ADVISER INFORMATION PROGRESSIVE CARE PROGRESSIVE. TotalCareMax. Extra information around how the product works.

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1 ADVISER INFORMATION PROGRESSIVE CARE TotalCareMax Extra information around how the product works.

2 AN INNOVATIVE APPROACH TO INSURANCE Insurance that makes sense Sovereign s Progressive Care is a severity-related trauma product designed to meet your clients needs throughout their lives. Unlike traditional trauma products, Progressive Care has no expiry age and enables your clients to receive multiple claim payments if the severity of their medical condition worsens or if they suffer from unrelated medical conditions. These payments could be used to pay for specialist medical treatment, rehabilitation costs, or to provide financial breathing space during recovery. Progressive Care offers your clients: > > Cover for more than 60 medical conditions at various stages of severity and at various claim payment levels. It s grouped under five Categories of Conditions: Cancer Heart & Arteries Brain & Nerves Loss of Function Other Health Events > > Improved affordability As a severity-related trauma product, Progressive Care generally costs less than traditional comprehensive trauma products. Since claim payments under Progressive Care are aligned to the seriousness of the medical condition, the thresholds for full claim payments are generally higher than traditional trauma products. > > Access to partial claim payments at an earlier stage of the condition Progressive Care s severity tiers offer lower claim payment thresholds for some covered conditions. For example, Progressive Care provides a built-in partial payment for early stage cancerous tumours (Stage 0 carcinoma-in-situ) and lower severity strokes (refer to the policy document for a complete list of conditions and payment amounts). This means your clients may access a partial claim payment earlier for more conditions than under a traditional trauma product. > > Opportunity for multiple claims Progressive Care can make further pay outs as your client s condition worsens or for unrelated medical conditions. Stand down periods, minimum survival periods and other conditions apply. Refer to the policy document for details. Progressive Care provides your clients: > > A long-term customer relationship The opportunity for multiple claim payments and no expiry age enables your clients to retain their cover for life (subject to cover remaining within at least one Category). > > Future-proofing Built-in options to increase cover, and Guaranteed Enhancement passback wording. > > More cover than ever The potential for a full claim payment in each of the five Categories effectively offers your clients a built-in buyback option. > > Progressive Care for children with the entry age starting from 2 years old, parents have the option to take out trauma insurance for their children either as standalone or part of the family insurance. This can help support the whole family through a difficult time such as allowing parents to take time off work to be there for their child. PAGE 2

3 HOW IT WORKS Here is a quick snapshot of the categories in Progressive Care and the severity levels within each. 10% 10% Cancer Heart & Arteries Brain & Nerves Loss of Function Other Health Events This is an illustrative guide only. Claims are subject to the terms and conditions of the policy document. Benefit payments: Lump sum payments in line with severity of medical condition Severity levels: Level 5 (least severe) through to level 1 (most severe) with benefit calculated on 10%,,, and of the sum assured available Minimum sum assured: $50,000 Maximum sum assured: $1,500,000 ($250,000 for children aged 2-15) Eligible ages: From 2 years onwards with individual consideration from age 70 Term of cover: No maximum expiry age Accessibility of cover: Your clients could receive multiple payments if their condition worsens, if they suffer from a more severe related condition, or they suffer from an unrelated medical condition. Choice of cover: Progressive Care is available as either Personal Cover (retail cover) or as Business Protection (key-person cover for employers). Progressive Care can also be taken as a standalone benefit or as an accelerated benefit linked to a TotalCareMax Life Cover policy. Progressive Care vs traditional trauma products Severity-related trauma products, like Progressive Care, originated in South Africa and over the last decade have appeared in the UK, Asia and Australia. Since launching Progressive Care to the New Zealand market, the response from our Advisers and your clients has been unprecedented, underlining the market need that this type of insurance fills. In advising your clients, consider the suitability of Progressive Care as an alternative or a compliment to traditional trauma products. In providing your recommendation, you will need to consider the advantages and limitations of both Progressive Care and traditional trauma products in meeting your client s needs. The table below summarises some general points of differences between these two product types as a starting point. Progressive Care Traditional Trauma Products Affordability Generally lower cost Generally higher cost Full claim payments Higher severity thresholds for some common medical conditions (e.g. cancer, heart attack) Lower severity for some common medical conditions (e.g. cancer, heart attack) Multiple claim payments As severity worsens and for unrelated medical conditions Partial claims for some medical conditions Stand down periods, minimum survival periods, exclusions and other conditions apply. Refer to the policy document for details. PAGE 3

4 BENEFITS INCLUDED WITH There are some great benefits included in our Progressive Care that help support your clients when they need it most. A note on exclusions Some built-in and optional benefits under Progressive Care are subject to specific exclusions or stand-down periods. These are noted throughout this document. The policy wordings have a complete list of exclusions. In addition, the following general stand-down periods and exclusions apply: 1. Some covered conditions are subject to a three month stand-down period. This means Sovereign will not pay a claim for any of these conditions, if signs or symptoms relating to that condition, occur within three months of policy commencement. Please see the policy wordings for a complete list. 2. Sovereign will not pay a claim where any of the following causes or contributes to the claim: a. An insured person (who may be a life assured or insured child of a life assured) deliberately injuring themselves, or attempting to do so; b. An insured person engaging in criminal conduct; c. A condition, or signs or symptoms leading to a condition, which an insured person has prior to policy commencement; or d. In relation to any insured person under the age of 21, an intentional act by a parent, guardian or other person who lives with or supervises that insured person. Here s a quick reference of what built-in benefits are available for each age bracket Built-in Benefits available Life assured aged 2-15 Life assured aged 16+ Children s Trauma Benefit Newborn Children s Benefit Claims expected to be low Applies but claims expected to be low Financial Advice Benefit Guaranteed Enhancement Benefit Special Events Increase Facility Before age 55 Future Insurability Benefit Before age 55 Built-in Children s Trauma Benefit If a child of the life assured suffers a covered condition of severity level 1, 2 or 3, the Children s Trauma Benefit will pay a benefit of of the sum assured (up to $20,000). Importantly, the payment of the Children s Trauma Benefit will not reduce the amount of any Progressive Care remaining for the life assured. Sovereign will pay a maximum of one claim per child under either the built-in Children s Trauma Benefit or the built-in Newborn Children s Benefit. A 14 day survival period applies and exclusions apply for any congenital conditions. Why this is important? The Children s Trauma Benefit provides an opportunity for your clients to obtain trauma cover for their children at no additional cost. Should the worst happen, your clients might choose to use the lump sum to support the family while they take time off work to care for their child or to cover unexpected costs. PAGE 4

5 Built-in Newborn Children s Benefit If the life assured s child is born with one of five specified congenital conditions and survives for thirty days after birth, the Newborn Children s Benefit will pay a benefit of of the sum assured (up to $20,000). The payment of the Newborn Children s Benefit will not reduce the amount of any Progressive Care remaining for the life assured. Please note that Sovereign will pay only one claim per child under either the Newborn Children s Benefit or the Children s Trauma Benefit across all Sovereign policies. The Newborn Children s Benefit is payable once per child across all Sovereign policies. A 12 month stand down period and 30 day minimum survival period applies. Why this is important? Built-in Guaranteed Enhancement Benefit All future enhancements to TotalCareMax will automatically be applied to your client s policy and the provision (or wording) that is most favourable to your client will be applied at claim time. Please note that any enhancements apply in respect of those claims where the claim event date occurs after the date of enhancement. Why is this important? Your clients will automatically benefit from any favourable future changes to our TotalCareMax product range. This helps to ensure that your clients policies continue to deliver value long after the policy was purchased. The Newborn Children s Benefit enables your client to take time off work to care for their child. Built-in Financial Advice Benefit With the Financial Advice Benefit, your client is able to obtain financial advice from a Sovereign-approved Financial Adviser at the time of receiving a full claim payment under their Progressive Care. Sovereign will reimburse your clients for fees of up to $2,500 (incl. GST). This is a one-off payment across all Sovereign policies for each life assured. Optional benefits are also available to enhance your client s insurance. Visit Sovereignillustrations.co.nz for full details. Why is this important? A major health scare can reduce your client s ability to earn an income and can have a lasting effect on their financial situation. The Financial Advice Benefit provides your clients with an opportunity to obtain the advice they need to plan for their future. Flexible ways clients can increase their cover Life changing events can increase your clients financial responsibilities. The Special Events Increase Facility and the Future Insurability Benefit offer your clients the opportunity to increase their Progressive Care up to once per year without having to provide further medical information (maximum increase limits apply). Please note that these increases are not available if the life assured has already suffered a condition under Progressive Care. Where a claim of another type has been notified or accepted for the life assured, Sovereign will exercise its discretion in determining if the increase can be applied based on the nature of the claim. Built-in Special Events Increase Facility The Special Events Increase Facility enables your clients to increase the level of cover under their Progressive Care following major changes throughout their life. The specified list of events includes significant milestones which might result in increasing financial responsibilities. These special events include: having a child, becoming married, taking out or increasing a residential home loan, achieving a significant salary increase and other major events. The Special Events Increase Facility is available from age 16 and beofre the age of 55. Built-in Future Insurability Benefit The Future Insurability Benefit allows your clients to increase their cover at every third policy anniversary and does not require any specific events to occur. The Future Insurability Benefit is is available from age 16 and beofre the age of 55. PAGE 5

6 THE BOTTOM LINE Combining Progressive Care with other Sovereign products provides wide-ranging cover for your clients. Let s take a look at how that might work: Sarah s Journey Sarah, a contract accountant, takes out Sovereign s Disability Income (with a four-week wait) and Sovereign s Progressive Care. A few years later, following a routine mammogram, she is diagnosed with stage one breast cancer, requiring a mastectomy and chemotherapy. She quickly undergoes surgery but needs time off for follow-up treatment and to recover. Because Sarah has a Progressive Care policy, she is able to claim of her cover within the Cancer Category as a claim payment. And, because she also has Sovereign Disability Income Protection, she is not financially disadvantaged as a result of having to take time off work, despite being a contractor and not having sick leave to fall back on. Sarah s Progressive Care payment covers her during the four-week wait period of her Disability Income policy, ensuring there is no financial loss before payments begin. And, with Progressive Care, she has the reassurance that her policy will continue to protect her should the breast cancer ever return or she suffers a new medical condition. Where multiple unrelated claims occur within a 12 month period, Sovereign will deduct those claims from any current claim. See policy document for further details. Summary Income Protection: Sarah will not be financially disadvantaged from taking time off work. Progressive Care: Progressive Care provides a benefit which Sarah can choose to use during the four-week wait period of her Disability Income policy. Sarah claims on her Progressive Care policy, leaving her with of cover within the Cancer Category and full cover within all other Categories. Cancer Heart and arteries Brain & nerves Loss of function Other health events PAGE 6

7 In the next example, you can see how other Sovereign products work hand in hand with Progressive Care: Joe s Journey At 32 years of age, Joe talks to his Adviser about reviewing his insurance to better protect himself and his financial future. He already has Sovereign s Life Cover and decides to also take out Private Health Plus and Progressive Care. Now aged 45, he has to visit the cardiologist, so he submits a claim form to Sovereign and is reimbursed for his specialist s visit under his Private Health Plus policy. The cardiologist advises Joe that he needs an angioplasty procedure to unblock two of his arteries, which can be undertaken in a private hospital. Under his Private Health Plus policy, Sovereign pays for this procedure and covers the cost of his private medical hospital stay. However, Joe is also eligible to claim on his Progressive Care policy to help him with his recovery/rehabilitation. This leaves him with of the cover available under the Heart & Arteries Category, if his condition becomes more severe in the future. Reassuringly, Joe also has available available in all other Categories, should he experience an unrelated health event in the future. In this instance, two of three Sovereign policies have been claimed on, giving Joe the best possible recovery outcome. Summary Private Health Plus: Joe s Private Health Plus policy covers the cost of his specialist visit, his procedure and his private hospital stay. Progressive Care: Joe can claim on his Progressive Care policy to help with recovery, leaving him with of the cover available under the Heart & Arteries Category and available in all other Categories. Cancer Heart and arteries Brain & nerves Loss of function Other health events PAGE 7

8 sovereign.co.nz Sovereign House 74 Taharoto Road, Takapuna, Auckland 0622 Private Bag Sovereign, Victoria Street West, Auckland 1142 Telephone: Fax Other things you should know: The availability of insurance cover is subject to your application being approved. All applications are subject to individual consideration. Special conditions, exclusions and premium loadings may apply. This insurance is underwritten by Sovereign Assurance Company Limited ( Sovereign ). For full details of the products and benefits offered by Sovereign, please refer to the policy document(s) which are available from Sovereign. Sovereign, the policy insurer, is part of the Commonwealth Bank of Australia Group and is a related company of ASB Bank Limited and its subsidiaries ( the Banking Group ). None of the Banking Group, the Commonwealth Bank of Australia, any of their directors, or any other person, guarantees Sovereign or its subsidiaries, or any of the products issued by Sovereign or its subsidiaries. The information contained in this publication is general in nature and is not intended as advice. It may not be relevant to individual circumstances and before making any insurance decision, you should consult PROGRESSIVE a professional Adviser. CARE Copies of our disclosure statements are available on request, free of charge. PAGE