Some of the conditions do not have all five severity levels.
4. Standalone or accelerated benefit
The schedule will specify if you have chosen a standalone or an accelerated benefit.
6. The amount of cover
The sum assured is the maximum amount of cover you have for each category. After the first claim is paid under a category , the balance of the sum assured is the maximum amount Sovereign will pay you for any subsequent claim under that category . Once the balance of the sum assured is exhausted for a category , no further claims will be paid under that category .
Standalone
If you have chosen a standalone benefit, a payment under this benefit does not reduce the sum assured under your Life Cover Benefit (if any).
Accelerated
If you have chosen an accelerated benefit, the sum assured for this Progressive Care Benefit cannot be greater than the sum assured for your Life Cover Benefit. When Sovereign pays an accelerated Progressive Care Benefit, the Life Cover Benefit for the life assured will decrease by the same amount. Any other accelerated benefits relating to that Life Cover Benefit will be reduced, if necessary, so that those accelerated benefits do not exceed the decreased Life Cover Benefit. If the Life Cover Benefit is reduced to nil, all accelerated benefits relating to that Life Cover Benefit will be removed. The maximum combined amount payable under the Life Cover Benefit, Specified Terminal Conditions Benefit, Terminal Illness Benefit, Bereavement Support Benefit, Repatriation Benefit, accelerated Progressive Care Benefit and, if applicable, the accelerated Living Assurance Benefit and the accelerated Total Permanent Disablement Benefit is the amount of the Life Cover Benefit for that life assured. When Sovereign has paid the equivalent of the sum assured of the Life Cover Benefit, your cover under this benefit will change from accelerated to standalone. This will require you to pay an increased premium . This increase will be calculated on the rates applicable at the time to the standalone Progressive Care Benefit.
a) First claim
The amount paid for the first claim for a life assured under this appendix is determined by Sovereign as follows: 1. Sovereign determines if the life assured has suffered the condition . 2. Sovereign identifies which category the condition falls under i.e. Cancer , Heart and Arteries, Brain and Nerves, Loss of Function or Other Health Events. 3. Sovereign determines the severity level percentage that applies to the condition . 4. The severity level percentage is then multiplied by the sum assured . This is the amount paid for the first claim. 5. The balance of the sum assured available for future claims under the category that the claim is paid under is then calculated as the sum assured minus the amount paid for the first claim.
b) Subsequent claims
Any claim made for a life assured after the first claim paid to you under this appendix for that life assured is a subsequent claim. Sovereign will determine whether or not the condition relied upon for a subsequent claim is a related condition to a previous Progressive Care Benefit claim for that life assured . The way subsequent claims are determined depends upon the length of time that has passed since the previous claim event date and whether the condition claimed for is a related condition or not.
5. The severity level
The lump sum amount that Sovereign will pay at claim time will depend on the severity level of the life assured's condition and your sum assured/balance of the sum assured you have available under the applicable category . The severity level of the life assured's condition determines the percentage of the sum assured that is used to determine the lump sum benefit that Sovereign will pay you. The percentage of the sum assured for each severity level is shown below.
More than 12 months after previous claim event date or related condition
If the subsequent claim's claim event date is more than 12 months after the preceding claim's claim event date or if the subsequent claim is for a related condition , then Sovereign determines the amount to be paid for the subsequent claim as follows: 1. Sovereign determines if the life assured has suffered the condition . 2. Sovereign identifies the category that the condition falls under i.e. Cancer , Heart and Arteries, Brain and Nerves, Loss of Function or Other Health Events. A subsequent claim can be made in the same category or a different category to the previous claim. 3. Sovereign determines the severity level percentage that applies for the condition :
Severity Level
Percentage
1 (most severe)
100%
2
75%
3
50%
4
25%
5 (least severe)
10%
The severity level of a condition is stated in the Schedule of Categories for the category the condition comes within.
818 TCP-PC version 12 Effective 12 May 2026
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