consent has been given for the continuation of the appendix . However, if a life assured is on claim and the reason for the business being wound-up or liquidated is due to the total disability or partial disability of the life assured, the benefit will remain in force until the end of the benefit payment period for that life assured .
13. When will Sovereign cease paying a benefit?
Sovereign will cease paying a benefit if:
(a) The life assured fails to undergo and complete:
–
any surgical operation; and/or
–
any medical rehabilitation programme; and/or
When the benefit is cancelled by the policy owner.
–
any social rehabilitation programme; and/or
In addition, this appendix cannot be assigned to another policy owner, unless consent is given by Sovereign in writing. Termination will take effect upon receipt of written notification from the policy owner. 15. When will this appendix terminate for the life assured? This appendix will terminate and eligibility for the Business Continuity Benefit will cease for a life assured:
–
any vocational rehabilitation programme,
which a registered medical practitioner approved by Sovereign considers reasonably necessary. (b) The life assured fails to undertake any medical examinations that Sovereign requires the life assured to have, at our expense. (c) The life assured fails to comply with the requirements of Section 12 above. (d) Sovereign determines that the life assured is no longer totally disabled or partially disabled . (e) The benefit payment period expires in relation to the life assured. (f) The life assured or anyone acting on behalf of the life assured makes a false or fraudulent statement in respect of a claim or supports any claim with false evidence. (g) The life assured is no longer actively involved in the business , unless the reason for this is related to a claim.
> At the expiry of the benefit term for that life assured as shown in the schedule .
> When the life assured dies.
> If the life assured is no longer actively involved in the business for more than 60 days for reasons other than total disability , unless Sovereign has been notified in writing and its written consent has been given for the continuation of the appendix . > If the business is wound-up or liquidated unless Sovereign has been notified in writing and its written consent has been given for the continuation of the appendix . However, if a life assured is on claim and the reason for the business being wound-up or liquidated is due to the total disability or partial disability of the life assured, the benefit will remain in force until the end of the benefit payment period for that life assured .
(h) The life assured is in prison for any reason.
(i) The life assured dies.
If Sovereign ceases paying a benefit in accordance with paragraphs (a), (b) or (c) and the life assured subsequently complies with the relevant requirement(s), then: > The date that the life assured complied with the relevant requirement(s) will, subject to the provisions of this appendix, be treated as the disablement date for a new claim.
> When the benefit is cancelled by the policy owner.
16. Exclusions – when Sovereign won’t pay a benefit Sovereign will not pay a benefit where any of the following directly or indirectly cause or contribute to the total disability or partial disability : > The life assured deliberately injures himself or herself or attempts to do so. > The life assured engages in or is part of any conduct that is criminal. > The life assured does not comply with the treatment recommended by the attending treatment providers. > Pregnancy of, or childbirth by, the life assured, unless the disability lasts for more than 90 days after the end of pregnancy, in which case the waiting period will start from the 91 st day. If the life assured is imprisoned for any reason, no monthly benefit will be payable during the term of imprisonment.
> The waiting period will be waived for the new claim.
> The original claim and the new claim will be considered to be the same claim in respect of the benefit payment period . > No monthly benefit payments will be payable retrospectively for any period of time before the date that the life assured subsequently complies with the relevant requirement(s).
14. When will this appendix terminate for the policy owner?
This appendix will terminate for the policy owner:
At the expiry of the benefit term as shown in the schedule .
If the business is wound-up or liquidated unless Sovereign has been notified in writing and its written
863 TCB-BC version 3 Effective 21 May 2019
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