Life Cover Benefit is reinstated.
applying immediately before the accelerated Essential Living Assurance Benefit claim.
Any accelerated benefits relating to the Life Cover Benefit for the life assured that have been reduced or removed as a result of the accelerated Living Assurance Benefit claim will not be reinstated.
The Optional Life Cover Buyback can be exercised:
− within 60 days of the accelerated Essential Living Assurance Benefit claim payment; or
13. Exclusions – when Sovereign won’t pay a benefit
within 60 days of the life assured surviving a period of six months after an accelerated Essential Living Assurance Benefit claim payment for one of the following conditions:
−
Sovereign will not pay any benefit described in this appendix where any of the following (and in each case either directly or indirectly) causes or contributes to the claim: The life assured (or the child in the case of a children’s benefit) deliberately injures himself or herself or attempts to do so. The life assured (or the child in the case of a children’s benefit) engages in or is part of any conduct that is criminal. Any condition or any symptom or signs leading to the condition (whether or not a registered medical practitioner has been consulted) that existed before the risk commencement date , unless Sovereign is satisfied that you or the life assured could not have known of the existence of the condition or symptom or signs leading to the condition , or the condition or symptom or signs leading to the condition were declared on your application and accepted by Sovereign.
▪
Paraplegia;
▪
Quadriplegia;
▪
Diplegia;
▪
Hemiplegia;
▪
Alzheimer’s disease;
▪
Permanent blindness;
▪
Permanent loss of hearing;
▪
Dementia;
▪
Permanent loss of use of limbs ;
▪
Multiple sclerosis;
▪
Idiopathic Parkinson’s disease; or
within 60 days of the life assured surviving a period of twelve months after an accelerated Essential Living Assurance Benefit claim payment for all other conditions.
−
Sovereign will not pay a Children’s Trauma Benefit that arises as a direct or indirect consequence of:
a pre-existing condition ; or
The Life Cover Benefit can be reinstated following a full payment claim or a partial payment claim.
any congenital condition .
Only one Life Cover Buyback reinstatement will apply per life assured per policy.
These exclusions apply to any subsequent benefit increase you make.
The maximum Life Cover Benefit that can be reinstated is 100% of the accelerated Essential Living Assurance Benefit claim or $2 million, whichever is the lesser.
14. How to make a claim.
To make a claim, refer to the section in your Sovereign TotalCare Max policy entitled ‘How to make a claim’.
No reinstated Life Cover Benefit is payable:
− within six months (for the conditions listed above that require a six month survival period); or
In addition, for a Living Assurance Benefit claim, Sovereign will require information acceptable to us, including medical evidence and reports, showing proof of the condition - giving rise to the claim. Sovereign may require the life assured or his or her child (if applicable) to have an examination by a registered medical practitioner appointed by Sovereign before accepting liability for a claim. For advice about submitting a claim you can phone Sovereign on 0800 500 108 or your Adviser. Find claim information online at sovereign.co.nz
− within twelve months (for all other conditions ),
from the date of the accelerated Essential Living Assurance Benefit claim payment, except where the claim event is for accidental death. No Life Cover Buyback Benefit is available if the life assured has suffered a claim event under a Terminal Illness Benefit or a Specified Terminal Conditions Benefit under any Sovereign policy , whether or not a claim has been made. Any exercise of the Life Cover Buyback Benefit may require an increase in premium . This premium increase will be calculated on the rates applicable at the time the
803 TCP-LAE version 14 Effective 12 May 2026
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