best doctors®

A unique service offered by sovereignA second medical opinion

when you need it most.

BEST DOCTORS2

Contents■ A unique service offered by Sovereign................................... Page 3

■ What is Best Doctors? ........................................................... Page 4

■ Who are the ‘Best Doctors’? .................................................. Page 5

■ What benefits does it offer? ................................................... Page 6

■ Which illness or conditions does Best Doctors review?........... Page 7

■ How Best Doctors works ....................................................... Page 8

■ Best Doctors in real life ......................................................... Page 9

■ What do people think of Best Doctors? .................................. Page 10

■ Frequently asked questions ................................................... Page 11

■ Employee support material .................................................... Page 14

■ Who is Sovereign? ................................................................. Page 15

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Best doctors®

A unique service offered By sovereignA second medical opinion when you need it most.

Nobody likes to think about falling seriously ill. But should this happen, we want you to feel confident about your diagnosis, and to make sure you get definitive advice about the treatment that’s right for you.

That’s why we’re proud to bring the unique medical advice offered by Best Doctors to you as part of your Sovereign workplace insurance scheme.

Imagine for a moment that you, or someone in your immediate family, had received the news that they’re seriously ill.

Your first reaction at this emotional time will be to ask a number of key questions:

■ Am I making the best treatment decision?

■ Is the diagnosis correct?

■ Is surgery the best option?

■ Are there any new treatment options we should consider?

■ What’s going to happen to me and my family?

You now have the option to speak to Best Doctors.

With your Sovereign workplace insurance scheme, your employees (members), and their immediate families1, will now get access to the unique medical advice service offered by Best Doctors.2

“I want everyone connected to Best Doctors to know how much comfort I got from their work.” Quote from a Best Doctors patient

1 Immediate family means the eligible life assureds’ partner (spouse, civil, or de facto) and any birth child or child under legal guardianship of the life assured and/or the life assureds’ partner.

2 When accessing the service, members may incur personal expenses such as faxing or mailing any completed information and consent forms to Best Doctors.

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These doctors will be able to provide confidence, clarity and certainty to the patient’s diagnosis and treatment plan.

The end result could change a life.

Best Doctors was established to achieve one specific goal; namely to connect ill people to a network of peer-nominated, leading specialists from around the globe.

What is Best Doctors?Best Doctors was founded by doctors from Harvard Medical School in 1989 and now helps people in over 30 countries around the world; including the US, UK and Canada.

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As part of the Best Doctors’ network recruitment process, these specialists across the world are asked the same question:

The result is the ultimate vote as to who is the best of the best in their respective field. In other words, the Best Doctors’ network is the doctors’ choice.

Periodically this network is reviewed, following a well-established and accepted peer review process that ensures quality standards are met.

Who are the ‘Best Doctors’?A network of over 50,000 specialists voted by other doctors as leaders in their field.

If you or a family member need a doctor in your speciality, who would you refer them to?

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For your organisation■ May reduce the period of recovery and subsequent absence from work

by providing access to the best medical information.

■ Forms a valuable part of an employee benefits package, which should aid recruitment and reduce turnover by attracting and retaining the best calibre staff.

For employees and their Families■ Provides unlimited access to leading medical specialists from around

the world who can advise on anything from chronic disease to pain management and serious illness.

■ Ongoing support and updates from a dedicated medical professional about their case.

■ In-depth case review from a leading medical specialist on the diagnosis of a serious illness or injury.

■ Guidance through the best treatment options available from a unique database.

What benefits does it offer?Access to Best Doctors benefits not only your employees and their families, but your organisation too:

“Best Doctors is a very popular benefit. Our employees value the ability to have their case reviewed by world-leading experts.”

Graham Clark Head of Compensation & Benefits, Société Générale Corporate and Investment Banking (UK).

“We actively communicate Best Doctors as part of our employee benefit package – we also signpost relevant staff at point of need.”

Nora Tisdall Occupational Health Manager, Wrigleys.

“Put simply, I think that Best Doctors is a fantastic benefit for employees, their families as well as us as an employer. I would recommend it to anybody. It’s the perfect complement to our workplace health programme.”

Mona Smith HR Leader, PerkinElmer.

“We’re delighted to be working with Best Doctors because it’s an innovative proposition that we can provide to staff that the competition can’t. So far over 100 staff have benefited from the service, including our CEO!”

Charlie Johnston HR Director, Cisco, UK and Ireland.

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Which illnesses or conditions does Best doctors revieW?Best Doctors will arrange leading specialist medical advice about serious medical conditions such as cancer, stroke and any other conditions causing you major discomfort or disruption to a healthy and productive life.

The illness doesn’t need to be a claimable condition under your workplace insurance scheme from Sovereign.

And this applies to anyone in your immediate family.

If you’d like to discuss whether advice is available for your particular situation, call Best Doctors on 0800 425 005.

Please note: consultations regarding acute care cases (emergency room), pregnancy and mental health conditions are not available through Best Doctors.

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The BesT DocTors meDical review process

A medical professional from Best Doctors will become their dedicated point of contact and support them throughout the entire medical review process.

They’ll note their medical history and document any questions they may have.

They’ll need to sign a consent form so Best Doctors can collect all the relevant medical information.

This may incluDe:■ medical records

■ imaging studies

■ treatment plans

■ surgical reports, or

■ pathology, including test results and biopsies.

The employee will need to provide the policy number along with a photocopy of their proof of employment (e.g. payslip, work pass, business card, etc).

How Best Doctors worksIf a member, or one of their immediate family, is diagnosed with an illness it takes just one call to Best Doctors to set the process in motion.

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Alexis* was born with severe cardiac defects. By six weeks she had developed

signs of respiratory distress, congestive heart failure, poor oral intake and failure to thrive. The family was told there was nothing that could be done, and Alexis would soon die.

Hospice care, high doses of morphine and cardiac medications were started.

To Alexis’ parents it seemed as if all their options had been exhausted until Alexis’ mother called Best Doctors.

The Best Doctors’ team connected Alexis and her treating physician with one of the world’s top Paediatric Cardiac Surgeons, chosen from the Best Doctors’ global network of over 50,000 specialists.

The Best Doctors’ assigned specialist recommended a pioneering surgery that would not only save Alexis’ life, but also offer her full life-expectancy.

A few weeks later, after the complex surgery was successfully completed, Alexis’ heart worked perfectly and she now lives a normal life.

“Our baby is alive, her little heart is fixed. Alexis is playing with her older brother, laughing and has no more pain. Our family is overwhelmed with joy. Thank you Best Doctors.”

Mary* was 33 and had completely lost her sight over a period of months. She was diagnosed with an aggressive

brain tumour requiring emergency open head surgery; a procedure both dangerous and disfiguring.The location of the tumour required the optic nerve to be cut and permanent blindness would result.

She turned to Best Doctors in the hope they could find an alternative treatment.

Thanks to Best Doctors she discovered she did not have a life-threatening tumour; rather she had sarcoidosis, a treatable inflammatory condition.

For final determination and expert advice on treatment, the assessment was forwarded to a Rheumatologist, from the Best Doctors’ global network, who confirmed sarcoidosis.

The Rheumatologist immediately phoned Mary’s surgeon and recommended cancelling the operation. Mary’s surgeon was sceptical, but at the insistence of the specialist, agreed to delay the operation for 48 hours.

During this time, anti-inflammatory drugs were administered and the change was dramatic: her eyesight began to return almost immediately.

Today, Mary is healthy and active with full eyesight and thankful for the services of Best Doctors.

Best Doctors in real life

* The information contained in these case studies is based on real life cases. However, in order to preserve the privacy of the patients their personal details have been removed.

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What do people think of Best doctors?Some stats from the regular quality survey provide the best answer.

94% of Best Doctors users responded ‘Yes’ when asked if the report answered all of the questions raised

73% responded ‘Very valuable’ and 24% ‘Valuable’ when asked how valuable the Best Doctors service was

96% responded ‘Yes’ when asked if they would tell family and friends about Best Doctors.

Source: Best Doctors, Quality Survey Results, February 2012.

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FAQs

Best DoCtorsDo you have a question?how Does BesT DocTors work?It’s simple. If you are diagnosed with a serious medical condition or a condition that is causing disruption to your daily life (for example, a chronic skin condition or knee injury) call Best Doctors on 0800 425 005. Best Doctors will guide you through the process, helping you to understand your options and enlisting world leading medical specialists to analyse your condition, giving you and your treating doctor information to make the best decisions every step of the way.

who can use This service?The Best Doctors medical advice service is only available to members of Sovereign’s workplace insurance scheme and their immediate family.

whaT is The DefiniTion of ‘immeDiaTe family’?Immediate family means the eligible life assureds’ partner (spouse, civil, or de facto) and any birth child or child under legal guardianship of the life assured and/or the life assureds’ partner.

which illnesses or conDiTions Does BesT DocTors review?Best Doctors will endeavour to assist all members when they use the service and there is sufficient information available. The illness doesn’t need to be a claimable condition under the member’s Sovereign workplace insurance scheme.

All serious medical conditions such as cancer, stroke and heart problems, along with any other conditions causing individuals major discomfort, such as chronic skin conditions, allergies, knee injuries, etc. However, there may be circumstances whereby the service cannot be provided. These instances generally include conditions that require face-to-face contact, for example, emergency, pregnancy and mental health conditions.

how long Does The meDical review process Take Through BesT DocTors?The turnaround time from initial contact through to review completion is estimated to take between two to three months in total. However, each turnaround time will depend on the complexity of the case, and whether additional pathology tests may be required during the review process.

how Does BesT DocTors DeTermine who ‘The BesT’ are?Doctors are best qualified to evaluate the experience and skill sets of other doctors. That’s why Best Doctors uses a peer nominated process where they ask the doctors themselves to nominate who they think are leaders in their field. The responses form the basis of the Best Doctors global network which is consistently recognised by doctors and patients for its quality, integrity and independence. For example, cardiologists will receive ballots featuring the names of other cardiologists. They then nominate other doctors whom they think should be included in the next round of voting. This process is refreshed every two years to keep it current. This is essential as the medical world is constantly evolving.

are There any resTricTions on The numBer of Times memBers can use This service?No. This service is unlimited. Scheme members can use it as many times as they, or their immediate family, need. Best Doctors aims to ensure that all members’ questions are answered, therefore even after the medical review has been completed the member has the opportunity to ask further questions.

Do memBers neeD To make a claim To use The service?No. Best Doctors is completely separate from claims. Scheme members can use this service regardless of whether they have submitted a claim to Sovereign.

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will The BesT DocTors service affecT an insurance claim?Best Doctors will not share their findings with Sovereign, and members use of the service won’t affect the assessment of a claim. The Best Doctors medical review report can’t be used to support a claim with Sovereign; nor will Sovereign request a Best Doctors’ report in connection with a claim. However, the member’s treating specialist may, with their consent, share information from the Best Doctors medical review report with Sovereign. Member’s privacy will be protected throughout the process.

whaT happens if The BesT DocTors reporT proviDes a DifferenT view on a case where a claim has Been rejecTeD?Sovereign has one of the most respected claims teams in the industry and a history of paying claims. However, if a Best Doctors report supports a claim that was rejected the member can take the report to their treating doctor and the claim can be reassessed. Sovereign will not be able to review a claim using the content of the Best Doctors report, only information received from the GP or treating specialist can be used.

who pays for our employees’ access To BesT DocTors?Best Doctors doesn’t employ doctors, but calls on the appropriate specialist in their network to review cases in their area of expertise. When one of these specialists participates in a medical review process, he/she is paid a consulting fee by Best Doctors – there is no charge to your employees or their family for this process.

However, when accessing the service, your employees may have to pay for faxing or mailing any completed information and consent forms to Best Doctors.

Doctors aren’t paid to be listed in the Best Doctors network, nor does Best Doctors accept payments from doctors to include them in the network.

Do The meDical communiTy know aBouT BesT DocTors?Yes – information has been provided to key representatives in the New Zealand medical community (including the Medical Council of New Zealand) about the service and how it works. If Best Doctors needs to approach local doctor to request medical records, they will fully explain the service.

FAQs continued

how will BesT DocTors work wiTh The local meDical communiTy?Best Doctors will work with the member’s New Zealand GP or specialist, so long as the member authorises this. It is a complementary service designed to work alongside current medical advice being received. Furthermore, Best Doctors will only review the member’s medical records in order to provide the service. It is fully compliant with the Privacy Act.

isn’T asking for aDDiTional aDvice from BesT DocTors insulTing To local DocTors?No, not in our experience. In fact, in the 20 years that Best Doctors has been operating the opposite has been found to be true. When patients choose to share the information with their treating doctors, the treating doctors who’ve worked with Best Doctors have been delighted with the results. Many doctors already consult informally with other doctors on challenging cases. Treating doctors welcome the additional information that this service provides as patient care is their number one priority.

Does The scheme memBer neeD To visiT The leaDing specialisT?No. The Best Doctors’ medical team assesses the medical records and contacts the world’s leading specialist for a second opinion on diagnosis and recommended treatment. The member’s main contact point is always with Best Doctors.

whaT personal informaTion is proviDeD To sovereign if a memBer uses The BesT DocTors service?Best Doctors will not share the employee’s personal details with anyone except for the purpose of delivering the service. Best Doctors does not share any personal information with Sovereign or any other company. Sovereign will only be informed of the number of people who have used the service and the medical conditions it has been used for. Additionally, Sovereign does not provide Best Doctors with the names and address of members who are eligible for access to the service. Rest assured, the member’s privacy is fully protected:

■ Sovereign will not receive a copy of the medical review report from Best Doctors.

■ Nor will Sovereign accept the medical review report in support of a claim.

■ Best Doctors will not share the names of participants with Sovereign.

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■ Sovereign will not ask for a copy of the medical review report.

■ If a copy of a medical review report is received by Sovereign, it will be promptly returned to the sender.

■ If received, a copy of your medical review report will not be retained on Sovereign’s system.

■ The report from Best Doctors won’t be sent to the member’s local treating doctor unless the member chooses to do so.

However, the local treating specialist (with the member’s permission) may use information from the medical review report when submitting medical information to Sovereign.

whaT iDenTificaTion Does The employee neeD To supply for The meDical review?On the initial phone call Best Doctors simply ask for the company name. We then send the employee an information pack. The pack requests that the employee send back a photocopy of their proof of employment (e.g. payslip, work pass, business card, etc). We will not contact you, the employer, to qualify eligibility. Best Doctors does not hold the names of employees, just a total number of eligible staff.

whaT if an employee leaves The company?Unfortunately, unless they choose to personally take out a Best Doctors eligible insurance policy with Sovereign, they will lose their access to Best Doctors. However, if they have initiated a case and then leave the company, Best Doctors will see the case through until completion.

can employees ouTsiDe of new ZealanD access This service?Yes, the number for employees outside of New Zealand is +617 3360 7771.

Do you have any liaBiliTy as an employer? Best Doctors explain the liability concerns with wording in the information pack that is sent to the scheme member. The Best Doctors Information Pack is sent out to every patient who undergoes a medical review. The patient must sign this before Best Doctors proceeds. Clause 3.9 and 3.11 specifically provides a level of indemnification to both Sovereign and their group risk clients. Below is a brief summary around Best Doctors’ liability position:

Best Doctors has never been subject to any lawsuit related to the delivery of the Best Doctors Services. Best Doctors and its subcontractors are not engaged directly in the delivery of medical treatment or medical diagnosis to

the members. It is up to the member and his/her treating physician to ultimately decide the course of treatment. In order for Best Doctors to have any liability, the member would have to decide to sue Best Doctors and not the treating physician and/or hospital, and then Best Doctors would have to be held liable instead of the treating physician that actually decided the course of action and actually treated the member. None of our experts ever sees a member face-to-face, and members are informed at every stage that there is no doctor-patient relationship between the member and Best Doctors and all decisions are ultimately up to the member and his/her treating physician. Further, Best Doctors has significant quality control measures in place at all levels of delivery to ensure the quality of the Best Doctors Services.

The client’s liability related to the Best Doctors Services is even more limited. In order for the client to have such liability, it would need to be sued directly and not bring in Best Doctors, or it would need to be sued based on a theory that it was negligent in choosing Best Doctors (despite its established client base and numerous articles in reputable magazines on our services). Although Best Doctors believes liability related to Best Doctors Services is remote, it contractually provides indemnification to its clients for any third party claim related to the Best Doctors Services. In addition, in order to be overly cautious of any potential risks to its clients or ourselves, Best Doctors has purchased $15M in Professional Liability coverage that handles “Contingent Medical Malpractice” claims. This Contingent Medical Malpractice insurance provides for coverage of any risk associated with a claim related to the performance of the Best Doctors Services.

If you have any further questions please call Best Doctors on 0800 425 005.

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EmployEE support matErialYour adviser can provide you with the following Sovereign and Best Doctors support material for you to provide to your employees:

Promotional poster

0800 number wallet card

Intranet content (electronic)

Employee information brochure

Template welcome email (electronic)

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Who is sovereign?Sovereign has been a part of New Zealanders’ lives since 1989 and today provides life, business, rural and health insurance, home loans, investment and superannuation products to more than 650,000 customers.One in every five New Zealanders over the age of 15 years has a relationship with Sovereign.* Our products are carefully designed to meet the specific needs of our many and varied personal and business customers, helping them build independence and financial freedom.

For more information, visit www.sovereign.co.nz

Important InformatIonBest Doctors is not an insurance policy (including health insurance) and it doesn’t replace your relationship with your current doctor or medical specialist.

Best Doctors is independent of Sovereign Assurance Company Limited (“Sovereign”) of 74 Taharoto Road, Takapuna, Auckland, 0622. Sovereign does not guarantee the quality of any advice provided through the Best Doctors service or the ongoing availability of the service. Sovereign may withdraw access to the service or change the terms on which access to the service is made available at any time. Information about Best Doctors was sourced from Best Doctors and is not guaranteed by Sovereign to be accurate or complete. Neither Sovereign, its related companies, nor their directors, officers or employees accept any liability whatsoever for any loss or damage arising out of use of the Best Doctors service, or out of the use of or reliance on the information provided in this document. Best Doctors terms and conditions and eligibility criteria apply.

Sovereign is not responsible for any costs associated with becoming eligible to use, or use of, the Best Doctors service (including without limitation the cost of any medical consultations or treatment, travel, lodging, telephone calls, faxes, or mail) except as set out in a Sovereign policy contract.

This brochure has been prepared by Sovereign and is correct at March 2012 but may be subject to change. Best Doctors, Best Doctors InterConsultation and the star-in-cross logo are trademarks of Best Doctors, Inc., in the United States and in other countries and are used under licence.

* Census 2006 -Statistics New Zealand

Telephone +64 9 487 9000 facsimile +64 9 487 8003 freephone 0800 500 103 freefax 0800 329 768email enquire@sovereign.co.nz weB www.sovereign.co.nz

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