12.
What is the Home Modification or Equipment Expenses Benefit and when will Sovereign pay it?
Income Protection Benefit sum assured will not decrease.
10.
Rehabilitation and Support
Sovereign may agree to pay you an additional lump sum payment of up to 12 times the monthly benefit amount calculated in Section 2. This payment is to cover the costs of buying specialised equipment or completing home alterations that, because of the life assured’s total disability , have become necessary, in Sovereign’s opinion after considering the recommendation of an occupational therapist or an appropriate specialist approved by Sovereign. You must apply in writing to Sovereign before incurring these costs. Any benefit that Sovereign may agree to pay for the specialised equipment or home alterations will be reduced by any costs of buying specialised equipment or completing home alterations you or the life assured recover, or are entitled to recover from any other source.
On receiving notification of a new or potential claim, we will appoint the life assured a Case Manager, who will work with the life assured to understand their personal situation and assist them with the claims process. They will work with the life assured to consider what rehabilitation or functional support could assist the life assured's return to work or improve their capacity to work, either during or after the waiting period as appropriate in the opinion of Sovereign. Acceptance of any costs associated with the agreed rehabilitation and functional support by Sovereign does not mean that we will accept liability for any other benefit under this appendix and are accepted at the sole discretion of Sovereign.
13.
What is the Bed Confinement Benefit and when will Sovereign pay it?
11.
What is the Vocational Retraining Benefit and when will Sovereign pay it?
If, at any time during the waiting period the life assured is confined to bed under full-time care for more than three days and is in an occupation class other than five, then Sovereign will pay a Bed Confinement Benefit for each complete 24 hour period after the first 72 hours of bed confinement. This benefit will be a daily benefit equivalent to 1/365 th of the benefit amount shown in the schedule , which you would be entitled to if the life assured was totally disabled and the waiting period was over. Sovereign will continue to pay the benefit until the waiting period is over, or until the life assured is no longer confined to bed under full-time care , whichever is the earlier. If you have chosen the Premier Cover Option and at any time during the waiting period the life assured is confined to bed under full-time care for more than three days, then Sovereign will also pay the Bed Confinement Benefit for each complete 24 hour period within the first 72 hours of bed confinement.
Sovereign may agree to pay you a Vocational Retraining Benefit The benefit payable will be the cost of a programme of vocational training for the life assured provided:
> the programme is approved in advance by Sovereign, and reviewed regularly; and
> the sole purpose for the programme is to assist the life assured to return to gainful employment at an earlier date than would otherwise have been possible; and
> the life assured actively participates and complies with the programme; and
> the cost of the programme is limited to the fee charged by the institution providing the programme and does not include the cost of text books, equipment and stationery, accommodation and transport costs; and > the total amount which Sovereign will pay as a Vocational Retraining Benefit is limited to 12 times the monthly benefit amount as calculated in Section 2, except if the benefit payment period is one, two or five years where the total amount is limited to 6 times the monthly benefit amount as calculated in Section 2; and > vocational retraining must take place within New Zealand, or the country in which the life assured was residing for 6 months before becoming disabled; and
14.
Home Care Benefit
If the life assured is totally disabled , Sovereign will pay a Home Care Benefit monthly in arrears in addition to the Total Disability Income Benefit. The Home Care Benefit is a payment for the services of the person providing care to the life assured and is payable to the person providing care, not the policy owner named in the schedule . The person providing the care will not be acting as an employee, contractor or agent of Sovereign. A registered medical practitioner must certify that the life assured requires full-time care at home or in a hospital because of the life assured’s disability. The full-time care must be provided by either:
> the life assured is receiving the Total Disability Income Benefit when the programme begins.
Any benefit which Sovereign may agree to pay is to be reduced by any programme costs you or the life assured recover or are entitled to recover from any other source.
807 TCP-DI version 13 Effective 12 May 2026
Page 5 of 12
Powered by FlippingBook