The Wayback Machine - https://web.archive.org/all/20060615040935/http://www.instant-mortgage-insurance.co.uk:80/policy_wording.html
Mortgage Payment Protection Insurance
initial disclosure | demands and needs | instant quote | apply for cover | policy summary | policy wording | about us | contact us
terms of business | introducers/affiliates | press coverage | website terms of use | privacy policy | home

Policy wording (HICL/PS/958)

1. The special words we use

The special words we use in this policy document are shown in bold type with their meanings alongside them. Except where the context otherwise requires, the masculine includes the feminine, the singular includes the plural and vice versa, as appropriate.

Additional Cover means 25% additional cover over and above the combined total of your mortgage payment, life premium and household premium.
Administrator means Paymentshield Limited.
Benefits office means an employment services job centre (or any equivalent) in the United Kingdom.
Business means a company, profession, trade or industry registered in the United Kingdom.
Carer’s Allowance means a state benefit paid to you if you look after a severely disabled person.
Ceased to trade means the business has permanently stopped trading, been wound up or put into the hands of a registered insolvency practitioner or, if the business is a partnership, the partnership has been permanently dissolved.
Certificate means the document we send you that confirms the cover you hold under the policy.
Chronic condition means a condition that occurs before the start date and that continues indefinitely or cannot be cured or eradicated and that recurs or requires treatment.
Condition means any illness, injury, disease or sickness, including any related illness, injury, disease, sickness, or associated symptoms.
Consultant means a suitably qualified independent medical specialist who is working at a recognised hospital in the United Kingdom. It does not include you or any of your family.
Controlling director means you own more than 20% of the issued shares of the business you work for.
Direct debit means the written or verbal authority you give us which allows us to collect the premium from your Bank or Building Society account.
Disability means you are disabled and you are under the care and attendance of a doctor or consultant.
Disabled means you have a medical condition that stops you from doing your normal work or any other job that you are reasonably able to do given your experience, education and/or training. This must be confirmed by a doctor or consultant.
Doctor means a doctor of medicine who is registered with the General Medical Council and working in the United Kingdom. It does not include you or any of your family.
Eligible for cover means you meet the eligibility requirements of the policy as detailed in section 4.
Employed or Employment means your employer deducts PAYE tax and national insurance contributions from your gross income and your work is of a permanent nature or you work under a fixed term contract or sub contracting basis and your sole source of income derives from that contract.
End date means the date on which your cover under the policy ends as detailed in section 21.
Exclusion period means the first 3 calendar months immediately after the start date.
Existing borrower means your mortgage has been in force for more than 30 days on the start date.
Family means your husband, wife or partner of either sex that you live with as if married or a relative of you or of your husband, wife, or partner.
Fixed Term Contract means a formal written contract to provide services or remuneration with a business direct or another contractor of a business for a fixed period of time.
Household premium means the normal monthly cost (or monthly equivalent of an annual charge) you pay for the buildings and/or contents insurance on the property named on your certificate.
Lender means the financial institution that grants you a mortgage.
Life premium means the normal monthly premium you pay for the life policy or savings plan that is intended to protect and/or pay off your mortgage.
Monthly benefit means the total amount of monthly cover you have selected under the policy. This is also the most we will pay out in the event of a claim (or a proportion of the amount for split cover). Your monthly benefit is shown on your certificate.
Mortgage means the secured loan you have taken out with the lender to purchase the private residential property you live in.
Mortgage payment means the normal monthly repayment you make to the lender for your mortgage.
New borrower means your mortgage has been in force for 30 days or less at the start date.
Normal income

means one of the following:

  • Employed - the average monthly income you have received during the past 12 months.
  • Self-employed - the monthly average of the annual income you declared to the Inland Revenue on your self-assessment return for the previous tax year.
Normal pregnancy means symptoms which normally accompany pregnancy (including multiple pregnancy) and which are generally of a minor and/or temporary nature (such as morning sickness or fatigue) which do not represent a medical hazard to you or your baby, a combination of minor symptoms or childbirth (including delivery by caesarean section or other medically or surgically assisted delivery which does not cause medical complications).
Payment in lieu of notice

means one of the following:

  • Any payment you receive that relates to the notice period you should have served under your contract of employment.
  • Any part of a compensation payment for loss of office (including any part of a payment under a compromise agreement) that relates to the notice period you should have served under your contract of employment.
Period of claim means any separate period of unemployment or disability for which you are receiving monthly benefit payments.
Policy means the specific type and level of insurance we provide under these conditions.
Pre-existing condition means any medical condition for which you have received treatment, medication or advice in the 12 month period immediately before the start date. This includes any treatment to monitor the condition.
Premium means the monthly amount you must pay for your cover under the policy.
Proposal means the application form that you complete for insurance under the policy.
Proprietor means you own (alone or with others - except as a shareholder), the business you work for.
Qualification period means the period of time that you will need to be unemployed or disabled before you qualify for claim payments. The qualification period options under this policy are detailed in section 16.
Relative means a brother, sister or lineal descendant.
Schedule means the document we send you which confirms the premiums due under your policy.
Self-employed or Self-employment

means you are classed as Schedule D for income tax purposes and you are required to make Class 2 National Insurance contributions and are not classified as employed. You will also be classed as being self-employed if you fall into one of the following categories:

  • You are a proprietor or controlling director.
  • You are a relative of either a proprietor or a controlling director who is working in the same business as you.
Single cover means you are the only person named on the certificate and you alone are insured for 100% of the monthly benefit.
Split cover means two people are named on the certificate and both of you are insured for a percentage of the monthly benefit.
Start date means the date your cover begins. The start date is shown on your certificate.
Treatment means advice, examinations, consultations, medications, or long term monitoring by a doctor or consultant.
Type of cover

means one of the following options:

  • Unemployment and disability cover.
  • Unemployment only cover.
  • Disability only cover.

The type of cover you have selected is shown on your certificate.
Unemployed

means you are entirely without work due to one of the following reasons:

  • Employed - your employer has totally and permanently terminated your job due to circumstances entirely beyond your control;
  • Self-employed - the business you work for has totally and permanently ceased to trade due to circumstances entirely beyond your control, or the control of any co-director or partner in the business;

or you have ceased to work to become a full-time carer for a member of your family and are in receipt of Carer’s Allowance.
Unemployment means you are unemployed and you are not receiving any form of payment or reward from your previous employment or self-employment.
United Kingdom means Great Britain, Northern Ireland, Channel Islands and the Isle of Man.
We, us, or our means Hamilton Insurance Company Limited.
Work means you are employed or self-employed and you are actively working for at least 16 hours per week. You must also be making the appropriate National Insurance contributions.
You, your, or yourself means the person or persons named on your certificate.

2. The type of cover the policy provides

Unemployment and disability cover will provide you with the maximum level of protection in the event of a claim.

If you take out unemployment only cover or disability only cover, you must be aware of the following points:

  • If you take out unemployment only cover, you will not be able to claim for disability. If you suffer a disability during a period of unemployment, your monthly benefit payments will be suspended until you are able to actively continue seeking work.

  • If you take out disability only cover, you will not be able to claim for unemployment. If you become unemployed during a period of disability, you will only continue to receive monthly benefit payments while you remain disabled.

3 . The level of cover the policy provides

The maximum monthly benefit (including any additional cover) is either £1,500 or 65% of your normal income, whichever is the lower.

Subject to the maximum monthly benefit limits above, you can take out the amount of monthly cover you need to protect the combined total of your mortgage payment, life premium and household premium.

Where your mortgage allows you to make variable payments to your lender such as a flexible mortgage, your mortgage payment should be the average monthly amount you intend to pay your lender.

4. The eligibility requirements of the policy

You are eligible for cover under the policy if at the start date:

  • you are 18 to 64 years of age and you are permanently resident in the United Kingdom;

  • you work in a business that is situated in the United Kingdom;

  • you are taking out the policy to protect the mortgage payments on the residential property you live in; and

  • you agree to keep to the terms and conditions set out in the policy document.

You are not eligible for cover under the policy if at the start date:

  • you are not personally named on the mortgage;

  • you are acting as a guarantor on the mortgage (even if you are personally named on the mortgage);

  • you are aware of any circumstances that could result in you making a claim for unemployment benefits under the policy;

  • your work is casual, temporary or seasonal (including any work for a temporary employment agency);

  • you are in any kind of work where unemployment is a regular or re-occurring feature of your particular job; or

  • you are currently unable to attend your work due to a disability. (This does not apply if you are on maternity leave, paternity leave, adoption leave or parental leave).

5. The number of people who can be insured

  • If you are the only person named on the mortgage, you can only take out single cover.

  • If your mortgage is in joint names (other than with any other person who is named as a guarantor), you have the following options:

    • You can take out single cover provided that you are classed as being the main income earner.

    • If you are both eligible for cover, you can take out split cover and you will both be insured for part of the monthly benefit. In the event of a claim, we will divide your monthly benefit in the same percentage as the normal income of each person at the start of the claim.

    • If you are both eligible for cover, you can both take out a separate policy to cover the full monthly benefit.

6. Making sure your mortgage remains protected

Your monthly benefit will not automatically increase or decrease in line with any changes to your mortgage payment.

If you want to amend your monthly benefit because your mortgage payment has increased or decreased due to interest rate changes, we will amend your monthly benefit without notice provided that you tell us within 30 days of receiving the notification from your lender.

If you want to amend your cover under the policy for any other reason, you will need to give us 90 days written notice.

7. Duration of the Insurance

This is a monthly contract. The policy is issued for an initial period from the start date to the date the first premium is due and will automatically be renewed for a further month on payment of each premium as it falls due.

8. The payment of premiums

Premiums are collected monthly in advance by direct debit. The date on which the first premium becomes due for payment is shown on the schedule.

If you make a claim under the policy, you must continue to pay your premium as it falls due. We will reimburse any premium you have paid during a period of claim by increasing your monthly benefit.

We can change your premium by giving you 30 days notice in writing. The premium includes Insurance Premium Tax (IPT) 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 charges are implemented.

In the event that a premium remains unpaid 30 days after the date on which it is due to be paid, cover under this policy shall cease.

9. When the policy pays out for unemployment

Subject to the policy exclusions, we will pay unemployment benefits if you are registered as being unemployed and available for work at a benefits office (unless you are exempt) and you can provide us with satisfactory evidence that you are actively looking for permanent work.

We will consider the first day of your unemployment to be the date on which you are first registered at a benefits office as being unemployed and available for work (unless you are exempt).

If you are receiving payment in lieu of notice, your qualification period will not begin until your payment in lieu of notice period has ended.

If your previous employment was on a fixed term contract you must have at least 12 months continuous service with that business to receive full entitlement to claim benefits under the policy. If your previous employment was on a fixed term contract and you have less than 12 months continuous service with that business you are not insured for the non renewal of your fixed term contract and entitlement to monthly benefit will end on the date that your fixed term contract was originally intended to terminate.

Alternatively, subject to the policy exclusions, we will pay unemployment benefits if you cease to work to become a full-time carer for a member of your family and are in receipt of Carer’s Allowance. We will consider the first day of your unemployment to be the first date you were both without work and in receipt of Carer’s Allowance.

10. The unemployment exclusions

We will not pay out unemployment benefits under the policy if:

  • You knew about unemployment on or before the start date or, in our reasonable opinion, you should have known.

  • You knew you would need to become a full-time carer on or before the start date or in our reasonable opinion you should have known.

  • You were not in continuous work for 6 months before your first claim for unemployment (this is waived if you were in continuous work for 6 months before the start date).

  • Your work is casual, temporary or seasonal (this includes any work you do for a temporary employment agency).

  • You are receiving payment in lieu of notice or, you are doing any job (employed or self-employed) for any form of payment or reward.

  • Unemployment is a regular feature of your particular job.

  • Unemployment occurs because:

    • you resign, or accept voluntary unemployment;

    • you refuse any offer of reasonable alternative employment by your employer, which based on your qualifications, previous experience and the location of such employment it would have been reasonable for you to accept;

    • you retire or take early retirement in lieu of unemployment;

    • your employer takes disciplinary action against you as a result of your misconduct, fraud, dishonesty or breach of contract;

    • you fail to meet any of the performance standards or targets laid down by your employer;

    • you participate in any industrial action;

    • your apprenticeship or training contract comes to an end;

    • your unemployment occurs as a result of any civil unrest, war, radioactive contamination or any other related event;

    • your unemployment occurs while you are working away from the United Kingdom for more than 90 days in a row. This is waived if you:

    • work for the British Armed Forces or as a Civil Servant in a British Embassy/Consulate;

    • are required by your employer to work at another location within the European Union;

  • your unemployment occurs as a result of a disability.


11. Additional unemployment exclusions

If you are an existing borrower, we will not pay out unemployment benefits under the policy if:

  • You become unemployed within the exclusion period.

  • You are told about unemployment within the exclusion period (even if your unemployment only commences after the exclusion period has ended).

12. When the policy pays out for disability

Subject to the policy exclusions, we will pay disability benefits if you are unable to work as a result of your disability and you are not receiving any form of payment or reward other than your normal or statutory sick pay.

We will consider the first day of your disability to be the date on which a doctor or consultant first certifies that you are unable to work.

13. The disability exclusions

We will not pay out disability benefits under the policy if:

  • You knew about impending disability on or before the start date;

  • Your disability is due to a pre-existing condition unless you have not suffered from, received treatment or consulted a doctor or consultant about the condition in the 24 months before your disability occurred;

  • Your disability is due to a chronic condition;

  • You are disabled due to any type of self-inflicted injury, alcohol abuse, drug abuse, or you fail to follow any medical advice;

  • You are disabled due to stress, anxiety, depression or any nervous disorder (this is waived if a suitably qualified consultant certifies that the condition prevents you from working);

  • You are disabled due to normal pregnancy;

  • You are disabled due to backache or a back related condition where there is no physical or radiological evidence of a medical abnormality (this is waived if a suitably qualified consultant certifies that the condition prevents you from working);

  • You are disabled due to any operation or treatment that is not medically necessary (including any cosmetic or beauty treatment);

  • You are disabled due to any of the unemployment exclusions;

  • You are doing any job for payment or reward or, you are receiving any form of payment or reward for managing or carrying out any part of the day to day running of the business you work for.

14. General conditions for making a claim

You must tell us about your claim within six months of the event that brought about your claim.

The policy only pays out if:

  • your claim occurs between the start date and the end date;

  • you were employed or self-employed when your claim occurred;

  • you have paid all your premiums;

  • you give us all the evidence we need to check your claim.

You cannot claim for unemployment and disability at the same time.

You cannot alter your cover during a period of claim.

We will only pay a claim arising from the type of cover you have selected.

Monthly benefit is reduced if it is more than 65% of your normal income.

If you have any other unemployment or disability insurance to cover your mortgage payment, we will reduce your monthly benefit by an amount equal to the benefits you are entitled to receive under any other insurance policy.

You can transfer a claim between unemployment and disability (or vice versa) but if you do, we will not pay out more than 12 monthly benefit payments in total for any one period of claim.

You can make a completely new claim as long as you have returned to work for at least 90 days in a row.
Two claims separated by less than 90 days continuous work are treated as the same period of claim. You will only be entitled to receive the monthly benefit entitlement that is left over from the previous period of claim. This period is reduced to 30 days continuous work for any claim that arises from a medical condition that is not related to the disability that brought about the previous claim.
We will not pay out any monthly benefit if you give us any false, misleading or fraudulent information.

If you are offered a temporary job, you can suspend a claim for unemployment provided that:

  • you tell us in advance, who you will be working for;

  • your temporary job lasts for at least one week and for no longer than six months in a row;

  • you do not have more than three separate temporary jobs during any one period of claim.

15. 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, PO Box 229, Southport PR9 9WU - Telephone: 0870 759 4020.

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:

  • If you are unemployed - independent evidence that you remain registered with a benefits office as being unemployed and available for work. We will also require proof that you are still actively looking for work.

  • If you are disabled - independent evidence that you are still disabled and that you remain under the regular care and attendance of a doctor or consultant. We will also require proof that you are not receiving any form of payment or reward (other than your normal or statutory sick pay).

16. When your claim becomes due for payment

The period of time you will have to wait before you are entitled to receive your first monthly benefit payment will depend on the qualification period option you have selected under the policy (as detailed below).

  • Qualification period - option 1 (back to day one cover after 30 days)

    To qualify for monthly benefit, your unemployment or disability must last for at least 30 consecutive days.

    On the 31st day of continuous unemployment or disability, we will pay an amount equal to one monthly benefit. From the 31st day onwards, we will pay an amount equal to 1/30th of the monthly benefit for each day that you remain continuously unemployed or disabled.

    Any monthly benefit due to you will be paid monthly in arrears.

  • Qualification period - option 2 (back to day one cover after 60 days)

    To qualify for monthly benefit, your unemployment or disability must last for at least 60 consecutive days.

    On the 61st day of continuous unemployment or disability, we will pay an amount equal to two monthly benefits. From the 61st day onwards, we will pay an amount equal to 1/30th of the monthly benefit for each day that you remain continuously unemployed or disabled.

    Any monthly benefit due to you will be paid monthly in arrears.

  • Qualification period - option 3 (30 day excess period)

    To qualify for monthly benefit, your unemployment or disability must last for at least 30 consecutive days.
    From the 31st day onwards, we will pay an amount equal to 1/30th of the monthly benefit for each day that you remain continuously unemployed or disabled. Any monthly benefit due to you will be paid monthly in arrears and the first payment will be made on the 61st day.

  • Qualification period - option 4 (60 day excess period)

    To qualify for monthly benefit, your unemployment or disability must last for at least 60 consecutive days.
    From the 61st day onwards, we will pay an amount equal to 1/30th of the monthly benefit for each day that you remain continuously unemployed or disabled. Any monthly benefit due to you will be paid monthly in arrears and the first payment will be made on the 91st day.

17. When your claim payments will stop

We will stop making claim payments on the date that you have received 12 monthly benefit payments for any one period of claim, or the date that one or more of the following events should occur (whichever is the earlier):

  • your unemployment or disability ends;

  • you fail to meet any of the policy conditions for claim payments;

  • the end date of the policy (as detailed in section 21).

18. Obligations and rights when making a claim

You must attend an independent medical examination if we believe it is necessary to check your claim (we will pay the cost of the examination). If you refuse to attend a medical examination and you do not provide us with a satisfactory reason, we will not pay any monthly benefit.

We may contact any other person or organisation that we consider necessary to assist in checking your claim and where necessary, you must provide us with a signed authority to obtain this information.

We may ask to see your personal bank or financial statements.

We may arrange an interview with you to help you look for work.

We will only pay monthly benefit when we receive satisfactory evidence of your entitlement to claim.

If you delay sending us a completed claim form or any other evidence we require, your claim could take longer to check. This may lead to us paying the monthly benefit late, or not paying the monthly benefit at all.

19. Circumstances that may affect your cover

You must tell us if at any time:

  • you start to live or work outside the United Kingdom;

  • you cease work or start working for less than 16 hours a week;

  • you change from employed to self-employed (or vice versa);

  • you start to work on a fixed-term contract basis;

  • you no longer live in the property named on your certificate;

  • you change the people named on your mortgage;

  • your mortgage comes to an end;

  • your lender issues legal proceedings against you because you have missed too many mortgage payments;

  • you hold any other unemployment and/or disability insurance.

20. Cancellation rights under the policy

You can cancel your cover by writing to the address on your certificate and your cover will end on the date we receive your written request.

If, having examined your policy, you decide not to proceed, you have a statutory right to cancel for up to 14 days from the start date, however, we offer a 30 day cancellation period without charge. We will not refund any premium if you cancel your cover more than 30 days after the start date.

We can cancel your cover by giving you 30 days written notice. This will not affect your rights to receive claim benefits for any event that occurred before the cancellation date.

21. When cover under the policy will terminate

Cover will cease on the first of the following events:

  • the date on which you die;

  • the date on which you retire from work or reach the age of 65;

  • the date on which your mortgage comes to an end (unless we have agreed to transfer your cover);

  • the date on which your home becomes the subject of repossession proceedings in a county court or high court;

  • the date on which your premium is more than 30 days overdue;

  • the date on which you or we cancel your cover.

22. General conditions that apply to the policy

We will cancel your cover and not pay monthly benefit if you:

  • do not keep to the terms and conditions set out in the policy document or

  • give us any false, misleading or fraudulent information.

If we cancel your policy due to any of the reasons detailed above, we may (at our sole discretion) refund a percentage of any premiums you have already paid.

The contract between you and us is made up of:

  • the policy document

  • the certificate and schedule;

  • any endorsements;

  • your proposal and any other written statement or information you give us in connection with the policy.

The policy will not have any cash-in or surrender value.

We may change the policy by adding an endorsement to it. If we do, we will write to you at least 30 days before any endorsement comes into force.

If we add an endorsement to the policy (other than as a legal requirement), we will not make any further endorsement within the next 180 days.

All procedures relating to the policy, are carried out on our behalf by the administrator.

We will pay the monthly benefit for your mortgage payment to your lender (unless we have agreed anything different with you in writing).

We will deduct from your monthly benefit, any amounts that we are required to deduct by law.

23. What you should do if you have a complaint

The administrator handles complaints on our behalf.

If you are unhappy with any aspect of the sale of this policy or have cause for complaint you should initially contact the person who arranged the cover for you.
If however, you are unhappy with the general administration or claims handling of the policy or have cause for complaint you should contact the Paymentshield Customer Services Team by telephone or in writing by letter or email.

The address is:
Paymentshield Limited
PO Box 229
Southport
PR9 9WU

Customer Services Helpline: 0870 759 4000

Email: enquiries@paymentshield.co.uk

The Customer Services Team will tell you what we will do to resolve your concerns and how long it will take.

Where you remain dissatisfied with the response you may refer the matter to Hamilton Insurance Company Limited, at their head office, for a final response.

The address is:
Hamilton Insurance Company Limited
North Street
Winkfield
Windsor
Berkshire
SL4 4TD

If you are still dissatisfied with the resolution you receive, or your complaint has not been resolved within 8 weeks, you have the right to ask the Financial Ombudsman Service (FOS) to review your case.

The address is:
The Financial Ombudsman Service (FOS)
South Quay Plaza
183 Marsh Wall
London
E14 9SR

Customer Services Helpline: 0845 080 1800

Email: complaint.info@financial-ombudsman.org.uk

If you contact any of the above organisations, this will not affect any right of legal action you may have under the policy.

24. The law and language applicable to the contract

The policy is governed by English law. The language used in this policy and any communication relating to it will be English.

25. Data Protection Act Notification

Both we and the administrator hold personal information about you in order to provide you with insurance, to process claims you may make on your policy, to comply with regulatory requirements and to prevent fraud. Both we and the administrator may need to disclose information about you to one or more insurance companies, loss assessors, regulatory authorities and fraud prevention agencies.

If you have questions about our use of personal information, or if you believe our records are inaccurate, you should write to the Data Protection Officer, Paymentshield Limited, PO Box 229, Southport PR9 9WU.

26. Compensation

We are a member of the Financial Services Compensation Scheme (FSCS). The scheme provides compensation if its members go out of business or into liquidation and are unable to meet any valid claims under its policies. Most insurance contracts are covered for 100% of the first £2,000 and 90% of the remainder of the claim. Further information on the scheme can be obtained from the FSCS on 0207 892 7300 or by email at enquiries@fscs.org.uk.

27. Hamilton Insurance Company Limited

The insurance for this policy is underwritten by Hamilton Insurance Company Limited which is authorised and regulated by the Financial Services Authority (FSA) as an insurance company and to undertake insurance mediation under registration number 202671. You can check this out by visiting the FSA’s website www.fsa.gov.uk/register or by contacting the FSA on 0845 606 1234.

Hamilton Insurance Company Limited is an incorporated company, limited by shares, registered in England under number 1655888.

Hamilton Insurance Company Limited is a member of the Association of British Insurers (ABI) and Financial Ombudsman Service (FOS).

Registered Office: North Street, Winkfield, Windsor, Berkshire SL4 4TD, United Kingdom.

28. Enquiries and Assistance

If you have any queries about your policy please contact our Customer Services Team on 0870 759 4000.

 

 

This website is owned and operated by Burgesses Ltd who are authorised and regulated by the Financial Services Authority and members of The British Insurance Brokers Association.
 

 

 
click here to get an instant quote for mppi