claim. Where ACC reverses a decision for a previously declined claim, Sovereign reserves the right to seek reimbursement from ACC or the policy owner of any related claims paid by Sovereign . e) Where ACC agrees to contribute to the policy owner ’ s or life assured ’ s private hospital costs , Sovereign may cover additional costs up to the reasonable charges or as specified in the benefit sheet . f) Sovereign will not be liable for any additional costs where a lead care provider of ACC is used to provide private hospital medical treatment or procedures.
If a child insured under the policy has reached the age of 21 and is a dependent , then you can apply to have them remain on this policy until the anniversary date following his/her 25th birthday. Sovereign may request you to provide proof to establish that a child insured under this policy is a dependent . You will be charged the appropriate age related premium for each dependent . On reaching the age of 25 each dependent can elect to purchase their own policy from the range of policies being offered at that time by Sovereign to retail customers. The dependent must make written application to Sovereign within three months after the anniversary date following his/her 25th birthday to be able to purchase the policy without providing evidence of good health. You may remove any life assured under this policy with effect from an anniversary date . You must advise us that you wish to remove a life assured from this policy at least 30 days before the applicable anniversary date.
6 . How can you amend your policy?
a) Adding family members
You may apply to Sovereign in writing to extend cover under this policy at any time to include:
c) Adding or removing optional Absolute Health benefits or adjusting your excess
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the policy owner ;
> the spouse or de facto partner of the policy owner ;
You may make a request to Sovereign in writing to add or remove the optional benefits specified in the benefit sheet or to change the excess . Sovereign is not under any obligation to agree to any optional benefit addition or removal or change to the excess unless we are satisfied that the life assured is in good health. The life assured may be required to provide further health information before an optional benefit is added or removed or change to the excess is made. Any optional benefit addition or removal or change to the excess may result in a change to your premium . Any change to your premiums , benefits, or excess will start from the date notified to you by Sovereign in the applicable policy endorsement.
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any child under the age of 21.
Sovereign is not under any obligation to add any additional life assured unless we are satisfied that the life assured is in good health. Children are automatically covered under this policy for the first three months after being born. For a child ’ s cover to continue after the first three months, you must advise us in writing of the child ’ s name, date of birth and gender. If you provide these details to us within this three month period, the child will automatically be accepted for cover under this policy without the need to provide evidence of good health. Details received outside this period will result in the child having to be medically assessed. If a child is added to your policy and the child is the first child to be covered under this policy, a premium increase will be required. No premium increase will be necessary if one or more children are already covered under this policy. If an additional adult is added then the appropriate premium will need to be calculated and paid. The additional adult will need to provide evidence of good health.
7. When can your policy be cancelled
a) When can you cancel your policy?
If for any reason you are not happy with your policy, you may return it to us within 15 days from the date your policy document is received. You will be deemed to have received your policy document three days after postage from Sovereign . In such cases Sovereign will promptly refund any premiums paid under your policy provided that no benefits have been paid or any claim has been made. Alternatively, changes to your policy may be made and a replacement policy document issued. You can cancel your policy at any other time by giving Sovereign notice in writing. If you have elected to pay premiums less frequently than monthly, we will refund any part of a premium already paid for this policy to cover any period of more than one month beyond the date of cancellation (being the date we receive the cancellation notice). Otherwise, we do not have to refund any premiums or part of premiums already paid.
b) Removing a family member/dealing with adult dependent children
Under normal circumstances children listed on the schedule are covered until the first anniversary date after their 21st birthday. You will receive written notification from Sovereign advising you that a child ’ s cover under this policy is soon to expire prior to that anniversary date . On reaching the age of 21 each child covered under this policy can elect to purchase their own policy from the range of policies being offered at that time by Sovereign to retail customers. The child must make written application to Sovereign within three months after the anniversary date following his/her 21st birthday to be able to purchase the policy without providing evidence of good health.
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710 ABH-UMB version 8 Effective 8 April 2022
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