medical consultations or treatment, travel, lodging, telephone calls, faxes or mail), unless covered by a Sovereign policy.
9. What is the Business Mentors Benefit?
Business Mentors is available to the policy owner following an accepted claim for a life assured under this appendix . Business Mentors provides independent, impartial advice on your business by one of over 1,700 mentors around the country. If a claim is approved under this appendix, Sovereign will pay the costs of a two year membership to Business Mentors. Business Mentors is independent of Sovereign and Business Mentors terms and conditions and eligibility criteria apply. Sovereign may withdraw access to the service or change the terms on which access to the service is made available with 90 days’ notice. Neither Sovereign, its related companies, nor their directors, officers or employees accept any liability whatsoever for any loss or damage arising out of the use of the Business Mentors service, or the unavailability of Business Mentors. Sovereign is not responsible for any cost associated with becoming eligible to use, or use of, the Business Mentors service (including without limitation the cost of any travel, lodging, telephone calls, faxes or mail), unless covered by a Sovereign policy.
Contact Best Doctors on 0800 425 005.
Best Doctors and the star-in-cross logo are trademarks of Best Doctors, Inc., in the United States and in other countries and are used under licence.
11. How to make a claim
To make a claim, the relevant procedures in the section of your TotalCare Max policy e ntitled ‘How to make a claim’ must be followed. In addition, for a Business Continuity claim, Sovereign will require: the life assured to be examined by a registered medical practitioner acceptable to Sovereign, before accepting liability for a claim; and a Sovereign claims form completed by the life assured and a registered medical practitioner (at your expense); and
Sovereign will only pay one Business Mentors Benefit for each business .
other information which Sovereign may reasonably request to help assess the claim; and
where the “Business Indemnity Benefit” has been chosen, you will be required to provide Sovereign with financial information and accounts for the 12 months immediately prior to the disablement date ; and the life assured to undergo medical and/or surgical treatment (including any operation or vocational, medical and/or social rehabilitation programme) at your expense which the life assured’s registered
10. What is the Optional Employee Upgrade Benefit?
The Optional Employee Upgrade Benefit will only apply if shown in the schedule .
medical practitioner or a registered medical practitioner approved by Sovereign considers necessary; and
If selected this benefit enables your employees and their immediate family use of Best Doctors as many times as they need to. Best Doctors can provide additional advice on critical, chronic and degenerative conditions after the person who is suffering the condition has seen a specialist. The Best Doctors service can be accessed regardless of whether the condition is covered by this appendix. Best Doctors is only available to current employees of the business and cover will cease once they leave the employment of the policy owner. Best Doctors reserves the right to audit employee numbers of the policy owner’s business . Best Doctors is independent of Sovereign and Best Doctors terms and conditions and eligibility criteria apply. Sovereign may withdraw access to the service or change the terms on which access to the service is made available with 90 days’ notice. Neither Sovereign, its related companies, nor their directors, officers or employees accept any liability whatsoever for any loss or damage arising out of the use of the Best Doctors service, or the unavailability of Best Doctors. Sovereign is not responsible for any cost associated with becoming eligible to use, or use of, the Best Doctors service (including without limitation the cost of any
any other information that Sovereign may deem relevant to the assessment of the claim.
12. Ongoing Claims Requirements
For ongoing claims Sovereign will require:
> Completion of a monthly medical certificate by a registered medical practitioner (at your expense) in a form from time to time approved by Sovereign for the purposes of determining ongoing entitlement to payment of a Business Continuity Benefit. > Completion of a monthly individual declaration by the life assured in a form from time to time approved by Sovereign, which may include completion of daily activity logs detailing the life assured’s functional activities for the purposes of determining ongoing entitlement to payment of a Business Continuity Benefit. > Proof of any remunerated or non-remunerated work completed during the claim period.
> Any other information that Sovereign may deem relevant to the ongoing assessment of the claim.
863 TCB-BC version 3 Effective 21 May 2019
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