ACCIDENT AND SICKNESS EXCLUSIONS

You will not be covered for:-

• Any pre-existing medical condition that you are aware of, or have been treated for during the 12 months immediately prior
   to the start date of this Policy. However, this exclusion is waived (except for chronic conditions) if you have been symptom
   free for a period of no less than 24 months before the start date of any claim.
• Any backache or back related condition for which we have not received scan evidence (MRI, X-Ray, CT Scan) of abnormal
   findings. However, we will pay up to a maximum period of 3 months if evidence of abnormal findings has been found at
   an examination conducted by your Doctor. Benefits will not be payable after this 3 month period if scan evidence of the
   abnormality causing the disability is not provided.
• Any mental or nervous disorders including stress and anxiety unless diagnosed by a Community Mental Health
   team or a consultant psychiatrist.
• Normal pregnancy or childbirth unless there are medical complications.
• An accident or sickness lasting for less than the waiting period (shown on your Insurance Schedule).

Definition of a Pre-existing Condition:-
• a condition for which treatment has been given in the 12 month period prior to the Start Date; or
• a condition for which diagnosis has been made in the 12 month period prior to the Start Date; or
• a condition, whether diagnosed or not, for which investigations have commenced in the 12 months prior to
   the start date; or
• a Chronic Condition that you were aware of at the start date; or
• a condition of which You were aware of at the start date. This exclusion is waived if You have been symptom free
   for a period of 24 months prior to the start date of your claim, except for Chronic Conditions.

Definition of a Chronic Condition:-
A Chronic Condition is a condition which has at least one of the following characteristics:-
• it continues indefinitely; or
• it is constant and is controlled rather than cured; or
• it has symptoms which recur and have required consultation, treatment or care in the past; or
• it requires long-term monitoring or treatment, consultations, check-ups, examinations or tests.

 

UNEMPLOYMENT EXCLUSIONS

You will not be covered if:-

• You were aware of impending unemployment at the start date of this Policy.
• You became unemployed or received verbal or written notification of unemployment within the initial exclusion period
   or at the start date you knew or in our reasonable opinion you had reason to believe you were to become unemployed.
• You are made aware, by any means, within the initial exclusion period, of anything that might lead to your unemployment,
   not withstanding that no specific reference has been made to your personal situation and that your unemployment may
   not take place until after the initial exclusion period
• Your unemployment arises from any programme of job losses, any departmental or company restructure, or merger with
   another company, announced by your employer before the start date, or within the initial exclusion period.

You cannot claim unemployment benefit:-

• For any period of unemployment for which you have received payment in lieu of notice.
• If you accept voluntary redundancy or you retire or resign.
• If unemployment is a regular or seasonal occurrence in your normal line of work
• If you are not registered as unemployed with the Department of Work and Pensions as actively seeking work. You must
   also be registered for Job Seekers Allowance
• If your unemployment lasts for less than the waiting period (shown on your Insurance Schedule).
• If you are employed by any member of your family in a partnership or company, special exclusions may apply to you. Please
   see Special Notes page 7 of the Policy Terms and Conditions.

If you are a contract worker you cannot claim unemployment benefit:-

If you are made unemployed at the end of a fixed term contract unless you have been;
• employed continuously by the same employer for at least 2 consecutive years or
• employed on a fixed-contract for at least 1 year which has been renewed at least once or
• employed originally on a permanent basis by the same employer but were subsequently transferred to a
   fixed-term contract by the employer without a break in employment.

If you are a self-employed worker you cannot claim unemployment benefit:-

• If your business has not been registered as having ceased to trade with the HMRC as a direct result of being
   unable to pay its debts as and when they fall due.

CARER COVER EXCLUSIONS

You will not be covered if:-

• The condition of the person being cared for existed prior to the start date
• The community care assessment does not confirm that the person being cared for requires a carer
• Your work ceases for any other reason not associated with the need to become a carer
• You are currently receiving benefits under any other section of this policy
• We reasonably believe that at the start date of this policy you were aware of the need or likely need at any time in the
   future, for a member of your immediate family to require a carer.

Please see Policy Terms and Conditions for full details of all of the exclusions