Sports Injury Insurance

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Fills the gaps other insurance leaves behind

Sports Injury

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Who is the insurer?

This policy is underwritten by Pinnacle Insurance plc. helpucover is a trading style of Pinnacle Insurance plc. Pinnacle Insurance plc is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

What is Sports Injury insurance?

This insurance provides you with coverage, for Sports Injury which occurs whilst playing sport or training, anywhere in the world.

It will provide protection in the event of a sporting injury, offering financial compensation for a range of injuries. It also provides income replacement in the event that you are medically unfit to work as a result of a sporting injury, subject to certain terms and conditions being met. Eligibility

You will be eligible to become insured under the policy, if at the start date:

(i) you are over 18 years and under 60 years of age; (ii) you have fully completed the application form and

have been accepted by us for insurance under the policy;

(iii) you are permanently living in the United Kingdom, the Channel Islands or the Isle of Man; and (iv) you are an amateur sportsperson.

What are the benefits and features?

Sports Injury benefits include compensation for broken bones, permanent loss of sight, dental cover, help towards physiotherapy costs, hospital cash and income replacement. In order to claim benefit under this policy, you must:

• have suffered an accidental bodily injury whilst playing sports or training during the period of insurance;

• satisfy the definition of ‘amateur sportsperson’ as set out in Section 2 of the Policy; and

• have paid the premium and continue to do so during your claim.

Benefits are payable at the rates shown in the Table of Benefits overleaf.

For full details, please refer to Section 5 of your policy document.

Payment of benefits will depend upon you providing us with the information (as listed in Section 7 of your policy document) regarding your accidental bodily injury and the surrounding circumstances.

What am I NOT covered for?

Benefit will not be payable as a result or consequence of any of the following:

• self-inflicted injury occurring whilst sane or insane; • participating in a sport other than as an amateur

sportsperson;

• participating in certain dangerous or hazardous sports as listed in Section 6 (iv) of your policy document;

• any injury which is diagnosed by a doctor more than 7 days after the event which caused the injury; • playing sport whilst under medical instruction not to

do so, or whilst otherwise unfit to do so; or • any dental accident/injury that occurs whilst you

have failed to wear a mouth guard approved by the British Dental Health Foundation, when participating in a sport that requires such protection.

For a full list of exclusions, please refer to Section 6 of the policy document.

How long does the contract run for?

The contract will end if you cease to be an amateur sportsperson, when you reach 65 years of age, you fail to pay the monthly premium when due or the date you or we cancel this policy.

You may consider it appropriate to review the level of benefit provided by your policy on a regular basis to check whether it is sufficient for your needs.

Premiums

The amount you pay for cover may change during the time you have this policy. This may be because of changes to our expected future costs. We will only change your premium for this reason where there is a change to the specific factors we have set out in your policy, and that change results in our expected future costs being higher or lower than assumed when the premium was set. This may include changes to our expected future claims costs due to changes in the cost of medical treatments (e.g. physiotherapy).

We will review your premium at least annually and you will be given at least 30 days’ written notice of any alteration to the premium rates under this policy unless the change is due to legislative, tax or regulatory requirements. We may review your premium more frequently than annually if it becomes necessary due to significant changes in any of the specific factors referred to above. Except where your premium is changed due to legislative, tax or regulatory requirements, the minimum period between consecutive changes will be 180 days. As a result of the premium review, your monthly premium may go up, stay the same or go down, and there is no limit to the amount of any change. If a review results in an increase to your premium and you do not wish to pay the increase you can contact us to discuss your options or cancel.

More information on the circumstances when your premium may change is contained in Section 8 of your policy document.

You must continue to meet the conditions (i) to (iv) above to remain eligible for the levels of cover that apply to you. If your circumstances change or you no longer meet these conditions, you should contact us straight away.

This policy summary does not contain the full terms and conditions of the contract. Full terms and conditions can be found in the policy document 02413.

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Terms and Conditions

We may vary or waive the terms and conditions of this policy. This may be to:

• vary the cover provided under this policy because of changes to our expected future costs. We will only change your terms and conditions for this reason where there is a change to the specific factors we have set out in Section 8 of your policy, and that change results in our expected future costs being higher or lower than assumed when the premium was set. This may include changes to our expected future claims costs due to changes in the cost of providing medical treatments (e.g. physiotherapy); • improve your cover;

• comply with any applicable laws or regulations; • reflect any changes to taxation; or

• correct any typographical or formatting errors that may occur.

You will be given at least 30 days’ written notice of any alteration to the terms and conditions of cover under this policy unless the change is due to legislative, tax or regulatory requirements.

Except where the terms and conditions of cover under this policy are changed due to legislative, tax or regulatory changes, the minimum period between consecutive changes will be 180 days.

Such changes may have the effect of increasing or reducing the cover previously provided under this policy. If you do not wish to continue your cover you can contact us to discuss your options or cancel.

More information on the circumstances when your terms and conditions may change is contained in Section 11 of your policy document.

Your right to cancel

You can cancel your policy at any time.

If you cancel the policy within 30 days of receiving the policy documents, you will receive a full refund of any premium you have paid, provided you have not made a claim.

If you cancel your cover after this period, no refund will be payable.

To cancel please contact: Customer Services Department helpucover Pinnacle House A1 Barnet Way Borehamwood Hertfordshire WD6 2XX Telephone: 0330 123 1925

Our Right to Cancel

We may cancel your insurance cover immediately where there is evidence of dishonesty or exaggerated behaviour by you (or someone acting on your behalf) or where you have misrepresented or when asked failed to disclose something at the time of application which would have caused us to decline you for cover.

We may cancel your insurance cover by giving not less than 90 days’ written notice. We will only do this in the circumstances set out in Section 12 of your policy. How do I make a claim?

Please contact the: Claims Department helpucover Pinnacle House A1 Barnet Way Borehamwood Hertfordshire WD6 2XX Telephone: 0330 123 1925 online: www.support.cardifpinnacle.com How do I make a complaint?

If you have a problem with the service you receive, you can write to the:

Customer Relations Manager helpucover

Pinnacle House A1 Barnet Way Borehamwood Hertfordshire WD6 2XX

If we cannot resolve your complaint to your satisfaction you may be entitled to complain to the Financial Ombudsman Service.

Would I receive compensation if Pinnacle Insurance plc were unable to meet its liabilities? We are covered by the Financial Services Compensation Scheme (FSCS). If we are unable to meet our liabilities to you, you may be entitled to compensation from the FSCS. Further information is available from their website: www.fscs.org.uk

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TABLE OF BENEFITS Bronze Silver Gold

Fracture(s) of the:

(i) hip or pelvis (excluding coccyx);

(ii) leg (including heel and ankle but excluding kneecap), collar-bone, arm (including wrist and elbow) or skull (including jaw, nose and cheekbone); (iii) shoulder-blade, hand (excluding fingers) or foot

(excluding toes and heel). A dislocation of:

(i) spine or hip;

(ii) knee, ankle, collar-bone, elbow, wrist (excluding fingers);

(iii) any other joint requiring general anaesthetic or traction. £1,000 £500 £400 £500 £250 £150 £1,500 £750 £600 £750 £375 £225 £2,000 £1,000 £800 £1,000 £500 £300 Torn ligaments £200 £300 £500

Loss of sight £5,000 per eye

Dental Cover - for accidental bodily injury requiring dental

treatment we will pay 100% of costs up to a maximum of: £10,000 per policy year£2,500 per incident Hospital Cash Benefit - for accidental bodily injury requiring

treatment in hospital, a cash benefit is payable for each night you spend in hospital, payable for a maximum of 10 consecutive nights per claim and 21 nights per policy year:

£10 per night £15 per night £25 per night Income Replacement - if an accidental bodily injury, for

which we have paid benefits above, means you are unfit to work for 7 consecutive days or more, we will pay from the 8th day onwards, 1/30th of the monthly benefit for each continuous day you remain unfit for work.

This will be paid monthly in arrears up to a maximum of 3 monthly benefit payments. Regardless of whether you are working or not, you must be certified by a doctor as being medically unfit to work.

Up to £250 per month

Up to £750 per policy year

Up to £500 per month

Up to £1,500 per policy year

Up to £750 per month

Up to £2,250 per policy year

Physiotherapy Benefit - for accidental bodily injury, which subject to referral by your doctor, requires physiotherapy we will pay 75% of costs up to a maximum of:

£250

per policy year per policy year£500 per policy year£1,000

Note: For physiotherapy and dental benefits we will require a receipt together with the completed claim form confirming

the treatment undertaken. The physiotherapist or dentist confirming your treatment must be qualified, practising and registered with the appropriate professional governing body.

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UNDERWRITTEN BY : PINNACLE INSURANCE PLC

Head and Registered Office : Pinnacle House A1 Barnet Way Borehamwood Hertfordshire WD6 2XX United Kingdom Company Registered Number : 1007798

Policy Number : 02413 Date of Policy : 18thMay 2009

This policy is designed to provide you with Sports Injury cover provided you meet the eligibility requirements in Section 3 and you have paid the monthly premium. The policy will provide coverage for Sports Injury, which occurs whilst playing sport or training, anywhere in the world.

This policy provides you with everything you need to know about your cover and contains all the contractual terms and conditions of your cover including the exclusions.

Please read your policy and schedule carefully as together they explain the benefits that are available to

you and the criteria you must meet to qualify for those benefits. Please make sure that you:

• are eligible for the insurance cover; • know what level of benefit you have chosen;

know what is covered and what is not covered by this policy; and • understand the terms and conditions for making a claim.

This policy uses words and phrases that have specific meanings. You will find these explained in Section 2 “Definitions”. Defined words are shown in “bold” wherever they appear.

1. CONTACT DETAILS

As there may be times when you need to get in touch with us, we have put our contact details in this section so that they are easy to find.

If you need to speak to us please call: 0330 123 1925. Lines are open Monday to Friday, 8.30am to 6pm.

If you need to write to us, you should address your letter to the relevant department and send it to the address below: For general enquiries, amendments or cancellations: Customer Services Department

For claims: Claims Department

To make a complaint: Customer Relations Department

Address: helpucover*

Pinnacle House, A1 Barnet Way Borehamwood, Hertfordshire WD6 2XX

You can also download a claim form and track your claim online at: www.support.cardifpinnacle.com

Please inform us immediately of any change in your address or any other change affecting you which requires an alteration to your schedule.

*helpucover is a trading style of Pinnacle Insurance plc. Pinnacle Insurance plc is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

2. DEFINITIONS

The following words and phrases will have the following meanings where they appear in bold type.

“accident/accidental” means a sudden and unforeseen event which happens by chance after the start date; “amateur sportsperson” means an individual who derives no income from his or her participation in a sport; “benefit” means the amount of benefit as specified under Section 5;

“bodily injury” means injury to your body as specified in the Table of Benefits in Section 5 resulting from accidental,

external and violent means and occurring whilst playing sport or training (specifically excluding any sickness, disease or any naturally occurring condition or degenerative process);

“consultant” means a medical specialist registered under the Medical Act 1983 (as amended) who is a member of a

recognised Royal College (for example, the Royal College of Surgeons) and is recognised by that Royal College to be a consultant in the United Kingdom (or the equivalent recognised professional medical governing body in the Channel Islands, the Isle of Man or the country you have travelled to). A consultant cannot be you, your spouse, civil partner, a relative, close friend or someone who lives with you;

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“dislocation” means the displacement of bone from its normal position at the joint;

“doctor” means a qualified medical practitioner registered with the General Medical Council and working in the United

Kingdom, the Channel Islands or the Isle of Man (or the equivalent recognised professional medical governing body in the country you have travelled to). A doctor who confirms your bodily injury when you are making a claim cannot be

you, your spouse, civil partner, a relative or someone who lives with you; “end date” means the date your cover ends as set out in Section 9;

“fracture(s)/fractured” means one or more breaks in the continuity of the tissue of one or more bones which may or

may not require surgical treatment, traction, reduction under a local or general anaesthetic, or hospitalisation;

“hospital” means a lawfully operated establishment which has accommodation for residential patients with organised

facilities for diagnosis and surgery which provides 24 hour a day nursing services by registered nurses and

“hospitalisation” shall be construed accordingly;

“loss of sight” means total, permanent and irrecoverable loss of function, or loss by physical separation, of one or

both eyes;

“monthly benefit” means the amount of benefit as specified under Section 5 (v);

“monthly premium” means the amount specified in the schedule that you must pay us each month for insurance cover

under this policy;

“policy” means the insurance terms and conditions set out in this document;

“policy year” means the 12 month period immediately following the start date and each subsequent period of 12 months thereafter;

“schedule” means the letter we send you which shows details of your cover;

“start date” means the date your application for insurance is accepted by us as shown in the schedule; “torn ligament” means the breaking of the band of fibrous tissue which links the bones and strengthens joints; “we, us, our” means Pinnacle Insurance plc;

“you, your” means the person named on the schedule who has been accepted for insurance cover under this policy.

The singular shall include the plural and vice versa. Within this policy, headings are only included to help you and do not form part of the insurance contract.

3. ELIGIBILITY

You will be eligible to become insured under this policy, if at the start date you:

(i) are over 18 and under 60 years of age;

(ii) have fully completed the application form and have been accepted by us for insurance under this policy; (iii) are permanently living in the United Kingdom, the Channel Islands or the Isle of Man; and

(iv) are an amateur sportsperson.

You must continue to meet the conditions (i) to (iv) above to remain eligible for the levels of cover that apply to you.

If your circumstances change or you no longer meet these conditions, you should contact us straight away.

4. CHANGING THE LEVEL OF BENEFIT

If you want to change your level of benefit, you can do so at an anniversary of the start date. You must ask us in writing and we will confirm if we agree to the change in your level of benefit.

5. BENEFITS

We will pay the benefit described in the Table of Benefits directly to you, if you suffer an accidental bodily injury whilst

playing sport or training after the start date and before the end date.

6. WHEN YOU ARE NOT COVERED UNDER THIS POLICY

Benefit will not be payable under Section 5 above as a result or consequence of any of the following: (i) self-inflicted injury occurring whilst sane or insane;

(ii) committing a criminal act;

(iii) being under the influence of, or being affected by, alcohol or drugs unless prescribed by a doctor (other than prescribed for the treatment of drug addiction or alcohol dependency);

(iv) ballooning, boxing, martial arts, bungee jumping, caving, climbing, competing in any race (other than on foot or whilst swimming), competitive driving or riding of motorised vehicles, diving, horse riding, engaging in air travel, hang gliding, hunting, hydroplaning, ice hockey, ice skating, motor sports, mountaineering, parachuting, pot-holing, riding a motorcycle as a rider or passenger, skiing, use of sledges, skeletons, snow boards, snow mobiles, bobsleighs, toboggans or luge, water skiing, white water canoeing or white water rafting;

(v) any injury which is diagnosed by a doctor more than 7 days after the event which caused the injury; (vi) playing sport whilst under medical instruction not to do so, or whilst otherwise unfit to participate;

(vii) in contravention of any safety guidelines (including guidelines on protective clothing and equipment) published by the sports national body (where applicable); or

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TABLE OF BENEFITS Bronze Silver Gold

(i) (a) Fracture(s) of the:

(i) hip or pelvis (excluding coccyx);

(ii) leg (including heel and ankle but excluding kneecap), collar-bone, arm (including wrist and elbow) or skull (including jaw, nose and cheekbone);

(iii) shoulder-blade, hand (excluding fingers) or foot (excluding toes and heel).

(b) A dislocation of: (i) the spine or hip;

(ii) the knee, ankle, collar-bone, elbow, wrist (excluding fingers);

(iii) any other joint requiring general anaesthetic or traction. (c) Torn ligaments £1,000 £500 £400 £500 £250 £150 £200 £1,500 £750 £600 £750 £375 £225 £300 £2,000 £1,000 £800 £1,000 £500 £300 £500

(ii) Loss of sight £5,000 per eye

(iii) Dental Cover

For accidental bodily injury requiring dental treatment we will pay 100% of costs up to a maximum of:

£2,500 per incident £10,000 per policy year

(iv) Hospital Cash Benefit

For accidental bodily injury requiring treatment in hospital, a cash benefit is payable for each night you spend in hospital, payable for a maximum of 10 consecutive nights per claim and 21 nights per policy year:

£10 £15 £25

per night (v) Income Replacement

If an accidental bodily injury, for which we have paid benefits under Sections 5 (i) to (iv) above, means you are unfit to work for 7 consecutive days or more, we will pay from the 8thday onwards, 1/30thof the monthly benefit for each continuous day you remain unfit for work.

This will be paid monthly in arrears up to a maximum of 3

monthly benefit payments.

Up to £250 Up to £500 Up to £750 per month

Up to £750 Up to £1,500 Up to £2,250 per policy year

(vi) Physiotherapy Benefit

For accidental bodily injury, which subject to referral by your

doctor, requires physiotherapy we will pay 75% of costs up to a

maximum of:

£250 £500 £1,000

per policy year

Note: Payment of the benefit will depend upon you providing us with the information (as listed in Section 7)

regarding your accidental bodily injury and the surrounding circumstances.

For fracture benefits under Section 5 (i) (a) only one benefit payment will be paid per specified body part per

accidental bodily injury. For example, an accidental bodily injury resulting in one or more fractures to one

or more bones in the leg would receive one benefit payment in total and not one benefit payment per fracture or per fractured bone.

For physiotherapy and dental benefits we will require a receipt together with the completed claim form confirming the treatment undertaken. The physiotherapist or dentist confirming your treatment must be qualified, practising and registered with the appropriate professional governing body. The physiotherapist or dentist cannot be your spouse, your civil partner, someone who lives with you, a relative or close friend. For Income Replacement benefits, regardless of whether you are working or not, you must be certified by a

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7. CLAIMS

(i) You should request a claim form from us by using the contact details in Section 1.

The fully completed claim form should be returned to us together with any supporting evidence listed in this Section 7 as soon as possible, but no later than 90 days of the occurrence of the injury. All the relevant sections should be completed to avoid a delay in receiving benefits.

Continuing Claim Forms (if required) - to confirm your ongoing eligibility for benefit, we will ask you to fill in a continuing claim form each month. You must send this to us as soon as possible, but no later than 90 days from the date we last paid your monthly benefit.

Completion and postage of the claim form or the continuing claim form will be at your expense.

If any documents requested under this Section 7 are not received promptly our claims assessment process will be delayed which may prevent us paying your claim.

If the name of any document changes e.g. “Fit Note”, we will require you to send us the document which takes its place.

We will only ask for information relevant to your claim. If you are unable to supply any evidence listed in this

Section, we require then we may ask you for alternative evidence to support your claim.

(ii) To be able to process your claim quickly we will always request that you send us a fully completed claim form including the declaration section along with:

(a) medical report from your doctor or consultant;

(b) Fit Notes supplied to you by your doctor or consultant; and (c) receipts for physiotherapy treatment.

(iii) We may require medical evidence in addition to your doctor’s initial report, and/or ask you to undergo a medical

examination with a doctor or consultant appointed by us.

We will pay the costs of this additional medical evidence. If you refuse or the appointment is not kept, we will be

unable to validate and pay your claim. (iv) Benefits will be paid directly to you.

(vi) Interest will not be added to any amount payable.

8. PREMIUMS

(i) Each monthly premium covers you for one month. At the start of your insurance cover we may collect more than one monthly premium to make sure you are covered for the correct period.

(ii) This policy has reviewable premiums, which means that your monthly premium may change subject to us giving

you 30 days’ notice. When reviewing your premiums, we will only consider any future impact of one or more of

the following:

(a) changes due to new information arising from our own experience suggesting that our future claims experience is likely to be better or worse than previously assumed. This information includes changes to the number of claims we expect to pay, changes to the average expected duration of our claims payments or changes to the average expected amount paid per claim;

(b) changes due to new information arising from external sources such as general industry, population or reinsurer experience suggesting that our future claims experience is likely to be better or worse than previously assumed. This includes information on the cost of providing medical treatments e.g. physiotherapy costs

(c) relevant changes to our previous assumptions in relation to: (i) expenses related to providing the insurance;

(ii) policy lapse rates which means the average time policies are held; (iii) interest rates;

(iv) tax rates;

(v) the cost of any legal or regulatory requirements. (iii) Any changes to your premium we make will not:

(a) be made as a result of any reason other than changes in the assumptions mentioned above; (b) be based on whether you have made a claim; or

(c) be made to recover any previous losses.

(iv) We will review your premium at least annually and you will be given at least 30 days’ written notice, at your last known address, of any alteration to the premium rates under this policy unless the change is due to legislative, tax or regulatory requirements. If your premium is changed due to legislative, tax or regulatory requirements which are outside our control, then we may not be able to give you 30 days’ notice.

(v) We may review your premium more frequently than annually if it becomes necessary due to significant changes

in any of the assumptions referred to above. Except where your premium is changed due to legislative, tax or regulatory requirements, the minimum period between consecutive premium changes will be 180 days. (vi) As a result of the premium review, your monthly premium may go up, stay the same or go down, and there is no

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(vii) If we change your monthly premium and you do not wish to continue your cover you should contact us to discuss your options. Depending on the type of policy you have, you may be able to change the amount of your

benefit or change your type of cover. Alternatively you can cancel as set out in Section 10.

(viii) You must continue to pay your monthly premium while you are making a claim under this policy to ensure that cover can continue after your claim has ended. If, during a claim, you cancel your policy or fail to pay the

monthly premium when due we will continue to pay the benefit provided that the claim was made prior to the

date on which you cancelled or first failed to pay the monthly premium when due. You will not, however, be covered for any new claim made on or after that date.

9. WHEN COVER ENDS

(i) All cover under this policy and all benefits shall automatically end on the earliest to occur of the following: (a) the date you cease to be an amateur sportsperson;

(b) the date you reach 65 years of age;

(c) the date you fail to pay the monthly premium when due;

(d) the date you cancel your insurance as set out under the terms of this policy; or (e) the date we cancel your insurance in accordance with Section 12 “Our Right To Cancel”. (ii) If you are already receiving benefits for a valid claim, we will continue to pay the benefit provided that:

(a) the event leading to your claim occurred prior to the date you cancelled your policy or the date the monthly

premium was not paid when due; and

(b) cancellation was not due to dishonesty or exaggerated behaviour, misrepresentation or when asked failure to disclose a material fact you (or by someone acting on your behalf).

You will not be covered for any new claim arising on or after the cancellation date.

(iii) When this policy ends it will not have any cash or surrender value, other than any premium refund that may arise under Section 10 below.

10. YOUR RIGHT TO CANCEL

(i) Within the “cooling off period” - if you decide you do not want the cover and wish to cancel your policy, you can do so within 30 days of the start date or the date you receive these policy documents, whichever is the later (the “cooling off period”). You will receive a full refund of any monthly premium you have paid provided no claim has been made under the terms of this policy. If you have made a claim, no refund of monthly premium will be payable.

(ii) Outside the “cooling off period” - if you cancel outside the initial 30 day cooling off period, no refund of monthly

premium will be payable.

(iii) If we change your monthly premium and/or vary or waive your terms and conditions and you do not wish to continue your cover you should contact us to discuss your options. Alternatively you can cancel without notice and without penalty. Any cancellation will take effect at the end of the period for which you have already paid your

monthly premium.

(iv) All cancellation requests should be made to us. For contact details, please see Section 1.

11. TERMS AND CONDITIONS

(i) We may vary or waive the terms and conditions of this policy to reflect changes in the assumptions set out in

Section 8 (ii) (c) above which we use to design and price your insurance cover. Such changes may have the effect of increasing or reducing the cover previously provided under this policy.

(ii) When changing your terms and conditions we will only consider any future impact of changes in one or more assumptions due to the reasons set out in Section 8 (ii) (c) above.

(iii) In addition, we may also vary or waive your terms and conditions to: (a) improve your cover;

(b) comply with any applicable laws or regulations; (c) reflect any changes to taxation;

(d) correct any typographical or formatting errors that may occur.

(iv) You will be given at least 30 days’ written notice to your last known address of any alteration to the terms and conditions of cover under this policy unless the change is due to legislative, tax or regulatory requirements. If your cover is changed due to legislative, tax or regulatory changes which are outside our control, then we may not be able to give you 30 days’ notice.

(v) Except where the terms and conditions of cover under this policy are changed due to legislative, tax or regulatory changes, the minimum period between consecutive changes will be 180 days.

(vi) Any changes to your terms and conditions we make will not:

(a) be made as a result of any reason other than changes in the assumptions mentioned in Section 8 (ii) (c) or for the reasons set out in this Section 11 (iii) above;

(b) be based on whether you have made a claim; or (c) be made to recover any previous losses.

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12. OUR RIGHT TO CANCEL

(i) We may cancel your policy immediately:

(a) where there is evidence of dishonesty or exaggerated behaviour by you (or by someone acting on your behalf) in relation to the cover provided under this policy;

(b) where you deliberately tell us something which is untrue or misleading in response to any question we ask

you when you take out cover under this policy, or apply to vary your cover under this policy (or we can

demonstrate from the relevant circumstances that you did not take reasonable care to ensure the statements

you made to us were true);

(c) where when asked, you unintentionally tell us something which is untrue or misleading in response to any question we ask you when you take out cover under this policy which, if correctly represented at the time of application, would have caused us to decline you for cover; or

(d) where necessary to comply with any applicable laws or regulations.

If your policy is cancelled as a result of Section 12 (a), (b) or (d), we will not return any monthly premiums you have paid under the terms of this policy. If your policy is cancelled as a result of Section 12 (c), we will return any monthly

premiums you have paid under the terms of this policy provided no claim has been made.

(ii) We may cancel your insurance cover by giving not less than 90 days’ written notice:

(a) in the unlikely event that for any of the reasons listed in Section 8 we expect to experience unsustainable losses for the particular country or market sector that applies to your policy; or

(b) if we decide for reasons of strategy or cost that it is no longer viable for us to continue to provide cover within the particular country or market sector that applies to your policy.

(iii) Any decision to cancel cover will not be made at an individual level and will not be based on whether you have made a claim, except where Section 12 (a), (b) or (c) applies.

(iv) Cancellation of your policy will not affect your entitlement to claim for any event occurring before the date of cancellation, except where Section 12 (a), (b) or (c) applies.

13. INVALID BENEFIT PAYMENTS

If we make any payments as a result of dishonesty or exaggerated behaviour (or by someone acting on your behalf),

you will no longer be entitled to any benefits under this policy and we may demand that any payments made by us are

paid back. We may take legal action against you for the return of such monies and we may demand that you reimburse

us for any costs incurred.

We have a regulatory obligation to prevent fraud. In the event of a claim, any information you have supplied relevant to

this insurance and on the claim form, together with other information relating to the claim may be shared with other insurers in order to prevent fraudulent claims.

14. GENERAL CONDITIONS

(i) You must respond honestly to any request for information we make when you take out cover under this policy, or

apply to vary your cover under this policy. In the event that any statement of fact you make is untrue or misleading, this may affect the validity of your policy, and whether you can make a claim.

(ii) Benefits cannot be paid to anyone else or in any way other than as described in this policy.

(iii) When your cover under this policy ends it will not have any cash or surrender value. (iv) The rights given under this policy cannot be transferred to anyone else.

(v) A person who is not a party to the contract of insurance set out in this policy shall have no rights under the Contracts (Rights of Third Parties) Act 1999 (the Act) to enforce any term of this policy provided that this shall not affect any right or remedy of any person which exists or is available otherwise than pursuant to the Act. (vi) We are covered by the Financial Services Compensation Scheme (FSCS). If we are unable to meet our liabilities

to you, you may be entitled to compensation from the FSCS. Further information is available from their website: www.fscs.org.uk

(vii) This policy is governed by English law. Any legal proceedings will be held in the courts of England and Wales unless you live in Scotland, Northern Ireland, the Channel Islands or the Isle of Man, in which case you will be entitled to commence legal proceedings in your local courts.

(viii) We will use the English language in all documents and communications relating to this policy. (ix) To improve the quality of our service, we will be monitoring and recording some telephone calls. (x) Failure to comply with any condition of this policy may result in the suspension or the stopping of benefits.

15. ENQUIRIES AND COMPLAINTS

STEP 1 While it is always our intention to provide a first class standard of service, if you do have any concerns regarding your insurance cover, please address them to us. For contact details, please see Section 1.

STEP 2 Should you remain dissatisfied with the outcome of any internal enquiries, you have the right to refer

your complaint to the Financial Ombudsman Service, Exchange Tower, Harbour Exchange Square,

London E14 9SR.

(12)

Figure

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References

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