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1. Introduction
Serious illness can strike at any age. The specified illness cover claims paid by Irish Life show the average age of specified illness cover claimants is just 37 and 82% of all claims paid are to people under age 49.
The AGSI Group Specified Illness Cover Plan, helps you control your and your families' financial
future if you were to become seriously ill.
All members of AGSI who are under age 57 can join the plan. Spouses of these members under age57, can also join the plan.
It is important that you read the Explanatory Booklet carefully as it explains what you are covered for under
the plan, when you can claim and, in the case of Specified Illness Cover, what exactly each illness is defined as.
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2. Specified Illness Cover - Details of the Plan
The Benefit
Member and spouse up to age 50 €35,000 Specified Illness Cover
Member and spouse age 50 to 65 €16,000 Specified Illness Cover
Hopitalisation expenses after 7 consecutive days/max 182 days €35 per day
Plus FREE Benefit For all who Join
Each of your children (aged between 1 and 21), are automatically covered
for €20,000 Specified Illness Cover and €10,000 Life Cover (aged between 1 and 21)
The Cost: - €5.66 per week
This cost will be deducted from your salary. It is your responsibility to ensure that your deductions have been set up and continue to be deducted from your pay. Your cover will commence the day the first deduction is taken from your salary. When you retire it is your responsibility to ensure that your contributions are paid directly to Halligan Insurances by Direct Debit. You must set up this direct debit within one month of retirement. The cost of the plan is reviewed every two years. If large numbers of people leave the plan or if there is a high number of people claiming then Irish Life Assurance reserves the right to review the cost of cover. The next review of the plan will take place in July 2007.
Specified Illness Cover is paid if you suffer any of the following illnesses and survive (assuming you have not suffered from that illness or a related illness previously).
Alzheimer’s disease - Angioplasty (two or morearteries)
Aorta graft surgery - Benign brain tumour - Cancer - Coma
Coronary artery surgery - Creutzfeld-Jakob disease (CJD)
Emphysema - Heart attack - Heart valve and structural surgery
HIV/AIDS from blood transfusion - HIV/AIDS from needlestick injury
HIV/AIDS as result of physical assault - Kidney Failure - Loss of Hearing
Loss of Sight - Loss of Speech - Major organ transplant - Motor neurone disease
Multiple sclerosis - Paralysis of two or more limbs2
(Please note: no cancer claims will be paid where the condition presents within 6 months of the date of commencement of cover under the group plan).A full definition of each illness is given in Section 3 of this booklet.
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Is there a survival period?
Yes. If you suffer a specified illness and wish to claim under the plan, you must survive for a
minimum period after the date on which the illness was diagnosed or surgery took place,
before a payment can be made. In the event of death within this period no benefit is payable.
The relevant periods are:
(a) 14 days for heart attack, coronary artery surgery, angioplasty (two arteries), cancer, coma,
emphysema, stroke, kidney failure, heart valve surgery, aorta graft surgery, major organ
transplant, benign brain tumour, multiple sclerosis, motor neurone disease, severe burns,
CJD, HIV/AIDS from needlestick injury, HIV/AIDS from physical assault, HIV/AIDS from
blood transfusion, paralysis of two or more limbs and severance of two or more limbs.
(b) six months for Parkinson's Disease, Alzheimer's Disease and loss of sight.
(c) six months for bacterial meningitis in respect of children's cover and
(d) twelve months for loss of hearing and loss of speech.
(e) 14 days after surgery in cases where there has been pre-payment of part of the benefit.
The balance of the benefit would be paid upon survival after this period.
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When am I covered until?
You shall cease to be covered once you:
• cease to be a member of AGSI before normal retirement date (except when promoted to a higher grade)
• reach age 65
• are paid a claim under the plan
• die
or
• cease to make contributions
Spouses (where applicable) are no longer covered once:
• they reach age 65
• they are paid a claim under the Plan
• they die
• you cease to make contributions
• you cease to be a member of AGSI
or
If you claim then your spouse can still be covered and vice versa once satisfactory arrangements are made to continue making contributions.
Each of your children (over age 1) is no longer covered once they
• reach age 21
• are paid a claim under the Specified Illness plan
• die
or
• you leave the plan
If you have more than one child then please note that if one child claims the others are still
covered. In addition, if one or more child claims you and your spouse/partner remain covered.
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Do I have to provide Medical Information?
Members can apply for this Specified Illness cover without providing any medical information if they join the plan at the first available opportunity.
However due to this concession, you will not be covered for pre-existing conditions under the
Specified Illness Cover portion of the plan on the following basis (these conditions will also apply to your spouse/partner, where applicable).
1. Where you have previously suffered, at any time prior to the commencement date of cover from
one of the specified illnesses covered you will never be covered for that illness and cannot
therefore claim for that illness. For example, if you contracted cancer in 1990 you can never
claim under cancer. You are however covered for the remaining illnesses.
In addition, because of the links between heart attack, stroke, coronary artery surgery,
angioplasty and heart transplant if you have suffered or undergone one of the above prior to the
commencement date of cover you can never claim under any of these five illnesses.
For example, if you underwent coronary artery surgery in 1992 you will never be covered for and
cannot claim in respect of heart attack, stroke, coronary artery surgery, angioplasty or heart
transplant. You are covered for the remaining illnesses.
2. In the event of one of the specified illnesses covered occurring within two years of the
commencement date of cover you will not be paid a claim for a particular illness and cover for that illness will cease, if prior to the commencement date of cover you suffered from one
of a number of related conditions which are set out under each illness in Section 3 of this booklet. For example, a claim would not be paid and cover for heart attack will cease in the event of a heart attack occurring in the first two years of cover, if prior to joining the scheme, you suffered with a condition that could lead to a specified illness, then you must be in the scheme a minimum of two years before qualifying for cover for illness. Being a diabetic before the commencement date of cover means that if you suffer a stroke or a heart attack or undergo coronary artery surgery, angioplasty or major organ transplant in the first two years of cover, a claim will not be paid and cover for that specified illness will cease.
It should be noted that the second set of provisions only arises if the event occurs within the
first 2 years of cover. Thus a diabetic who first suffers a heart attack three years after the
commencement date of cover will be eligible to claim.
3. No cancer claims will be paid where the condition presents within the first six months of you joiningthe plan. In such circumstances cover in respect of cancer ceases. |
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For explanation of each specified illness covered and its
pre-existing conditions please refer to Explanatory Booklet. |
Click to launch PDF Explanatory Booklet |
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