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Under this Policy the Insurer agrees to provide benefits in the event of death, Disability (comprising Accident & Sickness), Unemployment and Serious Illness on the basis of the following terms, conditions and exclusions.
This Policy and Your Terms and Conditions together set out the details of the insurance contract between You and the Insurer.
In the event of You needing to make a claim please contact the Claims Helpline on 0845 120 5203*.
Eligibility for cover If You are not in good health at the Start Date this may affect Your ability to claim under certain sections 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 the cardholder named on the Agreement;
- must be a UK Resident;
- must be between the ages of 18 and 65;
- must be 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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| Meaning of words used in this Policy |
These words are listed in alphabetical order and whenever they are used in the Policy in bold typeface they have the meanings set out below.
'AGREEMENT': Your credit card agreement with Egg.
'CANCER': a malignant tumour characterised by the uncontrolled growth of malignant cells and the invasion of tissue. The term cancer includes leukaemia but the following cancers are excluded:
- non-invasive carcinoma in situ;
- all forms of lymphoma in the presence of any Human Immunodeficiency Virus;
- Kaposi's sarcoma in the presence of any Human Immunodeficiency Virus; or
- any skin cancer other than invasive malignant melanoma.
'CIVIL DISORDER': war, civil war, military activity other than normal peace time activity, rebellion, revolution, riot or other civil commotion.
'CORONARY ARTERY BYPASS GRAFT': the undergoing of open heart surgery on the advice of a Consultant Cardiologist to correct narrowing or blockage of one or more coronary arteries with by-pass grafts but excluding balloon angioplasty, laser and other procedures.
'CREDIT LIMIT': the maximum amount of credit from time to time available to You under the Agreement.
'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:-
- the date of Your death; or
- the date You reach the age of 65; or
- the date on which You permanently retire from Work; or
- the date of termination of insurance cover under this Policy by either the Insurer or You; or
- the date on which a premium has remained unpaid by You for a period of three months after it is due;
- the date on which the Agreement is terminated.
'HEART ATTACK': the death of a portion of heart muscle as a result of inadequate blood supply as evidenced by an episode of typical chest pain, new electrocardiographic changes and by elevation of the cardiac enzymes.
'INSURER': In respect of Life cover, AXA Sun Life plc Registered Number 3291349. In respect of Serious Illness, Accident & Sickness, and Unemployment cover, AXA Insurance UK plc, Registered number 78950. Both companies are members of the AXA Group of Companies and have their Registered Office at 5 Old Broad Street, London EC2N 1AD. AXA Insurance UK plc and AXA Sun Life plc are authorised and regulated by the Financial Services Authority (FSA) and are entered in the Financial Services Authority register under numbers 202312 and 185063 respectively.
'KIDNEY FAILURE': end stage renal failure presenting as a chronic irreversible failure of both kidneys to function, as a result of which either regular renal dialysis or renal transplant is initiated.
'MAJOR ORGAN TRANSPLANT': the actual undergoing as a recipient of a transplant of a heart, liver, lung, pancreas or bone marrow; alternatively, confirmation by an appropriate consultant of acceptance onto the official United Kingdom waiting list for one of the above transplants.
'MONTHLY BENEFIT': an amount equivalent to 10% of the Outstanding Balance as at the commencement date of Your Disability or notification of Your Unemployment or 10% of the Credit Limit whichever is the lesser.
'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.
'OUTSTANDING BALANCE': Your total indebtedness to Egg under Your Agreement including the amount of any transactions authorised but not showing under Your Agreement as at the date of Your death, diagnosis of a Serious Illness, commencement of Your Disability or the notification of Your Unemployment.
'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':
- a condition for which treatment and or advice has been suggested by a registered medical practitioner during the 12 month period prior to the Start Date which re-occurs within 24 months after the Start Date; or
- a condition which has been diagnosed by a registered medical practitioner during the 12 month period prior to the Start Date which re-occurs within 24 months after the Start Date; or
- a condition whether diagnosed or not for which significant and substantive symptoms were experienced or for which investigations have been commenced by a registered medical practitioner during the 12 month period prior to the Start Date which re-occurs within 24 months after the Start Date; or
- a chronic or continuing disease that You were aware of at the Start Date.
'SELF-EMPLOYED': You are 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.
'SERIOUS ILLNESS': Cancer, Coronary Artery Bypass Graft, Heart Attack, Kidney Failure, Major Organ Transplant or Stroke, all requiring diagnosis by a Doctor.
'START DATE': the date You become insured under this Policy.
'STROKE': a cerebrovascular incident resulting in permanent neurological damage. Transient ischaemic attacks are specifically excluded.
'UNEMPLOYED/UNEMPLOYMENT': You being entirely out of Work and being registered for work with the relevant Government agency and in the 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.
'UK 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 UK Resident who has applied for this insurance and has agreed to pay the premium under this Policy and who at the Start Date is:
- the named cardholder on the Agreement
- a UK Resident;
- between the ages of 18 and 65; and
- 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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These conditions explain the rules of the Policy.
1. This insurance shall be for monthly periods in arrears and the premium shall be due monthly on the same date as the minimum monthly amount is due to Egg under the terms of the Agreement. During the Period of Insurance this insurance shall be automatically renewed on the same date provided the premium is paid to Egg and is accepted by the Insurer.
2. No provision or condition of this Policy may be waived or modified except by an endorsement signed by an authorised official on the Insurer's behalf.
3. This Policy shall have no surrender value.
4. If any information provided by You or anyone acting on Your behalf to Us or the Insurer is inaccurate or if You fail to disclose any information which might reasonably affect the Insurer's decision to provide insurance to You, Your right to any benefit under this Policy shall end.
5. You must not act in a fraudulent manner.
If You or anyone acting for You: - 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 or damage caused by Your wilful act or with Your connivance.
Then the Insurer:
- 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.
6. The Insurer may at any time change any term or condition of this Policy including the premium payable by giving not less than 30 days written notice of such change to You at Your last known address.
7. The Insurer may terminate insurance cover under this Policy by giving not less than 30 days written notice to You at Your last known address. The Insurer's termination will not affect the Insurer's liability for events occurring during the Period of Insurance which may give rise to a claim.
8. You may terminate Your cover under this Policy by giving not less than 30 days written notice to Us.
9. It is not possible for You to transfer Your rights under this Policy.
10. All benefits payable under this Policy shall be paid to Egg for the credit of Your credit card Agreement.
11. It is a pre-condition of the Insurer's liability that You comply with all parts of this Policy and that You take all reasonable steps to minimise the Insurer's risk and continuing liability under this Policy.
12. This Policy, any endorsement to it, any proposal and any other written statement made by You or on Your behalf on which the Insurer has relied when accepting You for cover under this Policy, shall constitute the entire contract between You and the Insurer.
13. Insurers share information with each other to prevent fraudulent claims via a register of claims. A list of participants is available on request. Any information You supply on a claim, together with information You have supplied on any application form and other information relating to a claim, will be provided to the register participants.
14. It is the duty of the Financial Services Compensation Scheme to ensure that a percentage of sums owed to Policyholders is paid if their insurance company is in liquidation and unable to pay. Such payments are subject to restrictions and not all Policyholders may benefit. Further details are available on request.
15. We will always communicate with You in English.
16. Other taxes or costs may exist that are not paid through Us or the Insurer or imposed by Us or the Insurer.
17. You can change Your mind and cancel Your Policy within 31 days from the date of receipt of Your Policy document. If You want to cancel Your Policy then You should call Us on 08451 233 233. You can also write to Us at Egg, Pride Park, Derby DE99 3GG, or You can send Us a secure e-mail from Our website. Please ensure that You include Your full name and address in any correspondence. Provided no claim has been made, We will refund back to Your card account any premium that We may have charged to Your card for this period. You will receive confirmation of the cancellation within 30 working days.
If You do not cancel Your Policy within the above period, then the Policy will continue.
18. This Policy has no minimum duration.
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| Section A Accident & Sickness Insurance |
What is covered
The Insurer will pay Monthly Benefits if, during the Period of Insurance, You suffer Disability.
Payment of Monthly Benefit is subject to the following conditions:
1. i. You must have been Disabled for a continuous period of 30 days after which Daily Benefit shall become payable; and
ii. Daily Benefit shall then become payable in respect of each additional day that You are continuously Disabled until the earliest of the following dates:
- the date on which You cease to be Disabled or fail to provide proof that You are Disabled; or
- the date on which You return to Work; or
- the date on which the Insurer has paid 12 consecutive Monthly Benefits in respect of any one Disability claim; or
- the End Date.
2. No benefit is payable for the first 30 days of Disability.
3. If the Insurer stops paying Monthly Benefit because You have received 12 consecutive Monthly Benefits and any subsequent Disability claim results from the same condition then 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 six months.
4. Where two periods of Disability arising from the same condition are separated by six calendar months or less the Insurer will treat this as one continuous claim.
5. Subject to paragraphs 3 and 4 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 one month.
6. 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:
- intentionally self-inflicted bodily injury; or
- Normal Pregnancy and Childbirth Related Conditions. (See Special Notes); or
- Your consumption of alcohol or You taking drugs other than under the direction of a Doctor (provided that such direction is not given due to Your treatment for drug addiction or dependence); or
- Civil Disorder; or
- a Pre-existing Condition; or
- 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
- 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
- criminal or fraudulent acts in which You are involved; or
- surgery which is not medically necessary or is undertaken solely at Your request; or
- 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 continued supervision of and receiving treatment from a Consultant Psychiatrist; or
- backache and related conditions unless there is radiological evidence of medical abnormality resulting in Disability.
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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| Section B Unemployment Insurance |
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 Monthly Benefits if, during the Period of Insurance, You suffer Unemployment.
Payment of Monthly Benefit is subject to the following conditions:
1. i. You must have been Unemployed for a continuous period of 30 days, after which Daily Benefit shall become payable; and
ii. Daily Benefit shall then become payable in respect of each additional day that You are continuously Unemployed until the earliest of the following dates:
- the date on which You cease to be Unemployed or fail to provide proof that You are Unemployed; or
- the date on which the Insurer has paid in total 12 consecutive Monthly Benefits in respect of any one Unemployment claim; or
- the End Date.
2. No benefit is payable for the first 30 days of Unemployment.
3. Unemployment benefits are payable only if You have been in continuous Work for at least six months immediately prior to Your Unemployment.
4. Where You are Unemployed for two periods separated by less than six calendar months the Insurer will treat this as one continuous claim.
5. 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 Your temporary Work and have received the Insurer's agreement, if the temporary Work does not continue for more than six 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.
6. 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.
7. If, during payment of an Unemployment claim, You are not able to actively seek Work only because of a Disability, the Insurer may consider continuing to pay Monthly Benefit under the Unemployment Insurance Part of this Policy or at the Insurer's option under the Accident & Sickness Insurance Part of this Policy.
8. If You are in receipt of a payment in lieu of notice, Your Unemployment will not be deemed to have started until the day after the period covered by the payment in lieu of notice and Your entitlement to benefit will not start until 30 days after the expiry of the period for which You have received payment in lieu of notice.
What is not covered
The Insurer will not pay benefit if:
- Your Unemployment occurs within 30 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 30 days after the Start Date; or
- Your Unemployment is in any manner voluntary; or
- You are, at the date of Your Unemployment:
- engaged in an occupation of which Unemployment is a regular or recurrent feature; or
- employed under a fixed-term contract of Employment (see special notes), the term of which expires on a known or fixed date; or
- 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
- outside of the United Kingdom for a period intended to last for 90 days or more in any one year.
- 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; or
- Your Unemployment results directly or indirectly from:
- Your own acts, omission or negligence; or
- criminal or fraudulent acts in which You are involved; or
- Civil Disorder; or
- 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 one 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 six 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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What is covered
The Insurer will pay the lesser of either the Outstanding Balance (including up to three months arrears) or the Credit Limit if, during the Period of Insurance, You die.
What is not covered
The Insurer will not pay benefit if the death arises from, or is due, directly or indirectly to:
- a Pre-existing Condition; or
- 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
- Civil Disorder; or
- 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
- intentionally self-inflicted bodily injury; or
- 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
- criminal or fraudulent acts in which You are involved; or
- surgery which is not medically necessary or is undertaken solely at Your request.
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| Section D Serious Illness Insurance |
What is covered?
The Insurer will pay the lesser of either the Outstanding Balance (including up to three months arrears) or the Credit Limit if, during the Period of Insurance, You suffer Serious Illness from which You survive for a period of 30 days or more from the date of diagnosis.
Exclusions:
Pre-existing conditions exclusion
No benefit will be payable in respect of a claim arising in connection with a condition which was diagnosed before the Start Date of this Policy. In addition, no benefit will be payable for any Serious Illness condition which, in the opinion of the Insurer's Chief Medical Officer, has resulted directly or indirectly from a condition for which You have previously received treatment or of which You were aware at the Start Date of the Policy.
NB for the purposes of this exclusion, the suffering or undergoing of a Heart Attack or Stroke is considered to be the same condition.
What is not covered
The Insurer will not pay benefits if the Serious Illness:
- is suffered by You within three months of the Start Date.
- results, directly or indirectly from:
- intentionally self-inflicted bodily injury; or
- 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
- Civil Disorder; or
- 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.
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In the event of Your 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.
If Your claim is selected, Your claim details will be provided to the Insurer's Back to Work Assistance service provider, MENTOR Professional Services Ltd. The full address for MENTOR Professional Services is available upon request.
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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.
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The most important factors in getting Your complaint dealt with as quickly and efficiently as possible are:-
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 Card, 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 e-mail
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.
Financial Ombudsman Service
South Quay Plaza
183 Marsh Wall
London E14 9SR
Telephone 0845 080 1800 Fax 020 7964 1001
Referral to the Financial Ombudsman will not affect Your right to take legal action against Us.
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| Confidential and independent counselling |
Your Policy includes a confidential and independent counselling programme. The service provides You and Your immediate family with assistance, practical help and guidance on:
- medical information;
- stress counselling.
Telephone: 0845 300 2081 and quote 'Egg Card care'. Lines are open 24 hours a day 365 days a year.
There is also an Unemployment support helpline available which includes:
- access to a job vacancy database;
- practical help and guidance on returning to Work;
- personal and legal advice.
Telephone: 0845 300 2082 and quote ' Egg Card care'. Lines are open 9am to 5pm Monday to Friday.
Fully trained professional and advisory staff operate these helplines.
These services are free of charge except for the cost of Your telephone call.
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| THE LAW APPLICABLE TO THIS CONTRACT |
You and the Insurer are free to choose the law applicable to this contract. In the absence of an agreement to the contrary the law of England and Wales will apply. If You reside in Scotland or Northern Ireland the law applicable to that appropriate country will apply.
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Initial Disclosure Documents and Policy Summaries are available at www.egg.com; alternatively they can be provided in paper format upon request. Please call 08451 233 233 to request a copy.
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