years in a row we will insure you if you are dismissed during the term of your contract. We will not insure you if your contract is not renewed and any entitlement to monthly benefit under this insurance will automatically end on the date your contract was originally intended to finish.

Self-employed and their relatives
If you are the sole proprietor or a partner in the business you are working for, or you are a relative of the sole proprietor or a partner in the business you are working for, we will insure you if that business stops trading.

Claiming more than once – under disability or unemployment sections only

We will treat a claim which happens within three months of a separate claim you have made as the same period of claim. For unemployment claims you can make a new claim as long as you have been in continuous employment for at least three months between each claim. For disability claims if you make a claim within three months of a previous claim arising from the same cause, we will treat it as the same claim.

Circumstances when you cannot claim

A. Unemployment

We will not pay benefit if:

• you have not been in continuous employment for at least six months before your first period of unemployment under this contract;
  
• your work is seasonal or temporary;
  
• your fixed-term contract ends (but, depending on the other conditions of this contract, you may be entitled to benefit during your fixed-term contract);
  
• you accept voluntary redundancy, resign or retire;
  
• you are dismissed by your employer as a result of misconduct, or breaking your contract, or you fail to meet the standards or targets laid down by your employer;
  
• you knew about the possibility of unemployment (or in our reasonable opinion you should have known about it) at the loan start date;
• you are made unemployed due to any of the disability exclusions; or
  
• your unemployment happens while you are away from the EU for a period of more than 90 days. This clause will not apply if your reason for leaving the EU is because you: work for the British Armed Forces; or work as a civil servant in a British embassy or consulate.
  

B. You will not be entitled to any benefit for any period in which you are receiving pay instead of serving notice.

Suspending an unemployment claim for temporary work

If you are eligible to claim for unemployment under this insurance and you are offered a temporary job, you can suspend your claim as long as:

a) you tell us who you will be working for (even if you will be self-employed), how many hours you will be working for and how long the temporary employment will last;
b) your temporary job lasts for at least one week and no longer than six months and you do not have more than three separate jobs during any one period of claim; and
c) you continue to meet the conditions of this insurance and tell us immediately if any of the above circumstances change.
You are eligible to claim for unemployment when a temporary job ends. We will begin paying you again (up to your chosen maximum benefit payments for any one period of claim or until your loan is completed, which ever is the earlier).

C. Life, Critical Illness and/or disability

We will not pay benefit if:

• your death or disability is due to or arises from AIDS or being infected by HIV. We will pay your claim for disability if a specialist certifies that that condition prevents you from working;
  
• you deliberately injure yourself or your death, critical illness or disability is caused by alcohol, solvent abuse or drugs (other than drugs taken under the direction of a doctor or consultant and not to treat drug addiction);
  
• your death, critical illness or disability results from any condition, injury or illness, disease or sickness which came about as a result of a pre-existing condition;
  
• your disability arises from stress, anxiety or depression or any mental or nervous disorder unless a specialist certifies that that condition prevents you from working;
  
• your disability is caused by pregnancy, childbirth, miscarriage or abortion other than a medical complication which directly occurs as a result of your pregnancy or pregnancy-related conditions;
  
• your disability is due to a back-related condition unless there is radiological evidence of a medical abnormality or visible wound, or a specialist certifies that that condition prevents you from working;
  
• you not getting or following medical advice if our appointed medical officer thinks it was reasonable for you to do this;
  
• your disability arises from medical operations or treatments which are not medically necessary, including cosmetic or beauty treatments; or your disability is caused by any of the unemployment exclusions.
  

For unemployment and disability sections
You cannot claim disability and unemployment benefit at the same time.

We will not pay for any benefit as a result of:
war, revolution, terrorist activity, riot, or any similar event; or radioactive contamination from ionising radiation or contamination from any nuclear fuel, or from any nuclear waste arising from burning nuclear fuel; or the radioactive, toxic, explosive or other dangerous effect of any explosive nuclear equipment or part of that equipment.

General conditions

This contract and any endorsements together with the loan agreement and certificate and any written statement or other information you have made make up the contract between you and us. This contract or any of the terms of this contract cannot be changed unless this is done in writing by one or more of our authorised officials. If at the time any condition of this contract becomes invalid, illegal, or cannot be enforced, it will not affect the rest of the contract.

All benefits under this insurance will not be taxed, although this may change in line with any amendments to legislation. If this happens, we will take from any monthly benefit any amounts, which, by law, we have to take. You and we are free to choose the law which applies to this insurance contract. Unless you and we agree otherwise this insurance will be governed by English law and the English courts will deal with any disputes. We will process any information you give us according to the conditions of the Data Protection Act 1998 for the purpose of providing insurance and handling claims. This may involve passing your information to other organisations.

Fraud
If we discover any fraud or that you have hidden any facts relating to this insurance, we will end this cover and you must repay us any money we have paid you and you will lose any rights to make a claim under this insurance.

Change in your circumstances/changing jobs

You must within 14 days or as soon as reasonably possible give the intermediary who arranged this insurance written notice of any change in your personal circumstances, including changing your employer, occupation, residing or working outside the UK, for unemployment &/or disability: changing from being employed to self-employed (or vice versa), start working less than 20 hours per week, or any other relevant circumstance (if in doubt please write to your intermediary). Any claims arising from a change in circumstances may not be covered by this insurance unless we have agreed to the change in writing.

Transferring this contract to someone else

You may transfer the benefits of this contract to a new lender if we send you written confirmation that this is acceptable.

How to claim

You must initially contact your lender and request a claim form within 30 days of becoming unemployed or disabled or as soon as reasonably possible. In the event of a critical illness condition when you, or the person or people wanting to make a claim, send us the claim form you must give your certificate reference and state under which section you are making a claim. In the event of your death your representative must contact us as soon as reasonably possible.

You will then receive a claim form (or in the event of your death your representative). You (or your representative) will need to fill this in and return it to us as soon as reasonably possible, giving us all the information we ask for so we can process your claim. You (or your representative) will be responsible for giving us the proof we need. If you delay in sending in a claim to us it may make your claim harder to confirm. It could also lead to a delay in paying your claim or not paying your claim at all. For disability claims you must allow us access to your medical records as defined by the Access to Medical Records Act 1988 and if we want you to have a medical you must have one, or we may refuse to pay your claim. We will pay any costs involved for the medical.

We will pay the benefit when we receive satisfactory evidence of your entitlement to claim. Throughout the period for which you claim under this contract we will need you to provide evidence for your claim. We will not pay benefit for any period of disability or unemployment for which you do not provide evidence. Once we have accepted a claim, we will either pay your outstanding loan amount or for disability or unemployment pay your selected benefit for the month passed.

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