Life policy terms and conditions

Life policy terms and conditions

 

It seems there is plenty to write about this week. 

Russell Hutchison has said the following on his blog moneyblog this week.

An Australian man whose daughter went to live in Syria claims she did nothing wrong by going there, and was misled into the venture which was supposed to be for humanitarian purposes. Headlines describe her as a "Jihadist." But her motivation is not the point as far as the insurance claim is concerned.

Everyone knew that Syria was a very dangerous place to go, and regrettably the young woman, Amira Karroum, must have known this too: even if she believed that it was a humanitarian mission. You can look up the disclosure documents and terms applicable on this website. The issue is whether the country was deemed hazardous for travel. The Australian Government website does not show the history of when Syria was deemed hazardous but I would be surprised if it was not listed as such before January 2014.

Looking through the articles included, while it is a more extreme situation, the situation is one that kiwi's face with their insurance cover when they travel, not just with life cover either.

With the life claim in the article. Not to take away from the fathers loss, but it's likely the claim isn't justified to be paid on the current policy wording published by the provider.

Reading through the website documents with the provider, though Amira Karroum's may be different, as the website one was issued in August 2015.

The relocation overseas needed to be notified and approved by the provider, if the intention was longer than 3 years. Was her intention longer than 3 years? This wasn't clear in the story and may be a key consideration if in her version of the policy.

This was also conditioned on continuing to make premium payments and maintain account balances. Did she continue to pay her premiums?

There is an exclusion for militant activity but there's no evidence that suggest she was fighting, though the stories do seem to be contradicting.

The overseas cover is contingent on the destination not being considered hazardous.

Looking at the statement of why Amira's claim payment was declined

The claim 'it was illegal to travel there', isn't a justified reason for declining the claim, illegal activity is not actually excluded in the life cover documentation, though it is for other benefits in the policy.

The claim is likely a decline on the basis pre-approval for coverage in Syria was not requested before departure and Syria would have been deemed a hazardous destination prior to travel and automatically excluded. Much the same as Israel and a number of other countries in the region are listed presently. 

The militant activity is possibly a reach, but would also be a consideration. 

It's possible the overseas requirements have been added since this claim was notified, if so then the only clause that could be used to decline is the militant one, if it to wasn't added post notification.

What can you do?

Clearly having the right sort of policy in place helps, reading and complying with the terms and conditions is also something that's recommended.

What is interesting is this claim would likely be declined on a number of New Zealand direct and bank life policies too. My lenthy technical blog, death definitions and life insurance, from last week gives more details in this area.

A few key standard policy exclusions on some policies I discovered that would not have paid in a similar situation:

  • you being in a country or region in which the New Zealand Government has advised against all travel or advised that all non-essential travel should be deferred. These countries or regions are currently classified as ‘Extreme’ or ‘High’ risk and can be found at www.safetravel.govt.nz. If the New Zealand Government no longer publishes these ratings, we will use the last rating list published by the New Zealand Government or choose an alternative list that we will inform you of on or before the next anniversary of the start date of your policy;
  • No benefit will be paid if the death of the Person Insured is caused by war, invasion, act of foreign enemy, hostilities (whether war is declared or not), civil war, military or usurped power, rebellion, revolution, insurrection, riot or civil commotion.
  • The Insured’s involvement in an unlawful act whether or not the Insured is charged or convicted of an offence in respect of that act; 
  • If the claim is due, directly or indirectly, to War or any act of War, invasion, Terrorism or any acts of Terrorism, act of foreign enemy, hostilities, strike, riot and/or civil commotion, civil war, rebellion, revolution, insurrection, military or usurped power
  • deployment in the armed forces/peace corps or as a journalist or news cameraman outside NZ, Australia, UK, Ireland, USA, Canada, Hong Kong or Singapore
  • If death occurs whilst taking part in any unlawful act;
  • War or any act thereof, invasion, acts of foreign enemies, civil war, civil unrest, rebellion, revolution insurrection assuming the proportions of or amounting to an uprising, military or usurped power

These exclusions are excerpts from a number of life insurance policies available through banks and directly with providers today. They also apply in a New Zealand domestic situation.

Do you travel to interesting places? Are you concerned? Give me a call on 021 022 69 127

Jon-Paul Hale

Written by : Jon-Paul Hale

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