8. Key terms
premium
The amount payable by you to Sovereign under this policy, comprising the cost of the benefits chosen by you , plus the policy fee , if any.
In this policy document and optional benefit appendices some words have special meanings:
ACC
The Accident Compensation Corporation of New Zealand.
premium due date
The date on which the premium is payable under the policy, as agreed with Sovereign.
anniversary date
The anniversary in each year of the first premium due date.
Registered Medical Practitioner(s)
A person, acceptable to Sovereign, who is registered and practising as a medical practitioner in New Zealand or Australia, other than:
appendix
The appendix contains the terms of any benefit you have chosen.
You ;
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The life assured;
claim event
The death, illness, injury, condition , redundancy, or (for health benefits only) specialist consultation or diagnostic tests that you are claiming for under your Sovereign TotalCare Max policy. As defined in the Optional Benefit Appendix for Comprehensive Living Assurance Benefit, Progressive Care Benefit, Essential Living Assurance Benefit and Essential Disability Income Benefit. The consumer price index (all groups) issued by the Government Statistician or any index which may replace that index.
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A member of the life assured’s family or your immediate family; The life assured’s or your business partner or associate.
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Sovereign reserves the right to accept the advice of a medical practitioner practising outside New Zealand or Australia with qualifications equivalent to New Zealand or Australian standards.
condition(s)
risk commencement date
The commencement date of the benefit, as shown in the schedule .
consumer price index
Sovereign policy / policies
Any policy or policies where Sovereign is the insurer.
health benefit(s)
The Specialist and Diagnostic Testing Benefit.
substantially incorrect
A statement is substantially incorrect only if the difference between what was stated and what is actually correct would have been considered material by a prudent insurer.
material
A statement is material only if that statement would have influenced the judgment of a prudent insurer in fixing the premium or in determining whether he/she would have taken or continued the risk upon substantially the same terms.
the schedule
The most recent schedule for your policy and:
any notice of a change to premiums ; and any policy alteration or endorsement documents recording a change to your policy.
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non-health benefit(s)
Any benefit shown on the schedule , excluding the health benefits .
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pass back date
The date that the relevant change to Sovereign’s TotalCare Max policy comes into effect, as determined by Sovereign.
transfer of ownership form
Sovereign’s standard form for an assignment of a policy by way of ordinary transfer.
policy fee
The administration fee charged by Sovereign as detailed in the policy illustration.
you/your
The 'Policy Owner' named in the schedule.
The Sovereign TotalCare Max illustration enclosed with this policy document.
policy illustration
policy year
The period from the risk commencement date to (but
excluding) the first anniversary date , or from an anniversary date to (but excluding) the next anniversary date .
800 TC-UMB Version 9 Effective 06 March 2017
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