(a) For a condition that is not a related condition, the severity level percentage is then multiplied by the sum assured . This will be the amount paid for the subsequent claim, unless the balance of the sum assured for the category that the condition falls under is less, in which case the balance of the sum assured for the category will be the amount paid for the subsequent claim. (b) For a related condition , the severity level percentage of the related condition must be higher than the severity level percentage of the previous condition that it relates to. The amount by which the severity level percentage increases from the previous severity level percentage is then multiplied by the sum assured . This will be the amount paid for the subsequent claim, unless the balance of the sum assured for the category is less, in which case the balance of the sum assured for the category will be the amount paid for the subsequent claim. For the avoidance of doubt, you cannot claim more than the sum assured in total for the life assured’s first claim and all subsequent related claims to that first claim.
the commencement of secondary school for the first time by a child of the life assured ;
financially supporting a dependent child through a first course of full-time tertiary education;
taking out or increasing a home loan because the life 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 experiencing the death of a spouse or de facto partner, you may write to Sovereign asking us to increase the Progressive Care Benefit for that life assured .
What is the maximum cover that can be added?
Within 12 months of the previous claim event date and not a related condition
The maximum increase for each special event cannot exceed the lower of: 50% of the original Progressive Care Benefit for the life assured ; or
If you make a subsequent claim, where the claim event date is within 12 months of the immediately preceding claim's claim event date and the subsequent claim is not for a related condition , then Sovereign will deduct all claims paid under this appendix for that life assured within the previous 12 months from the amount determined in accordance with steps 1 to 3 immediately above. This may mean that no benefit is payable. This deduction will not apply if the current or previous claim is/was for a condition that is the result of an accident.
$250,000.
The total of all increases made under this Facility cannot exceed the lower of: 100% of the original Progressive Care Benefit for the life assured ; or
$750,000.
In the case of taking out or increasing a home loan, the individual increase cannot exceed the amount of the home loan or the increase in the home loan. In the case of an annual salary increase, the individual increase cannot exceed five times the annual salary increase. The maximum increases outlined above each apply in respect of all Progressive Care Benefits, Living Assurance Benefits and similar benefits for that life assured across all Sovereign policies . Both of the following maximum sum assured limits also apply across all Sovereign policies for each life assured : (a) the total of the sum assured for all Living Assurance Benefits, Progressive Care Benefits, and similar trauma benefits (combined), including increases under this Facility must not exceed $2,000,000; and (b) the total of the sum assured for all trauma benefits combined must not exceed $2,000,000 and the total sum assured for all trauma and Total Permanent Disablement Benefits (and similar benefits) combined must not exceed $5,000,000.
c) Two or more claims for conditions arising simultaneously from one event
If a single event causes the life assured to have one or more simultaneously arising conditions, Sovereign will only pay one claim. For each condition , Sovereign will determine the amount in accordance with steps 1 to 3 in b) above and the amount paid will be the highest of these amounts. The balance of the sum assured will reduce for the category that the condition with the highest amount falls under, while the balance of the sum assured will be unchanged for other categories .
7. Built-in Special Events Increase Facility
What is the Special Events Increase Facility?
On each occasion when one of the following circumstances occurs for a life assured on the Progressive Care Benefit:
What are the other conditions applying to this Facility?
having a child (by birth or legal adoption);
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:
becoming married or entering into a civil union;
becoming legally separated, divorced or the dissolution of the life assured s civil union;
818 TCP-PC version 12 Effective 12 May 2026
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