Pilots Loss of Licence Insurance Permanent and Temporary Depravation of a Pilot’s Licence By the Licence Issuing Authority 11/03/2015 Product Disclosure Statement V1.1 Contents PRODUCT DISCLOSURE STATEMENT (PDS) ............................................................................................. 2 THE INSURER ....................................................................................................................................... 2 THE AGENT(S)....................................................................................... Error! Bookmark not defined. CLAIMS & GENERAL ENQUIRIES .............................................................................................................. 2 SOME EXCLUSIONS FROM COVER APPLY................................................................................................ 3 YOUR DUTY OF DISCLOSURE ................................................................................................................... 3 YOUR DUTY OF DISCLOSURE FOR RENEWALS .................................................................................... 3 WHO NEEDS TO TELL US? ................................................................................................................... 3 IF YOU DO NOT TELL US ...................................................................................................................... 3 BENEFITS OF THIS FINANCIAL PRODUCT................................................................................................. 4 WHAT ISN’T COVERED BY THIS FINANCIAL PRODUCT ............................................................................ 5 REMUNERATION ..................................................................................................................................... 8 IF YOU HAVE A COMPLAINT OR QUERY .................................................................................................. 8 PRIVACY POLICY ...................................................................................................................................... 9 YOUR POLICY ........................................................................................................................................... 9 IMPORTANT INFORMATION ................................................................................................................... 9 DEFINITIONS.......................................................................................................................................... 10 1 PRODUCT DISCLOSURE STATEMENT (PDS) THE INSURER The insurer of this Policy: Certain Underwriters at Lloyd's of London One Lime Street London EC3M 7HA UK LLYOD’S REPRESENTATIVE Howard Global Insurance Services Ltd Marlow House 1A Lloyd’s Avenue London EC3N 3AA No 3867929 Phone: + 44 (0) 20 7702 5700 Fax: + 44 (0) 20 7702 5701 CLAIMS & GENERAL ENQUIRIES For all claims queries contact: WSC Insurance Brokers Caringbah and Bowral NSW Phone 1300 733 476 Mob: 0414 266 216 Fax: 02 4861 5144 E: [email protected] AFS Licence: 238854 Mail: PO Box 1437 Bowral NSW 2576 Website: www.wscbrokers.com.au This Product Disclosure Statement (PDS) contains important information about this Pilot Loss of Licence Insurance Product. Other documents may form part of this PDS. Any such documents will include a statement identifying them as part of this PDS and will be provided to You at the same time as You are given this PDS. The information in this PDS has been prepared without taking into account Your personal objectives, financial situation or needs. You should therefore consider this PDS carefully before making any decision whether to take out this Pilot Loss of Licence Insurance, if You already hold such insurance, to keep or renew the insurance. This PDS is prepared by the Insurers who are responsible for it. It includes the terms and conditions applying to this insurance which will be issued to You if You apply for, or seek to renew, the insurance and We accept Your application or if You seek to be covered by it as an Insured Person. We recommend You read the PDS in conjunction with the Policy Wording. 2 SOME EXCLUSIONS FROM COVER APPLY A benefit is not payable if an exclusion applies. These exclusions are explained in the relevant Cover Sections and the Exclusions Section and in some cases in the Policy Schedule or an Endorsement issued by Us. YOUR DUTY OF DISCLOSURE Whether You are entering into a policy for the first time or are proposing to renew, vary, extend or reinstate a policy you have a duty of disclosure. If you are unsure if something is relevant you should inform us regardless. Your duty of disclosure for new policies when answering our questions You must be honest and You have a duty under law to tell Us anything known to You, and which a reasonable person in the circumstances, would include in the answer to the question. We will use the answers in deciding whether to insure You and anyone else to be insured under the policy, and on what terms. YOUR DUTY OF DISCLOSURE FOR RENEWALS If You have already entered into a policy and You are proposing to renew, vary, extend or reinstate the policy Your duty of disclosure changes. You have a duty to tell us of everything that You know, or could reasonably be expected to know, that is relevant to our decision to insure You and to the terms of that insurance. WHO NEEDS TO TELL US? It is important that You understand You are answering our questions in this way for yourself and anyone else that You want to be covered by the policy. Your duty does not require disclosure of matters that: reduce the risk common knowledge We know or, in the ordinary course of our business, should know, and We have indicated We do not want to know. IF YOU DO NOT TELL US If You do not answer our questions in this way or disclose everything You know, the Insurer may reduce or refuse to pay a claim, or cancel the policy. If You answer Our questions fraudulently, The Insurer may refuse to pay a claim and treat this policy as never having been in force. Failure to comply with Your duty of disclosure, especially concerning Your Medical History, , could severely affect the result of any subsequent claim made on the policy and could lead to a claim being declined. 3 BENEFITS OF THIS FINANCIAL PRODUCT Benefits The Insured Person is insured for those Benefits stated in the Schedule as 'Insured'. 2.1. If an Insured Person sustains Bodily Injury or Illness (other than Classified Illness) during the Period of Insurance which results in the Insured Person Losing his/her Licence the Underwriter will pay the sum insured shown in the Schedule. 2.2. If an Insured Person becomes Disabled as a consequence of Bodily Injury or Illness (but not as a result of Classified Illness) sustained during the Period of Insurance and the Insured Person remains Disabled for more than the Waiting Period the Underwriter will pay the sum insured shown in the Schedule for each subsequent full month for which the Insured Person remains Disabled. If the Insured Person does not remain Disabled for a full month, a proportional benefit based on the number of days Disabled will be paid. The Underwriter will only pay for up to the maximum number of months of benefit shown in the Schedule in respect of any one cause. No payment will be made in respect of the Waiting Period. No benefit will be paid after the death of the Insured Person other than for Accidental Death. 2.3 If an Insured Person suffers from a Bodily Injury or Illness during the Period of Insurance for which a diagnosis of a Critical Illness is made, the Underwriter will pay one third of the Sum Insured shown in the Schedule for the Capital Benefit provided that the Insured is alive thirty days following the date of such diagnosis. Paralysis ) Loss of limbs) As a result of Blindness ) sickness or accident Deafness ) Alzheimer’s Disease Parkinson’s Disease 4 2.4. If an Insured Person becomes Disabled as a consequence of Classified Illness during the Period of Insurance and the Insured Person remains Disabled for more than the Waiting Period the Underwriter will pay the sum insured shown in the Schedule for each subsequent full month for which the Insured Person remains Disabled. If the Insured person does not remain Disabled for a full month, a proportional benefit based on the number of days disabled will be paid. The Underwriter will only pay for up to the maximum number of months of benefit shown in the Schedule in respect of any one cause. No payment will be made in respect of the Waiting Period. No benefit will be paid after the death of the Insured Person. 2.5. If an Insured Person dies by Accidental Death (as defined) during the Period of Insurance, The Underwriter will pay up to the maximum benefit shown in the Schedule of Benefits or the Benefit noted and selected by the Insured Person on the Health Declaration. Accidental Death includes the consequence of exposure to the elements and the indirect consequence of accidental injury. WHAT ISN’T COVERED BY THIS FINANCIAL PRODUCT Exclusions 4.1. Unless liability has been admitted by the Underwriter, Benefits 2.1. Benefit 2.2. or 2.3 will not be paid if the Insured Person dies either before Benefits have been paid by the Underwriter or until the waiting period stated in the schedule or 60 days has passed since the Insured Person first became Disabled. 4.2. No Benefits will be paid if the Bodily Injury, Illness, Classified Illness or Critical Illness is the direct or indirect consequence of: 4.2.1. War involving any one of the following countries, United Kingdom, United States of America, France, Peoples Republic of China or The Russian Federation. Nuclear/Chemical/Biological Terrorism Exclusion It is agreed that, regardless of any contributory cause(s), this insurance does not cover any claim(s) in any way caused or contributed to by an act of terrorism involving the use or release or the threat thereof of any nuclear weapon or device or chemical or biological agent. For the purpose of this exclusion an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or ethnic purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public, in fear. If the Underwriters allege that by reason of this exclusion any claim is not covered by this insurance the burden of proving the contrary shall be upon the Assured. 02/02 LSW 1175 5 4.2.2. A criminal act for which the Insured Person was found guilty and which could have carried a custodial sentence (whether imposed or not). 4.2.3. Active duty with any Armed Force on any kind of combat assignment. 4.2.4. Intentional self-injury or attempted suicide. 4.2.5. Pregnancy, childbirth, abortion or complications thereof. 4.2.6. Venereal Disease or its consequences. 4.2.7. Acquired Immune Deficiency Syndrome, AIDS related complex or any related conditions or any condition resulting from the presence of the Human Immuno Deficiency Virus (unless such condition was contracted as a direct consequence of medical treatment for an unrelated illness or medical condition - such illness or medical condition not being drug or alcohol abuse or a venereal disease). 4.2.8. Any Illness, Classified Illness or Critical Illness which You first sort Medical attention or advice on within 12 (twelve) months before the Commencement Date and the Illness, Classified Illness or Critical Illness and was noted on the Medical Application unless agreed and accepted by the Underwriter in writing. 4.2.9 Any condition or injury that you sort Medical attention or advice on within 12 (twelve) months before the Commencement date and the condition or injury and was noted on the Medical Application unless agreed and accepted by the Underwriter in writing. 4.2.10 Any psychiatric illness or mental or nervous disorders”. 4.2.11 Alcohol, other than under the Classified Illness Benefit. An Insured Person being under the influence of alcohol exceeding those levels defined by law for the use of a motor vehicle in the country in which the Insured Person resides. 4.2.12. Drugs, other than under the Classified Illness. An Insured Person being under the influence of drugs or narcotics that are not lawfully available or which have not been prescribed by or taken in accordance with the instructions of an independent qualified medical practitioner; 4.2.13. Flying involving hazardous activities including but not limited to the following: (i) the intentional dropping, spraying or release of any substance or object, (ii) slung cargo, (iii) aerial photography, (iv) fire-fighting, (v) slash and burn, (vi) animal capture or (vii) the use of ultra-light aircraft. 4.2.14. Deliberate exposure of the Insured Person to exceptional danger (except in an attempt to save human life or to prevent loss of or damage to aircraft or aircraft equipment). 6 REMUNERATION Intermediary Remuneration Your insurance broker is paid a commission when a policy is issued, renewed or varied. The type and amount of remuneration may vary. Third Parties Third parties such as Group Employers, Financial Advisors and other providers may be paid a commission when a policy is issued, renewed or varied. The type and amount of remuneration may vary. IF YOU HAVE A COMPLAINT OR QUERY This Insurance does not comply with the Insurance Council of Australia’s General Insurance Code of Practice. Any enquiry or complaint relating to this insurance should be referred to: Howard Global Insurance Services Ltd Marlow House, 1A Lloyd's Avenue, London, EC3N 3AA Telephone +44 (0)20 7702 5700 Facsimile +44 (0)20 7702 5701 Registered in England & Wales at Craven House, 16 Northumberland Avenue, London WC2N 5AP, No 3867929 Authorised and Regulated by the Financial Conduct Authority If this does not resolve the matter or you are not satisfied with the way a complaint has been dealt with, you should write to: Lloyd’s Underwriters’ General Representative in Australia Suite 2, Level 21 Angel Place 123 Pitt Street Sydney, NSW 2000 Telephone Number: (02) 9223 1433 Facsimile Number: (02) 9223 1466 If Your dispute remains unresolved You may be referred to the Financial Ombudsman Service Limited under the terms of the General Insurance Code of Practice. For other disputes You will be referred to other proceedings for resolution. Details are available from Lloyd’s Underwriters’ General Representative in Australia at the address above. 7 PRIVACY POLICY Lloyd’s and its agents are bound by the obligations of the Privacy Act 1988 as amended by the Privacy Amendment (Private Sector) Act 2000 (The Act). These set basic standards relating to the collection, use, disclosure and handling of personal information. “Personal information” is essentially information or an opinion about a living individual whose identity is apparent or can reasonably be ascertained from the information or opinion. An individual who believes their privacy may have been prejudiced has a right to make a complaint about the matter. In the first instance, Your complaint should be addressed to Underwriters. If You or the Insured are dissatisfied with the response, You may refer the matter to Lloyd’s Australia Ltd, who has the appropriate authority to investigate and address matters of this nature. Lloyd’s Australia can be contacted at: Lloyd’s Australia Ltd Suite 2, Level 21, Angel Place 123 Pitt Street Sydney, NSW 2000 Telephone: 02 9223 1433 Fax: 02 9223 1466 Lloyd’s Australia will respond in writing within fifteen (15) working days, and if You remain dissatisfied with their response, You will be provided at that time with the details of any other avenues for resolution that may be available to You YOUR POLICY The information You have given will be the basis of the contract of insurance with Us. For the contract to be valid, all the information You have given Us must be true and complete. Your policy, which is Our policy booklet, the most recent policy schedule and any endorsement(s) is evidence of that contract. This is an important document which You should read carefully and keep in a safe place. In return for Your premium We will provide insurance as described in the following pages and in Your policy schedule. The Geographical Limit of this cover is World Wide, This Policy is governed by and is to be construed in accordance with the Law of the Commonwealth of [Australia] and happen within the period of insurance as shown on Your policy schedule. You must pay Your insurance premium with 30 days from the policy commencement date stated on the payment notice otherwise Your policy will cease to operate. IMPORTANT INFORMATION Please read this policy booklet with Your policy schedule to make sure that You are satisfied with Your insurance. If You have any questions please contact Us. 8 DEFINITIONS Accident Shall mean a single, sudden and unexpected event which occurs at an identifiable time and place during the Period of Insurance. Accidental Death Accidental Death to an Insured Person happening during the Period of Insurance which is not the consequence of sickness disease or any degenerative condition or gradually operating cause. Accidental Death includes the consequence of exposure to the elements and the indirect consequence of accidental injury. Anniversary Date As stated in the Schedule Benefits The Benefits defined in Section 2 and which are shown as insured in the Schedule. Bodily Injury Accidental injury to an Insured Person sustained during the Period of Insurance which is not the consequence of sickness disease or any degenerative condition or gradually operating cause and solely and, independently of any other cause, it causes the disablement of the Insured. Bodily Injury includes the consequence of exposure to the elements and the indirect consequence of accidental injury. Classified Illness An illness which first manifests during the Period of Insurance which is by its nature or origin: a) b) Critical Illness Benefit either directly or indirectly consequent upon or contributed to by drugs or alcohol (unless prescribed by a Medical Practitioner in the treatment of an Illness), or is incapable of diagnosis with available objective evidence or has not been diagnosed despite such evidence being available. If the Insured sustains Bodily Injury or Illness during the Period of Insurance for which a diagnosis of a Critical Illness is made by the Underwriter, the Underwriter will pay one third of the Sum Insured shown in the Schedule for the Capital Benefit provided that the Insured is alive thirty days following the date of such diagnosis. Paralysis ) Loss of limbs) As a result of Blindness ) sickness or accident Deafness ) Alzheimer’s Disease Parkinson’s Disease 9 Critical Illness Cont: Any of the following diagnoses: Paralysis Total and permanent paralysis as a result of sickness or accident. Evidence of total permanent failure of spinal cord conductivity due to transection must be provided, and the temporal and causal connection with the damaging occurrence must be obvious. Loss of Limbs Complete and permanent loss of function of both legs, or both arms, or one arm and one leg through accident or disease. Blindness Total, clinically certified, irreversible loss of sight in both eyes as a result of acute sickness or accident. The blindness must be certified by an ophthalmologist’s report. Deafness Total, clinically certified, irreversible loss of hearing in both ears as a result of acute sickness or accident. The deafness must be certified by a Medical Practitioner. Alzheimer’s Disease Deterioration or loss of intellectual capacity or abnormal behaviour as evidenced by the clinical state and accepted standardised questionnaires or tests, arising from Alzheimer’s disease or irreversible organic disorders, excluding neurosis and psychiatric illness, resulting in significant reduction in mental and social functioning requiring the continuous supervision of the Insured Person. The diagnosis must be clinically confirmed by an appropriate consultant and be supported by the Company’s Chief Medical Officer. Parkinson’s Disease Slowly progressive degenerative disease of the central nervous system as a result of loss of pigment containing neurones of the brain (substantia nigra).Unequivocal diagnosis of Parkinson’s Disease must be provided by a consultant neurologist where the condition cannot be controlled with medication; and shows signs of progressive impairment; and activities of daily living assessment confirms the inability of the Insured Person to perform, without assistance, three or more of the following: bathing, dressing, using the lavatory, eating, ability to move in or out of bed or a chair. Only idiopathic Parkinson’s disease is covered. Drug-induced or toxic causes of Parkinsonism are excluded. 10 Underwriter Certain Underwriters at Lloyd’s in London as stated on the Schedule. Commencement Date The latter of either the date shown in the Schedule or the date an Insured Person first becomes insured under this Policy. Disabled Such state of health that prevents and continues to prevent an Insured Person from reaching the required Licence Standards for the Licence held by the Insured Person. Expiry Date The first to occur of either the date shown in the Schedule or the date that the Insured Person ceases to be insured under this Policy (either by agreement or automatically in accordance with Condition 5.2.) Illness Any illness not included under Bodily Injury which first manifests during the Period of Insurance. Illness includes premature senile degenerative change but excludes Classified Illness. Insured The Insured stated in the Schedule. Insured Person The Insured Persons defined in the Schedule. Licence or Certificate All Licences and Certificates held by an Insured Person in accordance with the Insured Person's usual Occupation. Licensing Authority Shall mean the civil aviation authority or aviation authorities by which the Insured is required to be licensed in order to carry out the ordinary duties of his occupation or employment. Loss of Licence Deprivation of a Licence by the Licence Issuing Authority as a Permanent consequence solely and directly of Bodily Injury, Illness, Classified Illness or Critical Illness which is permanent or if the Licensing Issuing Authority, as a matter of practice or in accordance with its regulations, does not issue a permanent denial of the medical certificate, restoration of the Licence is unlikely to occur on medical grounds for the foreseeable future in the opinion of the Underwriter. For this purpose the foreseeable future will be deemed to be a period of not less than 5 years from the date the Insured Person first became Disabled. Loss of Licence Temporary 11 Deprivation of a Licence by the Licence Issuing Authority as a consequence solely and directly of Bodily Injury, Illness, Classified Illness or Critical Illness which is Temporary or if the Licensing Issuing Authority, as a matter of practice or in accordance with its regulations, does not issue a permanent denial of the medical certificate, restoration of the Licence is likely to occur on medical grounds for the foreseeable future in the opinion of the Underwriter. For this purpose the foreseeable future will be deemed to be a period of not less than 2 years from the date the Insured Person first became Disabled. Medical Practitioner A registered member of the medical profession who is qualified to treat the cause of Disability and who is not a relative or friend of the Insured Person for the purposes of certifying such Disability. Occupation The Occupation of an Insured Person as declared to the Underwriter Premium Any Premium due to or payable by the Underwriter from time to time. Period of Insurance The Period commencing with the Commencement Date and ending with the Expiry Date both days inclusive and any other Period which the Underwriter agrees to accept. This Policy The Policy, the Schedule and any Endorsements or Memoranda attached to the Policy from time to time. You/Your Means; the named Insured in the Schedule or the Insured Member. Waiting Period The Waiting Period stated in the Schedule. All periods of absence resulting from the same medical condition will be aggregated for the purposes of assessing whether the Waiting Period has been exceeded. We/Our/Us Means; the Underwriter subscribing to this Insurance. 12
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