Policy
Eligibility
Meaning of words used in this policy
General Conditions
Accident and Sickness Insurance
Permanent Total Disability Insurance
Unemployment Insurance
Life Insurance
Accidental Death Insurance
How To Make A Claim
Caring for our customers
Confidential and Independent Counselling
The law applicable to this contract
Legal footnote

LIFE, ACCIDENTAL DEATH, ACCIDENT & SICKNESS AND UNEMPLOYMENT POLICY

Welcome to Your Egg Loan Repayment Protection Policy Document.

Under this Policy the Insurer agrees to provide benefits in the event of Death, Accidental Death, Disability (comprising accident & sickness), and Unemployment, depending on the sections You have chosen to include, on the basis of the following terms, conditions and exclusions.

In the event of You needing to make a claim please contact the Claims Helpline on 0845 120 5203.

Telephone calls may be monitored or recorded to assist with staff training and for quality control purposes.

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If You are not in good health at the Start Date this may affect Your ability to claim under the Life and/or Accident and Sickness Insurance Part of this Policy.

IMPORTANT: This Policy contains general provisions and specific exclusions which define the extent of insurance cover. It is particularly important that You check that You are eligible to be covered under this Policy by carefully reading the following summary of requirements.

On the Start Date You must be:

1. a party to Your Agreement;

2. a U.K. resident;

3. at least 18 years of age;

4. under 65 years of age;

5. in Work.

If You have any enquiry regarding Your eligibility please contact Us Tel. No. *08451 233 233.

*Telephone calls may be monitored or recorded to assist with staff training and for quality control purposes.

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Accidental Death: death solely as the result of bodily injury (including drowning) and caused directly by accidental, external, visible and violent means and independently of any physical or mental illness.

Agreement: Your credit agreement with Egg.

Civil Disorder: war, civil war, military activity other than normal peace time activity, rebellion, revolution, riot or other civil commotion.

Daily Benefit: a sum equivalent to one thirtieth of the Monthly Benefit.

Disability: a state of incapacity resulting solely from an accidental bodily injury or sickness or disease which occurs or starts during a period when You are in Work and which wholly prevents You from doing Your Work or other work that Your experience, education or training would allow You to do. Such Disability shall be deemed to start on the day You first consult, or receive treatment from, and are certified as being unfit to work by, a Doctor.

Disabled: You suffering from Disability and being under the continued supervision of, and receiving treatment from, a Doctor.

Doctor: a medical practitioner practising in the United Kingdom being a fully registered person under the Medical Act 1983, other than You, Your Partner or any of Your co-habitees or relatives.

Employment: You working for remuneration under a contract of employment and paying Class 1 National Insurance contributions.

End Date: the earliest of the following dates:

i. the date of Your death; or

ii. the date You reach the age of 65; or

iii. the date on which a payment is made under the Permanent Total Disability section of the Policy; or

iv. the date on which You permanently retire from Work; or

v. the Repayment Date.

Excess Period: the period of days starting on the date of the incident giving rise to a claim which must elapse before Daily Benefits are payable.

Insurer: In respect of Life cover, AXA Sun Life plc, Registered Number 3291349. In respect of Unemployment, Accidental Death, Permanent Total Disability and Accident & Sickness, AXA Insurance UK plc, Registered Number 78950 except where the term of the loan is 60 months or more in which case in respect of Permanent Total Disability and Accident and Sickness, AXA Sun Life plc, Registered Number 3291349. Both companies are members of the AXA Group of Companies and have their Registered Office at 5 Old Broad Street, London EC2N 1AD.

Monthly Benefit: the monthly amount (or the monthly equivalent if payments under the Agreement are made other than on a monthly basis) due from You to Egg under the original terms of the Agreement.

Normal Pregnancy and Childbirth Related Conditions: any symptoms which normally accompany a pregnancy and/or childbirth (including those related to multiple pregnancy) and which do not represent an unusual or significant hazard to mother or baby.

Partner: Your husband or wife or the person (whether or not of the same sex) who You permanently live with in a similar relationship.

Period of Insurance: the period from the Start Date to the End Date.

Pre-Existing Condition:

1. A condition for which treatment and or advice has been suggested by a Doctor during the 12 month period prior to the Start Date which re-occurs within 24 months after the Start Date; or

2. A condition which has been diagnosed by a Doctor during the 12 month period prior to the Start Date which re-occurs within 24 months after the Start Date; or

3. A condition whether diagnosed or not for which significant and substantive symptoms were experienced or for which investigations have been commenced by a Doctor during the 12 month period prior to the Start Date which re-occurs within 24 months after the Start Date; or

4. A chronic or continuing disease that You were aware of at the Start Date.

Repayment Date: the date on which the final repayment or payment under the original terms of Your Agreement becomes due.

Self-Employed: You actively working alone or in partnership with others and paying Class 2 National Insurance contributions and being assessable to Income Tax under Schedule D Case I or II.

Settlement Figure: the amount required by Egg at the date of Your death or Permanent Total Disability (whichever occurs first) to discharge Your indebtedness under the Agreement, including any payments due to Egg which are up to 3 months in arrears.

Start Date: the start date of the Agreement.

Unemployment/Unemployed: You being entirely out of Work and being registered for work with the relevant Government agency and in receipt of Job Seekers Allowance (or the equivalent benefit should this change). You must be actively looking for Work.

Additionally, if You are Self-Employed Your business must have totally and permanently ceased to trade as a direct result of it being unable to pay its debts as and when they fell due. If You are a woman who has reached statutory pensionable age You will be considered as Unemployed if You provide evidence throughout the period of Your claim that You are looking for Work.

United Kingdom: England, Scotland, Wales and Northern Ireland.

U.K. Resident: a person who lives lawfully in the United Kingdom for at least 40 weeks in any 52 week period throughout the Period of Insurance.

We, Us, Our: Egg Banking plc (registered number 2999842) of Pride Park, Derby DE99 3GG (We are a bank authorised and regulated by the Financial Services Authority (FSA) and entered in the FSA register under number 205621).

Work: being in Employment or Self-Employed.

You, Your: a U.K. Resident who has applied for this insurance and has agreed to pay the premium under this Policy and who at the Start Date is:

i. the first named party to an Agreement; and

ii. at least 18 and under the age of 65 years; and

iii. in Work.

Where a legal statute is referred to in this Policy it shall mean the statute as amended at the relevant time.

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• make a claim under the Policy knowing the claim to be false or fraudulently exaggerated in any respect or
• make a statement in support of a claim knowing the statement to be false in any respect or
• submit a document in support of a claim knowing the document to be forged or false in any respect or
• make a claim in respect of any loss caused by Your wilful act or with Your connivance

• shall not pay the claim
• shall not pay any other claim which has been or will be made under the Policy
• may at its option declare the Policy void
• shall be entitled to recover from You the amount of any claim already paid under the Policy
• shall not make any return of premium
• may inform the police of the circumstances.

(Your Agreement will show if You have chosen this Cover)

Daily Benefit payable monthly in arrears to Egg if, during the Period of Insurance, You suffer Disability.

Please note payment of Daily Benefit is subject to the following conditions:

1. i. You must have been Disabled for more than the Excess Period after which Daily Benefits shall become payable; and

ii. Daily Benefit shall become payable in respect of each additional consecutive day that You are Disabled until the earliest of the following dates:

a. the date on which You cease to be Disabled or fail to provide proof that You are Disabled; or

b. the date on which You return to Work; or

c. the End Date.

2. No benefit is payable for the Excess Period.

3. The maximum Monthly Benefit payable under the Accident & Sickness Insurance Part of this Policy is £1,500.

4. If the Insurer stops paying Monthly Benefit because:

You have returned to Work You will not be entitled to any further Monthly Benefit under the Accident & Sickness Insurance Part of this Policy until You have returned to Work for a continuous period of at least 6 months if Your Disability results from the same cause or condition.

5. Where two periods of Disability arising from the same condition are separated by 6 calendar months or less the Insurer will treat this as one continuous claim.

6. Subject to paragraphs 4 and 5 above, You will not be entitled to any further Monthly Benefit under the Accident & Sickness Insurance Part of this Policy until You have returned to Work for a continuous period of at least 1 month.

7. Benefit shall not be payable under the Accident & Sickness Insurance Part of this Policy if You are currently receiving benefit under the Unemployment Insurance Part of this Policy.

What is Not Covered

The Insurer will not pay benefits if the Disability results, directly or indirectly, from:

i. intentionally self-inflicted bodily injury; or

ii. Normal Pregnancy and Childbirth Related Conditions (See Special Notes); or

iii. backache and related conditions unless there is radiological evidence of medical abnormality resulting in Disability; or

iv. Your consumption of alcohol or You taking drugs otherwise than under the direction of a Doctor (provided that such direction is not given due to Your treatment for drug addiction or dependence); or

v. Civil Disorder; or

vi. any psychotic or psychoneurotic illness, mental or nervous disorder or stress or stress related condition, unless the condition has been diagnosed by a Consultant Psychiatrist and You are under the continued supervision and receiving treatment from a Consultant Psychiatrist; or

vii. a Pre-Existing Condition; or

viii. ionising radiations or contamination by radioactivity from any nuclear waste from the combustion of nuclear fuel or the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof; or

ix. any event which occurs whilst You are outside of the United Kingdom for a period intended to last for 90 days or more in any one year; or

x. surgery which is not medically necessary or is undertaken solely at Your request.

Special Notes

When a claim is made by You for a pregnancy or childbirth related condition, the Insurer may refer to a Doctor who specialises in Obstetrics for an opinion as to whether the condition is a Normal Pregnancy and Childbirth Related Condition. The Insurer will consider this opinion to be final.

(This Section only applies if You have chosen Accident and Sickness Insurance Cover)

What is Covered

The Insurer will pay the Settlement Figure to Egg if, during the Period of Insurance, Your Disability lasts for 24 months or more and in the Insurer's reasonable opinion prevents You from engaging in any work or occupation for remuneration or profit.

What is Not Covered

The Insurer will not pay benefits if the Permanent Total Disability results, directly or indirectly, from:

i. intentionally self-inflicted bodily injury; or

ii. Normal Pregnancy and Childbirth Related Conditions (See Special Notes); or

iii. backache and related conditions unless there is radiological evidence of medical abnormality resulting in Disability; or

iv. Your consumption of alcohol or You taking drugs otherwise than under the direction of a Doctor (provided that such direction is not given due to Your treatment for drug addiction or dependence); or

v. Civil Disorder; or

vi. any psychotic or psychoneurotic illness, mental or nervous disorder or stress or stress related condition, unless the condition has been diagnosed by a Consultant Psychiatrist and You are under the continued supervision and receiving treatment from a Consultant Psychiatrist; or

vii. a Pre-Existing Condition; or

viii. ionising radiations or contamination by radioactivity from any nuclear waste from the combustion of nuclear fuel or the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof; or

ix. any event which occurs whilst You are outside of the United Kingdom for a period intended to last for 90 days or more in any one year; or

x. Surgery which is not medically necessary or is undertaken solely at Your request.

Special Notes

When a claim is made by You for a pregnancy or childbirth related condition, the Insurer may refer to a Doctor who specialises in Obstetrics for an opinion as to whether the condition is a Normal Pregnancy and Childbirth Related Condition. The Insurer will consider this opinion to be final.

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(Your Agreement will show if You have chosen this Cover)

What is Covered

If You are Self-Employed the Insurer will only pay benefit if You are without work due to the business in which You were Self-Employed totally and permanently ceasing as a direct result of it being unable to pay its debts as and when they fell due.

The Insurer will pay:

Daily Benefit payable monthly in arrears to Egg if, during the Period of Insurance, You suffer Unemployment.

Please note payment of Daily Benefit is subject to the following conditions:

1. i. You must have been Unemployed for more than the Excess Period after which Daily Benefit will become payable; and

ii. Daily Benefit shall then become payable in respect of each additional consecutive day that You are continuously Unemployed until the earliest of the following dates:

a. the date on which You cease to be Unemployed or fail to provide proof that You are Unemployed; or

b. the date on which the Insurer has paid 12 consecutive Monthly Benefits in respect of any one Unemployment claim; or

c. the End Date.

2. No benefit is payable for the Excess Period.

3. The maximum Monthly Benefit payable under the Unemployment Insurance Part of this Policy, is £1,500.

4. Unemployment benefits are payable only if You have been in Work continuously for at least 6 months immediately prior to the date of Your Unemployment.

Subject to paragraphs 5 and 6 If You cease to be entitled to Daily or Monthly Benefit under the Unemployment Insurance Part of this Policy, then You will not be entitled to any further Daily or Monthly Benefit under the Unemployment Insurance Part of this Policy until You have returned to Work for a continuous period of at least 6 months.

5. Where You are Unemployed for two periods separated by less than 6 calendar months the Insurer will treat this as one continuous claim.

6. If whilst You are Unemployed You wish to commence temporary work then, provided You have first contacted the Insurer and have given the Insurer full details of the temporary work and have received the Insurer's agreement, if the temporary work does not continue for more than 6 months the Insurer will not, during that period, pay Monthly Benefit but will treat Your claim as suspended and will thereafter, commence or resume payment of Monthly Benefit as if You had one continuous claim.

7. Benefit shall not be payable under the Unemployment Insurance Part of this Policy if You are currently receiving benefit under the Accident & Sickness Insurance Part of this Policy.

8. If during payment of an Unemployment claim, the only reason You are not actively seeking Work is because of a Disability, the Insurer may consider continuing to pay Daily or Monthly Benefit under the Unemployment Insurance Part of this Policy, subject to a maximum of 12 Monthly Benefits from the date of the original Unemployment.

9. If You are in receipt of a payment in lieu of notice, no Unemployment benefit will be payable in respect of the period covered by the payment in lieu. Your Unemployment will not be deemed to have started until the day after the expiry of the period for which You have received payment in lieu of notice and the Excess Period shall only begin at this point.

What is Not Covered

The Insurer will not pay benefit if:

i. Your Unemployment occurs within 60 days of the Start Date or notification of Unemployment was given to You (or if, in the reasonable opinion of the Insurer You were aware of a forthcoming notification) prior to the Start Date or within 60 days after the Start Date; or

ii. Your Unemployment is in any manner voluntary; or

iii. You are, at the date of Your Unemployment:

a. engaged in an occupation of which Unemployment is a regular or recurrent feature; or

b. employed under a fixed-term contract of employment (see special notes), the term of which expires on a known or fixed date; or

c. employed on a temporary basis or employed by an employer for a specific task or job and the completion of this task or job has resulted in Your Unemployment;or

d. outside of the United Kingdom for a period intended to last for 90 days or more in any one year; or

iv. You were employed by:

a company of which You were a director and/or had a 30% or more shareholding (other than by way of bona fide investment in a company quoted on a recognised stock exchange) unless Your company has been wound up by a creditor who was not a director of that company.

v. Your Unemployment results directly or indirectly from:

a. Your own acts, omission or negligence; or

b. criminal or fraudulent acts in which You are involved; or

c. Civil Disorder; or

d. ionising radiations or contamination by radioactivity from any nuclear waste from the combustion of nuclear fuel or the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.

Special notes

If You become Unemployed due to the expiry of or during a fixed term contract where Your Employment has been renewed at least once during the Period of Insurance with the same employer on fixed term contracts, provided there is no period between the contracts when You were without Employment and You have been in Employment for a total unbroken period of 1 year or more exclusion iii b will not apply.

If You become Unemployed due to the expiry of or during a fixed term contract where Your Employment has been renewed at least twice during the Period of Insurance with the same employer on fixed term contracts, provided there is no period between the contracts when You were without Employment and You have been in Employment for a total unbroken period of 6 months or more exclusion iii b will not apply.

If You become Unemployed during a fixed term contract which has not been renewed at least once during the Period of Insurance You may be eligible to claim benefit for the period until the original expiry date of the fixed term contract, subject to a maximum of 12 Monthly Benefits.

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(Your Agreement will show if You have chosen this Cover)

What is Covered

The Insurer will pay:

the Settlement Figure to Egg if, during the Period of Insurance, You die.

What is Not Covered

The Insurer will not pay benefit if the death results, directly or indirectly, from

i. a Pre-existing Condition; or

ii. any event which occurs whilst You are outside of the United Kingdom for a period intended to last for 90 days or more in any one year; or

iii. Civil Disorder; or

iv. ionising radiations or contamination by radioactivity from any nuclear waste from the combustion of nuclear fuel or the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof; or

v. Your consumption of alcohol or You taking drugs otherwise than under the direction of a Doctor (provided that such direction is not given due to Your treatment for drug addiction or dependence); or

vi. criminal or fraudulent acts in which You are involved; or

vii. surgery which is not medically necessary or is undertaken solely at Your request; or

viii. suicide within 12 months of the Start Date.

Special Notes

(This Section only applies if You have chosen Life Insurance Cover)

What is Covered

The Insurer will pay:

£5,000 to Your legally appointed personal representatives if, during the Period of Insurance, Accidental Death is suffered by You or Your Partner (whichever occurs first). Such payment is in addition to any Life Insurance benefit payable in relation to the same death under the Life Insurance Part of this Policy.

What is Not Covered

The Insurer will not pay benefit if the Accidental Death arises from or is due directly or indirectly from:

i. any event which occurs whilst You are outside of the United Kingdom for a period intended to last for 90 days or more in any one year; or

ii. Civil Disorder; or

iii. ionising radiations or contamination by radioactivity from any nuclear waste from the combustion of nuclear fuel or the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.

Special Notes

The maximum benefit payable under the Accidental Death Insurance Part of this Policy, is £5,000.

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In the event of You needing to make a claim please contact the Claims Helpline on 0845 120 5203.

Telephone calls may be monitored or recorded to assist with staff training and for quality control purposes.

You may contact the Claims Helpline using TypeTalk, Telephone 18001 0845120 5203.

Notice of any claim should be given within 120 days of the date of the event giving rise to that claim together with, at Your expense, such information and proof as the Insurer may reasonably require. If such notice and information is not given within this 120 day period then, other than in exceptional circumstances, no benefits will be paid in respect of the claim.

Throughout any period for which Disability or Unemployment benefits are claimed You should provide, at Your expense, such proof of continued Disability or Unemployment as may be reasonably required by the Insurer and other than in exceptional circumstances, no benefits shall be payable for any period for which the required substantiating proof is not provided.

The Insurer may require You, at its expense, to be examined by a medical examiner of its choice. If You fail to attend any such examination, no further benefit shall be payable. The Insurer may also arrange for an agent to visit You. The purpose of any such visit will be to gather details relating to Your claim in order to ensure an accurate assessment. It is essential that You make yourself available for any such visit. If You fail to do so, no further benefit shall be payable.

When making a claim for Unemployment, Your claim may be selected for Back to Work Assistance.

This specialised service is designed to provide help, guidance and assistance with Your job search and is provided at the Insurer's expense.

We realise that things can go wrong and there may be occasions when You feel that We have not provided the service You expected. When this happens We want to hear about it so We can try and put things right. If You have cause for complaint it is important You know We are committed to providing You with an exceptional level of service and customer care.

Who to contact?

• to be sure You are talking to the right person and
• that You are giving them the right information

So We begin by establishing Your first point of contact:

Step One - initiating your complaint:

Does Your complaint relate to

A Your Policy?

B a claim on Your Policy?

If A You need to contact the Customer Relations Office, Egg Banking plc, Pride Park, Derby, DE99 3GG. Telephone: 08451 233 233. Or e-mail at complaints@egg.com

If B You need to contact Egg Loans, St Andrews House, Portsmouth Road, Esher, Surrey, KT10 9SA. Telephone 0845 120 5203.

We expect that the majority of complaints will have been quickly and satisfactorily resolved at this stage but if You are not satisfied You can take this matter further.

Step Two - contacting AXA Head Office

If Your complaint is one of the few that cannot be resolved by this stage write to the Head of Customer Care who will arrange for an investigation on behalf of the Chief Executive:

Customer Care
AXA Insurance
Civic Drive
Ipswich IP1 2AN

Or You may use email customercare@axa-insurance.co.uk

Or telephone 01473 205 926 or fax 01473 205 101.

Step Three - beyond AXA

If the Insurer has given You their final response and You are still dissatisfied You may refer Your case to the Financial Ombudsman Service (FOS).

The FOS is an independent body that arbitrates on complaints about general insurance products. It will only consider complaints after the Insurer has provided You with written confirmation that their internal complaints procedure has been exhausted.

Your Policy includes a confidential and independent counselling programme. The service provides You and Your immediate family with assistance, practical help and guidance on:

i. medical information;

ii. stress counselling.

Telephone: 0845 300 2081 and quote 'Egg Loan Creditor Care'. Lines are open 24 hours a day 365 days a year.

There is also an unemployment support helpline available which includes:

i. access to a job vacancy database;

ii. practical help and guidance on returning to work;

iii. personal and legal advice.

Telephone: 0845 300 2082 and quote 'Egg Loan Creditor Care'.

Lines are open 9 to 5 Monday to Friday.

Fully trained professional and advisory staff operate these helplines.

Egg Banking plc sells Egg Loan Repayment Protection only on behalf of AXA Insurance UK plc and AXA Sun Life plc. Egg Banking plc, AXA Insurance UK plc and AXA Sun Life plc are authorised and regulated by the Financial Services Authority.

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