Chronic lung disease
internal needs, persisting continuously for at least 96 hours, requiring the use of endo-tracheal intubation in the intensive care unit of a hospital. The life assured must have also sustained a neurological deficit causing at least 25% permanent impairment of whole person functioning or inability to perform one of the activities of daily living . Unconsciousness caused by drug and alcohol abuse is specifically excluded. The benefit payable is 10% of the sum assured to a maximum of $20,000 across all Personal Sovereign policies for the life assured .
The life assured has irreversible chronic lung disease as confirmed by an appropriate medical specialist on the basis of respiratory function tests and which satisfies any one of the following criteria:
Type I respiratory failure defined as O2 <60mm hg; or
Type 2 respiratory failure defined as CO2 >45 mm hg; or
the provision of home oxygen therapy according to clinical practice guidelines for hypoxia O2 <55 mm hg (or 60 mm hg in the presence of pulmonary hypertension);
FEV1 <35% predicted;
Major transplant surgery
DLCO (diffusing capacity or gas transfer) < 40% predicted; or
The life assured has undergone, or been placed on the major organ transplant waiting list in New Zealand or Australia for, a transplant from a human donor of one or more of the following organs or substances:
is unable to perform at least one of the activities of daily living as a result of the respiratory failure.
The benefit payable is 10% of the sum assured to a maximum of $20,000 across all Personal Sovereign policies for the life assured .
Kidney;
Heart;
Lung;
Chronic renal failure
Liver;
The kidneys of the life assured have reached the end-stage of renal disease resulting in chronic irreversible failure of the kidneys to function, as a result of which regular renal dialysis is instituted or transplantation performed.
Pancreas;
Bone marrow; or
Intestine.
HIV
The transplant of all other organs, parts of organs or any other tissue transplant is excluded.
Infection with the Human Immunodeficiency Virus (HIV) must have been acquired by accident or violence during the course of the life assured’s normal occupation or through the medium of a blood transfusion, transfusion of blood products, organ transplant, assisted reproduction technique or other medical procedure or operation performed by a registered healthcare professional and/or in a registered hospital care institution, or surgical centre or surgical clinic. You must prove this to our satisfaction. Sero-conversion to the HIV infection must occur within six months of the accident . HIV infection transmitted by any other means, including but not limited to sexual activity or non-medical intravenous drug use, is not covered under this appendix . Any incident giving rise to a potential claim must be reported to us within 30 days of the incident and be supported by a negative HIV Antibody Test taken within seven days after the incident. Sovereign may decline your claim if we are not given access to independently test all blood samples used, if we require, or if the life assured does not allow Sovereign to take further independent blood tests. The benefit payable is 10% of the sum assured to a maximum of $20,000 across all Personal Sovereign policies for the life assured .
Severe burns
The life assured has suffered tissue injury caused by thermal, electrical or chemical agents. As a result, the life assured has full thickness or third-degree burns to: at least 20% of the body surface area (as measured by age-appropriate use of The Rule of 9 or the Lund and Browder Body Surface Chart); or
50% of both hands, requiring surgical debridement and/or grafting; or
25% of the face, requiring surgical debridement and/or grafting.
The benefit payable is 10% of the sum assured to a maximum of $20,000 across all Personal Sovereign policies for the life assured .
16. Definitions for Newborn Children’s Benefit conditions
Cleft palate
Intensive care benefit
A fissure of the palate at birth associated with possible
A state of unconsciousness with no reaction to stimuli or
803 TCP-LAE version 14 Effective 12 May 2026
Page 15 of 18
Powered by FlippingBook