Group Insurance. Group Life Assurance for Approved Death in Service Benefits Policy conditions

Transcription

1 Group Insurance Group Life Assurance for Approved Death in Service Benefits Policy conditions

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3 Introduction Our commitment to plain English This Policy uses everyday language wherever possible and is laid out in clearly marked sections, designed to provide you with the information you need, when you need it. However, because it is a legal document, we have had to define certain terms we have used in the text. We have tried to keep these to a minimum and, where they do appear, have written them in italics and explained their meanings in the margin. A complete list of these defined terms and their meanings is also included in alphabetical order at the back of the Policy. The nature of the Policy and what it explains The Policy sets out the terms of the legal contract between us. It provides you with clear details of: 1. Who is included and for what benefits. 2. When benefits are payable. 3. What premiums are due and when. 4. How our joint rights and liabilities are protected. It is important that you read the Policy as a whole, including the enclosed Policy Particulars which set out the terms individual to your scheme. This introduction is for information only. It does not form part of the Policy.

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5 Group Life Assurance Policy for Approved Death in Service Benefits This Policy is issued by Canada Life Limited (referred to as we from now on) in response to a written proposal and declaration from the Trustee(s) of the scheme named in the enclosed Policy Particulars (referred to as you from now on). It witnesses that: 1 The Policy is issued to you on the terms set out below in the Policy Conditions and in your Policy Particulars, all of which form part of the Policy. 2 We agree to pay you the benefits described in the Policy in accordance with its terms, provided that premiums are also paid in accordance with its terms and that all other requirements of the Policy are met. 3 The Policy and any benefits payable under the Policy shall not be assignable, and we shall not be affected by any notice of any assignment, trust, charge or lien or other dealing with the Policy or any benefits payable under the Policy. 4 Where we use words in the singular, the same applies to the plural (and vice versa), unless it is clear that this is not the case. 5 The law applicable to, and governing, the Policy is English law. 6 This Policy does not acquire a surrender value. Please read this Policy carefully, then keep it in a place of safety for future reference. Signed for and on behalf of Canada Life Limited: Dave Johnston Managing Director, Group Insurance

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7 Contents Section 1 Who is included and for what benefits? 8 A. Standard acceptance 8 B. If a claim arises in the meanwhile 8 C. Acceptance on special terms 8 D. Acceptance at our discretion 9 E. The information we need you to provide 9 F. Membership during absence from work 9 G. When membership must cease 10 Section 2 When are benefits payable? 11 A. Payment of lump sum benefit 11 B. Payment of pension benefits 11 C. Reduction for age difference 11 D. Annual increase in pension payable 11 E. Conditions of payment of pension benefits 11 F. The evidence we need to support a claim 12 G. Payment procedures 12 H. Policy benefits related to scheme benefits 12 Section 3 What premiums are payable and when? 13 A. How premiums are calculated 13 B. If premiums are discontinued 14 Section 4 How are both our rights protected? 15 A. Terms at the commencement date 15 B. The basis on which we review the Policy 15 C. Third party rights 15 Policy definitions and their meanings 16

8 Section 1 Who is included and for what benefits? What we mean by Eligible employee : anyone who fits the description of eligibility given in your Policy Particulars Scheme benefit : the benefit (or benefits) set out in your Policy Particulars. Normal inclusion date : the first date on which an eligible employee qualifies for inclusion in the Policy, as explained in your Policy Particulars. A. Standard acceptance We will include an eligible employee in the Policy for the scheme benefit as from the normal inclusion date, provided we have received any evidence of insurability necessary to accept such a person for that benefit on our standard terms. Any increase in the amount of a person s scheme benefit occurring after the person s normal inclusion date is also subject to our acceptance. Any eligible employee who cannot be included in the Policy on standard terms for the total scheme benefit may, nevertheless, be included for a smaller amount, subject to any additional terms that we may impose at that time. B. If a claim arises in the meanwhile If any eligible employee dies on or after the normal inclusion date (or date of increase in scheme benefit) but before we have obtained the necessary evidence of insurability to consider that person for acceptance for the entire scheme benefit, he or she will be treated as though that evidence had not been required provided the death occurs within a period of no more than 90 days commencing on the date we are notified of the amount of the person s scheme benefit. This paragraph will not apply to the following: Any scheme benefit if that person was previously not acceptable on standard terms or has not provided medical evidence or other requirements that have previously been requested; Any part of the scheme benefit which, when combined with any death benefits we are providing for the eligible employee under any other policy, exceeds 2,000,000. This includes the cash equivalent of any pension benefits payable following the eligible employee s death. Any scheme benefit where the death is directly or indirectly linked to any medical condition or complication the person has suffered within the 5 years immediately preceding the 90 day period. C. Acceptance on special terms If evidence of insurability is such that we can only accept a person on special terms for either the whole or any part of the scheme benefit, or for an increase in its amount, on special terms, we will write to let you know what those terms will be and the date we have assumed risk for that person s entire scheme benefit. If we receive written confirmation from you that such terms are not acceptable, this cover will be cancelled from the date we receive such notification. Premiums will be charged for the period we were on risk. 8

9 What we mean by Member : a person who is included in the Policy. Where both lump sum benefits and pension benefits are insured, but the member: Cannot be included for the total amount of their scheme benefit and their scheme benefit is restricted, or Some of their scheme benefit has been accepted on special terms The restriction or the amount of scheme benefit accepted on normal terms will apply in the same proportion to the lump sum benefit and the pension benefit. If either of these benefits subsequently ceases to be insured by us, the restriction or amount of benefit accepted on normal terms applying to the remaining benefit will be unchanged. Scheme : the scheme named against that heading in your Policy Particulars, being the scheme in connection with which the Policy has been taken out. Annual revision date : the date, as shown in your Policy Particulars, when the years premiums are calculated. Maternity leave : a female member s period of absence that immediately precedes and follows the conclusion of her pregnancy, during which she has the right to return to work for an employer. Paternity leave : a member s period of absence that immediately follows the conclusion of his partner s pregnancy, during which he has the right to return to work for an employer. D. Acceptance at our discretion Subject to our written consent and any special terms we specify, we may agree to: The inclusion of a person who is included in the scheme but is not an eligible employee; The inclusion of an eligible employee in the Policy on a date other than his or her normal inclusion date; A larger or smaller benefit than the specified scheme benefit for or in respect of a particular member. E. The information we need you to provide We will need you to supply us with such information as we may require to operate the Policy. This will include a statement from you within the period of 30 days immediately following each annual revision date (or longer, if we both agree) setting out any membership details that we may require. We reserve the right to ask you to produce such details of the scheme (including copies of the documents by which it is governed) as we may require. You must notify us of any intention to amend the terms of the scheme; no amendments made will affect the terms of the Policy, except as agreed by us and notified to you in writing. F. Membership during absence from work If premiums continue to be paid in respect of a member, and for so long as the member continues to qualify for death in service benefits under the terms of the scheme, he or she may still be included in the Policy if granted a leave of absence in the following circumstances: During any period of illness, disablement, maternity or paternity leave; During an absence of no more than 1 year if engaged in service for the Armed Forces of the Crown and/or any organisation concerned with National Service work for the Crown; and During an absence of no more than 3 years for any other reason. 9

10 What we mean by Commencement date : the date on which the Policy becomes effective, as set out in your Policy Particulars. If, however, i) a member is absent from work on the commencement date and ii) immediately before that date benefits in respect of a member were insured under any other policy, we will not agree to include the member under this Policy beyond the date on which his or her cover would have ceased under that other policy, had it remained in force. In order for membership to continue in the above circumstances, you must provide us with any details of such members that we may request at an annual revision date Unless otherwise agreed between us in writing, the amount of a member s benefit (or benefits) will not be any less during a temporary absence from work than it was immediately before the absence occurred. Employer : this term refers to any employer or employers who have employees included or eligible for inclusion in the scheme, and that we have agreed in writing to include in the Policy. G. When membership must cease A member s inclusion in the Policy will cease on whichever of the following events occurs first: On reaching the age for termination of membership set out in your Policy Particulars. On ceasing to be an eligible employee. On ceasing to be actively engaged in the service of an employer for any reason, other than during a period of temporary absence in which cover is continued under the terms previously described in Section 1F. The expiry of their contract of employment. In any event membership must cease immediately if a member is no longer being treated by the employer as an employee for the purposes of the scheme. In applying this provision, if, under any retirement benefits scheme of the employer, a member is regarded as having retired from or left the service of the employer, he or she will also be regarded as having ceased to be treated by the employer as an employee for the purposes of the scheme. 10

11 Section 2 When are benefits payable? What we mean by Insured benefit : the total benefit (or benefits) for which the member has been included in the Policy. Spouse : the person to whom the member was married immediately before his or her death, provided that subject to agreement between us in any particular case, a person who was not legally married to the member may nevertheless be treated as his or her spouse (provided that person was, in your opinion, financially dependent on the member at the time of the member s death). Eligible child : any natural or legally adopted child of the member (or any other child who was, in your opinion, financially dependent on the member at the time of the member s death) who qualifies for a pension under the rules of the scheme and who is: i) under 18, or ii) over 18 but under 25, and continuing to receive full-time education or vocational training, or iii) dependent on the member because of disability at the time of the member s death. Eligible dependant : a person selected by you and notified to us, being someone who qualifies to receive a pension as a result of the member s death, under the rules of the scheme. A. Payment of lump sum benefit If a member s insured benefit is or includes a lump sum benefit we will pay you that benefit as soon as possible following a member s death, subject to our acceptance of your claim. Any benefit so paid is to be applied by you in accordance with the provisions of the scheme. B. Payment of pension benefits If a member s insured benefit is or includes a pension or pensions we will pay you that pension or those pensions in accordance with the following provisions, subject to our acceptance of your claim. The pension(s) will normally be payable by monthly instalments in advance, starting on the date of the member s death, and finishing on the last monthly due date before the relevant terminating date specified below. In the case of a spouse s pension the terminating date is the date of the spouse s death. In the case of a spouse s and orphan s pension the terminating date is the date on which there ceases to be either a spouse or an eligible child. In the case of a children s pension the terminating date is the date on which there ceases to be an eligible child. In the case of a dependant s pension the terminating date is the date of the eligible dependant s death (or the date he or she ceases to be an eligible child, if the eligible dependant is an eligible child). In the case of a dependant s and orphan s pension the terminating date is the date on which there ceases to be either an eligible dependant or an eligible child. C. Reduction for age difference If any part of the insured benefit is a pension payable for the benefit of someone other than the member s eligible child, and that person is more than 10 years younger than the member, the pension will be reduced in amount by 2.5% for each year by which the difference in their ages exceeds 10. D. Annual increase in pension payable On each anniversary of a member s death any pension then in payment will be increased in amount on the basis set out in your Policy Particulars. E. Conditions of payment of pension benefits Pensions payable under the Policy will be paid to you in such a manner as we agree between us. If, at your request, we agree in any case to act as your agent, and pay a pension direct to the person entitled to benefit from that pension under the scheme any payments made will be regarded as having been paid to you. They will be subject to a deduction by us of any tax which you would otherwise be liable to deduct under the terms of the scheme. Any payment of pension under the Policy which depends on the death or existence of any person is subject to our being provided with satisfactory proof of such death or existence. 11

12 F. The evidence we need to support a claim We will need written notice as soon as practicable after a member s death. Payment of the insured benefit is subject to our being provided with such documents and information as we may need. This will include a Registrar s Certificate of Death of the member and satisfactory proof of the member s age. If a claim is made for a pension benefit we will also require satisfactory proof of age of any person on whose existence payment of the pension depends, and, in the case of the member s spouse or eligible child, satisfactory proof of the marriage, birth or legal adoption, as the case may be. G. Payment procedures Benefits under the Policy are payable to you by us in the currency of the UK. The receipt of any payment by you (or by any person we have agreed to pay on your behalf under the terms of Section 2E) will mark an end to our responsibilities for that payment. H. Policy benefits related to scheme benefits The Policy has been taken out by you to provide benefits which are provided for members under the scheme. You are required to exercise any options available under the Policy in such a way as to ensure that the benefits paid to you are dealt with in accordance with the provisions of the scheme. 12

13 Section 3 What premiums are payable and when? What we mean by Commencement date : the date on which the Policy becomes effective, as set out in your Policy Particulars. A. How premiums are calculated Premiums are payable by you to us in advance, the first premium being due on the commencement date and subsequent premiums from each annual revision date after the commencement date being payable either annually, monthly, quarterly or half-yearly in advance. Your Policy Particulars will show the premium frequency that you have selected as the basis of this Policy. The premiums due for the Policy will be calculated in one of two ways. Where both lump sum and pension benefits are insured, either method of calculation may be used in each case. Your Policy Particulars will show which basis applies. 1. Single premium basis: This basis is normally used where there are less than 20 members included in the Policy. If for a Policy that is single premium costed, the number of members included in the Policy increases to 24 or more at any time, we reserve the right to alter the costing to the unit rate basis. On the commencement date and on each subsequent annual revision date, we will calculate separate premiums in respect of the lump sum and/or pension benefits to which this basis of calculation applies for each member then included in the Policy. These premiums are for the period from the relevant calculation date until the next annual revision date in respect of the relevant part of the member s insured benefits under the Policy. If, after the commencement date, a member is first included in the Policy or has an increase in insured benefit other than on an annual revision date, we will calculate an additional premium in respect of that member to cover the period between the member s entry date (or date of increase in insured benefit) and the next annual revision date. Any premium or additional premium will be calculated according to the member s age, gender, location and occupation, together with any evidence of health that may have been supplied, and the premium frequency selected on each annual revision date. If, after the commencement date, a member ceases to be included in the Policy, or has a decrease in insured benefit other than on an annual revision date we will calculate a refund of premium in respect of that member for the period from the date the member ceases to be included in the Policy (or has a decrease in insured benefit) to the next annual revision date. Any additional premium or refund of premium due under the Policy as above will be calculated by reference to the number of days in the period concerned, expressed as a proportion of a complete year, and will be that proportion of a full year s premium. 13

14 What we mean by We will send you a statement of account as at the commencement date and as at each subsequent annual revision date, setting out the premium then payable in respect of each member and the total payable in respect of all members. Any additional premium or refund of premium arising from an event occurring since the last statement of account was issued will normally be included in the account issued at the following annual revision date. 2. Unit rate basis: This basis is normally used where there are 20 or more members included in the Policy. If for a Policy that is unit rate costed, the number of members included in the Policy falls below 17 at any time, we reserve the right to alter the costing to the single premium basis. The premium for each 12 month period following an annual revision date is calculated by applying the relevant premium rate(s) shown in your Policy Particulars: i) in the case of lump sum benefits, to the total of all the insured benefits included in the Policy at the beginning of that period. i) in the case of pension benefits, to the total of all the insured benefits included in the Policy at the beginning of that period as if all members included in the Policy had someone entitled to receive pension benefits under the scheme in the event of their death at that time. Periodic review date : the date on which your premium rates are reviewed, as shown in your Policy Particulars. Policy year : any 12 month period from an annual revision date during which the Policy is in full force. The premium rate(s) will apply until the next periodic review date, at which time we will recalculate the rate(s) and advise you of any change. If the period of time from the commencement date to the following annual revision date is other than a year, a premium will be required to cover that period. This premium will be calculated on a pro rata basis, according to the period of time in question, and will be payable on the commencement date. Your premiums will be adjusted up or down at each annual revision date to take account of any changes in membership and benefits during the previous policy year (or since the commencement date if this was less than one year prior to the annual revision date). If a higher premium is required, we will ask for a payment from you. If a reduced premium applies, the payment will come from us. Any such adjustment will be made on the basis that we will notify to you. B. If premiums are discontinued We allow 30 days grace for payment of premiums. If any premium is not paid within that period, or any longer period of time agreed between us premiums will be deemed to have been discontinued from the date they were due. In this event, cover under the Policy will also be discontinued from that date. You will need our agreement to resume payment of premiums, or if you require a longer period of grace than 30 days. This agreement will be subject to any terms and conditions that we may impose, including our right to levy a charge on any premiums or instalments that are paid after the date they fall due for payment. 14

15 Section 4 How are our joint rights protected? A. Terms that bind us both The Policy sets out our joint rights and liabilities. It provides evidence of a legal contract between us and takes effect from the commencement date. The terms of the Policy are dependent upon information you have provided. If this has been mis-stated, or if there has been any alteration of material fact between the date you provided the information and the commencement date, the Policy may be amended or discontinued with effect from the commencement date. B. The basis on which we review the Policy We reserve the right to revise the premium rate(s) and to revise or add to the other Policy terms on any periodic review date, or at any other time one of the following situations arises: If a change is agreed in the basis to be used for calculating the benefits provided under the Policy. If a change is agreed in the conditions for assessing eligibility for inclusion in the Policy or, if eligibility is based on membership of a retirement benefits scheme, a change occurs in the membership conditions of that scheme. If we agree to an additional employer or an additional group of employees being included in the Policy or an employer or group of employees are removed from the Policy. If either the number of members included in the Policy or the total benefit insured increases or decreases by more than 25% of the total number or the total benefit insured applicable on the last periodic review date (or on the commencement date if no periodic review date has yet taken place). If any part of the scheme ceases to be treated as an exempt approved scheme for the purposes of Chapter I, Part XIV of the Income and Corporation Taxes Act If any new legislation (or change in legislation) comes into force on or after the commencement date which affects the way that premiums and/or benefits are treated for tax purposes for you, your members or us, or the way that our life assurance fund (into which premiums are paid) is treated for tax purposes. If you fail to comply with any of the terms of the Policy we will not be bound to accept any further premiums. In this event premiums under the Policy will be deemed to have discontinued, and cover under the Policy will cease. C. Thirds party rights Any person or company who is not a party to this Policy does not and shall not have or acquire any right under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of this Policy but this does not affect any right or remedy of a third party which exists or is available apart from that Act. 15

16 Policy definitions and their meanings Annual revision date : the date, as shown in your Policy Particulars, when the years premiums are calculated. Commencement date : the date on which the Policy becomes effective, as set out in your Policy Particulars. Eligible child : any natural or legally adopted child of the member (or any other child who was, in your opinion, financially dependent on the member at the time of the member s death) who qualifies for a pension under the rules of the scheme and who is: i) under 18, or ii) over 18 but under 25, and continuing to receive full-time education or vocational training, or iii) dependent on the member because of disability at the time of the member s death. Eligible dependant : a person selected by you and notified to us, being someone who qualifies to receive a pension as a result of the member s death, under the rules of the scheme. Eligible employee : anyone who fits the description of eligibility given in your Policy Particulars Employer : this term refers to any employer or employers who have employees included or eligible for inclusion in the scheme, and that we have agreed in writing to include in the Policy. Insured benefit : the total benefit (or benefits) for which the member has been included in the Policy. Maternity leave : a female member s period of absence that immediately precedes and follows the conclusion of her pregnancy, during which she has the right to return to work for an employer. Member : a person who is included in the Policy. Normal inclusion date : the first date on which an eligible employee qualifies for inclusion in the Policy, as explained in your Policy Particulars. 16

17 Paternity leave : a member s period of absence that immediately follows the conclusion of his partner s pregnancy, during which he has the right to return to work for an employer. Periodic review date : the date on which your premium rates are reviewed, as shown in your Policy Particulars. Policy year : any 12 month period from an annual revision date during which the Policy is in full force. Scheme : the scheme named against that heading in your Policy Particulars, being the scheme in connection with which the Policy has been taken out. Scheme benefit : the benefit (or benefits) set out in your Policy Particulars. Spouse : the person to whom the member was married immediately before his or her death, provided that subject to agreement between us in any particular case, a person who was not legally married to the member may nevertheless be treated as his or her spouse (provided that person was, in your opinion, financially dependent on the member at the time of the member s death). 17

18 About Canada Life The Canada Life Assurance Company provides insurance and wealth management products and services through domestic operations in Canada and international operations in the Republic of Ireland, Isle of Man, Germany and the U.K., as well as branch and subsidiary operations in other countries. Canada Life is a subsidiary of The Great-West Life Assurance Company and a member of the Power Financial Corporation group of companies. Canada Life Limited, 3 Rivergate, Temple Quay, Bristol BS1 6ER. Telephone All forms are available to download from our website: Canada Life Limited, registered in England no Registered Office: Canada Life Place, Potters Bar, Hertfordshire EN6 5BA Telephone Facsimile The Canada Life Marketing Group consists of Canada Life Limited, Canada Life Management (UK) Limited and Canada Life International Limited. These companies are authorised and regulated by the Financial Services Authority. The Financial Services Authority does not, however, regulate this specific product. GRP N Expires March 2005