Mortgage Protection Insurance - policy terms and conditions
1. The special words we use in these policy terms and conditions
The special words we use are shown below with their meanings alongside them.
Except where the context otherwise requires, the masculine shall include the
feminine, the singular shall include the plural and vice versa as appropriate.
| Additional cover
|
an amount up to 25% of the mortgage payment you have
chosen under this Mortgage Protection Insurance policy. |
| Administrator |
Paymentshield Limited. |
| Benefit period |
a period of up to 12 months for each separate period
of claim. |
| Benefit split |
either single cover or split cover as shown on your
certificate of cover. |
Business
|
a company, profession, trade or industry owned and
run by you (either alone, or with others) which is registered in the United
Kingdom, Channel Islands or Isle of Man. |
Certificate of cover
|
the document you receive confirming the specific
type and level of cover we give you under this Mortgage Protection Insurance policy. |
| Consultant |
a suitably qualified registered medical specialist
(other than you or a relative) at a major hospital in the United Kingdom,
Channel Islands or Isle of Man. |
Controlling director |
you own more than 20% of the issued shares of the
business you work in. |
Direct debit |
the instruction which gives us the authority to collect
the premium from your bank or building society. |
| Disability |
an accident or sickness which a doctor (or consultant)
confirms prevents you from doing your normal work or any other work you
are reasonably able to do given your experience, education or training. |
| Disabled |
you are suffering from a disability. |
| Doctor |
a medical practitioner (other than you or a relative)
who is registered with the General Medical Council and working in the United
Kingdom, Channel Islands or Isle of Man. |
| Eligible
for cover |
you meet the eligibility requirements
of this Mortgage Protection Insurance policy (see section 8).
|
Employed
|
your employer is taking PAYE tax and national insurance
contributions for you and:
your work is permanent; or
you work on a fixed term contract and you have at least two years continuous
service.
If you work on a fixed term contract and you have less than two years continuous
service, you are not insured against your employer not renewing your contract
and your entitlement to receive monthly benefit will end on the date that
your contract should originally end. |
| End date |
the date cover under this Mortgage Protection Insurance policy ends (see
section 15). |
Exclusion period
|
a period of three calendar months immediately after
this Mortgage Protection Insurance policy start date. |
| Existing borrower
|
your mortgage has been in force for more than 30
days on this Mortgage Protection Insurance policy start date. |
| Free cover |
the period immediately after this Mortgage Protection Insurance policy start date
during which you will not have to pay any premium. The free cover you will
receive is shown on your certificate of cover. |
| Important facts |
the circumstances that you must reveal on or before
this Mortgage Protection Insurance policy start date (see section 22).
Lender the bank, building society or finance company that grants you a mortgage. |
| Monthly benefit |
the total amount of monthly cover you have under
this Mortgage Protection Insurance policy.
This is also the most we will pay you each month if you make a claim (this
will depend on the benefit split). The monthly benefit you have chosen is
shown on your certificate of cover. |
| Mortgage |
the first loan you took out with a lender and secured
against the property you are living in as your private home. |
| Mortgage payment
|
the normal monthly amount you must pay your lender
under the terms of your mortgage agreement (see section
2). |
| New borrower |
your mortgage has been in force for 30 days or less
on this Mortgage Protection Insurance policy start date. |
| Normal income |
if you are employed - the average monthly income
you have received before deductions (or if you are paid every week, the
monthly equivalent) during the past 12 months; or
if you are self-employed - the monthly average of your yearly income as
declared on your self- assessment return for the previous tax year. This
must be confirmed by the Inland Revenue. |
| Payment in lieu of notice
|
any payment, or any compensation for losing your
job (including any payment made under a compromise agreement), that relates
to any period of notice that you are entitled to, or should have been served
by your employer, under the terms of your contract of employment or letter
of appointment. |
Period of claim
|
any separate period of unemployment or disability
for which you are receiving monthly benefit. |
Policy |
the insurance cover we provide under these conditions. |
| Policy start date
|
the date cover begins as shown on your certificate
of cover. |
| Pre-existing medical
condition |
any condition or disease for which you received treatment,
medication or advice (including examinations or consultations to monitor
the condition) in the 12 months before this Mortgage Protection Insurance policy start date. |
Premium |
the monthly amount you pay to us by direct debit
for insurance under this Mortgage Protection Insurance policy. The monthly premium you pay is shown on
your certificate of cover. |
| Proposal |
your application for insurance under this Mortgage Protection Insurance policy including
the direct debit. |
| Proprietor |
you own (either alone or with others, except as a
shareholder) the business that you work in. |
Relative
|
your husband, wife, partner, or any other immediate
family member related to you by blood, marriage, or law. |
Self-employed
|
you are classed for taxation purposes as schedule
D and you have to make Class 2 national insurance contributions: and/or
you are a proprietor;
you are a controlling director; or
you are a relative of either the proprietor or a controlling director of
the business that you work in. |
| Single cover |
you alone, are insured for 100% of the monthly benefit.
|
Split cover
|
both people named on the certificate of cover are
insured for a percentage of the monthly benefit. |
| Type of cover |
unemployment and disability cover;
unemployment only cover; or
disability only cover.
The type of cover you have chosen is shown on your certificate of cover. |
| Unemployed |
you no longer have a job because of circumstances
beyond your control. |
| Unemployment |
you have become unemployed. |
| Waiting period |
means the first 30 days of any claim for unemployment
or disability as shown on your certificate. |
| We, us or
our |
Hamilton Insurance Company Limited. |
Work
|
you are actively employed or self-employed for at
least 16 hours a week and you are making the appropriate national insurance
contributions. |
You or your
|
the person or people named on your certificate of
cover. |
2. How this Mortgage Protection Insurance policy works
- You select the amount of cover you need to protect your mortgage payment.
Where your mortgage agreement allows you to make variable payments to your
lender (e.g. a flexible mortgage plan), this should be the average monthly
amount you intend to pay;
- You select the type of cover you require.
- You select the benefit split you require.
- You pay a monthly premium to keep this Mortgage Protection Insurance policy in force.
- We pay a fixed monthly benefit for up to 12 months if you are unemployed
or disabled (as applicable) for longer than the waiting period.
Important note - The most we will pay as a monthly benefit is £1,500
or an amount equal to 65% of your normal income, whichever is the lower.
3. The type of cover this Mortgage Protection Insurance policy provides
The type of cover provided under this Mortgage Protection Insurance policy is unemployment and disability insurance.
This will offer you maximum protection in the event of a claim. You can (if
required) restrict your policy to unemployment only cover or disability only
cover but you must be aware of the following facts:
- if you take out unemployment only cover you will not be able to claim for
any disability. If you suffer a disability during any period of unemployment,
your monthly benefit payments will be suspended until you are able to continue
actively seeking work; or
- if you take out disability only cover you will not be able to claim for
any unemployment. If you become unemployed during any period of disability,
you will only be able to continue to receive monthly benefit while you remain
disabled.
4. The number of people who can be insured under this Mortgage Protection Insurance (the benefit split)
- If your mortgage is in your name only, or your mortgage is in joint names
and you are the only person who is eligible for cover, we will issue single
cover in your name.
- If your mortgage is in joint names and both of you are eligible for cover,
you have the following options:
- you can take out single cover in your name and be insured for 100% of
the monthly benefit provided that you are the main income earner. The
restriction relating to main income earner will be waived if both parties
to the mortgage wish to be insured for 100% of the monthly benefit by
taking out two separate policies; or,
- you can take out split cover and you will both be insured for a percentage
of the monthly benefit. If you make a claim, we will divide your monthly
benefit in the same percentage as the normal income of each person at
the commencement of the claim.
5. Free cover for new borrowers
If you are a new borrower, you will receive three months free cover.
If you restrict your Mortgage Protection Insurance policy to unemployment only cover or disability only cover,
we will also restrict your free cover to the same type of cover.
6. Free cover for existing borrowers
If you are an existing borrower, you will receive three months free cover.
If you are an existing borrower, you will not be insured against unemployment
during the three month initial exclusion period.
If you restrict your Mortgage Protection Insurance policy to disability only cover, we will also restrict
your free cover to the same type of cover. If you have restricted your Mortgage Protection Insurance policy
to unemployment only cover, you will only be insured against disability during
the free cover period.
7. Transferring cover from another insurer
If you transfer your cover from another insurer, we will ignore the unemployment
exclusion period for existing borrowers as long as your existing Mortgage Protection Insurance policy has
been in force for at least six months and you have not made a claim under that
policy.
8. The eligibility requirements of this Mortgage Protection Insurance policy
You are eligible for cover under this Mortgage Protection Insurance policy if:
- you are at least 18 and under 65;
- you live and work in the UK;
- you are taking out this Mortgage Protection Insurance policy to protect the mortgage on the private residential
property you live in; and
- you agree to keep to this Mortgage Protection Insurance policy conditions.
You are not eligible for cover under this Mortgage Protection Insurance policy if:
- you are aware of any circumstances that may result in you becoming unemployed;
- your work is of a casual, temporary or seasonal nature;
- you work for a temporary employment agency;
- unemployment is a regular feature of your particular job; or
- you are currently disabled. This clause does not apply if you are on maternity
leave.
9. The waiting period under this Mortgage Protection Insurance policy
This Mortgage Protection Insurance policy has a 30 day waiting period
during which you will not be entitled to receive any monthly benefit if your
unemployment or disability lasts for 30 days or less. After that, you will receive
an amount equal to one monthly benefit payment on the 31st day you are still
unemployed or disabled.
10. When this Mortgage Protection Insurance policy pays out for unemployment
Subject to the exclusions detailed in section 11, we
will pay out for unemployment if:
- you are unemployed and you are registered as available for work (unless
you are exempt) at an employment office (or equivalent) in the UK; and
- you can provide independent evidence that you are actively looking for permanent
work.
We will consider the first day of your unemployment to be the day you are first
registered as unemployed and available for work (unless you are exempt) at an
employment office (or equivalent) in the UK and receiving the appropriate national
insurance credits. If you are receiving payment in lieu of notice the waiting
period will not begin until your payment in lieu of notice period has ended.
11. What prevents this Mortgage Protection Insurance policy paying out for unemployment
(the exclusions)
We will not pay out for unemployment if:
- You do not tell us about your claim for unemployment within six months of
the event.
- You were aware at the start date of any circumstance that would lead to
you making a claim for unemployment, or in our reasonable opinion, you should
have been aware.
- You were not in continuous work for the six month period immediately before
your first claim for unemployment. This clause will be waived if you were
in continuous work for the six month period immediately before the start date.
- Your work is of a casual, temporary or seasonal nature (including any work
for a temporary employment agency), or unemployment is a regular feature of
your particular job.
- You resign, retire, leave your occupation voluntarily or you accept early
retirement in lieu of unemployment.
- Your unemployment occurs as a result of:
- your misconduct including fraud, dishonesty, breach of contract or any
other circumstance that resulted in your employer taking disciplinary
action against you;
- your failure to meet the standards or targets laid down by your employer
- your participation in any industrial action;
- the expiry of an apprenticeship or training contract;
- civil unrest, war, radioactive contamination or any other related event.
- Your unemployment happens while you are working away from the UK for more
than 90 days in a row. This clause will not apply if you:
- work for the British Armed Forces or as a Civil Servant in a British
embassy or consulate;
- work for a company that is registered within the UK and your employer
asks you to work within the European Union.
- You are receiving payment in lieu of notice.
- Your unemployment occurs as a result of any disability.
12. When this Mortgage Protection Insurance policy pays out for disability
Subject to the exclusions detailed in section 13, we
will pay out for disability if:
- you were actively working when your disability occurred; and
- you cannot work as a result of the disability you are claiming for and you
are under the regular care and attendance of a doctor (or consultant).
We will consider the first day of your disability to be the day on which a
doctor (or consultant) first certifies that you are unable to work due to the
disability you are claiming for.
13. What prevents this Mortgage Protection Insurance policy paying out for disability
(the exclusions)
We will not pay out for disability if:
- You do not tell us about your claim for disability within six months of
the event.
- You were aware at the start date of any circumstance that would lead to
you making a claim for disability under this Mortgage Protection Insurance policy, or in our reasonable opinion
you should have been aware.
- Your disability is caused by a self-inflicted injury, alcohol abuse, drug
abuse or you fail to follow any medical advice.
- Your disability is caused by stress, anxiety, depression or any other nervous
disorder unless a suitably qualified consultant certifies that the condition
prevents you from working.
- Your disability is caused by any pre-existing condition.
- Your disability is caused by pregnancy or a normal pregnancy related condition
(other than a medical complication which happens as a result of your pregnancy).
- Your disability is caused by backache or a back related condition where
there is no physical or radiological evidence of a medical abnormality unless
a suitably qualified consultant certifies that the condition prevents you
from working.
- Your disability arises from any operation or treatment which is not medically
necessary.
- You are doing any other job for payment or reward or you are receiving any
form of payment or reward for helping, managing or carrying out any part of
the day to day running of your business.
- Your disability is caused by any of the unemployment exclusions.
14. Cancellation rights under this Mortgage Protection Insurance policy
You can cancel this Mortgage Protection Insurance policy by writing to us and your cover will end on the day
we receive your written request. If you cancel this Mortgage Protection Insurance policy within 30 days of
the start date, we will refund any premium you have paid. We will not refund
any premium if you cancel this Mortgage Protection Insurance policy more than 30 days after the start date.
We can cancel this Mortgage Protection Insurance policy by giving you 90 days written notice. This will not
affect your right to receive claim benefits for any unemployment or disability
which occurred before the cancellation date.
15. When cover under this Mortgage Protection Insurance policy will terminate (the
end date)
Cover will end on the date that one or more of the following events should occur:
- you die;
- you retire from work or reach the age of 65;
- your mortgage comes to an end (unless we have agreed to transfer your cover);
- the property named on your mortgage agreement becomes the subject of repossession
proceedings in a county court or high court;
- your premium becomes more than 30 days overdue;
- you no longer reside in the UK; or
- you or we cancel this Mortgage Protection Insurance policy.
16. General conditions for making a claim
- This Mortgage Protection Insurance policy only pays out if:
- your unemployment or disability occurs after the start date and before
the end date;
- you meet all the claim requirements under these policy terms and conditions;
- you have paid all your premiums; and
- you give us all the evidence we need to check your claim.
- You cannot claim for unemployment and disability at the same time.
- If you restrict your Mortgage Protection Insurance to unemployment
only cover or disability only cover, we will only pay for a claim arising
from the specific type of cover you have selected.
- We will reduce your monthly benefit if it is more than 65% of your normal
income.
- If you have any other unemployment or disability insurance, we reserve the
right to reduce your monthly benefit by an amount equal to the claim benefits
you receive under that insurance.
- You can transfer a claim between unemployment and disability (or vice versa)
but if you do, we will not pay more than 12 monthly benefit payments for that
period of claim.
- You can make a completely new claim under this Mortgage Protection Insurance policy as long as you have
returned to work for at least 90 days in a row. We will treat two claims separated
by less than 90 days work in a row as the same period of claim and you will
only be entitled to receive the balance of any monthly benefit payments left
from the previous period of claim. We will reduce this period to 30 days for
any claim arising from a medical condition that is not related to the disability
that brought about the previous claim.
- We will not pay any monthly benefit if you give us any false, misleading
or fraudulent information, or if you fail to tell us about any important fact.
- If you make a claim for unemployment and you are offered a temporary job,
you can suspend your claim provided that:
- you tell us beforehand who you will be working for;
- your temporary job lasts for at least one week and no longer than six
months; and
- you do not have more than three separate temporary jobs during any one
period of claim.
17. What to do if you have to make a claim
If you want to make a claim under this Mortgage Protection Insurance policy, you should contact:
Paymentshield Claims Department
P O Box 229, Southport, PR9 9WU.
Phone: 0870 759 4020; Fax: 0870 759 4021
We will send you a claim form which you must fill in and return to us as soon
as possible, together with any further evidence we may need. You will also need
to provide the following information:
- unemployment - evidence that you are still unemployed and actively looking
for work; or
- disability - evidence that you are still disabled and that you are still
under the regular care and attendance of a doctor (or consultant).
18. When we will make claim payments
Your initial claim payment will be made on the first day immediately after the
waiting period.
After that, we will pay an amount equal to 1/30th of the monthly benefit for
each day you are still unemployed or disabled. We will continue to make payments
monthly in arrears until the earliest of the following events:
- the last day you are unemployed or disabled;
- the date on which you stop giving us evidence that you are still unemployed
or disabled;
- the date on which you have received 12 monthly benefit payments for any
one claim; or
- the end date of this Mortgage Protection Insurance policy.
19. Obligations and rights when making a claim
You must have an independent medical examination if we believe it necessary
to validate your claim (we will pay the cost of the examination). If you fail
or refuse to have a medical examination and you do not give us a satisfactory
reason, we will not pay any monthly benefit.
We reserve the right to contact any other person or organisation that we consider
necessary to assist in the validation of your claim and where necessary, you
must provide us with the relevant authority to obtain this information. We can
also ask to see your personal bank or financial statements.
We may arrange a personal interview with you to help you look for further permanent
work.
We will only begin to make monthly benefit payments when we receive full and
satisfactory evidence of your eligibility to claim. If you delay sending us
the claim form or any other evidence we require, your claim may be harder to
check. This may lead to us paying monthly benefit late or not paying it at all.
20. The paying of premiums
Premiums are payable monthly in advance by direct debit. If you make a claim
under this Mortgage Protection Insurance policy, you must continue to pay your premium as it falls due. We
will increase your monthly benefit to reimburse any premium you have paid during
a period of claim.
We can change your premium by giving you 30 days notice in writing.
The premium you pay includes Insurance Premium Tax at the current rate. If we
are required by law to increase the level of Insurance Premium Tax or to make
any other charges, we will increase your premium from the date any such changes
are implemented.
21. Making sure your mortgage is protected
If your mortgage payment alters due to interest rate changes, you can amend
your monthly benefit (without notice) provided that you tell us within 30 days
of the notification from your lender.
If you want to alter your monthly benefit for any other reason or you want to
amend the type of cover or benefit split you hold under this Mortgage Protection Insurance policy, you will
need to give us 90 days written notice.
22. Important facts you will need to disclose on
or before the start date
You must tell us if:
- You are under the age of 18 or over 64.
- You work or live outside the UK.
- You would not be eligible to register as unemployed in the UK.
- You are not actively working for at least 16 hours a week.
- You are aware of any impending unemployment which may affect you.
- You are aware of any redundancies, restructure or reorganisation within
the business you work in, even if you do not believe these actions will result
in you becoming unemployed.
- You are aware of any financial or contractual threat to the business you
work in, even if you do not believe these actions will result in you becoming
unemployed.
- You have been registered as unemployed within the last 12 months.
- Your employer has taken any disciplinary action against you including performance
related issues.
- Your work is of a casual, temporary or seasonal nature (including any work
for a temporary employment agency) or unemployment is a regular feature of
your particular job.
- You have a pre-existing condition which may result in you having to take
time off work or you are currently unable to work because of a disability
(including any maternity leave).
- You are using your mortgage for commercial purposes (including buy to let
mortgages) or you are not living in the mortgaged property.
23. Circumstances that may affect your continuing cover under this Mortgage Protection Insurance policy
You must tell us if:
- You start to work or reside outside the UK.
- You resign, retire or stop working voluntarily.
- Your status changes from employed to self-employed (or vice versa).
- You start working for less than 16 hours a week.
- Your mortgage ends or your lender issues proceedings against you because
you have missed too many mortgage payments.
- You have, or take out, any other unemployment and/or disability insurance.
24. General conditions that apply to this Mortgage Protection Insurance policy
- If you do not keep to this Mortgage Protection Insurance policy conditions, we will not pay any monthly
benefit.
- We will cancel your Mortgage Protection Insurance policy and not
pay any monthly benefit if you give us any false, misleading or fraudulent
information, or if you fail to tell us about any important fact. Under these
circumstances, we may refund a percentage of any premium you have already
paid.
- Unless we agree otherwise in writing, English law is the law that will apply
to this Mortgage Protection Insurance policy.
- The contract between you and us is made up of:
- this Mortgage Protection Insurance policy;
- the certificate;
- any endorsements;
- your proposal; and
- any other written statement or information you give us.
- This Mortgage Protection Insurance policy will not have any cash-in
value.
- We may change this Mortgage Protection Insurance policy by adding an endorsement to it. We will let you
know at least 30 days before any endorsement comes into force. If we add an
endorsement to this Mortgage Protection Insurance policy, we will not be entitled to make any further endorsement
within the next 180 days.
- All administration procedures will be carried out on our behalf by the administrator.
- We will pay the monthly benefit covering your mortgage payment to your lender.
We will deduct from your monthly benefit any amounts we are required to deduct
by law.
25. What you should do if you have a complaint
We try to provide a first-class standard of service. If you do have a complaint,
please write to:
The Managing Director,
Paymentshield Limited, PO Box 229, Southport PR9 9WU
Phone: 0870 759 4010 or Fax: 0870 759 4011
If the matter is not sorted out to your satisfaction, please write to:
The Chief Executive,
Hamilton Insurance Company Limited
North Street, Winkfield, Windsor, Berkshire SL4 4TD.
If you are still not satisfied, you can ask either of the following organisations
to review your case:
- The Insurance Ombudsman (IOB):
135 Park Street, London SE1 9EA. Phone: 0845 600 6666; or
- The Association of British Insurers (ABI):
51 Gresham Street, London EC2V 7HQ. Phone: 0207 600 3333.
If you contact the Insurance Ombudsman (IOB) or the Association of British
Insurers (ABI), this will not affect any right of legal action you may have
under this Mortgage Protection Insurance policy. Your interests are
also protected under the Policyholders Protection Act. You can get details
from the Policyholders Protection Board at the Association of British
Insurers (ABI).
26. Access to medical records
We may ask the doctor (or consultant) who is caring for you to fill in a medical
report so we can deal with your proposal for this insurance. To do this, we
need your permission. Please sign the Access to Medical Reports Act 1988 (in
Northern Ireland The Access to Personal Files and Medical Reports (Northern
Ireland) Order 1991) declaration contained on the proposal.
You do not have to give your permission to our Chief Medical Officer being given
the report. However, under these circumstances, we may be unable to process
your proposal. If you give your permission, you have the right to tell your
doctor (or consultant) that you want to see the report before it is sent to
us. In this case, your doctor (or consultant) cannot send it to us unless you
have either seen the report or 21 days have passed without you contacting your
doctor (or consultant) to arrange to see the report. If at first you decide
that you do not want to see the report but you change your mind before your
doctor (or consultant) sends us the report, you can tell your doctor (or consultant).
You will then have 21 days to see the report. We may not be able to go ahead
with your proposal without medical information. As a result, the sooner you
act, the quicker we can consider your proposal for this insurance. Whether or
not you ask to see the report before it is sent to us, your doctor (or consultant),
if you ask, must let you see a copy for up to six months after they send it
to us. If you ask for a copy of the report, your doctor (or consultant) may
charge a reasonable fee to cover the cost.
If you see the report before it is sent to us, your doctor (or consultant) cannot
send it to us until he or she has your permission. You can ask your doctor (or
consultant) to change any part of the report, and if they refuse you can ask
your doctor (or consultant) to send us a separate statement with the report
giving the reasons why you consider it to be wrong or misleading. Your doctor
(or consultant) can refuse to let you see any part of the report that in his
or her opinion would be likely to cause you or others any physical or mental
harm. They can refuse if any part of the report may reveal information about
another person unless that person gives permission or has cared for you in a
professional way. In these cases, your doctor (or consultant) must tell you.
You could then see any other part of the report. If it is the whole report that
is affected, your doctor (or consultant) must not send it to us unless you give
your permission.
27. Data protection act notification
We may use the personal details provided by you, or any third parties, to:
- give you quotations and administer your Mortgage Protection Insurance policy;
- support the development of our business by including your details in client
surveys; or
- assist in market research
We have a set of practices in place to ensure that confidential information
(including medical & lifestyle) about you is held securely. We may also
share these details with other insurance organisations to help offset risks,
administer your Mortgage Protection Insurance policy, handle claims and prevent fraud.
We will store your details on computer but we will not keep them for longer
than necessary. Under the terms of the Data Protection Act 1998 you are entitled
to a copy of all the information we hold about you for which a reasonable fee
may be charged.
28. The insurer and administrator
This Mortgage Protection Insurance policy is underwritten by Hamilton
Insurance Company Limited, North Street, Winkfield, Windsor, Berkshire SL4 4TD.
The administrator is Paymentshield Limited, PO Box 229, Southport PR9 9WU.
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