BENEFIT
COVERED EXPENSES
MAXIMUM COVER
$300 per day after the third day, up to a maximum of $3,000 per life assured , per policy year .
Lump sum payment paid if the life assured is admitted to a public hospital for a continuous period of more than three days (not including admissions on a private fee paying basis or for obstetric care).
Public hospital cash grant
For the purposes of this grant, a ‘day’ must include an overnight stay.
Upon the death of a life assured , prior to attaining the age of 70 years, and where the cause of death is not excluded under this policy, Sovereign will continue to provide cover under this policy for the surviving lives assured covered by the policy at the time of death, without requiring further premiums for 12 months from the date of death.
Waiver of Premium
No maximum cover .
Covers reasonable charges of sterilisation including vasectomies and female sterilisation procedures (i.e. tubal ligation and hysteroscopic sterilisation).
Applies only after two years of continuous cover.
Loyalty benefit: Sterilisation
Prior approval must be received from Sovereign .
Excess applies.
If, during the course of any medical procedure or treatment in a private hospital , a life assured should die directly as a consequence of any erroneous or negligent action, omission or failure to observe reasonable and customary standards by a care provider of the said hospital, a death benefit shall become payable, provided: > the death occurs within 30 days of such a recorded and proven incident; and > a public admission of such incident and liability is made by the said hospital and verified and confirmed by the relevant government authority , a court of law, coroner’s inquest or the Medical Council of New Zealand; and > the death is independent of any other cause other than the termination of the life support system after brain death has been established. Provides a contribution towards the cost, up to the maximum cover for this benefit, of medically necessary sleeve gastrectomy, gastric banding or bypass surgery including the costs of the related consultations, tests and diagnostic imaging for the life assured , where surgery is recommended by a specialist because the life assured has all of the following:
$30,000 per life assured .
Medical misadventure
$7,500 per life assured, per lifetime for the Bariatric surgery and Bilateral
a BMI of: a.
40 or more, or
b. 35 or higher and at least one of the following obesity- related diseases that is expected to be improved:
Loyalty benefit: Bariatric surgery
breast reduction loyalty benefits combined.
–
coronary heart disease;
–
type 2 diabetes;
Excess applies.
–
obstructive sleep apnoea;
– osteoarthritis in a weight bearing joint (radiological evidence required); or – blood pressure greater than 140/90 that cannot be effectively controlled via medication; and
completed physical growth; and
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711 ABH-BS version 8 Effective 08 April 2022
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