Promoter & Investment Manager Spitfire Asset Management Pty Ltd

Transcription

1 Insurance Guide 1st June Version 1.1 Contents 1. Insurance in Spitfire Super 2. Death and TPD Insurance 3. Income Protection Insurance 4. Insurance Costs 5. Features of Spitfire Super s Insurance Benefits 6. Other Insurance Terms and Conditions 7. Insurance Definitions Spitfire Super Administrator OneVue Super Services Pty Limited Promoter & Investment Manager Spitfire Asset Management Pty Ltd Trustee Equity Trustees Superannuation Limited Mail: Phone: Website: ABN: AFSL: PO Box 1282, Albury NSW super@spitfire.io Mail: Phone: Website: L20, 207 Kent Street, Sydney, NSW 2000 (02) super@spitfire.io ABN: AFS Representative No , a Corporate Authorised Representative of CIP Licensing Limited (AFSL ) Mail: Phone: Fund: GPO Box 2307, Melbourne, Victoria 3001 (03) The Executive Superannuation Fund RSE Registration R Unique Super Identifier ( USI )

2 The information in this document forms part of the Spitfire Super Product Disclosure Statement dated 13 February Things you should know: This Insurance Guide ( Guide ) is issued by Equity Trustees Superannuation Limited (AFSL No ; ABN ; RSE Licence No L ), as Trustee of The Executive Superannuation Fund ABN ( the Fund ), of which Spitfire Super is a part. This Guide is for general information purposes only and is not intended to be relied on alone for the purpose of making an insurance decision or other decisions pertinent to your insurance through Spitfire Super. It has been prepared without taking account of the objectives, financial situation and needs of any particular person. You should also consider obtaining professional advice before making decisions about your insurance through Spitfire Super, to determine if it is appropriate to your needs. Please read the relevant PDS available at or contact Spitfire Super for a copy. The terms of the trust deed governing the Fund have precedence over anything in the PDS and the Guides. Insurance cover is provided through group insurance policies issued by Hannover Life Re of Australasia Ltd (ABN ) to the Trustee. The information in the Spitfire Super s Product Disclosure Statement ( PDS ) and this Guide is a summary only of the main features of the available insurance benefits and significant terms and conditions. Insurance cover and benefits are subject to detailed terms and conditions (including defined terms) that are set out more fully in the group insurance policies. The relevant policies can be made available on request to the Trustee. The payment of any insured benefits by the Trustee from Spitfire super is subject to acceptance of a claim by the Insurer, the trust deed and superannuation legislation. In any dispute relating to insurance cover or insured benefits, the strict policy wording in the group insurance policies will always prevail. If, for whatever reason, insured benefits are denied, reduced or limited by the Insurer, then the benefit payable from Spitfire Super will be affected. 2

3 1. Insurance in Spitfire Super We believe that insurance should be affordable and transparent. Spitfire Super, through a third party insurer Hannover Life Re of Australasia Ltd (the Insurer), provides a range of affordable insurance options to help you, or your family, overcome life s challenges: Spitfire Super offers the following insurance cover to eligible members: Death Insurance Provides a lump sum benefit if you die or are diagnosed with a Terminal Illness. Death and Total Permanent Disablement (TPD) Insurance Provides a lump sum benefit if you die, suffer a Total and Permanent Disablement Income Protection Insurance Pays a set percentage of your Monthly Income for a selected term in the event that you a suffer Total Disability or Partial Disability as a result of an Illness or Injury. Death and TPD insurance cover may be provided to eligible members automatically and is also available on application to the Insurer. Income Protection insurance cover is only available on application to the Insurer. In this Guide, words in italics have the meaning set out in pages and month means calendar month. The costs (called insurance costs ) relating to any insurance cover you may have are deducted from your Spitfire Super account. Insurance costs comprise insurance premiums payable to the Insurer and insurance administration fees. More about insurance costs can be found in pages Important Information - Change of Circumstances If you are insured through Spitfire Super and change your: occupation; or location; or income and/or number of hours you are working; or employment (eg you cease working altogether or the nature of your employment changes) this may have an impact on your cover or eligibility to claim benefits. Therefore, please immediately let the Spitfire Super Administrator know of any change to your circumstances. 3

4 2. Death and TPD Insurance Default Cover As a member of Spitfire Super, you may receive an amount of death and TPD cover automatically, without having to provide full health evidence. This is called Default Cover. Default Cover does not include Income Protection cover. Default Cover commences on the date your Spitfire Super account receives the initial contribution or a rollover from another superannuation fund for you, provided you are eligible for Default Cover at that date. Eligibility for Default Cover You will receive Default Cover if you are an Eligible Person and meet the following requirements: 1. You have been accepted for membership of Spitfire Super, completed the required form (via your online account), and Spitfire Super has received an initial contribution or a rollover from another superannuation fund for you; 2. You are not applying for, entitled to, and have not been paid a total and permanent disablement benefit or a terminal illness benefit from any source (eg from a superannuation fund, life insurance policy, Workers Compensation, Disability Pension or Veterans Affairs); and 3. You have accurately confirmed as part of the process of establishing your online account that you are eligible for default cover and have not declined or cancelled (opted out) of Default Cover. The circumstances in which you will not be an Eligible Person include if you: are not an Australian citizen, holder of an Australian permanent visa or temporary work (skilled) visa or New Zealand citizen residing and working in Australia; are aged 15 or below, or 65 or more; are working in an Excluded Occupation or perform any duties of an Excluded Occupation; do not meet the insured cover requirements under the policy. How much cover is Death and TPD Default Cover? The amount of Default Cover provided depends on your age, as shown in Table 1 below. Table 1 Death & TPD Default Cover Group Life Default Cover level of cover Age Next Birthday Death TPD $ 100,000 $ 100, $ 150,000 $ 150, $ 200,000 $ 200, $ 250,000 $ 250, $ 300,000 $ 300, $ 200,000 $ 200, $ 180,000 $ 180, $ 160,000 $ 160, $ 140,000 $ 140, $ 120,000 $ 120, $ 100,000 $ 100, $ 80,000 $ 80, $ 60,000 $ 60, $ 40,000 $ 40, $ 20,000 $ 20,000 Insurance costs relating to this cover are shown in Table 3 on page 11 and are deducted from your Spitfire Super account. 4

5 What limits apply to Default Cover? During the initial period of Default Cover, cover is limited to an Illness first diagnosed, or an Injury that first occurs, on or after the date the cover commences for you. This limited cover is called New Events Cover. It will apply for 24 months from the date your cover commenced. However, if you are not At Work for 60 consecutive days immediately prior to the end of the 24-month period, New Events Cover will continue to apply until you have been At Work for 60 consecutive days. Once you have cover through Spitfire Super (other than Accident Cover), you can apply to remove the New Events Cover limitation by completing the Insurer s Short Form Personal Statement available from your online account or available on request from the Spitfire Super Administrator. Approval is subject to the Insurer s approval. Other limits apply. See pages for other terms and conditions that impact death and TPD cover which are also applicable to Default Cover. Changing or applying for Death and TPD Cover At any time, you can: opt out of Default Cover (by writing to the Fund, which is effective from the date of receipt unless you opt out during the cooling off period); downgrade your insurance from death and TPD cover to just death cover (by writing to the Trustee, which is effective from the date of receipt); reduce your level of cover (by writing to the Fund, which is effective from the date of receipt); apply to fix your level of Default Cover, which will affect the insurance costs deducted from your account, is subject to TPD tapering (see page 6) and may be subject to underwriting with the Insurer (see page 18-20); or apply to have your insurance increased without providing medical evidence following a Nominated Event (see Life Events cover on page 15-16) or subject to underwriting with the Insurer (see pages 18-20). All insurance cover through the Spitfire Super other than Default Cover is called Voluntary Cover. You have a cooling off period during which you can cancel Default Cover and obtain a refund of the insurance costs. The cooling off period is 30 days from the date cover commences. Cancellation of cover during the cooling off period means that your cover will be deemed not to have started and no insured benefit will be payable. Voluntary Cover You can apply for Voluntary Cover if you: are an Eligible Person who wants to apply for insurance cover, or already have cover through Spitfire Super (other than Accident Cover) and you want to increase your cover. The circumstances in which you will not be an Eligible Person include if you: are not an Australian citizen, holder of an Australian permanent visa or temporary work (skilled) visa or New Zealand citizen residing and working in Australia; are aged 15 or below, or 65 or more; are working in an Excluded Occupation or who performs any duties of an Excluded Occupation. do not meet the Insured Cover requirements. Voluntary Cover is subject to underwriting by the Insurer and only commences from the date notified to you (through your online account). Voluntary Cover is subject to confirmation of your acceptance of any individual insurance premium loadings, exclusions, limitations, special terms conditions or restrictions imposed by the Insurer within 28 days of the date of the Insurer s offer, and payment of the required total insurance premium due to be paid within 30 days after the due date. All Voluntary Cover is rounded up to the nearest $1,000 and is provided as fixed cover, for an amount nominated by you (subject to various conditions eg see Tapering of Voluntary TPD Cover and Maximum Cover below and page 6). Voluntary Cover is only available to commence before your 60th birthday. If you apply for Voluntary Cover, Accident Cover may apply in the interim while your application is being assessed by the Insurer (see page 18-20). You can also apply to the Insurer to transfer the amount of any other existing cover you may have into Spitfire Super, subject to satisfactorily completing the Insurer s Transfer of Insurance Application Form and meeting other terms and conditions. Transferred cover is also Voluntary Cover. See pages for more information about transferred cover. You have a cooling off period during which you can cancel Voluntary Cover and obtain a refund of insurance costs. The cooling off period is 30 days from the date cover commences. Cancellation of cover during the cooling off period means that your cover will be deemed not to have started and no insured benefit will be payable. Otherwise, the cancellation of Voluntary Cover will apply from the date Spitfire Super receives your written request to cancel the cover. 5

6 Tapering of Voluntary TPD Cover For Voluntary Cover, the amount of fixed TPD cover is subject to the following tapering (reduction in the amount of benefit) from age 61: Table 2 Tapering of TPD Cover Age Next Birthday Up to 61 0% 62 20% 63 40% 64 60% 65 80% Maximum Cover Reduction in Benefit The maximum total cover you can have through Spitfire Super and through other cover you have with any insurer is: for death cover - $5 million for Terminal Illness cover - $3 million, and for TPD cover - $3 million. An additional maximum applies when cover is transferred into Spitfire Super (see page 6). Cost of Death and TPD Cover The cost of death and TPD Cover (including Default Cover and Voluntary Cover) is set out on pages Death Benefit Your beneficiary(s) will receive a death benefit if, on the date of death, you have death cover subject to meeting the terms and conditions of the policy. TPD Benefit You will receive a TPD benefit if, on the Date of Disablement, you have TPD cover; subject to meeting the terms and conditions of the policy and: 1. you are a Permanent Employee, Contractor or self-employed person; 2. you have worked an average of at least 15 hours per week during the previous 6 months prior to the Date of Disablement; 3. you satisfy at least one of the following: (a) (b) (c) (d) (e) you are Unlikely to Return to Work, or you suffer a Permanent Impairment, or you have suffered the total, permanent and irrecoverable Loss of Use of 2 limbs, or the sight of both eyes, or 1 limb and the sight of 1 eye, or as a result of Injury or Illness, you are first diagnosed with a total and permanent deterioration or loss of intellectual capacity and are under the continuous care and supervision by another adult for at least 6 consecutive months and, at the end of that 6 month period, you are likely to require permanent ongoing continuous care and supervision by another adult, or you suffer an Injury or Illness, that in the Insurer s opinion: totally and irreversibly prevents you from performing 2 of the Activities of Daily Living without assistance from another adult for at least 6 consecutive months, and since they became ill or injured, you have been under the regular care and attention of a Doctor for that Injury or Illness, and you are unable to ever again be able to perform at least 2 of the Activities of Daily Living without assistance from another adult. If you have TPD cover and you do not satisfy 1 and 2 above on the Date of Disablement, or you are a Casual Employee, a TPD benefit is only payable if you satisfy 3(c), (d) or (e) above. If you have TPD cover and you are suffering from 1 or more of the Immediate Assessment Conditions, and all claim requirements have been received by the Insurer, the 6 month waiting period that applies to 3(a), (d) and (e) above is waived and assessment of a claim commences immediately. In order to satisfy 3(c), (d) or (e) above, you must be disabled to such an extent as a result of that Injury or Illness that, in the Insurer s opinion, you are unlikely ever at any time in the future to engage in any Gainful Employment for which you are reasonably suited by education, training or experience. 6

7 Terminal Illness Benefit If you are diagnosed with a Terminal Illness, a Terminal Illness benefit will be paid if you have death cover and the following conditions are all satisfied: a. The Date of Certification of the Terminal Illness is on or after the date your death cover commenced and before it ceased, and b. Your Terminal Illness benefit will be the lesser of your death cover or $3 million, and c. You supply, at your expense, supporting medical evidence from 2 Doctors (with at least 1 being be a specialist practising in the field to which the Terminal Illness relates) approved by the Insurer. The Insurer can ask for additional information. From the date a Terminal Illness claim has been lodged, you will no longer be eligible for Total and Permanent Disablement, any increase in death cover or any reinstatement of that cover. If a claim for Terminal Illness is admitted by the Insurer, your death cover will cease from that date unless you have death cover in excess of $3 million, in which case any residual death cover will be payable as a death benefit on your death while an insured member of Spitfire Super and the Insurer has continued to receive insurance premiums for the Insured Cover. Where a Terminal Illness benefit is paid, it will be considered as an advance payment of your death cover. 3. Income Protection Insurance Eligibility for Cover Income Protection insurance is only available on application to the Insurer. That is, Income Protection cover is Voluntary Cover and is subject to acceptance by the Insurer. You may select to include a Superannuation Contribution Benefit in your Income Protection insurance, subject to the terms and conditions of the policy. You may receive Income Protection cover if you are an Eligible Person and meet the following requirements: You are a Permanent Employee, Contractor or self-employed person working for at least 15 hours per week. You are not able to receive cover if you are a Casual Employee or unemployed; You have submitted a satisfactorily completed Insurance Application, and all information requested by the Insurer to enable the Insurer to assess your application (called the Insurer s underwriting requirements ); and Spitfire Super receives your initial contribution to your Spitfire Super account for the payment of applicable insurance premiums. Income Protection cover only commences on the date advised to you in writing, subject to confirmation of your acceptance of any individual insurance premium loadings, exclusions, limitations, special terms conditions or restrictions imposed by the Insurer, and payment of the required insurance premium. The circumstances in which you will not be an Eligible Person include if you are: not an Australian citizen, holder of an Australian permanent visa or temporary work (skilled) visa or New Zealand citizen residing and working in Australia; aged 15 or below, or 65 or more; working in an Excluded Occupation. Contact the Spitfire Super Administrator for the applicable Insurance Application Form. If you apply for Income Protection Cover, Accident Cover may apply while your application is being assessed by the Insurer. You can also apply to the Insurer to transfer the amount of any other existing cover you may have into Spitfire Super, subject to satisfactorily completing the Insurer s Transfer of Insurance Application Form and meeting other terms and conditions. Transferred cover is also Voluntary Cover. See page for more information about transferred cover. Amount of Cover and Benefits The amount of cover payable per month (Monthly Benefit) depends on your Monthly Income immediately before the date of Total Disability or Partial Disability, based on the latest amount of salary or income advised by you to the Insurer on which your insurance premium has been paid. (Note: if your salary or income subsequently increases, this will not be relevant to the calculation of your cover or benefits, unless you apply for and are accepted for increased cover). If you are not a Permanent Employee or Contractor working for your employer for at least 15 hours a week immediately before your Total Disability or Partial Disability, your Monthly Income will be averaged over the 12 months immediately before the date of your disability. The amount of Monthly Benefit is subject to some maximum limits. The maximum Monthly Benefit is $30,000 per month. This amount includes any insured amount under any other policies with the Insurer or any other insurer. An additional maximum applies when cover is transferred into Spitfire Super (see page 6). The Monthly Benefit is 75% of your pre-disability Monthly Income plus (if applicable) a Superannuation Contribution 7

8 Benefit. The Superannuation Contribution Benefit is an amount equal to an agreed percentage of your Monthly Income paid by your employer, subject to a maximum of 15%. The Superannuation Contribution Benefit will be paid to your account in Spitfire Super to cover superannuation contributions your employer was required to make for you to Spitfire Super or any other superannuation fund immediately before your Total Disability (unless you have ceased to be a member of Spitfire Super, in which case the Insurer may, but is not required to, pay the benefit to another complying superannuation fund). For Partial Disability, the amount of the Superannuation Contribution Benefit is adjusted so that it corresponds to the proportion of the Monthly Benefit payable for Partial Disability. If the Superannuation Contribution Benefit applies to you it is payable for as long as the Insurer must pay a Total Disability or Partial Disability benefit. The Monthly Benefit (including any Superannuation Contribution Benefit) cannot exceed the amount of your Income Protection cover at the date of Total Disability. The amount of the Monthly Benefit may be reduced by Benefit Offsets (see page 10). Monthly Benefits are payable monthly in arrears for all or part of a month during which a benefit is payable, and any required insurance premium has been paid. The Insurer will generally pay Income Protection benefits directly to you (less any applicable tax), except any Superannuation Contribution Benefit will usually paid into your Spitfire Super account. Changing Income Protection Cover You will have a cooling off period after the Insurer has accepted your application for Income Protection cover, during which you can cancel the cover and obtain a refund of insurance costs. The cooling off period is 30 days from the date cover commences. Cancellation of cover during the cooling off period will mean that your cover will be deemed not to have started and no insured benefit will be payable. Otherwise, you may opt out of all your Income Protection cover or reduce the amount of cover on written request to Spitfire Super. Any cancellation or reduction of cover will apply from date Spitfire Super receives your request. You may apply to increase the amount of your cover by submitting a satisfactorily completed Insurance Application, subject to meeting the Insurer s underwriting requirements. Any increase in cover will apply from the date that is notified to you in writing, subject to the payment of additional insurance premiums due for additional cover. You may also apply to change your Waiting Period or Benefit Period by submitting the relevant form. Decreasing your Waiting Period or increasing your Benefit Period is also subject to the Insurer s underwriting requirements and is subject to the payment of additional insurance premiums. You will have a cooling off period after the Insurer has accepted your application to decrease your Waiting Period or increase your Benefit Period. During 30 days from the date of the change, you can cancel the change and obtain a refund of any associated insurance costs. Cancellation of cover during the cooling off period will mean that the change will be deemed not to have happened. Cover ceases automatically in certain circumstances see page 15. Contact the Spitfire Super Administrator for the applicable Insurance Application Form or other forms. Cost of Income Protection Insurance The cost of Income Protection cover is set out on pages Insurance premiums for Income Protection insurance are waived by the Insurer while a Monthly Benefit for Total Disability is being paid to you by the Insurer (and related insurance administration fees will not apply while premiums are waived). Insurance costs are payable by you if you are in receipt of a Partial Disability benefit. When Income Protection Benefit Is Payable Total Disability If you have Income Protection cover and suffer Total Disability, the insurer will pay a Monthly Benefit that accrues from the expiry of the Waiting Period. The Insurer will continue to pay a benefit for Total Disability for the period you suffer Total Disability during the Benefit Period. Partial Disability A benefit will be payable if you have Income Protection insurance and you are Partially Disabled, provided you suffered Total Disability continuously for a period of at least 7 days out of 12 consecutive days immediately before suffering Partial Disability and: you have ceased to suffer Total Disability, and you have resumed partial employment, or in the Insurer s opinion, you are deemed capable of returning to partial employment duties, and as a result of the Injury or Illness that caused your Total Disability, you have received, or would in the Insurer s opinion receive, a Post-Disability Income that is less than your Monthly Income, and you are under the continuous and regular care of a Doctor undergoing appropriate treatment. The benefit amount is calculated by the following formula, less any Other Disability Income that accrues during the month: ((A B)/A) x C Where: is your pre disability Monthly Income 8

9 is your actual Monthly Income earned during the month of Partial Disability is the Monthly Benefit which would otherwise be payable if you had suffered Total Disability. No Partial Disability benefit is accrued or payable until the Waiting Period has ended. If you suffer Partial Disability and no work is available then, the Insurer will calculate a Post-Disability Income on the basis of your capacity to earn, based on medical and other evidence available to the Insurer. A Partial Disability benefit is also subject to the applicable Waiting Period and Benefit Period and will cease to be paid in the circumstances that cause a Total Disability benefit to cease. Duration of benefits Monthly Benefit payments for Total Disability or Partial Disability cease at the earliest of the following events: you ceasing to meet the definition of Total Disability or Partial Disability, as applicable you die the expiry of the Benefit Period you reach age 65 you are no longer under the regular care of and following the advice of a Doctor you reside overseas for a period longer than agreed by the Insurer you fail to provide information requested by the Insurer to assess your claim you make a fraudulent claim. Waiting Period This is the length of time that must lapse before the Insurer begins to pay any Total Disability or Partial Disability benefit. The Waiting Period commences on the date that you first receive medical advice from a Doctor about your Injury or Illness and the Doctor certifies that you suffer Total Disability. If you suffer Total Disability and unsuccessfully (due to your Injury or Illness) return to work during the Waiting Period, the original Waiting Period will continue if the number of days you return to work for is no more than 10% of the Waiting Period. You can choose from a 30, 60 or 90 day Waiting Period, subject to the Insurer s approval. The Waiting Period affects the insurance costs relating to your insurance cover. If your Waiting Period begins after insurance cover ceases, a benefit under the Income Protection policy is not payable. If your Waiting Period begins before the cessation of cover, the Insurer will pay a benefit under the policy as a result of an Injury or Illness in accordance with the policy until you are At Work. This is subject to the applicable Benefit Period and provisions relating to Recurrent Disability (see page 10). Benefit Period This is the maximum length of time (for any one claim) you can receive a Monthly Benefit while you suffer Total Disability or Partial Disability. However, if a Monthly Benefit has been continuously paid for the entire Benefit Period, a Monthly Benefit for a disability caused by the same or related Injury or Illness may be paid if: the periods of disability are separated by at least 6 months, and you returned to being At Work for your employer for at least 6 consecutive months undertaking all duties and hours of your usual occupation immediately before your disability, and the required insurance premiums have continued to be paid. Another Benefit Period and Waiting Period applies to the subsequent disability. You can choose from a 2 or 5 year Benefit Period or a Benefit Period up to age 65, subject to the Insurer s approval. It commences the day after the expiry of the Waiting Period. The Benefit Period affects the cost of your insurance cover. A Monthly Benefit will not be payable if an exclusion applies. See page 18. Recurrent Disability If a recurrence of a disability (caused by the same medical condition) occurs within 6 months of returning actively to your usual hours of work (prior to the disability) it will be considered to be a continuation of the previous period of disability, Another Waiting Period will not apply, however the same Benefit Period will apply. Your usual hours of work before your earlier period of disability will be considered as your full time work. Benefit Indexation If a Total Disability benefit has been paid for 12 continuous months, the amount of the Monthly Benefit will be indexed by the lesser of the annual CPI (Consumer Price Index) percentage increase or 5%. The Monthly Benefit will then be increased for each consecutive 12 month period where a Total Disability benefit continues to be paid. Death benefits while on claim In the event of death while you are receiving a Total Disability or Partial Disability benefit, the Insurer will pay an additional 9

10 lump sum death benefit equal to 3 times the Monthly Benefit payable immediately prior to your death, on receipt of satisfactory evidence. Benefit Offsets The amount of the Monthly Benefit for Total Disability or Partial Disability paid for a month is reduced by any Other Disability Income that you are entitled to during that month. Unless the Insurer agrees otherwise, a reduction will be made where your Monthly Benefit plus Other Disability Income exceeds 75% of your pre-disability Monthly Income or the maximum Monthly Benefit. If your entitlement to Other Disability Income is in dispute, the Insurer will, at their discretion, pay the full amount of benefits due under the policy on a conditional basis until the dispute is resolved. If the Insurer chooses to pay, and you receive Other Disability Income, the Insurer may offset those payments received from future benefits or recover the amount of the benefit paid which would have been offset. 4. Insurance Costs Insurance costs depend on your age, gender and occupation. You should provide details of your occupation when you join Spitfire Super. You can change or update your occupation category at any time by contacting the Spitfire Super Administrator. Any change in occupation will apply from the date Spitfire Super receives notification from you. Insurance costs include the Insurer s insurance premiums (based on premium rate tables in the insurance policy) and an insurance administration fee of 11% (Inclusive of GST) of the Insurer s insurance premiums. The insurance administration fee is payable by the Trustee to the Spitfire Super Administrator monthly in arrears (by the end of each month). The insurance premiums are payable to the Insurer monthly in arrears and are due by the end of each month. Insurance costs are deducted from Spitfire Super member accounts, where applicable. The deductions may be adjusted from time to time, for example, to take into account changes to your insurance cover during a year. 10

11 Death and TPD Insurance Costs Table 3 Death only cover and death and TPD cover Annual Insurance Costs (White Collar rates per $1,000 of cover). The premium rates (that form part of the insurance costs for death and TPD cover) include stamp duty (where applicable). If you do not provide details of your occupation when you join Spitfire Super, the Insurer will apply the Blue Collar occupation category to your insurance premiums. The insurance costs relating to Professional occupations are lower. The insurance costs relating to Blue Collar occupations are higher. See the Insurer s occupation loadings below, which affect the amount of insurance premiums and total insurance costs. The insurance costs shown below (inclusive of the insurance administration fee) apply to both Default Cover and Voluntary Cover, although additional insurance costs (because of individual insurance premium loadings) may apply If you are accepted for Voluntary Cover. 11

12 Occupation Loadings The insurance costs in Table 3 (above) apply if you have death only or death and TPD cover through Spitfire Super and you meet the White Collar occupation category. The following occupation loadings as a % of White Collar insurance premium rates apply if you meet either the Professional occupation category or the Blue Collar occupation category (as described below) and will result in an adjustment to the insurance costs: Occupation category Death Death & TPD Professional 90% 90% White collar 100% 100% Blue Collar 128% 206% Income Protection Insurance costs 12

13 Table 4 Income Protection Cover - Annual Insurance Costs (White Collar rate per $1,000 sum insured). Insurance costs relating to Professional occupations are lower. 13

14 Insurance costs relating to Blue Collar occupations are higher. See the Insurer s occupation loadings below, which affect the amount of insurance premiums and total insurance costs. If you are accepted for Income Protection Cover, additional individual insurance costs (because of individual insurance premium loadings) may apply. The premium rates (that form part of the insurance costs for income protection cover) do not include stamp duty. Where stamp duty is applicable, it is deducted from your account. The amount of stamp duty imposed varies between States and Territories and the rate of stamp duty that you are charged will depend on your location. Stamp duty rates range from 5% to 12% of the Insurer s insurance premium rates, depending on which State you live in, and are subject to change. Occupation Loadings The insurance costs in Table 4 (above) apply if you have income protection cover through Spitfire Super and if you meet the White Collar occupation category. The following occupation loadings as a % of White Collar insurance premium rates apply if you meet either the Professional occupation category or the Blue Collar occupation category (as described below) and will result in an adjustment to the insurance costs: Occupation category Income Protection Professional 90% White collar 100% Blue Collar 220% 14

15 5. Features of Spitfire Super s Insurance Benefits Interim Accident Cover You receive Accident Cover in the interim on the date the insurer receives your application for Voluntary Cover (other than an application to transfer cover (see page 16-17) and an application to increase cover following a Life Events (see page 15-16). If, while covered by interim Accident Cover, you: die as a result of an Injury (if the application is for death cover that is available to you), or suffer Total and Permanent Disablement as a result of an Injury (if the application is for TPD cover that is available to you), suffer Total Disability as a result of an Injury (if the application is for Income Protection cover that is available to you); the Insurer will pay: for death or TPD cover, as applicable, the lesser of the amount being applied for or $1,500,000 as if you were an Insured Person; for Income Protection cover, the lesser of the amount being applied for or $15,000 per month as if you were an Insured Person. The maximum Benefit Period for a claim under interim Accident Cover is 2 years. During any period in which a Total Disability benefit under interim Accident Cover is paid, the Insurer is not liable to pay any other benefits under Spitfire Super s Income Protection insurance policy. Accident Cover does not apply to Life Events increases. A benefit is not payable for Partial Disability under Accident Cover. Accident Cover usually commences from the date the Insurer receives a satisfactorily completed application for Voluntary Cover. Accident Cover ceases on the earliest of: when the Insurer notifies of its underwriting decision; when the application is withdrawn, cancelled or the Insurer is advised the application is not being proceeded with; 90 days after commencing, although Accident Cover can also apply for a period, up to 28 days greater than 90 days if the Insurer offers you special terms, conditions, restrictions, exclusions or insurance premium loadings see page 12); the policy ceases; or any other cessation of cover event occurs (see page 18). Accident Cover will not be payable where: (a) Your death is directly or indirectly the result of suicide or attempted suicide, or (b) (c) Your TPD is directly or indirectly the result of an intentional self-inflicted injury or attempted suicide, or Your Total Disability is directly or indirectly the result of an intentional self-inflicted injury. The Insurer may take into account any information that they receive during a claim under Interim Accident Cover in exercising their discretion as to whether they accept, refuse or offer special terms, conditions, restrictions, exclusions or insurance premium loading for any insurance cover that is being applied for. Overseas Cover Insurance cover continues if you have insurance cover (other than Accident Cover) through Spitfire Super while you are Overseas, provided required insurance premiums are received by the Insurer, cover does not cease for some other reason (see cessation of cover events on page 18), the period overseas is no longer than 5 years and, in the Insurer s opinion, the overseas residence is temporary in nature. The Insurer will pay benefits for up to 6 months while you remain Overseas. If your entitlement is ongoing, the Insurer will continue to pay your benefit on your return to Australia. Life Events Increases If you have death only or death and TPD cover (other than Accident Cover) through Spitfire Super, you can apply to increase that cover without providing medical evidence if one of the below Nominated Events occurs: a. marriage; or b. divorce; or c. you or your Partner gives birth or adopts a child; or d. you purchase a home for your permanent residence with a mortgage on that residence of $100,000 or more; or e. you take out a new business loan, or increase an existing business loan, of more than $100,

16 Life Events increases are conditional on: (a) (b) (c) (d) (e) (f) (g) (h) you, being having cover through Spitfire Super (other than Accident Cover) on the date the Nominated Event occurred, and you are less than 60 years of age on the date that you applied for the increase in cover, and you have not been declined, or have any exclusions, insurance premium loading, limitations, special terms, conditions or restrictions applying to your cover under the Spitfire Super s insurance policy, and you must not be applying for, intending to apply for, or have been paid a TPD benefit or Terminal Illness benefit from the Spitfire Super s insurance policy, any superannuation fund or life insurance policy, and you provide the Insurer with sufficient proof to their satisfaction that the Nominated Event occurred, and your satisfactorily completed application to request the increase in cover (contact the Spitfire Super Administrator for the relevant form) is received by the Insurer within 90 days of the Nominated Event, and your cover will not exceed the maximum cover (see page 6), and you are At Work on the date the Nominated Event occurred and At Work on the date the Insurer accepts your application. You can only increase your cover: (i) (j) (k) for the same type of cover for which you are currently insured, and once for each Nominated Event, and once for any Nominated Event in any 12-month period, and The maximum amount of the increase is the lesser of: (l) (m) (n) (o) 25% of your Default Cover, or the amount of your mortgage on your new permanent residence, or the amount of your new business loan, or the amount of the increase to your existing business loan. The increase in cover will be rounded up to the nearest $1,000 and provided as Voluntary Cover. All Voluntary Cover is provided as fixed cover and any TPD cover provided will reduce by a tapering factor each year (see page 6). New Events Cover will apply to the increased portion of cover for the first 12 months after the Insurer has accepted the application (see page 5). The Insurer will not pay the increased cover if death or TPD, was the result of suicide, or a self-inflicted Injury, that occurred within the first 13 months from the date that the Insurer agrees to this increase. (Other terms and conditions of the policy as set out later in this Guide, also apply). You will be notified of the date the increase will commence. Additional insurance costs apply. Transfer of Cover You can transfer the amount of other insurance cover you have into Spitfire Super. Other insurance cover is existing cover under: a) a group life insurance policy (e.g. insurance provided by another superannuation fund), or b) an individual retail life or income protection insurance policy, provided it was underwritten and accepted for cover within the previous 5 years. The transfer of other existing cover is subject to you being an Eligible Person and meeting all the following criteria: a) You must be aged less than 60 for death cover and TPD cover, and less than 65 for Income Protection cover, b) You must not be working in an Excluded Occupation, c) You must confirm that your insured benefit in your existing fund or insurance policy will cease on cover commencing with Spitfire Super. No claim will be considered under Spitfire Super s insurance policy where you retain any form of your previous cover elsewhere, d) You must not continue the cover, after acceptance of the transfer under Spitfire Super s insurance policy, under any other insurance arrangement, reinstate cover or effect a continuation option with any fund, and e) You must provide a copy of your most recent Benefit Statement or Policy Renewal Statement dated within the previous 12 months as evidence of your current cover and insured benefit previously held. This includes a copy of the advice you received from the insurer or fund advising you of acceptance of your insurance and if the acceptance was on standard terms or subject to additional terms, 16

17 f) Your existing cover must not be subject to any insurance premium loading, restriction, exclusion or pre-existing condition exclusion or restriction in regard to medical or other conditions, and g) You must satisfactorily complete the Transfer of Cover Application Form, including answering no to the agreed health questions, that is received by Spitfire Super within 31 days of being completed (contact the Spitfire Super Administrator for the relevant form). Where all of the above requirements have been met, the transferred amount of cover will commence to apply in Spitfire Super from the latter of the date the Insurer accepts the Transfer of Cover Application Form and your Spitfire Super account balance being sufficient to pay the required insurance premium. If the account balance is not sufficient to pay the insurance premium within 31 days of the date the Insurer accepts the Transfer of Cover Application Form, the transfer of cover will not be considered to have started and a new Transfer of Cover Application Form is required to be completed. For transferred Income Protection cover, the amount of cover will be transferred across for the same or greater waiting period or the same or lesser benefit period as you choose when electing to transfer cover to Spitfire Super. Where any of the above requirements have not been met, transfer of cover will not be considered to have started and any insurance costs paid in relation to the transfer of cover will be refunded. Cover transferred to Spitfire Super will become subject to the terms and conditions of Spitfire Super s insurance policies as summarised in this Guide, including insurance premium rates (and stamp duty, if any) applicable under these policies. The amount of transfer cover For death and TPD - Transferred death only or death and TPD cover will be rounded up to the nearest $1,000. It is provided as fixed cover (which means that the TPD cover will reduce by a tapering factor each year as described on page 6). When the transferred cover is combined with existing death and TPD cover in Spitfire Super, the total must not exceed $1,500,000. For Income Protection - When the transferred cover is combined with existing Income Protection cover in Spitfire Super the total must not exceed $15,000 per month. The Maximum Cover (see page 6) applies in addition to these limits for transferred cover. 17

18 6. Other Insurance Terms and Conditions Cessation of Death, TPD and Income Protection Insurance Your death, TPD and/or Income Protection cover will terminate at the earliest of the following: you reach age 65 you cease to be an Australian resident you cease to reside in Australia or fail to meet the Insurer s agreed terms of cover while you are Overseas you commence active service with the armed forces of any country, other than the Australian Defence Force Reserves while performing duties in Australia you cease to be a member of Spitfire Super there are insufficient funds in your account to meet the next insurance premium due (where this applies, cover ceases on the last day of the month in which the insurance premium fell due and was paid) you die you are subject to a fraudulent claim under the insurance policy the Spitfire Super Administrator gives notice to the Insurer that your cover will cease. Note: the Spitfire Super Administrator will give notice if the it receives a written request from a Spitfire Super member to cancel or opt out of cover, effective from the date of receipt of the written request the date on which all cover under the insurance policy ceases. No death benefit is payable if the date of death is after death cover ceased. No TPD benefit is payable if the Date of Disablement is after TPD cover ceased. No Terminal Illness benefit is payable if the Date of Certification is after the date cover for that benefit ceased. Cessation of Death Insurance Your death cover will also cease if the Insurer admits a Terminal Illness or TPD claim, unless the amount of Terminal Illness benefit is less than the amount of death cover. Exclusions applicable to Death, TPD and Income Protection Insurance No insured benefit will be payable where the claim is directly or indirectly the result of: war or act of war, or the person was in a country listed on the DFAT website ( as subject to a do not travel warning at the time they entered the country, or any additional exclusion imposed by the Insurer as advised in writing. Other Exclusions applicable to Death and TPD Insurance No insured death benefit will be payable where the death is directly or indirectly the result of suicide or attempted suicide within 24 months from the date the insurance cover commenced. (This exclusion does not apply to Default Cover for death.) No insured TPD benefit will be payable where Total and Permanent Disablement is directly or indirectly the result of an intentional-self-inflicted injury or attempted suicide. Other Exclusions applicable to Income Protection Insurance No insured Total Disability or Partial Disability benefit will be payable where a claim is directly or indirectly the result of: intentional-self-inflicted harm or attempted suicide, or participation in a criminal act, or Normal and uncomplicated pregnancy or childbirth. For avoidance of doubt, complications such as threatened or actual miscarriage, participation in an IVF or similar programme, multiple pregnancy or discomfort from morning sickness, backache, varicose veins, ankle swelling or bladder problems are considered normal and uncomplicated and are therefore excluded. Underwriting If underwriting is required, you must provide the Insurer with all information that it regards as necessary for its underwriting purposes, in the form chosen by the Insurer. After considering all information requested and received for the amount of insured cover that was subject to underwriting, the Insurer may in its absolute discretion: 18

19 accept the insured cover, or offer to accept the insured cover subject to whatever exclusions, insurance premium loading, limitations, special terms, conditions or restrictions the Insurer considers appropriate, or refuse to provide the insured cover. You will be notified in writing of the commencement date of any insured cover that the Insurer agrees to provide following underwriting. Insured cover subject to adjustment or special terms The Insurer can vary your cover in various circumstances (such as where you have given an incorrect date of birth). If the Insurer offers special terms, conditions, restrictions, exclusions or insurance premium loading, cover will be subject to your acceptance of these terms, and cover will commence from the date that your acceptance is received by the Insurer, provided that your acceptance is within 28 days of the date of the Insurer s offer. From the date of the Insurer s offer, the Insurer will provide Accident Cover (see page 15) for an additional period of time being the lesser of 28 days or the date that you accept or refuse the offer. Any exclusions, insurance premium loading, limitations, special terms, conditions or restrictions that came into effect will apply to the insured amount above Default Cover (if applicable). Duty of Disclosure Before you are covered under a life insurance contract with Spitfire Super (including all cover other than Default cover), you have a duty to tell the Trustee or the Insurer anything that you know, or could reasonably be expected to know, which may affect the Insurer s decision to insure you and on what terms. This duty of disclosure continues until the Insurer agrees to insure you. The same duty applies before you extend, vary insurance cover. You do not need to disclose anything that: reduces the risk you are insured for; or is common knowledge; or the Insurer knows or should know as an insurer; or the Insurer waives your duty to tell it about. If you do not disclose something In exercising the following rights, the Insurer may consider whether different types of cover can constitute separate contracts of life insurance. If they do, it may apply the following rights separately to each type of cover. If you do not disclose something that you are required to, and the Insurer would not have insured you if you had disclosed, it may avoid the cover within 3 years of issuing it. If the Insurer chooses not to avoid the cover, it may, at any time, reduce the amount for which you have been insured. This would be worked out using a formula that takes into account the premium that would have been payable if you had disclosed everything you should have. However, for death cover, the Insurer may only exercise this right within 3 years of issuing the cover. If the Insurer chooses not to avoid the cover or reduce the amount for which you have been insured, it may, at any time vary the cover in a way that places it in the same position it would have been in if it had been told everything it should have been told. However, this right does not apply to death cover. If your failure to disclose is fraudulent, the Insurer may refuse to pay a claim and treat the cover as if it never existed. All questions on any application you make in relation to insurance cover (including disclosure to another insurer in relation to transferred cover) are relevant to whether the Insurer accepts the risk and, if so, on what terms. Privacy Privacy laws protect your privacy. The way in which the Trustee and Insurer collect, use, disclose and handle your information is described in the Trustee and the Insurer s Privacy Policies. Please be aware that the duty of disclosure as explained above applies to the information you provide. If you fail to comply with this duty you may be in breach of it, the consequences of which are explained under Duty of Disclosure. The Trustee and Insurer may collect and use or disclose your personal information (including health and sensitive information) to assess, verify and process your application and any claim made. The Trustee and Insurer may collect or disclose information relating to you or your application or any claim you may make to or from each other and a range of services including: financial advisers, reinsurers, superannuation trustees, past or present medical practitioners, health professionals, hospitals, government department(s) which retain health records or as part of the Trustee s regulatory requirements, personal accountants or current or former employers or lawyers, claim investigators and other third party service providers. If this information is not provided, your application for insurance or an insurance claim may not be processed. You have a right to access any personal information held about 19