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MAJORCARE
HEALTH INSURANCE POLICY
These MajorCare policy wordings apply to policies with a Policy Inception Date of November 1 2003 or later.
Table of Contents
1. Policy benefits
2. Your payments
> Premium
> Method of paying premiums
> What happens if you do not pay the premium on time?
> Change in premium amount
3. Cancelling the policy
> When can you cancel your policy?
> When can Sovereign cancel the policy?
4. How to claim a benefit
> Prior approval / direct payment to providers
> Claims submitted for reimbursement
5. Claims on other insurers
6. Amending the policy
> Adding family members
> Removing a family member / cover for adult children
> Adding or removing a benefit / adjusting excess
7. Miscellaneous
> What forms part of this contract?
> Law or Government Authority changes affecting Sovereign or the policy
> Policy subject to laws of New Zealand
> Notices
> Transfer of ownership
> Information about your policy
> No surrender value
> Suspension of cover
> Complaints procedure
8. Key terms
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1. Policy benefits
You must pay all premiums to Sovereign at its head office in New Zealand (see Section 7d). Premiums are normally paid by direct debit. In addition we can offer facilities to pay premiums by credit card, or, you can pay premiums by cheque. Premium payments are not effective until after they have been cleared and credited to our bank account.
Your Sovereign MajorCare policy can provide financial assistance if you incur major medical expenses. Details of the MajorCare benefits you have chosen and the names of the people insured for the MajorCare benefits (called the life or lives assured ) are shown in the schedule . Sovereign will pay the MajorCare benefits to you , as the policy owner (s), an eligible provider , or to your estate. The MajorCare benefits provided are detailed in the attached MajorCare benefits sheet . It is Sovereign 's normal business practice to review the MajorCare benefits on a regular basis. This is to ensure it continues to provide cover for current medical treatments for common medical conditions at the time. It is also to ensure the insurance product remains commercially viable for Sovereign. A review of the MajorCare benefits may result in Sovereign changing the MajorCare benefits and updating this policy document accordingly. The following are examples of circumstances when Sovereign may wish to change the MajorCare benefits for all policy owners : > To increase the level of MajorCare benefits under the policy or to add new MajorCare benefits; > To move all policy owners to a refreshed policy document with a new drafting style/layout and similar levels of MajorCare benefits; > To allow for an unexpected increase in the type or level of claims that will not be sustainable long term based on the current schedule of premium rates or at any premium rates (uninsurable); > To take account of a significantly escalated or new public health threat e.g. a pandemic. Sovereign will give you at least 30 days' notice of any pending MajorCare benefit and policy document change. Such notice will include an updated MajorCare policy document and MajorCare benefits sheet highlighting any change to the MajorCare benefits and will confirm the actual date from which the revised MajorCare benefits and policy changes will take effect. You always retain the right to cancel this policy at any time – see Section 3 Cancelling this policy.
c) What happens if you do not pay the premium on time?
You have 30 days’ grac e in respect of any premium due. Sovereign will be entitled to cancel your policy by written notice to you at your last known address if a premium remains outstanding 31 days after a premium due date . If you want to have this policy reinstated, you must write to Sovereign . Sovereign does not have to reinstate this policy but may do so on any conditions it considers appropriate. If Sovereign has to pay a MajorCare benefit under this policy when a premium is overdue, the overdue premium may be deducted from the MajorCare benefit.
d) Change in premium amount
It’s Sovereign's normal business practice to revie w premiums on a regular basis. This is usually done each year on the policy anniversary date . Please note that; > Premium increases will always be applied across the policy type. > There will not be an increase in premium for your own policy based on your claim history or experience. > Premiums for MajorCare benefits are related to the life assured ’s age, unless otherwise agreed to by Sovereign. > Premiums will increase each year and the premium increase will usually take effect from the policy anniversary date . > Any policy fee will increase each year on the anniversary date in line with the consumer price index . The other circumstances in which your premium will change are as follows: > When you add or remove optional MajorCare benefits or adjust the excess > When you add or delete a life or lives assured to/from this policy.
2. Your payments
a) Premium
3. Cancelling this policy
To ensure that your policy remains in force you must pay the premium on a regular basis as agreed with Sovereign . The initial premium is shown in the schedule , the first payment of premium is due to Sovereign on the first premium due date , which normally coincides with the risk commencement date . The premium may change from time to time (as described below) and you will need to pay the new premium from the next premium due date and thereafter. Sovereign will advise you in writing of the new premium 30 days before the change takes effect.
a) When can you cancel your policy?
If for any reason you are not happy with this 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. Alternatively changes to your policy may be made and a replacement policy document issued.
b) Method of paying premiums
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You can cancel your policy at any time by giving Sovereign notice in writing. Sovereign does not have to refund any part of the premium you have paid. As there are annual MajorCare benefit entitlements within your policy, you may remain liable to pay any premium due on this policy through to the next anniversary date , this will be at Sovereign ’s discretion. From (and including) the date that Sovereign receives notice of cancellation of your policy, you will not be entitled to any MajorCare benefits under this policy unless otherwise agreed and confirmed in writing by Sovereign .
For any claim enquiries or before incurring any costs in respect of a claim a life assured should first call our MajorCare Claims Hotline on 0800 500 1080
There are two ways to claim a MajorCare benefit:
> you can seek prior approval from Sovereign in
accordance with section 4a below and we will arrange to pay the respective eligible provider s or health providers directly, less any excess ; or > you can pay for the medical costs incurred yourself and then submit your claim to Sovereign for reimbursement in accordance with section 4b below. Sovereign strongly recommends that you utilise our prior approval service at all times. This will ensure that Sovereign approves all medical treatments or procedures before you incur any costs.
b) When can Sovereign cancel this policy?
If you or a life assured has:
> failed to disclose all material information to us prior to inception, variation or reinstatement of this policy; or > made a statement on the faith of which this policy was issued, renewed, varied or reinstated, that was, in terms of the Insurance Law Reform Act 1977:
a) Prior approval and direct payment process for claims:
Sovereign has preferred provider relationships with a number of health providers and private hospitals . Prior approval and direct payment processes to these eligible providers or health providers and Sovereign approved facilities are streamlined. We therefore encourage you to use these eligible provider s or health providers and Sovereign approved facilities . The policy owner must comply with the following requirements when seeking Sovereign ’s prior approval and direct payment of any claims: > Prior approval requests should be made as soon as you are aware of a pending private hospital admission, MRI or CT scan. We need a minimum of seven working days to process a claim prior to the actual private hospital admission or procedure. Failure to notify Sovereign within the required time frame may result in a prior approval authorisation being declined, or, held up until Sovereign has had the opportunity to fully assess the claim.
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materia l, and
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substantially incorrect , and
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for a life policy made either fraudulently ; or
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within the period of three years immediately preceding the date on which the policy is sought to be avoided or the date of death of the life assured , whichever is earlier.
Sovereign may, at its complete discretion, either:
> Avoid from inception your entire policy (this means this policy is deemed never to have existed), or > Avoid from inception any individual benefit(s) provided by your policy (this means the individual benefit(s) are deemed never to have existed), or > Alter the terms upon which cover is provided under your policy. If we choose to alter the terms of your policy we may do so effective from the risk commencement date . If this policy or any MajorCare benefit provided by this policy is avoided from inception you will forfeit and we will be entitled to retain all premiums paid in relation to the benefit or policy. Sovereign can cancel this policy and decline liability in respect of any claim made under this policy if you , a life assured or anyone acting on your behalf makes a claim under this policy that is false or fraudulent in any respect. In the event that fraud is established after payment of the claim all amounts paid in relation to the false or fraudulent claim must be repaid to Sovereign . Sovereign can cancel this policy if a premium has not been paid within 31 days of the premium due date .
> The policy owner should provide Sovereign with:
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details of the planned medical treatment or procedure; and
– a copy of your health provider’s referral certificate and any other relevant clinical notes that may be requested by us in order to satisfy us that the medical treatment or procedure being contemplated is medically necessary and that it falls within the terms and benefits of this MajorCare policy. > Where possible you should provide Sovereign with an estimate of the costs for the medical treatment or procedure, if the hospital and surgeon are not Sovereign approved providers.
> Allow Sovereign in its sole discretion to:
4. How to claim a benefit
– contact the healthcare provider and obtain an estimate of the costs associated with the medical treatment or procedure under the claim;
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negotiate the proposed costs; and
You must submit all claims to Sovereign within 12 months of the health provider performing the medical treatment or procedure.
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request that a second opinion is sought.
Subject to you requesting otherwise, Sovereign can nominate alternate providers of healthcare who Sovereign considers to be suitably qualified to perform the medical treatment or procedure under the claim. Following assessment and approval of the medical treatment or procedure Sovereign will allocate a prior approval reference number to the claim and will fax or post you or, the life assured and the Sovereign approved provider a letter confirming that the claim has been approved. You must ensure that the prior approval number is quoted on all of the invoices/accounts relating to the pre-approved claim that are sent to Sovereign . Sovereign may in its sole discretion reimburse any health care provider or eligible provider directly. If this MajorCare policy is cancelled for any reason and there are outstanding claims relating to any insured event occurring before the date of cancellation, Sovereign must receive the relevant claim forms within 30 days of the cancellation date, otherwise the claim(s) will not be payable. Sovereign is not under any obligation to consider a claim unless all of the required information is provided to us . All claims are paid in New Zealand dollars. You also need to use your best efforts to notify Sovereign within 24 hours after an emergency private or public hospital admission, procedure or scan has taken place. b) When you pay for treatment yourself and then submit a claim for reimbursement: You should give Sovereign notice of a claim as soon as possible by calling our MajorCare Claims Hotline. On such notification Sovereign will send you a claim form. You should complete the claim form and send it together with the eligible provider ’s or health provider’s referral le tter and / or medical certificate and all of the original receipts and itemised invoices, to us .
5. Claims on other insurers
Where another insurer including but not limited to ACC may have a responsibility in respect of a claim the following provisions apply. It is the policy owner’s or life assured’s responsibility to advise Sovereign that another insurer is involved in a claim that has been submitted to Sovereign . Before Sovereign accepts a claim under this policy, you must firstly make a claim to other insurers for any expense recoverable from a third party or under any contract of indemnity or insurance. Any expenses recoverable in this way will be deducted from the reimbursement provided by Sovereign under this policy. For the purposes of this policy ACC is defined as another insurer.
For claims involving ACC :
a) It is the life assur ed’s or policy owner’s responsibility to submit any accident related claim to ACC in the first instance. Where surgery is indicated, the life assured or policy owner must seek or obtain prior approval from ACC for private hospital costs. b) In respect of any accident related hospital treatment Sovereign will not pay for MRI or CT scans required within seven days of the injury occurring. Under the ACC Act treatment within seven days of the injury occurring is deemed to be ‘acute’ requiring treatment to be undertaken in a public hospital . c) If due to the policy owner’s or life assured’s failure to comply with ACC ’s requirements ACC refuses to cover the claim or ceases claim cover, the policy owner or life assured will be deemed by Sovereign to not have made a reasonable effort to secure cover and will therefore be ineligible to claim under this policy. d) If ACC declines cover for private hospital treatment of an accident related condition, Sovereign reserves the right to apply to ACC for a review of that decision on the policy owner’s or life assured’s behalf. 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 MajorCare benefits 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.
For any claim to be admissible:
> the medical treatment or procedure must be medically necessary, as evidenced by the health provider’s referral certificate and any other documentation requested by Sovereign to satisfy itself that the medical treatment or procedure is medically necessary; and > premiums must be fully paid at the time the medical treatment or procedure takes place. Subject to the terms of this policy, Sovereign will pay all reasonable charges for medically necessary treatment up to the respective policy limits. If the costs of the medical treatment or procedure are greater than Sovereign ’s MajorCare benefit limits, or, the reasonable charges , the balance of the charges remaining after Sovereign has paid the reasonable charges will be your responsibility.
6. How can you amend this policy?
a) Adding family members
You may apply to Sovereign in writing to extend cover under this MajorCare policy at any time to include:
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> The spouse or de-facto partner of a life assured ,
> Any child or dependent who transfers to his/her own MajorCare policy will be issued with the MajorCare policy wording that is current at the date of transfer. You may remove any life assured under this policy at the 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. c) Adding or removing optional MajorCare benefits or adjusting your excess You may make a request to Sovereign in writing to add or remove optional MajorCare benefits specified in Section 3 of the MajorCare benefits sheet or to change the excess . If Sovereign agrees to your request any changes to the MajorCare benefits or the excess can only take effect from the next anniversary date . Sovereign is not under any obligation to agree to any optional benefit addition or removal or change in 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 an excess is made. Any optional benefit addition, or removal, or change to an excess may result in a change to your premium . Any change in premium , MajorCare benefits, or, excess to your policy will start from the date notified to you by Sovereign in the applicable policy endorsement.
> Any child under the age of 21 of an adult life assured .
Sovereign is not under any obligation to add an additional life assured(s) unless we are satisfied that the life assured(s) is in good health. Children are subject to an exclusion for congenital disorders as specified in Section 4 of the MajorCare benefits sheet unless Sovereign agrees otherwise. Children of an adult life assured 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 t he 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 health. Details received outside of this period will result in the child having to be medically assessed. If a child is added to your MajorCare 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 on 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 health unless Sovereign agrees otherwise.
b) Removing a family member / dealing with adult dependent children
7. Miscellaneous
> 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 will be offered the opportunity to transfer to his/her own MajorCare policy without providing evidence of good health. However, the child must make a written application to Sovereign within three months after the anniversary date following his/her 21st birthday. > If a child insured under this policy has reached the age of 21 and falls within the definition of being a dependent , then you can apply to have them remain on this policy until he/she reaches the age of 25. You will be charged the appropriate age related premium for each dependent and cover will continue under this policy until the first anniversary date after their 25 th birthday. On reaching the age of 25 each dependent will be offered the opportunity to transfer to his/her own MajorCare policy without providing evidence of good health. However, the dependent must make a written application to Sovereign within three months after the anniversary date following his/her 25th birthday. Sovereign may request that you provide proof to establish that a child insured under this policy falls within the definition of a dependent .
Your Sovereign MajorCare policy is classified as a term life insurance policy.
a) What forms part of this policy contract?
All the terms of this policy are contained in and based on:
> This policy document including the MajorCare benefits sheet , schedule and any alterations made to this policy document, the MajorCare benefits sheet or schedule as permitted under this policy. > Any application forms and declarations made by you , at any time, concerning this policy.
> All statements, which a life assured , has made to Sovereign .
> Any provisions which any legislation states must be included in this policy, unless those provisions can be contracted out of, in which case they are not included.
> The policy illustration .
Nothing else forms part of this contract.
b) Law or Government Authority changes affecting Sovereign or this policy
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If changes in the law occur after the policy commencement date and we believe on reasonable grounds that those changes will affect:
f) Information about your policy
Shortly before each anniversary date , Sovereign will send you a letter containing information about your policy. You may at any time write to Sovereign or your Sovereign adviser for further information about your policy.
> Our liability for tax, or
> The tax treatment of premiums payable or claims receivable, or > The way in which the policy works or the amount of benefit payable Then we can change the provisions of the policy but only to take into account the effect of the law change.
g) No surrender value
This policy does not participate in the profits of Sovereign . This policy has no surrender value or cash value if it is cancelled.
h) Suspension of cover
c) Policy subject to laws of New Zealand
You may write to Sovereign requesting suspension of cover under this MajorCare policy for the following reasons: > a life assured is traveling overseas for a period of two to 12 months; or > a life assured is registered as unemployed for a period of two to six months. Sovereign will require evidence of overseas travel or unemployment before agreeing to a suspension of this policy. No premiums will be payable and no cover will be provided under this MajorCare policy during the period of suspension. Cover under this MajorCare policy will be reinstated as long as premiums recommence when the overseas travel or unemployment ends or within the maximum time allowances, whichever comes first. During the term of this MajorCare policy, the total suspension period is a maximum of 12 months for overseas travel, and a maximum of six months for registered unemployment.
The laws of New Zealand govern this policy, which has been issued in New Zealand.
d) Notices
When you write to Sovereign about this policy, you must send all correspondence to Sovereign ’s head office in New Zealand or to a substitute address provided to you by Sovereign . The mailing address for Sovereign ’s head office is:
Private Bag Sovereign Victoria Street West Auckland 1142
The street address for Sovereign ’s head office is:
Sovereign House 74 Taharoto Road
Takapuna Auckland
If more than one person owns this policy, all of the policy owners must sign any correspondence sent to Sovereign . However, Sovereign will not be liable to any policy owner if we act on correspondence signed by one or more, but not all, of the policy owners . Sovereign is not bound by anything contained in a letter or notice you send unless we actually receive the letter or notice at Sovereign ’s address. When Sovereign writes to you about this policy, we will send the letter or notice to the address for the policy owner shown in the schedule , or a substitute address that you have given to us . You must immediately notify Sovereign of any changes to your postal or residential address. Every notice required to be given to you by Sovereign shall be deemed to be delivered three days after having been posted.
i) Complaints Procedures
Complaints by policy owners to Sovereign must be made in writing to the address specified in Section 7d or a substitute address provided by Sovereign . If the policy owner is not satisfied with the outcome of the complaint they have the right to refer the complaint to the Insurance and Financial Services Ombudsman. The Ombudsman can only deal with a complaint after Sovereign ’s internal complaints proced ure has been exhausted and a letter acknowledging this has been sent to the complainant.
e) Transfer of ownership
You may assign your policy at any time by completing the Memorandum of Transfer printed at the back of this policy. More than one person can own or take an assignment of this policy. A trust or trustee cannot own this policy. To be valid the assignment must be registered with Sovereign . No charge is payable in respect of an assignment of this policy.
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8. Key terms
fraudulently
A statement is made fraudulently if the person making the statement makes it;
In this policy the following words have defined meanings:
> Knowing it is incorrect; or
ACC
The Accident Compensation Corporation of New Zealand or its successor.
> Without belief in its correctness; or
> Recklessly, without caring whether it is correct or not.
ACC Act
The Parliamentary Act of New Zealand that regulates ACC , which is in effect at the time of an accident occurring.
general practitioner
A medical practitioner who is registered to practice medicine in New Zealand and who specialises in the delivery of primary healthcare services.
anniversary date
The annual anniversary of the risk commencement date of this policy.
insured event
A medical treatment, procedure or other event included under the MajorCare benefits.
consumer price index
The consumer price index (all groups) issued by the New Zealand Government Statistician or any index, which may replace that index. A Sovereign approved surgical centre or clinic where minor surgery is carried out and where patients are not required to stay overnight. A person registered to practise dentistry under the terms of the Dental Act 1988 or any subsequent replacement legislation.
life or lives assured
The life or lives assured listed in the schedule .
day stay clinic
MajorCare benefits sheet
The most recently updated MajorCare benefits sheet issued by Sovereign, which forms part of this policy and explains the benefits payable under MajorCare. A statement is material only if that statement would have influenced the judgment of a prudent insurer in fixing the premium or in determining whether he/she would have taken or continued the risk upon substantially the same terms.
dentist
material
dental practitioner
A recognised health professional, who is registered with the Dental Council of New Zealand (or its successor).
Any child of a life assured or any child under the legal guardianship of a life assured covered under this policy and aged between 21 and 25 years, who is financially dependent on the life assured (for example; a 22 year old attending a full time tertiary course). A “registered health professional” as defined in Section 4(1) of the Health and Disability Commissioner Act 1994 (excluding any person registered or enrolled under the Psychologists Act 1981 or any replacement legislation),or, any other provider which Sovereign advises is acceptable. The amount applied to and deducted from the MajorCare benefits under this policy by Sovereign as specified in the schedule .
dependent
oral surgeon
A Sovereign approved dental Specialist who has specific registration to perform complex oral surgery.
physician
A Sovereign approved medical practitioner who is qualified in a specialist field of medicine and is registered as a physician with the New Zealand Medical Council.
eligible provider
policy fee
The administration fee charged by Sovereign detailed in the policy illustration .
policy illustration
The Sovereign illustration enclosed with and forming part of this policy document.
excess
policy owner, you, your and yourself
The policy owner listed in this policy document.
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routine screening
premium(s)
Any preventative treatment, health surveillance testing, or investigative procedures performed by a health care provider where the policy owner or life assured has no medical symptoms.
The amount of premium payable by you to Sovereign under this policy comprising the cost of the MajorCare benefits chosen by the policy owner plus the policy fee if any as detailed in the schedule .
schedule
The latest (in time) schedule of policy details including endorsements that forms part of this policy document.
premium due date
The date on which the premium is payable under the policy, as agreed with Sovereign.
Sovereign approved facility
Any hospital, day stay centre, or clinic licensed in accordance with the Health and Disability Services (Safety) Act 2001 approved or accredited by Sovereign . Any health provider who has been approved by Sovereign as having the appropriate qualifications/ registration to provide healthcare services to Sovereign or its policy owners and life assured s.
private hospital
A Sovereign approved privately owned hospital which is licensed as a private hospital in accordance with the Health and Disability Services (Safety) Act 2001.
Sovereign approved provider
prostheses
The artificial parts used to replace bodily parts when specific types of surgery are undertaken.
public hospital
A hospital service or institution licensed in accordance with the Health and Disability Services (Safety) Act 2001 directly or indirectly owned or funded by the New Zealand Government or any of its agencies. Charges for medical treatment that are determined by Sovereign in its sole discretion to be reasonable and within a range of fees charged under similar circumstances by persons of equivalent experience and professional status in the area in which the medical treatment is provided. A person, who is registered and practicing as a medical practitioner in New Zealand that is approved by Sovereign , other than; > you; > the life assured ; > a member of the life assured ’s family or your immediate family; > the life assured ’s or your business partner or associate. A person registered as a nurse (whether as a comprehensive nurse, or a general nurse, or otherwise), or as a midwife, under the Nurses Act 1977.
Sovereign, we, our or us
Sovereign Assurance Company Limited.
Sovereign benefit maximums
The listing established by Sovereign, which specifies the maximum amounts payable by Sovereign for the supply of
reasonable charges
prostheses and disposable laparoscopic equipment.
Sovereign Criteria
A set of criteria Sovereign uses to consider and approve chemotherapy or radiotherapy treatments under the Private Hospital Non-Surgical benefit in order to ensure the treatment falls within reasonable charges .
Registered Medical Practitioner
The criteria is determined by:
> Whether the medicine is
recommended for public funding by the Pharmaceutical Therapeutics Advisory Committee (or its successor); > The medical advice of the treating oncologists; > International evidence of clinical effectiveness;
registered nurse
> Other factors that Sovereign
reasonably assesses as relevant.
Risk commence- ment date
The commencement date that cover under this policy takes effect.
specialist(s)
A Sovereign approved medical practitioner who is qualified in a specialist field of medical or surgical practice and is registered as a
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specialist with the New Zealand Medical Council.
terrorist act
Any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption, or commission of an act dangerous to human life or property, against any individual, property or government, with the stated or unstated objective of pursuing economic, ethnic, nationalistic, political, racial or religious interest, whether such interests are declared or not, and shall include any act which is verified or recognised by the (relevant) Government as an act of terrorism. Robberies or other criminal acts primarily committed for personal gain and acts arising primarily from prior personal relationships between perpetuator(s) and victim(s) shall not be considered terrorist acts.
substantially incorrect
A statement is substantially incorrect only if the difference between what was stated and what is actually correct would have been considered material by a prudent insurer. A policy as defined in Section 2A of the Securities Regulations 1983 that is not a security or a life insurance policy for the purposes of the Securities Act 1978.
term life insurance policy
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