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. 1 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. 2 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: 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. 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. 3 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. 4 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: 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 5 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: 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: 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. 6 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. 7
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