851 TCB-LIFE version 8 Effective 12 May 2026
TOTALCAREMAX BUSINESS
OPTIONAL BENEFIT APPENDIX
Life Cover Benefit
This appendix only applies if cover under the schedule for your Policy includes the Life Cover Benefit. This appendix forms part of and is incorporated into the TotalCare Max policy, the terms of which apply to this appendix .
This is a Life Cover Benefit. Details of the benefit chosen and the names of the people insured for the benefit (called the life or lives assured) are shown in the schedule .
Sovereign may at its sole discretion alter this list of conditions from time to time as a result of the conditions becoming curable or improvements in the medical outlook for the conditions since 2015. Sovereign will give 30 days prior written notice to you, before any change takes effect.
1.
When will Sovereign pay a Life Cover Benefit?
Sovereign will pay a Life Cover Benefit when the life assured for the benefit, as specified in the schedule , dies. Sovereign will pay the benefit as soon as we are satisfied with all the information which must be presented at the time of making a claim.
4.
Financial and Legal Advice Benefit
If Sovereign pays a claim under the Life Cover Benefit, the Specified Terminal Conditions Benefit, or the Terminal Illness Benefit then Sovereign will reimburse you for fees incurred up to $2,500 including GST (in total) that you pay for financial planning advice you receive from an accredited Adviser or legal advice received from a legal professional approved by Sovereign, subject to the following conditions: You must pay for the financial planning or legal advice within the 12 months following Sovereign paying the Life Cover Benefit claim. Sovereign will only pay one Financial and Legal Advice Benefit per life assured across all Sovereign policies . This is in addition to the sum assured.
2.
Terminal Illness Benefit
You can apply to Sovereign for a Terminal Illness Benefit of up to 100% of the applicable Life Cover Benefit if the life assured has been diagnosed as having an illness where in Sovereign’s opinion despite all reasonable medical treatment they are expected to live for no more than 12 months. The registered medical practitioner treating the illness must provide supporting evidence of the illness, possible medical treatment, the prognosis and confirm that the definition of Terminal Illness has been met. This Terminal Illness Benefit will be treated as an early payment of the Life Cover Benefit. The Life Cover Benefit will then be reduced by the amount paid for the Terminal Illness Benefit.
5.
Counselling Benefit
3.
Specified Terminal Conditions Benefit
The Counselling Benefit covers the cost of a Psychiatrist or Psychologist consultation and/or counselling for the life assured and/or a close relative of the life assured where the support treatments and/or consultations directly relate to a claim under the Life Cover Benefit, the Specified Terminal Conditions Benefit or Terminal Illness Benefit. After referral by the registered medical practitioner we will reimburse up to $2,500 including GST (in total) per life assured, subject to the following conditions: The consultation and/or counselling must be paid for within 12 months following Sovereign paying the Life Cover Benefit, the Specified Terminal Conditions Benefit or Terminal Illness Benefit claim; and
You can apply to Sovereign for a Specified Terminal Conditions Benefit of the lower of:
30% of the applicable Life Cover Benefit; or
$250,000
if the life assured has been unequivocally diagnosed by an appropriate registered medical practitioner as having any of the following incurable terminal conditions:
Motor Neurone Disease
Exocrine Pancreatic Cancer (Stages 3 or 4)
Sovereign must be provided with a receipt for the consultation and/or counselling being claimed.
Non-Small Cell Lung Cancer (Stage 4)
Distal Oesophageal Cancer (Stage 4)
The $2,500 is payable once per life assured per policy. This is in addition to the sum assured.
This Specified Terminal Conditions Benefit will be treated as an early partial payment of the Life Cover Benefit. The Life Cover Benefit will then be reduced by the amount paid under the Specified Terminal Conditions Benefit. The premium will adjust to reflect the reduced cover.
851 TCB-LIFE version 8 Effective 12 May 2026
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6.
Repatriation Benefit
EXAMPLE 1:
Original benefit = $100,000 Original benefit x 5 = $500,000 Cover available after the use of this Facility cannot exceed $500,000 Total increase under this Facility cannot exceed $400,000
If the life assured dies, Sovereign will reimburse you for the costs of returning the life assured's body to New Zealand or their home country upon receipt of evidence acceptable to Sovereign. If the life assured is the sole policy owner, Sovereign will reimburse the person that has paid for the costs of repatriation upon receipt of evidence acceptable to Sovereign. The maximum amount of the Repatriation Benefit across all Sovereign policies and AIA New Zealand policies for that life assured is the lower of:
EXAMPLE 2:
Original benefit = $2,500,000 Original benefit x 5 = $12,500,000 Cover available after the use of this Facility cannot exceed $10,000,000 Total increase under this Facility cannot exceed $7,500,000 The Optional Business Safeguard Facility cannot be exercised within six months of the risk commencement date .
The Life Cover Benefit; or
$25,000.
The Repatriation Benefit will be treated as an early payment of the Life Cover Benefit. The Life Cover Benefit will then be reduced by the amount paid.
In any 12 month period you can make only two increases under this Facility.
7.
Premium Conversion Facility
You must make the request within three months of the relevant business event.
You may at any time:
To apply for the increase in cover, you need to write to Sovereign to satisfy us that the value of the life assured’s financial interest is at least equal to the requested increase to the amount of cover. You must include: − A valuation of the business or valuation of the life assured to the business (as provided by an independent qualified accountant or business valuer); and/or
Convert all or part of your Life Cover Benefit from the premium shown in the schedule to a Level premium structure. The Life Cover Benefit under your policy will be reduced by the sum assured amount converted; or Convert a Level premium Term to a further Level premium Term, of which duration may be the same or less than current Level premium Term. Sovereign will not require you or the life assured to produce further medical evidence at the time of conversion. The terms and conditions of the new policy will be those which are then offered by us to the general public. Premiums will be calculated on the current age of the life assured . Any special terms, exclusions or premium loading that applied to your existing Life Cover Benefit will apply to your new Life Cover Benefit.
− Evidence of the loan guarantee, and any other contractual or financial evidence we may request.
Any increase is subject to approval by Sovereign.
The method chosen to value the business or life assured must be in accordance with established business valuation practice for the industry. The independent qualified accountant or business valuer cannot be a family member, business partner, employee or employer of you or the life assured. The method of valuation and valuer must be satisfactory to Sovereign. In the first six months following an increase, the life assured will only be covered for the amount of the increase if the life assured’s death occurs as a direct and sole result of an accident . You cannot apply for an increase under this Facility if at any time the life assured has made, or was entitled to make, a claim under the Life Cover Benefit.
8.
Optional Business Safeguard Facility
The Optional Business Safeguard Facility applies only if shown in the schedule .
On each occasion that the financial interests of a life assured in the business increases, or their loan guarantee increases, or their value to the business increases, you may write to Sovereign asking us to increase the Life Cover Benefit for that life assured without the need to provide medical evidence, subject to the following conditions: The Life Cover Benefit for a life assured under this policy after the use of this Facility cannot exceed the lesser of five times the original Life Cover Benefit or $10,000,000.
Each Optional Business Safeguard Facility increase will require an increase in premium . This increase will be
calculated on the rates applicable at the time the Optional Business Safeguard Facility is used.
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9. How to make a claim
To make a claim, you must follow the relevant procedures in the section of your TotalCare Max policy entitled ‘How to make a claim’.
In addition, for a Life Cover Benefit claim, Sovereign will require:
A full death certificate (in the event of the death of a life assured), and a coroner’s report if applicable.
A grant of administration – probate, or certificate of administration, or letters of administration if the deceased was the sole owner of the policy. For a Terminal Illness Benefit, evidence from a registered medical practitioner diagnosing an illness which will result in the death of the life assured within 12 months of the diagnosis and any other evidence we may reasonably require. For a Specified Terminal Conditions Benefit, evidence from a registered medical practitioner with an unequivocal diagnosis of a specified condition and any other evidence we may reasonably require.
10. Exclusions – when Sovereign won’t pay a benefit
Sovereign will not pay any benefit under this appendix where the life assured dies or becomes terminally ill as a direct or indirect result of an intentional self-inflicted act (whether sane or insane) within 13 months of the risk commencement date or, if cover under this appendix has been reinstated, the date of reinstatement. This exclusion applies to any subsequent benefit increase you make.
11. Key terms
accident
Injury caused by violent, accidental, external and visible means.
accredited Adviser
Either an Adviser with a current financial adviser agreement with Sovereign Services Limited or a member of a financial services industry body approved by Sovereign.
AIA New Zealand policy /policies
Any policy or policies where AIA New Zealand Limited is the insurer.
home country
The country in which the life assured was born or, their country of permanent residence.
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