Absence from School Scheme

Aegis: Terms & Conditions

IMPORTANT NOTE: Data Protection Act

Any information you provide to SFS Group Ltd will only be used for the operation of your membership as it relates to you, and for internal SFS Group Ltd marketing purposes. It will not be released to any third parties. SFS Group Ltd follows a confidentiality policy, which means that your personal data will be processed fairly and securely in accordance with the Data Protection Act 1998.

Your personal data will be available only to those who need to see it for the purposes stated above. This may include our Insurers.

General Definitions

Accident means a sudden, unexpected, unusual, specific event which occurs at an identifiable time and place during the Year.

Agreement means an application for membership of AEGIS, duly signed by both the Trustee and the Admitted Parent.

Assured means any child at a Participating School with an Admitted parent.

Bodily Injury means identifiable physical injury which (a) is caused by an Accident and (b) solely and independently of any other cause, except sickness and disease directly resulting from, or medical or surgical treatment rendered necessary by, such injury, occasions the death or Permanent Total Disablement of the Assured within twelve months from the date of the Accident.

Commencement Date means the first day of the first term after a completed Agreement and the relevant Contribution have been received by SFTS Trustees Limited.

Facial Disfigurement means permanent scarring affecting at least 20% of the facial area.

Holiday Period means a period during which the Assured was suffering continuously from a single Sickness or Injury and which falls between two terms in which the Assured was absent from lessons for a period equivalent to the chosen Qualification Period during the first term and during the first 14 days of the second term by reason of the same Sickness or Injury.

Insurer means Unum Limited (trading as Unum); Certain Underwriters at Lloyd's; and AXA PPP healthcare limited; or any other insurance underwriter chosen by SFS Group Ltd

Loss of Limb means permanent loss by physical separation of a hand at or above the wrist or of a foot at or above the ankle and includes permanent total and irrecoverable loss of use of hand, arm or leg.

Member means an Eligible Parent(s) who has completed an Agreement; who meets the requirements for joining; and who has remitted the appropriate contribution to SFTS Trustees Limited.

Permanent Total Disablement shall be deemed to have occurred when the Assured has been totally disabled from attending full time education for a period of 12 consecutive months and at the end of that period is beyond hope of improvement and without prospect of being able to undertake any gainful occupation or being able to support him/herself financially.

Pre-existing Conditions means that no benefit shall be payable for the Assured's inability to attend school due to any medical condition that was diagnosed before the cover started or due to any Sickness or Injury for which the child has received treatment, medication, medical advice or hospital care before the cover started.

Sickness or Injury means a medical or physical condition that is certified by a medical practitioner acceptable to the Insurer and which, when it exists during term, results in an Assured being unable to attend lessons for the duration of the condition.

General Conditions

1. Limit of Indemnity
   • The liability of Underwriters for any loss, theft or damage shall not exceed the sum(s) insured stated on the membership certificate.
2. Claims Procedure
   • It is a condition precedent to the liability of the Insurer that, following any happening likely to give rise to a claim, the Member shall:
     1. as soon as reasonably possible notify and confirm in writing to the Insurer through SFS Group Ltd, and, if required, give full details within 30 (thirty) days of the incident together with such information and assistance as the Insurer may reasonably require;
     2. in the case of the Personal Possessions Scheme, notify the Assured's School following any loss, or damage by theft, attempted theft or malicious damage; and the police, if such a loss or damage has occurred outside the premises of the school.
3. Payment of Contributions Contributions are paid to SFTS Trustees Limited on or around the 7th of January, May and September each year. Such contributions shall be payable each term during the period of this Agreement until and including the final term of the academic year in which the Assured attains the age of 18.
4. Evidence for claims
   • Payment of any Benefit under this Agreement is subject to satisfactory proof to the Insurer of such evidence as they may require in relation to:
     1. the happening of an event by reference to which Benefit is payable and
     2. the title of the person claiming payment.
5. Fraudulent Claims
   • If the Member shall make any claim knowing the same to be false or fraudulent as regards amount or otherwise, membership shall become void and all claims hereunder shall be forfeited.
6. Cooling Off Period
   • Once your application has been accepted and your membership documentation issued, SFTS Trustees offer a 14 day cancellation period during which you are entitled to a refund of any contributions you have paid.
7. Cancellation Clause
   • The contract between a Member and the Trustee may be cancelled only at the end of any school term by 30 (thirty) days notice to the Member at their last known address. This contract may also be cancelled at any time by the Member by writing to SFS Group Ltd, and the cancellation will take effect from the end of the term in progress or the date of receipt of the notice by SFS Group Ltd if that date falls between the last day of one term and the first day of the following term at the relevant school.
8. Termination of Agreement
   • SFTS Trustees Limited reserves the right to terminate this Agreement at any time on not less than three months' notice.
9. Notice
   • Notice shall be deemed to be received if sent by recorded delivery post and properly addressed; or if confirmed in writing by SFS Group Ltd after a telephone call from the Member.
10. Applicable Law
    • The parties are free to choose the law applicable to this contract. Unless specifically agreed to the contrary, this contract shall be subject to English Law.
11. Complaints
    • Any enquiry or complaint should be addressed in the first instance to the Customer Service Department of SFS Group Ltd at Crossways House, 54-60 South Street, Dorking, Surrey, RH4 2HQ.

If you are still unhappy with any issue connected with the handling of your membership or claim, then you should direct your enquiry in writing to:

Unum
Milton Court
Dorking
Surrey RH4 3LZ

If you are still unhappy with any issue connected with the handling of your membership or claim, then you should direct your enquiry in writing to:

The Financial Ombudsman Service, South Quay Plaza, 183 Marsh Wall, London E14 9FR

Scheme specific Terms & Conditions

The Terms and Conditions below should be read in association with the AEGIS General Terms and Conditions indicated above.

1. Policy Specific Definitions
   • Accident means a sudden, unexpected, unusual, specific event which occurs at an identifiable time and place during the Year.
   • Holiday Benefit means Benefit in respect of a Holiday Period payable at a rate of £80 per week or at such other rate as the Insurer and the Trustee shall from time to time agree.
   • Holiday Period means a period during which the Assured was suffering continuously from a single Sickness or Injury and which falls between two terms in which the Assured was absent from lessons for a period equivalent to the chosen Qualification Period during the first Term and during the first 14 days of the second Term by reason of the same Sickness or Injury. Interrupted Qualification Period means a non-continuous period exceeding the chosen Qualification Period of Sickness or Injury during a single Term of which the first seven days are continuous.
   • Partial Scheme Benefit means a rate equal to 75% of the Benefit.
   • Policy means the policy issued by the Insurer in the name of the Trustee providing for Absence from School cover or any policy from time to time substituted therefor by agreement between the Insurer and the Trustee.
   • Pre-existing Conditions means no Benefit shall be payable for the Assured's inability to attend school due to any medical condition that was diagnosed before the cover started or due to any Sickness or Injury for which the child has received treatment, medication, medical advice or hospital care before the cover started.
   • Qualification Period means a continuous period of Sickness or Injury of at least seven, fourteen or twenty-one days (depending upon the Qualification Period chosen).
   • School Fees means the tuition and, where relevant, the boarding fees at any Participating School.
   • Sickness and Accident Period means the period of time which the Assured is unable to attend lessons at school during Term because of Sickness or Injury, including weekends and occasional holidays during Term.
   • Sickness or Injury means a medical or physical condition that is certified by a medical practitioner acceptable to the Insurer and which, when it exists during Term, results in an Assured being unable to attend lessons for the duration of the condition.
   • Term means one of three set periods of attendance at school during a school year, each lasting approximately twelve weeks.
   • Trust means the trust established by trust deed of which SFTS Trustees Limited is the present trustee.
   • Trustee means SFTS Trustees Limited and any other trustees or trustee of the Master Policy Trust from time to time.
   • Voluntary Withdrawal means the permanent withdrawal of an Assured from school because of Sickness or Injury.
   • Voluntary Withdrawal Benefit means Benefit payable will be the next Term's school fees net of any bursary, assisted place or scholarship.
   • Voluntary Withdrawal Period means the period commencing on the first day of the first Term commencing on or after the date of Voluntary Withdrawal and ending on the last day of that Term.
2. Scheme Benefit and Partial Scheme Benefit
   • Subject to Clause 4(b) below, Scheme Benefit is payable in respect of a Sickness and Accident Period.
   • Where the Assured remains on the school premises during a Sickness and Accident Period, Partial Scheme Benefit is payable.
   • Scheme Benefit or Partial Scheme Benefit payable in respect of the Assured shall be that provided by the Benefit level applicable under this Agreement immediately before the commencement of the Qualification Period or Interrupted Qualification Period. Benefit shall be payable for part of a week at the rate of one seventh of the Benefit per week for each day of absence from lessons.
3. Overriding Maximum Benefit
   • In no case shall Benefit be payable by reason of a single Sickness or Injury for a period or periods exceeding in total three Terms and two Holiday Periods, or one term in the case of Voluntary Withdrawal.
4. Payment of Benefit
   1. Subject to Clause 4 under Section B in the AEGIS General Terms and Conditions Booklet, Benefit shall be payable in accordance with the following provisions of this clause.
   2. Benefit shall first become payable on the day following the last day of the Qualification Period or Interrupted Qualification Period and will be equal to the scheme Benefit or Partial Scheme Benefit for that part of the Qualification Period falling within the term. Benefit is paid at the end of a calendar month.
   3. Thereafter scheme Benefit or Partial Scheme Benefit will be payable monthly in arrears during the Sickness and Accident Period.
   4. In the case of Voluntary Withdrawal, Benefit for the whole Voluntary Withdrawal Period is payable on the later of:
      • (i) the last day of the Qualification Period or Interrupted Qualification Period, and
      • (ii) seven days after notification to the Master Policy Trustee of Voluntary Withdrawal. Benefit will be applied primarily in discharging any outstanding liability to the school in respect of the Assured and the balance (if any) will be payable to the Member. The outstanding liability to the school shall be the amount notified by the school to the Trustee and shall not be affected by any dispute between the school and the Member.
   5. Holiday Benefit for the whole of a Holiday Period shall become payable 14 days after commencement of the term following that Holiday Period and will be paid at the end of a calendar month.
5. Subsequent Sickness or Injury
   • If following a Sickness and Accident Period in respect of which Benefit was paid and the Assured returns to school, Benefit will cease to be payable, and no further Benefit shall be payable in respect of any subsequent Sickness or Injury until completion of a further Qualification Period or further Interrupted Qualification Period.
6. The legal structure of the Absence from School Insurance
   • The Absence from School Scheme is established as a trust for the benefit of its members and its trustee is SFTS Trustees Limited. The Trustee collects contributions, and pays benefits to members. To enable the Trustee to pay benefits as they fall due. it has chosen to insure its liability to pay benefits with Unum, a specialist insurer of such schemes.
   • SFTS Trustees Limited is a specialist trustee company managed by Lawrence Graham, solicitors, of 190 Strand, London SW2R 1JN, which SFS Group Ltd uses for the collection of contributions and payment of claims. This ensures that a customer's money is protected. SFTS Trustees Limited is also the trustee of the Absence from School Scheme and is authorised and regulated by the Financial Services Authority.

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