Sample Policy Conditions
LEGAL DOCUMENT
KEEP SAFE
Aviva Cancer Support Plan
These Policy Conditions, the Schedule and Special Conditions (detailed in the Schedule, if any),
together with the answers you gave to the questions you were asked when you applied for cover,
contain full details of and form the life assurance contract (the "Policy") between the Policyholder
named on the Schedule and Aviva Life & Pensions UK Limited in respect of the Aviva Cancer Support
Plan.
Where the words "Aviva" or "we" or "us" or "our" are used in these Policy Conditions, they refer to
Aviva Life & Pensions UK Limited. The words "you" and "your" means the Policyholder.
Please read the Policy carefully, to confirm that it meets your requirements.
The Policy for the Aviva Cancer Support Plan is issued to you.
1. LEGAL POSITION/INTERPRETATION
1.1 The Policy for your Aviva Cancer Support Plan is a contract underwritten by Aviva.
1.2 Aviva has its branch, Aviva Life & Pensions Ireland, at the following address: One Park Place,
Hatch Street, Dublin 2, Ireland. You should use this address for any written communication with
Aviva relating to your Policy. Premiums and Benefits under this Policy are payable through
Aviva's branch in the currency of Ireland.
1.3 Subject always to Condition 4 (Cover Moratorium), your Policy is effective from the Policy Start
Date shown on the Schedule until the Cover End Date, which means the earlier of:
- The End Date shown on the Schedule;
- Any date on which the Policy ceases or terminates in accordance with these Policy Conditions.
1.4 As specified in Condition 4 (Cover Moratorium) cover under this policy will only start 90 days
from the Policy Start Date shown on the Schedule.
1.5 The Schedule gives details of the Life Insured to whom the Policy relates.
1.6 The laws of Ireland apply to your Policy.
1.7 The Policy Conditions should be read together. Whether or not it specifically refers to them, a
condition may be qualified by other relevant conditions. These Policy Conditions may be
qualified by special conditions in the Schedule.
1.8 The headings are for reference purposes only and will not affect the interpretation of these
Policy Conditions.
2. PREMIUMS
2.1 You have agreed to pay the Premiums shown on the Schedule. Premiums are payable, at the
frequency shown on the Schedule, from the First Premium Due Date until the Last Premium Due
Date or if earlier the date on which the Policy ceases or terminates in accordance with these
Policy Conditions.
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2.2 Unless otherwise agreed with Aviva, the Premiums will be paid by direct debit from your bank
account.
2.3 It is your responsibility to ensure that Premiums are paid as they fall due. Premiums must be paid
within 30 days of the due date, otherwise your Policy will automatically terminate and no
benefits will be payable. If a benefit becomes payable within the 30-day period of grace, the
amount payable will be reduced by the amount of any outstanding Premiums.
3.
DEATH BENEFIT
3.1 No death benefit will be payable under this Policy in any circumstances including (without
limitation) even if cancer is discovered after death of the Life Insured. No benefit will be
payable under this Policy if the Life Insured dies within a period of 14 days after Date of
Diagnosis at Condition 5.1 (i.e. before midnight on the fourteenth day after the Date of
Diagnosis with the day after the Date of Diagnosis counting as the first such day).
4.
COVER MORATORIUM
4.1 Cover under this Policy will not start until the Cover Start Date stated in the Schedule, which is
90 days after the Policy Start Date and this Policy will not cover any Minor Cancer or Major
Cancer which would in the reasonable opinion of the Aviva Chief Medical Officer have been
diagnosed prior to the Cover Start Date if the Life Insured had sought medical advice from a
qualified medical practitioner within that 90 days.
5.
DATE OF DIAGNOSIS
5.1 Date of Diagnosis is the date the histological sample is taken which subsequently confirms the
diagnosis of a Minor Cancer or Major Cancer.
6.
MINOR CANCER
6.1 Minor Cancer under this Policy means the diagnosis of cancer-in-situ needing surgical removal
on the advice of a qualified medical practitioner.
For the above definition the following is not covered:
 The removal of a tissue sample for diagnosis, analysis and/or histological purposes only.
6.2 The Minor Cancer Cover Amount is shown on the Schedule.
6.3 The Minor Cancer Cover Amount will become payable if the Life Insured is diagnosed as having
a Minor Cancer as defined in this Condition 6, on or after the Cover Start Date stated in the
Schedule and prior to the Cover End Date and then and survives for a period of 14 days after
Date of Diagnosis (i.e. survives until after midnight of the fourteenth day after the Date of
Diagnosis with the day after the Date of Diagnosis counting as the first such day).
6.4 You may only have one Aviva Cancer Support Plan at any one time. If you have more than one
Aviva Cancer Support Plan, we’ll only consider a claim for Minor Cancer under this Condition 6
under one Aviva Cancer Support Plan. Any additional Aviva Cancer Support Plan policies will be
cancelled by us and we’ll refund all your premiums (without interest) in respect of the
additional policies.
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6.5 Payment of the Minor Cancer Cover Amount in accordance with this Condition 6 is, without
limitation on Condition 1.7, subject always to Conditions 2 (Premiums), 4 (Cover Moratorium), 5
(Date of Diagnosis), 8 (Medical Evidence), 9 (Territorial Limits) and 10 (Claim Requirements).
6.6 On payment of the Minor Cancer Cover Amount, we won’t make any further payment under
this Policy in respect of Minor Cancer.
7.
MAJOR CANCER
7.1 Major Cancer under this Policy means any malignant tumour positively diagnosed with
histological confirmation and characterised by the uncontrolled growth of malignant cells and
invasion of tissue. The term malignant tumour includes leukaemia, sarcoma and lymphoma
except cutaneous lymphoma (lymphoma confined to the skin).
For the above definition, the following are not covered:
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Any cancers which are histologically classified as any of the following:
- pre-malignant,
- non-invasive,
- cancer in situ,
- having borderline malignancy, or
- having low malignant potential.
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Any skin cancer (including cutaneous lymphoma) other than malignant melanoma that
has been histologically classified as having caused invasion beyond the epidermis (outer
layer of skin).
7.2 The Major Cancer Cover Amount is shown on the Schedule.
7.3 The Major Cancer Cover Amount will become payable if the Life Insured is diagnosed as having
a Major Cancer as defined in this Condition 7, on or after the Cover Start Date stated in the
Schedule and prior to the Cover End Date and then survives for a period of 14 days after the
Date of Diagnosis (i.e. survives until after midnight of the fourteenth day after the Date of
Diagnosis with the day after the Date of Diagnosis counting as the first such day).
7.4 You may only have one Aviva Cancer Support Plan at any one time. If you have more than one
Aviva Cancer Support Plan, we’ll only consider a claim for Major Cancer under this Condition 7
under one Aviva Cancer Support Plan. Any additional Aviva Cancer Support Plan policies will be
cancelled by us and we’ll refund all your premiums (without interest) in respect of the
additional policies.
7.5 If at the time that the Major Cancer Cover Amount becomes payable, the Minor Cancer Cover
Amount has not previously been paid under Condition 6, the Minor Cancer Cover Amount will
then become payable in addition to the Major Cancer Cover Amount.
7.6 Payment of the Major Cancer Cover Amount in accordance with this Condition 7 is, without
limitation on Condition 1.7, subject always to Conditions 2 (Premiums), 4 (Cover Moratorium), 5
(Date of Diagnosis), 8 (Medical Evidence), 9 (Territorial Limits) and 10 (Claim Requirements).
7.7 On payment of the Major Cancer Cover Amount, the Policy will terminate and no further benefits
will be payable.
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8.
MEDICAL EVIDENCE
8.1 Before payment of the Minor Cancer Cover Amount or Major Cancer Cover Amount under this
Policy, Aviva will require proof to its reasonable satisfaction of the occurrence of the Minor
Cancer or Major Cancer.
8.2 You will be required to supply such proof at no cost to Aviva and in such form, including medical
certificates, as Aviva may reasonably require.
8.3 In making a determination whether a Life Insured is suffering from a Minor Cancer or Major
Cancer, Aviva will have regard to evidence and opinion provided by its Chief Medical Officer and
may have regard to evidence or opinion provided by a physician who, at the time, holds an
appointment as a registered consultant in a hospital within the Territorial Limits specified in
Condition 9. In addition, particular requirements as to evidence or opinion may be required to
fulfil the definition of the Minor Cancer under Condition 6 or Major Cancer under Condition 7.
8.4 Aviva may reasonably require that you undergo, at no cost to Aviva, medical examinations with
medical practitioners nominated by Aviva.
8.5 In the event of conflicting medical evidence or opinion, the occurrence of Minor Cancer or
Major Cancer will be determined by Aviva having consulted with its Chief Medical Officer.
8.6 No benefit will be payable in respect of any medical condition which is not a Minor Cancer as
defined in Condition 6 or a Major Cancer as defined in Condition 7.
9.
TERRITORIAL LIMITS
A claim in respect of a Major Cancer or Minor Cancer will be invalid unless the diagnosis is made
by a hospital consultant who is both registered to practice and working at a medical facility
inside the Territorial Limits at the time the diagnosis is made. The term "Territorial Limits"
means the European Union, Andorra, Channel Islands, Gibraltar, Iceland, Isle of Man,
Liechtenstein, Monaco, Norway, San Marino, Switzerland, Vatican City, Australia, Canada, Hong
Kong, New Zealand, Singapore, South Africa, or U.S.A.
10. CLAIM REQUIREMENTS
10.1 Any claim in respect of Minor Cancer or Major Cancer must be made in writing within 6 months
of the date on which a Life Insured is medically diagnosed and certified as suffering the cancer
(which requires that all the conditions stated in the definition of the Minor Cancer in Condition
6 or the Major Cancer in Condition 7 are satisfied).
10.2 The following will be required by Aviva in relation to a claim:
10.2.1 Written notice and evidence acceptable to Aviva of the relevant Minor Cancer or Major
Cancer (see Condition 8 (Medical Evidence) for further details);
10.2.2 Evidence of title of the claimant;
10.2.3 A form of discharge (supplied by Aviva), completed and signed by the claimant;
10.2.4 These Policy Conditions, including the Schedule and any Special Conditions attaching;
10.2.5 Any other documents, including evidence of identity, which Aviva may reasonably
require.
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11. CASH-IN VALUE
Your Policy will not have a cash-in value at any time.
12. REINSTATEMENT
12.1
If your Policy terminates, because of non-payment of Premiums, you may reinstate it within
6 calendar months of the date on which the first unpaid Premium was due, provided that you
provide Aviva with such medical and other evidence of good health as Aviva may reasonably
require and pay all outstanding Premiums.
12.2 If you wish to reinstate your Policy, you must inform Aviva in writing.
13. TERMINATING YOUR POLICY
13.1 You may terminate your Policy at any time by notifying Aviva in writing (enclosing these Policy
Conditions, including the Schedule) and ceasing payment of further Premiums.
13.2 As stated in Condition 2, Aviva will terminate your Policy if you fail to pay the Premiums due.
13.3 The benefits under your Policy will be cancelled immediately on termination.
14. AVIVA RIGHT TO CHANGE
14.1 We may change the terms of this Policy for any of the following reasons:
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to respond, in a proportionate manner, to changes in the way we administer policies of this
type;
to respond, in a proportionate manner, to changes in technology or general practice in the
life and pensions industry;
to respond, in a proportionate manner, to changes in taxation, the law or interpretation of
the law, decisions or recommendations of the Financial Services Ombudsman, regulator or
similar person, or any code of practice with which we intend to comply;
to respond in a proportionate manner to any changes in the tax status of the policy;
to respond in a proportionate manner to any changes in the tax status or residency of the
policyholder;
to correct errors, if it is reasonable to do so.
14.2 If we think any alteration to these Policy Conditions is to your advantage, we’ll make it
immediately and tell you at a later date. We’ll also do this if the alteration is due to regulatory
requirements.
14.3 If any alteration is to your disadvantage, we’ll aim to tell you in writing at least 30 days before
we make it. However, external factors beyond our control may mean we have to give you less
notice.
14.4 If any alteration is to your disadvantage, we’ll outline any options then available at the time of
writing to you.
15. MIS-STATEMENT OF AGE
15.1 If the date of birth provided to us for the Life Insured is incorrect but within our age limits, we’ll
adjust the cover amount and base the payment we make for any successful claim on the correct
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date of birth. If, using the correct date of birth, the age of any life insured when you took out
your policy would have been outside our age limits, we won’t pay any benefit and we’ll cancel
your Policy, however, we’ll refund all your premiums (without interest).
16. MISREPRESENTATION
16.1 We have issued this Policy to you on the understanding that the information (including without
limitation that on smoker status) you gave us when you applied for cover is true and complete
in all material respects, that you were resident at the time you completed the application form
and that we have been given all relevant information in relation to your taking out this policy
with us and we have been told of any changes or additions after you apply for this Policy but
prior to the Policy Start Date.
If this is not the case, then we may decide to do one or more of the following:
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reduce one or both of the cover amounts;
increase the premiums;
not to pay any benefit;
cancel the policy with or without a refund of premiums.
16.2 If your Policy is reinstated under the terms of condition 12 of this Policy, we’ll reinstate it on the
understanding that the information (including without limitation that on smoker status) given in
the evidence of health form and any other relevant information in relation to our reinstating
this policy is true and complete in all material respects, that you were resident at the time of
reinstatement and that all relevant information has been provided and we have been told of
any changes or additions after you apply for this Policy but prior to the Policy Start Date.
If this is not the case, then we may decide to do one or more of the following:
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reduce one or both of the cover amounts;
increase the premiums;
not to pay any benefit;
cancel the policy with or without a refund of premiums.
16.3 Information is material or relevant if it might influence the judgment of a reputable insurer
when fixing the premiums or cover amounts or when deciding whether to provide cover at all.
16.4 For the purpose of this Condition 16 and Condition 18 the term “resident” means resident for
tax purposes in the Republic of Ireland.
17. ASSIGNMENT
If you assign the policy to someone else, you must tell us in writing of the date, purpose and
assignee. Before we can pay a claim we’ll need (along with other requirements in condition 10
of this policy) proof of who legally owns the policy.
18. ELIGIBILITY/RESIDENCE
18.1 You as Policyholder and as life Insured must be at least 18 years of age but under 60 years of
age to apply for this policy.
18.2 At the time you complete the application form you must be a resident.
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18.3 If you stop being a resident, you should seek independent professional advice as to any possible
taxation consequences of keeping this policy in force.
19. COMPLAINTS
Any complaints about this Policy should be referred to Aviva. However, if your complaint is not
dealt with to your satisfaction, you may refer your complaint to:
Financial Services Ombudsman's Bureau
Address: 3rd Floor, Lincoln House, Lincoln Place, Dublin 2
Lo-call: 1890 88 20 90 Fax: (01) 662 0890
E-mail: [email protected]
Website: www.financialombudsman.ie
Full details of the remit of the Financial Services Ombudsman's Bureau can be obtained directly
from their office.
20. YOUR 30 DAY GUARANTEE
You have a 30 day cooling off period to change your mind about taking out this Policy. The
cooling off period begins on the day you receive your policy documents. If you wish to cancel
your Policy within the cooling off period, you can do so by sending us a signed and dated letter
to the address shown above, instructing us to cancel your Policy. You should also return your
Policy Conditions and your Schedule. Your letter should be posted on or before the 30th day
after the day that your received your policy documents. Once we receive your cancellation
request, we’ll cancel your Policy and refund any premiums (without interest) you have paid.
For and on behalf of Aviva Life & Pensions UK Limited
Gary Marshall
Managing Director
Aviva Life & Pensions Ireland
Aviva Life & Pensions UK Limited, trading as Aviva Life & Pensions Ireland, is authorised by the Prudential Regulation Authority in the UK and is regulated by the Central Bank of Ireland
for conduct of business rules.
Aviva Life & Pensions UK Limited, trading as Aviva Life & Pensions Ireland, is also regulated in the UK: by the Prudential Regulation Authority for prudential rules and, to a limited extent,
by the Financial Conduct Authority for applicable UK conduct rules.
Registered Branch Office in Ireland (No 906464) at One Park Place, Hatch Street, Dublin 2. Tel 01 898 7000 Web www.aviva.ie
Registered in England (3253947) at 2 Rougier Street, York, YO90 1UU.
Telephone calls may be recorded for quality assurance purposes.
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