premiums will increase with any reduction in waiting period ; only one reduction in waiting period under this benefit is allowed without evidence of health; any loadings, exclusions or special terms on the cancelled policy will be applied to the reduced waiting period benefit. 18. What is the Concurrent Waiting Period Benefit? If the life assured is disabled and able to receive a Mortgage and Income Protection Benefit under this policy, and they also hold a Business Overheads, Business Continuity, Rural Continuity or Locum Cover policy, then the waiting periods applicable to the life assured under each policy will be served concurrently from the disablement date . If during the waiting period under this policy, the life assured is able to claim the Recurrent Disablement Benefit under a Business Overheads, Business Continuity, Rural Continuity or Locum Cover policy, the portion of their waiting period for their Mortgage and Income Protection under this policy will be considered to have been continuous and only the remaining period will apply. 19. What is the Optional Claim Indexation Benefit? The Optional Claim Indexation Benefit applies only if “CPI Linked” is specified in the schedule . Where the Optional Claim Indexation Benefit is selected, the Mortgage and Income Protection Benefit sum assured shown in the schedule will increase on each anniversary date , by the same percentage as the percentage increase in the consumer price index for the preceding year ending 30 September. If the consumer price index falls in any year, the Mortgage and Income Protection Benefit sum assured will not decrease. Any increase as a result of an increase in the consumer price index will be subject to the maximum benefit amounts allowable under this benefit.
The Back to Work Payment is a lump-sum payment equivalent to 3 times the life assured’s monthly disability benefit for the last full month immediately before the claim ceased, as calculated in accordance with Section 2 for a total disability, and Section 5 and (if applicable) Section 6 for a partial disability. Sovereign will only pay the Back to Work Payment once per claim across all policies where AIA New Zealand Limited is the insurer, and it will not be paid where the benefit payment period is one or two years. If the life assured suffers a recurrence of the same or a related illness or injury within 12 months of a Total or Partial Disability Income Benefit ceasing, then any Back to Work Payment made in respect of that claim will be deducted from the amount of the Total or Partial Mortgage and Income Benefit payable. 21. What is the Optional Mental Health Limitation? The Optional Mental Health Limitation applies only if it is shown in the schedule and if no mental health exclusion applies for this appendix . If the Optional Mental Health Limitation applies, Sovereign will only pay a claim due to a mental health disorder for a maximum of two years throughout the life of this benefit. The Optional Mental Health Limitation payment period will commence if in Sovereign’s opinion, after considering the advice of a registered medical practitioner and other relevant information, the life assured is deemed to be totally disabled or partially disabled as a result of a mental health disorder .
22. 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. In addition, for a Mortgage and Income Protection Benefit claim, Sovereign will require: the life assured to be examined by a registered medical practitioner acceptable to Sovereign, before accepting liability for a claim; and a Sovereign claims form completed by the life assured and a registered medical practitioner (at your expense); and other information which Sovereign may reasonably request to help assess the claim, which may include evidence of monthly earnings, taxable income, business accounts, ACC details or similar; and the life assured to undergo medical and/or surgical treatment (including any operation or vocational, medical and/or social rehabilitation programme) at your expense which the life assured’s registered medical practitioner or a registered medical practitioner approved by Sovereign considers necessary; and any other information that Sovereign may deem relevant to the assessment of the claim (this may include evidence of the life assured’s mortgage amount).
20. What is the Back to Work Payment and when will Sovereign pay it?
Sovereign will pay you a Back to Work Payment if:
a Total or Partial Mortgage and Income Protection Benefit has been paid for a life assured for a continuous period of longer than 12 months but less than 24 months; and the life assured engages in work or carries on business; and the life assured is no longer totally disabled or partially disabled; and the life assured has ceased to be on claim with Sovereign.
820 TCP-MIP version 8 Effective 12 May 2026
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