Personal Accident and Accidental Death Benefit Policy Wording

Transcription

1 Personal Accident and Accidental Death Benefit Policy Wording This Policy has been arranged by Motorplus Limited (trading as ULR Additions) with Qdos Broker & Underwriting Services Limited and is underwritten by UK General Insurance Limited on behalf of: Ageas Insurance Limited, Registered in England No Registered Office: Ageas House, Hampshire Corporate Park, Templars Way, Eastleigh, Hampshire SO53 3YA. Motorplus Limited, Qdos Broker & Underwriting Services Limited and UK General Insurance Limited are authorised and regulated by the Financial Conduct Authority. Ageas Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. This can be checked on the Financial Services Register at register or by contacting them on Subject to the appropriate premium having been paid the Insurer agrees to cover the Insured Person as set out in this Policy. Unless expressly stated nothing in this Policy will create rights pursuant to the Contracts (Rights of Third Parties) Act Important Information PLEASE NOTE THAT IT IS A CONDITION OF THIS COVER THAT AT ALL TIMES YOUR VEHICLE IS COVERED BY A POLICY OF MOTOR INSURANCE. This is Your Personal Accident and Accidental Death Benefit Policy. Please spend some time reading through the Policy to ensure that it meets Your requirements. If there is anything You do not understand, please contact us. We will be happy to assist. This is a contract of insurance between You and Ageas Insurance Limited. The insurance provided can provide payment in respect of accidental death or personal injury resulting from a motor accident, subject to the terms, limits of indemnity, exclusions and conditions contained herein. This document forms a legally binding contract of insurance between You and the Insurer. The contract does not give, or intend to give, rights to anyone else. No one else has the right to enforce any part of this contract. The Insurer may cancel or change any part of the contract without getting anyone else s permission. The contract is based on the information You provided in Your proposal for insurance. The insurance provided by this document covers death or disability that occurs during any period of insurance for which You have paid, or agreed to pay the premium. The insurance is provided under the terms and conditions contained in this document. Demands and Needs This Policy meets the demands and needs of customers who want to insure against the risk of accidental death or certain bodily disablement or injury. This Policy will cover You for the sums set out within this document in respect of certain risks. Motorplus Limited does not make any personal recommendation as to whether this Policy will suit Your individual circumstances. Cancellation Right You may cancel this Policy at any time by sending a written instruction to the Administrator and returning Your insurance documents. This insurance runs concurrently with Your Motor Insurance Policy. In the event of cancellation or non-renewal of Your Motor Insurance Policy all cover under this insurance shall cease. If the Policy is cancelled within the 14 day withdrawal period a full refund of premium will be given. If the Policy is cancelled after the 14 day withdrawal period there will be no refund in premium. The Insurer may cancel this insurance by giving 14 days notice in writing. In the event of cancellation a refund of a proportionate part of the premium corresponding to the un-expired period of insurance will be given provided You have not made a claim against this Policy. Making a Claim 24/7 In the event of a claim please do not appoint Your own solicitor as this may invalidate the cover provided by this Policy. Note that all claims must be reported to us as soon as possible after the Accident. If You need to notify a potential claim, please immediately contact our Claims Department: 21

2 CALL Or Or write to Motorplus Claims Kircam House 5 Whiffler Road Norwich NR3 2AL Please quote Personal Accident Cover in all communications. REMEMBER The claims line is open 24 hours a day, 365 days a year. Definitions The words and phrases listed below will have the following meanings: Accident Any Bodily Injury which is caused by a sudden, unexpected specific event occurring within the Period of Insurance following a road incident within the Territorial Limits. Administrator Motorplus Limited, Kircam House, Whiffler Road, Norwich, NR3 2AL, an insurance intermediary who has been given authorisation by the Insurer to issue this insurance cover and manage claims on behalf of the Insurer. Bodily Injury A physical injury incurred during the Period of Insurance, resulting solely and independently from an Accident which within 12 months from the date of the Accident results in the Insured Person s death or disability. Insured Person You and any other person entitled to drive the Insured Vehicle and passengers. Insured Vehicle The private motor car shown on the Policy Schedule. Insurer UK General Insurance Limited on behalf of Ageas Insurance Limited. UK General Insurance Limited are an insurers agent and in the matters of a claim act on behalf of the insurer. Loss of Limb(s) The loss of a hand or foot by physical severance or total loss of use of an entire hand or foot. Loss of Sight The permanent and total Loss of Sight which is consider as having happened when: in both eyes, if an Insured Person s name is added to the Register of Blind Persons on the authority of a fully qualified ophthalmic specialist; or in one eye if, after correction, the degree of sight an Insured Person has left in that eye is 3/60 or less on the Snellen Scale (meaning they can see at three feet what they should be able to see at 60 feet). Loss of Use The total and irrecoverable Loss of Use where the loss is continuous for 12 months and such loss of is deemed permanent and beyond possibility of improvement. Motor Insurance Policy The Motor Insurance Policy which has been issued to the Policyholder for the Insured Vehicle. Period of Insurance 12 calendar months from the date of inception of this Policy. Permanent Total Disablement Disablement which entirely prevents an Insured Person from working in any business or occupation of any and every kind and which after a period of 12 months from the date of disablement, in the opinion of a medical referee, shows no sign of ever improving. Policyholder/You/Your The individual, named on the Policy Schedule, who has paid the appropriate premium. Qdos Qdos Broker & Underwriting Services Limited, an insurance intermediary who has been delegated the authority to bind cover and manage claims on behalf of the Insurer. Sum Insured The maximum amount the Insurer will pay in the event of a claim made against this Policy, as specified within this document under the section titled This Policy Will Cover. 22

3 Territorial Limits The United Kingdom of Great Britain and Northern Ireland, the Isle of Man and the Channel Islands and up to 21 days in Europe in the Period of Insurance. This Policy Will Cover Provided that: 1. the Insured Person has not attained 81 years of age; and 2. the Insured Person is normally resident in the United Kingdom; the Insurer will pay up to the Sum Insured shown if an Insured Person suffers loss, damage, death or Bodily Injury whilst driving or travelling in the Insured Vehicle during the Period of Insurance. The Policyholder must ensure that the Insured Vehicle remains insured for the RTA compulsory risks throughout the lifetime of this Policy. In the event of cancellation or non-renewal of that Motor Insurance Policy all cover under this insurance shall cease. 1. Accidental Death 30, Loss of Sight in one or both eyes 30, Loss of one or more limb(s) 30, Permanent total loss of speech 30, Permanent total loss of hearing - in one ear 7,500 - in both ears 30, Permanent total disability 30,000 If the Insured Person is under 16 years of age the benefit under Item 1. Accidental Death is limited to 2,500. The maximum accumulation limit for any one Accident shall be 240,000. This Policy Will Not Cover The Insurer will not be liable for: 1. claims arising from or relating to physical or mental conditions or disabilities of a recurring or chronic nature from which the Insured Person suffered and was known to suffer, prior to the inception of this insurance. 2. death or disablement directly or indirectly arising out of or consequent upon or contributed to by: a. use of the Insured Vehicle for hire or reward, racing, competition, rallies, trials, speed testing or for any purpose in connection with the motor trade, haulage or courier services, minibus, private or public hire or professional driving instruction; b. riding a motorcycle or moped as a driver or passenger; c. an Insured Person committing or attempting to commit suicide or intentionally inflicting self injury, while sane or insane; d. war, riot, act of foreign enemy (whether war is declared or not), civil war, revolution, power seized unlawfully, terrorism, nuclear, chemical or biological materials being released or escaping, or any other similar event; [For the purpose of this exclusion, terrorism means an act, or acts, of any person or group committed for political, religious or similar purposes, with the aim of influencing any government or putting the public, or any section of the public, in fear. Terrorism can include, but is not limited to, using or threatening to use force or violence. The people who carry out acts of terrorism can either be acting alone, or acting on behalf of or in connection with any organisation or government. If any part of this exclusion is found not valid, or we cannot enforce any part of it, the rest will still apply] e. deliberate exposures to exceptional danger (except in an attempt to save human life), or the Insured Person s own criminal act, or being under influence of alcohol or drugs; f. provoked assault or fighting (except in bona fide self defence); or g. any matrimonial or family dispute. 23

4 General Conditions 1. Claims When a claim or possible claim occurs, You or an Insured Person must notify the Administrator, in writing, as soon as possible. You or the Insured Person must seek and follow advice from a registered medical practitioner, and have any medical examination that the Administrator requests. If an Insured Person dies, the Administrator will be entitled to ask for, at their expense, a post-mortem examination. You or any Insured Person must provide (at Your or their own expense) any documents, information and evidence the Administrator requires. Please see section Making a Claim 24/7 for contact details. 2. Fraudulent Claims If any Insured Person makes any request for payment under this Policy knowing it to be fraudulent or false in any respect or ought reasonably in the circumstances to know it to be fraudulent or false or where there is collusion between any parties to the dispute, this Policy shall become void and any premiums paid hereunder shall be forfeited and we shall be entitled to recover any monies previously paid. 3. Aggravated Physical Disability If the consequence of an injury is aggravated by a physical disability or condition of an Insured Person which existed before the Accident occurred, the amount of any compensation payable under this insurance in respect of the consequences of the Accident shall be the amount which is reasonably considered would have been payable if such consequences had not been so aggravated. 4. Cooling Off Period You may cancel this Policy, without giving reason, by sending written notice to the Administrator, returning the insurance documents within 14 days of inception or within 14 days of You receiving the insurance documents (if later). Your premium will be refunded in full provided a claim has not been made against this Policy. If a claim has been made against this Policy no refund of premium will be provided. 5. Cancellation You may cancel this Policy at any time by sending a written instruction to the Administrator and returning Your insurance documents. This insurance runs concurrently with Your Motor Insurance Policy. In the event of cancellation or non-renewal of Your Motor Insurance Policy all cover under this insurance shall cease. However, unless it is cancelled within the 14 day cooling off period, there will be no refund in premium. The Insurer may cancel this insurance by giving 14 days notice in writing. In the event of cancellation a refund of a proportionate part of the premium corresponding to the un-expired Period of Insurance will be given (provided You have not made a claim against this Policy). 6. Notification The Police must be notified immediately following any event likely to give rise to a claim under this insurance. 7. Governing Law Unless some other law is agreed in writing, this Policy is governed by English law. If there is a dispute, it will only be dealt with in the courts of England or of the country within the United Kingdom in which Your main residence is situated. Complaints Procedure It is the intention to give You the best possible service but if You do have any questions or concerns about this insurance or the handling of a claim You should in the first instance contact: The Nominated Complaints Handler Qdos Broker & Underwriting Services Limited Qdos Court Rossendale Road Earl Shilton Leicestershire LE9 7LY Tel Fax compliance@qdosconsulting.com Please ensure Your policy number is quoted in all correspondence to assist a quick and efficient response. If it is not possible to reach an agreement, You have the right to make an appeal to the Financial Ombudsman Service. This also applies if You are insured in a business 24

5 capacity and have an annual turnover of less than 2 million and fewer than ten staff. You may contact the Financial Ombudsman Service at: The Financial Ombudsman Service, South Quay Plaza, 183 Marsh Wall, Docklands, London, E14 9SR. Tel: complaint.info@financial-ombudsman.org.uk The above complaints procedure is in addition to Your statutory rights as a consumer. For further information about Your statutory rights contact Your local authority Trading Standards Service or Citizens Advice Bureau. Financial Services Compensation Scheme Ageas Insurance Limited is covered by the Financial Services Compensation Scheme. You may be entitled to compensation from the scheme in the event that Ageas Insurance Limited cannot meet their obligations. This depends on the type of business and the circumstances of the claim. Most insurance contracts are covered for 90% of the claim with no upper limit. You can obtain further information about compensation scheme arrangements from the FSCS at or by phoning Consumer Insurance (Disclosure & Representations) Act 2012 You are required by the provisions of the Consumer Insurance (Disclosure and Representations) Act 2012 to take care to supply accurate and complete answers to all questions and to make sure that all information supplied to us is true and correct. You must tell us of any changes to the answers You have given as soon as possible. Failure to advise us of a change to Your answers may mean that Your Policy is invalid and that it does not operate in the event of a claim. You must contact us immediately in the event that there is a change to Your circumstances, as follows: 1. You change Your address; 2. You are convicted of a criminal offence or receive a police caution; 3. You have insurance refused, declined, cancelled or terms applied by another insurance provider. Data Protection Act 1998 Please note that any information provided to us will be processed by us and our agents in compliance with the provisions of the Data Protection Act 1998, for the purpose of providing insurance and handling claims, if any, which may necessitate providing such information to third parties. We may also send the information in confidence for process to other companies acting on their instructions including those located outside the European Economic Area, some of which may not have equivalent Data Protection laws. We may obtain information about You from credit reference agencies, fraud prevention agencies and similar organisations to enable us to check Your credit status and identity. These agencies will record Our enquiries, which may be seen by other companies who make their own credit enquiries. We may also check Your details with fraud prevention agencies. If You provide false or inaccurate information and we suspect fraud, we will record our concerns. We and other organisations may use these records to help make decisions on insurance proposals and claims, prevent fraud, recover debt and check Your identity to prevent money laundering. Under Data Protection legislation, You can ask Us in writing for a copy of certain personal records held about You. A charge of 10 will be made. Motorplus Limited trading as ULR Additions is authorised and regulated by the Financial Conduct Authority. 25