FAQs

For the purpose of calculating your insurance cover ‘salary’ is an employee's annual salary or base wage, agreed in writing with your employer.

Your insurance cover under the policy will cease on the earliest of the following:

For Life, on your 70th birthday;

For Income Protection and Critical Illness on your 65th birthday;

For Life cover, when a terminal illness claim is accepted by the insurer, or in the 

event of your death;

• Critical Illness cover, when a Critical Illness claim is accepted by the insurer;
• The date your work hours reduce to less than 30 hours per week;
• The date that you cease employment with your employer;
• Cancellation of this policy by the insurer or your employer.

An ‘AAL’ is the maximum level of cover the insurer will provide before you will be required to submit evidence of good health. You will be sent further details if this applies to you. If you undertake hazardous pursuits (i.e. trail bike riding, abseiling, etc.) you will be accepted to the automatic limits without any exclusions. Once your eligible cover exceeds this limit, the insurer may apply exclusions for cover in excess of the AAL.

Cover is provided 24 hours a day on a worldwide basis subject to the insurer’s  approval prior to departure.

If you terminate employment with your employer, you may have the option to continue your group insurance cover under a personal policy at your own expense (Continuation Option). 

The application for cover must be made within 45 days of ceasing employment.

The policies will be subject to any special terms and conditions, including premium loadings and/or exclusions that existed under your employer paid policy. Retail rates will apply and quotations will be provided at the time of your application.

Conditions apply and you should contact continuationoptions.  nz@mercermarshbenefits.com for further details.

A payment arising from the death of an employee generally must be paid to the deceased employee’s estate or financial dependents. Ultimately the Policy Owner, your employer, has full discretion in determining where the benefit will be paid.

If you take a leave of absence without pay, your cover may continue for up to 12 months. Cover is subject to both your employer and the insurer’s approval.

Cover will cease upon expiration of the agreed period and restrictions, or special conditions may be imposed.

You should notify the People & Capability Operations team immediately if you think you may be eligible to claim. This will ensure the relevant paperwork is provided to initiate the claim as soon as possible.

You can add a child, aged up to and including 20 years old, to a new or existing policy. Any dependent children aged 21 or over will need to take out their own policy, but you can continue to pay their premium.

When a dependent child on your policy reaches 21, we’ll contact you if they need to transfer to their own policy.

You can update your contact details anytime in My Southern Cross or the app.

Please contact us to remove a member from your policy.

Your policy document details the benefits available and the terms and conditions that apply, including any limits and exclusions.

It also sets out whether a healthcare service is eligible for cover in an easy-to-understand chart. In order to be eligible, a procedure must be listed in the coverage tables and not otherwise excluded under one of the general exclusions listed in your policy document. 

If you want to check cover for a surgical procedure and you’re registered to My Southern Cross, you can use our Procedure Checker tool on the My Southern Cross website. If you need further assistance, please get in touch.

Log in to My Southern Cross to view the general exclusions for your plan, your membership certificate and a list of some of your benefits and remaining balances.

If you need further assistance, please get in touch.

The quickest way to claim is online through the app or My Southern Cross. You'll need to be the policyholder, as members on a policy can't claim through the app or My Southern Cross at the moment. You can download a paper claim form here, but it can take over 10 days to process.

If you’re using an Affiliated Provider they’ll claim on your behalf and for day-to-day healthcare services you can check if your provider has Easy-claim to claim for eligible healthcare services at the time of treatment.

The fastest way to make a claim is online in My Southern Cross or using our app.

Online claims are usually assessed and paid within 5 working days, it can take up to 10 working days to assess a posted claim.

You can still download a claim form here if required.

Currently only policyholders can claim for themselves and other members on the policy. The easiest way to do this is through the app or in My Southern Cross.  If you’re using an Affiliated Provider they’ll claim on your behalf.

Any member over the age of 16 can use Easy-claim to claim for eligible healthcare products and services from Easy-claim providers. Just show your Member Card or use the app as your virtual Member Card at the time of treatment. 

Your policy excludes cover for treatment provided outside New Zealand, except as specifically set out in the overseas treatment allowance. Eligibility criteria apply. Please contact us if you need to discuss this further.

For options for cover while you're overseas, get in touch with the team at Mercer Marsh Benefits.