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Terms and Conditions
Accidental Death and Fracture Cover - Terms and Conditions
Underwritten by Avon Insurance plc.
You should read this policy carefully as you are responsible for deciding that it meets your requirements as Avon Insurance plc are not making a personal recommendation that it is suitable for your individual needs.
1 Schedule
| Benefit number | If you have an accident that directly causes: | The benefit for the insured is: |
| 1 | Your death within 12 months of the date of the accident | £50,000 |
| 2 | One or more fractures of your skull, neck or spine with permanent, irreversible brain or spinal cord damage causing paralysis of one or more limbs and/or serious disability | £50,000 |
| 3 | One or more fractures of your: a) skull, neck, spine, or pelvis b) leg including hip, knee and ankle | £10,000 £10,000 per leg |
| 4 | One or more fractures of your: a) jaw, cheekbone or collarbone b) arm including shoulder, elbow and wrist | £5,000 £5,000 per arm |
The benefit payable may be reduced if a pre-existing condition has caused or contributed to your bodily injury. Other limitations also apply (see section 5).
2 Meaning of words
Wherever the words below appear in bold, they will have the following meanings.
| Accident | A sudden and unexpected event which happens at an identifiable time and place while the policy is in force and results in bodily injury. |
| Activities of daily living |
|
| Bodily injury | Physical harm not caused by sickness, disease or any other naturally occurring condition or gradual deterioration. |
| Doctor | A legally qualified medical practitioner other than you, anyone you live with or a member of your immediate family, who is currently registered with the General Medical Council in the United Kingdom to practice medicine. |
| Fracture | A break in the continuity of the bone requiring treatment in a hospital |
| Hospital | A registered establishment providing medical and surgical treatment and 24-hour nursing care by registered nurses for ill or injured people. This does not include a convalescent, self-care or rest home, or a department in a hospital that has the role of a convalescent or nursing home. |
| Monthly premium | The amount payable by you to us each month (or any other frequency, if agreed by us in advance) for the cover provided under this policy. |
| Serious disability | Bodily injury which results in your inability to perform three or more activities of daily living. |
| We, us or our | Avon Insurance plc. |
| You, your or yourself | The person named in the Schedule as the Insured. |
3 Benefits
Once you have applied for cover, if you have an accident:
- that directly causes a condition detailed in your Schedule,
- that is after the start date and before the policy ends as defined in section 6,
- and provided we have collected your monthly premium when it becomes due,
you will be entitled to the corresponding benefit detailed in your Schedule, subject always to the terms of this policy
We will pay the benefits to you or, in the event of your death, to your estate.
This policy has no cash-in or maturity value.
4 Exclusions
A. We will not pay you benefits for an accident that is directly or indirectly the result of:
- war, invasion, hostilities (whether war is declared or not), civil war, rebellion or being on naval, military or airforce active duty or operations;
- riding on a motorcycle or moped;
- rock climbing or mountaineering of any type, potholing or parachuting;
- racing or practising for racing, other than on foot or while swimming;
- taking part in any flying activity, other than as a passenger in a commercially licensed aircraft;
- you committing suicide or your deliberate self-harm;
- exposing yourself to danger:
a) deliberately (except in an attempt to save human life); or
b) when your judgement or actions are impaired while you are under the influence of alcohol, or any drug neither prescribed nor taken as prescribed by a doctor.
B. We will not pay you any benefit if you have lived outside the United Kingdom, the Channel Islands or the Isle of Man for more than 12 weeks in total in the 12 months before the accident.
5 Limitations
The most we will pay in total for all claims under this policy is limited to an amount equal to the death benefit (benefit 1).
We will not pay you the relevant benefit for any accident unless you have sought medical treatment within 30 days of the accident.
If, prior to your accident, you already had a sickness, disease, naturally occurring condition or injury that has contributed to your bodily injury then we will ask a doctor to assess the impact and we will reduce your benefit accordingly.
6 When does this policy end?
This policy ends when:
- we have paid the maximum total benefit we are liable to pay under this policy;
- you cancel the policy as set out in section 10;
- we cancel the policy as set out in section 10;
- you reach the age of 90; or
- you die.
7 Claims
The claimant must notify us of a potential claim as soon as possible. If we are disadvantaged by any delay in notifying us, we will reduce the benefit to reflect the disadvantage caused by the delay.
To tell us about a claim and obtain a claim form, please contact us using the details shown below.
The claimant will need to provide certificates, information or evidence to support the claim at their own expense.
8 Complaints
If you or your legal personal representative are not satisfied with any part of our service, please contact us using the details shown below.
If you are not satisfied with the way in which we have dealt with your complaint, the Financial Ombudsman Service may review the complaint if referred to them by you. There is no charge for this service. Financial Ombudsman Service, South Quay Plaza, 183 Marsh Wall, London E14 9SR. Phone 0800 0 234 567. The Ombudsman’s decision is binding on us, but you can reject it, and doing so will not affect your legal rights.
9 Important information
The quoted monthly premium includes Insurance Premium Tax. If there is any future change in the rate of Insurance Premium Tax, we have the right to adjust the monthly premium accordingly. Any alteration in the rate of tax will be announced publicly.
10 Cancelling this policy
You can tell us that you wish to cancel your policy at any time by contacting us using the details shown below.
If you do this within 14 days of receiving your original policy documents, we will refund any premiums collected under this policy.
If you do not do this, you are agreeing to make the monthly premium payments under this policy.
If you give notice to cancel after the 14 day cancellation period, your policy will finish when the next monthly premium is due and we will not refund any premiums for this period.
We have the right to cancel this policy if there is any attempt to fraudulently claim on this policy by you.
We may cancel the policy at any time by giving you 60 days written notice at your last known address.
11 The law applicable to the contract
This contract shall be governed by English Law and shall be subject to the exclusive jurisdiction of the English Courts.
12 Data protection notice
You agree that we can use your personal data, including any sensitive personal data, to set up, provide and administer your policy, including underwriting, claims handling, fraud prevention and research purposes. This includes personal data you have given to us or to anyone else for these purposes.
This could involve passing your personal data to regulatory or other organisations and public bodies including the police or to other countries. We will make sure your personal data is adequately protected in accordance with the Data Protection Act 1998 and EU Directives.
We would like to use your personal data to send you information about other products or services similar to those that you have already purchased, offered by us and our subsidiaries. If you do not wish us to do this by telephone or post please write to us at the address shown below. If you do not wish us to do this by electronic means (e-mail or SMS) please visit www.avon-insurance.co.uk/contactus.htm and complete the on-line form.
The Data Protection Act 1998 gives you the right to a copy of your personal data held by us. If you would like to know what personal information we hold about you, or more details about how we will process your information, please contact us using the details shown below. There may be a charge for this.
13 Financial Services Compensation Scheme
We are covered by the Financial Services Compensation Scheme (FSCS), which means that you may be entitled to compensation from the scheme if we cannot pay what we owe under this policy. This depends on the type of policy and the circumstances surrounding your claim. You can find out more at http://www.fscs.org.uk/ or by calling 020 7741 4100 or 0800 678 1100.
14 Other
We are authorised and regulated by the Financial Services Authority (FSA) for general insurance.
If you want to check our statutory status on the FSA's register you can do so by visiting the FSA website (www.fsa.gov.uk/register/) or by contacting the FSA on 0845 606 1234. Our FSA registration number is 202029.
The contract and other documents are written in English. We will communicate with you in English throughout the duration of the policy.
John Roberts
Managing Director, Avon Insurance plc
Avon Insurance plc, (No. 209606). Registered in England. Registered Office: Tiddington Road, Stratford-upon-Avon, Warwickshire CV37 7BJ. Authorised and regulated by the Financial Services Authority. A member of the NFU Mutual group of companies and the Association of British Insurers.
Contact Details
Avon Insurance plc
Avon House
Ryon Hill Park
Warwick Road
Stratford – upon - Avon
CV37 0UY
Telephone: 01789 415 050
Email: enquiries@avon-insurance.co.uk
Direct Debit Guarantee
- This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
- If there are any changes to the amount, date or frequency of your Direct Debit, Avon Insurance will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Avon Insurance to collect a payment, confirmation of the amount and date will be given to you at the time of the request
- If an error is made in the payment of your Direct Debit, by Avon Insurance or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society
- - If you receive a refund you are not entitled to, you must pay it back when Avon Insurance asks you to
- You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.
