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Coronavirus: your group protection questions answered

Jul 14, 2020, 11:52 AM
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With the news that COVID-19, more commonly known as Coronavirus, is spreading across the UK we wanted to provide you with clarification around Aviva’s reaction to the pandemic and how we aim to help protect our customers, colleagues and associates.

 

Claims

Life Insurance: “Death claims arising from COVID-19 would be paid, subject to the usual policy terms and conditions.”

Critical Illness: “Although COVID-19 isn’t a covered condition on critical illness policies, if complications as a result of the virus lead to other insured criteria being met, the claim would be paid subject to the terms and conditions of the specific policy.”

Income Protection: “Income Protection customers with the COVID-19 infection who are unable to work, due to incapacity, past the deferred period on their policy would be covered, subject to the terms and conditions of their policy.”

Will Aviva need to see any additional information for claims?

We’ll need to be notified when COVID-19 is the cause of a claim. In the event of a mortality, our claim forms ask for cause of death. If the cause of death isn’t notified on a form we receive, Aviva will contact the scheme Trustees, the employer, or the appointed IFA to find out the cause of death. Where certificates are required to validate a claim, we’ll prioritise dealing with these promptly and make sure our service standards will continue to be met. All other existing information requirements remain unchanged.

 

Event limits

Where a claim is made under Aviva’s group life policies as a result of COVID-19, the event limit detailed in the policy conditions will apply. Aviva has been monitoring the development of COVID-19. The situation is dynamic and progressing rapidly. We concluded that COVID-19 met our definition of a single originating cause once it was clear that there were multiple confirmed cases of infection in the UK, that there was evidence of mortality of individuals ordinarily resident in the UK, and that there was evidence that the number of infections was increasing.

Is a ‘pandemic’ included in your definition of a ‘catastrophe’?

We don’t provide specific criteria for the definition of a catastrophe. The clause may be applied to a range of scenarios, subject to there being a single originating cause of claims.

Can the catastrophe clause only be invoked when a pandemic is formally declared?

No. The application of the catastrophe clause is at Aviva’s discretion, subject to the requirement that there is a single originating cause of claims.

Where can the client find details of a scheme’s event limit?

Details of the particular scheme event limit can be found in the policy schedule.

Is a time limit applied to the event limit?

No, a time limit does not apply.

How is Aviva’s event limit defined?

There is no change to our event limit wording and the full definition can be found in our policy conditions.

 

Travel Restrictions

Do your policy terms require clients to follow Foreign & Commonwealth Office (FCO) travel guidance?

During the quotation process, we ask about a client’s business travel. As part of our medical underwriting process we will ask individuals about their business travel. Personal travel undertaken by an individual on their own behalf would not be expected to be disclosed and would not invalidate cover. Unless we have applied a specific restriction, which will be noted on the policy schedule, Aviva’s standard terms and conditions don’t include any restrictions or exclusions for business travel against FCO advice at the current time.

Do any additional travel information requirements apply to forthcoming rate reviews or quotes?

Before the policy commences, or when rates are reviewed, we’ll ask the employer to tell us about any business travel. This will be detailed when the quote or rate review is obtained. Once that information has been provided, insured employees will be covered wherever they travel in the world. This is based on our current terms & conditions and practice.

 

Temporary Policy Adjustments

Can an employee carry out temporary alternative work with another organisation during the pandemic?

Group Life: There is no change to our normal temporary absence terms and these can be found in our policy conditions. In summary, we can continue to provide cover for a maximum period of 36 months, providing premiums continue to be paid and and they remain an employee with a UK contract of employment with the policyholder.

Group Critical Illness:There is no change to our normal temporary absence terms and these can be found in our policy conditions. In summary, we can continue to provide cover for a maximum period of 36 months, providing premiums continue to be paid and and they remain an employee with a UK contract of employment with the policyholder.

Group Income Protection: For a period of 12 months from 16 March 2020, if for business reasons due to COVID-19 an employer agrees to allow their employees to carry out voluntary work, be temporarily deployed to the NHS, take up temporary employment elsewhere, or be called up to the Armed Forces Reserve, this will not affect the level of cover under their scheme. This position will be honoured for as long as premiums continue to be paid for the full insured benefits, we continue to receive member data for full salaries and they remain an employee with a UK contract of employment with the policyholder.

If there is a need to make a claim, the deferred period will start from the date of incapacity and benefit payments will start from either the end of the deferred period or the agreed return to work date, whichever is later. We will ignore any reduction in salary during the temporary absence period for the purposes of calculating the insured benefits. Our normal terms and conditions in respect of claims assessments will still apply.If this applies to someone who is already claiming under Group Income Protection, please refer to our claims team to ensure that any impacts on benefits payments can be assessed.

Where an employee has been furloughed or had their hours or pay temporarily reduced by their employer, will we consider retaining cover based on the member’s salary prior to the reduction?

Group Life:

Our temporary absence policy terms allow for an employer to maintain cover for an employee for a period of up to 36 months, this includes furloughed employees, providing that a UK contract of employment remains in place and premiums continue to be paid based on their full amount of cover. Any increases in benefits during this period are limited to a maximum of 7% per year.  We are happy to extend this policy term to also take into account those employees where their contract of employment remains unchanged but have had their hours or pay temporarily reduced due to COVID-19 for the same period.  

Temporary absence cover may be limited in line with individual scheme’s rules and these will still apply.

Group Income Protection Earnings:

If we are satisfied via the employer that an insured member’s earnings have been impacted due to COVID-19 and if incapacity occurs in the period from 16 March 2020 until 31 October inclusive, COVID-19 related or not, we will ignore the reduction for purposes of calculating the insured benefits for the following reasons:

• For those employees who have been placed on reduced hours/zero hours, we can continue to provide their cover based on the normal contractual hours they were working prior to the reduction

• For those employees who have been placed on furlough or had their salary temporarily reduced or put to zero, we can continue to provide their cover based on their salaries prior to the reduction

This cover will be provided on the assumption that:

Employees retain their UK contracts of employment;
• Premiums continue to be paid in full based on the employees’ salaries/hours prior to the reduction;
Our normal terms and conditions will still apply; and
• Member data provided will continue to show the full salaries/pay on which benefits are to be based

This position covers the period from 16 March 2020 until 31 October 2020 inclusive.

This is our standard position and if an employer wants us to consider an alternative approach we must be notified in advance for agreement, directly or through their financial intermediary.

Group Critical Illness Benefit Limits:

Our temporary absence policy terms allow for an employer to maintain cover for an employee for a period of up to 36 months, this includes furloughed employees, providing that a UK contract of employment remains in place and premiums continue to be paid based on their full amount of cover. We are happy to extend this policy term to also take into account those employees where their contract of employment remains unchanged but have had their hours or pay temporarily reduced due to COVID-19 for the same period.  

Are Aviva applying any restrictions on Life Insurance?

Other than the event limit, there are no other existing restrictions on the cover, subject to any scheme specific exclusions or limitations set out in the client's policy schedule. Individual members' benefits could be restricted due to medical underwriting terms.

For schemes where eligibility is linked to active Pension Scheme membership (i.e. paying contributions), where members have elected to take a contribution break due to their hours being reduced or they have been furloughed, will we be prepared to maintain their level of cover?

Yes, we can maintain the member’s level of cover. This position will be honoured provided premiums continue to be paid for the full insured benefits. This is our current position and covers the period from 16 March 2020 to 31 October 2020 inclusive. We will continually review this position and will extend this period if we feel that the circumstances warrant it.

How can we support clients who are struggling financially due to COVID-19?

We recognise these are challenging times for us all. We want to help support our customers and be flexible enough to help them retain their benefits rather than reduce or lose their valuable protection. If you would like to know what options are available, please speak to your Account Manager about your clients' individual circumstances.

 

*A UK contract of employment includes contracts of employment with Channel Islands or Isle of Man companies covered under the policy. 

 

Flexible Benefit & Voluntary Benefit Schemes

We would always recommend that an employer or an employee should try to maintain what is an important protection benefit for themselves and their loved ones, especially in the current environment. Therefore, we encourage any party who is concerned about the financial consequences of COVID-19 to contact us to discuss their situation. However, we recognise the financial pressure that these exceptional circumstances may cause and therefore we have a range of options for flexible benefits schemes to help manage insurance cover. 

What changes can employees make to their voluntary benefits in respect of COVID-19?

We will recognise COVID-19 as a Lifestyle Event. Employees will be able to reduce their benefits at any time (employees will not have the ability to increase benefits during the COVID-19 lifestyle event).  Where employees have reduced their benefits via the COVID-19 lifestyle event, they can elect to increase benefits at the next annual benefits selection window or via one of the scheme’s other lifestyle events. Future increases would be subject to the standard terms of the scheme.      

What assistance can be provided for those employees who, as a result of COVID-19, are struggling to fund the level of voluntary cover they have selected?

We will allow an employer to select a fixed window of 3 to 6 months (the actual length to be selected by the employer), within which an employee can elect to suspend or reduce their cover or defer payment of their premium.

The employee will need to understand that should they elect to suspend cover, no claims will be paid in respect of the voluntary cover for the fixed length of the window. Similarly, if they elect to reduce cover, we will only pay a claim based on the reduced amount.

At the end of the window, the policy cover and payments will be reinstated to the previous level.

We would ask, that if an employer wishes to offer these options to their employees, that you contact us so we can talk through the different options and the specific terms and conditions that will apply to each of the differing Group Protection contracts.

Any option we offer will be subject to the employer being able to supply us with the correct data, and their Flex Platform being able to effectively handle what is a non-standard approach to benefit calculation and premium collection.  

What is our stance regarding flexible benefit election window?

If, for business reasons due to COVID-19, a customer is unable to facilitate an annual flexible benefits selection window, Aviva will allow the customer to maintain current benefits selections for the following year e.g. Aviva will allow a client to skip the annual flex window for 2020.

What assistance can be provided for employers who, as a result of COVID-19, wish to suspend cover for employees furloughed under the Government CJRS?

Where employers wish to suspend cover for employees who have been furloughed, we will consider such requests on a case by case basis. If you would like to know what options are available, please speak to your Account Manager about your clients’ individual circumstances. 

 

Medical Underwriting

Have you added any new medical underwriting questions?

Group Protection medical underwriting have introduced new underwriting questions into our application process. These ask:

• "Have you ever been treated in hospital due to Coronavirus (COVID-19)?"

• "Within the last 30 days have you: Experienced symptoms of a cough, a high temperature or fever, breathing difficulties, or any other symptoms of Coronavirus (COVID-19) or been diagnosed with Coronavirus (COVID-19)? Or; Self-isolated for any other reason or had contact with someone who's been confirmed or suspected to have Coronavirus (COVID-19)?

For those applicants that do require medical underwriting, underwriters will obtain a response to the new question, this together with all other relevant factors will enable us to balance the need to make prudent risk based decisions whilst also ensuring we give access to insurance to as many customers as we’re able to.

What's happening about medical underwriting requirements; are you still processing medical evidence?

We are carrying out Tele Interviews (TIV) and issuing General Practitioner Reports for completion as normal.

In most cases, we are also now able to arrange a medical examination where one is required, with either a doctor or nurse. We will contact the customer, as appropriate, to ascertain whether or not they are happy to proceed with the medical. It may be that there are circumstances where it is still not yet appropriate to request a medical, even if the customer would like one, and we will address these situations individually on a case by case basis. We are continually keeping this approach under review.

 

What happens if you can't obtain a medical examination?

In most cases, we are now able to arrange a medical examination where one is required.  If there are reasons whereby it is still not appropriate to request a medical (e.g. more stringent lockdown measures in place, or significant underlying medical conditions) we regret that we will ‘Postpone’ these members. That is, we are unable to offer any terms of acceptance for the benefit subject to underwriting (usually the benefit over the Free Cover Limit). Those members who have received postponed decisions as a result of our current guidelines around COVID-19 will continue to be reviewed over the coming weeks. We will take care of this by getting in touch and there is no action required.

 

Are you automatically extending Temporary Cover during the underwriting process, or adding Temporary Cover to those members not usually eligible?

We are not automatically extending the Temporary Cover beyond the normal 90 days; we still believe that this gives sufficient time to complete the medical declaration or TeleInterview (TIV).

We are unable to offer extensions in the following scenarios:

• If this has previously been provided and where a member did not submit a declaration/TIV

• If a medical examination is required, and we are unable to obtain it at the present time

We are not looking to give Temporary Cover to those who are not eligible for it. However, in exceptional circumstances we can consider an extension of the Temporary Cover on an individual basis, as we do currently; and any extension to it would be allowed with the same terms & conditions.

 

'Actively at work'

Employees who are required to work from home following overseas travel, or due to business continuity plans, would be treated as Actively at Work as set out in Aviva’s terms and conditions. This is provided that they:

aren’t working against medical advice

are following their normal occupation; and

are working their normal number of contracted of hours.

Aviva will consider someone to be Actively at Work if they:

would have been capable of performing their job role if they hadn’t been furloughed, required to shield, self-isolate, or carry out voluntary work/temporary employment elsewhere. This would include temporary deployment to the NHS or call up to the Armed Forces Reserve; and

work from home, or at a location that is not their normal place of work, provided they aren’t working against medical advice and, were it not for the circumstances surrounding COVID-19, they would remain medically fit to perform their usual job role in their normal place of work.

Would you pay a Group Income Protection claim for a member who is fit for work but has been advised to shield because they are in a high risk group?

Our assessment will consider whether the symptoms of an illness or injury are preventing a member from working.  Generally, we won’t pay claims where the member could work were it not for the risk to health posed by COVID-19.  This is aligned to our position on Actively at Work above which does not penalise an individual where they are having to shield but are otherwise medically fit to perform their job role.

However, we understand that there may be exceptions to this and we will consider claims where there is a medically recognised significant risk and all reasonable adjustments have been taken by the employer. 

If a member is self-isolating and then becomes infected, how would this affect deferred periods for Group Income Protection?

The deferred period will start from the point that an individual is unable to work due to COVID-19 and satisfies the definition of incapacity as set out in the terms and conditions of the policy.

 

Business Continuity Plan

Has your organisation taken precautions to mitigate the spread of COVID-19?

We take advice from the World Health Organisation (WHO) and the governments in each market we operate. We’ve significantly increased our IT capacity to enable our people to safely work from home and continue to service our customers and intermediaries. For the small number of key workers still required to come to our offices, we’re taking all necessary precautions to ensure their safety and wellbeing, including deep cleaning, closure of common areas and adequate distancing between desks.

Have steps been taken to address any potential impacts associated with third parties who support your operations?

We insist that all third-party suppliers have an active business continuity and disaster recovery plan appropriate to the level of services they provide to us and/or our customers. Disaster recovery and business continuity plans are revisited on an annual basis.

Will Aviva relax processes which require documents to have a wet signature, so that scanned copies will be accepted instead?

Where an Aviva digital solution is unavailable and previously we have insisted on ‘wet signatures’ and asked for them to be posted to us, until 31st July (we will continually review this position and will extend this period if we feel that the circumstances warrant it) we can now accept the following methods of signature:

• Forms printed off, signed and a clear image is emailed to us

• Genuine digital crypto-based signatures

We are in the process of implementing a digital solution for all forms and will communicate when this is ready in due course. Until this time we will also be prepared to accept all other forms of electronic signature but only if accompanied by an email from the work account of the individual signing the form or, in respect of a member, an identifiable personal email account of the individual concerned (the completed document needs to be attached to the email).

Can brokers and clients still contact members of the team via the usual numbers?

Yes, you can continue to use your usual contact numbers. In the event of any changes to this, we’ll notify you accordingly.

Are there any impacts on Aviva processing incoming mail?

We are continuing to deal with incoming mail as normal including cheque payments. If it is easier to send us any communications electronically, or you would like to verify that we have received your written instructions, please speak to your normal Aviva point of contact. 

Is Aviva able to send outgoing mail in the post?

Where possible, we have switched to electronic methods of communication. Cheque payments are still being issued in the normal manner and direct debit notifications letters are being sent electronically where we have an email address.

 

Generic Disclosure

The situation with COVID-19 is dynamic and developing quickly. As a consequence, Aviva reserves the right to update this guidance at any time. In the event that guidance is updated, Aviva will endeavour to produce an updated guide as soon as practicable.  Any updated guidance would apply immediately.

What guidance do you offer regarding COVID-19?

We believe the best approach to an emerging pandemic is to have a strong, consistent and joined-up approach nationally, in line with the public health response. So, we’d encourage all customers to follow government and NHS advice on COVID-19.

We will continue to monitor the situation and take advice from the:

World Health Organisation (WHO).

For more information about COVID-19 and advice on preventing the infection from spreading, please visit the:

Public Health England information pages.

Public Health Wales information pages.

Public Health Scotland information pages.

Public Health Northern Ireland information pages.

WA14046 07/2020

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