7. When will Sovereign cease paying a benefit? Sovereign will cease paying a benefit if: (a) Sovereign determines that the life assured is no longer totally disabled or a total disability benefit is no longer payable under a Sovereign Personal disability income policy for the life assured. (b) The life assured reaches age 65. (c) The life assured’s Mental Health Limitation payment period ends (if applicable for the life assured under the Sovereign Personal disability income policy ); (d) The life assured ceases to be a member of a KiwiSaver scheme; (e) 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. (f) The life assured is in prison for any reason. (g) The life assured dies. 8. Exclusions – When Sovereign won’t pay a benefit? Sovereign will not pay a Retirement Protection Benefit if: > the life assured became totally disabled prior to, or within six months following the risk commencement date of this Retirement Protection Benefit; > a total disability benefit is not payable under a Sovereign Personal disability income policy for the life assured; > a partial disability benefit is payable in respect of the life assured under a Sovereign Personal disability income policy ; > the life assured is not a member of a KiwiSaver scheme .
The premium payable for the reinstated benefit will be based on Sovereign’s premium rates at the time of the reinstatement. If Sovereign does not receive notification to reinstate the cover under the Sovereign Personal disability income policy for the life assured within the required time and, as a result, cover for the life assured under that Sovereign Personal disability income policy terminates, then cover under this Retirement Protection Benefit appendix will also terminate for that life assured.
4. Law changes Without limiting the law changes section of your
TotalCare Max policy, if changes to the KiwiSaver law or regulations occur after the risk commencement date and Sovereign believes on reasonable grounds that those changes will affect this benefit, then Sovereign can change the provisions of this appendix in whatever way it deems appropriate. 5. Tax Sovereign understands that under current tax legislation premiums payable for agreed value disability protection insurance are generally not deductible and claim payments are generally not taxable. In the event of a tax change you may elect that, for the purpose of calculating the Retirement Protection Benefit only, the benefit amount shown in the schedule is increased to an amount agreed by Sovereign to reflect the change in tax treatment. Your premiums from that point onwards will be adjusted to reflect the increased amount of benefit and will be based on premium rates applicable at that time. An election under this clause must be made within 180 days of the tax change . No further underwriting will be required for the increase but any existing exclusions and endorsements will apply. No election under this clause may be made if a Retirement Protection Benefit is payable in respect of the life assured (or would have been payable had a claim been made). 6. How to make a claim To make a claim, the relevant procedures in the section of your TotalCare Max policy entitled ‘How to make a claim’ must be followed. The ‘How to make a claim’ and ‘Ongoing Claim Requirements’ sections of the Sovereign Personal disability income policy also apply to this Retirement Protection Benefit. In addition, Sovereign will not pay a claim under this Retirement Protection Benefit until Sovereign has received all the information it needs to pay this Retirement Protection Benefit, including the name of the life assured’s KiwiSaver scheme .
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813 TCP-RP version 3 Effective 19 October 2015
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