CLAIMS
PROCEDURE
General conditions for making a claim
The policy only pays out if:
1. your unemployment or disability occurs after the
start date of your mortgage protection policy and before
the end date
2. you meet all the claim requirements under these policy
terms
3. conditions you have paid all your premiums
4. you give us all the evidence we need to check your
claim.
If you want to make a claim
under the mortgage protection policy, you should contact:
Paymentshield Claims
Department
P O Box 229, Southport, PR9 9WU.
Phone: 0870 759 4020
Fax: 0870
759 4021
We will send you a claim
form which you must fill in and return to us as soon
as possible, together with any further evidence we may
need. You will also need to provide the following information:
unemployment - evidence
that you are still unemployed and actively looking for
work; or
disability - evidence that
you are still disabled and that you are still under
the regular care and attendance of a doctor (or consultant).
You cannot claim for unemployment
and disability at the same time.
If you restrict your mortgage protection insurance to
unemployment only cover or disability only cover, we
will only pay for a claim arising from the specific
type of cover you have selected.
We will reduce your monthly benefit
if it is more than 65% of your normal income.
If you have any other unemployment
or disability insurance, we reserve the right to reduce
your monthly benefit by an amount equal to the claim
benefits you receive under that insurance.
You can transfer a claim between
unemployment and disability (or vice versa) but if you
do, we will not pay more than 12 monthly benefit payments
for that period of claim.
You can make a completely new claim under the policy
as long as you have returned to work for at least 90
days in a row. We will treat two claims separated by
less than 90 days work in a row as the same period of
claim and you will only be entitled to receive the balance
of any monthly benefit payments left from the previous
period of claim. We will reduce this period to 30 days
for any claim arising from a medical condition that
is not related to the disability that brought about
the previous claim.
We will not pay any monthly benefit
if you give us any false, misleading or fraudulent information,
or if you fail to tell us about any important fact.
If you make a claim for unemployment
and you are offered a temporary job, you can suspend
your claim provided that:
you tell us beforehand who you
will be working for;
your temporary job lasts for
at least one week and no longer than six months; and
you do not have more than
three separate temporary jobs during any one period
of claim.
When we will make claim payments
Your initial claim payment will be made on the first
day immediately after the waiting period.
After that, we will pay an amount
equal to 1/30th of the monthly benefit for each day
you are still unemployed or disabled. We will continue
to make payments monthly in arrears until the earliest
of the following events:
the last day you are unemployed or disabled;
the date on which you stop giving
us evidence that you are still unemployed or disabled;
the date on which you have received
12 monthly benefit payments for any one claim; or
the end date of the policy.
Obligations and rights when
making a claim
You must have an independent medical examination if
we believe it necessary to validate your claim (we will
pay the cost of the examination). If you fail or refuse
to have a medical examination and you do not give us
a satisfactory reason, we will not pay any monthly benefit.
We reserve the right to contact any other person or
organisation that we consider necessary to assist in
the validation of your claim and where necessary, you
must provide us with the relevant authority to obtain
this information. We can also ask to see your personal
bank or financial statements.
We may arrange a personal interview
with you to help you look for further permanent work.
We will only begin to make monthly benefit payments
when we receive full and satisfactory evidence of your
eligibility to claim. If you delay sending us the claim
form or any other evidence we require, your claim may
be harder to check. This may lead to us paying monthly
benefit late or not paying it at all.
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