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Frequently asked questions about the Doctor Locum Insurance Scheme

Q: Suppose I have a claim or my health deteriorates — can you guarantee that my cover cannot be cancelled or reduced, or my monthly premium increased?

A: Whether you have cover on an individual basis or via our Group Policy, under the Platinum Plus Scheme - yes. As the benefits are provided under a group scheme, unless the Master Policy is terminated or your cover cancels, your cover remains continuous through to age 70 (65 on the Group Scheme). In fact, unlike many other policies of this type, once you are accepted into the scheme you can never be individually selected for any adjustment or cancellation of your cover or increase in your monthly premium. However, please note your Policy will be cancelled if your claim continues for the maximum 52 week duration. With the Platinum Scheme you will renew your cover each year and the terms will be dependent on your health and claims history at that time.

Q: In the event of a claim, how much benefit will I receive?

A: The amount paid will be the actual cost of your locum doctor or employee, or if less, the amount for which you are insured at the time of the claim.  It is therefore important that your level of cover accurately reflects the actual cost if you had to engage a locum.  This is the same whether you have an Individual or Group policy, but you should be aware that under the Group policy there is an overall maximum benefit payable of 50% of the total practice benefit - so, if 10 members are insured at benefit of £1,500 per week each (so £15,000 benefit in total), the maximum payable at any one time would be £7,500.  Essentially this means you would need to have 5 of the staff team off work at the same time.

Q: How do I make a claim?

A: Simply contact Doctor Insurance Services on 01245 283483 for a claim form. You will then need to submit the completed form together with medical certificates and invoices/letters confirming the cost of the locum

Q: What do you mean by disabling injuries or illness?

A: Those serious enough to prevent you from working for a period of more than 4 weeks and require a locum doctor or employee to be employed in your absence.

Q: Will I be covered for existing medical conditions?

A: When you apply, if you have had time off work (or received advice or treatment or should have done so) for a particular condition within the last 3 years, that condition will not be covered for the first 3 years. However, once you have been covered for 3 consecutive years under the scheme free from the problem and/or any treatment, this limitation will not apply. The time period is extended to 5 years on the individual Platinum policy.

Q: I don’t need cover for the first 8 weeks. Can the Scheme be adapted to cover this?

A: Yes. The deferment period under Plan A on the individual policies can be extended from the standard 4 weeks to either 8 or 13 weeks. For further information please contact Doctor Insurance Services.  The Group Scheme does not offer this level of flexibility, offering only the standard 4 week deferred period which is, by far, the most requested deferred period under any of our policies.

Q: Will I be covered for HIV/AIDS?

A: Yes, provided that the infection: i. Was caused during the currency of the Policy by an accident whilst on duty leading to a needlestick/sharp injury or by mucus, exposure to blood or bloodstain fluid, or ii. Is as a result of a blood transfusion which was given as part of a medical treatment regime after your cover under the Policy commenced.

Q: And what about exclusions — are there any?

A: Surprisingly few, and only those that you might expect. Briefly, these include illness or injury arising from air travel (except as a fare paying passenger or in connection with your professional duties); war, suicide, self inflicted injury, drug addiction; professional sport; illegal acts; HIV/ AIDS (except as above); military service (if more than 30 days a year), and illness or injury when no medical supervision is sought. Full details of the terms, conditions and exclusions applying to this insurance are contained in the Policy document.

Q: Can I claim tax relief on my Doctor Locum Insurance Scheme premiums?

A: Yes — it is our understanding that tax relief at your highest marginal rate can be claimed, in which case any benefits you receive will be taxable. However you should seek your own professional advice.

Q: How can I pay my premiums?

A: Premiums are payable by monthly direct debit - at no additional charge to you. With the Platinum Scheme we can also accept annual payment by bank transfer or credit/debit card.

Q: Can I increase my cover in the future to keep pace with the rising cost of employing a locum?

A: To help protect you against inflation, benefits and monthly premiums are automatically increased by 5% at the end of each Policy year, regardless of any subsequent deterioration in your health. If these increases prove insufficient you can always apply for extra cover at any time. This increase is only applied to the main locum cover, not the additional covers provided

Q: Are there any additional benefits included within the plan?

A: Yes, on both the Platinum and Platinum Plus plans benefits are also payable in the event of the insured being called for Jury Service, along with Maternity/ Paternity Benefit, a lump sum benefit in the event of an accident causing death or permanent disablement, Bereavement/Family Emergency Cover and Suspension Cover. Please refer to the Policy Wording for full details.

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