Chronic lung disease
Intensive care benefit
The life assured has irreversible chronic lung disease as confirmed by an appropriate medical specialist on the basis of respiratory function tests and which satisfies any one of the following criteria:
Full payment
A state of unconsciousness with no reaction to stimuli or internal needs, persisting continuously for at least 96 hours, requiring assisted ventilation (including the use of endo-tracheal intubation and/or tracheostomy) in the intensive care unit of a hospital. The life assured must have also sustained a neurological deficit causing at least 25% permanent impairment of whole person functioning or inability to perform one of the activities of daily living . Unconsciousness caused by drug and alcohol abuse is specifically excluded.
Type 1 respiratory failure defined as O2 <60 mm hg; or
Type 2 respiratory failure defined as CO2 >45 mm hg; or
the provision of home oxygen therapy according to clinical practice guidelines for hypoxia O2 <55 mm hg (or 60 mm hg in the presence of pulmonary hypertension); or
FEV1 <35% predicted; or
DLCO (diffusing capacity or gas transfer) < 40% predicted; or is unable to perform at least one of the activities of daily living as a result of the respiratory failure.
Partial payment
Chronic renal failure
A state of unconsciousness with no reaction to stimuli or internal needs, persisting continuously for at least seven days, requiring assisted ventilation (including the use of endo-tracheal intubation and/or tracheostomy) in the intensive care unit of a hospital.
The kidneys of the life assured have reached the end-stage of renal disease resulting in chronic irreversible failure of the kidneys to function, as a result of which regular renal dialysis is instituted or transplantation performed.
Unconsciousness caused by drug and alcohol abuse is specifically excluded.
Cognitive impairment
A permanent and irreversible loss of cognitive function that requires the life assured to be under continual care and supervision by an appropriate carer for at least 8 hours per day, as certified by an appropriate specialist.
The benefit payable is 25% of the sum assured to a maximum of $75,000 across all Business Sovereign policies for the life assured .
HIV
Major transplant surgery
Infection with the Human Immunodeficiency Virus (HIV) must have been acquired by accident or violence during the course of the life assured ’s normal occupation or through the medium of a blood transfusion, transfusion of blood products, organ transplant, assisted reproduction technique or other medical procedure or operation performed by a registered healthcare professional and/or in a registered hospital care institution, or surgical centre or surgical clinic. You must prove this to our satisfaction. Sero-conversion to the HIV infection must occur within six months of the accident . HIV infection transmitted by any other means, including but not limited to sexual activity or non-medical intravenous drug use, is not covered under this appendix . Any incident giving rise to a potential claim must be reported to us within 30 days of the incident and be supported by a negative HIV Antibody Test taken within seven days after the incident. Sovereign may decline your claim if we are not given access to independently test all blood samples used, if we require, or if the life assured does not allow Sovereign to take further independent blood tests.
The life assured has undergone, or been placed on the major organ transplant waiting list in New Zealand or Australia for, a transplant from a human donor of one or more of the following organs or substances:
Kidney;
Heart;
Lung;
Liver;
Pancreas;
Bone marrow; or
Intestine.
The transplant of all other organs, parts of organs or any other tissue transplant is excluded. The transplant must be considered medically necessary and the condition affecting the organ deemed untreatable by any means other than organ transplant, as confirmed by an appropriate medical specialist .
852 TCB-LAC version 19 Effective 12 May 2026
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