810 TCP-FP version 10 Effective 12 May 2026
TOTALCAREMAX PERSONAL
OPTIONAL BENEFIT APPENDIX
Family Protection Benefit
This appendix only applies if you have chosen a Family Protection Benefit. The terms of your TotalCare Max policy document also apply to this appendix . Details of the Family Protection Benefit you have chosen and the names of the people insured for the benefit (called the life or lives assured) are shown in the schedule .
assured has purchased a new home, a new residential investment property, a vacation home, or a bare block of land zoned as residential, or is making extensions to a residential property or residential investment property owned by the life assured; becoming responsible for the full-time care or payment for long term care of a close relative ; receiving an annual salary increase. This special event is not available to a life assured who is self-employed; or
1.
When will Sovereign pay a Family Protection Benefit?
Sovereign will pay a monthly Family Protection Benefit when the life assured for the benefit, as specified in the schedule , dies. Sovereign will begin paying the benefit as soon as we are satisfied with all the information which must be presented at the time of making a claim. The benefit will continue to be paid for the benefit term as shown in the schedule . This will be either a fixed term or to a nominated future date, e.g. to age 45, the life assured’s 45th birthday . 2. Bereavement Support Benefit Upon receiving written notification that the life assured for the Family Protection Benefit has died, Sovereign will pay the lower of:
experiencing the death of a spouse, civil or de facto partner,
you may write to Sovereign asking us to increase the Family Protection Benefit for that life assured.
What is the maximum cover that can be added?
The maximum increase for each special event cannot exceed the lower of:
the monthly amount of the Family Protection Benefit; or
$25,000 .
50% of the original Family Protection Benefit for the life assured; or
The Bereavement Support Benefit will be treated as the first monthly payment or part thereof, of the Family Protection Benefit. Only one Bereavement Support Benefit payment per life assured will be made.
$500 per month.
The total of all increases made under this facility cannot exceed the lower of:
50% of the original Family Protection Benefit for the life assured; or
3.
Special Events Increase Facility
$1,500 per month.
What is the Special Events Increase Facility?
The maximum increases outlined above each apply in respect of all Family Protection and/or similar benefits for that life assured across all Sovereign policies .
On each occasion when one of the following circumstances occurs for a life assured on the Family Protection Benefit:
having a child (by birth or legal adoption);
What are the other conditions applying to this facility?
becoming married or entering into a civil union;
You do not need to produce any medical evidence regarding the life assured when you request this increase, but any special events increase is subject to the following conditions: You must make the request within 12 months of the relevant special event and provide Sovereign with suitable evidence of the occurrence of the event. A life assured over the age of 50 is not eligible for special events increases.
becoming legally separated, divorced or the dissolution of the life assured’s civil union; financially supporting a dependent child through a first course of full-time tertiary education; the commencement of secondary school for the first time by a child of the life assured;
taking out or increasing a home loan because the life
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5.
Counselling Benefit
In any 12 month period you can make only one increase under this facility. Sovereign will increase the Family Protection Benefit for a life assured from the date we accept your request. Each special events increase will require an increase in premium . This increase will be calculated on the rates applicable at the time the Special Events Increase Facility is exercised. Any loadings, exclusions or special terms on the original Family Protection Benefit sum assured will be applied to the increased amount.
The Counselling Benefit covers the cost of a Psychiatrist or Psychologist consultation and/or counselling for a close relative of the life assured where the support treatments and/or consultations directly relate to a claim under the Family Protection Benefit. After referral by a registered medical practitioner we will reimburse up to $2,500 including GST (in total) per life assured, subject to the following conditions: The consultation and/or counselling must be paid for within 12 months following Sovereign first commencing to pay the Family Protection Benefit; and Sovereign must be provided with a receipt for the consultation and/or counselling being claimed for. The $2,500 is payable once per life assured per policy. This is in addition to the sum assured.
When will Sovereign not pay a claim under this facility?
a. Increases in sum assured added to this policy
After a special events increase under this Facility has been made, Sovereign will not pay the increased benefit amount if before the increase, the life assured qualified for payment of the Family Protection Benefit. b. Increases in sum assured issued as an additional new policy Where this policy or any part of the sum assured under it, has been issued as the result of an increase under the Special Events Increase Facility, then: the Special Events Increase Facility under this policy will not be available for the proportion of the sum assured that represents the increase. Sovereign will not pay the increased benefit amount if, before the increase, the life assured qualified for payment of the Family Protection Benefit.
6.
Parents Grieving Benefit
Sovereign will make a Parents Grieving Benefit payment if:
a child of a life assured dies prior to birth but after at least 24 weeks gestation; or
a child of a life assured dies.
Sovereign will not make any payment if the death occurs within 12 months of the risk commencement date except where it is an accidental death. This Parents Grieving Benefit ceases on the child’s 21 st birthday.
How much will Sovereign pay for the Parents Grieving Benefit?
4.
Financial and Legal Advice Benefit
The benefit payable:
If Sovereign pays a claim under the Family Protection Benefit, then Sovereign will reimburse you for fees incurred up to $2,500 including GST (in total) that you pay for financial planning you receive from an accredited Adviser or legal advice received from a legal professional approved by Sovereign, subject to the following conditions: You must pay for the financial planning or legal advice within the 12 months following Sovereign paying the Family Protection Benefit claim. Sovereign will only pay one Financial and Legal Advice Benefit per life assured across all Sovereign policies . This is in addition to the sum assured.
if the child is under 10 years of age Sovereign will pay a maximum of one claim of $2,000 per child under the Parents Grieving Benefit across all Sovereign policies and AIA policies ; or if the child is 10 years of age or over Sovereign will pay a maximum of one claim of $15,000 per child across all Sovereign policies and AIA policies for a life assured. Payment of the Parents Grieving Benefit will not reduce the sum assured of the Family Protection Benefit.
7.
Premium Conversion Facility
You may at any time:
Convert all or part of your Family Protection Benefit from the premium shown in the schedule to a Level premium structure. The Family Protection Benefit under your policy will be reduced by the sum assured amount converted; or Convert a Level premium Term to a further Level premium Term, of which duration may be the same or less than current Level premium Term.
Sovereign will not require you or the life assured to produce
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further medical evidence at the time of conversion. The terms and conditions of the new policy will be those which are then offered by us to the general public. Premiums will be calculated on the current age of the life assured . Any special terms, exclusions or premium loading that applied to your existing Family Protection Benefit will apply to your new Family Protection Benefit.
9.
How to make a claim
To make a claim, you must follow the relevant procedures in the section of your TotalCare Max policy entitled ’How to make a claim’.
In addition, for a Family Protection Benefit claim, Sovereign will require:
A full death certificate (in the event of the death of a life assured), and a coroner’s report if applicable. A grant of administration – probate, or certificate of administration, or letters of administration if the deceased was the sole owner of the policy.
8.
Suspension of Premium Benefit
A life assured can suspend their cover under this Family Protection Benefit appendix for up to 12 months if they:
go on parental leave;
10.
Exclusions – when Sovereign won’t pay a benefit
go on leave without pay for any reason;
become unemployed or redundant;
Sovereign will not pay any benefit under this appendix where the life assured dies as a direct or indirect result of an intentional self-inflicted act (whether sane or insane) within 13 months of the risk commencement date or, if cover under this appendix has been reinstated, the date of reinstatement. This exclusion applies to any subsequent benefit increase you make.
experience at least a 20% reduction in pay (comparing the most recent payslip against a previous payslip from the same year); or if self-employed, experience a 30% reduction in revenue (by comparing one month’s revenue against the same month for the previous year),
provided that:
11.
Key terms
The premium type shown in the schedule for the Family Protection Benefit is Rate for Age; You notify Sovereign within three months of one of the above listed suspension events occurring and provide evidence to Sovereign of the suspension event; and Sovereign acknowledges in writing receipt of that notification. Cover for the life assured will be suspended from the date set out in Sovereign's written acknowledgement. No premium will be payable during the period that the cover is suspended. No claim under this Family Protection Benefit appendix will be payable for any claim event that occurs during the period that the cover is suspended. A claim may only be payable if the life assured first meets the criteria for an eligible claim under this policy after their cover is reinstated. Cover under this Family Protection Benefit appendix may be reinstated at the end of the suspension period in accordance with this section without the need to provide further medical evidence, provided that the benefit has been suspended for no longer than 12 months. At the end of the suspension period, the benefit will be automatically reinstated for the life assured. Cover for the life assured will be reinstated from the date set out in Sovereign's written acknowledgement. The premium payable for the reinstated benefit will be based on Sovereign's premium rates at the time of reinstatement.
accidental death
Death which is the result of external or internal bodily injury caused directly by violent, accidental, external and visible means, not attributable to any other event. Either an Adviser with a current financial Adviser agreement with Sovereign Services Limited or a member of a financial services industry body approved by Sovereign . Regular remuneration that is subject to PAYE, excluding allowances in lieu of non-monetary remuneration and extra income such as, but not limited to, bonuses and overtime payments.
accredited Adviser
annual salary
AIA New Zealand policy/policies
Any policy or policies where AIA New Zealand Limited is the insurer.
child/children
Any biological child/children, adopted child/children or child/children under the legal guardianship of:
> a life assured: or
> the spouse, civil or de facto partner of a life assured.
close relative
A relative who is the life assured’s spouse, civil or de facto partner, mother, father, step mother, step father, brother, sister, step brother,
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step sister, child, grandfather or grandmother.
fixed term
The period in years, from the death of the life assured, chosen when you selected a fixed term benefit. This will be shown in the schedule . The age chosen when you selected a to age benefit, as shown in the schedule . Any benefit will be payable until the life assured would have attained that age.
to age
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