your expense which the life assured’s registered medical practitioner or a registered medical practitioner approved by Sovereign considers necessary.
The TPD Future Insurability Benefit under this policy will not be available for the proportion of the sum assured that represents the increase. Sovereign will not pay the increased amount if, before the increase, or within six months of the increase, the life assured: − Suffers any claim event for anything other than an accident under the Total Permanent Disablement Benefit; or − Has any symptoms or signs leading to a claim event (whether or not a registered medical practitioner has been consulted) that may result in a claim for anything other than an accident under the Total Permanent Disablement Benefit. 15. Waiver of Total Permanent Disablement Waiting Period Sovereign will, at its discretion, waive the three month waiting period when assessing a Total Permanent Disablement Benefit claim if: In Sovereign’s opinion, the life assured has met all other requirements for payment of a Total Permanent Disablement Benefit; and
Any other information that Sovereign may deem relevant to the assessment of the claim.
17. Exclusions – when Sovereign won’t pay a benefit Sovereign will not pay any Total Permanent Disablement Benefit where any of the following (and in each case either directly or indirectly) causes or contributes to the disablement:
The life assured deliberately injures himself or herself or attempts to do so; or
The life assured engages in or is part of any conduct that is criminal.
These exclusions apply to any subsequent benefit increase you make.
18. When will this appendix terminate for a life assured? This appendix will terminate and eligibility for the Total Permanent Disablement Benefit will cease for a life assured:
Sovereign expects the life assured to survive beyond three months after the incapacity began.
In exercising this discretion, Sovereign will consider whether the medical condition of the life assured enables an assessment to be made immediately in respect of whether the life assured has met all other requirements for payment of a Total Permanent Disablement Benefit. Sovereign will not waive the three month waiting period if, in our opinion, after considering suitable medical evidence, we believe that the life assured may die within three months after the incapacity began. A decision not to waive the three month waiting period will not affect our consideration of a Total Permanent Disablement Benefit claim for the life assured if the life assured survives for three months after the incapacity began. 16. 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.
When the life assured dies; or
When the benefit is cancelled by the policy owner; or
When the full sum assured has been paid.
In addition, for a Total Permanent Disablement 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.
A Sovereign claims form completed by the life assured and a registered medical practitioner (at your expense).
Other information which Sovereign may reasonably request to help assess the claim, which may include evidence of earnings, taxable income, business accounts, Accident Compensation Corporation details or similar. The life assured to undergo medical and/or surgical treatment (including any operation or vocational, medical and/or social rehabilitation programme) at
817 TCP-TPD version 11 Effective 12 May 2026
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