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 Progressive Care 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.
if the child is 10 years of age or over Sovereign will pay a maximum of one claim of $15,000 per child across Sovereign policies and AIA policies for a life assured . Payment of the Parents Grieving Benefit will not reduce the sum assured of the Progressive Care Benefit for the life assured .
At the end of the suspension period, the benefit will be automatically reinstated for the life assured .
14. Built-in Counselling Benefit
The Counselling Benefit covers the cost of a Psychiatrist or Psychologist consultation and/or counselling for the life assured and/or a close relative of the life assured where the support treatments and/or consultations directly relate to a claim under the Progressive Care Benefit. After referral by an appropriate 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 paying the Progressive Care claim; and
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 the reinstatement.
16. Optional Total Permanent Disablement condition
The Total Permanent Disablement condition is available as an option once the life assured reaches age 16. The schedule will specify if you have chosen the Optional Total Permanent Disablement condition and, subject to the provisions of this appendix , is included as a severity level 1 condition within the Loss of Function category . The Optional Total Permanent Disablement condition will cease to apply, and premiums for this condition will cease, following any severity level 1 claim payment. Premiums for the Optional Total Permanent Disablement condition will not be affected by a claim payment for a condition of any other severity level. The Optional Total Permanent Disablement condition does not apply to any child of a life assured covered under the Built-in Children’s Trauma Benefit or the Optional Children’s and Maternity Benefit.
Sovereign must be provided with a receipt for the consultation and/or counselling being claimed.
The $2,500 including GST (in total) is payable once per life assured per policy. This is in addition to the sum assured.
15. Built-in Suspension of Premium Benefit
A life assured can suspend their cover under this Progressive Care Benefit appendix for up to 12 months if they:
go on parental leave;
go on leave without pay for any reason;
become unemployed or redundant;
The Optional Total Permanent Disablement condition is only available before the life assured attains age 65.
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),
17. Optional Children’s and Maternity Benefit
The Children’s and Maternity Benefit is available as an option once the life assured reaches age 16. The schedule will specify if you have chosen the Optional Children’s and Maternity Benefit. The benefit is payable in addition to any benefit payable under the Built-in Children’s Trauma Benefit or the Built-in Newborn Children’s Benefit.
provided that:
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.
a.
Children’s Critical Conditions Benefit
Cover for the life assured will be suspended from the date set out in Sovereign’s written acknowledgment.
What is the Children’s Critical Conditions Benefit?
No premium will be payable during the period that the cover is suspended.
Sovereign will pay a Children’s Critical Conditions Benefit if a child of a life assured suffers a condition of severity level 1, 2, 3, 4 or 5, except for the Optional Total Permanent Disablement condition .
No claim under this Progressive Care Benefit appendix will be payable for any condition that occurs during, the period that the cover is suspended.
This Benefit is only payable if the child of the life assured :
818 TCP-PC version 12 Effective 12 May 2026
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