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Policy Level Requirements Guidance

Documentation

It is important that Customers are provided with appropriate documentation so that they can understand the cover and so that they have the necessary information to make claims and complaints.

While Customers must be able to access the full master/group policy wording on request, as it is the insuring document, this is unlikely to be the best way to communicate coverage details. This is because the master/group policy may be confusing and contain significant information not relevant to the Customer regarding the structure of the relationship between the managing agent, the master/group policyholder and any administrator or broker.

Customers should instead be provided with evidence of cover, or other appropriate documentation, containing the critical features that would be contained in a consumer policy wording including the terms and conditions relevant to coverage and contact details for claims and complaints. Generally, the Customer should be given a level of detail equivalent to that which they would receive if they were to purchase their own separate insurance policy.

Where the Customer is opting-in to the cover the details of coverage should be provided at an appropriate time for the Customer to make an informed decision.

This documentation may be provided by the master/group policyholder or another administrator, subject to any local licensing requirements. The master/group policyholder must not produce insurance documentation.

The documentation should be provided in a suitable format. This may be a physical copy, an email attachment or a link to an online document. For example, an employer may choose to provide the documentation via a staff handbook or intranet site. If documentation is to be made available online at a minimum Customers must be provided with a direct link to that documentation. It is not sufficient just to advise Customers that the documentation can be found on the staff intranet or club website.