Progressive Care

• When needed most - Severity level tiers mean that Progressive Care can provide partial claim payments at an earlier stage of the condition than traditional trauma products (subject to any previous claims paid under the policy). However, higher severity thresholds generally apply for full claim payments compared with traditional trauma products.

• More than once - Clients can receive multiple claim payments for unrelated medical conditions or as medical conditions worsen (stand down periods and conditions apply).

• For more conditions - Covers more than 60 medical conditions at various stages of severity and at various claim payment levels (grouped under five Categories of Conditions - Cancer, Heart and Arteries, Brain and Nerves, Loss of Function and Other Health Events).

If a child of the life assured suffers a covered condition of severity level 1, 2 or 3, the Children's Trauma Benefit will pay a benefit of 50% of the sum assured (up to $20,000). Importantly, the payment of the Children's Trauma Benefit will not reduce the amount of Progressive Care for a life assured.

A stand down period, 14 day survival period, pre-existing condition exclusion and congenital condition exclusion apply

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.

This benefit is included for the life of the policy, however claims are expected to be low for a life assured aged between 2 to 15 years.

Why is this important?

The Children's Trauma Benefit provides some trauma cover for their children aged 2 to 21 years within their standard premium cost. Should the worst happen, your clients can rely on 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 thirty days after birth, the Newborn Children's Benefit will pay a benefit of 50% of the sum assured (up to $20,000). The payment of the Newborn Children's Benefit will not reduce the amount of any Progressive Care 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 minimum survival period applies.

This benefit is included for the life of the policy, however claims are expected to be low for a life assured aged between 2 to 15 years.

Why is this important?

The Newborn Children's Benefit enables your client to take time off work to care for their child.

This optional benefit provides additional children's trauma cover of up to a further 50% of the sum assured (up to $50,000) per child of the life assured (for up to 10 children).

The children's benefit is paid if a named child of the life assured suffers any covered condition under Progressive Care 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 Progressive Care or Comprehensive Living Assurance, but not both for the same life assured.

This optional benefit is paid once per child per benefit and is paid in addition to the built-in Children's Trauma Benefit. This optional benefit can be added to either Progressive Care or Comprehensive Living Assurance, but not both for the same life assured.

The Optional Children's and Maternity Benefit also provides cover for three defined serious pregnancy complications and a bereavement support benefit if a child of the life assured should pass away before age 3.

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

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

If your clients select this option, an "own occupation" TPD condition is added as a severity level 1 condition (i.e. 100% payment) under the Progressive Care "loss of function" category. This enables them to claim under the "loss of function" category for a wider set of conditions not otherwise covered under Progressive Care, which may lead to total and permanent disability.

Consider the example below:

Mary had $250,000 of standalone Progressive Care cover and had selected the optional TPD condition.

Mary suffered major burns in an accident which qualified her for a severity level 3 payment (50% payment) under the "loss of function" category. Mary received a claim payment of $125,000 ($250,000 x 50%). The remaining cover under the "loss of function" category was reduced to $125,000 ($250,000 -$125,000).

Five years later, Mary became totally and permanently disabled as a result of an unrelated mental health issue.

Mary received a claim payment of $125,000 for the optional TPD condition under the "loss of function" category. The remaining cover under the "loss of function" category reduced to nil.

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.

This enables your clients to increase their Progressive Care 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 special events include: having a child, becoming married, taking out or increasing a residential home loan, achieving a significant salary increase, and other major events.

The Special Events Increase Facility offers your clients the opportunity to increase their Progressive Care 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 Progressive Care. 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.

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 Progressive Care 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 Progressive Care. 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 TotalCareMax will automatically be applied to your client's policy and the provision (or wording) that is most favourable to your client will be applied at claim time.

Please note that any enhancements 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 TotalCareMaxproduct range. This helps to ensure that your clients' policies remain contemporary and continue to deliver value long after the policy was purchased.

With the Financial Advice Benefit, your client is able to obtain financial advice from a Sovereign-approved Financial Adviser at the time of receiving a full claim payment under their Progressive Care. Sovereign will reimburse your clients for fees of up to $2,500 (incl. GST). This is a one-off payment across all Sovereign policies for each life assured.

Why is this important?

A major health scare can reduce your client's ability to earn an income and can have a lasting effect on their financial situation. The Financial Advice Benefit provides your clients with an opportunity to obtain the advice they need to plan for their future.

Sovereign offers its Specialist and Diagnostic Testing Benefit with Best Doctors* as an optional benefit with Progressive Care. 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 add-on benefit is subject to its own terms and conditions which differ from Progressive Care. Please refer to the applicable policy document.

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

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.