Group insurance. Product Disclosure Statement (PDS) Preparation date: 16 May 2007

Transcription

1 Group insurance Product Disclosure Statement (PDS) Preparation date: 16 May 2007 This PDS contains information about the following products: Group Life Insurance (superannuation) Group Life Insurance (non-superannuation) Group Income Protection (superannuation) Group Income Protection (non-superannuation) Group Income Protection Plus (non-superannuation)

2 Important information This Product Disclosure Statement (PDS) is designed to give you an overview of the CommInsure group insurance products. The Policy Documents form the basis of the contract with the policy owner and should be read carefully. This PDS is issued by The Colonial Mutual Life Assurance Society Limited ABN AFSL (referred to in this PDS as CommInsure, CMLA, we, our or us ). Apart from CMLA, neither Commonwealth Bank of Australia ABN nor its subsidiaries are responsible for any of the statements contained in this PDS. CommInsure is a registered business name of CMLA. The Colonial Mutual Life Assurance Society Limited Level 7, 39 Martin Place, Sydney NSW 2000 CMLA (the Insurer) is a wholly owned, but non-guaranteed, subsidiary of the Commonwealth Bank of Australia. Apart from CMLA, the Commonwealth Bank of Australia and its subsidiaries do not guarantee the group insurance products. The information contained in this PDS is general information only and does not take into account your individual objectives, fi nancial situation or needs. You should assess whether the products are appropriate for you and consider talking to an adviser before making a decision. The examples and illustrations provided in this PDS are only intended to demonstrate how certain benefi ts are calculated. All benefi ts will be determined in accordance with the relevant policy conditions. No benefi ts are payable unless the relevant policy conditions are satisfi ed. The offer made in this PDS is available only to persons receiving this PDS in Australia. Applications from outside Australia will not be accepted. All references to monetary amounts in this PDS are references to Australian dollars. References to you or your should be read as referring to an employer or superannuation fund trustee (whichever is applicable), as the policy owner. Where the policy owner is a superannuation fund trustee, references to employer should be read as referring to the standard employer sponsor of members of the superannuation fund.

3 Contents 2 Overview 2 CommInsure group insurance 2 What is group insurance? 2 Who qualifies to take out CommInsure group insurance? 2 What are the benefits of CommInsure group insurance over an individual retail insurance policy? 2 What are the benefits of CommInsure group insurance for your superannuation fund or business? 2 Why CommInsure? 3 Features of the CommInsure group insurance products 3 CommInsure group insurance main cover types 3 Superannuation and non-superannuation policies 3 CommInsure group insurance product range 4 Group life insurance 5 Employment requirements 5 Terminal illness benefit 5 Total & Permanent Disablement (TPD) cover 6 Options 7 Automatic Acceptance Limits (AALs) 8 Interim cover 8 Cover expiry age 8 End of cover 8 Continuation option 9 Extended cover 9 Leave without pay 9 Worldwide cover 9 Exclusions 10 Group income protection range 12 Employment requirements 12 Monthly benefit 12 Total or partial disability benefit 13 When will we stop paying the total or partial disability benefit? 13 Waiting period 13 Benefit payment period 13 Indexation 13 Waiver of premium 13 Recurrent disability benefit 13 Rehabilitation expense benefit 14 Donor elected transplant benefit 14 Death benefit 14 Options 15 Automatic Acceptance Limits (AALs) 15 Cover expiry age 15 End of cover 16 Continuation option 16 Extended cover 16 Leave without pay 16 Worldwide cover 17 Limitations and exclusions 17 Group Income Protection Plus 20 General terms and conditions 20 Costs 20 When premiums must be paid 20 Varying the policy and premium rates 20 Taxation 20 Takeover terms 21 Continued cover 21 Underwriting 21 Cooling-off period 21 Claims 22 How to apply 23 Privacy of your personal information 23 Collection of personal information 23 You need to provide us with accurate and relevant information 23 Other members of the Commonwealth Bank Group (Group) 23 Other disclosures 23 Access 23 Further information 24 Complaint handling procedure 25 Medical definitions Group insurance application forms 1

4 Overview CommInsure group insurance CommInsure s group insurance product range has been designed with your needs in mind. We provide simple, affordable solutions to meet your life and disability insurance needs and our fl exible approach means that we can tailor a plan to meet the specifi c requirements of your employees or members. Our goal is to ensure that our products provide practical cover at an affordable price, without sacrifi cing security or service. CommInsure offers a range of group insurance including: death and terminal illness cover Total & Permanent Disablement cover, and income protection. What is group insurance? Group insurance is usually taken out by an employer for the benefi t of employees or by a trustee of a superannuation fund for the benefi t of fund members. Who qualifies to take out CommInsure group insurance? To qualify for a CommInsure group insurance policy, there must be a group involved such as a superannuation fund, a group of employees or an association. The group must have a minimum of 200 insured persons and a minimum aggregate annual premium of $60,000. What are the benefits of CommInsure group insurance over an individual retail insurance policy? The main benefi ts include: Flexible automatic acceptance options for insurance cover In most circumstances, group insurance offers automatic acceptance which means individual underwriting is not required within defi ned benefi t limits and terms. Lower premium rates Usually, group insurance policies offer lower premium rates than individual retail products. Fewer restrictions Generally, group insurance policies contain fewer restrictions and exclusions. Option to continue cover Group insurance offers an option for individuals to continue cover under an individual retail product when employment ceases. What are the benefits of CommInsure group insurance for your superannuation fund or business? Improve planning, budgeting and cash flow By outsourcing the insurance risk to a specialist like CommInsure, the fi nancial burden of managing the illness or injury of an employee or member is minimised. Instead of having to reserve for fl uctuating claims costs, you can plan and budget well in advance, knowing that CommInsure is there to support you and your employees or members. Attract the best people with group insurance Group insurance is a cost-effective and valuable benefi t employers can offer to help attract and retain employees. Employers can use this benefi t to attract top performers, who may be accustomed to income protection and life cover as standard package inclusions. Safeguard employees income Employees tend to neglect protecting their income. By providing income protection, employers signal to their employees that they want to help safeguard their living standards and lifestyle positioning the employer s business as a caring and attractive workplace. Protect employees families An employer can offer their employees the assurance that: if they should suffer a serious illness or injury and are unable to work again, a lump sum payment may be available to help ease their fi nancial burden, or if the worst should happen and they die, a lump sum payment may be available to help provide fi nancial support for their family at a time when it s needed most. Save tax Group insurance is a cost-effective way to provide employee or member benefi ts, as in most cases you will be entitled to a tax deduction for the premiums paid. You should seek your own tax advice. Expert claims management When you place your group insurance with us, you have access to an expert claims management team. Our case managers are experienced specialists in claims assessment and management and will assess claims effi ciently and fairly. We treat all benefi ciaries with respect and compassion and always abide by our obligations of privacy and confi dentiality. Why CommInsure? When choosing insurance, perhaps more than any other service, you need a name you can rely on. CommInsure is one of the leading providers of group insurance to both the Australian corporate and superannuation fund markets and is the part of the Commonwealth Bank Group which provides insurance services. We are one of Australia s largest life insurers and have been helping to provide fi nancial security to Australian families for over 130 years. CommInsure represents the union of many experienced and trusted life insurers including Prudential, Legal and General and Colonial. CMLA s Statutory Fund No. 1 (superannuation business) and No. 5 (non-superannuation business) each have one of the highest solvency ratios of life company statutory funds in Australia. CommInsure helps to protect the lifestyles of Australians with a fresh approach to insurance through innovation, simplicity, competitive products and responsive service. 2

5 Features of the CommInsure group insurance products Some of the key features of our group insurance range include: competitive Automatic Acceptance Limits, where no health evidence is required fl exible options to suit your needs guaranteed renewal of the contract guaranteed premium rates for up to three years (please refer to General terms and conditions on page 20, as some conditions may apply) a continuation option under which an insured person may take out an individual policy without providing further health evidence (refer to Continuation option on pages 8 and 16, as conditions apply) extended cover for up to 60 days after an insured person s cover ceases (subject to policy conditions refer to Extended cover on pages 9 and 16), and tailored policy features designed for both the superannuation and non-superannuation environments. CommInsure group insurance main cover types CommInsure offers three main types of cover that you can provide for your employees or members: Superannuation and non-superannuation policies Group insurance policies that are linked to employersponsored superannuation plans are classifi ed as superannuation policies, while all other policies are classifi ed as non-superannuation policies. CommInsure group insurance product range Superannuation group insurance Group Life Insurance Death Death and TPD Group Income Protection Income Protection Non-superannuation group insurance Type of cover When is the benefit paid? Death only Death and Total & Permanent Disablement (TPD) Provides a lump sum payment to the policy owner in the event of an insured person s death or terminal illness. A lump sum benefi t is paid to the policy owner in the event of the death or terminal illness of an insured person or if the insured person becomes totally and permanently disabled. Group Life Insurance Death Death and TPD Income Protection Group Income Protection Income Protection Plus Income protection A monthly benefi t is paid to the policy owner if an insured person is disabled due to an illness or injury for longer than the nominated waiting period. The maximum monthly benefi t is 85% of an insured person s monthly income (this includes an optional 10% allowance for superannuation contributions), subject to a maximum of $30,000 per month ($20,000 for benefi t payment periods greater than two years). 3

6 Group life insurance Group life insurance provides a lump sum payment on death, terminal illness or Total & Permanent Disablement (TPD). Death (including Terminal Illness) Group Life Insurance Death and TPD (including Terminal Illness) Key features Group life insurance offers: death cover terminal illness cover optional TPD cover death, terminal illness and TPD cover for both permanent and casual employees as well as contractors optional own occupation TPD defi nition (see page 6) for professional and senior management employees optional top up accidental death cover optional guaranteed insurability, and cover for leave without pay (refer to page 9 for conditions). Only one benefi t is payable under group life insurance. However, where an insured person s death cover is greater than their TPD cover, a death benefi t equal to the amount of the difference may be payable if a TPD benefi t was paid for the insured person and the person then passes away within one year of their TPD. A summary of CommInsure group life insurance is shown adjacent. Please also refer to the Policy Document for further details. Group life insurance at a glance Benefits Death Terminal illness Total & Permanent Disablement Death, terminal illness and TPD cover for casual and permanent employees as well as contractors Worldwide cover Leave without pay cover Interim accident cover Continuation option Extended cover max. 3 years max. 12 months Options Top up accidental death cover Guaranteed insurability Automatic variation of cover Choice of TPD defi nitions Eligibility criteria and cover limits Death cover TPD cover Minimum entry age 16th birthday 16th birthday Maximum entry age 69th birthday 60th birthday Maximum cover expiry age 70th birthday 70th birthday Minimum cover No minimum cover Maximum cover $5,000,000 $2,000,000 Note: An insured person s TPD cover cannot exceed that person s death cover. Minimum number of insured persons 200 Minimum annual premium $60,000 4

7 Level of death and TPD cover The level of death and TPD cover can be tailored to suit the needs of the group. Some examples include: multiple of an insured person s salary multiple of future service times the insured person s salary, or a defi ned lump sum. For example, the policy owner elects to provide death and TPD cover to all employees equal to four times salary. This would mean that if an insured person s salary was $80,000, they would receive death and TPD cover of $320,000 (4 x $80,000). In a superannuation environment, group life insurance can cover the shortfall between: a member s death and TPD benefi ts, and the amount accumulated in the superannuation fund for the member. Insuring this difference protects the future fi nancial security of each member and protects the fund against volatility in cash fl ows. In addition to this formula or plan based cover (which we refer to as basic cover in this PDS), you can take out voluntary cover for an insured person. All voluntary cover must be accepted by us before it applies. We may request medical or other evidence before accepting voluntary cover. Please refer to the Underwriting section on page 21 for more information. Employment requirements CommInsure covers both permanent and casual employees, as well as contractors for death, terminal illness and TPD cover. However, the TPD cover we provide may vary depending on whether or not an insured person is employed or engaged on a permanent basis for at least 15 hours per week. An insured person is employed or engaged on a permanent basis if they are employed or engaged under a single and ongoing contract that: is of indefi nite duration or is for a fi xed term of no less than twelve months requires the person to perform identifi able duties requires the person to work a regular number of hours each week, and requires the employer to pay superannuation contributions on behalf of the person. Unless takeover cover applies, only an insured person who is in active employment on the date their cover starts will be covered for pre-existing conditions. An insured person who is not in active employment will be covered for pre-existing conditions once they return to active employment for two consecutive months. A person is in active employment if they are employed or engaged by the employer to carry out identifi able duties, are actually performing those duties and, in our opinion, are not restricted by illness or injury from being capable of performing those duties (and the duties of their normal occupation) at least 35 hours per week. Terminal illness benefit CommInsure s terminal illness benefi t is an advance payment of the death benefi t, allowing you to access the benefi t upon the insured person being diagnosed with a terminal illness. A person is regarded as terminally ill when a medical practitioner, specialising in the insured person s illness, certifi es in writing that the illness will (despite reasonable medical treatment) lead to the insured person s death within twelve months of the date of the certifi cation. For this benefi t to be paid, we need to be satisfi ed with this evidence; and the illness from which the insured person suffers must occur, and the date of the certifi cation must take place, while the insured person is covered under the group life policy. Life insurance cover ends for an insured person upon payment of the terminal illness benefi t. Total & Permanent Disablement (TPD) cover TPD cover provides a lump sum payment in the event that an insured person is totally and permanently disabled. TPD cover is only available in conjunction with death cover. An insured person is totally and permanently disabled if one of the following applies: (a) the person suffers, as a result of illness or injury: (i) the total and permanent loss of the use of two limbs (ii) blindness in both eyes, or (iii) the total and permanent loss of the use of one limb and blindness in one eye where: limb means the whole hand below the wrist or whole foot below the ankle, and blindness means the permanent loss of sight to the extent that visual acuity is 6/60 or less, or to the extent that the visual fi eld is reduced to 20 degrees or less of arc or (b) the person is, as a result of illness or injury, totally unable to perform without the physical assistance of another person any two of the following activities of daily living: dressing the ability to put on and take off clothing toileting the ability to use the toilet, including getting on and off mobility the ability to get in and out of bed and a chair continence the ability to control bowel and bladder function feeding the ability to get food from a plate into the mouth and the person is permanently and irreversibly unable to do so for life or 5

8 Group life insurance 6 (c) all of the following clauses (i), (ii), (iii) and (iv) apply to the person: (i) the person was, on the date of disablement, aged 65 years or less (ii) the person is absent from all work as a result of suffering cardiomyopathy, primary pulmonary hypertension, major head trauma, motor neurone disease, multiple sclerosis, muscular dystrophy, paraplegia, quadriplegia, hemiplegia, diplegia, tetraplegia, dementia and Alzheimer s disease, Parkinson s disease, blindness, loss of speech, loss of hearing, chronic lung disease or severe rheumatoid arthritis (each as defi ned in the Medical defi nitions section on pages 25 to 27) (iii) we consider, on the basis of medical and other evidence satisfactory to us, the person is unlikely ever to be able to engage in any occupation, whether or not for reward, and (iv) the person is likely to be so disabled for life where occupation means an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience. You have a choice of the following two options: Any occupation definition (d) The person: (i) was, immediately before the date of disablement, employed or engaged by the employer on a permanent basis and for at least 15 hours per week (ii) was, on the date of disablement, aged 65 years or less, and (iii) as a result of illness or injury, has been absent from all work for six consecutive months from the date of disablement and we consider, on the basis of medical and other evidence satisfactory to us, that the person is unlikely ever to be able to engage in any occupation, whether or not for reward where occupation means an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience. Own occupation definition (e) The person: (i) was, immediately before the date of disablement, employed or engaged by the employer on a permanent basis and for at least 15 hours per week (ii) was, on the date of disablement, aged 65 years or less, and (iii) as a result of illness or injury, has been absent from all work for six consecutive months from the date of disablement and we consider, on the basis of medical and other evidence satisfactory to us, the person is unlikely ever to be able to engage in any occupation, whether or not for reward where: occupation means: for a professional or a person in senior management, the person s occupation based on the general area of expertise of the person for all others, an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience professional means a person who satisfi es all of the following requirements: has an accredited higher education qualifi cation belongs, or is eligible to belong, to a professional body earns a salary greater than $80,000 per annum, and only works in an offi ce environment and in a sedentary capacity person in senior management means a person who satisfi es all of the following requirements: is part of the senior management of the employer earns a salary greater than $80,000 per annum, and only works in an offi ce environment and in a sedentary capacity accredited higher education qualifi cation means a certifi cate, diploma, degree or other qualifi cation which we accept is a higher education qualifi cation in terms of the guidelines, standards and criteria set down for a qualifi cation having Higher Education Sector Accreditation under the Australian Qualifi cations Framework Australian Qualifi cations Framework means the unifi ed system of national qualifi cations which is monitored by the Australian Qualifi cations Framework Advisory Board established by the Ministerial Council on Education, Employment, Training and Youth Affairs (MCEETYA) or such other system of national qualifi cations acceptable to us. For the purpose of the TPD defi nitions, date of disablement means the later of the date the insured person ceases all work and the date on which a medical practitioner certifi es that the person suffers from the illness or injury that is the principal cause of the TPD. Options You can tailor your group life insurance cover further by selecting from the following options to apply to your plan: Top up accidental death cover option We offer accidental death cover as a low cost option for top up of group life insurance. The top up accidental death cover option, if selected, allows the policy owner to provide insured persons with an additional benefi t should their death result from an accident.

9 Accidental death cover is designed as an additional feature and does not replace the need for suffi cient death cover. It can only be purchased at plan level and will only apply while an insured person s death cover remains in force. We will not pay a benefi t under this option if death does not occur within 120 days of the accident or death is due to suicide, attempt at suicide or intentional self-infl icted injury or infection. Top up accidental death cover restrictions Minimum number in the group Minimum total annual premium for the group Maximum cover 300 insured persons $100,000 Lesser of the amount of insured person s existing death cover and $1,000,000 Guaranteed insurability option The guaranteed insurability option, if selected, allows the policy owner to increase the voluntary cover for any insured person at a later point in time without having to provide any further health evidence. Voluntary cover for an insured person can be increased when: the insured person gets married, or adopts or becomes a natural parent of a child, or the insured person mortgages their home as security for a loan to purchase that home. To increase an insured person s cover under this option, you must provide us with evidence of the relevant event within 60 days after it occurs. This evidence must be satisfactory to us. Under the guaranteed insurability option, the voluntary cover can be increased by up to 25% of the insured person s basic cover or $100,000 or, in the case of a mortgage, the amount of the loan (whichever is less). This option is purchased at plan level and can only be exercised once per insured person. Automatic variation of cover If you select this option, the amount of basic cover for an insured person will automatically increase or decrease during the policy year in line with the insured cover formula which we have agreed to for the insured person. However, an automatic increase will: only occur if our written acceptance is not otherwise required according to the provisions in the policy relating to the automatic acceptance limit and takeover cover, and only apply to the extent that it does not, during a policy year, result in the amount of basic cover of the insured person increasing in total by more than 25% of the amount which applied on the later of the date cover commenced for the insured person and the most recent review date. The premium will be adjusted to take into account the variation in the insured person s basic cover. Own occupation TPD definition We offer an own occupation TPD defi nition for professional and senior managerial staff based on the general area of expertise of the person. To be eligible for this defi nition, an insured person must be a professional or a person in senior management (each as defi ned on page 6). Automatic Acceptance Limits (AALs) We offer competitive Automatic Acceptance Limits based on size of the group and average cover. We have increased our Automatic Acceptance Limits through a two-tiered AAL structure. Cover under the higher AAL will be issued without you providing us with any evidence of health, but that cover will not, to the extent it exceeds the lower AAL, cover pre-existing conditions. This limited cover will apply until the insured person has completed two consecutive years of active employment. After that, the cover will no longer be limited cover. New AALs at a glance AAL Tier 2 Tier 1 No cover for pre-existing conditions Full cover CommInsure s new AAL provides you with higher automatic insurance cover limits. To qualify for, and maintain, automatic acceptance all of the following conditions must be satisfi ed: the plan must have clearly defi ned categories of membership so that an insured person cannot choose the level of cover the plan must have a clearly defi ned method for determining cover for all insured persons there must be at least 50 insured persons at least 75% of all eligible persons must be covered at all times, and for superannuation policies, at least 75% of persons eligible for membership of the superannuation fund are members of the fund and, the fund must be a default fund for the purpose of the Choice of Fund requirements. If a person does not become insured within 120 days (90 days for non-superannuation policies) of becoming an employee or contractor of the employer, we will provide cover up to the AAL without evidence of health. However, this cover will be limited, as it will not cover pre-existing conditions. Also, the cover will not apply for intentional self-infl icted injuries or infections or suicide (but only where the suicide happens within 13 months of the cover commencing). AAL Tier 1 and 2 amounts are both payable for a claim arising from a new event. Only Tier 1 amount is payable for a claim arising from a pre-existing condition. 7

10 Group life insurance Interim cover If: automatic acceptance does not apply, or an insured person s cover exceeds the automatic acceptance limit, or you apply for voluntary cover for an insured person the insured person will need to be underwritten. We offer accidental death cover and (where we have agreed in writing to provide TPD cover for the insured person) accidental TPD cover during the underwriting process. Accidental death cover (and, where applicable, accidental TPD cover) commences on the date we are notifi ed in writing of your request for cover and will end on the earliest of the following: the date that the cover has been accepted on any terms the date that the cover has been declined the date the request for cover is withdrawn the date we cancel the interim accident cover 120 days has expired from the date we are notifi ed of your request for cover. We will only pay a benefi t under interim cover if the death or, if applicable, disablement occurs within 120 days of the accident. The benefi t we pay is the amount of cover requested, but the total amount will not exceed $1,000,000. A benefi t is only payable once under interim cover. Cover expiry age The maximum cover expiry age is 70 for death, terminal illness cover and TPD cover. We may decrease the cover expiry age on your request. Where the TPD cover is not a reducing formula we will, each year, for a minimum of fi ve years, reduce the TPD cover for an insured person in accordance with a method agreed between you and us. A maximum of 50% of the formula benefi t can be paid after age 65. End of cover Cover for an insured person employed or engaged on a permanent basis will end on the earliest of the following: the date any benefi t becomes payable for the insured person under the group life policy (however, death cover may continue where a TPD benefi t is paid in some circumstances see page 4) the insured person reaches the cover expiry age the insured person is no longer an employee or contractor of the employer where applicable, the insured person is no longer a member of the superannuation fund if we agree for you to terminate cover for individual insured persons under the group life policy, the date we receive a written request from you to cancel the insured person s cover or on another date we agree to in writing if the insured person goes on leave without pay and our requirements are satisfi ed (see Leave without pay on page 9), the date on which the insured person has continuously been on leave without pay for twelve months after the leave commenced if the insured person goes on leave without pay and our requirements are not satisfi ed (see Leave without pay on page 9), the date on which such leave commences the date the cover terminates for non-payment of premiums, and the date the policy terminates. Cover for an insured person not employed on a permanent basis will end on the earliest of the following: the date any benefi t becomes payable for the insured person under the group life policy 30 consecutive days have passed since the insured person was last actively performing all the duties of his or her usual occupation with his or her employer the insured person reaches the cover expiry age where applicable, the insured person is no longer a member of the superannuation fund 30 consecutive days have passed since the insured person was last an employee or contractor of the employer if we agree for you to terminate cover for individual insured persons under the group life policy, the date we receive a written request from you to cancel the insured person s cover or on another date we agree to in writing the date the cover terminates for non-payment of premiums, and the date the policy terminates. Continuation option CommInsure s group life insurance offers the insured person the option to continue death cover under an individual policy when their group insurance cover ceases. The following must be satisfi ed for a continuation option to apply: the person is no longer an employee or contractor of the employer and, if applicable, a member of the superannuation fund the person is less than 60 years of age at the time their cover ends under the group life policy the person is, at the time their cover ends under the group life policy, employed or engaged on a permanent basis for at least 15 hours per week no benefi t is, or is about to be, payable for the person under the group life policy and no circumstances exist which, if the subject of a claim under the policy, would result in a benefi t being payable for the person under the policy the group life policy is still in force the premium payable in respect of the person s cover under the group life policy is not overdue at the time that cover ends our minimum policy issue requirements are met 8

11 the person does not join any armed forces (other than the Australian Armed Forces Reserve) before the date the individual policy is issued our underwriting requirements for occupation, residency and pastimes are met we receive the application and correct premium within 60 days of cover ending under the group life policy for that person, and if the person s cover is limited because they did not become insured within 120 days (90 days for non-superannuation policies) of becoming an employee or contractor of the employer, they must have been continuously covered under the group life policy for at least two years at the time their cover ended. This option does not extend to any accidental death cover which applied for the person under the group life policy unless the standard terms of the new individual policy we issue upon the exercise of the option make provision for accidental death cover. The death cover under the individual policy will be issued: at the level of death cover which we have accepted for the insured person under the group life policy at the date cover ended for the insured person under a new individual policy owned by the insured person that provides benefi ts no greater than those provided to the insured person under the group life policy on the terms and at the premium rates current for the individual policy at the time it is issued with any exclusions that applied to the insured person s cover under the group life policy, and without the benefi t of any of the optional features a person can select under the individual policy. Extended cover If an insured person who is eligible to exercise the continuation option: (a) dies, or (b) had Total & Permanent Disablement cover under the group life policy and becomes totally and permanently disabled as a result of an accident within 60 days of their cover ending under the group life policy but before they exercise the continuation option we will pay a death or Total & Permanent Disablement benefi t, as applicable. The amount of the benefi t is the insured cover for the insured person that applied under the group life policy at the date cover ended for the insured person. If an insured person who is employed or engaged on a permanent basis dies within 60 days of their cover ending under the group life policy and at the time of their death: (a) they are not eligible to exercise the continuation option (b) they have not reached the cover expiry age (c) the group life policy is in force, and (d) a benefi t is not payable for them under the group life policy for terminal illness or Total & Permanent Disablement. We will, subject to the conditions of the group life policy, pay a death benefi t provided that, at the time the insured person s cover ended under the policy, the insured person was no longer an employee or contractor of the employer. The amount of the benefi t is the cover for the insured person that applied under the group life policy at the date cover ended for the insured person. Leave without pay An insured person who takes leave without pay will continue to be covered if all of the following requirements are satisfi ed: the insured person is employed or engaged on a permanent basis immediately before they go on leave the insured person s employer approves the period of leave in writing before the insured person goes on leave, and premiums for the cover continue to be paid. The insured person s cover will then cease when they have continuously been on leave without pay for twelve months after the leave commenced or when their cover otherwise ceases under the group life policy. An insured person who takes leave without pay will not continue to be covered if any of the above requirements are not satisfi ed. Worldwide cover During a guarantee period and for 13 weeks after it, cover under the policy will apply on a worldwide basis for all insured persons. After this period, no cover applies outside Australia unless we have previously agreed. In the event of a terminal illness or TPD claim, we require insured persons to return to Australia for medical assessment. We pay the costs of any medical assessment that we may require (see page 21); however, we do not cover the cost of return travel to Australia for such assessment. Please include information about overseas employees at quotation time. For further details, please refer to the Policy Document. Exclusions We will not pay a benefi t for an insured person if his or her death, terminal illness or, if applicable, TPD is directly or indirectly caused by war, including any act of war (whether declared or not), revolution, invasion, rebellion or civil unrest. We will not pay a benefi t for death caused directly or indirectly by a pandemic illness or any other condition which is directly or indirectly caused by, or related to, the pandemic illness, where: we have given you at least 14 days prior notice of the operation of this pandemic illness exclusion, and the death occurs within 30 days of the death cover starting, restarting or increasing (but only the increased benefi t is not payable). A pandemic illness is an illness for which a pandemic alert or similar publication is issued by the Australian Government or the World Health Organisation. 9

12 Group income protection range The CommInsure group income protection range comprises two products: 1. Group Income Protection provides all the basic benefi ts of income protection at an affordable price. It is designed to replace up to 75% of the insured person s regular monthly income (and, if the super monthly benefi t is selected, up to 100% of compulsory employer superannuation contributions) if the insured person is unable to work due to sickness or injury. It is available as a superannuation policy as well as a non-superannuation policy. 2. Group Income Protection Plus is a comprehensive income protection product. In addition to the cover provided under Group Income Protection, it offers a variety of benefi ts and features for added protection. Group Income Protection Plus is only available as a non-superannuation policy. The products in the group income protection range provide you with a monthly payment if an insured person is disabled due to illness or injury for longer than the applicable waiting period. Group income protection range Key features The group income protection range offers: replacement of up to 75% of income while an insured person is disabled due to illness or injury optional additional insurance to cover employer superannuation contributions up to 10% of income your choice of waiting period, benefi t payment period and benefi t formula to meet your requirements a choice of the Group Income Protection policy or, for nonsuperannuation, the enhanced Group Income Protection Plus policy annual Consumer Price Index (CPI) indexation of the monthly benefi t to a maximum of 7.5% at the end of each consecutive twelve month period that disability benefi ts are paid, for benefi t payment period options greater than two years options to reduce your premium, including the any occupation disability defi nition and mental illness limitation. A summary of benefi ts of the group income protection range is shown on page 11. Please also refer to the Policy Document for further details. Non-superannuation Superannuation Group Income Protection Group Income Protection Plus Group Income Protection 10

13 Group income protection range at a glance Group Income Protection Group Income Protection Plus Benefits Total disability benefi t Partial disability benefi t CPI indexation (for benefi t payment periods greater than two years) Waiver of premium during total disability or partial disability Recurrent disability Rehabilitation expense Leave without pay cover Continuation option Extended cover Death benefi t 1 1 Donor elected transplant benefi t 1 1 Crisis benefi t Specifi c injuries benefi t Bed confi nement benefi t Home care benefi t Options Waiting period 14 days, 1 month, 2 months, 3 months, 6 months or 2 years 2 Benefi t payment period 2 years, 5 years or cover expiry age 14 days, 1 month, 2 months, 3 months, 6 months or 2 years 2 2 years, 5 years or cover expiry age Automatic variation of cover Any occupation disability defi nition Super monthly benefi t Mental illness limitation (for benefi t payment periods greater than two years) 1 This benefi t is equal to two months income protection benefi t. 2 This waiting period is only available where the client already has a CommInsure group income policy with a two year benefi t payment period. Eligibility criteria and cover limits Group income protection range Minimum entry age Maximum entry age Maximum cover expiry age Employment requirements Minimum cover Maximum cover Minimum number of insured persons th birthday 60th birthday 65th birthday Minimum annual premium $60,000 A person must be employed or engaged by the employer on a permanent basis for at least 15 hours per week. No minimum cover Up to 85% of an insured person s monthly income (this includes an optional 10% allowance for superannuation contributions), subject to a maximum of $30,000 per month for the two year benefi t payment period or $20,000 for benefi t payment periods greater than two years. 11

14 Group income protection range Employment requirements For cover to apply under a group income protection range policy, an insured person must at all times be employed or engaged on a permanent basis for at least 15 hours per week. If an insured person ceases to satisfy this requirement, their cover will cease. A person is employed or engaged on a permanent basis if they are employed or engaged under a single and ongoing contract that: is of indefi nite duration or is for a fi xed term of no less than twelve months requires the person to perform identifi able duties requires the person to work a regular number of hours each week, and requires the employer to pay superannuation contributions on behalf of the person. Unless takeover cover applies, only an insured person who is in active employment on the date their cover starts will be covered for pre-existing conditions. An insured person who is not in active employment will be covered for pre-existing conditions once they return to active employment for two consecutive months. A person is in active employment if they are employed or engaged by the employer to carry out identifi able duties, are actually performing those duties and, in our opinion, are not restricted by illness or injury from being capable of performing those duties (and the duties of their normal occupation) at least 35 hours per week. Monthly benefit The monthly benefi t you can apply for is up to 75% ( the insured percentage ) of the insured person s monthly income. However, the monthly benefi t we pay will not exceed the lesser of: the monthly benefi t we last agreed to $30,000 (for benefi t payment periods of two years) or $20,000 (for benefi t payment periods of greater than two years), and the monthly benefi t calculated by reference to the insured person s pre-disability income. Pre-disability income is the monthly income the insured person earned working for the employer immediately before becoming disabled. We may reduce the monthly benefi t payable to you by certain benefi t offsets, namely: (a) any income (other than benefi ts received under our group income protection policy) or commutation of income, paid or payable in respect of an insured person as a result of the insured person s illness or injury including: (i) sick leave payments (a reduction is not made if the policy is non-superannuation) (ii) any amounts payable under legislation such as workers compensation or motor accident compensation, and (iii) any benefi ts payable under other income protection insurance policies (b) any income earned by the insured person from personal exertion while disabled, but excluding any such income earned from the employer, and (c) any income which we believe the insured person could reasonably be expected to earn in their occupation while disabled. Any income described in paragraph (a) or (b) which is in the form of a lump sum or is exchanged for a lump sum has a monthly equivalent of 1/60th of the lump sum over a period of 60 months. We also offer an optional super monthly benefi t to cover compulsory employer superannuation contributions. You can apply for a super monthly benefi t of up to 10% of an insured person s monthly income. For more information on the super monthly benefi t, please refer to page 15. We will pay a maximum of $30,000 per month (if a benefi t payment period of two years applies) or $20,000 (if a benefi t payment period greater than two years applies) on account of both the monthly benefi t and any super monthly benefi t. Total or partial disability benefit Total disability benefit The total disability benefi t is the sum of the monthly benefi t and any super monthly benefi t, after benefi t offsets have been made. For details of the benefi t offsets, please refer to the Monthly benefi t section on this page and the Super monthly benefi t section on page 15. For example, if a total disability benefi t becomes payable for an insured person and they have the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 we will pay a benefi t of $3,360 ($3,000 + $360) per month. The total disability benefi t is paid if an insured person is totally disabled after the waiting period has ended. The total disability benefi t can continue until the end of the benefi t period, provided the insured person continues to be totally disabled, but not beyond the cover expiry age. An insured person is totally disabled if, due to illness or injury, they are: unable to perform at least one income producing duty of their own occupation not working in any occupation, whether or not for reward, and under the regular care of, and following the advice of, a medical practitioner. An income producing duty is a duty of the insured person s own occupation that generates at least 20% of the insured person s monthly income. Own occupation means the normal occupation or work carried out by the insured person before becoming disabled. An insured person must be totally disabled for at least 14 out of the fi rst 19 consecutive days of the waiting period to qualify for a total disability benefi t. 12

15 Partial disability benefit If an insured person is partially disabled after the waiting period has ended, we will pay a proportion of the total disability benefi t based on the reduction in the insured person s income. This benefi t is called the partial disability benefi t. The partial disability benefi t can continue until the end of the benefi t payment period, provided the insured person continues to be partially disabled, but not beyond the cover expiry age. An insured person is partially disabled if they are not totally disabled, but because of illness or injury they: have been totally disabled for at least 14 out of the fi rst 19 consecutive days of the waiting period are unable to work in their own occupation at full capacity after becoming totally disabled, because of the illness or injury that caused the total disability are working in their own occupation in a reduced capacity, or working in another occupation are earning a monthly income less than their pre-disability income (as defi ned in Monthly benefi t on page 12), and are under the regular care of, and following the advice of, a medical practitioner. We calculate the partial disability benefi t according to the following formula: Monthly benefi t ( A x monthly benefi t ) + B any partial super monthly benefi t where A is the income the insured person earned working for the employer during the month and B is the insured person s pre-disability income. To illustrate, if the following applies: the insured person suffers a partial disability which results in their pre-disability income reducing from $4,000 to $2,000 per month the insured person s monthly benefi t is $3,000 there is no partial super monthly benefi t, and there are no benefi t offsets we will calculate the partial disability benefi t as follows: $3,000 ( $2,000 x $3,000) $4,000 Partial disability benefi t = $3,000 $1,500 = $1,500 per month When will we stop paying the total or partial disability benefit? The total and partial disability benefi ts are payable monthly in arrears from the end of the waiting period until one of the following happens: (a) the insured person is no longer totally disabled or partially disabled (b) the benefi t payment period ends (c) the insured person dies (d) the insured person reaches the cover expiry age, or (e) if the insured person was employed or engaged under a fi xed term contract at the time of their disability, the expiry of the remaining term of that contract. Waiting period The waiting period is the initial period for which an insured person has to be disabled before a disability benefi t is payable. There are some important aspects of the waiting period that you should understand: You can select from a wide range of options to best suit your needs: we offer 14 days, one month, two months, three months, six months or two years. The two year waiting period option is only available if you already have a group income policy with a two year benefi t payment period. The waiting period starts on the date a medical practitioner examines the insured person and certifi es that he or she is disabled. The insured person must be totally disabled for at least 14 out of the fi rst 19 consecutive days of the waiting period to qualify for a benefi t. The insured person can return to work at full capacity for up to fi ve consecutive days during the waiting period without the waiting period starting again, provided this occurs once only. The days the insured person works are added to the waiting period. Benefit payment period This is the maximum period for which a disability benefi t will be paid in respect of an insured person s disability from any one or related cause. You can choose from two years, fi ve years or to cover expiry age. Indexation If we are paying a disability benefi t for an insured person with a benefi t payment period greater than two years, the monthly benefi t will be increased by the percentage increase in the Consumer Price Index (CPI). This will apply at the end of each consecutive twelve month period for which benefi ts are payable, up to a maximum of 7.5%. Waiver of premium Whilst we are paying a disability benefi t for an insured person, any premium falling due for that insured person from the end of the waiting period will be waived until the disability benefi t is no longer payable. Recurrent disability benefit If an insured person becomes totally or partially disabled again from the same or a related illness or injury within six months of the end of payment of a disability benefi t, a new waiting period will not apply and the disability will be treated as a continuation of the original claim. Rehabilitation expense benefit We will meet rehabilitation expenses for an insured person who is disabled if: we approve the rehabilitation expenses in writing before they are incurred, and 13

16 Group income protection range the expenses are incurred to directly assist the insured person in returning to work in a gainful occupation or in undertaking a vocational retraining program because of their disability. Generally, these expenses will include the cost of a rehabilitation program (other than a rehabilitation program provided for under health insurance legislation) which a medical practitioner certifi es is necessary for the insured person s rehabilitation. We will meet these costs by payment directly to the provider of the applicable service. The maximum amount we will pay in respect of any one disability for the insured person is the lesser of: the expenses, and 24 times the monthly benefi t and any super monthly benefi t less any amounts that can be claimed from any other source for those expenses. This amount will be paid in addition to the disability benefi t and whether or not a disability benefi t is payable. For example, if an insured person undergoes an approved rehabilitation program costing $85,000 and they have the following cover: Monthly benefi t: $3,000 Super monthly benefi t $360 a benefi t of $80,640 (24 x ($3, )) will be paid in the event that the rehabilitation expense benefi t becomes payable. Donor elected transplant benefit If an insured person undergoes, for the fi rst time, a donor elected transplant (as defi ned in the Medical defi nitions section starting on page 25) at least 90 days after cover commenced for the insured person, we will pay a one-off amount equal to two times the total of the monthly benefi t and any super monthly benefi t, even if the insured person is working. This benefi t will end on the earliest of: the benefi t has been paid for two months for the insured person the insured person reaches the cover expiry age, or the insured person dies. To illustrate, if an insured person has the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 and the donor elected transplant benefi t becomes payable, a lump sum benefi t of $6,720 (2 x ($3,000 + $360)) will be paid. This benefi t is only payable once for an insured person. Death benefit If an insured person dies while they are entitled to a total or partial disability benefi t or, for Group Income Protection Plus, a crisis benefi t or a specifi c injuries benefi t, we will pay a one-off amount equal to two times the total of the monthly benefi t and any super monthly benefi t. To illustrate, if an insured person has the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 and a death benefi t becomes payable, a lump sum of $6,720 (2 x ($3, )) will be paid. Options You can tailor your cover further by selecting from the following options to apply to your plan: Any occupation disability definition This option offers a reduction in premiums on the basis that an any occupation disability defi nition applies to a claim after it has been paid for two years. If this option applies we must, for the purpose of determining whether the insured person is totally disabled after the expiration of the two years, be satisfi ed that because of illness or injury the insured person is: (a) unable to perform any occupation for which they are reasonably suited by education, training or experience (b) under the regular care of, and following the advice of, a medical practitioner, and (c) not working in any occupation, whether or not for reward. If this option applies we must, for the purpose of determining whether the insured person is partially disabled after the expiration of the two years, be satisfi ed that because of illness or injury the insured person is: (a) unable to work at full capacity in any occupation for which they are reasonably suited by education, training or experience (b) working in their own occupation in a reduced capacity, or working in another occupation (c) earning a monthly income that is less than their predisability income, and (d) under the regular care of, and following the advice of, a medical practitioner. 14

17 Mental illness limitation This option offers a reduction in premiums on the basis that disability benefi ts payable as a result of mental illness are limited to 24 monthly payments. This option can only be selected if the benefi t payment period of your Income Protection or Income Protection Plus policy is greater than two years. If this option applies and you make a claim for a disability benefi t due to an insured person s mental illness, we will only ever make up to 24 monthly benefi t payments in total in respect of that illness whether or not those payments relate to: (a) the total disability benefi t or the partial disability benefi t (or both) (b) one or more periods of disability, or (c) one or more claims and once 24 such payments are made, no further benefi ts will be payable in respect of that illness or any other mental illness which is directly or indirectly caused by, or related to, that illness. Please refer to the Medical defi nitions section starting on page 25 for the meaning of mental illness. Super monthly benefit This option allows you to cover compulsory employer superannuation contributions for an insured person. If this option applies and an insured person is disabled, we will pay the super monthly benefi t to a regulated superannuation plan. The super monthly benefi t you apply for can be up to 10% ( super insured percentage ) of the insured person s monthly income. However, the super monthly benefi t we pay will not exceed the lesser of: the super monthly benefi t we last agreed to your chosen super insured percentage times the insured person s pre-disability income (as defi ned in the Monthly benefi t section on page 12), and the actual average monthly compulsory employer superannuation entitlement the insured person benefi ted from in the twelve months prior to disability. We may reduce the super monthly benefi t payable by any benefi ts payable under other income protection insurance policies, but only to the extent that the benefi ts are designed to replace in whole or in part the compulsory employer superannuation entitlements from which the insured person would have benefi ted had he or she not been disabled. We will pay a maximum of $30,000 per month (if a benefi t payment period of two years applies) or $20,000 (if a benefi t payment period of greater than two years applies) on account of both the monthly benefi t and any super monthly benefi t. If a regulated superannuation plan does not exist, or cannot accept payment of the super monthly benefi t, for an insured person at the time the benefi t becomes payable, then no benefi t will be paid. Automatic variation of cover If you select this option, the amount of cover for an insured person will automatically increase or decrease during the policy year in line with the insured person s income. However, an automatic increase will: only occur if our written acceptance is not otherwise required according to the provisions in the policy relating to the automatic acceptance limit and takeover cover, and only apply to the extent that it does not, during a policy year, result in the amount of cover of the insured person increasing in total by more than 25% of the amount which applied on the later of the date cover commenced for the insured person and the most recent review date. The premium will be adjusted to take into account the variation in the insured person s cover. Automatic Acceptance Limits (AALs) We offer competitive Automatic Acceptance Limits based on size of the group and average cover. Cover under the AAL will be granted without you providing us with any evidence of health. To qualify for, and maintain, automatic acceptance all of the following conditions must be satisfi ed: the plan must have clearly defi ned categories of membership so that an insured person cannot choose the level of cover the plan must have a clearly defi ned method for determining cover for all insured persons there must be at least 50 insured persons at least 75% of all eligible persons must be covered at all times, and for superannuation policies, at least 75% of persons eligible for membership of the superannuation fund are members of the fund and the fund must be a default fund for the purpose of the Choice of Fund requirements. If a person does not become insured within 120 days (90 days for non-superannuation) of becoming an employee or contractor of the employer, we will provide cover up to the AAL without evidence of health. However, this cover will be limited, as it will not cover pre-existing conditions. Cover expiry age The cover expiry age for our group income protection range is 65. We may decrease the cover expiry age on your request. End of cover Cover for an insured person will end on the earliest of the following: the insured person reaches the cover expiry age the insured person is no longer an employee or contractor of the employer where applicable, the insured person is no longer a member of the superannuation fund if we agree for you to terminate cover for individual insured persons under a group income protection policy, the date we receive a written request from you to cancel the insured person s cover or on another date we agree to in writing 15

18 Group income protection range if the insured person goes on leave without pay and our requirements are not satisfi ed (see Leave without pay on this page), the date on which such leave commences if the insured person goes on leave without pay and our requirements are satisfi ed (see Leave without pay on this page), the date on which the insured person has continuously been on leave without pay for twelve months after the leave commenced the insured person ceases to be employed or engaged on a permanent basis for at least 15 hours per week the insured person joins any armed forces (other than the Australian Armed Forces Reserve) the date the cover terminates for non-payment of premiums, and the date the policy terminates. Continuation option CommInsure s group income protection range offers the insured person the option to continue cover under an individual policy when their group insurance cover ceases. The following must be satisfi ed for a continuation option to apply: the person is no longer an employee or contractor of the employer or, if applicable, a member of the superannuation fund the person is less than 60 years of age at the time their cover ends under the group income protection policy the person is, at the time their cover ends under the group income protection policy, employed or engaged on a permanent basis for at least 15 hours per week no benefi t is, or is about to be, payable for the person under the group income protection policy and no circumstances exist which, if the subject of a claim under the policy, would result in a benefi t being payable for the person under the policy the group income protection policy is still in force the premium payable in respect of the person s cover under the group income protection policy is not overdue at the time that cover ends our minimum policy issue requirements are met the person does not join any armed forces (other than the Australian Armed Forces Reserve) before the date the individual policy is issued our underwriting requirements for occupation, residency and pastimes are met we receive the application and correct premium within 60 days of cover ending under the group income protection policy for that person, and for superannuation policies, if the person s cover is limited because they did not become insured within 120 days (90 days for non-superannuation policies) of becoming an employee or contractor of the employer, they must have been continuously covered under the group income protection policy for at least two years at the time their cover ended. This option does not extend to additional options which applied for the person under the income protection policy unless we agree otherwise. The income protection cover under the individual policy will be issued: under an indemnity styled individual policy owned by the person that provides benefi ts no greater than those provided to the person under the group income protection policy at the level of cover which we have accepted for the person under the group income protection policy at the date cover ended for the person on the terms and at the premium rates current for the individual policy at the time it is issued without the benefi t of any of the optional features a person can select under the individual policy, unless we agree otherwise, and with any exclusions that applied to the person s cover under the group income protection policy. Extended cover If an insured person who is eligible to exercise the continuation option becomes disabled within 60 days of their cover ending under the group income protection policy but before he or she exercises the continuation option, and is disabled immediately after the waiting period has ended, we will pay the disability benefi t subject to the conditions of the group income protection policy. Leave without pay An insured person who takes leave without pay will continue to be covered if all of the following requirements are satisfi ed: the insured person is employed immediately before they go on leave the insured person s employer approves the period of leave in writing before the insured person goes on leave premiums for the cover continue to be paid. The insured person s cover will then cease when they have continuously been on leave without pay for twelve months after the leave commenced or when their cover otherwise ceases under the group income protection policy. If an insured person is on leave without pay at the time he or she is disabled and is covered at that time, benefi t payments will not start until after the insured person s specifi ed return date. An insured person who takes leave without pay will not continue to be covered if any of the above requirements are not satisfi ed. Worldwide cover During a guarantee period and for 13 weeks after it, cover under the policy will apply on a worldwide basis for all insured persons. After this period, no cover applies outside Australia unless we have previously agreed. In the event of an income protection claim, we require the insured person to return to Australia for medical assessment. We pay the costs of any medical assessment that we may 16

19 require (see page 21); however, we do not pay the cost of return travel to Australia for such assessment. Please include information about overseas employees at quotation time. For further details, please refer to the Policy Document. Limitations and exclusions For cover to apply under a group income protection policy, an insured person must be employed on a permanent basis at all times for at least 15 hours per week. If an insured person ceases to satisfy this requirement, their cover will cease. We will not pay a benefi t for an insured person if their illness, injury or medical condition was directly or indirectly caused by: intentional self-infl icted injury or infection or attempt at suicide (whether or not sane at the time) normal and uncomplicated pregnancy or childbirth, including multiple pregnancy, caesarean birth, threatened miscarriage, participation in in-vitro fertilisation or other medically assisted fertilisation techniques and normal discomforts of pregnancy, such as morning sickness, backache, varicose veins, ankle swelling and bladder problems, or war, including any act of war (whether declared or not), revolution, invasion, rebellion or civil unrest. It is against the law for us to make certain payments because of the Health Insurance Act 1973 (Cth) and the National Health Act 1953 (Cth). We will not make a payment under any policy if the payment would cause us to infringe either of these acts. Six months is the maximum time in total we will pay a benefi t for a disabled insured person while they are outside Australia. We will only pay one benefi t at a time even if you are eligible for more than one benefi t. Group Income Protection Plus Group Income Protection Plus is an enhanced product which can be taken instead of Group Income Protection. The additional benefi ts provided by Group Income Protection Plus are set out below. Crisis benefit If an insured person suffers, for the fi rst time, one of the medical conditions set out below at least 90 days after cover commenced for the insured person, we will pay a total of the monthly benefi t and any super monthly benefi t for up to six months (even if the insured person is working). This benefi t will be payable instead of and not in addition to any disability benefi t. This benefi t is paid from the date of the incident; no waiting period applies. This benefi t will not be paid if the bed confi nement benefi t, specifi c injuries benefi t or home care benefi t is payable or has been paid for the insured person. The following medical conditions are covered: paraplegia quadriplegia diplegia hemiplegia tetraplegia cancer stroke heart attack major organ transplant chronic kidney failure coronary artery disease requiring by-pass surgery. Please refer to the Medical defi nitions section starting on page 25 for the meanings of these terms. This benefi t will end on the earliest of: the benefi t has been paid for six months for the insured person the insured person reaches the cover expiry age if the insured person was employed or engaged under a fi xed term contract at the time the crisis benefi t becomes payable, the expiry of that contract, or the insured person dies. To illustrate, if an insured person has the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 and the crisis benefi t becomes payable, a benefi t of up to six monthly benefi t payments of $3,360 ($3,000 + $360) will be paid. This benefi t is only payable once for an insured person. Specific injuries benefit If an insured person suffers one of the following events as a result of an injury that fi rst occurs on or after the start of the insured person s cover, we will pay the monthly benefi t plus any super monthly benefi t for up to the specifi ed payment period, even if the insured person is working. If one injury results in more than one of the following events, we will only pay for the event with the longest payment period. This benefi t will be payable instead of and not in addition to any disability benefi t. This benefi t is paid from the date of the incident; no waiting period applies. This benefi t will not be paid if the donor elected transplant benefi t, bed confi nement benefi t, crisis benefi t or home care benefi t is payable or has been paid for the insured person. This benefi t will only be paid once for an insured person. This benefi t will end on the earliest of: the benefi t has been paid for the payment period for the insured person the insured person reaches the cover expiry age if the insured person was employed or engaged under a fi xed term contract at the time the specifi c injuries benefi t became payable, the expiry of the remaining term of that contract, or the insured person dies. 17

20 Group income protection range To illustrate, if an insured person has the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 and the specifi c injuries benefi t becomes payable for an elbow fracture, a benefi t of two monthly benefi t payments of $3,360 ($3,000 + $360) will be paid. The list of events covered and the payment periods for those events are as follows: Event Payment period Paraplegia 60 months 1 Quadriplegia 60 months 1 Total and permanent loss of use of: Both hands or both feet or sight in both eyes One hand and one foot One hand and sight in one eye One foot and sight in one eye One arm or one leg One hand or one foot or sight in one eye Thumb and index fi nger from the same hand 24 months 24 months 24 months 24 months 18 months 12 months 6 months Fracture requiring a plaster cast or other immobilising device of the following bones: Thigh (shaft) Pelvis (except coccyx) Skull (except bones of the face or nose) Arm, between elbow and shoulder (shaft) Shoulder blade Leg (above the foot) Kneecap Elbow Collarbone Forearm, between wrist and elbow (shaft) 3 months 3 months 2 months 2 months 2 months 2 months 2 months 2 months 1.5 months 1.5 months Bed confinement benefit We will pay the bed confi nement benefi t if an insured person is totally disabled to the extent that they are continuously confi ned to bed for longer than three successive days during the waiting period. A medical practitioner must certify that the insured person requires the continuous full-time care of a registered nurse for more than three days in a row. After the three successive days, we will pay the lesser of $150 and 1/30th of the total of the monthly benefi t and any super monthly benefi t for each successive day that the insured person is confi ned to bed. To illustrate, if an insured person has the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 and a bed confi nement benefi t becomes payable, a benefi t of $112 (($3, ) 30) per day will be paid for up to 30 days. The bed confi nement benefi t will be paid for a maximum of 30 days. This benefi t will end on the earliest of: the insured person is no longer confi ned to bed (in the terms described above) the waiting period ends the benefi t has been paid for 30 days for the insured person if the insured person was employed or engaged under a fi xed term contract at the time the bed confi nement benefi t became payable, the expiry of the remaining term of that contract, or the insured person reaches the cover expiry age. This benefi t will not be paid if the crisis benefi t, specifi c injuries benefi t or home care benefi t is payable or has been paid for the insured person. Home care benefit We will pay a benefi t for up to six months if an insured person is totally disabled and is receiving home care for at least three successive days. Home care is provided by a direct family member: who was in permanent paid work for at least 30 hours per week immediately before the insured person became disabled, and whose income is reduced as a result of caring for the insured person. This benefi t is paid in addition to the disability benefi t. The insured person must not be performing any work, and a medical practitioner must certify that the insured person requires care at home for at least seven hours per day because of his or her disability. A direct family member is an insured person s spouse or de facto spouse, parent or parent-in-law, child or sibling who is aged at least 18 years. 1 If the benefi t payment period is two years, the maximum payment period is 24 months. 18

21 The benefi t each month is the lesser of: $2,000 50% of the total of the monthly benefi t and any super monthly benefi t, and 50% of the amount we consider is the monthly income lost by the direct family member because of providing home care. This benefi t will not be paid if the crisis benefi t, specifi c injury benefi t or bed confi nement benefi t is payable or has been paid for the insured person. To illustrate, if an insured person has the following cover: Monthly benefi t: $3,000 Super monthly benefi t: $360 and the home care benefi t becomes payable where the direct family member s lost monthly income is $2,000, a home care benefi t of up to six monthly payments of $1,000 ($2,000 2) will be paid. In this example, the maximum home care benefi t payable is the lesser of $2,000, $1,680 (being 50% of the monthly benefi t plus the super monthly benefi t) and $1,000 (being 50% of the direct family member s lost monthly income). The benefi t will end on the earliest of: the home care is no longer certifi ed by a medical practitioner as being required the insured person is no longer totally disabled the benefi t has been paid for six months for the insured person if the insured person was employed or engaged under a fi xed term contract at the time the home care became payable, the expiry of that contract, or the insured person reaches the cover expiry age. 19