POLICY
WORDING
1. How the UK mortgage payment
insurance policy works
You select the amount of cover you need to protect
your mortgage payment. Where your mortgage agreement
allows you to make variable payments to your lender
(e.g. a flexible mortgage plan), this should be the
average monthly amount you intend to pay;
You select the type of
cover you require.
You select the benefit
split you require.
You pay a monthly premium
to keep the policy in force.
Paymentshield (the
policy administrator) pay a fixed monthly benefit
for up to 12 months if you are unemployed or disabled
(as applicable) for longer than the waiting period.
Important note - The most Paymentshield will pay
as a monthly benefit is £1,500 or an amount equal
to 65% of your normal income, whichever is the lower.
Click
here for Mortgage Payment Protection Insurance
2. The type of cover the policy provides
The type of cover provided under the policy is unemployment
and disability insurance. This will offer you maximum
protection in the event of a claim. You can (if required)
restrict your policy to unemployment only cover or disability
only cover but you must be aware of the following facts:
if you take out unemployment
only cover you will not be able to claim for any disability.
If you suffer a disability during any period of unemployment,
your monthly benefit payments will be suspended until
you are able to continue actively seeking work; or
if you take out disability only cover you will not be
able to claim for any unemployment. If you become unemployed
during any period of disability, you will only be able
to continue to receive monthly benefit while you remain
disabled.
3.
The number of people who can be insured (the benefit
split)
If your mortgage is in your name only, or your mortgage
is in joint names and you are the only person who is
eligible for cover, we will issue single cover in your
name.
If your mortgage is in joint names and both of you are
eligible for cover, you have the following options:
you can take out single cover
in your name and be insured for 100% of the monthly
benefit provided that you are the main income earner.
The restriction relating to main income earner will
be waived if both parties to the mortgage wish to be
insured for 100% of the monthly benefit by taking out
two separate policies; or,
you can take out split cover
and you will both be insured for a percentage of the
monthly benefit. If you make a claim, we will divide
your monthly benefit in the same percentage as the normal
income of each person at the commencement of the claim.
4. Free cover for new borrowers
If you are a new borrower, you will receive three months
free cover.
If you restrict your policy to unemployment only cover
or disability only cover, we will also restrict your
free cover to the same type of cover.
5.
Free cover for existing borrowers
If you are an existing borrower, you will receive three
months free cover.
If you are an existing borrower, you will not be insured
against unemployment during the three month initial
exclusion period.
If you restrict your policy to disability only cover,
we will also restrict your free cover to the same type
of cover. If you have restricted your policy to unemployment
only cover, you will only be insured against disability
during the free cover period.
6.
Transferring cover from another insurer
If you transfer your cover from another insurer, we
will ignore the unemployment exclusion period for existing
borrowers as long as your existing policy has been in
force for at least six months and you have not made
a claim under that policy.
Click
here for Mortgage Payment Protection Insurance
7.
The eligibility requirements of the policy
You are eligible for cover under the policy if:
you are at least 18 and under
65;
you live and work in the UK;
you are taking out the policy
to protect the mortgage on the private residential property
you live in; and
you agree to keep to the policy
conditions.
You are not eligible for cover under the policy if:
you are aware of any circumstances
that may result in you becoming unemployed;
your work is of a casual, temporary
or seasonal nature;
you work for a temporary employment
agency;
unemployment is a regular feature
of your particular job; or
you are currently disabled. This
clause does not apply if you are on maternity leave.
8.
The waiting period under the policy
The policy has a 30 day waiting period during which
you will not be entitled to receive any monthly benefit
if your unemployment or disability lasts for 30 days
or less. After that, you will receive an amount equal
to one monthly benefit payment on the 31st day you are
still unemployed or disabled (Our "back to day
one" cover ensures that you receive full cover
from the first day of your sickness/disability as long
as the sickness/disability lasts more than 30 days).
9.
When the policy pays out for unemployment
Subject to the exclusions detailed in section 11, we
will pay out for unemployment if:
you are unemployed and you are registered as available
for work (unless you are exempt) at an employment office
(or equivalent) in the UK; and
you can provide independent evidence
that you are actively looking for permanent work.
We will consider the first day
of your unemployment to be the day you are first registered
as unemployed and available for work (unless you are
exempt) at an employment office (or equivalent) in the
UK and receiving the appropriate national insurance
credits. If you are receiving payment in lieu of notice
the waiting period will not begin until your payment
in lieu of notice period has ended.
10. What prevents the policy paying out for unemployment
(the exclusions)
We will not pay out for unemployment if:
You do not tell us about your claim for unemployment
within six months of the event.
You were aware at the start date
of any circumstance that would lead to you making a
claim for unemployment, or in our reasonable opinion,
you should have been aware.
You were not in continuous work
for the six month period immediately before your first
claim for unemployment. This clause will be waived if
you were in continuous work for the six month period
immediately before the start date.
Your work is of a casual, temporary
or seasonal nature (including any work for a temporary
employment agency), or unemployment is a regular feature
of your particular job.
You resign, retire, leave your
occupation voluntarily or you accept early retirement
in lieu of unemployment.
Your unemployment occurs as a
result of:
your misconduct including fraud,
dishonesty, breach of contract or any other circumstance
that resulted in your employer taking disciplinary action
against you;
your failure to meet the standards
or targets laid down by your employer
your participation in any industrial action;
the expiry of an apprenticeship
or training contract;
civil unrest, war, radioactive
contamination or any other related event.
Your unemployment happens while you are working away
from the UK for more than 90 days in a row. This clause
will not apply if you:
work for the British Armed Forces
or as a Civil Servant in a British embassy or consulate;
work for a company that is registered within the UK
and your employer asks you to work within the European
Union.
You are receiving payment in lieu of notice.
Your unemployment occurs as a result of any disability.
11. When the policy pays out
for disability
Subject to the exclusions detailed in section 13, we
will pay out for disability if:
you were actively working when your disability occurred;
and
you cannot work as a result of
the disability you are claiming for and you are under
the regular care and attendance of a doctor (or consultant).
We will consider the first day
of your disability to be the day on which a doctor (or
consultant) first certifies that you are unable to work
due to the disability you are claiming for.
12. What prevents the policy
paying out for disability (the exclusions)
We will not pay out for disability if:
You do not tell us about your claim for disability within
six months of the event.
You were aware at the start date
of any circumstance that would lead to you making a
claim for disability under the policy, or in our reasonable
opinion you should have been aware.
Your disability is caused by
a self-inflicted injury, alcohol abuse, drug abuse or
you fail to follow any medical advice.
Your disability is caused by
stress, anxiety, depression or any other nervous disorder
unless a suitably qualified consultant certifies that
the condition prevents you from working.
Your disability is caused by
any pre-existing condition.
Your disability is caused by
pregnancy or a normal pregnancy related condition (other
than a medical complication which happens as a result
of your pregnancy).
Your disability is caused by
backache or a back related condition where there is
no physical or radiological evidence of a medical abnormality
unless a suitably qualified consultant certifies that
the condition prevents you from working.
Your disability arises from any
operation or treatment which is not medically necessary.
You are doing any other job for
payment or reward or you are receiving any form of payment
or reward for helping, managing or carrying out any
part of the day to day running of your business.
Your disability is caused by
any of the unemployment exclusions.
13. Cancellation rights under
the policy
You can cancel the policy by writing to us and your
cover will end on the day we receive your written request.
If you cancel the policy within 30 days of the start
date, we will refund any premium you have paid. We will
not refund any premium if you cancel the policy more
than 30 days after the start date.
We can cancel the policy by giving you 90 days written
notice. This will not affect your right to receive claim
benefits for any unemployment or disability which occurred
before the cancellation date.
14. When cover under the policy
will terminate (the end date)
Cover will end on the date that one or more of the following
events should occur:
you die;
you retire from work or reach
the age of 65;
your mortgage comes to an end
(unless we have agreed to transfer your cover);
the property named on your mortgage
agreement becomes the subject of repossession proceedings
in a county court or high court;
your premium becomes more than
30 days overdue;
you no longer reside in the UK;
or
you or we cancel the policy.
15. General conditions for
making a claim
The policy only pays out if:
your unemployment or disability occurs after the start
date and before the end date;
you meet all the claim requirements under these policy
terms and conditions;
you have paid all your premiums;
and
you give us all the evidence
we need to check your claim.
You cannot claim for unemployment
and disability at the same time.
If you restrict your 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.
16. What to do if you have
to make a claim
If you want to make a claim under the 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).
17. 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.
18. 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.
19.
The paying of premiums
Premiums are payable monthly in advance by direct debit.
If you make a claim under the policy, you must continue
to pay your premium as it falls due. We will increase
your monthly benefit to reimburse any premium you have
paid during a period of claim.
We can change your premium by
giving you 30 days notice in writing.
The premium you pay includes
Insurance Premium Tax at the current rate. If we are
required by law to increase the level of Insurance Premium
Tax or to make any other charges, we will increase your
premium from the date any such changes are implemented.
20. Making sure your mortgage
is protected
If your mortgage payment alters due to interest rate
changes, you can amend your monthly benefit (without
notice) provided that you tell us within 30 days of
the notification from your lender.
If you want to alter your monthly
benefit for any other reason or you want to amend the
type of cover or benefit split you hold under the policy,
you will need to give us 90 days written notice.
21. Important facts you will
need to disclose on or before the start date
You must tell us if:
You are under the age of 18 or
over 64.
You work or live outside the
UK.
You would not be eligible to
register as unemployed in the UK.
You are not actively working
for at least 16 hours a week.
You are aware of any impending
unemployment which may affect you.
You are aware of any redundancies,
restructure or reorganisation within the business you
work in, even if you do not believe these actions will
result in you becoming unemployed.
You are aware of any financial
or contractual threat to the business you work in, even
if you do not believe these actions will result in you
becoming unemployed.
You have been registered as unemployed
within the last 12 months.
Your employer has taken any disciplinary
action against you including performance related issues.
Your work is of a casual, temporary
or seasonal nature (including any work for a temporary
employment agency) or unemployment is a regular feature
of your particular job.
You have a pre-existing condition
which may result in you having to take time off work
or you are currently unable to work because of a disability
(including any maternity leave).
You are using your mortgage for
commercial purposes (including buy to let mortgages)
or you are not living in the mortgaged property.
22. Circumstances that may
affect your continuing cover under the policy
You must tell us if:
You start to work or reside outside the UK.
You resign, retire or stop working
voluntarily.
Your status changes from employed
to self-employed (or vice versa).
You start working for less than
16 hours a week.
Your mortgage ends or your lender
issues proceedings against you because you have missed
too many mortgage payments.
You have, or take out, any other
unemployment and/or disability insurance.
23. General conditions that
apply to the policy
If you do not keep to the policy conditions, we will
not pay any monthly benefit.
We will cancel your policy and
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. Under these circumstances,
we may refund a percentage of any premium you have already
paid.
Unless we agree otherwise in
writing, English law is the law that will apply to this
policy.
The contract between you and
us is made up of:
the policy;
the certificate;
any endorsements;
your proposal; and
any other written statement or
information you give us.
The policy will not have any
cash-in value.
We may change the policy by adding an endorsement to
it. We will let you know at least 30 days before any
endorsement comes into force. If we add an endorsement
to the policy, we will not be entitled to make any further
endorsement within the next 180 days.
All administration procedures
will be carried out on our behalf by the administrator.
We will pay the monthly benefit
covering your mortgage payment to your lender.
We will deduct from your monthly benefit any amounts
we are required to deduct by law.
25. What you should do if you have a complaint
We try to provide a first-class standard of service.
If you do have a complaint, please write to:
The Managing Director,
Paymentshield Limited, PO Box 229, Southport PR9 9WU
Phone: 0870 759 4010 or Fax: 0870 759 4011
If the matter is not sorted out to your satisfaction,
please write to:
The Chief Executive,
Hamilton Insurance Company Limited
North Street, Winkfield, Windsor, Berkshire SL4 4TD.
If you are still not satisfied, you can ask either of
the following organisations to review your case:
The Insurance Ombudsman (IOB):
135 Park Street, London SE1 9EA. Phone: 0845 600 6666;
or
The Association of British
Insurers (ABI):
51 Gresham Street, London EC2V 7HQ. Phone: 0207 600
3333.
If you contact the Insurance
Ombudsman (IOB) or the Association of British Insurers
(ABI), this will not affect any right of legal action
you may have under the policy. Your interests are also
protected under the Policyholders’ Protection Act.
You can get details from the Policyholders’ Protection
Board at the Association of British Insurers (ABI).
25. Access to medical records
We may ask the doctor (or consultant) who is caring
for you to fill in a medical report so we can deal with
your proposal for this insurance. To do this, we need
your permission. Please sign the Access to Medical Reports
Act 1988 (in Northern Ireland The Access to Personal
Files and Medical Reports (Northern Ireland) Order 1991)
declaration contained on the proposal.
You do not have to give your
permission to our Chief Medical Officer being given
the report. However, under these circumstances, we may
be unable to process your proposal. If you give your
permission, you have the right to tell your doctor (or
consultant) that you want to see the report before it
is sent to us. In this case, your doctor (or consultant)
cannot send it to us unless you have either seen the
report or 21 days have passed without you contacting
your doctor (or consultant) to arrange to see the report.
If at first you decide that you do not want to see the
report but you change your mind before your doctor (or
consultant) sends us the report, you can tell your doctor
(or consultant). You will then have 21 days to see the
report. We may not be able to go ahead with your proposal
without medical information. As a result, the sooner
you act, the quicker we can consider your proposal for
this insurance. Whether or not you ask to see the report
before it is sent to us, your doctor (or consultant),
if you ask, must let you see a copy for up to six months
after they send it to us. If you ask for a copy of the
report, your doctor (or consultant) may charge a reasonable
fee to cover the cost.
If you see the report before
it is sent to us, your doctor (or consultant) cannot
send it to us until he or she has your permission. You
can ask your doctor (or consultant) to change any part
of the report, and if they refuse you can ask your doctor
(or consultant) to send us a separate statement with
the report giving the reasons why you consider it to
be wrong or misleading. Your doctor (or consultant)
can refuse to let you see any part of the report that
in his or her opinion would be likely to cause you or
others any physical or mental harm. They can refuse
if any part of the report may reveal information about
another person unless that person gives permission or
has cared for you in a professional way. In these cases,
your doctor (or consultant) must tell you. You could
then see any other part of the report. If it is the
whole report that is affected, your doctor (or consultant)
must not send it to us unless you give your permission.
26. Data protection act notification
We may use the personal details provided by you, or
any third parties, to:
give you quotations and administer your policy;
support the development of our
business by including your details in client surveys;
or
assist in market research
We have a set of practices in
place to ensure that confidential information (including
medical & lifestyle) about you is held securely.
We may also share these details with other insurance
organisations to help offset risks, administer your
policy, handle claims and prevent fraud.
We will store your details on
computer but we will not keep them for longer than necessary.
Under the terms of the Data Protection Act 1998 you
are entitled to a copy of all the information we hold
about you for which a reasonable fee may be charged.
27. The insurer and administrator
The policy is underwritten by Hamilton Insurance
Company Limited, North Street, Winkfield, Windsor, Berkshire
SL4 4TD.
The policy administrator
is Paymentshield Limited, PO Box 229, Southport PR9
9WU.
Click on the
image below to be taken to our dedicated Mortgage Insurance
Site .
