Budget Income Protection. Guaranteed Premiums. This is an important document. Please keep it in a safe place.

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1 Budget Icome Protectio Policy Coditios Guarateed Premiums Documet referece: MIMIBIP11G This is a imptat documet. Please keep it i a safe place.

2 Budget Icome Protectio Guarateed Premiums Policy Coditios Welcome to LV=, ad thak you f choosig our Budget Icome Protectio policy. Welcome to LV= ad thak you f choosig our Budget Icome Protectio policy, which is oe of a umber of differet types of life ad health isurace policies available i our Flexible Protectio Pla. These coditios, your Policy Schedules, applicatio, ay declaratios you have made, ay documets we sed you cofirmig chages to your policy ad the amout of your cover, fm a cotract betwee you ad us uder your pla. These are imptat documets, so please keep them i a safe place. This cotract is siged o our behalf ad starts o the date show i your Policy Schedule. Mike Rogers Chief Executive LV=, Pyes Hill House, Rydo Lae, Exeter EX2 5SP If we ca help you, by providig these documets i Braille, i large prit o audiotape, please let us kow. 2

3 Cotets Defiitios 4 Why choose LV= Budget Icome Protectio? 6 Sectio A What you re covered f 7 A1 Ow Occupatio cover 8 A2 Wk Tasks cover 10 Sectio B Claims ad paymets B1 Whe you eed to tell us about your accidet sickess 13 B2 The evidece we eed to suppt your claim 13 B3 How we pay you 14 B4 How much we will pay out 15 B5 How we wk out how much we will pay you 16 B6 1,500 Beefit Guaratee 18 B7 What happes if you become sick agai (liked claims) 19 B8 What happes if you go back to wk part time i your occupatio (Rehabilitatio beefit) Ow Occupatio cover oly 20 B9 What happes if you recover, but ot eough to go back to your occupatio (Proptioate beefit) Ow Occupatio cover oly 22 B10 What happes if you re isurig someoe else 24 Sectio C The claim limit C1 What happes if we have made paymets to you up to the claim limit 25 C2 What happes if you eed to claim i the future, ad we have already paid a previous claim up to the claim limit 25 Sectio D Other Coditios D1 Iflatio-liked cover 26 D2 Guarateed icrease optios 27 D3 Chagig your policy 30 D4 What to do if you stop wkig 30 D5 Back to wk suppt 31 D6 Payig your premiums 31 D7 Stoppig premiums 31 D8 Re-startig your premiums 32 D9 Ca you chage the amout of my premium? 32 D10 Proof of your age ad ame 33 D11 Whe you ca cacel your policy 33 D12 Whe we ca cacel your policy 34 D13 Whe your policy eds 35 D14 Trasferrig the policy to someoe else 35 D15 The law that applies to your policy 35 Appedix A - Special Coditios f Docts ad Surgeos 36 3

4 Defiitios We explai these terms because this is a legal documet. I some cases the wds may have other meaigs i every day use. We have highlighted these wds i bold (other tha persoal terms such as you ad we ) so you kow whe they apply. You meas the perso who applied f this policy, the perso who is isured ad the perso legally etitled to the paymet from this policy. Where we use your it has the same meaig. We, us, our meas Liverpool Victia Friedly Society Limited. Amout of your cover ad amout of cover meas the amout you are isured f. This is show o your Policy Schedule. Claim limit meas the maximum period of 24 moths f which we will make paymets to you, after the ed of your waitig period f ay oe sigle claim. All claims withi six moths of each other f the same accidet sickess, will be treated as a related claim, ad will cout as oe sigle claim. Ed date meas the date whe your policy eds. This date is show i your Policy Schedule. Homemaker meas someoe who is ot i paid upaid wk havig chose to stay at home ad look after their family ad icludes a carer. By family we mea their husbad, wife civil parter, ad/ their childre. To be a homemaker you caot be claimig Jobseekers Allowace. If you are claimig Jobseekers Allowace we will cosider you uemployed. Icome meas your taxable eared icome befe ay icome tax is paid, mius ay expeses which are allowable agaist icome tax. You ll fid this figure o your P60 if you are employed your tax retur if registered self employed with HM Reveue ad Customs. If you ow a limited compay the your icome ca also iclude divided icome from your busiess as log as: The divided icome is clearly related to your wk activities The frequecy of divided paymets must be of a established patter, rather tha irregular oe-off paymets. The divideds are paid from aual profits et of tax. If the divideds are higher tha the profit figure, we will use the et profit figure istead. Your icome ca also iclude divideds paid to your spouse civil parter as log as they are also a shareholder, ad they do t take over the ruig of the busiess. Ay divideds paid to your spouse civil parter must be appropriate f their level of shareholdig, ad must have bee declared f tax purposes. However if your spouse civil parter has used the same divided icome f their ow icome protectio cover, it ca t also be icluded i your icome. Icome befe the claim meas the icome you received from your occupatio i the 12 moths befe the date you became uable to wk. F self employed people we will average earigs over three years. Where there are less tha three years recds it will be based o the recds available. 4

5 Iflatio meas the risig cost of goods ad services such as your weekly shoppig, gas ad electricity. We will measure this usig the Retail Prices Idex, uless this stops beig published, i which case we would use aother similar published idex. Occupatio meas your occupatio at the time you became sick had the accidet that meat you were uable to wk. Pla meas your LV= Flexible Protectio Pla, your Pla Schedule, ad ay policies (icludig this policy) which are icluded i it. Pla aiversary meas each 12 moth aiversary from the date your pla igially started. This will be the same as the 12 moth aiversary of your policy uless you have added a ew policy to a existig pla. You ca check this o your Pla Schedule. Policy meas these coditios, your Policy Schedule, ay Special Provisios listed i that Policy Schedule ad ay documets we sed you to cofirm chages to your policy the amout of your cover. We will apply a Special Provisio whe we are ot able to offer you a policy based o the terms detailed i these coditios. This may be because of your occupatio, your health your leisure activities. We will let you kow if this applies to you befe we start askig you f ay moey. Premium ad premiums mea the mothly amout you pay f the amout of your cover Related claim meas you are uable to wk either directly idirectly due to the same accidet sickess that we have igially agreed to pay a claim f. Start date meas the date whe your policy started. This date is show i your Policy Schedule. Uable to wk, iability to wk, able to wk, ability to wk The way we measure these uder this policy depeds o whether you have Ow Occupatio cover, Wk Tasks cover. We explai this i detail i Sectio A1 f Ow Occupatio Cover, ad Sectio A2 f Wk Tasks Cover. Waitig period meas the umber of moths you have chose to wait after you are uable to wk, befe we will start payig you, whe we approve a claim. You choose the waitig period whe you apply f your policy. This will be show i your Policy Schedule. 5

6 Why choose LV= Budget Icome Protectio? This policy is desiged to help you cope if you lost your icome as a result of sickess a accidet. However we will oly make paymets to you f ay sigle claim f a maximum of 24 moths. By doig this we are able to offer you a lower premium tha would be available f you uder our Icome Protectio policy. The cover we ca offer depeds o your occupatio whe you take out the policy. Whe you ask f a quote we ca tell you what type of cover is available. We will cofirm this whe you apply. Ow Occupatio cover This pays out if, because of a accidet sickess, you are uable to do your usual occupatio. You would ot be expected to go back to wk i a differet occupatio f as log as you are uable to do your usual occupatio, the policy will cotiue to pay out. This is explaied i detail i Sectio A1 Wk Tasks cover This pays out if, because of a accidet sickess, you are totally uable to carry out three me tasks from a list of everyday activities. This is explaied i detail i sectio A2. If you re a homemaker If you are a homemaker we have a special type of cover. It pays out if because of sickess accidet you are totally uable to carry out two me tasks from the followig list of activities: Shoppig, Cookig, Laudry, Housekeepig ad Childcare. Full details will be explaied i your Policy Schedule uder the headig of Special Provisios. 6

7 Sectio A What you re covered f This sectio tells you about: What you re covered f The types of cover available This policy is desiged to pay you a regular icome if you are uable to wk due to sickess accidet. There are two ways we ca measure whether you are uable to wk; we call these Ow Occupatio, ad Wk Tasks cover. We determie which cover we ca offer by lookig at your occupatio, your health ad ay leisure activities you take part i, particularly if we cosider ay of them to be dagerous. Examples of leisure activities that we cosider to be dagerous would iclude private flyig, parachutig rock climbig. Sometimes we will use a differet measure, f example, if you are a homemaker. If this is the case, this will be explaied i full befe your policy starts, ad is also explaied i your Policy Schedule uder the headig Special Provisios. We tell you which cover we ca offer befe your policy starts. F referece you will fid this o your Policy Schedule. (If you have t applied yet you may have this ifmatio o your quote. Make sure you look at your cover whe your acceptace terms are set to you i case it has chaged from your quote). O the followig pages we explai the differet types of cover i me detail, ad explai what you re covered f, ad what you re ot covered f. You oly eed to read the sectio that applies to the type of cover show o your Policy Schedule. So, if your Policy Schedule shows that you have Ow Occupatio cover, you oly eed to read Sectio A1, ad if it shows you have Wk Tasks cover, read Sectio A2. 7

8 A1 Ow Occupatio cover What s covered Uable to wk due to sickess accidet I this sectio, the wds uable to wk ad iability to wk mea that we will pay a claim if, followig your waitig period, because of sickess accidet, you are totally uable to carry out all the mai duties of your occupatio ad are t doig ay other paid upaid wk. The wds able to wk ad ability to wk mea that you ca wk. By mai duties, we mea the duties that ca t reasoably be left out without affectig your ability to do your occupatio. Whe assessig your ability to carry out those duties, we will cosider whether there are ay chages that you your employer ca reasoably make that would allow you to cotiue i your occupatio. Your cover is restricted if you are ot doig your occupatio befe the accidet sickess preveted you from doig it. If this is the case you are still covered but we will use the me restrictive measures explaied uder Wk Tasks cover i sectio A2 to wk out whether to pay a claim. You recover but oly go back to your occupatio part-time If you have bee claimig o your policy, but recover eough to go back to your occupatio part-time, we may pay you some of the amout of your cover. We explai this i me detail i Sectio B8. You recover but go back to wk i a differet occupatio We realise that you might recover, but are ot well eough to go back to your occupatio. We wat to help with your recovery ad help you get back to paid wk. So, if you are still ot well eough to go back to your occupatio but wat to start wk i a ew paid job f less moey, the we may be able to pay you a proptio of the amout of your cover to help with this. We explai this i me detail i Sectio B9. All types of sickess accidet There are o restrictios o the type of sickess accidet, uless we have told you about ay restrictios befe your policy starts. We will list ay exclusios o your Policy Schedule uder the headig of Special Provisios. Sickess medical coditios that you had befe you applied As we ask you f all your medical histy befe we offer you the policy, we will cover all illesses uless we have told you that we wo t befe your policy starts. We will list ay exclusios o your Policy Schedule uder the headig of Special Provisios. We will tell you about ay exclusios befe we ask you f the first premium. Chagig your occupatio You re covered if you chage your occupatio. You are ot required to tell us, however you may wish to check with us whether your ew occupatio would give you a lower premium. If it would t, you ca still keep your existig cover so there is othig to lose by askig. Me ifmatio o how you ca chage your policy if you chage your occupatio ca be foud i Sectio D3. 8

9 A1 Ow Occupatio cover cotiued... Travellig Abroad We will pay you after your waitig period, if you have a valid claim ad you are i ay of the followig coutries: Australia, Austria, Belgium, Bulgaria, Caada, Chael Islads, Cyprus, Czech Republic, Demark, Estoia, Filad, Frace, Germay, Gibraltar, Greece, Hugary, Icelad, Irelad, Isle of Ma, Italy, Latvia, Lithuaia, Luxembourg, Malta, Netherlads, New Zealad, Nway, Polad, Ptugal, Romaia, Slovakia, Sloveia, Spai, Swede, Switzerlad, UK USA. If you are aywhere else i the wld we would pay you f a maximum of 26 weeks. If, at the ed of the 26 weeks, you have retured to oe of the coutries above we will cotiue to pay you if you still have a valid claim. Please ote we will stop payig a claim if you travel from oe of the coutries listed above to stay i oe that is ot listed f me tha two weeks, eve if this is just f a holiday. What s ot covered Uemploymet This policy will oly pay out if you are uable to do your occupatio (paid upaid) because of sickess accidet. This meas we wo t pay a claim if you are ot wkig f a differet reaso, f example if you have chose ot to wk, whether paid upaid, you have bee made redudat. This would also apply if you are employed by your ow limited compay but have o actual cotracts wk. Of course, if you are already uemployed at the time you have a accidet sickess that prevets you from the takig paid upaid wk, the you are still covered. This is explaied uder the What s covered sectio. However it s imptat to uderstad that we ca stop payig a claim if you become fit f wk eve if there is o vacacy that you ca apply f. Sickess accidet ad still wkig You caot geerally claim uder this policy if you are sick have had a accidet ad are still able to wk i your occupatio are doig other paid wk. The oly exceptio is where you recover but we re already payig a valid claim. Me detail o this is explaied i Sectios B8 ad B9. Do please check with us if you wk i me tha oe job. You may ot be covered if you are able to do oe job but ot the other. If we have already made paymets to you up to the claim limit If we are makig paymets to you, ad we have made these paymets up to the claim limit, the the paymets will stop. Me details about what happes if you have reached the claim limit are explaied i Sectio C. 9

10 Gettig home if you have sickess a accidet abroad This policy does ot cover you f the costs of returig home if you are abroad, f example if you eed special medical assistace special seatig arragemets o a plae. Please remember: It s a good idea to have appropriate travel isurace whe travellig abroad. Death This policy does ot pay out i the evet of your death. I that evet, this policy will ed ad, if we were payig you, the paymets would stop. Fraud ad Deliberate o-disclosure Please uderstad that whilst we kow that the vast majity of our customers are hoest, we do have to protect ourselves (ad our customers) agaist the effect of fraud. F this reaso we will cacel the policy ad ot pay a claim if we fid someoe has deliberately withheld ifmatio from us has itetioally provided us with false ifmatio lied to us, whe they applied, whe they claim, whe they apply to re-start their premiums (see Sectio D8). Me detailed ifmatio o whe we ca cacel the policy ca be foud i Sectio D12. A2 Wk Tasks cover What s covered Uable to wk due to sickess accidet I this sectio, the wds uable to wk ad iability to wk mea that due to sickess accidet, you are uable to do ay paid upaid wk ad caot carry out at least three of the followig activities, usig appropriate equipmet to help you but without the help of aother perso: Walkig to be able to walk a distace of 200 metres o flat groud (with the use of a walkig stick other aid if ecessary) without stoppig. Climbig to be able to walk up dow a flight of 12 stairs (with the use of a hadrail) without stoppig. Bedig to be able to bed keel to pick up somethig from the flo ad stad up agai. Commuicatig to be able to aswer the telephoe ad take a simple message. Eyesight to be able to read a stadard daily ewspaper to pass the stadard eyesight test f drivig. (after crectio by spectacles cotact leses if ecessary). Dexterity to be able to use a pe, pecil keyboard. Healthcare to be able to make arragemets to see a doct ad take regular medicatio as prescribed. 10

11 A2 Wk Tasks cover cotiued Fiacial idepedece to be able to uderstad the value of moey, ad hadle routie fiacial trasactios. If you are ot i paid upaid wk befe the accidet sickess preveted you from wkig, you are still covered, ad we still will use the above measure to wk out whether to pay a claim. All types of sickess accidet There are o restrictios o the type of sickess accidet, uless we have told you about ay restrictios befe your policy starts. We will list ay exclusios o your Policy Schedule uder the headig of Special Provisios. Sickess medical coditio that you had befe you applied As we ask you f all your medical histy befe we offer you the policy, we will cover all illesses uless we have told you that we wo t befe your policy starts. We will list ay exclusios o your Policy Schedule uder the headig of Special Provisios. We will tell you about ay exclusios befe we ask you f the first premium. Chagig your occupatio You re covered if you chage your occupatio. You are ot required to tell us, however you may wish to check with us whether your ew occupatio would give you a lower premium whether we could offer you Ow Occupatio cover. If it would t, you ca still keep your existig cover so there is othig to lose by askig. Me ifmatio o how you ca chage your policy if you chage your occupatio ca be foud i Sectio D3. Travellig Abroad We will pay you after your waitig period, if you have a valid claim ad you are i ay of the followig coutries: Australia, Austria, Belgium, Bulgaria, Caada, Chael Islads, Cyprus, Czech Republic, Demark, Estoia, Filad, Frace, Germay, Gibraltar, Greece, Hugary, Icelad, Irelad, Isle of Ma, Italy, Latvia, Lithuaia, Luxembourg, Malta, Netherlads, New Zealad, Nway, Polad, Ptugal, Romaia, Slovakia, Sloveia, Spai, Swede, Switzerlad, UK USA. If you are aywhere else i the wld we would pay you f a maximum of 26 weeks. If, at the ed of the 26 weeks, you have retured to oe of the coutries above we will cotiue to pay you if you still have a valid claim. Please ote we will stop payig a claim if you travel from oe of the coutries listed above to stay i oe that is ot listed f me tha two weeks, eve if this is just f a holiday. 11

12 What s ot covered Uemploymet This policy will oly pay out if you are uable to wk, because of sickess accidet. This meas we wo t pay a claim if you are ot wkig f a differet reaso, f example if you have chose ot to wk, you have bee made redudat. Of course, if you are already uemployed at the time you have a accidet sickess that prevets you from wkig, the you are still covered. This is explaied uder the What s covered sectio. Also it s imptat to uderstad that we will stop payig a claim if you are able to wk eve if there is o vacacy that you ca apply f. Sickess accidet ad still wkig: You caot claim uder this policy if you are sick have had a accidet ad are still able to wk i your occupatio are doig other paid wk. If we have already made paymets to you up to the claim limit If we are makig paymets to you, ad we have made these paymets up to the claim limit, the the paymets will stop. Me details about what happes if you have reached the claim limit are explaied i Sectio C. You recover ad go back to wk If you recover ad go back to wk full time part-time i your occupatio, i a differet wk, the your claim will stop. This meas Sectios B8 & B9 do ot apply to Wk Tasks cover. Gettig home if you have sickess a accidet abroad This policy does ot cover you f the costs of returig home if you are abroad, f example if you eed special medical assistace special seatig arragemets o a plae. Please remember: It s a good idea to have appropriate travel isurace whe travellig abroad. Death This policy does ot pay out a lump sum i the evet of your death. I that evet, this policy will ed ad, if we were payig you, the paymets would stop. Fraud ad Deliberate o-disclosure Please uderstad that whilst we kow that the vast majity of our customers are hoest, we do have to protect ourselves (ad our customers) agaist the effect of fraud. F this reaso we will cacel the policy ad ot pay a claim if we fid someoe has deliberately withheld ifmatio from us has itetioally provided us with false ifmatio lied to us, whe they applied, whe they claim, whe they apply to re-start their premiums (see Sectio D8). Me detailed ifmatio o whe we ca cacel the policy ca be foud i Sectio D12. 12

13 Sectio B Claims ad Paymets This sectio tells you about: Whe we will pay the amout of cover How much we will pay B1 Whe you eed to tell us about your accidet sickess If you are uable to wk because of your accidet sickess it is imptat that you tell us withi the times give below, so we ca maage your claim as quickly as possible, ad start makig paymets to you as soo as we ca. You ca tell us i writig, by phoe by fax. (a) If the waitig period you ve chose is two moths less You eed to tell us withi two weeks after your accidet occurs, sickess starts. If we do t hear from you util after two weeks, we will still pay your claim, if it s valid, but we will cout your waitig period as if you became uable to wk two weeks befe you told us. (b) If the waitig period you ve chose is three moths me You eed to tell us withi eight weeks after your accidet occurs, sickess starts. If we do t hear from you util after eight weeks, we will still pay your claim, if it s valid, but we will cout your waitig period as if you became uable to wk eight weeks befe you told us. If you are ot i paid upaid wk whe you make a claim we will cout your waitig period from the date o which your accidet sickess meat you became totally uable to carry out at least three of the activities listed i the Wk Tasks cover sectio. B2 The evidece we eed to suppt your claim To make a claim: Ask us f a claim fm Fill i the claim fm tellig us about your accidet illess, your occupatio ad your icome. Retur the fm to us as soo as possible, mally withi 14 days So that we ca assess your claim, we will eed evidece of your icome, ad we may eed to get medical repts from your doct. If we do, we will eed you to complete a coset fm. The fm will fully explai your rights uder the Access to Medical Repts Act Please uderstad that whilst the vast majity of our customers are hoest, we do have to protect ourselves (ad our customers) agaist the effect of fraudulet claims. Therefe, if you are asked f additioal ifmatio, please do ot take this as a reflectio of our opiio of you. We do t kow what evidece we will eed util you make a claim, as all claims are looked at idividually. We wo t ask f uecessary evidece ad we will explai why we eed aythig we ask f. 13

14 Whilst we are payig you, we may ask you to complete extra declaratios about your iability to wk as a routie review. As part of this review, we may eed routie medical repts from your doct(s), other specialists your employer. Whe this happes we will tell you what we eed ad supply the fms f you ad your doct(s) to fill i. If your doct charges f this, you will have to pay f it, as we do ot cover this cost. However, we will pay f all other o routie medical repts evidece we ask f. We may eed you to be examied by a doct of our choice. We may also ask f other evidece to cosider your claim to cofirm that you are still uable to wk. Some examples of the evidece we may eed are: a rept from ay doct ( ay alterative medical practitioer) who has treated examied you. a rept from a member of our staff a perso actig o our behalf who has visited you i your ow home to discuss the claim. You are ot covered if ay of the ifmatio we ask f is ot provided, uless there is a good reaso. I the wst case, this could mea that we would refuse stop payig your claim. B3 How we pay you Oce we approve a claim, we will pay you a moth i arrears. This meas that the first paymet will be paid at the ed of the moth after your waitig period eds. (Your waitig period is the umber of moths you have chose to wait befe we will start payig you.) F example f a waitig period of two moths, if you were uable to wk i Jauary, we would make the first paymet at the ed of March. Paymets will be made directly ito your bak buildig society accout. You eed to be cotiuously uable to wk throughout this period f us to start payig a claim. If you were uable to wk f less tha a whole caledar moth, we would wk out how much to pay you by dividig the umber of days you could t wk by the umber of days i the moth. The example o the ext page shows you how we wk out what to pay whe this happes. The figures used i the example do t relate to your ow policy. If you are a Doct Surgeo directly employed by the NHS you may be able to claim uder our NHS Docts ad Surgeos sick pay guaratee. This meas we would pay your claim early if you ve chose a waitig period of 12 moths. F me ifmatio please read Appedix A - Coditio 3. 14

15 Example Rosie makes a claim. Her policy has a 2 moth waitig period. The waitig period eds o 15th March. Rosie s first paymet would be calculated as follows: (31-15) = 16 (as there are 31 days i March ad the first 15 are ot eligible f paymet) (16 / 31) x 100 = 52% This meas Rosie will receive 52% of the full mothly amout payable at the ed of March. We will cotiue to pay you util oe of the followig happes: You are ow able to wk (as defied uder the type of cover you have) your policy reaches its ed date your death. We explai how we wk out how much we will pay you i Sectios B4 & B5. B4 How much we will pay out Oce we have approved your claim, we will wk out the total mothly paymet as follows: (a) If you are wkig i your occupatio whe you become uable to wk we will pay the lower of: (b) the amout of your cover at the time, the maximum mothly amout we could pay you. We explai this i Sectio B5 If you are a homemaker ot i paid upaid wk whe you become uable to wk we will pay the lower of: the amout of your cover at the time, 1,500 a moth mius ay other mothly paymets f ay accidet sickess policies that you are receivig paymets from (f example: this could be a mtgage paymet protectio policy a credit card paymet pla). This limit of 1,500 ca be icreased by us i the future. If we decide to icrease this limit, we will let you kow. Uftuately, we wo t be able to refud ay premiums if we do t pay the amout of your cover i full. So, it is wth checkig this if your circumstaces chage, f example if you chage your job. 15

16 B5 How we wk out how much we will pay you The example below illustrates how we wk out how much we will pay you. Example Joh ears 30,000 a year, which gives him a mothly take home pay of 1,900. He ca take out Budget Icome Protectio policy f a maximum of 55% of his aual icome of 30,000. (Which divided by 12 meas he could take out a Budget Icome Protectio Policy f a maximum of 1,375 a moth. Joh chooses 1,375 a moth cover. His employer will pay him f 6 moths if he ca t wk due to a accidet sickess, so he chooses a waitig period of 6 moths. A year after takig out his Budget Icome Protectio policy, he applies f a small persoal loa, ad takes out paymet protectio isurace o that loa. 5 years after takig out his Budget Icome Protectio policy, Joh becomes sick ad is uable to wk as a result. His paymet protectio isurace f his loa starts payig 300 a moth. By this time his salary has also icreased to 36,000. To wk out the maximum mothly amout we will pay uder Joh s policy: First of all we wk out 55% of Joh s icome befe the claim 36,000 x 55% = 19,800 The we divide this by 12 to wk out the mothly equivalet 19, = 1,650 The we take off the paymets from his paymet protectio isurace 1, = 1,350 The maximum mothly amout we could pay based o his icome is 1,350 a moth. As the amout of his cover is me tha the maximum mothly amout, we could oly pay Joh 1,350 a moth, ad ot the 1,375 he is covered f. But because we ige ay over-isurace of up to 10%, we agree to pay the full amout he is covered f of 1,375.This is because the differece betwee is amout of cover ad the maximum we could pay is less tha 10%. After the 6 moth waitig period he starts to receive tax free paymets from LV= of 1,375 a moth. We wk out the maximum mothly amout, as follows: First we take 55% of your icome befe the claim ad divide this by 12. If this wks out to be less tha 1,500 a moth we ll use 1,500 a moth istead if you qualify f the 1,500 beefit guaratee. We explai the requiremets f the guaratee i Sectio B6. If you are a Doct a Surgeo, the we may use a figure of 3,000 istead. We explai these special requiremets f the guaratee f Docts ad Surgeos i Appedix A - Coditio 1. 16

17 The we take off ay of the followig mothly paymets, befe tax, that you are etitled to: paymets from ay other sickess accidet isurace o your life (f example, ay mtgage paymet protectio credit card protectio you are claimig o) 60% of sickess beefit retiremet paymets you receive from ay source 60% of ay cotiuig icome pesio paymets that you are still receivig whilst you are claimig, (we do t take ito accout ay icome eared befe you became uable to wk f example a bous that is paid at the ed of the year) We take these paymets off so that you do t mally receive paymets totallig me tha your icome ad lose the icetive to go back to wk. Do t fget that the paymets we make to you are free of icome tax ad therefe closer to your previous taxed icome. Fially we check the result agaist the amout of your cover. We will pay the lower of the maximum mothly amout ad the amout of your cover as show o your Policy Schedule. We wo t reduce the amout we pay you by the amout of ay state sickess beefits - you ca cotiue to receive these i additio to the paymets you receive from this policy. However ay paymets from this policy could affect the amout of state beefit you ca claim. So you will eed to make sure that you metio the paymets from this policy at the time you claim ay state beefits. However if the maximum mothly amout is less tha your amout of cover, we will still pay your amout of cover as log as the differece is t me tha 10% of your amout of cover. F example: if your amout of cover is 2,000, as log as your maximum mothly amout is 1,800 me, the we ll still pay your amout of cover, eve though you are over-isured. Remember that your icome befe the claim geerally meas the icome you received from your occupatio i the 12 moths befe you became uable to wk. We ca use our discretio to base your icome befe the claim o your average icome over a loger period, if this me accurately reflects the icome you were aimig to replace ad where it meas your icome befe the claim is higher. F example we might do this if you have suffered a progressive sickess which has meat that your icome has reduced although you have still bee wkig. If you have iflatio-liked cover we will icrease the amout of your icome befe the claim each year, i lie with iflatio while we are payig you. We may chage the way i which we wk out the maximum mothly amout we will pay you, if ay of the followig chage: the way paymets from icome protectio policies are taxed the way ay of the paymets we take ito accout i wkig out the maximum mothly amout we will pay you are taxed. If we decide to do this, we will tell you about the chages we have made at least 30 days befe they become effective. Naturally, we will make sure ay chages we make are reasoable ad proptioate to the chages that have prompted the review. I fact, we will oly do this to make sure that o oe was etitled to receive me i total paymets tha they would uder this policy pri to the chages beig made ad i so doig lose the icetive to retur to wk. 17

18 B6 1,500 Beefit Guaratee At LV= we uderstad that your icome ca go up ad dow, ad that whe you come to claim it is possible that your icome might have dropped. If your icome drops but your amout of cover stays the same, it s possible that your amout of cover might ow be me tha the 55% of icome allowed. If this happeed we would usually reduce the amout we pay you to the maximum mothly amout (as explaied i Sectio B5). Whe you make a claim we will ask f ifmatio o your fiacial situatio to help us uderstad how we ca best help you with your claim. But if whe we do this, we fid your icome o loger suppts the amout of cover you chose, uder this guaratee we will pay you at least 1,500 a moth ( the amout of cover you chose if it was less tha 1,500) less the followig mothly paymets befe tax: paymets from ay other sickess accidet isurace o your life (f example, ay mtgage paymet protectio credit card proptio that you are claimig o) 60% of sickess beefits retiremet paymets you receive from ay source (except NHS sick pay if you re claimig uder the NHS Docts Surgeos Sick Pay Guaratee explaied i Appedix A - Coditio 3) 60% of ay cotiuig icome pesio paymets that you are still receivig whilst you re claimig (we do t take ito accout ay icome eared befe you became uable to wk - f example a bous that is paid at the ed of the year) To qualify f this guaratee you must have bee wkig f at least 16 hours a week if you re self employed, 25 hours a week if you re employed at the time you became uable to wk. You ca still receive state beefits (f example, Employmet ad Suppt Allowace) o top of the guaratee. If you are a Doct Surgeo, the we may be able to offer you a 3,000 beefit guaratee istead. Please see Appedix A - Coditio 1 f me ifmatio. 18

19 B7 What happes if you become sick agai (sometimes called liked claims) This sectio is imptat if you have bee claimig, retur to paid wk but the become too sick to wk agai. It is imptat as if you are uable to wk agai you might ot eed to wait befe we would start payig a claim agai. Oce we have started to pay you, you will hopefully become well eough to go back to wk. However, we realise that sometimes people are uftuate eough to fid they have to stop wk agai, because of the same sickess accidet. If this happes withi the first six moths of you goig back to wk, we will treat this as a related claim start payig you agai straight away as log as: ad ad the cause of your iability to wk is the same as it was f the igial claim. your occupatio is the same as it was whe you were first uable to wk. you tell us withi two weeks of the date that you stop wk agai. If we ca t cofirm that the reaso you are uable to wk is the same, you go back to wk i a differet occupatio we will have to treat this as a ew claim. If we do, you will eed to wait util aother waitig period eds agai befe we start to pay you agai. If the reaso that you are uable to wk is the same, we will treat this as a related claim. This meas if we have already made paymets to you up to the claim limit, the we will ot make ay further paymets to you f this claim. We will take ito accout the whole period f which we have bee makig paymets to you, to determie whether we have paid your claim up to the claim limit. Me details o what happes if we have paid a claim up to the claim limit ca be foud i Sectio C. 19

20 B8 What happes if you go back to wk part-time i your occupatio (sometimes called Rehabilitatio beefit) Ow Occupatio Cover oly Sectio B8 oly applies where your Policy Schedule states that you have Ow Occupatio cover. If you have Wk Tasks cover, Sectio B8 does t apply. Sectio B8 does ot apply f Ow Occupatio cover, if we have already made paymets to you up to the claim limit f your claim. Me details o what happes if we have paid a claim up to the claim limit, ca be foud i Sectio C. This sectio explais how we wk out what we will pay you if you ca oly go back to wk part-time after your sickess accidet. We have used examples, which you might fid helpful, later i this sectio. If you re claimig o your policy, ad we have started to make paymets to you, ad you the go back to wk i your occupatio part-time, we will cotiue to pay you if: ad ad you have bee uable to wk cotiuously f at least three moths you go back to wk f less tha 30 hours a week you wked f me tha 30 hours a week immediately befe you became uable to wk ad your icome from part-time wk is less tha your icome befe the claim. We uderstad that if you are self-employed, it might be difficult f you to prove your weekly wkig hours whe you make a claim. We will wk with you to try ad fid evidece that will suppt your wkig hours. A example of evidece that would help could be a copy of your accouts. We wk out how much we will pay you as follows: ( ) (Icome befe the claim mius your icome from part time wk) icome befe the claim x actual cover I this fmula, your icome from part time wk is based o the yearly equivalet befe ay tax is paid. F example if your mothly icome from part time wk was 500 befe tax, the we would use 6,000 i this fmula, ( 500 x 12 moths = 6,000 a year). By actual cover, we mea the amout we were payig you befe you wet back to wk part-time. If we applied either our 1,500 3,000 beefit guaratee, it will still be icluded as your actual cover. We will eed evidece of your icome from part-time wk, such as your P60, payslip, writte cofirmatio from your employer, ivoices your accouts. 20

21 We will eed to review the amout we pay you if ay of the followig chage: your icome from part-time wk the amout of your cover the maximum mothly amout we will pay you. We describe this i Sectio B5. We will pay you util oe of the followig happes: your icome from part-time wk is the same as me tha your icome befe the claim you are able to carry out the mai duties of your occupatio f me tha 30 hours a week we have made paymets to you up to the claim limit your policy reaches its ed date you die. The example below illustrates how we wk out what we will pay you if you go back to your occupatio o a part-time basis. Example Befe her accidet, Mega eared 30,000, givig her mothly take home pay of 1,900. Mega has bee claimig o her Budget Icome Protectio policy sice her accidet, because she has bee uable to wk. The amout of her cover is 1,250 a moth. After a year off wk, her doct tells her she ca start wk agai, but that she ca t wk me tha 20 hours a week. Her employer agrees to pay her a reduced salary of 18,000 a year, reducig Mega s take home pay to 1,200 a moth. To wk out what we will pay, we take Mega s part-time icome away from her icome befe the claim to give us the differece. 30,000-18,000 = 12,000 We the divide her reduced icome by her icome befe the claim ad multiply this by 100 to tell us the decrease i her icome as a percetage. 12,000 30,000 = 0.4 x 100 = 40% Mega s icome from part time wk is 40% less tha her icome befe the claim. So she will cotiue to receive 40% of her Budget Icome Protectio paymets. ( 1,250 x 0.4 = 500). This equates to 500 a moth. Befe her accidet, Mega took home 1,900 a moth. Now that she is back at wk part-time, she takes home 1,700 ( 1,200 from her job, plus 500 tax free from her policy). 21

22 B9 What happes if you recover but ot eough to go back to your occupatio (sometimes called) Proptioate beefit) Ow occupatio cover oly Sectio B9 oly applies where your Policy Schedule states that you have Ow Occupatio cover. If you have Wk Tasks cover, Sectio B9 does t apply. Sectio B9 does ot apply f Ow Occupatio cover, if we have already made paymets to you up to the claim limit f your claim. Me details o what happes if we have paid a claim up to the claim limit, ca be foud i Sectio C. This sectio explais how we wk out what we will pay you if you ca oly go back to wk i a differet occupatio after your accidet sickess. We have used examples that you might fid helpful later i this sectio. Where you recover from sickess accidet but are t fit eough to go back to wkig i your occupatio we will pay you if: ad ad because of sickess accidet you are totally uable to carry out the majity of the mai duties of your occupatio you start a differet occupatio your icome from your ew occupatio is lower tha your icome befe the claim. We wk out how much we will pay you as follows: (Icome befe the claim mius your icome from part time wk) icome befe the claim x actual cover I this fmula, icome from your ew occupatio is based o the yearly equivalet befe ay tax is paid. F example if your mothly icome from your ew occupatio was 500 befe tax, the we would use 6,000 i this fmula, ( 500 x 12 moths = 6,000 a year) By actual cover, we mea the amout we were payig you befe you wet back to wk i your ew occupatio. If we applied either our 1,500 3,000 beefit guaratee, it will still be icluded as your actual cover. So that we ca cotiue to pay you, we will eed: ad ad ( ) details of your ew occupatio a descriptio of your ew job evidece of your icome. 22

23 We will eed to review the amout we pay you if ay of the followig chage: your icome from your ew occupatio the amout of your cover the maximum mothly amout we will pay you. We describe this i Sectio B5. We will pay you util oe of the followig happes: your icome from your ew occupatio is the same as me tha your icome befe the claim (but we ca restart paymets if your icome falls agai, as explaied below) we believe you are fit eough to carry out the mai duties of your occupatio, based o the evidece we have received we have made paymets to you up to the claim limit your policy reaches its ed date you die. We will oly restart paymets to you where your icome from your ew occupatio falls below your icome befe the claim agai. If this happes withi 52 weeks less of us stoppig the paymets, your paymets will restart straight away. Naturally, you must have bee uable to do your occupatio throughout ad we have ot already paid you up to the claim limit. Befe we restart your paymets we will eed evidece of the reduced icome ad medical evidece that cofirms that the reductio i your icome is a direct result of your iability to wk. Regrettably, if you ca t provide this evidece we wo t be able to cotiue to pay you. The example o the followig page illustrates how we wk out what we would pay if someoe wet back to wk i lower paid wk. 23

24 B9 What happes if you recover but ot eough to go back to your occupatio (sometimes called Proptioate beefit) Ow occupatio cover oly cotiued... Example Roger used to be a computer aalyst, ad eared 16,800 a year givig him a mothly take home pay of 1,100. He has bee claimig o his policy sice his sickess started, because he has bee uable to wk. The amout of his cover is 700 a moth. After 6 moths, his doct tells Roger he ca start wkig agai, but that he ca t type. So Roger gets a job wkig o the equiries desk at a DIY ste. His ew job pays 12,000 a year, which gives him a take home pay of 800. To wk out what to pay, we take Roger s icome from his ew job away from his icome befe the claim to give us the differece. 16,800-12,000 = 4,800 We the divide his reductio i icome by his icome befe the claim ad multiply this by 100 to tell us the decrease i his icome as a percetage. 4,800 16,800 = x 100 = 28.6% Roger s icome from his ew job is 28.6% less tha his icome befe the claim. So he will cotiue to receive 28.6% of his Budget Icome Protectio paymets. 700 x 28.6% = 200 This equates to 200 a moth. Befe his illess Roger took home 1,100 a moth. Now that he is wkig i the DIY ste, he takes home 1,000 ( 800 from his ew job at the DIY ste, plus 200 tax free from his policy). B10 What happes if you re isurig someoe else If you are isurig someoe else, we will look at their occupatio, health ad leisure activities to wk out what cover we ca offer whe you take out the Policy if you wat to icrease the amout of cover uder Sectio D2, D3 D4. We will oly pay you if they are uable to wk as defied i the relevat sectios of these coditios ad, whe we wk out the amout we will pay you, we look at their situatio ad ot yours. If you are isurig someoe else, they will eed to complete the questioaire about their occupatio, health, leisure activities ad icome. If we eed ay doct s repts, these will eed to be provided by the doct of the perso you are isurig ad they will eed to give us their coset f us to ask f these. 24

25 Sectio C The claim limit This sectio explais what happes if we have bee payig a claim, ad we have made paymets to you up to the claim limit. The claim limit is the maximum period f which we will make paymets to you, after your waitig period f ay oe sigle claim. This period is 24 moths. C1 What happes if we have made paymets to you up to the claim limit If we have made paymets to you up to the claim limit f ay oe claim, the your claim will stop. This meas we will stop makig the paymets to you f that claim, eve if you are still uable to wk. You ll still cotiue to be covered, uless you are a homemaker. If you are a homemaker, ad we have paid ay sigle claim up to the claim limit, the we will cacel your policy, ad you will o loger be covered. If you are a homemaker, ad we have cacelled your policy, you wo t be etitled to ay refud of premiums paymet from it. C2 What happes if you eed to make a claim i the future, ad we have already paid a previous claim up to the claim limit If we have already paid a claim up to the claim limit, ad the reaso you are uable to wk agai is the same as the previous claim, we will treat this as a related claim. This meas you will ot be able to make a claim, util you have bee back at wk f a cotiuous period of least six moths. If you were wkig full-time befe your previous claim, this meas you will have had to have bee back at wk full-time f a cotiuous period of at least six moths. If you were oly wkig part-time befe your previous claim, you will have had to have bee back at wk part-time. Oce you have bee back at wk f a cotiuous period of at least six moths, ad you the become uable to wk agai, we will treat this as a ew claim. This meas whe your claim is accepted, we will start makig paymets to you agai after the ed of your waitig period. If the reaso you are uable to wk is ot the same as f your previous claim, we will treat this as a ew claim. This meas whe your claim is accepted, we will start makig paymets to you after the ed of your waitig period. 25

26 Sectio D Other Coditios This sectio tells you about other thigs you eed to kow, such as how to pay your premiums, ad how to cacel your policy. D1 Iflatio-liked cover Sectio D1 applies oly if you have chose f the amout of your cover to icrease i lie with iflatio. We refer to this as iflatio-liked cover. If you re usure whether this applies to you, you will fid whether ot this is icluded o your Policy Schedule. We will icrease the amout of your cover o each Pla aiversary. This meas every 12 moths from the start date of your Pla. This is show as the pla start date i your Pla schedule. However, if we are payig a claim whe we are due to icrease the amout of your cover, we wo t icrease your cover. Oce your claim has eded we will write to you ad let you kow whe the ext icrease is due to take place. Where we apply this icrease, the amout of your cover ad premium will both go up i lie with the icrease i iflatio. This icrease will be based o the 12 moth period edig three moths befe your Pla aiversary. If your Pla aiversary is less tha three moths after the start date of this policy, the first icrease i the amout of your cover will be made o the ext Pla aiversary. We will tell you what we will icrease the amout of your cover to ad your ew premium befe we icrease them. Ay Special Provisios that apply to your policy will also apply to ay iflatio-liked icreases. These Special Provisios will be show i your Policy Schedule. If the icreases mea that the amout of your cover becomes me tha three times the iitial amout of your cover (show i your Policy Schedule), we ca stop icreasig it. This allows us to protect ourselves if there has bee very high iflatio, as you beefit from the fact that the icreases to your premium are based o the age you were whe you bought this policy. You ca ask us ot to icrease the amout of your cover, but you must let us kow befe the Pla aiversary whe a icrease is due. We the wo t make ay further icreases to the amout of your cover f the rest of the term of your policy. Please ote if you ask us ot to icrease the amout of your cover, but later o decide that you wat us to start icreasig it agai, you will eed to re-apply f iflatio-liked cover. We ca t guaratee that we will be able to offer you iflatio-liked cover agai, as it will deped o your health, occupatio ad leisure activities ad whether we are offerig the same type of isurace at that time. 26

27 D2 Guarateed Icrease Optios You ca icrease your amout of cover (other tha f iflatio-likig, which we explai i Sectio D1 above) without havig to complete a full applicatio fm, if certai evets happe. The evet must happe to the perso isured. I all cases you ca oly do this withi three moths of the evet happeig. Whilst you ca use these optios me tha oce, you ca t use them at the same time. Oce you ve used a optio you must wait at least three moths befe you use aother. The Sigificat Career Progressio Icrease optio ca oly be used oce durig the life of your policy. We call these Guarateed Icrease Optios, because we guaratee that you ca icrease your amout of cover without further health questios f other types of icrease you would eed to aswer health questios. Because of this we limit whe ad by how much you ca icrease your cover. We ve explaied this i me detail below. Uftuately you wo t be able to icrease the amout of your cover by a Guarateed Icrease Optio if you are uable to wk. This will also be the case if you have already suffered a accidet sickess but you have t yet made a claim you are still i the waitig period. Your premium will go up to reflect the icrease i the amout of your cover. The additioal premium will be based o your age, whether you smoke ot ad your occupatio at the time you icrease the amout of your cover. Ay special terms that apply to your igial policy will also apply to the icreased amout of cover. The evets which are covered by our Guarateed Icrease Optios are: Mtgage icrease as a result of movig house home improvemet You ca use this optio if you icrease the amout of your mtgage because you re movig home if you are plaig home improvemets. You ca icrease the amout of your cover by up to 50% of the igial amout of cover show i your Policy Schedule. The maximum icrease to your policy is limited to the icrease to your mtgage repaymets. Example Marc has moved house ad icreased his mtgage. The amout of cover uder his existig Icome Protectio policy is 500 a moth. This was eough to meet his mtgage repaymets, but as his mtgage repaymets have ow goe up to 700 a moth, he eeds to icrease his cover. Marc ears 26,000 a year befe tax. This meas that the maximum amout of cover he ca have uder his policy is 14,300 a year 1,191 a moth. As he oly wishes to icrease his cover to 700 a moth, he ca because this is still less tha the maximum cover he could have which would be 1,191. Also as the amout which he wats to icrease his cover by ( 200) is less tha 50% of his igial amout of cover ( 500), he is allowed to do this uder the Guarateed Icrease Optio. 27

28 Marriage Civil Partership You ca use this optio if you marry eter a civil partership (as defied by the Civil Partership Act 2004). You ca icrease the amout of your cover by up to 50% of the igial amout of cover show i your Policy Schedule. Childbirth legal adoptio of a child You ca use this optio if you have a child, you legally adopt a child (this must be legally recogised i the UK). You ca icrease the amout of your cover by up to 50% of the igial amout of cover show i your Policy Schedule. Icrease i basic salary received from a employer You ca use this optio if you are employed ad have a icrease i salary of at least 10%. Your basic salary must have icreased because of a promotio, the award of a recogised professioal qualificatio both a chage of employmet ad employer. You must be employed immediately befe ad after the icrease i your basic salary. You ca icrease the amout of your cover by up to 50% of the igial amout of cover show i your Policy Schedule. Sigificat Career Progressio Icrease You ca oly use this optio oce durig the lifetime of your policy You ca use this optio if you are employed ad have a icrease i basic salary of at least 20%. This could be as a result of a promotio, a chage of employmet employer. If you have had a icrease of 20% you ca also iclude ay other salary icreases sice the start date of your policy. You ca icrease your amout of cover by up to a maximum of 20,000 a year. This optio ca oly be used oce durig the life of your policy. This optio ca t be used if you, ( a member of your family) are the ower, direct parter i the compay you are employed by. By member of your family we mea your husbad, wife, civil parter, paret, child, brother, sister, ay other relative by blood by marriage. Geeral limits f Guarateed Icrease Optios There are some limits f how much you ca chage the amout of cover by. The total of all the Guarateed Icrease Optios you use ca t be me tha 10,000 a year 50% of the igial amout of cover show o your Policy Schedule (the oly exceptio beig the Sigificat Career Progressio icrease - see above). However, if you re ot i paid upaid wk the the overall amout of cover is limited to 18,000 a year ( 1,500 a moth). F me ifmatio see Sectio D4. I additio there is a overall limit of 35,000 a year f the Guarateed Icrease Optios you ca use over the life of your policy. Oce this limit has bee reached whilst you may still be able to icrease your cover, but you ca t use oe of the Guarateed Icrease Optios (see Sectio D3 f me details). 28

29 The total cover after usig the Guarateed Icrease Optios must ot be me tha the maximum mothly amout. We explai how we wk out the maximum mothly amout of cover i Sectios B4 ad B5. The table below explais the limits i me detail. It also shows the maximum age at which you ca make use of these optios. I all cases you ca oly use these optios withi three moths of the evet occurrig. Whilst all of these optios ca be used me tha oce (with the exceptio of the Sigificat career progressio optio), you ca t use them at the same time. Oce you ve used a optio you must wait at least three moths befe you use aother. Evet Icrease limit Maximum Icrease Maximum Age Mtgage Icrease The lower of: 10,000 a year* 54 50% of the igial amout of cover show i your Policy Schedule The icrease i your mtgage repaymets Marriage/ Civil Partership 50% of the igial amout of cover show i your Policy Schedule 10,000 a year* 54 Childbirth/ Legal adoptio Icrease i basic salary Sigificat career progressio icrease (you ca oly use this optio oce) 50% of the igial amout of cover show i your Policy Schedule 50% of the igial amout of cover show i your Policy Schedule Noe other tha maximum icrease 10,000 a year* 54 10,000 a year* 54 20,000 a year* 54 * If you re ot i paid upaid wk, the the overall amout of cover is limited to 18,000 a year ( 1,500 a moth). F me ifmatio see Sectio D4. If you wat to use oe of the Guarateed Icrease Optios, we ll ask you f evidece of the chage of your circumstaces, such as: a copy of your mtgage offer your igial marriage certificate civil partership registratio certificate, the igial birth certificate adoptio certificate, a letter from your employer. copies of your payslips 29

30 D3 Chagig your policy You ca chage the amout of your cover, (other tha usig iflatio-likig a Guarateed Icrease Optio, which is explaied i Sectios D1 ad D2 above), your waitig period the term of your policy at ay time. You ca also apply to chage your policy, if you have chaged job. If you wat to do this please let us kow, ad we will supply you with a special applicatio fm to complete. We ll let you kow what ifmatio we eed at the time, ad we ll be able to help you complete the applicatio fm. Uftuately, we ca t guaratee that you ll be able to do this, as it will deped o your age, health ad medical histy, occupatio, leisure activities ad whether we are offerig the same type of isurace at that time. We ll wk out the ew premium depedig o your age, heath ad medical histy, occupatio, leisure activities, whether you smoke ad the premium rates available at the time. It is very imptat that you do t cacel your existig policy. We will cofirm the chages you ve requested to you, ad if you wish to proceed with them, we ll tell you if your existig policy eeds to be cacelled. If it does eed to be cacelled, we ll do this automatically f you. D4 What to do if you stop wkig It is very imptat that you tell us whe you are t i wk, because if you claim, we will assess whether you are uable to wk usig the wk tasks defiitio explaied i Sectio A2. We will also limit the amout of your cover to a maximum of 1,500 a moth (plus iflatio liked icreases). This meas that if your amout of cover was me tha 1,500 a moth, the most we will pay if you make a claim is 1,500 a moth. So if you do t tell us that you are ot i wk, you could fid that you are payig f cover that you caot claim f. Me details of how much we will pay out if you make a claim are explaied i Sectio B4. If you wish to reduce the amout of your cover to less tha 1,500 a moth because you are ot i wk, we ca do this f you, ad we will also chage the premium you eed to pay. You ca go back to the cover you had befe you stopped wkig if you go back to wk withi 24 moths of whe you stopped wkig. Your premium will chage back to what you were payig befe you stopped wkig. We will ask you to cofirm what your ew occupatio is, but we wo t ask you ay additioal medical questios if o claim was made durig the career break. You will eed to be back i paid wk f at least two moths befe a valid claim f your full amout of cover ca be made. Uless you have made a claim uder your policy, you ca apply to go back to the Ow occupatio defiitio at ay other time, but we will ask you to complete a special applicatio fm which asks you details about your ew occupatio, ad your health ad medical histy. Your premium may ot be the same as what you were payig befe you stopped wkig, ad will be based o you age, whether you smoke ot, ad your occupatio ad state of health at that time. You will eed to be back i paid wk f at least two moths befe a valid claim f your amout of cover ca be made. 30

31 If you fget to tell us that you are t i wk, ad claim while you are ot i wk, the amout of your cover will be limited to 1,500 a moth (plus ay iflatio liked icreases), ad we will assess whether you are uable to wk usig the wk tasks defiitio explaied i Sectio A2. Uftuately we wo t be able to refud your premiums if this happes. If you are a Doct a Surgeo ad are registered with the Geeral Medical Coucil ad are licesed to practice i the UK, the we have some special arragemets i place that allow you to take a sabbatical break, ad leave your cover i place. Please see Appedix A - Coditio 2 f me ifmatio. D5 Back to Wk Suppt We wat to help you get back to wk ad so we may provide fiacial suppt f you to receive back to wk services advice. This will be available where we believe you have a valid icome protectio claim ad that the suppt advice would help you retur to wk. The maximum amout available f each claim is oe moth s amout of cover. There is o waitig period f this. We ll eed to approve the services the moey is spet o ad agree the costs befe they re icurred so please check with us befe makig ay arragemets. D6 Payig your premiums You are resposible f payig premiums o the date show i your Policy Schedule. They ca oly be paid by Direct Debit. Your premiums are guarateed ot to icrease uless you have chose iflatio liked cover. If we are payig a claim uder this policy, you will still eed to pay the premiums. If you do t do this the we could stop payig you as your policy would evetually be cacelled. However, you may have chose to take out our Waiver of Premium policy alogside your policy. If you have, the you may ot have to cotiue payig us. You ca fid me ifmatio o this i our Waiver of Premium Policy Coditios. D7 Stoppig premiums We give you 60 days from the due date f you to pay a premium. If we have t received a premium from you, we will sed you a remider to let you kow. If you fail to pay ay premium withi this 60 day period, the your policy stops immediately, ad we will cacel it. We wo t pay aythig to you if this happes. If we cacel your policy, we ll let you kow. 31

32 D8 Re-startig premiums If your policy has stopped because you did t pay a premium, you ca ask us to start it agai. You ca do this withi six moths of the first upaid premium. So that we ca restart your policy, we will eed you to pay all of the premiums that you have t paid. You will also eed to complete some health questios. Uftuately, it is possible that we may ot be able to restart your policy, if we ca it may be o differet terms to those igially offered, f example if your health has got wse sice your policy started. I the evet that this happes, we will explai our decisio to you ad the reasos f it. Please ote as the policy has actually eded we are ot obliged to restart it f you. If you wished to restart your premium after six moths you would eed to apply f a ew policy. D9 Ca you chage the amout of my premium? We have desiged your policy with the aim that the amout of your premium wo t chage. We wk out the premium f your policy based o our curret uderstadig of: the way your policy is taxed ad the facts that we re legally able to take ito accout. We could oly chage the premium after the start date of your policy f the followig reasos: Chages to legislatio that chages the way its taxed Chages to legislatio that chages the facts we ca legally use A decisio by a UK court the Europea Court of Justice that chages the facts that we ca take accout of These are the oly times whe we ca chage the premiums f your policy. We ca t chage your premium f ay of the followig reasos: To icrease our profits, To make up f ay losses we ve made i the past, If you ve made a claim, If there have bee ay chages i your health sice the start date of your policy. If your premium is goig to chage we will let you kow at least 60 days befe we chage it. If we advise you of a icrease to your premium, you ca choose to cotiue payig the previous amout istead. The amout of your cover will the be reduced; to the amout that we wk out your existig premium will pay f. You must tell us, if you decide to do this, at least 30 days befe the chage is due to be made. You ca also choose to cacel your policy, although you should thik about it carefully befe doig so. If you decide to do this, your policy will ed, you wo t be covered, ad you wo t get aythig back. 32

33 D10 Proof of age ad ame The premium f the amout of your cover is based o your date of birth as show i your Policy Schedule. We will eed evidece of your age befe we will pay a claim o your policy. We will accept your igial birth certificate passpt as evidece, but ot photocopies. We recogise that these are valuable documets that other people may eed at the same time. We will look after the documets carefully, ad retur them to you quickly. It is really imptat that you check your Policy Schedule has the crect date of birth o it, as it affects the amout we ca pay out to you if you claim. If your actual date of birth differs from that show o your Policy Schedule, we will chage the amout of your cover to the amout that would have bee available based o your actual age ad the premiums you have paid. Of course, if whe you claim your ame is differet from your ame o your Policy Schedule ad birth certificate we will also eed evidece of this chage (f example a marriage certificate). We may eed to ask f additioal evidece, ad if we do, we will tell you what evidece we eed, ad why we eed it. D11 Whe you ca cacel your policy You ca cacel your policy at ay time, although if you do this you will lose all your cover ad you wo t get aythig back. If you decide to do this, please let us kow, so that we do t ask you to pay ay me premiums. 33

34 D12 Whe we ca cacel your policy If you are a homemaker, ad we have paid ay oe claim up to the claim limit, we will the cacel your policy. This is explaied i me detail i Sectio C. I all other cases, oce your policy starts we wo t cacel it, uless you have ot paid all of the premiums that are due. We have explaied this i me detail i Sectio D7. There is just oe exceptio. Please uderstad that whilst the vast majity of our customers are hoest, we do have to protect ourselves (ad customers) agaist the effect of fraudulet claims. We will cacel your policy if either you ayoe you are isurig act frauduletly, deliberately provide utrue, iaccurate misleadig ifmatio whe you apply f the policy, whe makig a claim, if you apply to chage your policy if you apply to re-start your premiums (this is explaied i Sectio D8). This meas we will cacel your policy if we decide that you would have kow, we decide that you reasoably ought to have kow, the true aswer to a questio we ask you, but have deliberately provided a false aswer. We may also cacel your policy, may ot pay the amout of your cover i full, if had you aswered all of the questios we asked you hoestly ad i full, it would have led us to a differet decisio about the amout of your cover. F example: a higher premium would have applied f the amout of your cover, the amout of your cover would have bee lower f the same premium, we would have restricted the claims we pay out o, the term of your policy would have bee restricted, your applicatio would have bee deferred, f example, pedig the outcome of a medical ivestigatio, your applicatio would have bee declied. If you apply f your policy o-lie, we will sed you a summary of the questios we ask ad the aswers you give. We will also do this, if, whe you apply, we telephoe you to ask you some further questios about your applicatio. Whe you receive this summary it s very imptat that you check the aswers you gave, as we rely o this ifmatio to set up your policy. If we cacel your policy you wo t be etitled to ay refud of premiums paymet from it. 34

35 D13 Whe your policy eds O the ed date show i your Policy Schedule, your policy will stop ad o further premiums will be due. If we re payig a claim at the time, we wo t make ay further paymets, ad your claim will automatically ed. You wo t receive aythig back whe your policy eds. D14 Trasferrig the policy to someoe else You ca t assig trasfer ay paymet i the evet of a claim uder your policy the policy itself to ayoe else. This meas you ca t give it to ayoe else put it i Trust. We will pay all paymets due uder your policy to you. These paymets, to coi a legal phrase, will be a full ad proper discharge of our liability. This meas we wo t owe aythig to ayoe else, oce we have paid you. No perso, compay, apart from you ad us ca have ay rights uder, may efce, this agreemet. D15 The law that applies to your policy The policy is govered by the law of Eglad as applied by the courts f that part of the UK where you live. We will always commuicate i Eglish. 35

36 Appedix A: Special Coditios f Docts ad Surgeos I this appedix we explai some special coditios that we offer to Docts ad Surgeos. These will oly apply to you if at the time you become uable to wk: you are a Doct Surgeo, ad you are registered ( provisioally registered) with the Geeral Medical Coucil, ad you are licesed to practice i the UK. These guaratees wo t apply if at the time you become uable to wk: your licece to practice i the UK has bee suspeded, you have bee removed from the Geeral Medical Coucil register, Please see each special coditio f me details o whe you will be eligible to beefit from them. 1. Docts Surgeos 3,000 Beefit Guaratee This 3,000 beefit guaratee oly applies, if you are a Doct Surgeo registered ( provisioally registered) with the Geeral Medical Coucil, with a licece to practice i the UK, at the time you become uable to wk. This guaratee wo t apply if you are wkig less tha 32 hours a week at the time you become uable to wk. Please ote if you do ot qualify f this guaratee, you may still qualify f the 1,500 beefit guaratee explaied i Sectio B6 of these policy coditios.. At LV= we uderstad that your icome ca go up ad dow, ad that whe you come to claim it is possible that your icome might have dropped. If your icome drops but your amout of cover stays the same, it s possible that your amout of cover might be me tha the 55% of icome allowed. If this happeed we would usually reduce the amout we pay you to the maximum mothly amout (as explaied i Sectio B5 of these policy coditios). Whe you make a claim we will ask f ifmatio o your fiacial situatio to help us uderstad how we ca best help you with your claim. But if whe we do this, we fid your icome o loger suppts the amout of cover you chose, uder this guaratee we will pay you at least 3,000 a moth ( the amout of cover you chose if it was less tha 3,000) less the followig mothly paymets befe tax: paymets from ay other sickess accidet isurace o your life (f example, ay mtgage paymet protectio credit card proptio that you are claimig o) 60% of sickess beefits retiremet paymets you receive from ay source (except NHS sick pay if you re claimig uder the NHS Docts Surgeos Sick Pay Guaratee explaied i Coditio 3 of this appedix) 60% of ay cotiuig icome pesio paymets that you are still receivig whilst you re claimig (we do t take ito accout ay icome eared befe you became uable to wk f example a bous that is paid at the ed of the year) 36

37 You ca still receive state beefits (f example, Employmet ad Suppt Allowace) o top of this guaratee. To qualify f this guaratee you must have bee wkig at least 32 hours a week at the time you became uable to wk. If we have agreed to pay the claim uder Sabbatical Break cover (see Coditio 2 below), as log as you were wkig at least 32 hours a week befe you took your sabbatical break the you ll still qualify f this 3,000 beefit guaratee. 2. Docts Surgeos Sabbatical Break cover This sabbatical break cover oly applies, if you are a Doct Surgeo registered ( provisioally registered) with the Geeral Medical Coucil, with a licece to practice i the UK, at the time you become uable to wk. This sabbatical break cover wo t apply if the date you become uable to wk is withi 12 moths of the start date of your policy. We realise that durig the term of your policy, you may wat to take a sabbatical break. If you do, we will treat you as if you are remaiig i full time employmet f up to two years. This meas that if, durig your sabbatical break, you suffer a accidet sickess that meas you would be uable to wk i your pre-sabbatical occupatio as a Doct Surgeo, we will base your claim o the icome you received i the 12 moths befe you took your sabbatical break. It s imptat to be aware that this cover oly lasts f a period of two years f each sabbatical break. So if you have t retured to wk withi two years ad you the make a claim the limits i Sectio D4 of these policy coditios will apply to your claim. You will still eed to cotiue to pay premiums f your policy whilst you are o your sabbatical break. If you do t the your policy will ed. This meas we wo t pay ay claim. If you take a sabbatical break ad the retur to wk, there has to be a period of 12 moths betwee sabbatical breaks. If you take aother sabbatical break withi 12 moths of returig to wk, we wo t pay a claim uder this coditio, ad the limits i Sectio C4 of these policy coditios will apply to your claim istead. You do t eed to tell us that you re takig a sabbatical break. However if you make a claim whilst o a sabbatical break we will eed you to provide us with documeted evidece that you had arraged ad fmally agreed a guarateed positio as a Doct Surgeo to retur to at the ed of your sabbatical break. If this evidece caot be provided, the we wo t be able to pay a claim uder this coditio, ad the limits explaied i Sectio D4 of these policy coditios will apply to your claim istead. 37

38 3. NHS Docts Surgeos sick pay guaratee This sick pay guaratee oly applies if you are a Doct Surgeo directly employed by the NHS. It does t apply to ay other Docts Surgeos. As with the other coditios i this Appedix you also must be registered ( provisioally registered) with the Geeral Medical Coucil, with a licece to practice i the UK, at the time you become uable to wk. It is imptat to uderstad it also oly applies if you ve chose a 12 moth waitig period f your policy. If you ve chose ay other waitig period, the this guaratee wo t apply. We guaratee: - whe you claim, we will pay out your cover early, based o how log you have bee directly employed by the NHS at the time you become uable to wk - that we wo t deduct your NHS sick pay whe we wk out the maximum mothly amout we ca pay you (explaied i Sectio B5 of these policy coditios). It s imptat to be aware though that whilst we wo t take off ay NHS sick pay whe wkig out the maximum mothly amout we ca pay you we will still take ito accout other cotiuig icome that you may be receivig. This is explaied i Sectio B5 of these policy coditios If you ve chose a waitig period of 12 moths f your policy, the if you become uable to wk, oce we ve agreed to pay your claim, we will start payig it befe the ed of your 12 moth waitig period as explaied i the table below: Legth of NHS Service at claim F a 12 moth waitig period we ll pay your claim early as follows: Up to 1 year 50% after 1 moth, the 100% after 3 moths Over 1 year ad up to 2 years 50% after 2 moths, the 100% after 4 moths Over 2 years ad up to 3 years 50% after 4 moths, the 100% after 8 moths Over 3 years ad up to 5 years 50% after 5 moths, the 100% after 10 moths 5 years ad over 50% after 6 moths, the 100% after 12 moths If you ve chose a waitig period other tha a 12 moth waitig period, the this guaratee wo t apply. This meas you would have to wait to the ed of your chose waitig period befe we would pay ay claim. We would also take ito accout ay NHS sick pay i wkig out how much we ca pay you as explaied i Sectio B5 of these policy coditios. 38

39 39

40 LV.com Liverpool Victia Friedly Society Limited: Couty Gates, Bouremouth BH1 2NF LV= ad Liverpool Victia are registered trademarks of Liverpool Victia Friedly Society Limited (LVFS) ad LV= ad LV= Liverpool Victia are tradig styles of the Liverpool Victia group of compaies. LVFS is authised ad regulated by the Fiacial Services Authity, register umber: LVFS is a member of the ABI, AFM ad ILAG. Registered address: Couty Gates, Bouremouth BH1 2NF. Phoe: /12