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Income Protection Insurance Policy

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

The income protection policy wording is comprised of four documents:

  1. The TotalCareMax Umbrella Wording PDF

  2. The Disability Income Protection Benefit Appendix PDF

  3. The Waiver of Premium Benefit Appendix PDF

  4. The Redundancy Benefit Appendix PDF (if this option is selected)

  5. The Policy Schedule

The Umbrella Wording is common to all of Sovereign’s TotalCareMax policies. The Income Protection Benefit Appendix provides details of the income protection benefit. The Waiver of Premium Benefit Appendix provides details of the waiver of premium benefit. The Policy Schedule is customised as it contains personal details such as who is insured and the benefit amount. 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’.

Income Protection Benefit Appendix

The Income Protection Benefit Appendix is comprised of the following sections:

  1. When will Sovereign pay a Total Disability Income Benefit?
  2. What amount will Sovereign pay for a Total Disability Income Benefit?
  3. What does totally disabled mean?
  4. When will Sovereign pay a Partial Disability Income Benefit?
  5. What is the amount of the Partial Disability Income Benefit?
  6. What is the Partial Disability Bridging Benefit and when will Sovereign pay it?
  7. What is the Enhanced Partial Disability Income Benefit and when will Sovereign pay it?
  8. What is the Recurrent Disablement Benefit?
  9. What is the Optional Claim Indexation Benefit?
  10. What is the Vocational Retraining Benefit and when will Sovereign pay it?
  11. What is the Home Modification or Equipment Expenses Benefit and when will Sovereign pay it?
  12. What is the Bed Confinement Benefit and when will Sovereign pay it?
  13. When can you suspend cover and when will Sovereign reinstate cover?
  14. What is the Future Insurability Benefit?
  15. What is the Back to Work Payment and when will Sovereign pay it?
  16. What is the Optional Mental Health Limitation?
  17. Extra Benefits for the Premier Cover Option
  18. How to make a claim
  19. Ongoing Claim Requirements
  20. When will Sovereign cease paying a benefit?
  21. When will this appendix terminate for a life assured?
  22. Exclusions – When Sovereign won’t pay a benefit
  23. Key terms

Waiver of Premium Benefit Appendix

The Waiver of Premium Benefit Appendix is comprised of the following sections:

  1. When will Sovereign waive the regular premiums payable under this TotalCareMax policy?
  2. What does totally disabled mean?
  3. How to make a claim for the Waiver of Premium Benefit
  4. Ongoing Claim Requirements
  5. When will Sovereign cease waiving the regular premiums payable under this TotalCareMax policy?
  6. Exclusions – when Sovereign won’t waive the regular premiums
  7. 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 income protection cover for the person insured;
  • A statement that the amount of cover qualifies for annual inflation adjustments;
  • 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 or Benefit Appendix.

Important Information

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