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.
851 TCB-LIFE version 8 Effective 12 May 2026
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