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Circumstances in which your policy will end, now additionally includes if we pay the maximum benefit amount for a single insured event 

Page 1 – Commencement and termination of the policy The cover provided by the policy commences on the policy start date and will continue until the earliest of the following, upon which the policy terminates: • you reach your 75th birthday; • payment of policy benefit to you for total permanent disablement - unable to look after yourself ever again; • you cease to be a UK resident; • you die; • you stop paying the premium. 

Page 7 – When does my cover start and end? When does my cover start and end? Your cover starts on the policy start date and ends on the earliest of the following: your 75th birthday; payment of a claim for you suffering 'Total Permanent Disablement - unable to look after yourself ever again'; our total benefit payment(s) for a single insured event suffered by you reaches the maximum benefit amount (see below) you cease to be a UK resident; you die; you stop paying the premiums. 

Introduction of an overall maximum total payment for a single insured event 

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Page 7 – When does my cover start and end? Maximum benefit amount payable  For a single insured event, the maximum we’ll pay, during the term of your policy, will be: For you:                         £50,000 per unit of cover  Under Child Cover:  £  5,000 per unit of cover 

For hospital stays (of five consecutive days or more) due to pregnancy related complications, we will now pay for all days in hospital; whereas previously we’d only pay for Day 5 onwards. 

Page 4 - 5.2 Sickness (including pregnancy-related complications) Policy benefit for hospitalisation due to pregnancy-related complications will be paid if an insured person is admitted to hospital as an inpatient for at least four complete and uninterrupted days (a day is a period of24 hours). Policy benefit will only be paid from day five onwards. 

Page 9 - Hospitalisation You are covered for each continuous 24-hour period that you are admitted to hospital in the UK, as an in-patient, as a result of:

• An accident.
• Sickness.
• Pregnancy-related complications, or 
• Voluntary organ donation by you.

Hospitalisation – What is covered and when?

• Hospital stays due to accident.- Cover begins from the policy start date 
• Hospital stays due to sickness -Cover starts 1 year after the policy start date 
• Hospital stays of at least 5 consecutive days, due to pregnancy-related complications.- Cover starts 1 year after the policy start date  
• Hospital stays for voluntary organ donation - Cover begins from the policy start date.

Revised definition of a ‘hospital’, to cover continuing in-patient treatment in separate premises from the hospital, while the patient is medically unable to be discharged. 

Page 15 – Definitions. Hospital - means an institution, registered as a hospital accordance with law, which has accommodation for resident patients and facilities for diagnosis, surgery and treatment including hospices where admittance is for terminal prognosis care. It does not include a long-term care nursing unit, a geriatric or pre-convalescent ward or an extended care facility for convalescence or rehabilitation. 

Page 4 – Definitions of important words and expressions used in this document. Hospital is defined as an institution registered as a hospital in accordance with law, with accommodation for resident patients and facilities for diagnosis, surgery, and treatment. This includes hospices where admittance is for terminal prognosis care. It also includes in-patient wards such as for occupational therapy or physiotherapy treatment – which may be in a separate premises, if the admission is to provide equivalent treatment that would otherwise be provided in a hospital.

Page 9 - Hospitalisation - What is not covered  Admission to any of the following are not covered by your policy: 

• A long-term care nursing unit.
• A geriatric or pre-convalescent ward.
• An extended care facility for convalescence or rehabilitation which doesn’t meet our definition of hospital on page 4. 
• A drug, alcohol, or other addiction / substance abuse rehab unit.

Clarification that no payment will be made for a hospital stay which began before the policy start date. 

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Page 9 - Hospitalisation - What is not covered:  Hospital stays that begin before the policy start date for any reason are not covered. 

Similarly to the max benefit limit for the main policyholder (parent), we now have a max total payment limit for a single insured event suffered by your child– of £5,000 per unit of cover.

Under Child Cover, a single insured event may be:

• A single accident, which results in any number of claims for any combination of benefit payments.
• A single, uninterrupted hospital stay.
• A diagnosis of cancer which results in payment of the Cancer benefit. (This is a separate insured event from any hospitalisation for treatment of the cancer). 

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Page 7 – Maximum benefit amount payable  For a single insured event, the maximum we’ll pay, during the term of your policy, will be:

For you:  £50,000 per unit of cover

Under Child Cover:  £ 5,000 per unit of cover 

Additional disclaimer for the policyholder to acknowledge that if making a Child Cover claim, they may be required to declare that they did not cause the injury to the child or expose the child to risk which led to the injury/illness, and that we won’t pay the claim until any investigation into the circumstances of the injury/illness has been completed and found the policyholder didn’t cause it. 

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Page 14 – Child Cover. Protection of Children We will co-operate with any investigation undertaken by the police or other agencies into the circumstances of the claim, including sharing any information you have provided to us in connection with the policy and the claim. We may withhold payment of the claim until informed of the outcome of the investigation. If any wrongdoing by you is found to have led to the child’s injury, no benefit will be paid. When making a claim under Child Cover, you may be required to confirm that no actions on your part:

• Deliberately caused the injury to the child;
• Deliberately caused the child to suffer the insured event; or, 
• Wilfully exposed the child to unreasonable risk leading to them suffering the insured event.

Addition to the child Broken Bones cover wording to allow for covering broken bones caused by (non-accidental) self-inflicted injury by the child or attempted suicide by the child, as well as accidental injury. (Does not apply to policyholder) 

Page 2 -Broken bones To help minimise disruption to normal life, we will pay the policy benefit shown in your Policy Schedule if, during the term of the policy, an insured person sustains bodily injury caused by an accident, which results in either a major broken bone or minor broken bone. 

Page 14 – Child Cover. Broken Bones.

What is covered

 Your child is covered if they sustain a Major Broken Bone or Minor Broken Bone due to accidental injury, or as a direct result of self-inflicted injury or their attempted suicide.

[…] 

When the cover starts

• Cover for your child suffering a broken bone due to an accident starts from the latter of the policy start date, or when Child Cover is added to your policy.
• Cover for your child suffering a broken bone caused by self-inflicted injury or their attempted suicide, starts 12 months after the policy start date, or 12 months after Child Cover is added to your policy.

In the same way that we’ve removed the 90-day limit on claim payments for hospital stays for the policyholder (parent), we have also removed the 90-day limit on claim payments for hospital stays by the child. Hospital stays can now be of any number of complete days, subject to the overall max benefit limit for a single Child Cover insured event.  

Page 4 - 5.3 Duration of hospitalisation Policy benefit for hospitalisation is only paid for each complete and uninterrupted 24 hour period (a day), up to a maximum of 90 days per accident or sickness. Days of hospitalisation that are less than 24 hours will not be paid. 

n/a 90-day limit removed.

Addition to the child Hospitalisation cover so that we now also cover hospitalisation for the treatment of (non-accidental) self-inflicted injuries by the child or injuries resulting from attempted suicide by the child, as well as accidental injury. (Does not apply to policyholder).  [note that we still won't cover hospitalisation for psychological treatment of the child to address any underlying mental illness, once the treatment of the self-inflicted injury has been completed] 

Hospitalisation in the UK as a result of an accident or sickness.

Page 3 - 5. Hospitalisation in the UK as a result of an accident or sickness 5.1 Accident We will pay the policy benefit shown in your Policy Schedule if, during the term of the policy, an insured person sustains bodily injury caused by an accident, which results in an insured person being admitted to hospital as an inpatient for at least 24 hours. 5.2 Sickness (including pregnancy-related complications) Provided you have held your policy for at least 12 months, we will pay the policy benefit shown in your Policy Schedule if, during the term of the policy, [an insured person is] admitted to hospital as an inpatient for at least 24 hours caused by sickness.

Page 14 - Child Cover. Hospitalisation

What is covered

Your child is covered for each complete 24-hour period they’re admitted to hospital in the UK, as an in-patient as a result of:

• An accident.
• Sickness
• Pregnancy-related complications, (i.e. your child’s pregnancy, not yours)
• Voluntary organ donation by the child.

[…]

Your child is covered for each complete 24-hour period they’re admitted to hospital in the UK, as an in-patient for the treatment of self-inflicted injuries or for injuries resulting directly from attempted suicide.

Self-inflicted injury - what's not covered Once the treatment of the self-inflicted injury has been completed, any further days spent in hospital to treat or investigate any psychological cause of the self-harm, or to prevent the child from repeating the self-harm, aren’t covered

We have enhanced the child cover for Cancer, by re writing the definitions of cancers that can be claimed for. As a result, the types of cancer that are explicitly covered under ‘malignant tumour’ is much longer now, and some lower grade/less severe cancers are now covered that were not previously – including carcinoma in situ (removed by surgery) and non-melanoma skin cancer. 

Page 5- Child Cover (optional)

If, during the term of the policy an eligible child suffers an insured event or is diagnosed with cancer - excluding less advanced cases, we will pay the policy benefit shown in your Policy Schedule, in order to support you through the disruption to normal life.

Page 14 – Definitions Cancer - excluding less advanced cases (applicable to optional Child Cover only) any malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue.  The term malignant tumour includes

• Leukaemia
• Sarcoma
• Lymphoma except cutaneous lymphoma (lymphoma confined to the skin).

For the above definition the following are not covered:

• All cancers which are histologically classified as any of the following:
  • Pre-malignant; 
  • Non-invasive; 
  • Cancer in situ; - having either borderline malignancy; or 
  • Having low malignant potential.
• All tumours of the prostate unless histologically classified as having a Gleason score of 7 or above or having progressed to at least clinical TNM classification T2bN0M0.
• Chronic lymphocytic leukaemia unless histologically classified as having progressed to at least Binet Stage A.
• Any skin cancer (including cutaneous lymphoma) other than malignant melanoma that has been histologically classified as having caused invasion beyond the epidermis (outerlayer of skin).
• All thyroid tumours unless histologically classified as having progressed to at least TNM classification T2N0M0. 

Page 16. Child Cover – Cancer

What is covered

Your child is covered if they’re diagnosed with Cancer by a qualified medical practitioner, which meets at least one of the definitions below.

A single diagnosis which meets more than one of these definitions, and/or which involves more than one tumour, will be treated as a single claim and one benefit would be payable.

Definitions

Malignant tumour

A malignant tumour that’s positively diagnosed with histological confirmation, and characterised by the uncontrolled growth of malignant cells and invasion of tissue, and/or any of the following:

• Leukemia;
• Sarcoma;
• Lymphoma (except cutaneous lymphoma - lymphoma confined to the skin);
• Merkel cell cancer;
• Polycythemia rubra vera;
• Aplastic anemia, resulting in permanent bone marrow failure with anemia, neutropenia, and  thrombocytopenia;
• Essential thrombocythemia;
• Primary myelofibrosis;
• Pseudomyxoma peritonei. 

Skin cancer (not including melanoma) - advanced stage as specified

Non-melanoma skin cancer that’s diagnosed with histological confirmation that the tumour is larger than two centimetres across, and has at least one of the following features:

• Tumour thickness of at least 4 millimetres; 
• Invasion into subcutaneous tissue (Clark level V); 
• Invasion into nerves in the skin (Perineural invasion);
• Poorly differentiated or undifferentiated (cells are very abnormal as demonstrated when seen under a microscope);
• Has re-occurred despite previous treatments.

Other cancers treated by surgery Histological diagnosis of any of the following that’s been treated by surgery to remove the tumour:

• Carcinoma in situ, characterised by the uncontrolled growth of malignant cells that are confined to the epithelial linings of organs;
• A neuroendocrine tumour (NET) of low malignant potential; or,
• A gastrointestinal stromal tumour (GIST) of low malignant potential. 

Clarification that when applying the max total benefit limit to Child Cover (£5k per single insured event), we treat the diagnosis of Cancer (which pays £5k on its own) as a separate insured event from the associated hospitalisation. So if a policyholder’s child was diagnosed with cancer as defined in the policy, they would receive £5,000 per unit of cover for child Cancer benefit, and also up to £5,000 for each hospital stay. 

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From Summary of Benefits, Page 3. Child Cover

The maximum amount payable under Child Cover for any ONE of the following insured events is £5,000 per unit of cover:

• A single accident, resulting in any combination of Child Cover benefits being paid.
• A single, uninterrupted hospital stay. 
• Diagnosis of cancer.

Payment of the benefit for diagnosis of cancer is a separate insured event from any hospital stays. 

We have relaxed the rules around needing to be a Healthcare Worker at the date you contracted one of the covered illnesses, to be able to claim under Specialist Healthcare Cover. If you already have SHC on your policy and you are diagnosed with any of the listed illnesses, you are covered, so long as SHC was in force at the date you contracted it. It is no longer relevant whether or not you were a Healthcare Worker at the time. 

Page 7 – Specialist Healthcare Cover (optional)

To help support you through the disruption to normal life, you can make a claim under Specialist Healthcare Cover during the term of the policy and for up to three years after the date you cease to be a healthcare worker if you have been diagnosed as having one of the infectious illnesses listed below. This must be evidenced by a Consultant and agreed by our Chief Medical Officer. We will pay the policy benefit shown in your Policy Schedule, however the policy benefit will not be paid if the date of contracting the infectious illness occurred after the date you ceased to be a healthcare worker.

• Clostridium difficile infection.
• Human Immunodeficiency virus (HIV).
• Hepatitis B.
• Hepatitis C.
• Bacterial meningitis.
• Septicaemia caused by methicillin-resistant Staphylococcus aureus (MRSA).
• Tuberculosis - excluding latent tuberculosis.

What’s not covered?

• Claims where an infectious illness listed above is contracted or where you have been referred for tests or investigations relating to the infectious illness before the policy start date or the date on which we accept inclusion of the optional Specialist Healthcare Cover (if added later).
• Claims where an infectious illness was contracted after the date you ceased to be a healthcare worker.
• Claims where you were not a healthcare worker at the time of selecting cover.

Specialist Healthcare Cover is not mentioned in the new policy Terms & Conditions document. The existing Terms & Conditions still apply, subject to the revisions described in this table.For ease of reference, we have provided the revised Specialist Healthcare Cover terms below.  

We have removed the extended period for diagnosis of the infectious illness which ran to 3 years after the policyholder ceased being a healthcare worker. It no longer applies, because we now disregard the occupation of the policyholder (as mentioned above). Now, only the date you contracted the illness matters (not the date of diagnosis). The contracted date must be during the term of the policy while Specialist Healthcare Cover is/was in force. 

Page 7 – Specialist Healthcare Cover (optional)

To help support you through the disruption to normal life, you can make a claim under Specialist Healthcare Cover during the term of the policy and for up to three years after the date you cease to be a healthcare worker if you have been diagnosed as having one of the infectious illnesses listed below. 

Specialist Healthcare Cover is not mentioned in the new policy Terms & Conditions document. The existing Terms & Conditions still apply, subject to the revisions described in this table.

For ease of reference, we have provided the revised Specialist Healthcare Cover terms below.