POLICY TERMS AND CONDITIONS.
嚜燜ERM ASSURANCE AND CRITICAL ILLNESS COVER
POLICY TERMS
AND CONDITIONS.
CONTACT US
Legal & General Assurance Society Limited
Registered in England No.166055
Registered office: One Coleman Street, London EC2R 5AA
We are authorised and regulated by the Financial Services Authority.
We are members of the Association of British Insurers.
W13368 11/11
T&C 51
Please keep these documents in a safe place,
in case you need to refer to them later.
This pocket contains your policy schedule.
You should read this in conjunction with the
printed policy terms and conditions.
TERM ASSURANCE AND CRITICAL ILLNESS COVER 每 POLICY TERMS AND CONDITIONS
Our, us or we
Legal & General Assurance Society Limited.
Permanent
Expected to last throughout the insured person＊s life, irrespective of when the cover ends or the
insured person retires.
Permanent neurological deficit with persisting clinical symptoms
Symptoms of dysfunction in the nervous system that are present on clinical examination and
expected to last throughout the insured persons life. Symptoms that are covered include numbness,
hyperaesthesia (increased sensitivity), paralysis, localised weakness, dysarthria (difficulty in
swallowing), visual impairment, difficulty in walking, lack of coordination, tremor, seizures, lethargy,
dementia, delirium and coma.
Policy
This policy issued by us, which consists of the policy terms and conditions and policy schedule.
Policy expiry date
The date that cover under this policy will end, as shown in your policy schedule.
Policy schedule
The schedule which shows the cover that you have and forms part of this policy.
Policy start date
The start date of this policy, as shown in your policy schedule.
Pre-existing condition
A pre-existing condition is any medical condition, disorder or handicap from which a child is already
suffering before the latest of:
? the date the policy is issued,
? the 30th day after the child＊s birth,
? for legally adopted children, the date of adoption.
Premium(s)
The amount you pay to us for this policy as shown in your policy schedule.
Principal office
Our principal office is:
City Park
The Droveway
Hove
East Sussex
BN3 7PY
Product
The type of cover, as shown in your policy schedule.
Relevant child
A natural child, legally adopted child (from the date of adoption) or stepchild of the life assured,
while such a child is aged more than 30 days and less than 18 years during the term of the policy.
Retail Prices Index (RPI)
The Retail Prices Index (RPI) provides an indication of inflation on a monthly basis. The RPI measures
and tracks the average change in the purchase price of goods and services such as housing expenses
and mortgage interest payments.
Successor in title
The person(s) legally entitled to the life assured＊s estate upon the death of the life assured.
Sum assured
The amount of Term Assurance and Critical Illness Cover, as shown in your policy schedule. If
reviewable premiums are included in your policy schedule, this amount may change as described
in section 7.3.
If decreasing cover was chosen, the table in your policy schedule will show how the amount of
Term Assurance and Critical Illness Cover decreases.
You or your
The policyholder(s) of the policy who is/are legally entitled to receive the sum assured and shown
as the ※grantee§ in the policy schedule. This may include trustee(s), assignee(s) or personal
representative(s) (where appropriate) and may be the same person(s) as the life assured.
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TERM ASSURANCE AND CRITICAL ILLNESS COVER 每 POLICY TERMS AND CONDITIONS
CONTENTS.
1. INTRODUCTION
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2. MAIN COVER
2.1 Who is covered?
2.2 How much cover is provided?
2.3 How long does this cover last?
2.4 How is the sum assured paid?
2.5 When is the sum assured payable?
2.6 Who is the sum assured paid to?
2.7 Exclusions
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3. CRITICAL ILLNESS COVER
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4. ADDITIONAL COVER
4.1 Mastectomy for Ductal Carcinoma In Situ
4.1.1 Exclusions
4.2 Children＊s Critical Illness Cover
4.2.1 Conditions
4.2.2 Exclusions
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5. GUARANTEED INSURABILITY OPTION
5.1 Increasing the sum assured
5.1.1 When can you use the guaranteed insurability option?
5.1.2 Conditions
5.2 Business Protection 每 Increasing the sum assured
5.2.1 When can you use the guaranteed insurability option?
5.2.2 Conditions
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6. WAIVER OF PREMIUM BENEFIT
6.1 Conditions
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7. PAYMENT OF PREMIUMS
7.1 When are premiums due to be paid?
7.2 Will the amount you pay ever change?
7.3 Reviewable premiums
7.3.1 Options at your premium review
7.4 What happens if you don＊t pay your premiums?
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8. GENERAL CONDITIONS
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9. HOW TO＃
9.1 Contact us
9.2 Make a claim
9.3 Change this policy
9.4 Cancel this policy
9.5 Make a complaint
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10. THE FINANCIAL SERVICES COMPENSATION SCHEME (FSCS)
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11. DEFINITIONS EXPLAINED
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TERM ASSURANCE AND CRITICAL ILLNESS COVER 每 POLICY TERMS AND CONDITIONS
1
INTRODUCTION
This policy sets out your contract with us and should be kept in a safe place. Words that appear
in blue bold are explained in section 11.
This policy consists of:
? the policy schedule and
? these policy terms and conditions.
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MAIN
COVER
MAIN
COVER
The main cover provided by this policy is:
? Life Cover, and
? Critical Illness Cover.
We will pay the sum assured if the life assured:
? dies or,
? is diagnosed with a critical illness as defined in section 3,
whichever occurs first, on or after the policy start date and on or before the policy expiry date.
2.1 Who is covered?
The life assured is covered.
2.2 How much cover is provided?
The amount of cover provided is the sum assured as shown in the policy schedule.
2.3 How long does this cover last?
This cover starts on the policy start date and ends on:
? the payment of the sum assured, or
? if no sum assured becomes payable, the policy expiry date.
Once this policy ends, no further benefits or premiums will be payable.
2.4 How is the sum assured paid?
The sum assured is paid as a lump sum unless otherwise shown in the policy schedule.
2.5 When is the sum assured payable?
The sum assured is payable on the death or diagnosis with a critical illness of the life assured, or
for a joint life policy, when the first of the lives assured dies or is diagnosed with a critical illness.
2.6 Who is the sum assured paid to?
The sum assured is paid to you or your successors in title.
2.7 Exclusions
We will not pay the sum assured:
a) In any circumstances that are shown under the exclusions section in your policy schedule.
b) If within the first year of this policy the life assured commits suicide, in which case this policy
will be void. This condition will not apply where a mortgage lender is legally entitled to the proceeds
of this policy, in which case we will pay the mortgage lender the lower of:
i) the benefits payable under this policy; and
ii) the amount the mortgage lender is legally entitled to.
TERM ASSURANCE AND CRITICAL ILLNESS COVER 每 POLICY TERMS AND CONDITIONS
3
CRITICAL ILLNESS COVER
If the life assured both contracts and is diagnosed with a critical illness as defined below, on or
after the policy start date and on or before the policy expiry date, the sum assured will be payable.
This cover is subject to the following condition:
? The contraction and diagnosis of a critical illness must be verified by a medical specialist
who holds an appointment as a consultant at a hospital in the UK and whose specialism we
reasonably consider is appropriate to the critical illness.
Under certain circumstances, we will allow verification in other countries. We will act reasonably
when exercising our discretion to allow verification in another country.
Alzheimer＊s Disease 每
resulting in permanent
symptoms
A definite diagnosis of Alzheimer＊s disease by a Consultant
Neurologist, Psychiatrist or Geriatrician.
There must be permanent clinical loss of the ability to do all
of the following:
? remember;
? reason; and
? perceive, understand, express and give effect to ideas.
For the above definition, the following is not covered:
??Other types of dementia.
Aorta Graft Surgery 每
requiring surgical
replacement
The undergoing of surgery to the aorta with excision and
surgical replacement of a portion of the aorta with a graft.
The term aorta includes the thoracic and abdominal aorta
but not its branches.
For the above definition, the following is not covered:
??Any other surgical procedure, for example the insertion
of stents or endovascular repair.
Aplastic Anaemia 每
with permanent bone
marrow failure
A definite diagnosis of Aplastic Anaemia by a Consultant
Haematologist. There must be permanent bone marrow failure
with anaemia, neutropenia and thrombocytopenia.
Bacterial Meningitis 每
resulting in permanent
symptoms
A definite diagnosis of Bacterial Meningitis resulting in
permanent neurological deficit with persisting clinical
symptoms.
For the above definition, the following is not covered:
??All other forms of meningitis other than those caused
by bacterial infection.
Benign Brain Tumour 每
resulting in either surgical
removal or permanent
symptoms
A non-malignant tumour or cyst in the brain, cranial nerves
or meninges within the skull, resulting in either surgical
removal or permanent neurological deficit with persisting
clinical symptoms.
For the above definition, the following are not covered:
? Tumours in the pituitary gland.
? Angiomas.
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