Proactive Financial Advice Ltd

ProActive Financial Advice Ltd

ProActive Financial Advice Ltd

Disclaimer : Please Note

Disclaimer: The information on this page about Trauma Insurance is provided for general informational purposes only and is not intended to be financial advice. Every individual’s situation is unique, and for specific advice tailored to your personal needs and circumstances, we recommend scheduling a consultation with one of our Licensed Financial Advisers. They can offer a personalized review of your policy to ensure it meets your particular requirements.

Trauma Insurance

The No Frills Facts about Trauma Insurance

Trauma Insurance, also known as Critical Illness or Serious Illness Cover, is a policy where the insured pays regular premiums in exchange for a lump-sum payout if they are diagnosed with a serious medical condition like cancer, heart attack, stroke, or if they experience a traumatic accident such as loss of limb, sight, hearing, major burns, or Total and Permanent Disability (TPD) etc.

To qualify for the payout, the insured must survive for at least 14 days after the diagnosis or accident and meet the severity criteria outlined in the policy.

The payout from Trauma Insurance has no restrictions on how it can be used, giving the insured full flexibility to cover medical bills, rehabilitation, household expenses, or anything else they may need.

Many policies also include a benefit that provides free trauma cover for children, offering extra protection and peace of mind for the whole family.

Policy Differences:

Trauma insurance policies can differ in their coverage and exclusions, and these can change over time as insurance products have evolved. Many newer policies come with the option to upgrade to the latest policy wordings, giving you the flexibility to claim under either the original terms or the updated conditions, whichever benefits you more. In contrast, older policies might lack this option, which could leave you with older terms. It’s also important to note that most trauma policies provide a one-off lump-sum payout upon diagnosis. However, some newer policies offer multiple payouts for different claims, with the amount based on the severity of the illness, or for other unrelated conditions. Reviewing older life insurance policies is wise to ensure they meet your current needs. It’s best to talk with a licensed financial adviser, as they can review your policy and provide greater detail about your coverage and the current market.

The Risks of Incomplete Information in Trauma Insurance Applications

When applying for a Trauma insurance policy, it is crucial to disclose all relevant information accurately and completely. If a person fails to provide full disclosure of their medical history, lifestyle habits, or other material facts at the time of application, the insurance company has the right to cancel the policy, deny a payout, or even return the premiums paid. This is because non-disclosure can affect the insurer’s ability to properly assess the risk involved. In cases where it is discovered that key information was withheld, particularly during a claim investigation, the insurer may reject the claim altogether based on non-disclosure, leaving the policyholder or their beneficiaries without the expected financial protection.

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What is not covered by Trauma Insurance (Exclusions)

An exclusion, sometimes referred to as a special provision or term, is an event that is not covered by your insurance policy.

In New Zealand, most underwritten Trauma insurance policies (which means you have supplied your Medical details to be taken into account) exclude coverage for:

› Intentional self-harm, including attempted suicide

› Taking part in a criminal activity

› If you or your child doesn’t survive for at least 14 days after first meeting the criteria for a covered condition

› Harm to a child that you or the child’s parents or guardians cause

If you have a non medical underwritten Trauma Insurance policy (which means you have not supplied your Medical details to be taken into account). These policies can have more permanent exclusions. It would be wise to review these policies with a Licenced Financial Adviser.

Additionally, if you have disclosed an existing health conditions or engage in risky lifestyle activities during your application, a loading might be applied to your premiums. This could also mean that any death or terminal illness related to these conditions or activities may be excluded from coverage. It’s important to review your insurance contract (also known as a policy schedule or certificate of insurance) to understand the specific exclusions and what is not covered by your policy. This is where a Licenced Financial Adviser can help by reviewing your policy.

Stepped and Levelled premium calculations:

You have several options for how often your premiums are reviewed. At the end of each review period, your premiums will be recalculated based on your coverage amount, age-related changes, and any updates to your insurer’s rates or relevant laws. Your premiums will also change if you adjust your coverage.

Generally, you can choose to have your premiums reviewed yearly, every 5 years, every 10 years, or at specific ages (65, 70 or 75).

If reviewed yearly, this is called “Rate for Age.”
Choosing a set period, known as “Levelled,” means premiums remain unchanged until the end of that period. You can also choose a mix of the two to suit your needs. Your adviser will work with you to help you choose the best premium review period or mix to suit your needs.

Policy Add-ons:

Some insurance providers allow for options to be added to Trauma Insurance policies. Trauma Insurance policies can often be customized with a range of add-ons to provide broader protection.

Common add-ons include Total and Permanent Disability (TPD) Cover, which provides a lump-sum payment if you become permanently unable to work due to illness or injury, and Waiver of Premium, which allows you to stop paying premiums if you’re unable to work for a certain period without losing coverage. You can also opt for the Free Children’s Trauma Cover, which offers the same level of trauma protection for your children, or choose Partial Payment Options, offering payouts for less severe conditions that may not meet the full criteria for a trauma claim but still require treatment or recovery time. Also Specific Injury Cover which provides a lumpsum payment if you sustain one of the covered injuries as a result of an accident.

These options allow for a more tailored policy to meet your specific needs. It is best to talk with a licensed financial adviser as they can provide information in greater detail on this cover. 

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Trauma Insurance FAQ's

Reflect on whether your savings would be sufficient if you were unable to work. If you don’t have enough funds to cover major medical expenses, Trauma Insurance could be a smart option. Serious illnesses like stroke, heart attack, or cancer can strike unexpectedly. Having Trauma Insurance can provide the financial support you need to navigate these challenging times without undue stress. Also, most insurers have a built-in benefit where they will offer a certain amount of free Trauma cover for a dependent of a life insured. In the event of a serious illness or injury to your child, the financial burden of treatment and time off work should be the least of your concerns.

The specific conditions covered by trauma insurance can differ between insurers. Generally, however, most comprehensive trauma insurance policies include coverage for more than 45 medical conditions. Commonly covered conditions include serious illnesses and events such as cancer, heart attack, stroke, and terminal illness. Some insurers also offer partial payments for less severe conditions. It is crucial to thoroughly review the policy document to understand what is and isn’t covered.

 

When taking out trauma insurance, you have the choice of an ‘accelerated’ or a ‘standalone’ policy.

Accelerated Trauma insurance allows you to link it with your Life Insurance, meaning that any Trauma insurance claims will reduce your Life insurance sum insured by the same amount. This option can be more cost-effective but will decrease your Life insurance coverage by the Trauma payout amount. You can add a Life Buy-back option to this policy, which reinstates your Life Insurance amount to its original level after a specified time period.

Alternatively, you can choose Trauma Cover as a standalone policy, ensuring that any Trauma insurance claims do not impact your Life insurance coverage.

Most insurance policies include a benefit that offers a certain amount of complimentary trauma coverage for the dependents of the insured. In the event of a serious illness or injury to your child, the financial burden of treatment and time off work should be the least of your concerns.

You have the flexibility to choose the “policy owner,” who will receive the payout if a claim is made. This could be you, or if you are establishing coverage with a partner, you can opt for a “joint” policy, giving both of you ownership of the insurance.

Given that everyone’s situation is unique, an adviser can assess your specific needs and provide research to explain why they recommend one insurance policy over others. They can also compare your current insurance coverage to ensure you are getting the best protection for the premiums you pay. Advisers are independent, allowing them to choose from various providers to best serve their clients’ interests. They are licensed by the government, have met educational standards, and participate in ongoing education to maintain their license. Their work is also regularly audited to ensure compliance with these standards.

Yes, Trauma insurance policies offer joint cover, so you and your partner can get covered in one policy. Some policies even allow an option to add your children (subject to eligibility) to the same policy, so the whole family can be covered.

You have the flexibility to change the ownership of your policy or convert it to a joint policy whenever you wish. This change requires the consent of all existing and new policy owners. For example, you can modify the policy ownership from just yourself to include joint ownership with your partner. An adviser can guide you through completing the Change of Ownership form.

If this is the first time you have had a Trauma policy then there is a waiting period before certain Trauma conditions would provide cover. The amount of time depends on your provider, the policy, and the condition you are claiming for. Your Adviser will be able to clarify this for you.

Each provider has slightly different online questionnaires, but you will generally be asked about your health and lifestyle, age, occupation, height, weight, smoking/vaping status, gender, hazardous hobbies, family medical history and the amount of coverage you would like.

Insurance premiums are influenced by the type and amount of coverage you select, as well as your risk of insurability. Underwriters evaluate this risk based on your specific circumstances, with higher risks leading to higher premiums. Factors they consider include your health and lifestyle, age, occupation, height, weight, smoking or vaping status, gender, hazardous hobbies, family medical history, and desired coverage amount. Additional options, such as buy-backs, accelerated versus stand-alone cover, and adding Total & Permanent Disability cover, which includes an extra medical condition, will also affect your premiums. Premiums can vary significantly among providers, making it important to compare options.

You have several options for how often your premiums are reviewed. At the end of each review period, your premiums will be recalculated based on your coverage amount, age-related changes, and any updates to your insurer’s rates or relevant laws. Your premiums will also change if you adjust your coverage. Generally, you can choose to have your premiums reviewed yearly, every 5 years, every 10 years, or to specific ages (65, 70 or 75). If reviewed yearly, this is called “Rate for Age.” Choosing a set period, known as “Levelled,” means premiums remain unchanged until the end of that period. You can also choose a mix of the two to suit your needs. Your adviser will work with you to help you choose the best premium review period or mix to suit your needs.

Most Trauma/Critical Illness Insurance policies offer a buy-back option, which you can add to your policy. This option allows the policy to be reinstated after a claim, which can be particularly beneficial when obtaining a new policy might be difficult. Adding this option only results in a slight increase in your premium.

This option includes an additional condition under the Full Trauma/Critical Illness Benefit, allowing the full sum insured to be paid out if you are unable to work and unlikely to return to work due to illness or injury. It’s essential to review your insurance contract to understand the necessary criteria for making a claim.

The type of policy you select influences how your premiums are calculated. Trauma/Critical illness insurance premiums can be categorized as Stepped, Level, or a combination of both. To determine the optimal structure for your needs, consult with your adviser.

Stepped premium policies increase on the annual anniversary of your policy. As you age, your premiums will rise, and your insured amount may also increase to keep pace with inflation (this adjustment is known as “indexation”). These factors contribute to higher premium costs. You do have the option to decline the annual indexation of the insured amount, which would result in a smaller premium increase.

In contrast, Level premium policies are designed to remain consistent each year until a predetermined age or term (such as 5, 10 years, or until age 65, 70 or 75). Premiums for Level policies will only change if you alter your coverage or when the level term concludes.

You have several options for how often your premiums are reviewed. At the end of each review period, your premiums will be recalculated based on your coverage amount, age-related changes, and any updates to your insurer’s rates or relevant laws. Your premiums will also change if you adjust your coverage. Generally, you can choose to have your premiums reviewed yearly, every 5 years, every 10 years, or at specific ages (65, 70 or 75). If reviewed yearly, this is called “Rate for Age.” Choosing a set period, known as “Levelled,” means premiums remain unchanged until the end of that period. You can also choose a mix of the two to suit your needs. Your adviser will work with you to help you choose the best premium review period or mix to suit your needs.

Indexation means your coverage amount is adjusted each year to reflect inflation. For example, if your policy covers $100,000 and the inflation rate is 3% that year, your coverage would increase to $103,000. This process ensures that your coverage remains adequate as the cost of living rises. You have the option to opt out of this annual increase if you wish.

Your premium is influenced by several factors, including your health and lifestyle, age, smoking/vaping status, gender, hazardous hobbies, and the amount of coverage you choose

An exclusion, sometimes referred to as a special provision or term, is an event that is not covered by your insurance policy. In New Zealand, most standard Trauma/Critical illness insurance policies exclude coverage for:

› Intentional self-harm, including attempted suicide
› Taking part in a criminal activity
› If you or any child we cover doesn’t survive for at least 14 days after first meeting the criteria for a covered condition
› Harm to a child we cover under a benefit that you or the child’s parents or guardians cause

Additionally, if you have disclosed an existing health conditions or engage in risky lifestyle activities during your application, these may be excluded or a loading might be applied to your premiums. It’s important to review your insurance contract to understand the specific exclusions and what is covered and not covered by your policy.

When you request a quote, it is based on the initial information you provide. Once you submit your details to the underwriters online, they might ask more detailed health and lifestyle questions to assess your risk factors. Depending on your responses, certain aspects of your health and lifestyle may be deemed higher risk by the insurer, which could result in an increase in the original quoted price.

During the application process for Trauma/Critical illness Insurance, you will need to complete an online questionnaire. Answer all questions to the best of your knowledge and if in doubt refer to your medical records if needed. Incomplete or incorrect disclosure of information can result in the denial of future claims and the cancellation of your policy. Moreover, failure to provide all necessary details may lead to application rejection, potentially affecting if you would like to apply with other insurers. It’s also essential to notify your insurer of any changes in your health status before your application is approved.

Typically, medical examinations or blood tests are not required if there is nothing that you disclose from your medical records that would concern an insurance Underwriter. However, if you are asked to undergo either, there will be no cost to you. Most insurers offer a Health Screening Service, where a registered nurse can visit you at your home or office at a convenient time.

Insurance premiums are determined by the type and level of coverage you choose, as well as your insurability risk. Insurers assess your risk based on your medical and family medical history. Higher risks result in higher premiums. Key factors considered when evaluating Trauma/Critical illness insurance risk include your age, gender, health, lifestyle, medical history, occupation and smoking/vaping status.

Smokers and vapers pay higher premiums than non-smokers. The good news is that if you quit smoking or vaping, your insurer will reduce the cost of your insurance. Once you have been smoke-free or vape-free for 12 months, you qualify as a “non-smoker” in the eyes of insurers.

Most Trauma/Critical Illness insurance providers offer worldwide coverage. Regardless of your travel destination, the purpose of your trip, or the length of your stay, your coverage remains intact. This means you are protected even if you travel or relocate overseas from New Zealand for any duration. Be sure to review your insurance contract to understand the specific exclusions and details of what is covered and what is not.

Not a problem. If you decide you do not want the policy you can cancel it within 14 days of receiving your policy document (this is known as the “free-look period”). A signed cancellation letter is all that is required. Any premiums paid during the free-look period will be fully refunded to you.

You, your beneficiary, or your legal representative will need to call or write to your insurer (the contact details will be included in the Product Disclosure Statement of your policy), also your adviser can assist you. You’ll be sent a claim form to complete and return back to them, along with proof the insured event took place. Your insurer may also ask your doctor (if applicable) to fill out a form. If you want to make a claim on your policy, you should do so as soon as possible.

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