5. When will Sovereign pay an Optional Partial Disablement Benefit? The Optional Partial Disablement Benefit only applies if shown in the schedule . If the life assured has been totally disabled or partially disabled and then immediately thereafter carries on farming at a reduced work capacity than was the case immediately before becoming totally disabled or partially disabled , an Optional Partial Disablement Benefit may apply. The following conditions must be satisfied: > the reduction in work capacity results from the continuation of the disability ; and > because of the reduction in work capacity, the life assured is working less than 20 hours per week; and > the waiting period is over; and > the life assured is no longer totally disabled ; and > if applicable, the period in respect of which a Total Disablement Benefit has been paid in advance has expired; and > where a lump sum payment has been made in lieu of monthly benefit payments as set out in Section 2, the benefit period to which the lump sum corresponds has expired. The Optional Partial Disablement Benefit will be paid monthly in arrears until, in Sovereign’s opinion, after considering the advice of a registered medical practitioner and other relevant information, the disability is no longer preventing the life assured from working at least 20 hours per week, or until the occurrence of any one or more of the events set out in Sections 12 or 13. A Partial Disablement Bridging Benefit (as set out in Section 7) will also be paid if you have been receiving a Total Disablement Benefit under this appendix before you commence receiving an Optional Partial Disablement Benefit. Any claim for a subsequent Optional Partial Disablement Benefit must be immediately preceded by a 14 day period of total disability . Refer to Section 8 for “What is the Recurrent Disablement Benefit?”. What is the amount of the Optional Partial Disablement Benefit? The amount that Sovereign will pay monthly is calculated in the following way: (50% x 1/12 th of the benefit amount shown in the schedule ) less offsets as defined in Section 3. 6. For example, for a benefit amount shown in the schedule of $60,000 per annum ($5,000 per month) with offsets of $1,000, the amount that Sovereign will pay monthly is: ($5,000 x 50%) - $1,000 = $1,500
> the life assured is no longer totally disabled ; and > based on the information provided to, and requested by Sovereign, we reasonably expect that an Optional Partial Disablement Benefit (as set out in Section 5) will be payable for that life assured for the first month after the life assured ceased to be totally disabled . The Partial Disablement Bridging Benefit is a lump-sum payment equivalent to 1/3 rd (33.3%) of the final monthly Total Disablement Benefit paid before the life assured ceased to be totally disabled . The Partial Disablement Bridging Benefit is paid at the end of the final month in respect of which a Total Disablement Benefit was paid for the life assured. Payment of the Partial Disablement Bridging Benefit does not affect the amount of the Optional Partial Disablement Benefit (as set out in Section 6). The Partial Disablement Bridging Benefit is payable once for all claims resulting from the same or a related injury or illness. The Partial Disablement Bridging Benefit is not payable where a lump sum payment has been made in lieu of monthly benefit payments, as set out in Section 2. 8. What is the Recurrent Disablement Benefit? The waiting period will be waived if in Sovereign’s opinion, after considering the advice of a registered medical practitioner and other relevant information, the life assured becomes totally disabled again and this is caused by the same or a related illness or injury as the original period of total disability , not later than 12 months after benefit payments related to the original claim ceased. The provisions of Sections 2, 3, 4, 5 and 6 of this appendix will apply to any benefit claimed. All claims resulting from the same or a related illness or injury will be considered to be the same claim in respect of the benefit payment period . 9. What is the Optional Peak Season Upgrade Benefit and when will Sovereign pay it? The Optional Peak Season Upgrade Benefit applies only if shown in the schedule . If you have chosen the Optional Peak Season Upgrade Benefit, then Sovereign will pay an additional 25% of the monthly benefit while the life assured is in receipt of a Total Disablement Benefit during the nominated 3 month peak season period as defined in the schedule , in any year. The nominated peak season period may only be changed with Sovereign’s written consent. There will be a 90 day stand down from the date the peak season period is changed on the schedule before any Optional Peak Season Upgrade Benefit is payable during the new peak season period. During this stand down period your previous peak season period will remain in force.
7.
What is the Partial Disablement Bridging Benefit and when will Sovereign pay it?
Where the Optional Partial Disablement Benefit applies as shown in the schedule , Sovereign will pay you a Partial Disablement Bridging Benefit if: > you have been receiving a Total Disablement Benefit under this appendix ; and
864 TCB-RC version 4 Effective 21 May 2019
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