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Disability Insurance Policy

This page describes the structure and contents of the policy wording.

The permanent disability policy wording is comprised of three documents:

  1. The TotalCareMax Umbrella Wording  PDF

  2. The Total Permanent Disablement Benefit Appendix  PDF

  3. The Policy Schedule

The Umbrella Wording is common to all of Sovereign’s TotalCareMax policies. The Benefit Appendix provides details of the permanent disability benefit (also known as total and permanent disablement). The Policy Schedule is customised as it contains personal details such as who is insured and the amount of cover. Each of these parts is summarised as follows:

TotalCareMax Umbrella Wording

The Umbrella Wording comprises eight sections, and these cover (in this order) the four major areas of benefits, premiums, claims and policy information. The purpose of each of the eight sections is summarised as follows, with the numbering following that in the Umbrella Wording:

  • 1. Policy Benefits

    A statement of what your policy is and what benefits it can provide. This section links the Umbrella Document to the Benefit Appendix and the Policy Schedule, and makes those part of the overall policy.

  • 2. Guaranteed Enhancement

    This provides a guarantee that if any applicable section or condition of your policy is enhanced in the future, then that enhancement will automatically be applied to your policy, subject to the conditions specified.

  • 3. Cover Options

    This describes the two inflation adjustment (indexation) options for your policy, namely no indexation at all and indexation which is based on changes in the Consumers Price Index. It also describes how you can increase or reduce the amount of cover under your policy.

  • 4. Your Premiums

    This section is a statement of the need to pay the agreed premiums on a regular basis, how premiums can be paid, what happens if you don’t pay a premium on time and when the premium can change. The premium type for your policy is rate for age.

  • 5. Making a Claim

    This section describes how to make a claim, and it provides an 0800 claims hotline number for that purpose. It also refers to the Benefit Appendix for information that may be required in order to make a claim.

  • 6. Cancellation

    This section details when and how you can cancel your policy, both during and after the initial 15-day free look period, and what happens if you give notice of cancellation. It also details the circumstances under which Sovereign would be entitled to cancel your policy.

  • 7. Important Information

    This specifies important information regarding your policy, including what forms part of the policy contract, changes in law, New Zealand jurisdiction, notices to Sovereign and to you, transfer of the ownership of your policy, worldwide cover and how to make a complaint.

  • 8. Key Terms

    This section defines the meanings of special words which are used throughout the document, including ‘Claim Event’, ‘Fraudulently’, ‘Material’, ‘Pass Back Date’, ‘Policy Illustration’, ‘Substantially Incorrect’ and ‘Term Life Insurance Policy’.

Total and Permanent Disablement Benefit Appendix

The Total and Permanent Disablement Benefit Appendix is comprised of the following sections:

  1. What effect does payment of an accelerated Total Permanent Disablement Benefit have?
  2. If you have selected an ‘any occupation Total Permanent Disablement Benefit’
  3. What does ‘any occupation Total Permanent Disablement’ mean?
  4. If you have selected an ‘own occupation Total Permanent Disablement Benefit’
  5. What does ‘own occupation Total Permanent Disablement’ mean?
  6. When does an ‘own occupation Total Permanent Disablement Benefit’ cease?
  7. When will Sovereign pay a Partial Permanent Disablement Benefit?
  8. Financial Advice Benefit
  9. Special Events Increase Facility
  10. Total Permanent Disablement Future Insurability Benefit
  11. Waiver of Total Permanent Disablement Waiting Period
  12. How to make a claim
  13. Exclusions – when Sovereign won’t pay a benefit
  14. When will this appendix terminate for a life assured?
  15. Key terms

Policy Schedule

The Policy Schedule comprises the customised part of the policy wording, and it is relatively brief. It specifies the following principal information:

  • The policy number;
  • The name of the person insured (the ‘Life Assured’);
  • The date of birth, gender and occupation of the person insured;
  • The amount of permanent disability cover for the person insured;
  • The name and physical address of the policy owner;
  • The monthly premium payable;
  • The risk commencement date (the date on which cover starts);
  • The signatures of two authorised officers of Sovereign in issuance of the policy.

The individual details on the Policy Schedule can be varied by notice or application to Sovereign as applicable, where permitted in accordance with the terms of the Umbrella Wording and Benefit Appendix.

Important Information

  • Please note that if you have already taken out a permanent disability insurance policy through KiwiCover, your policy wording may be different from the policy wording referred to above.