Payment Protection - Autosure
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Payment Protection Insurance
YOUR POLICY SCHEDULE SHOULD BE ATTACHED HERE.
Welcome About Your Policy Duty Of Disclosure
Thank you for choosing us to provide you with one of the most comprehensive Payment Protection Payment Protection Insurance (PPI) protects you You have a legal duty of disclosure when you apply
Insurance covers available today. for the repayment of your loan obligations to the for insurance, make changes to your policy and
financier, if you suffer an insured event. when making a claim, to tell us everything that a
prudent insurer would want to take into account in
The Insurer This document is the policy wording for your PPI deciding:
cover. • Whether to issue your policy;
This insurance policy is underwritten by DPL Insurance Limited. For more information and details on our • The applicable terms and conditions of your
Financial Strength Rating and Solvency Calculation go to www.dplinsurance.co.nz. Your policy is a contract between you and us and is policy;
comprised of: • The amount of your premium;
Customer Commitment • Your online application or application form; • Whether any alterations to your policy will be
• Your policy wording; and made;
We are committed to treating our customers with fairness, respect and dignity. This means that we will: • Your current policy schedule; and • Whether your policy will respond to your claim.
• Act with integrity at all times; • Any other document issued by us, which may
• Provide high quality service; vary or modify the above documents. If you breach the duty of disclosure, we may void
• Listen to our customers’ concerns; your policy from the start of the period of insurance
• Be open and transparent in all of our dealings; and Please keep these documents safe and read them and refund any premiums you have paid us.
• Take the time to answer any questions our customers have. together.
What You Are Insured For
It is important you read your policy in full and
Complaints understand your benefits and the terms and Payment Protection Insurance (PPI) protects you
conditions of your policy, including what your for the repayment of your loan obligations to the
We are committed to resolving all complaints and concerns quickly, respectfully and in good faith. If you insurance covers – and what it doesn’t. If there is financier, if you suffer an insured event.
have a complaint relating to our activities, in the first instance, please contact us. Any dispute which we anything you don’t understand, or if you have any
cannot resolve can be referred to our disputes resolution provider by contacting: questions, please contact us. PPI offers various cover options. The extent of
The Insurance and Financial Services Ombudsman your cover only applies to the insured events and
P. 0800 888 202, PO Box 10845, Wellington 6143, www.ifso.nz Defined Words benefits, which are shown in your policy schedule.
If a word is shown in bold it has a special meaning.
There is a list of these words and their meanings in The cover options are:
Our Guarantee
the Definitions section of this policy. • Employee – For people in fulltime permanent
employment;
If you are not completely happy with the cover provided by your policy, you can cancel it within 15 days of
• Self-Employed – For people who are self-
the start of the period of insurance, provided you have not made a claim under your policy. We will refund
employed; and
any premiums you have paid us.
• Everyday Essential – For everyone not listed above.
The cover types are:
• Individual Cover – Insured person is covered
for 100% of benefits; and
• Double Cover – Both insured persons are
covered for 100% of benefits (50% for each
person, if they both suffer an insured event
simultaneously).
1 Payment Protection Insurance - Policy Wording 032019v5 032019v5 Payment Protection Insurance - Policy Wording 2Employee Cover – Cover for the insured events listed below is subject to the terms and conditions Self-Employed Cover – Cover for the insured events listed below is subject to the terms and
of your policy. conditions of your policy.
Insured Event Benefit Insured Event Benefit
DEATH: If you die during the We will pay your loan balance outstanding at the date of your DEATH: If you die during the We will pay your loan balance outstanding at the date of your
period of insurance death, excluding any arrears of more than 90 days. period of insurance death, excluding any arrears of more than 90 days.
TERMINAL ILLNESS: If you are We will pay your loan balance outstanding at the date of your TERMINAL ILLNESS: If you are We will pay your loan balance outstanding at the date of your
diagnosed with a terminal illness diagnosis, excluding any arrears of more than 90 days. diagnosed with a terminal illness diagnosis, excluding any arrears of more than 90 days.
during the period of insurance during the period of insurance
ACCIDENT AND ILLNESS: If you Total Permanent Disablement – We will pay your loan balance ACCIDENT AND ILLNESS: If you Total Permanent Disablement – We will pay your loan balance
become disabled for more than outstanding at the date of your total permanent disablement, become disabled for more than outstanding at the date of your total permanent disablement,
seven consecutive days or excluding any arrears. seven consecutive days or excluding any arrears.
permanently disabled during Disablement – We will pay your monthly loan repayment, permanently disabled during Disablement – We will pay your monthly loan repayment,
the period of insurance calculated on a daily basis, for each day of your disablement, until the period of insurance calculated on a daily basis, for each day of your disablement, until
the earliest of: the earliest of:
• You confirm to us that you are no longer disabled; • You confirm to us that you are no longer disabled;
• You are certified as no longer disabled by a medical practitioner; • You are certified as no longer disabled by a medical practitioner;
or or
• The end of the period of insurance. • The end of the period of insurance.
HOSPITALISATION: If you are We will pay your monthly loan repayment, calculated on a daily HOSPITALISATION: If you are We will pay your monthly loan repayment, calculated on a daily
hospitalised during the period basis, for each day of your hospitalisation, excluding the first three hospitalised during the period of basis, for each day of your hospitalisation, excluding the first three
of insurance for more than three days, until the earliest of: insurance for more than three days, until the earliest of:
consecutive days • You are discharged as certified by a medical practitioner; consecutive days • You are discharged as certified by a medical practitioner;
• You have been hospitalised for 185 days; or • You have been hospitalised for 185 days; or
• The end of the period of insurance. • The end of the period of insurance.
CARER: If you become the carer We will pay your monthly loan repayment, calculated on a daily CARER: If you become the carer We will pay your monthly loan repayment, calculated on a daily
of an immediate family member basis, for each day from when you become a carer, until the earliest of: of an immediate family member basis, for each day from when you become a carer, until the earliest of:
during the period of insurance for • You confirm to us that you are no longer a carer; during the period of insurance for • You confirm to us that you are no longer a carer;
more than 28 consecutive days • You have been a carer for 185 days; or more than 28 consecutive days • You have been a carer for 185 days; or
• The end of the period of insurance. • The end of the period of insurance.
REDUNDANCY: If you are made We will pay your monthly loan repayment, calculated on a daily basis, BUSINESS INTERRUPTION: If your We will pay your monthly loan repayment, calculated on a daily
redundant during the period of for each day of your redundancy, until the earliest of: business suffers a business basis, for each day of your business interruption, until the earliest
insurance for more than 28 • You return to employment on substantially similar terms that you interruption during the period of:
consecutive days were on prior to your redundancy; of insurance for more than 28 • You confirm to us that your business interruption has ended;
• You have been redundant for 365 days; or consecutive days • Your business interruption has continued for 185 days; or
• The end of the period of insurance. • The end of the period of insurance.
EMPLOYER CEASES TRADING: We will pay your monthly loan repayment, if your employer ceases
If your employer ceases trading trading, and consequently you are no longer employed by that
causing you to become employer, calculated on a daily basis, for each day until the earliest of:
unemployed during the period • You return to employment on substantially similar terms
of insurance for more than 28 that you were on prior to your employer ceasing trading;
consecutive days • You have been unemployed for 185 days; or
• The end of the period of insurance.
SUSPENSION: If you are suspended We will pay your monthly loan repayment, calculated on a daily
during the period of insurance for basis, for each day of your suspension, until the earliest of:
more than 28 consecutive days • Your suspension ends;
• You have been suspended for 185 days; or
• The end of the period of insurance.
3 Payment Protection Insurance - Policy Wording 032019v5 032019v5 Payment Protection Insurance - Policy Wording 4Everyday Essential Cover – Cover for the insured events listed below is subject to the terms and Parental Leave permanent employment during the period of
conditions of your policy. There is no cover for any claim attributable either insurance.
Insured Event Benefit wholly or in part to parental leave.
Self-Injury or Suicide
DEATH: If you die during the We will pay your loan balance outstanding at the date of your Pregnancy, Childbirth, Miscarriage and There is no cover for any claim attributable either
period of insurance death, excluding any arrears of more than 90 days. Menopause wholly or in part to you attempting to commit
There is no cover for any claim attributable either suicide or committing suicide, intentionally injuring
TERMINAL ILLNESS: If you are We will pay your loan balance outstanding at the date of your
diagnosed with a terminal illness wholly or in part to infertility, pregnancy, giving yourself or deliberately exposing yourself to
diagnosis, excluding any arrears of more than 90 days.
during the period of insurance birth, caesarean section, miscarrying, having a exceptional danger (except in an attempt to save
pregnancy deliberately terminated or menopause, human life).
PERMANENT DISABILITY: If you We will pay your loan balance outstanding at the date of your total unless during the period of insurance, you are
become permanently disabled permanent disablement, excluding any arrears. hospitalised with complications for more than 3 Sexually Transmitted Diseases
during the period of insurance consecutive days or become disabled for more There is no cover for any claim attributable either
than 28 consecutive days after the pregnancy ends. wholly or in part to a sexually transmitted disease.
HOSPITALISATION: If you are We will pay your monthly loan repayment, calculated on a daily
hospitalised during the period of basis, for each day of your hospitalisation, excluding the first three Pre-Existing Conditions Vandalism
insurance for more than three days, until the earliest of: There is no cover for any claim attributable either There is no cover for any business interruption
consecutive days • You are discharged as certified by a medical practitioner; wholly or in part to any illness, injury or condition: claim attributable either wholly or in part to a
• You have been hospitalised for 185 days; or • You had known about; wilful and malicious act that causes damage or
• The end of the period of insurance. • You had any treatment for in the six months destruction.
prior to the start of the period of insurance; or
• Where a symptom existed that would cause War, Radioactivity and Terrorism
a reasonable person in the circumstances to There is no cover for any claim attributable either
What You Are Not Insured For psychological, personal or cosmetic reasons.
seek diagnosis, care or treatment. wholly or in part to:
Alcohol or Drugs Hazardous Activities • War, invasion, act of foreign enemy, hostilities
There is no cover for any claim attributable Prior Knowledge or war-like operations (whether war is declared
There is no cover for any claim attributable either wholly
either wholly or in part to your engagement in There is no cover for any claim attributable either or not), civil war, mutiny, rebellion, revolution,
or in part to alcoholism or drug addiction, or being
professional sporting activities, flying (other than as wholly or in part to any cause or condition that you insurrection, military coup, destruction or
under the influence of intoxicating liquor or drugs.
the passenger in an aircraft licensed for the carriage knew about or ought to have reasonably known or acquisition by government or local authorities;
of passengers), parachuting, hang-gliding or foreseen, prior to the period of insurance. • Nuclear weapon materials or ionising radiation
Business Interruption
There is no cover for business interruption, if you competitive racing (either on horseback or in motor or contamination by radioactivity from nuclear
powered vehicles). Psychiatric Disorder fuel or the combustion of waste from nuclear
have not been trading in the same style and in the
There is no cover for any claim attributable either fuel; or
same business for at least six months prior to the
Human Immunodeficiency Virus wholly or in part to any psychological, psychiatric • Acts of terrorism or action taken in controlling,
start of the period of insurance.
There is no cover for any claim attributable either or nervous condition or disorder, including (but not preventing, suppressing, or in any way relating
wholly or in part to Human Immunodeficiency limited to) anxiety, stress, depression or insanity. to an act of terrorism.
Criminal Act
There is no cover for any claim attributable either Virus (HIV), including Acquired Immunodeficiency
Syndrome (AIDs). Redundancy and Employer Ceasing Trading
wholly or in part to you engaging in a criminal act.
There is no cover for any redundancy claim and any Making A Claim
Natural Disaster claim due to your employer ceasing trading:
Disappearance If an event happens that may lead to a claim under
There is no cover for any claim attributable either • If you are self-employed;
Death will not be presumed by your disappearance, your policy you must:
wholly or in part to an earthquake, volcanic • Due to cessation of work, where the work is of
except in the event that your body is still missing 12 1. Take all reasonable steps to minimise the claim
eruption, tsunami or any other seismic event. a seasonal, contractual, or temporary nature or
months after the officially reported disappearance, and prevent any further claim;
where you are employed for a specific period
sinking or wrecking of your transport. 2. Freephone 0800 809 700 to notify us of the
Pandemic or by reference to specific work and become
unemployed at the expiration of the period or event;
Elective There is no cover for any claim attributable either 3. Complete any claim forms required by us;
wholly or in part to avian influenza, or any other on completion of the work;
There is no cover for any claim attributable either 4. Provide us with written statements, certificates
virus or disease that is declared to be an outbreak or • If you have accepted the redundancy
wholly or in part to any medical treatment or and any other supporting information that we
epidemic by the World Health Organisation, or the voluntarily; or
surgical procedure, which is not essential for may require, at your expense; and
New Zealand Government. • If you are not actively engaged in fulltime
medical reasons and is requested by you for
5 Payment Protection Insurance - Policy Wording 032019v5 032019v5 Payment Protection Insurance - Policy Wording 65. Assist us with your claim in any way we • Redundancy - evidence of your redundancy Total Benefit You must also notify us when your insured event
request. from your former employer and that you are The maximum amount we will pay for all claims comes to an end. If you fail to do so, then you are
registered with Work and Income New Zealand under your policy during the period of insurance is liable to repay us for any payments made after that
We may require you to authorise the disclosure of as a job seeker. Evidence that you are actively limited to the lesser of: date.
medical information and financial information that seeking alternative fulltime permanent • Your loan obligations to your financier as a
may be relevant to the claim, including information employment. result of an insured event; or Ending Your Policy
held by your medical practitioner, financier, • Employer Ceasing Trading - evidence of • A total of $200,000. After 15 days from the start of the period of
accountant or employer. your employer ceasing trading resulting in insurance, you are entitled to end your policy at
you becoming unemployed and that you are any time, by giving us 10 days’ notice in writing to
We have the right to make any reasonable enquiries registered with Work and Income New Zealand
Claim Payments our address stated in your policy schedule. We
in relation to a claim. We have the right, at our as a job seeker. Evidence that you are actively Subject to the terms and conditions of your policy, will refund your premium relating to the balance
expense, to have you medically examined. seeking alternative fulltime permanent claim payments will be made to your financier to of the period of insurance (calculated on a Rule of
employment. reduce or repay your loan obligations. 78 basis). If your premium has been added to your
It is your responsibility, at your own expense, to • Suspension - evidence of your suspension by loan amount, any refund of premium will be made
provide documentation to us demonstrating that your employer. to your financier.
the loss, damage or expense that you claim for is • Business Interruption - evidence of loss Period Of Cover
the result of an insured event covered under your or damage to your business as a result of The period of cover under your policy is set out We are entitled to end your policy at any time,
policy. It is also your responsibility to calculate the business interruption. Evidence of the in your policy schedule. The maximum period of by giving you 10 days’ notice in writing to your
dollar amount of the loss, damage and expense you actual experience of your business before cover, regardless of the term of your loan, is 60 address, as stated in your policy schedule. We will
are claiming. the business interruption and the probable months (5 years). refund your premium relating to the balance of
experience you would have had without the the period of insurance (calculated on a Rule of 78
In the case of death we have the right, at our business interruption. basis).
expense, to have a post-mortem examination of Policy Conditions
you. False / Fraudulent Claims
Claim Limits To be eligible to make a claim you must comply You or anyone acting on your behalf must not make
Individual and Double Covers with all the terms of your policy. If you or someone
Any payment of a claim is conditional on the a claim that is false or fraudulent in any way, or
following: on your behalf breaches your policy, then we may: make any false or incorrect statement in connection
Individual Cover: If an insured person named in the • Decline your claim in part or whole; and/or
• Death - proof of your death (death certificate with any claim.
policy schedule suffers an insured event, we will • Cancel your policy.
or coroner’s final findings report as applicable),
pay 100% of the relevant benefit.
age and identity. Governing Law
• Terminal Illness - evidence from a medical Accuracy of Statements and Fraud The Laws of New Zealand apply to your policy.
Double Cover: If either insured person named in the All statements and answers made by you or on your
practitioner of your terminal illness and Any proceedings relating to your policy must be
policy schedule suffers an insured event, we will behalf in the application for this insurance, when
evidence that you have obtained and are brought and heard in New Zealand.
pay 100% of the relevant benefit to the person who making changes to it and in any claim must be true,
following the advice of a medical practitioner.
suffered the insured event. If both persons named correct and complete in every respect. If you or
• Accident and illness - that you consult a Privacy Act 2020
in the policy schedule suffer an insured event someone on your behalf makes a statement that is
medical practitioner at your cost, as soon as Your policy schedule contains personal information
simultaneously we will pay 50% of the relevant not true, correct and/or complete, then we may:
possible after suffering a disability and, as necessary for us to evaluate your application for
benefit to each person. • Decline your claim in part or whole; and/or
required, continue consulting and following insurance, in order to decide whether to issue
the advice of a medical practitioner, until • Void your policy from the start of the period of insurance cover and if so on what terms. The
One Benefit insurance.
you are fit to resume fulltime permanent information collected will be held by DPL Insurance
You are only entitled to one claim payment at
employment. Limited, PO Box 33 1248, Takapuna, 0740 and our
any one time and only for the insured events and Amounts
• Hospitalisation - evidence from a agents. You have the right to request access to and
benefits which are shown in your policy schedule. All amounts stated in your policy are in New
medical practitioner or a hospital of your correction of your personal information subject to
hospitalisation. Zealand dollars and include Goods and Services Tax the Privacy Act 2020.
Recurring Disablement (GST).
• Carer - evidence of your fulltime permanent
If your disablement recurs within three months
employment before becoming a carer and
of your last claim payment, we will consider your Change in Circumstance
evidence that you spend at least 35 hours a
disablement as being recurring and your claim can You must notify us immediately if there are any
week caring for a member of your immediate
recommence, but only for the remaining part of the material changes to any circumstances that existed
family.
maximum benefit period. when you took out your policy.
7 Payment Protection Insurance - Policy Wording 032019v5 032019v5 Payment Protection Insurance - Policy Wording 8Definitions Disablement Monthly Loan Repayment in writing from your employer, as your position
Means any illness or injury that causes your total Means the monthly instalment (excluding any has been deemed superfluous to the needs of your
These definitions apply to the plural and any and continuous inability to perform your usual arrears, residual amount or balloon payment) you employer.
derivatives of these words. Where these words are business or occupation, as certified by a medical are required to pay to your financier, as shown on
used in the policy wording (in bold font), this is practitioner. your loan contract. Terminal Illness
what they mean. Means you are diagnosed by a medical practitioner
Employer Ceasing Trading If your loan contract shows a repayment frequency as suffering a medical condition that will result in
Act of Terrorism Means that your employer is no longer in business other than monthly, we will calculate the monthly your death in less than six months.
Means an act of any person or group(s), including or has been adjudicated bankrupt, or put into loan repayment instalment as a sum of the
but not limited to, the use of force or violence or the liquidation or receivership. repayments you are required to pay to your Total Permanent Disablement
threat thereof, which from its nature and context is financier a month (excluding any arrears, residual Means any illness or injury that causes your total
done for, or in connection with, political, religious, Financier amount or balloon payment). and permanent inability to perform your usual
ideological, ethnic or similar purposes, including the Means the finance company for your loan contract business or occupation, as certified by a medical
intention to influence any Government and/or to stated in the policy schedule, to which your policy Monthly loan repayment calculated on a daily basis practitioner.
put the public or any section of the public in fear. relates. means, dividing the total amount of your monthly
loan repayments for the term of your loan contract, Self-Employed
Arrears Fulltime Permanent Employment by the number of days of your loan contract and Means you are not an employee (other than of
Your loan obligations to the financier that are owed Means you are in continuous fulltime employment multiplying the result by the number of days of the your own business), generally you find your own
and should have been paid earlier. This includes any in New Zealand for wages or income and are insured event. work rather than being provided with work by an
penalties, fees and/or interest charges in relation to working a minimum of 20 hours every week. employer and you earn income from a trade or
the arrears. Parental Leave business you operate in New Zealand.
Hospitalisation Means taking leave to carry out parental duties
Balloon Payment Means you are placed in medical care in a hospital, for children who do not have a medical or Suspension
Means a one-off lump sum payment made at the as certified by a medical practitioner. psychological need for parent-specific care. Means a suspension from your fulltime permanent
end of your loan, which repays your loan. employment in New Zealand, where your employer
Immediate Family Period of Insurance is legally entitled to withhold your remuneration for
Business Interruption Means your partner, children, brothers, sisters, Means the period starting on the date shown on the period of suspension, as a direct result of lawful
Means the interruption or interference of normal parents and legal guardians. Partner is a marriage your policy schedule and the earliest of: strike-related action or a lockout.
business activity of the business operated by you in partner or de facto partner, as defined in the • The date that your loan obligation is assigned,
New Zealand caused by: Property (Relationships) Act 1976 or civil union discharged, refinanced or repayments are We, Us, and Our
• Damage or destruction of any building or partner as defined by the Civil Union Act 2004. completed; Means Autosure, a business division of DPL
other property or part thereof used at your • The date you default on your loan obligations Insurance Limited.
business premises; Injury and your financier takes steps to enforce its
• Prevention or hindrance of access to your Means an external or internal bodily injury rights; You and Your
business premises as a consequence of caused to you directly by an unintended external • Your 70th birthday; Means the insured person(s) named in your policy
damage to property within a 10km radius of occurrence. • The date of your death, or the date your schedule.
your business premises; or terminal illness benefit is paid on this policy;
• Damage to any electricity, gas, water, sewerage Insured Event or
or telecommunications system that is directly The events as described in your policy, which result • 4pm on the end date shown on your policy
connected to your business premises. in the risk of you defaulting on your obligations to schedule.
your financier under your loan.
Carer Policy Schedule
Means you have been in fulltime permanent Loan Means the most recent policy schedule we
employment in New Zealand for at least six months Means the credit contract between your financier have issued to you for your policy, including any
and you voluntarily become an unpaid caregiver to and you, to which your policy relates. amendments and endorsements that we send you
a member of your immediate family for at least 35 in writing.
hours a week, but excludes parental leave. Medical Practitioner
Means a registered person who holds a current Redundancy
practising certificate issued by the Medical Council Means the involuntary termination of your fulltime
of New Zealand. permanent employment, by notice of redundancy
9 Payment Protection Insurance - Policy Wording 032019v5 032019v5 Payment Protection Insurance - Policy Wording 10PA2_032019v5 Policy and Claim Enquiries Freephone 0800 267 873 E sales@autosure.co.nz www.autosure.co.nz
You can also read
