BupaCritical illness cover

Bupa critical illness (CI) cover pays a one-off lump sum benefit if a person covered dies, suffers or undergoes one of the specified critical illnesses or operations covered under the scheme. The policy only pays out on this benefit once.

Additional options

Other options are available:

n Subscription waiver

n Total and permanent disability (TPD)

n Indexation

n Reinstatement cover

n Fracture cover

Benefits automatically included

n Children's CI cover

n Increase options on specified events

n Access to Best Doctors Service

The contract allows variations after commencement (subject to agreement of Bupa) as follows;

n Vary the benefits

n Vary the terms

n Add benefits

n Remove benefits

n Vary the lives assured

n Vary the premium frequency

Acceptable age attained at commencement:

Anyone aged between 18 and 59 can apply.

Minimum policy term: Five years

Maximum expiry age:

The policy must cease before the assured's 70th birthday.

Maximum term (years) for CI cover: 40 years

Maximum sum assured where CI cover is included:

£1m for personal cover and £1.5m for business cover. These are in addition to £500,000 in the market with other providers.

Minimum acceptable monthly premium: £8.00

n If cancer or multiple sclerosis are excluded following underwriting, the premium will reduce - it can go below the minimum premium of £8.00.

n The reduction varies according to product and sex.

Guaranteed premium rates for stand-alone CI cover: Yes

Reviewable premium rates:

A reviewable rate option is available for all benefits except stand-alone term assurance. Where reviewable rates are selected, reviews will take place on the fifth anniversary of commencement and at the end of every following five-year period.

Cover basis:

The plan is available on a level, decreasing, or increasing basis.

Automatic sum assured indexation available:

The policyholder can help protect the value of the lump sum benefit over the years by selecting an indexation option when joining. If one of these options is chosen, the benefit can increase in line with the retail price index, average earnings index or by 5% or 3% each year on each anniversary of cover commencing.

Basis on which indexation increases are costed:

Indexation increases are costed on an age attained basis.

Waiver of premium (WOP) available:

A subscription waiver option is available when applying for cover on any of those persons covered.

Age waiver cover ceases:

WOP ceases at age 65.

Plan offers the option to buy-back CI cover after a claim:

A reinstatement option is available, with the terms dependent upon the illness contracted and subject to a specific timescale for reinstatement.

Maximum sum assured allowed under CI cover buy-back option:

The maximum CI buy-back sum assured will be the lower of £100,000, or the benefit paid under the original membership, less the amount of any benefit Bupa has provided under a new membership taken out following the exercise of the replacement option.

Option to vary term after start date other than by insurability:

The planholder may request a change to the terms of any benefit included in the plan at any time. Bupa will consider any requests at its discretion. Further medical evidence may be requested by Bupa at that time. Where an application is accepted, the change will be provided either:

n Under a new membership governed by the terms and conditions applicable at the time, or

n As a change to the benefit under the existing membership.

Plan permits variations to sum assured other than guaranteed insurability options (GIOs):

The planholder may request a change to the terms of any benefit included in the plan at any time. Bupa will consider any requests at its discretion. Further medical evidence may be requested by Bupa at that time. Where an application is accepted, the change will be provided either:

n Under a new membership governed by the terms and conditions applicable at the time, or

n As a change to the benefit under the existing membership.

Change lives assured after start date:

Bupa does not offer the facility to change a life assured under this plan. Any changes to the life assured would require a new application to be completed. The new application would be underwritten at that time.

GIOs:

A member may want to increase the critical event benefit when the member, or either member if more than one:

n Gets married

n Has a child or adopts or becomes the legal guardian of one

n Moves house and takes out larger mortgage

n Is promoted by their current employer or starts a new job with a different employer and their salary increases.

Maximum age to exercise GIO:

The member or elder member should be under 55 when Bupa receives the application for an increase in benefit.

Joint life separation:

There is an option to split joint life plans on divorce. Bupa would require written confirmation from both parties of its intention to cease the original policy and to split the contract into two single life plans.

Benefit enhanced on accident or accidental death:

There is a facility to have an additional payment made if a member suffers a fracture.

Fracture cover option :

If Bupa has provided the fracture cover option and the member suffers from a fracture listed by they provider, Bupa will pay fracture cover benefit to the member.

Notification of a change in occupation required:

Once the plan has commenced, Bupa does not require the member to advise it of a change of job.

Period within which a claim must be notified:

Claims should be made as soon as is reasonably practicable and within six months of onset of the illness or disability.

Best Doctors Service:

Clients' who make claims under their Bupa CI cover will also have access to Best Doctors, which is an independent service that can locate and contact the specialists qualified to treat the condition for which the claim has been made.

2006 model Association of British Insurers (ABI) CI definitions adopted:

The plan adopted the 2006 ABI CI definitions with effect from 25 April 2007.

Number of exclusions applicable to CI cover:

There are four CI cover exclusions, as follows:

n Failure to follow medical advice

n HIV/Aids

n Self-inflicted injury

n Living abroad

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