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Illustrations 9.6.3. This release in October 2012 consisted of a variety of changes to existing policy wordings for TotalCare Max policies, and introduced.

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Presentation on theme: "Illustrations 9.6.3. This release in October 2012 consisted of a variety of changes to existing policy wordings for TotalCare Max policies, and introduced."— Presentation transcript:

1 Illustrations 9.6.3

2 This release in October 2012 consisted of a variety of changes to existing policy wordings for TotalCare Max policies, and introduced additional services to the Best Doctors feature. The release has improved Sovereigns product ratings, customer’s perception of value and overall customer experience. These enhancements are passed back to all previous versions of TotalCare Max.

3 Best Doctors 2.0

4 Doctors Online Customers who have the Best Doctors benefit will be able to submit a medical question online and receive a researched response from doctor within 48 hours. Customers can ask non-emergency questions There is no limit to the number of enquiries that can be made Customers can also ask on behalf of their immediate family Questions/answers will be stored in the customers personal inbox to ensure confidentiality.

5 FindBestCare ® Following the InterConsultation process if overseas treatment is the best option Best Doctors will arrange all of the care details, including hospital, specialist, flights, hotels, transfers etc. Services include: Coordinating the necessary information with the medical specialists involved Monitoring of the treatment process Assistance with the hospital admittance process and medical appointments Ongoing support and information for customers and their family during the treatment process

6 Multimedia Library Customers will be able to search an online library that contains 300 educational videos that will help to explain what happens within the body. This is an easy and informative resource to help understand certain conditions Almost all common conditions covered Links to online healthcare resources

7 Policy Wording Changes

8 TPD – Own Occupation Old Policy Wordings The old policy wordings restricted customers from all employment during the 3 month qualifying period. New Policy Wordings The new policy wordings says the customer must only not be working in their OWN occupation during the 3 month qualifying period. It also clarifies 'own occupation' as being the business or occupation that the life assured was involved in immediately prior to incapacitation, and that the customer must not ever be able to resume work in that specific occupation.

9 TPD – Any Occupation Old Policy Wordings The old policy wordings state that the life assured must be so incapacitated that it is unlikely that they will ever engage in any gainful employment again. New Policy Wordings The life assured is now able to return to work after the initial 3 consecutive months of incapacitation, provided that they are not able to earn more than 25% of their pre-disablement earnings. This means that if they can return to either their job at a reduced capacity of 25% or less or they can do another job with substantially lower pay then they may still be entitled to a claim.

10 Income Protection- Offsets New Policy Wordings The new policy wordings will remove the Superannuation payment offset under the Total Disability and Partial Disability Benefits under Income Protection. This is great for clients that have a “to age 70” benefit. Premier Option only: The sick leave offset has also been removed under the Total Disability and Partial Disability Income Protection Benefits.

11 Income Protection– Wait Period Old Policy Wordings The old policy wordings state that the life assured must be totally disabled and remain so for a continuous period greater than the waiting period. New Policy Wordings The life assured no longer needs to be totally disabled for the entire waiting period. The life insured must be: totally disabled for the first 14 days of the waiting period; and either totally disabled or partially disabled continuously during the balance of the waiting period; and at the end of the waiting period is totally disabled and remains totally disabled thereafter.

12 For Income Protection, we had added a new Self Employment Definition: “For the purpose of this definition, the insured person is deemed to be in business rather than employment if he or she derives income (either realised or unrealised) from a company or other legal entity, and he or she has effective control, either directly or indirectly (e.g. through a trust, partnership or other legal structure) of more than 25% of the shares or ownership in that company or other legal entity”. Self Employed Definition

13 Living Assurance (Comprehensive) Angioplasty: New policy Wordings Where the life assured requires a coronary angioplasty to correct blockage of three or more arteries, they no longer need to have a level of occlusion (blockage) of at least 50% in each affected artery. Cancer Melanoma: New policy Wordings There is now no minimum depth of invasion for malignant melanoma under the Optional Early Cancer Upgrade Benefit, the melanoma must be less than 1.5mm depth of invasion. We will now pay a claim if there is evidence of ulceration of malignant melanoma. Skin cancers are still excluded unless they have spread to other organs.

14 Thank you


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