General conditions for making a claim
- The policy only pays out if:
- your unemployment or disability occurs after the start date and
before the end date;
- you meet all the claim requirements under these policy terms and
conditions;
- you have paid all your premiums; and
- you give us all the evidence we need to check your claim.
- You cannot claim for unemployment and disability at the same time.
- If you restrict your insurance to unemployment only cover or disability
only cover, we will only pay for a claim arising from the specific type
of cover you have selected.
- We will reduce your monthly benefit if it is more than 65% of your
normal income.
- If you have any other unemployment or disability insurance, we reserve
the right to reduce your monthly benefit by an amount equal to the claim
benefits you receive under that insurance.
- You can transfer a claim between unemployment and disability (or vice
versa) but if you do, we will not pay more than 12 monthly benefit payments
for that period of claim.
- You can make a completely new claim under the policy as long as you
have returned to work for at least 90 days in a row. We will treat two
claims separated by less than 90 days work in a row as the same period
of claim and you will only be entitled to receive the balance of any
monthly benefit payments left from the previous period of claim. We
will reduce this period to 30 days for any claim arising from a medical
condition that is not related to the disability that brought about the
previous claim.
- We will not pay any monthly benefit if you give us any false, misleading
or fraudulent information, or if you fail to tell us about any important
fact.
- If you make a claim for unemployment and you are offered a temporary
job, you can suspend your claim provided that:
- you tell us beforehand who you will be working for;
- your temporary job lasts for at least one week and no longer than
six months; and
- you do not have more than three separate temporary jobs during
any one period of claim.
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
P O Box 229, Southport, PR9 9WU.
Phone: 0870 759 4020; Fax: 0870 759 4021
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:
- unemployment - evidence that you are still unemployed and actively
looking for work; or
- disability - evidence that you are still disabled and that you are
still under the regular care and attendance of a doctor (or consultant).
When we will make claim payments
Your initial claim payment will be made on the first day immediately after
the waiting period.
After that, we will pay an amount equal to 1/30th of the monthly benefit
for each day you are still unemployed or disabled. We will continue to
make payments monthly in arrears until the earliest of the following events:
- the last day you are unemployed or disabled;
- the date on which you stop giving us evidence that you are still unemployed
or disabled;
- the date on which you have received 12 monthly benefit payments for
any one claim; or
- the end date of the policy.
Obligations and rights when making a claim
You must have an independent medical examination if we believe it necessary
to validate your claim (we will pay the cost of the examination). If you
fail or refuse to have a medical examination and you do not give us a
satisfactory reason, we will not pay any monthly benefit.
We reserve the right to contact any other person or organisation that
we consider necessary to assist in the validation of your claim and where
necessary, you must provide us with the relevant authority to obtain this
information. We can also ask to see your personal bank or financial statements.
We may arrange a personal interview with you to help you look for further
permanent work.
We will only begin to make monthly benefit payments when we receive full
and satisfactory evidence of your eligibility to claim. If you delay sending
us the claim form or any other evidence we require, your claim may be
harder to check. This may lead to us paying monthly benefit late or not
paying it at all.
