south yorkshire police federation yorks scheme... · critical illness ... terminal prognosis...

SOUTH YORKSHIREPOLICE FEDERATIONGROUP INSURANCE SCHEME

SCHEME BENEFITSEffective from 1 April 2018

2 Police Federation Group Insurance Scheme

USEFUL TELEPHONE NUMBERS

Federation Office 0114 229 1381

Worldwide Travel Insurance Policy Number VOY/PWSYP/2017Emergency Medical AssistanceService (24 hours) +44 (0)2920 468 794Non-Emergency Claims 01702 840 291 during office hours www.submitaclaim.co.uk/VOYPWSYP

Motor Breakdown Cover (UK) 01384 884 082 (Europe) +44 1384 884 082

Home Emergency 0330 303 1810

Legal Expenses 01384 887 581(quote LES/256/1424)

RedArc Plus 01244 625 180

Mobile Phone Cover 03444 120 982

Philip Williams and Company 01925 604 421

Claims ProceduresClaims should be reported as soon as is practical and if possible within 30 days of the incident /diagnosis. If claims are not reported within 90 days of the date of the incident / diagnosis theymay not be met. The onus is on the member to notify a claim and it is not the responsibility ofthe Federation to make a member aware of their entitlement to claim.

Police Federation Group Insurance Scheme 3

*Terminal Prognosis Advance only available for members aged 63 and under

SERVING MEMBER AGED UNDER 65Life Insurance £120,000Terminal Prognosis Advance on life insurance* 20% of sum insuredPersonal Injury Insurance: Permanent Total Disablement (due to accident) £100,000 Accidental Loss of Use of Limbs/Eyes/Hearing Up to £35,000 Hospitalisation Benefit £35 pn up to 7 nights Temporary Total Disablement excluding first 7 days £35 pw up to 104 weeks Sick Pay up to 26 weeks 15% Scale Pay Family Personal Injury Insurance IncludedCritical Illness £5,000RedArc Plus Family CoverFamily Travel Policy WorldwideLegal Expenses including ID Theft Protection IncludedDental Injury and Emergency Member & PartnerHome Emergency Assistance IncludedMotor Breakdown Cover (UK and Europe) Member & PartnerMobile Phone Member & PartnerCALENDAR MONTHLY PREMIUM £24.50

COHABITING PARTNER AGED UNDER 65Life Insurance £50,000Terminal Prognosis Advance on life insurance 20% of sum insuredCritical Illness £5,000Child Critical Illness £1,250Child Death Grant £2,000CALENDAR MONTHLY PREMIUM £5.50

SERVING MEMBER BENEFITS


RETIRED MEMBER BENEFITS

*Terminal Prognosis Advance only available for members aged 63 and under

RETIRED MEMBER OPTION A OPTION BLife Insurance - aged under 60 £50,000 £25,000Life Insurance - aged 60 to 64 (inclusive) £25,000 £12,500Terminal Prognosis Advance on life insurance* 20% of sum insured 20% of sum insuredPersonal Injury Insurance:

Permanent Total Disablement (due to accident) £35,000 £35,000Accidental Loss of Use of Limbs/Eyes/Hearing Up to £35,000 Up to £35,000Hospitalisation Benefit £35 pn up to 7 nights £35 pn up to 7 nightsTemporary Total Disablement excluding first 7 days £35 pw up to 104 weeks £35 pw up to 104 weeksFamily Personal Injury Insurance Included Included

RedArc Plus Family Cover Family CoverFamily Travel Policy Worldwide WorldwideLegal Expenses including ID Theft Protection Included IncludedDental Injury and Emergency Member & Partner Member & PartnerHome Emergency Assistance Included IncludedMotor Breakdown Cover (UK and Europe) Member & Partner Member & PartnerCALENDAR MONTHLY PREMIUM £33.50 £23.50

COHABITING PARTNER AGED UNDER 65Life Insurance £7,500Terminal Prognosis Advance on life insurance* 20% of sum insuredCALENDAR MONTHLY PREMIUM £5.00

RETIRED MEMBER AGED 65–69Life Insurance £5,000RedArc Plus Family CoverFamily Travel Policy WorldwideLegal Expenses including ID Theft Protection IncludedDental Injury and Emergency Member & PartnerHome Emergency Assistance IncludedMotor Breakdown Cover (UK and Europe) Member & PartnerCALENDAR MONTHLY PREMIUM £33.00

COHABITING PARTNER AGED 65–69Life Insurance £2,500CALENDAR MONTHLY PREMIUM £5.00


Applying to joinServing Officers and Police Staff canapply to join the scheme at any timeby completing an application formwhich is available from the FederationOffice. The first three monthlysubscriptions are free of charge whenjoining the schemefor the first time. New studentofficers may join the scheme freeof charge for their first 104 weeks ofservice. The Federation and/or PhilipWilliams & Co reserve the right todecline any applications.

Subscription collectionSubscriptions are collected monthlyby deduction direct fromsalary/pension unless that isnot possible when alternativearrangements may be agreed.Monthly subscription paymentsmust be maintained in order toremain a member of the schemeand to qualify for any benefits.

InsurersA list of the insurers is available onrequest. Full policy wordings forcertain policy sections are availableto download via QR codes. Thesemay also be available at theFederation Office, on the FederationWebsite or by visiting the GroupScheme section ofwww.philipwilliams.co.uk

How to cancel your coverIn the event that you need to cancelyour cover, please submit a letterwith a signature on to theFederation Office.

Cohabiting Partner ExtensionsAny cohabiting partner extensionwill cease when the member orcohabiting partner reach 70 yearsof age whichever is the sooner. Anycohabiting partner cover and/orextension will cease when themember ceases to be a memberof the scheme.

Career breaks, maternityleave, secondment or livingoverseasThose going on a career break,maternity leave, secondment or areliving overseas must contact theFederation Office to identify if covercan be maintained.

Retirement fromthe Police ServiceServing officers upon retirementfrom the Police may remain in thescheme as a retired member bysubmitting a completed membershipcontinuation form to the FederationOffice prior to retirement.

Individuals are not eligible to join thescheme after their retirement date.

Transfer, resignationor dismissalServing officers who transfer, resignor are dismissed from the policeservice are not eligible to remainin the scheme and all membershipand benefits will cease including anycohabiting partner extension.

Complaints procedureThe Federation Insurance Scheme is arranged on behalf of the Trusteesby Philip Williams and Company who are authorised and regulated by theFinancial Conduct Authority registration number 308860. The Trusteesare responsible for dealing with the insurance broker and organising thePolicies. Any complaints about any aspect of the Federation InsuranceScheme should in the first instance be directed to the Trustees. We willthen investigate any complaint; identify the appropriate person to speakto and then either resolve the matter with that organisation and theMember or arrange for the appropriate organisation to resolve it directlywith the member.

Therefore if you have any complaints about the Federation InsuranceScheme please contact the Federation Office on

0114 229 1381or simply write, giving details of your complaint to: South Yorkshire PoliceFederation, 3 Meadow Court, Amos Road, Sheffield S91BX.

This booklet is a summary only. The benefits are subject to certain exclusions and policy conditions notstated in this booklet which in the event of a claim will be applicable. The benefits are provided strictlyunder the terms of the insurance policies taken out by the trustees of the scheme. Subscription to thescheme entitles the member to the benefits provided by the scheme but confers no ownership of anyof the underlying policies which are vested in the trustees. The trustees retain the full policy wordingdetailing all benefits and exclusions which may be viewed on request to the Federation Office.

IMPORTANT INFORMATIONAPPLICABLE TO ALL BENEFITS


EXPLANATION OF BENEFITS

Life insuranceOn death of a member or subscribing cohabitingpartner the cash benefit detailed in the currentbenefits table will be paid. The policy is written in Trustso that if a member dies, the proceeds can be paid, bythe Trustees, to the member's dependants quicklyfree of tax and without having to wait for probate.Members should ensure that they have an up-to-datebeneficiary nominated and have lodged the detailswith the Federation Office, to assist the Trustees in

the event of a claim. If a member aged 63 or underreceives a terminal prognosis of 12 months or less, theymay apply to the Trustees for an advance of the deathbenefit of 20% of the relevant sum insured.

Child death grant(only applicable if cohabiting partner cover is selected)This benefit is paid upon the death of a dependant childof a member, aged between 6 months and 17 years.

Personal Injury Insurance

Injured PersonsCategory A Any serving member and police staff of South Yorkshire Police Service up to age 65 years.Category B Any retired member of South Yorkshire Police Service up to age 65 years.Category C Any Partner, aged under 65 years described in Category A or BCategory D Any Child, aged under 18 or under 22 if in full time education described in Category A or B

Benefit description Benefit amount

Category A Category B Category C Category DDeath Nil Nil £15,000 £7,500*Permanent Total Disablement £100,000 £35,000 £15,000 £7,500Loss of one or more limbs £35,000 £35,000 £15,000 £7,500Loss of sight in one or both eyes £35,000 £35,000 £15,000 £7,500Loss of hearing in both ears £35,000 £35,000 £6,000 £3,000Loss of hearing in one ear £8,750 £8,750 £1,500 £750Permanent disabling injuries Nil Nil Up to £15,000 Up to £7,500Temporary total disablement £35 per week £35 per week Nil NilBenefit period - 104 weeksDeferment period 7 daysHospital confinement £35 per night £35 per night £75 per week £37.50 per week(Overnight benefit) (immediately following (immediately following the accident) the accident)

Benefit period 7 nights 7 nights 52 weeks 52 weeksRegulation 28 Sick Pay 20% of scale pay Nil Nil NilQualifying period 182 daysBenefit period 183 days* £6,000 for children aged under 16 years


Permanent total disablementMeans disablement which has lasted for at least 12months and which in the insurers opinion is beyondhope of recovery and will in all probability continuefor the remainder of the member's life, will preventthe member from engaging in or giving attention tobusiness profession or occupation of any and everykind for the remainder of their life.

Hospitalisation benefitFor each consecutive night’s stay as a result of anaccident, this benefit will pay the amount shown in thebenefits table for each category applicable.

Temporary total disablement(including Post Traumatic Stress Disorder)This benefit will be paid should the member sufferinjuries which cause the member to be prevented fromcarrying out their usual occupation as a result of anaccident for up to 104 weeks (excluding the first sevendays). Benefit will also be paid under this section if amember suffers Post Traumatic Stress Disorder as aresult of attending an incident on police duty. Such PostTraumatic Stress Disorder must be the clear result ofan incident that was documented in the police recordsand be of sufficient severity to prevent the performingof duties.

Sick pay benefit (Regulation 28 cover)If a member suffers a reduction in pay under PoliceRegulations or terms of employment, the benefitsshown will become payable. The benefit ceases onreturn to work or if the member retires, resigns, isdischarged from the police service, or fails to pay themonthly scheme subscription. In addition the benefitshall not be payable if the member has been offeredreasonable adjusted duties with a return to full pay andhas declined such duties without reasonable cause.

Please note: Any overpayment due to a reversal in thedecision by South Yorkshire Police which results in aresumption of pay (including any back payment) ordue to a failure by the member to inform the insurersof a return to work must be repaid in a prompt andtimely manner.

Dental Injury & EmergencyThis policy provides cover for Dental Expenses in theevent of:– Dental Injury– Emergency Dental Treatment– Dentist Call-out Fees– Hospitalisation– Mouth CancerDefinitions are shown in the full policy wording.

Making a Dental ClaimNo prior authorisation is required. Undergo thetreatment, pay the dentist direct, and subsequentlysubmit a claim. Please ensure that proof of treatmentand receipts of costs are obtained. Claim forms areavailable from the Federation Office.

Documents can be downloadedby visiting the Group Schemesection of our websitewww.philipwilliams.co.ukor by scanning the QR code.


CRITICAL ILLNESS

The scheme benefits will be payable if a member, member's subscribing cohabiting partner or theirchild, aged from 30 days to 17 years, suffers from an insured illness and survives for more than 14days from the date of diagnosis or surgery.

Please refer to the policy wording for full definitions of the illnesses covered.

A pre-existing conditions exclusion applies together with other terms and conditions. Critical illness benefit ispayable once only in respect of conditions in a common group. Some illnesses may belong to more than onegroup, as shown above and in the full policy wording.

- Alzheimer’s disease – resulting in permanent symptoms (group C)- Aorta graft surgery – for disease (group A)- Bacterial meningitis – resulting in permanent symptoms (group C)- Benign brain tumour – resulting in permanent symptoms (group B)- Blindness – permanent and irreversible (group A&C)- Cancer – excluding less advanced cases (group B)- Coma – resulting in permanent symptoms (group A&C)- Coronary artery bypass grafts – with surgery to divide the breastbone (group A)- Creutzfeldt-Jakob disease (group C)- Deafness – permanent and irreversible (group A&C)- Heart attack – of specified severity (group A)- Heart valve replacement or repair – with surgery to divide the breastbone (group A)- HIV infection/Hep B virus – contracted from a blood transfusion, physical assault or an incident occurring whist performing Police Duties (group C)- Kidney failure – requiring dialysis (group C)- Loss of hands or feet – permanent physical severance of 2 or more hands or feet in any combination (group A&C)- Loss of speech – permanent and irreversible (group A&C)- Major organ transplant - undergoing of surgery or inclusion on official UK waiting list (group A)- Motor neurone disease – resulting in permanent symptoms (group C)- Multiple sclerosis – with persisting symptoms (group C)- Paralysis of limbs – total and irreversible (group A&C)- Parkinson’s disease – resulting in permanent symptoms (group C)- Severe burns – first-degree burns covering at least 60% of the total body surface area or second-degree burns covering at least 40% of the total body surface area or third-degree burns covering at least 20% of the total body surface area (group C)- Stroke – resulting in permanent symptoms (group A)- Traumatic head injury - resulting in permanent symptoms (group A&C)


REDARC PLUS


- Serious Illness- Bereavement- Long Term Disability- Stress- Telephone Support for people when discharged from hospital

Your Personal Nurse Adviser will be able to assist with:- Help in understanding the condition and all its implications- Explain options for treatment- Help to prepare for consultants appointment- Explain medical terms in simple everyday language- Help families to cope with consequences of illness- Information and advice on home adaptations/specialist equipment- Source suitable equipment & medical aids- Provide information on entitlements from NHS- Helping you to make as speedy a recovery as possible by providing suitable information and helping to navigate into the appropriate services- Provide good long term management of your condition- Simply a listening ear when you are feeling low, or want to talk to someone who is not emotionally involved

At the discretion of the nurse, when clinically necessary they may be able to arrange extra help.

The RedArc service is free of charge and confidential.If you think you may be eligible you should ring RedArc on

01244 625 180in normal business hours.

A telephone support service which provides access to a Personal Nurse Adviser for you and yourcohabiting family, to provide support in the event of:



This policy covers the member, their cohabitingpartner and any number of their unmarrieddependent children aged up to 17 years or 21years if in full time education (inclusive), allnormally resident in the family home, for anynumber of trips in any year up to 60 days pertrip. It covers travel worldwide and also in theUnited Kingdom.

The main sections of cover are:- Cancellation and curtailment up to £5,000- Emergency medical expenses up to £5,000,000- Personal Baggage up to £1,500- Personal Money up to £500- Public liability up to £2,000,000- Personal Accident up to £20,000.

Other benefits are included. Please see travel policyfor full details.

In the case of medical emergencyplease contact our nominatedemergency service, GlobalResponse, ontelephone number+44 (0) 2920 468 794Email [email protected] quote policy number VOY/PWSYP/2017

Other claims should be reported toClaims Settlement Agencies Ltd

01702 840 291Email: [email protected]

To download a claim form please visit www.csal.co.uk308 London Road, Hadleigh, Benfleet, Essex, SS7 2DDWe are now able to offer you the facility to submityour claim online which is the fastest and easiest wayto make a claim at:www.submitaclaim.co.uk/VOYPWSYPThe process should take approximately 10–15 minutesto complete (depending on the type of claim), butbefore continuing you should ensure you have yourpolicy number, trip dates, supporting documentationand details of the incident.

Main conditions and exclusionsThe policy will not cover you if any of the followingapply to you, a travelling companion, an immediaterelative, close business associate or someone uponwhom your trip depends whether they are travellingwith you or not (including any third party with whomyou may be staying on your trip):

1. You/they were aware of any reason why the tripcould be cancelled or curtailed.2. You/they were travelling against the advice of amedical practitioner or in order to get medicaltreatment abroad.3. You/they have been diagnosed as having aterminal illness.4. You/they are on a waiting list for surgery,treatment, or investigation at a hospital or areawaiting the results of hospital tests or investigations.

If there is any change in a person’s health between thedate the policy is issued and the start date of a tripyou must still comply with the Health Warranty. If youare unsure please notify Voyager Insurance ServicesLtd on 01483 806 816 immediately.

An excess of £50 is applicable for most policysections. The excess is payable per person, persection, per insured incident subject to a maximum of£100.

There are significant limitations and exclusions of coverfor property, including valuables and money, that is leftunattended or out of your immediate control andsupervision. Please also note the requirements fornotifications of loss/theft and the need for reports.

Full policy terms and conditions have been madeavailable. If you require further copies please contactthe Federation Office.

FAMILY TRAVEL POLICY


LEGAL EXPENSES


Some important facts about the Professional Fees policy are summarised below. This summarydoes not describe all of the terms and conditions of the policy. All references below to the coverprovided are contained within the full policy wording. Please note that a full policy wording isavailable for your inspection at the Federation Office upon request.

Legal helplineThere is a 24 hour legal helpline and this can be contacted on

01384 887 581for initial advice and further instructions in how to make a claim.Please quote scheme number LES/256/1424

Identity Theft Assistance and Claims 01384 377000

Debt Advice Helpline 01384 884085

Arranged by Legal Insurance Management Ltd.

Section of cover1. Criminal Prosecution Defence(£185,000)2. Personal Injury(£100,000)3. Residential Protection(£100,000)4. Peaceful Occupation(£100,000)5. Consumer Protection(£100,000)6. Data Protection(£100,000)7. Uninsured Loss Recovery & Motor Prosecution Defence(£100,000 but limited to £2,500 in providing representationfollowing the seizure of a vehicle as a result of incorrectinformation being on the Motor Insurance Database and £5,000for Motor Defence claims)8. Discrimination(£100,000)9. Probate(£100,000)

10. Employment(£100,000)11. Fund Trustee Defence(£100,000)12. Representation at Public Enquiries(£100,000)13. Independent Police ComplaintsCommission Investigations(£100,000)14. Disciplinary Hearings(£20,000)15. Bankruptcy and Debt Advice(£1,000)16. Education(£100,000)17. Taxation(£100,000)18. Identity Theft(£100,000)19. Pension Medical Appeals(£3,000)20. Assistance

Beneficiary/beneficiariesIn respect of Sections 3, 4, 11, 12, 13, 14, 15 and 19 the MemberIn respect of Section 1, 9 and 16 the Member and the Member’s cohabiting partnerIn respect of Sections 2, 5, 6, 7, 8, 10, 17, 18, and 20 the Member and:i) the Member’s cohabiting partner ii) children including stepchildren adopted children foster children and grandchildren normally resident with the Memberiii) the parents and grandparents of the Member and the Member’s cohabiting partner normally resident with theMember.

HOME EMERGENCY ASSISTANCE

Insured eventsCover is provided for domesticemergencies for the followinginsured events:- Breakdown of the main heating system- Plumbing and drainage problems- Damage which affects the security of the home, including locks and windows- Breakage or failure of the toilet unit- Loss of domestic power supply- Lost keys- Vermin infestation- Roof damage

With one call an approved contractor will come to your home andmake emergency repairs. Our cover includes all of the followingdomestic emergencies:

Cover is provided 24 hours a day, 365 days a year:

Emergency Costsa) The contractor’s call-out chargeb) Contractor’s necessary labour up to three hoursc) Parts and materials up to £150 and where necessaryd) Alternative Accommodation costs up to £500

The maximum payable by the insurer is £1,000 for all claims related bytime or original cause.

Home EmergencyA sudden unexpected event which clearly requires immediate action inorder to:a) prevent damage or avoid further damage to the home, and/orb) render the home safe or secure, and/orc) restore the main services to the home, and/ord) alleviate any health risk.

Claims Helpline 0330 303 1810An excess of £25 is payable per claim.



Comprehensive motor breakdown cover foryou and your cohabiting partner including:- Roadside Assistance/Recovery- Home Assist- Alternative Travel- Emergency Overnight Accommodation- Misfuel Assist- Message Service- Keys- European Assistance

Your Cover If a Vehicle in which you or your cohabiting partner aretravelling suffers a Breakdown due to a mechanical orelectrical failure, flat tyre, lack of fuel, misfuel,Accident, theft, vandalism or fire, service will beprovided. We will provide cover for any Breakdown inaccordance with the policy wording.

How to make a claim Call the 24 hour Control Centre on

01384 884 082For assistance in mainland Europe please call

+44 1384 884 082Please have the name of the covered member,your return telephone number, vehicle registrationnumber and precise location available whenrequesting assistance.

Covered Vehicle The car, motorcycle, campervan, motorhome (includingdomestic vans up to 3.5 tonnes), or car-derived vanwhich You or your cohabiting partner are travelling in/on at the time of the Breakdown including any towedcaravan or trailer of a proprietary make which is fittedwith a standard towing hitch and doesn’t exceed7 metres/23 feet (not including the length of the A-frame and hitch).

Any claim will be validated with the Police Federation,or other such administrative organisation, with costsfor any claims from non-eligible persons being theresponsibility of the claimant.

Cover will apply during the period of insurance andwithin the territorial limits. There is no age limit to thevehicle for breakdowns occurringin the UK. A vehicleage limit of ten years applies outside the UK.

UK AND EUROPEAN MOTOR BREAKDOWN





MOBILE PHONE

Covered individualsThis cover is provided for:- Subscribing Serving members and their partners

Please note that this policy does not cover RetiredMembers or mobile phones used by members' orpartners' children, even if the bill is paid by the memberor partner.

Cover applies to UK residents only.

Claims notificationIf you need to make a claim please contact BrightstarInsurance Services B.V. (UK Branch), Weston Road,Crewe, CW1 6BU.

Telephone number0344 412 0982Please refer to full policy terms and conditions priorto making a claim.

Your mobile phone is covered against the repair orreplacement cost of your mobile phone in the event of:- theft- accidental loss - accidental damage- breakdown whilst in your possession

The liability of the insurer in respect of any one claimand in aggregate for any 12 month period will be therepair or replacement cost of the mobile phone and inany event shall not exceed a total claim cost up to amaximum of £1000 including VAT.

A £75 excess is payable per claim.

The mobile phone should have a fully functioning SIMcard and be no more than 8 years old at the time of theincident as evidenced by the relevant proof ofownership. Upon acceptance of a claim, the insurermay at its discretion repair or replace your mobilephone. Replacement may be with a refurbished unit ora functionally equivalent product. This is NOT a new forold policy.

If the claims administrator replaces your mobile phone,your original item becomes the insurer’s property andthe replacement mobile phone is your property, withcoverage for that item continuing for the remainingperiod of insurance.

The maximum liability limit includes cover of up to£750 including VAT for unauthorised data usage for aperiod of up to 24 hour directly following a valid theftor accidental loss claim.

Please note any claim involving theft or accidental lossmust be reported to the appropriate police authoritieswithin 48 hours.

NOTES


35 Walton Road, Stockton Heath,Warrington, Cheshire WA4 6NW

Tel 01925 604 421Fax 01925 861 351www.philipwilliams.co.uk

Philip Williams and Company are authorisedand regulated by the Financial Conduct Authority.

PWI1985 02/18 v3