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Lifestyle
Lifestyle Services Group Limited Registered in England No. 5114385 Registered Office: Unit 12, Crewe Hall Enterprise Park, Weston Road, Crewe, Cheshire CW1 6UE
LSG/04/01/0205
SERVICES
GROUP
Combined Life Assurance Company Limited Registered in England No. 2443666 Registered Office: Combined House, 15 Wheatfield Way, Kingston upon Thames, Surrey KT1 2PQ
London General Insurance Company Limited Registered in England No. 1865673 Registered Office: Combined House, 15 Wheatfield Way, Kingston Upon Thames, Surrey KT1 2PQ
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Lifestyle
SERVICES
GROUP
bill protector insurance to cover your household bills
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Feel safe knowing that your bills will be covered. Nobody needs the added pressure. When everything goes wrong, we’ll be there for you!
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Contents
about our insurance services
Life, Disability & Redundancy/Business Failure Insurance Policy to cover your household bills Administered by Lifestyle Services Group Limited
Sections Policy Summary 1 What is Bill protector 2 Statement of Demands and Needs Policy Document 3 Your contract 4 Price 5 Important 6 Definitions 7 Benefits 7.1 Disability and unemployment benefits 7.2 Life benefits 7.3 How payments will be calculated 8
When 8.1 8.2 8.3
can you not claim any benefit? When can you not claim disability or life benefit? When can you not claim unemployment benefit? When can you not claim benefit, if you become a carer?
9 How do you make a claim? 10 Further information concerning your claim 10.1 General 10.2 Disability Claims 10.3 Unemployment Claims 10.4 Life Claims 11 12 13 14 15
What happens once your claim is approved? Cancelling the policy Fraud Enquiries/Complaints Other Information
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Policy Summary 1
What is Bill Protector
Bill Protector is a policy designed to pay you up to a maximum of £3,000 for a 12-month period, for specified household bills, if you cannot work due to disability, or unemployment as a result of redundancy, or you become a carer (if you are employed), or business failure (if you are self-employed). The maximum payment per month will be £250. A payment of up to a maximum of £750 will be paid upon your death, which covers your specified household bills up to £250 per month, for the three months prior to your death.
Who can apply for the policy? You -
can apply for this policy if: you are between the ages of 18 and 64 at the start date of your policy; you live in the UK, Channel Islands or Isle of Man for more than 40 weeks in any one year; you are contracted to work for more than 16 hours per week; and you have been working continuously for at least 6 months before the start date of the policy and/or have been on statutory maternity leave.
What are the benefits of the policy? If your claim is successful, you will be covered for up to a maximum of £250, including VAT, for each calendar month you are disabled or unemployed. If you die, your estate will receive up to £250, including VAT, per month for the period of the three months before your death.
Which household bills does the policy cover, and up to what amount am I covered? You are covered up to a maximum of £250 for each full calendar month you are disabled or unemployed, or, if you die, for each of the three months before your death, for the household bills covered, as detailed below (limits apply in each case): Council tax Energy supply (gas, electricity, oil, coal, etc.) Satellite/Cable TV subscription Fixed-line telephone One mobile phone bill Water supply/sewage collection Broadband subscription
up to
£150pm
up up up up up up
£100pm £50pm £50pm £50pm £40pm £30pm
to to to to to to
Any period of less than one month will be calculated at an average daily rate throughout the month. You will not be able to carry over any payments from month to month where we have not paid the maximum payment of £250. You must have been paying these bills regularly at the time of your disability, unemployment or death.
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How long does the cover last? Cover will continue until one of the following occurs: • you reach the age of 65 or you retire and have no intention of returning to work, whichever is the earliest; • we tell you that we will accept no further monthly payments; • you or your bank cancels your Direct Debit; • we try to collect a Direct Debit payment and we are unsuccessful; • you cancel your policy; • you are no longer a UK resident; • you transfer or assign the rights of the policy to a third party; or • you die.
Will the benefit change automatically? We may review the amount of cover annually. We will give you 30 days' written notice of any change.
Are there any health restrictions if I apply for the policy? If you meet the requirements set out in Section 3 of the Policy Document, you will be eligible for this insurance. You will be unable to claim benefit for health conditions which you know about, and have had diagnosed, or which you have received treatment or advice for, in the 12 months before the period of cover begins. Please read the policy documentation carefully to see if the cover is suitable for you.
When can I claim? When you are unable to work for a minimum of 15 consecutive days because of disability, you are made redundant (if you are employed), or suffer business failure (if you are self-employed). When you become a full-time carer for an immediate family member and you are receiving the Carer's Allowance. Your representative can make a claim if you die.
When do I need to request a claim form? You must tell us as soon as possible, but no later than 60 days from when you were first disabled or became unemployed. Your representative must tell us as soon as possible, but no later than 60 days after your death occurs.
How long must I be disabled before I can make a claim? You must have been working and become continuously disabled for at least 15 consecutive days during the period of cover. The qualifying period for disability benefits will not start until you consult a doctor. Your doctor will be required to confirm that you are unable to work.
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How long must I be unemployed before I can make a claim? You must have been working and become continuously unemployed for at least 15 consecutive days during the period of cover. The qualification period for unemployment benefits will not start until you have registered with the Department for Work and Pensions (or other relevant Government department or body), and you are not receiving pay in lieu of notice. Please see Section 7.1 of the Policy Document.
How will you assess my claim for disability? We will assess the duties of your occupation and your ability to perform them. You will qualify for benefit if you are unable to perform your essential duties at work, or any work that your experience, education and training may reasonably qualify you to do. We will require evidence from a doctor and your employer.
How will you assess my claim for unemployment? We • • • • •
will assess whether you are: registered with the Department for Work and Pensions; receiving the correct class of National Insurance Credits; available for work; able to, and are actively seeking, work; and receiving pay in lieu of notice.
We will require evidence from your last employer (if you were employed) or the Inland Revenue (if you were self-employed) and the Department of Work and Pensions (or other relevant Government department or body).
How will you assess my claim if I become a carer? We will assess whether you are: • caring for a member of your immediate family; • receiving Carer's Allowance.
How long is the claim paid for? Your benefit will be paid until the first of the following happens: • you recover and are no longer disabled or unemployed; • you reach the age of 65 or retire, whichever is the earlier; • we have made 12 payments for any 1 period of disability or unemployment; • you return to employment • cover ends (see “How long does the cover last?”) or • you die.
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What happens if I return to work after claiming for disability? There is no limit to the number of claims you can make. If you need to claim again for the same disability within 3 months of the end of your previous claim, we will treat it as a continuation of your previous claim, which will be limited to a maximum of 12 payments. If you claim again for an unrelated disability, you must have returned to work for at least 3 months following the end of your last claim.
What happens if I return to work after claiming for unemployment? There is no limit to the number of claims you can make. If you need to claim again for a period of unemployment within 6 months of the end of your previous unemployment claim, we will treat it as a continuation of your previous claim, which will be limited to a maximum of 12 payments.
What happens if I return to work part-time or take lower-paid work? Your claim will end if you return to work part-time or you take lower-paid work.
How will you pay my benefits? Payments will be made by cheque once a month. At the time you make a claim, we will agree a monthly cut-off date, by which time we must have received your bills for the monthly payment to be made. If you have not forwarded the bills by this date, payment will be rolled over to the next month.
Do I have to continue my monthly payment when I make a claim? Yes. We will continue to collect your monthly payment throughout the period of your claim. If you stop paying your monthly payment during the claim period, your policy and benefit will end.
How do I make a claim? To make a claim, please call 0870 333 4832. Please have your policy ID number available.
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What are the main circumstances where I am not covered? If you become unemployed during the first 90 days after the policy starts. Benefit will not be paid because of: • war and civil commotion; • ionising radiations; • self-inflicted injury; • criminal acts; • drug or alcohol abuse; • normal pregnancy; • any pre-existing medical condition; • failure to follow medical advice; • unemployment which does not follow 6 months of continuous employment and/or statutory maternity leave; • whilst you are on statutory maternity leave; • unemployment which you knew was likely to happen when the policy started; • you knowing you were going to become, or likely to become a Carer when the policy started; and • Infection with HIV or any HIV-related illness including AIDS. You must be disabled or unemployed for at least 15 consecutive days. You cannot claim if you are not in employment when you become disabled or become a carer. If you are making a claim for unemployment it must be of an involuntary nature. For instance, your policy does not cover voluntary redundancy. For further details, please read Section 8 of the Policy Document.
How much will my monthly payment be? Your policy is automatically renewed each month. Your payment will be £7.99 per month, which we will collect by Direct Debit. (Insurance Premium Tax is included in the insurance premium.)
Will the amount of my monthly payment increase in the future? We may, in the future, change the amount of your monthly payment. We will give you 30 days' written notice of any change.
What happens to the policy if I die? We will pay to your estate up to a maximum of £750, which covers your specified household bills for up to £250 per month, for the three months before your death. Your policy will then end.
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What happens if I stop paying my monthly payment? Cancellation or unsuccessful collection of your Direct Debit will be considered as a cancellation of your policy. We will attempt to collect your Direct Debit payment twice before we cancel your policy.
Does the policy have a cash-in value? Your policy has no cash-in value at any time.
Can I change my mind? If the policy does not meet your needs, please telephone our Customer Services team immediately. You can cancel your policy with immediate effect at any time. We will refund your payment if you cancel within the first 30 days after you apply for the policy, although if a claim has been made during this period we may recover any costs incurred. If you cancel after this time, we will not refund your monthly payment.
How do I contact you or make a claim? By phoning Customer Services on 0870 333 4832 between the hours below: Monday-Friday
9.00am-6.00pm
If you prefer, you may write to: Customer Services Lifestyle Services Group Limited PO Box 390 CREWE CW1 6ZP
Who do I contact if I have an enquiry or complaint? Call 0870 333 4832
Where can I find the full terms and conditions of my policy? The Policy Summary does not include the full definitions, exclusions, and terms and conditions. You should read the Policy Document for the detailed terms and conditions. We may change the terms, in certain circumstances, on giving 30 days' notice. We will write and explain if this happens.
Which law applies to my policy? Under European law, you and we may choose which law will apply to this contract. English law will apply unless both parties agree otherwise, in writing, before the policy starts.
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What further protection does the policy offer? In the unlikely event that the insurers are unable to meet their liabilities, you may be entitled to compensation from the Financial Services Compensation Scheme.
Who are the insurers? Disability and unemployment benefits are provided by London General Insurance Company Limited (FRN 202689). Life benefits are provided by Combined Life Assurance Company Limited (FRN 202801). The insurers are authorised and regulated by the Financial Services Authority, which can be checked on the FSA website at www.fsa.gov.uk/register or by phoning 0845 606 1234. Full details of the insurers can be found in Section 15.
2
Statement of Demands and Needs
In applying for this product, you believe insurance protection against the financial risks of being unable to pay your household bills in the event that you are disabled, unemployed, become a carer, or if you die, will be of benefit to you. You have been advised of the details of the policy in the summary of cover, including the main benefits and main exclusions and limits of the cover, and are not aware of any other insurance policy that you currently have that makes this policy unsuitable. You are aware of your obligation to provide all material information and have made a reasoned decision on the basis of the information provided in the summary of cover, and also have a period of 30 days after the commencement of the policy to cancel the contract if you wish to re-consider your decision.
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Policy document 3
Your contract
The Policy Summary, Policy Document and your Certificate should be read as one document. Words or expressions that have a particular meaning are shown in bold type and shall have the same meaning wherever they appear. All elements of service provided by us, and insurance cover provided by the insurer, are subject to the terms and conditions in this booklet, which may be changed in certain circumstances upon giving 30 days' notice in writing to you at your last known address. We may choose not to accept some applications. The terms and conditions provide for (i) the insurance that we have arranged on your behalf with the insurer, for which you pay a premium; and (ii) the service agreement with us which governs the provision of the services, for which you pay a service charge. Your policy is based on the information you gave to us about you and your personal details when you applied for the insurance. These details are contained in your Certificate. The Policy Summary, Policy Document and your Certificate detail what is covered and what is not covered, how claims are settled, and other important policy information.
We recommend that you read this booklet; the following sections may be particularly helpful: • • •
Benefits When can you not claim any benefit? How to make a claim?
Section 7 Section 8 Section 9
Our part of the contract is as follows: • • • •
• •
Cover will only apply during the period of insurance, the start date being shown on your Certificate. We will continue to collect your monthly payment by Direct Debit until you cancel your policy. Where we attach a special meaning to a word, it is shown in bold type. The policy will apply only to household bills for the main residence that you permanently reside in, as proven by the electoral roll. These may include bills in a partner's, spouse's or other's name (excluding landlord's). You may be required to provide additional evidence at the time of making a claim. We will handle claims on behalf of the insurer. We will hold money on behalf of the insurer.
Your part of the contract is as follows: • • •
You must be between the ages of 18 and 64 at the start date of your policy. You must be a UK resident. You must have been working continuously and/or have been on statutory maternity leave, for at least 6 months before the start date of your policy.
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You must be contracted to work for at least 16 hours per week. You must make a minimum of one month's payment in advance for each period of insurance of one month. You must ensure that all payments due to us have been made in full and without deduction or set-off. You must inform us if you retire before the age of 65 and have no intention of returning to work, or if you stop work for any reason not covered by this policy. You must inform us if you stop work to take statutory maternity leave. We will suspend your policy and contact you again when you intend to return to work. If you cancel your Direct Debit without notifying us, your insurance will end immediately.
You can request another copy of the Policy Document. It is also available in large print, audio and Braille versions. If you would like a copy in any of these formats please call Customer Services on 0845 333 4836, or write to: Customer Services Lifestyle Services Group Limited PO Box 390 CREWE CW1 6ZP Under European law, you and we may choose which law will apply to this contract. English law will apply unless both parties agree otherwise, in writing, before the start date. This contract is written in English and all communications with you will be in English.
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Price
The policy is automatically renewable each month, with the payment of £7.99 being taken by Direct Debit. The monthly payment consists of an insurance premium of £5.99 (inclusive of Insurance Premium Tax) and a service charge of £2.00.
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Important
If you meet the requirements set out in Section 3, you will be eligible for this insurance. You will be unable to claim benefit for health conditions which you knew about, and had had diagnosed, or which you have received treatment or advice for, in the 12 months before the start date. You will be unable to claim for unemployment which you knew about, should have known about or which was suspected, before the start date or which occurs during the first 90 days after the start date. Please read the policy documentation carefully to see if it is suitable for you.
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Definitions
Backache Any musculo-skeletal disorders arising from abnormalities of the whole or part of the vertebral column (including the cervical spine), discs, muscles attached to the spine, and those due to nerve-root irritation.
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Business failure The business in which you were self-employed ceasing totally and permanently as a direct result of an inability to pay its debts when they were due. You must have declared this to the Inland Revenue.
Carer A policyholder who at the start date was working (and was therefore eligible to take out cover) and who has subsequently become a carer because they are required to care for a member of their immediate family and receive the Carer's Allowance from the Department for Work and Pensions (or other relevant Government department or body).
Certificate Your Certificate of Insurance and Service Agreement.
Disability/Disabled A medical condition, which is diagnosed and confirmed by your doctor, which stops you carrying out your work or any work that your experience, education, or training may reasonably qualify you to do. If you are self-employed, a medical condition will only be acceptable as a disability if it stops you from assisting, managing and carrying on any part of the running of your business whatsoever. You must be under the care and attention of a doctor throughout your disability. You must not be receiving any salary from your employer apart from Statutory Sick Pay.
Doctor A qualified medical practitioner registered with the General Medical Council. The doctor must not be you, anyone related to you or your partner.
Employed/Employment/Work/Working In paid employment under a contract of services of 16 or more hours per week, under which you ordinarily work in the United Kingdom, Channel Islands, or Isle of Man and are paying Class 1 National Insurance contributions.
End Date The • • • • • • • •
date your insurance cover ends. This is the earliest of the following dates: the date you reach the age of 65 or you retire and have no intention of returning to work, whichever is the earliest; the date we tell you that we will accept no further monthly payments; the date on which you or your bank cancels your Direct Debit; the date your Direct Debit fails for the second time; the date you cancel your policy; the date you are no longer a UK resident; the date you transfer or assign the rights of the policy to a third party; or the date you die.
Immediate family An immediate family member must be either your spouse, your partner with whom you have resided for at least 6 months, or a child of which you, or your partner, are the legal guardian.
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Insurer/Insurers Disability and unemployment cover is provided by London General Insurance Company Limited, whose main business is general insurance. Life benefit cover is provided by Combined Life Assurance Company Limited, whose main business is life assurance. Details can be found in on the back cover.
Monthly Payment The amount payable by you, under the policy terms, to (i) the insurer for the insurance cover; and (ii) to us for the provision of services.
National Insurance Credits The credits added to your National Insurance record when you sign on at an office of the Department for Work and Pensions.
Normal Pregnancy/Childbirth-Related Conditions Symptoms which normally accompany pregnancy and/or childbirth (including those related to multiple pregnancies, delivery by caesarean section and surgically-assisted delivery) and which are generally of a minor and/or temporary nature (e.g. morning sickness or fatigue) not representing a medical hazard to mother or baby, or a combination of minor symptoms. You will not receive any benefit from this policy whilst you are on statutory maternity leave.
Period of cover The period from the start date to the end date of the policy.
Redundancy Being entirely without employment as a direct result of your employment being ended due only to your employer stopping or reducing the activities for which you were engaged, and you not being paid in lieu for the period claimed. Redundancy cannot be voluntary.
Self-employed Working for a profit, either alone or in association with others, whilst paying Class 2 National Insurance contributions and being assessable under Schedule D as defined by the Income and Corporation Taxes Act 1988.
Service Charge The amount payable by you, under the terms, to us for our services.
Services The work we undertake on your behalf in arranging the insurance and acting as an intermediary between you and the insurer.
Start Date The date your cover starts, as detailed on your Certificate.
UK Resident A person who lives lawfully in the United Kingdom, the Channel Islands, or the Isle of Man for at least 40 weeks in any 52-week period throughout the period of cover of the policy.
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Unemployed/Unemployment You are out of work due directly to your redundancy or business failure and have registered with the Department for Work and Pensions (or other relevant government department or body), and are receiving the correct class of National Insurance credits. You must be capable of, and be actively seeking, work. We will not consider you unemployed for any day you receive pay in lieu of notice. We will require evidence of your status to support your claim.
We/Us/Our Refers to Lifestyle Services Group Limited. Details can be found in Section 15.
You/Your The customer detailed on the Certificate who is party to the agreement.
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Benefits
7.1
Disability and unemployment benefits
If you are working and become continuously disabled, unemployed or a carer during the period of cover for at least 15 consecutive days, we will pay you up to ÂŁ250 for each calendar month you are disabled, you are unemployed, or you are a carer. We will then continue to pay this benefit on a monthly basis until whichever of the following occurs first: 1. 2. 3.
you cease to be disabled or unemployed, or fail to provide proof to us of your disability or unemployment; we have made 12 monthly payments for any event of disability or unemployment; or any condition stated under end date occurs.
Any period for which you have a valid claim for a period of less than one month will be calculated at an average daily rate throughout that month. The qualification period for disability benefits will not start until you consult a doctor. We will only pay the disability benefit if a doctor is treating you for the condition causing your disability on a regular and ongoing basis. Your doctor will be asked to confirm your disability. The qualification period for unemployment benefits will not start until you have registered with the Department for Work and Pensions (or other relevant Government department or body), and are receiving the correct class of National Insurance credits. We may require further evidence to support your claim and we will contact you if this is required. The qualification period for becoming a carer will not start until the Department of Work and Pensions (or other relevant department or body) have approved your Carer's Allowance. Where appropriate, payments will be backdated to the start of the period in which you received the Carer's Allowance. If you are self-employed, you can claim disability and unemployment benefit as set out above. We will require evidence from the Inland Revenue that you have declared the business failure to them.
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7.2 | 7.3 | 8 | 8.1
Life benefits
If you die during the period of cover, we will pay up to a maximum of £750, which covers your specified household bills for up to £250 per month, for the three months prior to your death. 7.3
How payments will be calculated
You are covered up to a maximum of £250, including VAT, for each full calendar month you are disabled, unemployed or for the three months prior to your death. Limits apply to each type of household bill covered, as detailed below: Council tax Energy supply (gas, electricity, oil, coal, etc.) Satellite/Cable TV subscription Fixed-line telephone One mobile phone bill Water supply/sewage collection Broadband subscription
up to
£150pm
up up up up up up
£100pm £50pm £50pm £50pm £40pm £30pm
to to to to to to
Any period less than one month will be calculated at an average daily rate throughout the month. You will not be able to carry over any payments from month to month where we have not paid the maximum £250 in any one month. The bill must be in your name, or you must have been responsible for paying the bill, at the time of your disability, unemployment or death.
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When can you not claim any benefit?
We will not pay any benefits if your claim results directly or indirectly from: 1. 2. 3. 4. 8.1
Taking participation in a criminal act. Alcohol or solvent abuse, or the taking of drugs, except under the direction of a registered medical practitioner and not for the treatment of drug addiction. War, invasion, hostilities, (whether war is declared or not), civil war, rebellion, revolution, riot, or civil commotion. Ionising radiations or radio-active contamination from nuclear waste produced by the combustion of nuclear fuels.
When can you not claim disability or life benefit?
We will not pay any disability or life benefits if your claim results directly or indirectly from: 1.
Backache or back-related conditions, unless a doctor provides confirmation of the existence of radiological evidence which confirms that there is an abnormality causing definite symptoms of restriction of movement.
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2. 3. 4.
5. 6. 7. 8. 9. 8.2
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Post-viral debility, chronic fatigue syndrome and myalgic encephalomyelitis (ME). You not following medical advice provided by your doctor and this extending the time you are disabled. Any existing condition or existing related condition you knew about, and had had diagnosed, or you were receiving medical treatment or advice for, during the 12 months before the start date, unless you have been symptom-free and have not consulted a doctor or received treatment for the condition in the 24 months before your claim. You suffering from normal pregnancy/childbirth-related conditions or are claiming statutory maternity leave benefits. Any emotional, stress-related, or psychiatric condition, unless it is due to organic mental disease or psychosis. Intentional self-inflicted injury or illness. Suicide or attempted suicide. Infection with Human Immunodeficiency Virus (HIV) or any HIV-related illness including Acquired Immune Deficiency Syndrome (AIDS).
When can you not claim unemployment benefit?
We will not pay any unemployment benefits: 1. 2. 3. 4. 5. 6. 7. 8.
9.
If you are not employed or self-employed for 6 continuous months before your unemployment. If your claim results directly or indirectly from voluntary unemployment, or if you are informed of your unemployment within 90 days of the start date. If, at the start date, you knew you were to become unemployed, or it is reasonable for us to conclude that you knew that it was likely to happen. If unemployment is a regular or seasonal event that occurs in your work. In respect of any period for which you have received any payment in lieu of notice, or in respect of any period after you have stopped working but before the effective date of redundancy given by your employer. If your unemployment results directly or indirectly from a strike, labour dispute, or lockout. If you refuse any offer of reasonable alternative employment by your employer which, by reason of your qualifications and previous experience, and the location of such employment, it would have been reasonable for you to accept. If your unemployment: a. is a result of your wilful misconduct, dishonesty or fraud; or b. if you do not make a genuine and continuing effort to get work. If your unemployment is brought about by the expiry of a fixed-term contract, or is in respect of a period beyond the natural expiry date of a fixed-term contract, other than where: a. you have been employed by the same employer on 2 or more consecutive fixed-term contracts which amount in total to at least 2 years and either: i. there has been no break in service between the date upon which one fixed-term contract ended and the next one started; or ii. the only breaks in your service are customary to the business in which you are employed and you have produced evidence satisfactory to us of the customary nature of these breaks; b. you have been on a contract for at least 12 months and have had the contract renewed at least once; or c. you were employed on a permanent basis by the same employer but were transferred to a fixed-term contract by the employer without a break in employment.
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8.3 | 9 | 10 | 10.1 | 10.2 | 10.3
When can you not claim unemployment benefit?
We will not pay any unemployment benefits: 1. 2.
9 1. 2. 3.
If you are not employed or self-employed for 6 continuous months before becoming a carer. If, at the start date, you knew you were to become a carer, or it is reasonable for us to conclude that you knew that it was likely to happen.
How to make a claim? You should telephone us on 0845 333 4836 and request a claim form. You must complete and sign the claim form, ensuring any sections to be completed by others are filled in and signed. Send the completed form to: Claims Department Lifestyle Services Group Limited PO Box 390 Crewe CW1 6ZP
Please note that we must receive a completed claim form, together with any other information which may reasonably be required, within 60 days of the event in question. If this does not happen, other than in exceptional circumstances, no benefits will be paid in respect of the claim.
10 Further information concerning your claim 10.1 1. 2. 3. 4. 10.2 1.
2.
General You must continue to pay your monthly payment during a claim. If your monthly payment is not received, you will not receive any benefits from this policy. If supporting evidence of your entitlement to claim is required, you must provide it at your own expense. You must agree to a medical examination at our expense if we wish. During our investigations, payment of any benefit may be withheld. Only one type of monthly benefit will be payable at any one time under this policy.
Disability Claims If you claim for the same disability within 3 months of your previous claim ending, we will treat it as a continuation of your previous claim, which will be limited to a maximum of 12 payments. If you claim again for an unrelated disability, you must have returned to work for at least 3 months following the end of your last claim. If you become unemployed during a disability claim, you must tell us immediately. If your disability claim ends before the end date but your unemployment continues and we have paid less than 12 monthly payments in respect of your disability claim, we may, at our discretion, continue to make monthly payments in respect of your unemployment, but we will make no more than 12 monthly payments from the date you became disabled.
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10.3 1. 2. 3.
4. 5. 6.
7.
10.4 1.
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Unemployment Claims To assist in proving your business failure, you will be asked to provide evidence from the Inland Revenue that your company has stopped trading, and you may be asked to supply us with trading accounts for the period immediately before you became unemployed. If you make a claim for unemployment benefit again within 6 months of your previous claim ending, we will treat it as a continuation of your previous claim, which will be limited to a maximum of 12 payments. If, during payment of an unemployment claim, you are not able to actively seek and/or be available for work because of a disability which, had you been at work, would have stopped you doing any work that your experience, education, or training may reasonably qualify you to do, we may, at our discretion, continue to pay monthly payments but we will not pay more than 12 monthly payments from the date the unemployment began. If you are offered a temporary position whilst you are claiming for unemployment, and if we approve it first, we may suspend your unemployment claim for a maximum period of 6 months, during which time we will require evidence of your continued search for work. You will be considered to have returned to work if you take part-time or lower-paid work. In the case of unemployment following the non-renewal of a fixed-term contract of the kind described in Section 8.2, paragraph 9b, redundancy will be considered to have started on the date on which your contract would customarily have been renewed. You must produce satisfactory evidence that you notified your employer of your availability for further renewal of the fixed-term contract. Any claim in respect of unemployment following the expiry of a fixed-term contract will be restricted to the natural expiry date of the fixed-term contract from which you were made unemployed or the date when 12 monthly payments have been made, whichever is the earliest date, unless you meet the criteria for fixed-term contracts stated above.
Life Claims We will need a copy of the Death Certificate. This should be provided by your next of kin or Executor of the Estate.
11 What happens once your claim is approved? 1.
2.
All claim payments will be made by cheque once a month direct to you. At the time you make a claim, we will agree a monthly cut-off date, by which time we must have received your bills for the next monthly payment. If you have not forwarded the bills by this date, payment will be rolled over to the next month. You will be required to complete a monthly continuation claim form to continue receiving benefits The form must be completed and returned along with your bills, by the monthly cut-off date. If your monthly continuation claim forms are not returned within 21 days of the monthly cut-off date, other than in exceptional circumstances, no further benefits will be paid in respect of the claim.
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12 Cancelling the policy 1.
If the policy does not meet your needs, please telephone our Customer Services team immediately on 0870 333 4832, or write to: Customer Services Lifestyle Services Group Limited PO Box 390 CREWE CW1 6ZP
2. 3. 4.
We will refund your payment if you cancel within the first 30 days after you apply for the policy,although if a claim has been made during this period we may recover any costs incurred. If you cancel after this time, we will not refund your monthly payment. We may cancel this policy with immediate effect by registered letter to you at your last known address if you submit fraudulent or inaccurate information, or for any other valid reason. We will not return any payments you have made. You may cancel this policy with immediate effect by telephoning Customer Services. We will not refund your monthly payment. Cancellation or unsuccessful collection of your Direct Debit will be considered as a cancellation of your policy. We will attempt to collect your Direct Debit payment twice before we cancel your policy.
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13 Fraud Identity fraud is a serious problem in the UK. Your details will be used to help prevent fraud of this nature happening to you. If you receive information about your details being used for fraudulent purposes, please call our Customer Services team on 0870 333 4832 and ask to be transferred to the Security and Risk Management team. Alternatively, you can write to: Security and Risk Management Lifestyle Services Group Limited PO Box 390 CREWE CW1 6ZP The personal details you supply to us during the application process will be used to combat fraud. These details will be retained for legal reasons for a reasonable period after your policy expires, and for up to one year after your policy expires in relation to fraud specifically. The contract between you and us is based on mutual trust. If you (or anyone acting for you): • •
make a claim against this policy knowing the claim to be false or fraudulently exaggerated in any respect; make a statement in support of a claim, knowing the statement to be false in any respect, or submit a document in support of a claim, knowing the document to be forged or false in any respect; or
•
make a claim with the intent to defraud us or the insurer;
then: • • • • •
we shall not honour the claim; we shall not honour any other claim which has been or will be made under any policy held by you; we shall not make any return of payments made for cover and we may, at our option, cancel this policy; we may be entitled to obtain from you the cost of any claim already paid under this policy (if necessary the cost may be obtained by court proceedings); we may be entitled to obtain from you the cost of any investigation into a fraudulent claim under this policy (if necessary the cost may be obtained by court proceedings); and
•
may inform the Police, Government or regulatory bodies of the circumstances.
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14 Enquiries/Complaints We will always be fair and reasonable when handling your policy or claim. Should there ever be an occasion when you feel that we have not provided you with a satisfactory level of service, we would like you to inform us so that we can do our best to solve the problem. We will do everything possible to ensure that your query is dealt with promptly. We will deal with all queries on behalf of the insurers. The easiest way to contact us is to call our Customer Relations team on 0870 333 4832. Alternatively, you can write to us at the following address: Customer Relations Department Lifestyle Services Group Limited PO Box 390 CREWE CW1 6ZP Please quote your policy number in all correspondence. Our staff will attempt to resolve your query immediately. If this is not possible, we promise to acknowledge your query within 5 working days of receiving it. In the unlikely event that your query has not been resolved within 4 weeks of our receiving it, we will write and let you know the reasons why, and what further action we will take. Once we have resolved your query, we will confirm our response in writing. If you are not satisfied with our decision, please contact our Customer Relations Manager on the number provided above. If you have a complaint relating to the policy wording or contract, please contact the insurers at their registered address. If you remain dissatisfied, you can, within 6 months of our final decision, refer your query for an independent assessment, to: The Financial Ombudsman Service South Quay Plaza 183 Marsh Wall LONDON E14 9SR We are covered by the Financial Ombudsman Service who, once contacted, will liaise with us on your behalf. They will inform you directly of their decision. You are entitled to contact the insurer if you wish. Following this procedure will not affect your statutory rights. Further information is available on the website at www.financial-ombudsman.co.uk. You are covered by the Financial Services Compensation Scheme. In the unlikely event that any of the parties to this insurance is unable to meet its liabilities, you may be entitled to compensation. The scheme covers 100% of the first ÂŁ2,000 of the claim, and 90% above this limit. Further information is available on the website at www.fscs.org.uk.
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15 Other Information Status Disclosure Lifestyle Services Group Limited can only offer creditor insurance products on behalf of the insurers, London General Insurance Company Limited and Combined Life Assurance Company Limited, for whom they act as an agent in respect of the sale of this product. Lifestyle Services Group Limited is authorised and regulated by the Financial Services Authority (FSA), with an FSA registered number of 315245, which can be checked on the FSA website at www.fsa.gov.uk/register or by telephoning 0845 606 1234. If you need to register a complaint, please follow the procedure detailed in Section 14. If Lifestyle Services Group Limited cannot settle your complaint, you may be entitled to refer it to the Financial Ombudsman Service. We are covered by the Financial Services Compensation Scheme. You may be entitled to compensation from the scheme if we cannot meet our requirements. For the purposes of the Data Protection Act 1998, the Data Controller in relation to the personal data you supply is Lifestyle Services Group Limited. Calls may be recorded or monitored for training/Customer Services purposes and/or the prevention or detection of crime.
customer services:
online:
0870 333 4832
www.lifestyleservicesgroup.co.uk 22