BNZ CREDITCARE PLUS INSURANCE

Transcription

1 BNZ CREDITCARE PLUS INSURANCE Policy Wording Effective 27 August 2018

2 CreditCare Plus Insurance Policy Wording Part A: The basic terms of the Policy Part B: Death and Terminal Illness cover in detail Part C: Illness and Injury cover in detail Part D: Redundancy cover in detail Part E: Defined Terms Part F: Disputes Part G: About Cigna Part H: Cigna s Financial Strength 1

3 CreditCare Plus (Credit Card) Insurance Policy Wording Introducing your Policy Thank you for choosing BNZ CreditCare Plus Insurance. Bank of New Zealand ( BNZ ) and your insurer Cigna Life Insurance New Zealand Limited ( Cigna, we, us, our ) are pleased to help protect you financially if the unexpected happens. BNZ CreditCare Plus Insurance is arranged through BNZ and is underwritten by Cigna. BNZ does not guarantee the obligations of Cigna and will not be liable if Cigna does not accept your claim. BNZ receives a commission on policies arranged. If the Policy Schedule shows you as an insured cardholder ( you, your, yourself ) and you are a primary or joint cardholder then you are covered under this CreditCare Plus Insurance Policy, subject to all terms and conditions outlined below. It s important to read your Policy wording document and keep it in a safe place, in case you need to refer to it later on. Part A: The basic terms of the Policy The insurance promise Under the terms of this Policy, Cigna promises to help you pay your BNZ credit card account as detailed in the Policy Schedule, if you: die, or are diagnosed with a terminal illness; or are unable to work because of an illness or injury; or are made redundant from employment. Cigna will pay all benefits into your insured BNZ credit card account as detailed in the Policy Schedule. Summary of Benefits This is a brief summary of the benefits under this policy. Please refer to Parts B, C and D for the full terms and conditions (including qualifications and exclusions), and Part E for meanings of important words and terms. If you have any questions, please contact us. Death and Terminal Illness Benefit (see Part B) If you die or are diagnosed with a terminal illness, we will pay the Total Debit Balance as at the date of death or diagnosis of a terminal illness, up to a maximum of $75,000. Illness and Injury Benefit (see Part C) If you have an illness or injury, and are completely off work for 15 consecutive calendar days because of this, then you can claim a benefit. Once your claim is accepted, benefits will continue while you are medically unable to work, or only able to work less than 60% of your pre-disability working hours. (Note that pre-disability hours are considered to be no more than 40 hours per week) This will provide you with financial assistance even if you return to work for reduced hours while you recover from your illness or injury. The monthly benefit amount payable is based on 30% of your Total Debit Balance (as at the date you are first medically unable to work). A maximum of twelve payments can be payable for any one claim. See below for more details (Part C). Pre-existing Conditions After the first 12 months of your policy you will be covered for illness, death or terminal illness that relates to pre-existing conditions. Conditions are only considered to be pre-existing if they were present in the 12 months prior to the insurance start date. Conditions that are not pre-existing will be covered from the insurance start date as shown on your policy schedule. Please read the full terms and conditions (in Parts B, C and E) carefully for details. Redundancy Benefit (see Part D) If you are made redundant and remain unemployed for 15 consecutive calendar days then you can claim a benefit. The monthly benefit amount is 30% of your Total Debit Balance (as at the notification date of your redundancy), and this is payable while you remain unemployed. A maximum of twelve payments can be payable for any one claim. See below for more details (Part D). How benefits are paid for Illness, Injury and Redundancy You will be compensated from the first day that you are unable to work because of illness or injury, or the date of your redundancy. These payments will not include any interest or credit card spending incurred after the date of your illness, injury or redundancy. These benefits are designed to pay over and above the minimum card repayments, with a monthly benefit amount equal to 30% of your Total Debit Balance. 2

4 Insurance Start Date The Insurance Start Date is shown on your Policy Schedule and is the date that your cover begins. Cooling Off Period You have 30 days from the Insurance Start Date in which you may cancel your Policy by advising Cigna in writing or by telephone. If you cancel your Policy during the 30-day period, you will receive a full refund of any premiums paid and written confirmation that your Policy has been cancelled. Please see Cigna s contact details at the end of this Policy document. What Product is covered? The BNZ Credit Card account shown on your Policy Schedule on which your premium is being charged. Who is covered under the Policy? The primary cardholder of your BNZ Credit Card account (being the first person named on the credit card application form for your BNZ Credit Card) and one nominated joint cardholder, if applicable, are covered under this Policy, subject to the terms and conditions. This Policy cannot be assigned to another person. Eligibility for cover Acceptance is guaranteed provided the cardholders are aged over 18 and under 65. The Policy will renew automatically on each Policy Anniversary until your 100th birthday unless you notify us in writing or by telephone that this Policy is not to be renewed. From the age of 65 you will be covered for the Death and Terminal Illness benefit only. If you are not working or are in paid work for less than 20 hours per week (either for yourself or for another employer) then you will be covered for the Death and Terminal Illness benefit only*. However, if you commence paid work for 20 hours or more per week then the full benefits of this Policy will apply. * If we have accepted an Illness and Injury claim then your benefit entitlements continue while you are working less than 20 hours per week, as detailed in Part C. Similarly if we have accepted a Redundancy claim then your entitlement to benefits continue while you remain Unemployed, as detailed in Part D. Is this insurance suitable for me? If you anticipate that you will not be working for at least 20 hours per week throughout the time you have this Policy, or you reach the age of 65, then you may wish to reconsider if this insurance is suitable for your particular needs. Cancellation If you wish to cancel your Policy at any time, please let us know in writing or by telephone. Cigna s contact details are shown at the end of this policy document. The premiums The premium payable is shown on your Policy Schedule. Your premium is charged monthly to your BNZ credit card account and is calculated on the Total Debit Balance as at the closing date of your monthly statement. Interest may be payable on the premium amount. Payment of the premium ensures cover for the month up to the closing date of the statement. If you have a zero or credit balance at the closing date of your monthly statement then you will pay no premium for that month. We may review and change the premium rates for all CreditCare Plus policies. If the premium rate changes we will write to you at least 30 days before any change happens. Please note that, although premiums will continue to be charged while you are on claim under this Policy, the monthly benefits are designed to pay over and above the required credit card repayments (including premiums) that are due. Variation of Premium and Policy terms The premium rates, insured events and exclusions for all CreditCare Plus policies are subject to change if it is reasonably necessary to protect Cigna s legitimate business interests. Examples include (but are not limited to): if changes in the law or its interpretation occur after the Insurance Start Date and Cigna reasonably believes that those changes will affect its tax liability, or how your Policy works, or the amount of benefit payable; or if Cigna s claims experience across all BNZ CreditCare Plus policies becomes significantly adverse. In such cases you will be given at least 30 days written notice in advance of the change, and any claims for events prior to the change would not be impacted. If you do not wish to accept the change then you may cancel your policy. 3

5 End of Insurance This Policy will end: when your BNZ Credit Card account is closed by you or by BNZ, for any reason; or when you notify Cigna that you wish to cancel your Policy; or when your premium is unpaid; or in the case of an individual cardholder, Cigna pays a death or Terminal Illness benefit. If an account has joint cardholders, then cover will continue for the remaining cardholder named on the Policy Schedule; or if this Policy, together with all other BNZ CreditCare Plus policies, is cancelled by Cigna by giving 90 days notice in writing to the primary insured cardholder at his or her last known address. In this situation individual policies cannot be singled out for cancellation and any claims for events prior to such cancellation would not be impacted; or if you provide false or incorrect information in support of a claim; or when total benefits of $75,000 have been paid under this Policy or any other BNZ CreditCare Plus Policy you may have. Cover for a primary or joint cardholder will end on the earliest of: the cardholder s 100th birthday; or payment of a death or Terminal Illness claim in respect of the cardholder. If you hold a Joint Policy and cover ends in respect of either cardholder, cover will continue for the remaining cardholder, in which case the premium will be adjusted to a single cardholder premium. How to claim If you wish to make a claim please notify Cigna as soon as possible, preferably no later than 60 days after the event giving rise to your claim. This may be done in writing or by calling Cigna on You will need to complete a claim form and provide any other information reasonably requested by Cigna to support your claim, at your expense. Further claims requirements for each benefit are given below. Death and Terminal Illness Benefit For a death claim, Cigna will require a final death certificate and any other information that Cigna requests to support the claim. Terminal Illness claims must be supported by a written diagnosis and prognosis by an appropriate registered medical specialist. Cigna may require you to have certain examinations or tests to confirm your Terminal Illness, in which case the costs for these examinations or tests would be met by Cigna. Illness and Injury Benefit Cigna may request supporting medical information to confirm your Illness or Injury and your Inability To Work, all of which would need to be provided by an appropriate registered medical practitioner. Cigna may also require you to have an examination or other reasonable tests to confirm your Illness or Injury and your Inability To Work, in which case the costs for these examinations or tests would be met by Cigna. Redundancy Benefit Cigna will require confirmation of your Redundancy from your employer. You must also provide Cigna with adequate ongoing proof that you are actively seeking paid employment. If you are offered and refuse employment for which you are Reasonably Suited then Cigna reserves the right to not pay benefits or to end your claim. Use of your BNZ Credit Card while on claim under this policy Subject to BNZ s terms and conditions, you can still use your BNZ Credit Card, but any amounts you spend after the date of the event giving rise to your claim will not be covered and you will be responsible for the payment of those amounts yourself. Part B: Death and Terminal Illness cover in detail How does Death and Terminal Illness cover work? If you die or are diagnosed with a Terminal Illness while this Policy is in force then Cigna will pay your Total Debit Balance as at the date of death or Terminal Illness diagnosis, up to a maximum of $75,000. Your cover under this Policy will cease upon payment of the Death or Terminal Illness benefit. We will not pay both a Death benefit and a Terminal Illness benefit for the same cardholder. 4

6 In the case of a Joint Policy, if both the primary and joint cardholders die from the same event then Cigna will only pay a single Death benefit (subject to a maximum of $75,000) in respect of that event. Situations in which Cigna will not pay a Death or Terminal Illness benefit Cigna will not pay a claim if your death or Terminal Illness is caused by or contributed to by: any Pre-existing Condition where your death occurs, or Terminal Illness is diagnosed, within 12 months of the Insurance Start Date; or intentionally self-inflicted injury within 13 months of the Insurance Start Date; or alcohol, or drugs taken by you unless prescribed and taken as prescribed by a registered doctor; or an unlawful act committed by you or in which you participated. Part C: Illness and Injury cover in detail How does Illness and Injury cover work? Cigna will pay an initial Monthly Benefit Amount if you have an Illness or Injury and are medically Unable To Work for 15 consecutive calendar days. You must have been in paid employment for one employer, or Self-employed, for at least 20 hours per week immediately prior to the Illness or Injury giving rise to your claim. Cigna will pay up to eleven further benefits (twelve in total) while you are unable to return to your Regular Employment or Self-employment because of your Injury or Illness. The initial Monthly Benefit Amount will be paid following our acceptance of your claim and will compensate you from the date that you are first Unable To Work. If you qualify for further benefits these will be paid in monthly intervals from the date that you are first Unable To Work. Cigna will continue payments until the earliest of the following occurs: when you return to your Regular Employment or Selfemployment, or are medically able to do so regardless of the availability of such work; or when the twelfth and final benefit amount is paid; or A maximum of $75,000 has been paid. Situations in which Cigna will not pay an Illness and Injury benefit Cigna will not pay a claim if your Illness or Injury is caused by or contributed to by: any Pre-existing Condition where the initial 15 day period for which you are Unable To Work commences within 12 months of the Insurance Start Date; or any medical treatment or surgical procedure which is not essential for medical reasons and is requested by you for psychological, personal or cosmetic reasons; or pregnancy, termination of pregnancy, or childbirth (except for any complications arising from these); or intentionally self-inflicted injury; or alcohol, or drugs taken by you unless prescribed and taken as prescribed by a registered doctor; or an unlawful act committed by you or in which you participated. Can I claim an Illness and Injury benefit more than once? Yes, you can claim more than once for an Illness or Injury. However, Cigna will pay no more than a maximum of $75,000 across all Illness and Injury claims under this Policy or any other BNZ CreditCare Plus Policy (or similar policy underwritten by Cigna) that you may purchase or already have. If, within six months of a claim ending, you suffer a relapse of the same or a related Illness or Injury we will treat this as a continuation of the original claim and you will be eligible for the remainder of the maximum 12 monthly payments. This means that if you re unable to return to your Regular Employment or Self-employment because of your Illness or Injury there would be no requirement for you to be Unable To Work for 15 consecutive calendar days. If, after six months of a claim ending, you suffer a relapse of the same or a related Illness or Injury, or you experience an unrelated Illness or Injury, the general terms and conditions of this Policy will apply and it will be considered a new claim. 5

7 In the case of a Joint Policy, if both the primary and joint cardholders are involved in the same event giving rise to a claim then Cigna will only pay a maximum of $75,000 in respect of that event. Part D: Redundancy cover in detail How does Redundancy cover work? Cigna will pay an initial Monthly Benefit Amount if you are made Redundant and remain Unemployed for 15 consecutive calendar days after the date of your Redundancy. You must have been in paid employment for your employer for at least 20 hours per week, for a continuous period of three months, immediately prior to the Redundancy giving rise to your claim. Cigna will pay up to eleven further monthly benefits (twelve in total) while you remain Unemployed. The initial Monthly Benefit Amount will be paid following our acceptance of your claim and will be calculated based on the Total Debit Balance at the date you were notified of Redundancy. If you qualify for subsequent benefits these will be paid in monthly intervals from the date of your Redundancy. Cigna will continue payments until the earliest of the following: when you are no longer Unemployed; or when the twelfth and final Monthly Benefit Amount is paid; or a maximum of $25,000 has been paid. Please note that to qualify for Redundancy benefit payments you must be actively seeking work, and willing to accept work for which you are Reasonably Suited. Redundancy cover does not apply if: you are Self-employed; or you are employed in seasonal, temporary, casual, relief work or on a fixed-term employment contract; or you take voluntary Redundancy; or you are dismissed; or you voluntarily resign; or your Redundancy, or the possibility of Redundancy was known to you prior to you taking out this Policy; or written or verbal notification of impending Redundancy occurs within 30 days of the Insurance Start Date. Can I claim a Redundancy benefit more than once? Yes, you can claim more than once for Redundancy. However you must have been working for at least 20 hours per week for one employer, for at least three months, before you can make another Redundancy claim. Please note that Cigna will pay no more than a maximum of $25,000 across all Redundancy claims under this Policy or any other BNZ CreditCare Plus Policy (or similar policy underwritten by Cigna) that you may purchase or already have. Part E: Defined Terms Illness means any illness or disease you have which first occurs after the Insurance Start Date (or reinstatement date if at Cigna s discretion this Policy is reinstated after it lapses). Inability To Work means being Unable To Work, or being medically unable to return to Regular Employment or Selfemployment. This will need to be confirmed by an appropriate registered medical practitioner. Injury means bodily injury to you caused by violent, accidental, external and visible means which first occurs after the Insurance Start Date (or Policy reinstatement date). Joint Policy means a policy insuring both the primary cardholder and a nominated joint cardholder, as stated on your Policy Schedule. Monthly Benefit Amount means 30% of the Total Debit Balance owing on your Credit Card as at the date of the event giving rise to your claim. Policy means this document, your Policy Schedule and your application details. Policy Schedule means the schedule sent to you with this document that shows the details specific to your Policy. Pre-disability Hours means the average hours per week that you were working in paid employment, prior to the event giving rise to your claim, subject to a maximum of 40 hours. 6

8 Pre-existing Condition means any injury, illness or degenerative condition which at the Insurance Start Date, or in the 12 months prior to the Insurance Start Date, was existing or diagnosed or for which you have or reasonably should have received or sought medical advice or treatment. Reasonably Suited means the type of work which you would reasonably be expected to do because of your education, training or experience. Redundant / Redundancy means you are Unemployed because your position is disestablished, as it is no longer needed by your employer. Note that to be eligible to make a claim you must remain Unemployed for 15 consecutive calendar days. Regular Employment means you are working, or able to work, for at least 60% of your Pre-disability Hours each week, for remuneration in your Usual Occupation for a single employer. Usual Occupation is the occupation that you were most recently working in for your principal source of income. Self-employed / Self-employment means you are employed by a company of which you, or your immediate family, have direct or indirect control, or you work for yourself in the capacity of a self-employed contractor, sole trader or otherwise for remuneration for 20 hours or more per week. Terminal Illness means an Illness that is expected to result in your death within 12 months of applying for a Terminal Illness Benefit. The Illness must be diagnosed while this Policy is in force, and supported by a written diagnosis and prognosis by an appropriate registered medical specialist. Total Debit Balance means: For claims purposes the total amount of debt on your covered BNZ credit card account at the date of any event for which a claim is made under this Policy, or the highest outstanding debt balance from the three months statements prior to the claim event date, whichever is greater. This amount will exclude: Unable To Work means you are unable to work for any hours per week in your Usual Occupation because of an Illness or Injury, and this is confirmed by an appropriate registered medical practitioner. Usual Occupation is the occupation that you were most recently working in for your principal source of income. To be eligible to make an Illness and Injury claim you must have initially been Unable To Work for 15 consecutive calendar days. Unemployed means that you are not in paid employment because of a lack of available job vacancies for which you are Reasonably Suited, and you are actively seeking work to the satisfaction of Cigna. Part F: Disputes If you have a complaint we are happy to discuss it. Please contact us in the first instance and our Customer Service team will do their best to resolve your issue straight away. However, if they can t sort out the issue, our dedicated Customer Resolution Manager will personally take on your case. Cigna is also a member of the Insurance and Financial Services Ombudsman (IFSO) scheme, a free, independent service which can help settle any dispute you are unable to resolve with us. Any dispute or action relating to this Policy will be determined in accordance with New Zealand law. IFSO contact details: Post P O Box , Wellington 6143 Phone info@ifso.nz Website any amounts on which premium is not being charged shown as Over Limit on your BNZ credit card statement together with accompanying interest; any purchases or cash advances you made when you knew of the possibility of an event giving rise to a claim which, in Cigna s opinion, are outside the normal conduct of your BNZ credit card account. 7

9 Part G: About Cigna Cigna New Zealand is a leading specialist provider of insurance products and services. We ve been operating in New Zealand for nearly a century, and protect over 250,000 New Zealanders with our insurance policies. Cigna New Zealand is part of Cigna Corporation, a Fortune 500 company and one of the world s largest publicly owned companies. A copy of Cigna s latest financial statements is available on request. We are required under the Insurance (Prudential Supervision) Act 2010 to establish a statutory fund. The statutory fund relevant to your Policy is Cigna s Statutory Fund Number One. Part H: Cigna s Financial Strength Cigna Life Insurance New Zealand Limited has an A (Excellent) financial strength rating which was given by A.M. Best Company Inc. The rating scale is: Secure A++ A+ Superior B B- Fair Vulnerable A A- Excellent C++ C+ Marginal B++ B+ Good C C- Weak For more information visit D E F S Poor Under regulatory Supervision In Liquidation Suspended 8

10 Contact us By phone By for general information about your Policy such as premiums and address changes to make a complaint claims.nz@cigna.com to request a claim form or ask any questions related to a claim By letter Cigna Life Insurance PO Box Manners Street Wellington 6142 By Fax CIG823 18/08/1275/01 9