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PAYMENT PROTECTION CERTIFICATE OF INSURANCE

MONTHLY PREMIUM CERTIFICATE
Underwritten at AmTrust International Underwriters Limited

Schedule

Certificate Number : 10000000

First Named Insured Person (A): Insurance Premium: £
Second Named Insured Person B):  
Address: Insured Monthly Benefit:
Split (A) £
Split (B) £
Post Code: Certificate Start Date:
First Named Date of Birth:  
Second Named Date of Birth:  

Maximum Benefit Period; Disability 24 months Unemployment 12 months.

Cover provided for the Insured Person:

Initial Exclusion Period; Disability NIL, Unemployment 60 days.

Waiting Period; Disability and Unemployment 30 days

In witness whereof this Certificate has been signed by the authorised Coverholder, Alexander Lauren Associates Limited

This #########

For Alexander Lauren Associates Limited

Authorised Signatory

The above schedule details are subject to the terms of this Certificate of Insurance

THIS IS TO CERTIFY THAT in accordance with the authorisation granted under Contract Number B0425594 to Alexander Lauren Associates Limited by AmTrust International Underwriters Limited and in consideration of the premium specified herein, AmTrust International Underwriters Limited are hereby bound, each to indemnify the Insured during the period in the schedule above.

Subject otherwise to the terms, conditions and exclusions in the Certificate of Insurance issued pursuant to the aforementioned Contract


PAYMENT PROTECTION CERTIFICATE OF INSURANCE
The above schedule details are subject to the terms of this Certificate.

You have applied for payment protection insurance with AmTrust International Underwriters Limited. In return for the appropriate premium, this certificate will insure You against Disability and Unemployment from the start date of this certificate.

Your Proposal and Certificate are part of this insurance contract.

WHAT THE WORDS MEAN
Some of the words and phrases We use in the contract Terms and Conditions have special meanings. Except where the context otherwise requires, the masculine shall include the feminine, the singular shall include the plural and vice versa as appropriate.

Amendment Date Means the date any amendment to the cover shown on Your Certificate comes into force.

Business Means a trade, industry or profession owned and operated by You either alone or in association with others and which is registered in the United Kingdom

Benefit Period Means the maximum number of Monthly Benefit payments that would be payable for any one period of Claim as shown on Your Schedule.

Ceases to Trade Means the permanent total cessation of Your Business caused entirely by circumstances beyond Your control or the control of any director or partner in Your Business.

Claim Period Means any separate period of time during which You are Unemployed or Disabled and receiving Monthly Benefit under this Certificate.

College means the Royal College of Surgeons, the Royal College of Physicians or any other Royal College of medical practitioners

Company Director Means a director who directly or indirectly owns 10% or more of the issued share capital of the company or a relative of a director who is working for the same company as You and who directly or indirectly owns more than 10% of the issued share capital of that company.

Consultant Means a medical specialist who is a member of a College and recognised by that College to be a consultant

Contract Employment Means You are Employed on a permanent fixed term contract of at least 13 weeks duration and You have not been in Continuous Employment with the same employer for at least 2 years. Under the Contract, You will not be covered for the non-renewal of Your contract and the payment of Monthly Benefit will automatically stop on the date Your contract was originally intended to finish.

Disability Means an accident or sickness certified by a registered medical practitioner in the UK (other than You or Your spouse) as preventing You from doing Your normal Work or any similar work for which You are reasonably qualified and You are not doing any other job for payment or reward.

Disabled Means you are suffering from a Disability.

Dismissed Means You are Employed and Your employment is terminated due to circumstances entirely beyond Your control.

Employed or Employment Means You are in permanent employment and Your employer is deducting P.A.Y.E. Tax and National Insurance Contributions on Your behalf.

Exclusion Period Means the period shown on Your Certificate which immediately follows the Start Date of this Certificate.

Monthly Benefit Means the amount of cover You have selected as shown on Your Certificate.

Period of Cover Means the period between the Certificate Start Date and the Termination Date for which the correct Premium has been paid.

Permanent Employment Means You are employed on a permanent basis and Your job has no fixed or pre-defined finishing date other than the normal retirement age for Your occupation or You have been in continuous employment either on a yearly contract which has been renewed at least once or on a renewable fixed term contract with the same employer for at least 2 continuous years.

Certificate Means insurance cover provided under Terms and Conditions.

Certificate Start Date Means the date cover commences on Your Certificate.

Pre-Existing Condition Means any sickness, condition or injury of which You were aware and for which You received treatment or advice (including regular or routine examination or consultations to monitor the condition) in the 12 months prior to the Certificate Start Date.

Premium Means the premium or premiums set out on your Certificate.

Self Employed or Self Employment Means You are in a profession or business alone or in association with others and paying Class 2 National Insurance contributions or You are a Company Director.

Termination Date of cover Means the earliest of the following to occur: a) You die

b) You retire from Work or reach age 65, whichever is the earlier,

c) You stop living in the U.K.,

d) You are more than six months in arrears with Your monthly repayment,

e) You have received the maximum number of Monthly Benefit payments allowed,

f) You default on your Premium payment

Unemployed or Unemployment Means a period during which you must be: a) Receiving Income Support, Job Seekers Allowance or You do not qualify for these benefits because You have been entitled to make reduced National Insurance contributions in the past,

b) actively seeking Work,

c) registered as available for Work at a Department for Education and Employment Office,

d) entirely without Work,

e) not in receipt of wages in lieu of notice,

f) If You are Self-Employed You must comply with (a) to (e) above, and have ceased to Trade and if You are a Company Director Your Company has been wound up by a creditor who is not a director of that company.

Waiting Period Means the period shown in Your Certificate during which You will need to be continuously Unemployed or Disabled before You are entitled to receive Monthly Benefit.

We or Us or Our Means AmTrust International Underwriters Limited

Working or Work Means gainful Contract Employment, Permanent Employment or Self Employment for sixteen hours or more each week. You must also be paying the appropriate National Insurance contributions

You or Your or YourSelf The person or persons named on Your Certificate.

WHO THIS CONTRACT IS FOR
You can be covered under this contract if: -

You are permanently resident in the United Kingdom, Channel Islands or the Isle of Man

You are aged 18 or over and will not have reached 65 years of age before the finishing date of cover

You are actively Working and You have been in continuous Employment for the 6 month period before the Certificate Start Date,

You are in good Health,

You cannot be covered under this contract if: -

You are aware of any impending Unemployment or Disability which may affect You,

You are in temporary or seasonal employment,

PAYMENT OF PREMIUMS
Monthly Premium

Premiums are payable by You in advance. If You are in receipt of monthly benefits under this certificate You must continue to pay the monthly premium as it falls due in order to ensure continuous cover under this certificate. The premium can be amended by giving You 30 days notice in writing. If there are any changes to the current level of Insurance Premium Tax or any new taxation levies are imposed then Your premium will be amended from the date any such taxation changes are implemented

PAYMENT OF CLAIMS
1. Disability Benefit

If You are in continuous Employment and become Disabled during the Period of Cover for longer than the Waiting Period We will pay one Monthly Benefit on the first day that You remain continuously Disabled following the Waiting Period to You. After that We will continue to pay one thirtieth of the Monthly Benefit for each day You remain continuously Disabled, monthly in arrears.

We will continue to pay until the earliest of the following events: -

a) The last consecutive day of Your Disability,
b) The date You stop providing due proof that You remain continuously Disabled,
c) We have made the maximum number of Monthly Benefit payments allowed in the Benefit Period,
d) The termination date of Your Certificate,

2. Unemployment Benefit
If You are in continuous Employment and become Unemployed during the Period of Cover for longer than the Waiting Period We will pay one Monthly Benefit on the first day that You remain continuously Unemployed following the Waiting Period to You. After that We will continue to pay one thirtieth of the Monthly Benefit for each day You remain continuously Unemployed, monthly in arrears.

We will continue to pay until the earliest of the following events: -

a) The last consecutive day of Your Unemployment,
b) The date You stop providing due proof that You remain continuously Unemployed,
c) We have made the maximum number of Monthly Benefit payments allowed in the Benefit Period,
d) The termination of Your Certificate,

Unemployment Cover Under This Certificate:
Unemployment Cover under this Certificate will vary in accordance with Your employment status:
(i) Employed (excluding Company Directors/Secretaries and / or their relatives or Contract Workers)
(a) if You are Working, You will be insured if You are Dismissed.
(ii) Employed Company Directors/Secretaries an/or their relatives
(a) if You directly or indirectly own less than 10% of the issued share capital of the Business You are Working for, or You are a relative of a Company Director or Company Secretary who directly or indirectly owns less than 10% of the issued share capital of the Business You are working for, You will be insured if You are Dismissed.
(b) If You directly or indirectly own 10% or more of the issued share capital of the Business You are working for or, You are a relative of a Company Director or Company Secretary who directly or indirectly owns 10% or more of the issued share capital of the Business You are Working for, You will be insured if that business ceases to trade and is wound up.

(iii) Employed Contract Workers
(a) if You have been Working on a renewable fixed term contract with the same employer for more than 2 consecutive years, You will be insured if You are Dismissed.
(b) If You have been Working on a renewable fixed term contract with the same employer for less than 2 consecutive years, You will be insured if You are Dismissed during the term of Your contract. You will not be insured against the non-renewal of Your contract and any entitlement to Monthly Benefit under this Certificate will automatically cease on the date Your contract was originally intended to terminate.

(iv) Self Employed and their relatives If You are the sole proprietor or a partner in the Business You are Working for or You are a relative of the sole proprietor or a partner in the Business You are Working for, You will be insured if that Business Ceases to Trade.

3. Claim Requalification
A Claim Period which occurs within 3 months of a separate Claim Period will be treated as one and the same Claim Period A new Claim Period can be made provided You have been in continuous Employment for at least 3 months between each Claim Period.

4. Suspending an Unemployment claim for temporary work.
If You are eligible to make a claim for Unemployment under this certificate and You are offered a temporary job You can suspend your claim provided that:

(a) You tell Us who You will be working for (even if You will be Self Employed ), how many hours of work You will be working for and the duration of Your temporary employment.
(b) Your temporary job lasts for at least one week and no longer than six months and You do not have more than three separate jobs during any one Claim Period
(c) You continue to comply with the terms and conditions of this certificate and tell Us immediately if any of the above circumstances should change.

Provided You are eligible to continue Your claim for Unemployment when a temporary job ends We will recommence the payment subject to a maximum combined total of twelve benefit payments for any one Claim Period.

CIRCUMSTANCES WHEN YOU CANNOT CLAIM

A. Unemployment

No Benefit will be payable to You if:

You have not been in continuous Employment for at least 6 months before Your first period of Unemployment under this contract,

You are notified of Unemployment within the Initial Exclusion Period even though Your Unemployment may not take place until after this period,

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 Work is seasonal or of a temporary nature,

Your fixed term contract ends (but, subject to the other term and conditions of this contract, You may be entitled to benefit during Your fixed term contract),

You accept voluntary redundancy, resign or retire,

You are Dismissed by Your employer as a result of misconduct, or breaking Your contract,

You were aware of the possibility of impending Unemployment (or in Our reasonable opinion You should have been aware) at the Certificate Start Date, 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

You are made Unemployed because of a civil commotion, riot, terrorist activity, insurrection, war or any act incidental to war (whether declared or not)

Your Unemployment occurs while You are away from the EC for a period intended by You to be more than 90 days - this clause will not apply if Your reason for leaving the EC is because You
a) Work for the British Armed Forces, or
b) Work as a Civil Servant in a British Embassy or Consulate.

You are made Unemployed due to any of the Disability exclusions.

No Benefit will be payable as a result of:

War, invasion, act of foreign enemy, hostilities (whether war is declared or not), civil war, rebellion, revolution or military or usurped power.

Radioactive contamination from:

  • Ionising radiation or contamination from any nuclear fuel, or from any nuclear waste arising from burning nuclear fuel; or
  • The radioactive, toxic, explosive or other dangerous effect of any explosive nuclear equipment or part of that equipment

No Benefit will be payable as a result of:
1) Loss or destruction of or damage to any property whatsoever, or any loss or expense whatsoever resulting or arising therefrom or any consequential loss;
2) Any legal liability of whatsoever nature;
3) Death or injury to any person;

Directly or indirectly caused by or contributed to by or arising from Biological or Chemical contamination due to or arising from;

  • Terrorism; and/or
  • Steps taken to prevent, suppress, control or reduce the consequences or any actual attempt, threatened, suspected or perceived terrorism.

For the purposes of this exclusion “terrorism” means any act(s) of any Person(s) or organisation(s) involving:

  • The causing, occasioning or threatening of harm of whatsoever nature and by whatever means;
  • Putting the public or any section of the public in fear:

In circumstances in which it is reasonable to conclude that the purpose(s) of the person(s) or organisation(s) concerned are wholly or partly of a political, religious, ideological or similar nature.

B. You will not be entitled to any Benefit for any period in which You are in receipt of payment in lieu of notice.

C. Disability
No benefit will be payable to You if:
Your Disability occurs within the Initial Exclusion Period.
Your Disability is due to or arises from Acquired Immune Deficiency Syndrome (AIDS) or infection by the Human Immunodeficiency Virus (HIV), unless a Consultant certifies that the condition solely prevents You from working,

You deliberately injure Yourself or Your Disability is due to alcohol, solvent abuse or drugs (other than drugs taken under the direction of a doctor or Consultant and not for the treatment of drug addiction),

Your Disability arises from stress, anxiety or depression or any mental or nervous disorder unless a Consultant certifies that the condition solely prevents You from Working,

Your Disability results from any condition, injury, illness, disease or sickness which came about as a result of a Pre-Existing Condition,

Your Disability is due to pregnancy, childbirth, miscarriage or abortion other than a medical complication which directly occurs as a result of Your pregnancy or pregnancy related conditions,

Your Disability is due to a back related condition unless there is radiological evidence of medical abnormality, visible wound, contusion, or a Consultant certifies that the condition solely prevents You from Working ,

Your Disability arises from medical operations or treatments which are not medically necessary, including cosmetic or beauty treatments,

Your Disability is due to any of the Unemployment exclusions.

No benefit will be payable as a result of:

War, invasion, act of foreign enemy, hostilities (whether war is declared or not), civil war, rebellion, revolution or military or usurped power.

Radioactive contamination from:

  • lonising radiation or contamination from any nuclear fuel, or from any nuclear waste arising from burning nuclear fuel; or
  • The radioactive, toxic, explosive or other dangerous effect of any explosive nuclear equipment or part of that equipment

No Benefit will be payable as a result of:
1) Loss or destruction of or damage to any property whatsoever, or any loss or expense whatsoever resulting or arising therefrom or any consequential loss;
2) Any legal liability of whatsoever nature;
3) Death or injury to any person;

Directly or indirectly caused by or contributed to by or arising from Biological or Chemical contamination due to or arising from;

  • Terrorism; and/or
  • Steps taken to prevent, suppress, control or reduce the consequences or any actual attempt, threatened, suspected or perceived terrorism.

For the purposes of this exclusion “terrorism” means any act(s) of any Person(s) or organisation(s) involving:

  • The causing, occasioning or threatening of harm of whatsoever nature and by whatever means;
  • Putting the public or any section of the public in fear:

In circumstances in which it is reasonable to conclude that the purpose(s) of the person(s) or organisation(s) concerned are wholly or partly of a political, religious, ideological or similar nature.

D. You cannot claim Disability and Unemployment Benefit at the same time.

CANCELLATION
We may cancel this Certificate at any time by giving 30 days written notice to You at Your last known address. This will not affect any rights to benefits which You may already have received under the Insurance before the Termination Date of Cover.
You can cancel the Certificate at any time by returning this Certificate of Insurance and asking Us in writing to cancel it. The insurance will be cancelled on the day We receive Your request.
If You cancel within 14 days of the Certificate Start Date We will refund any Premium You may have paid less an administration charge. No refund of Premium will be made where a claim has been paid on the Certificate.

FRAUD
Any fraud mis-statement or concealment in relation to any matter affecting this contract or any claim under this contract may render it null and void and all rights to claim will be lost.

ASSIGNMENT
The benefits of this contract may not be assigned to a third party.

DATA PROTECTION ACT
You should understand that any information You have provided will be processed by Us, in compliance with the provisions of the Data Protection Act 1998, for the purpose of providing insurance and handling claims, if any, which may necessitate providing such information to other parties.

GENERAL CONDITIONS
a) This contract and any endorsements of it together with the proposal and Certificate and any written statement of medical or other information made by You make up the contract between Us and You.
b) No alterations, variations, or relaxation of any of the terms of this contract can be made except in writing by one or more of Our authorised officials.
c) The parties to this contract may choose the law which shall govern it. In the absence of any agreement to the contrary this Certificate is subject to English law.
d) If at any time any provision or part thereof of this contract become invalid, illegal, or enforceable the remaining parts and/or provisions shall continue in full force and effect.
e) All benefits under this Certificate are non-taxable, although this may change in line with any amendments to legislation. In this event, We will deduct from any Monthly Benefit any sums which by law We are required to deduct.
f) A person who is not a party to this insurance has no right under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of this insurance but this does not affect any right or remedy of a third party which exists or is available apart from that Act.
g) Any omission, misrepresentation or false statement of a material fact in Your application for this insurance or any claim could affect the payment of benefits under this Certificate. A material fact is one which is likely to influence the acceptance of Your application or claim for insurance. If You are uncertain whether a fact is material You should declare it. If You make a claim which We consider to be fraudulent or exaggerated, all benefits under this contract will be lost and We will seek to recover any benefits paid under that claim
h) We will be entitled to take legal action in Your name for our own benefit against any other party in order to recover any payment we have made.
i) If, at the time of a claim, there is any other policy in force, insuring anything covered by this Certificate, We shall only be liable for our proportional share.

JOBCARE: BACK TO WORK SERVICE
This Insurance includes a confidential and independent back to work advice programme called Jobcare..

This service is free and is provided to Alexander Lauren Associates Limited by employment specialists PMA Limited.

The programme provides you and your immediate family living with you with the following:

  • if you become unemployed our Advisers will give you practical help and guidance on how to achieve a speedy return to work.

 

  • your Advisers will also send you a free guide to getting back to work including guidance on:
  • CV preparation
  • letters of application
  • sourcing vacancies
  • interview techniques
  • self employment
  • all designed to help you find the right job.
  • the service gives access to a National Job Vacancy Database that can be used to find jobs.
  • Career Change: help and guidance from the Advisers on identification of suitable skills to transfer into alternative employment opportunities.
  • the service is:
  • provided free to you and your immediate family
  • available 8am to 8pm Monday to Friday and 8am to Noon Saturdays
  • available immediately - simply call 0870 3003037 and quote reference MIB

NB: Remember - there is no charge for this service which can be used at any time during your policy.

HOW TO CLAIM
You must give Us notice of a claim by telephoning Our claim's helpline on telephone number 01653 604300.

You should do so as soon as reasonably possible and within 30 days after the end of the Waiting Period. We will send You the claim forms. You will need to complete these and return them to Us as soon as reasonably possible, giving Us all the information We ask for to enable Us to process Your claim This should include at least wage slips, termination notice and P60 or, if Self Employed, bank statements, invoices and annual accounts and Inland Revenue and National Insurance records. You will be responsible for providing Us with the proof We need. Delay in submitting a claim to Us may make Your claim harder to confirm and lead to delay in making payment or result in the non payment of Your claim. If We wish You to be medically examined at Our expense You must allow it; or Your claim could be either be stopped or denied.

Payment of Benefit will be made when We receive satisfactory evidence of Your entitlement to claim. Throughout the period for which the claim is made under this contract We will require You to provide evidence of continued Disability or Unemployment. Benefit will not be paid for any period of Disability or Unemployment for which the evidence required by Us is not provided. We may require You to produce this Certificate as proof of purchase. Once a claim has been accepted, Benefit will be paid to You monthly in arrears.

COMPLAINTS PROCEDURE
We aim to provide a first-class service.

If You have any cause to complain, or You feel that We have not kept our promise, please follow the procedures below.

If You are not happy with the way the matter is dealt with, please write to Our Customer Services Department, Alexander Lauren Associates Limited, Units 1&2, The Maltings, Castlegate, Malton, YO17 7DP. When You do this quote Your certificate number, which is on Your schedule.

After this action, if You are still not satisfied with the way a complaint has been dealt with, You may ask the Claims Manager at AmTrust International Underwriters Limited to review Your case (This would not affect Your rights to take legal action if necessary).

The address is: Claims Manager, AmTrust International Underwriters Limited, 122 Lower Baggot Street, Dublin 2, Ireland

If You still remain dissatisfied after following the above procedures in full, You can ask the Financial Ombudsman Service to review Your case. Further details will be provided at the appropriate stage.

Alexander Lauren Associates Limited, Units 1&2, The Maltings, Castlegate, Malton, YO17 7DP
Telephone: 01653 604300 Fax: 01653 692555 Email: info@ala.co.uk

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