Living Assurance

This trauma insurance pays a lump sum claim payment if your clients or their children are diagnosed with a critical illness or injury. This can help them cope with the sometimes significant cost of recovery from an illness like cancer or a heart attack.

Covering Childhood

With the Living Assurance entry age starting from 2 years old, parents have the option to take out trauma insurance for their children, either as standalone or part of the family insurance, with a maximum sum assured up to $250,000. This can help support the whole family through a difficult time such as allowing parents to take time off work to be there for their child.

Quick facts about Living Assurance

  • Eligible age:
    • Standalone Personal Comprehensive Living Assurance is available from age 2. Parents or legal guardians are required as the policy owner prior to age 16
    • Business Comprehensive Living Assurance and Accelerated Personal Comprehensive Living Assurance are available from age 16
    • Personal and Business Essential Living Assurance are available from age 16
    • Optional benefits can be applied for once the life assured is 16 years or over
    • Individual consideration from age 70
  • Minimum sum assured: No minimum
  • Maximum sum assured: $2,000,000 for clients aged 16 years and over. $250,000 for children aged 2 to 15 years.
  • Premium structure options available from age 16: Rate for age, 10 year fixed term, or to age 65 fixed term. If Living Assurance is selected with Life Cover as an accelerated benefit, indexation may apply.
  • Comprehensive full and partial payments: With the Comprehensive Living Assurance, your clients will be covered for over 45 defined medical conditions. The product is designed to provide a full payment of the sum assured for specified serious medical conditions, and partial payments for significant but non-life threatening conditions, including severe Crohn's disease, osteoporosis, rheumatoid arthritis and ulcerative colitis.

Built-in and Optional Benefits to support your clients' needs

  • If a child of the life assured suffers an applicable covered condition where the criteria for a full payment is met, the Children's Trauma Benefit will pay a benefit of 50% of the sum assured (up to $50,000). Importantly, the payment of the Children's Trauma Benefit will not reduce the amount of any Living Assurance remaining for the life assured.

    A 3 month stand down period and a 14 day survival period after suffering the condition applies. Exclusions apply for any pre-existing or congenital conditions.

    Please note that Sovereign will pay one claim per child under either the Newborn Children's Benefit or the Children's Trauma Benefit across all Sovereign policies. This benefit is included for the life of the policy.

    Why is this important?

    The built-in Children's Trauma Benefit provides some trauma cover for a life assured's children aged 2 to 21 years within their standard premium cost. Should the worst happen, your clients might choose to use the lump sum to contribute towards treatment costs or to take time off work to care for their child.

  • If the life assured's child is born with one of five specified congenital conditions and survives for 30 days after birth, the Newborn Children's Benefit will pay a benefit of 50% of the sum assured (up to $50,000). The payment of the Newborn Children's Benefit will not reduce the amount of any Living Assurance remaining for the life assured.

    Please note that Sovereign will pay only one claim per child under either the Newborn Children's Benefit or the Children's Trauma Benefit across all Sovereign policies.

    A 12 month stand down period and 30 day survival period applies.

    This benefit is included for the life of the policy.

    Why is this important?

    Your clients might choose to use the Newborn Children's Benefit to take time off work to care for their child.

  • With this Benefit, your clients are able to be reimbursed for the cost of financial and legal advice from a Sovereign approved financial adviser or legal professional. Sovereign will reimburse cost of up to $2,500 (including GST). This is a one-off payment across all Sovereign policies for each life assured.

    Why is this important?

    Navigating legal matters amd managing short, medium or long term finances following a claim can be challenging. The Financial and Legal Advice Benefit provides your clients with an opportunity to obtain the advice they need to plan for their future.

  • This enables your clients to increase their Living Assurance following major life changes for the life assured. The specified list of events includes significant milestones in a person's life known to result in increasing financial responsibilities. These significant events include: having a child, child starting secondary school, getting married, taking out or increasing a residential home loan, or making extensions to a residential property or residential investment, receiving a salary increase and other major events.

    The Special Events Increase Facility offers your clients the opportunity to increase their Living Assurance up to once per year without having to provide further medical information (maximum increase limits apply).

    This benefit is available once a life assured reaches age 16, and before age 55. Please note that these increases are not available if the life assured has already suffered a condition under Living Assurance. Where a claim of another type has been notified or accepted for the life assured, Sovereign will exercise its discretion in determining if the increase can be applied based on the nature of the claim.

    Why is this important?

    Life changing events can increase your clients' financial responsibilities. The Special Events Increase Facility allows your clients to increase their cover without having to provide further medical information for a life assured following a specified special event. Any increase under this benefit is subject to the conditions of the policy wording.

  • This benefit allows your clients to increase their cover at every third policy anniversary. The Future Insurability Benefit does not require any specific events to occur.

    The Future Insurability Benefit offers your clients the opportunity to increase their Comprehensive Living Assurance up to every three years without having to provide further medical information (maximum increase limits apply).

    This benefit is available once a life assured reaches age 16, and before age 55. Please note that these increases are not available if the life assured has already suffered a condition under Living Assurance. Where a claim of another type has been notified or accepted for the life assured, Sovereign will exercise its discretion in determining if the increase can be applied based on the nature of the claim.

    Why is this important?

    Life changing events can increase your clients' financial responsibilities. If your client does not experience one of the special events, they can still choose to increase their cover at every third policy anniversary.

  • All future enhancements to TotalCareMaxwill automatically be applied to your client's policy and the provision (or wording) that is most favourable to your client will be applied at claims time.

    Please note that any enhancements only apply in respect of those claims where the claim event date occurs after the date of enhancement.

    Why is this important?

    Your clients will automatically benefit from any favourable future changes to our TotalCareMax product range. This helps to ensure that your clients' policies remain contemporary and continue to deliver value long after the policy was purchased.

  • If a child of your client dies. We will pay a Parent's Grieving Benefit if a child of your client dies, of up to $2,000 for children under the age of 10 years and we will pay $15,000 for children between the ages of10 and 21 years.

    Why is this important?

    Losing a child is probably the singular most devastating event a parent could be asked to endure during their lifetime, regardless of the age of the child.

    In crisis, many families may find funding for a child's funeral is a challenge, and financial resources may not be quickly available to help support in this process.

  • Sovereign will pay you up to $10,000 towards the cost for your client, plus one support person, to return home from overseas should they have suffer a critical condition for the first time covered under the policy.

    Why is this important?

    Nobody has control over when and how they become ill.

    This benefit provides reimbursement for the unexpected costs to return home to NZ if a client suffers a covered trauma condition while overseas and their travel insurance policy hasn't provided the coverage they need to get home.

  • Sovereign will pay up to $2,500(including GST) to cover the cost of a Psychiatrist or Psychologist consultation and counselling for your client and/or their family where the treatment arises as a result of a Trauma claim.

    Why is this important?

    This benefit provides assistance for the life assured, or their support network, to help them deal with the emotional impacts following diagnosis of a covered Trauma condition and enables them to work through personal challenges and changes that are impacting in their lives with a fully trained Psychiatrist or Psychologist.

  • This benefit enables the life assured to suspend their Trauma cover if they go on parental leave, or go on leave without pay for any reason for up to 12 months.

    Notification to suspend must be received within three months from the commencement of leave.

    Cover will be suspended from the date set out in Sovereign's written acknowledgement of the receipt of notification and relevant evidence.

    During the period that cover is suspended, no claim will be payable for any Trauma condition that occurs.

    A total of 12 months suspension may be accepted without the need to provide further medical evidence. The cover will automatically be reinstated at the end of the 12 months suspension, unless advised otherwise.

    Why is this important?

    Having time away from work or taking an unpaid break can leave finances stretched and often means that clients need to find a way to balance living on a reduced budget. Introducing this benefit gives clients financial freedom to redirect funds when their budget is tight whilst ensuring they retain the ability to reinstate cover without having the added complexity of reapplying.

  • Upon reaching 21 years of age the Built-in Children's Trauma Benefit or Optional Children's and Maternity Benefit can be converted to a Comprehensive Living Assurance Benefit adult policy with no further medical evidence required, except where there is an increase in cover. The request for conversion must be made within 60 days of the child turning 21, and cannot occur if a claim has been made under the original policy.

    Why is this important?

    It formalises client's current ability to convert the Built-in Children's Trauma Benefit or Optional Children's and Maternity Benefit to a Comprehensive Living Assurance Benefit adult policy when a child reaches 21.

  • Your client may convert their Comprehensive Living Assurance Benefit to accelerated Comprehensive Living Assurance Benefit with an equal amount of Life Cover without any further medical evidence provided. Conditions apply.

    Why is this important?

    This benefit provides clients flexibility with product options to meet their needs.

  • Your client can convert all or part of their Comprehensive Living Assurance Benefit from the Premium specified in their Policy Schedule to a Level Premium structure (prior to reaching age 65 years), without further medical underwriting.

    Why is this important?

    This benefit provides customers flexibility with premium options to help manage affordability.

  • This optional benefit provides additional children's trauma cover of up to a further 50% of the sum assured (up to $75,000) per child of the life assured, and covers multiple children.

    The children's benefit is paid if a named child of the life assured suffers an applicable covered condition under Living Assurance except for the Optional Total Permanent Disablement condition (if applicable). This optional benefit is paid once per child across all Sovereign policies and is paid in addition to the built-in Children's Trauma Benefit. If both parents have taken the optional benefit under separate policies then two payments may be made. This optional benefit can be added to either Comprehensive Living Assurance or Progressive Care, but not both for the same life assured.

    A 3 month stand down period and a 14 day survival period applies. Exclusions apply for any pre-existing or congenital conditions.

    A benefit is also provided for three defined serious pregnancy complications in the sum of $10,000.

  • Your clients have the option to add cover for "own occupation" Total Permanent Disablement (TPD) as a claimable condition under Comprehensive Living Assurance.

    If your clients select this option, an "own occupation" TPD condition is added as a full payment condition under Comprehensive Living Assurance.

    This does not change the Comprehensive Living Assurance sum assured, but widens coverage to include conditions not otherwise covered under Comprehensive Living Assurance, which lead to total and permanent disability.

    The optional TPD condition expires at age 65, and does not apply to any children under the Children's Trauma Benefit or the Optional Children's and Maternity Benefit.

  • A great option for growing businesses, the Business Safeguard Facility provides your clients with the option to increase their benefit as their financial interests or their financial value to the business increases, without having to provide further medical information.

    Why is this important?

    This allows the Living Assurance cover to keep pace with changes in your client's business responsibilities.

  • This optional benefit provides cover for a number of minor cancer conditions that are treatable and non-life threatening at the early stages of diagnosis. The Early Stage Cancer benefit pays 25% of the original sum assured (up to $75,000) and does not reduce Living Assurance for a life assured.

    A 3 month stand down period and a 14 day survival period applies. And only one claim is payable per policy.

    Why is this important?

    By accessing a benefit payment at the early stages of a cancer diagnosis, your clients may choose to access specialist treatment before the cancer develops.

  • This optional benefit allows your clients to maintain the level of their Living Assurance by reinstating the benefit amount following a claim and without having to provide further medical information (a 12 month survival period applies and exclusions apply for any conditions that are related to the condition originally claimed for). Your clients can select this option for either standalone Living Assurance or for accelerated Living Assurance on a TotalCareMax Life Cover policy.

    Why is this important?

    This optional benefit allows your clients to restore their Living Assurance so that they can claim for unrelated medical conditions.

  • This optional benefit allows your clients to reinstate the original TotalCareMax Life Cover benefit following an accelerated Living Assurance claim and without having to provide further medical information. Minimum survival periods apply and reinstatements are not permitted if the life assured is eligible for a Life Cover Terminal Illness Benefit or the Specified Terminal Conditions Benefit.

    Why is this important?

    This is a great option to ensure that your client's Life Cover remains adequate.

  • Sovereign offers its Specialist and Diagnostic Testing Benefit with Best Doctors* as an optional benefit with Living Assurance. This benefit can make a real difference to the timeliness and choice of your clients' specialist medical advice. The Specialist and Diagnostic Testing Benefit provides coverage of up to $5,000 per year for specialist consultations, diagnostic imaging and tests. In addition, Best Doctors offers your clients the opportunity to seek a second opinion from an international network of medical specialists. Some specialists and diagnostic tests are not covered.

    Please note that this optional benefit is subject to its own terms and conditions which differ from Living Assurance. Please refer to the applicable policy document.

    Why is this important?

    • The New Zealand public health system provides quality emergency care and treatment for serious conditions. However, rising health care costs continue to put pressure on the public system's ability to offer prompt access to specialist consultations and diagnostic tests. Sovereign's Specialist and Diagnostic Testing Benefit enables your clients to access timely specialist advice so that their medical conditions can be promptly diagnosed.

    • Best Doctors' offers your clients and their families remote access to over 53,000 leading medical specialists worldwide. They have all been nominated by their peers as top experts in their field, and are there to help your clients.

    Access an Expert: Easy access to the world's best medical minds for advice and guidance on any medical condition.

    Find an Expert: Face to face consultations with a broad range of medical specialists in your clients' area.

    DocOnline: Unlimited access for clients to send medical questions to experienced, local GPs, with a response within 48 hours.

    Multimedia medical library: Access to hundreds of articles, videos and blogs on a wide range of medical conditions.

    * Best Doctors is a trademark of Best Doctors, Inc., in the United States and other countries, and is used under licence.

  • Accidental Injury Cover is an optional benefit that can be added to our core TotalCareMax (TCM) Personal and Business range (issued after February 2004 Illustrations version 8.3 or later) and provides customers an up-front lump sum payment, should they be injured accidentally. They can use this lump sum for whatever they need: covering treatment costs, getting taxis to work, hiring someone to help with children or running their business, or simply taking time off work to recover.

    Key product features:

    • Can be taken out with any of our core TCM products giving flexibility to you and your clients.
    • Sum assured can be anywhere between $500 - $5,000 a month with no proof of income required and flat rate pricing based on gender and smoking status.
    • Easy to understand insurance with four simple claim categories.
    • Once approved, claims are paid as a lump sum giving your clients quick access to funding to deal with the accidental injury they're facing.
    • There are no offsets against ACC or other insurances so your clients get the financial support they need, relevant to their situation.
    • Application is easy. For new customers, there are no extra questions than what is required for their core TCM products. For eligible existing customers there is a new, simple form to endorse it on to their existing policy.

    For more information please read the Accidental Injury Cover Personal Policy Wordings or Business Policy Wordings.

A note on exclusions

Some built-in and optional benefits under Living Assurance are subject to specific exclusions or stand-down periods. These are noted throughout this page. The policy wordings have a complete list of exclusions.

In addition, the following general stand-down periods and exclusions apply:

  1. Some covered conditions are subject to a three month stand-down period. This means Sovereign will not pay a claim for any of these conditions, if signs or symptoms relating to that condition, occur within three months of policy commencement. Please see the policy wordings for a complete list.
  2. Sovereign will not pay a claim where any of the following causes or contributes to the claim:
    1. An insured person (who may be a life assured or insured child of a life assured) deliberately injuring themselves, or attempting to do so;
    2. An insured person engaging in criminal conduct;
    3. A condition, or signs or symptoms leading to a condition, which an insured person has prior to policy commencement; or
    4. In relation to any insured person under the age of 21, an intentional act by a parent, guardian or other person who lives with or supervises that insured person.

The information on this page is provided as a sales support tool to be used in conjunction with the appropriate policy wording.