Your insurance cover. IAG & NRMA Superannuation Plan

Transcription

1 IAG & NRMA Superannuation Plan Your insurance cover The information in this document forms part of the Product Disclosure Statement (PDS) of the IAG & NRMA Superannuation Plan (Plan) dated 30 September September 2017 (V9.0) Factsheet 4 In this factsheet, you ll find information about: zyour category of membership in the Plan...2 zthe insurance cover you receive as a member of the Plan...2 zeligibility for insurance cover and when cover starts...4 zwhat happens if you don t join the Plan when you are first able to?...5 zwhat happens when your salary changes...5 zwhat your insurance cover costs...5 zhow your insured benefits are paid...7 zchanging your insurance cover...10 zwhen your insurance cover stops...10 zyour insurance cover on employer approved unpaid leave...11 zexplanation of insurance terms used in the PDS and this factsheet...11 The level of insurance required to help meet your family s financial needs, if you are unable to work due to illness or injury, or you die, is an important part of effective superannuation planning. The Plan has appointed MLC Limited as insurer for the insured benefits available through the Plan. Like most forms of insurance, conditions and exclusions apply to the insurance cover available through the Plan. While these conditions and exclusions are summarised in this factsheet, the insured benefits are subject to the terms of the insurance policies held by the Trustee. Depending on eligibility and your category of membership, the following benefits are available: zlump sum insurance covering death, terminal illness and total and permanent disability; and zmonthly income protection cover, called salary continuance insurance (SCI). Insurance related terms or expressions used in the PDS and this factsheet are shown in italic and explained at the end of this factsheet please see page 11. Forms referred to in the PDS and this factsheet can be found on the Plan website, or by calling the Plan Helpline on Plan Helpline

2 Your category of membership in the Plan There are five categories of Accumulation members in the Plan. The insured benefits available through the Plan vary depending on your category of membership. Following is an overview of each category: Permanent employee members This category includes permanent employees (and persons appointed on fixed term contracts of three months or more) of a participating employer of the Plan, as long as they have not exercised choice of fund in relation to their employer superannuation contributions. Casual employee members This category includes casual employees (and persons appointed on fixed term contracts of less than three months) of a participating employer of the Plan, from the date that a participating employer of the Plan first makes employer contributions for that person as a member of the Plan, as long as they have not excercised choice of fund in relation to their employer superannuation contributions. The insurance cover you receive as a member of the Plan Table 1 on page 3 provides an overview of the insurance features and standard cover provided through the Plan according to your category of membership. Any insurance cover provided is determined by your eligibility and is subject to insurer acceptance of your cover and the policy terms and conditions. Your eligibility for cover and how and when you are accepted for cover by the insurer is explained on page 4. Claiming an insured benefit If you believe you may be entitled to claim an insured benefit, you must notify the Trustee as soon as possible. The insurer will then advise you of its requirements to assess your claim, which you must provide at your cost. The insurer can require you to undergo vocational assessments, and/or medical examinations with doctors that it chooses, but if these are required, the insurer will meet the cost. Reserved members This category includes members who are no longer employed by a participating employer of the Plan, but who have retained a super account in the Plan. Retained members This category includes employees of a participating employer of the Plan who have exercised choice of fund and have employer contributions made to another superannuation fund, but who have retained a super account in the Plan. Spouse members This category comprises spouses of Plan members who have been admitted as members of the Plan. The participating employers in the Plan are: companies in the Insurance Australia Group (IAG); and National Roads and Motorists Association Limited and its related bodies corporate (NRMA). 2

3 Table 1: Standard cover and insurance options Cover Benefit Standard cover Maximum cover Death (including terminal illness) Funeral Total and permanent disablement (TPD) Salary continuance insurance (SCI) Lump sum. (The benefit on terminal illness represents the early payment of the death benefit insured amount, but it is paid to, or for the benefit of, the member. If the death benefit insured amount is more than the maximum amount payable by the insurer on terminal illness, the death benefit insured amount is reduced by the terminal illness benefit paid.) Lump sum paid to assist with costs arising from your funeral Lump sum on total and permanent disability Monthly income benefit and Monthly superannuation contribution benefit Permanent employee members: Two units¹ of cover. Casual employee members: An age based amount explained on page 4. Reserved members: Based on the level of cover applying immediately prior to ceasing employment with a participating employer. Retained members: Based on the level of cover applying immediately prior to ceasing contributions to the Plan. The insured amount for reserved and retained members reduces each month from age 55 at a uniform rate so that it is nil on the last monthly adjustment date before age 65. Spouse members: Nil (application can be made to the insurer for cover). Permanent employee members: 15,000 Casual employee members: 15,000 Reserved, retained and spouse members: If insurance cover is in place: 15,000 Permanent employee members: Two units¹ of cover. Casual employee members: Nil Reserved members: Based on your cover prior to ceasing employment with a participating employer. Retained members: Based on cover prior to ceasing contributions to the Plan. The insured amount for reserved and retained members reduces each month from age 55 at a uniform rate so that it is nil on the last monthly adjustment date before age 65. Spouse members: Nil (application can be made to the insurer for cover). Permanent employee members: Monthly income benefit 75% 2 of salary Monthly superannuation contribution benefit 10% of salary Waiting period 12 weeks 3 The benefits are payable for a period of up to 2 years. Casual employee members: Nil Reserved and retained members: Nil Spouse members: Nil 10,000,000 (The maximum amount payable on terminal illness is 3,000,000.) Period of cover Up to age 65 15,000 Up to age 75 3,000,000 Up to age 65 50,000 per month (including the Monthly superannuation contribution benefit) Up to age 65 1 Each unit of cover is equal to 5% of salary x years (with complete months counting as fractions of a year) from your current age to age If your annual salary is over 423,529, your SCI benefit will be calculated as 75% of your salary (plus 10% Monthly superannuation contribution benefit) up to 30,000 per month; then 25% of your salary (plus 10% Monthly superannuation contribution benefit) thereafter up to the maximum benefit of 50,000 per month. 3 If you apply for more insurance cover and/or a 4 week waiting period, you won t receive this extra cover or reduced waiting period unless the insurer agrees to provide it and, if so, notifies you in writing. In this notice the insurer will advise the date from which the extra cover and/or reduced waiting period applies. Plan Helpline

4 Casual employee members Casual employee members receive a fixed age based level of death insurance cover only. The amount of cover is based on a member s age at date of death or terminal illness, as shown in Table 2 below: Table 2: Insurance amounts for casual employees Your age Insured amount Insured amount including funeral cover Up to 34 40,000 55, ,000 45, ,000 39, ,000 33, ,000 27, ,000 21, Nil 15, and over Nil Nil Eligibility for insurance cover and when cover starts Permanent employee and casual employee members Unless you exercised your right to choose another superannuation fund for your employer superannuation contributions: zif you are a permanent employee member, you became a member of the Plan when your employment by a participating employer IAG or NRMA started. zif you are a casual employee member, you became a member of the Plan when your participating employer IAG or NRMA first pays employer superannuation contributions to the Plan for you. Your standard insurance cover starts when your Plan membership starts, up to the Plan s automatic acceptance limit. If you are not at work when your standard insurance cover starts, your cover is limited cover. Insurance cover which starts (or re-starts) on or after 1 July 2015 If, when your insurance cover starts (or re-starts), you have ever been paid, or are entitled to be paid, a Prior Benefit, no insured benefit will be paid for a claim arising from the same, or a related, injury or illness as that for which the Prior Benefit was paid or payable. In this clause Prior Benefit means a lump sum total and permanent disablement type benefit, or a lump sum terminal illness type benefit, from any insurer or superannuation fund. Automatic acceptance limits Automatic acceptance limits represent the maximum dollar amount of cover the insurer will provide to you without undertaking an underwriting assessment of your health and other relevant factors. An automatic acceptance limit of 1,250,000 applies to new members in the Plan for death and TPD cover and 20,000 a month for SCI cover. If you are eligible for standard cover above the automatic acceptance limit, then your cover in excess of the automatic acceptance limit is subject to acceptance by the insurer. You will be notified of the insurer s requirements in respect to underwriting this cover. Limited cover If you have limited cover, the insurer will only cover claims arising from: zan illness which first became apparent; or zan injury that first occurred; on or after the date your cover started. Limited cover will continue until you have been at work for 60 consecutive days. From that time, your standard cover will no longer be limited. While you have limited cover, you can apply to the insurer for the limitation to be removed, but this is subject to insurer acceptance. Reserved and retained members If you become a reserved or retained member before age 65, your SCI cover ceases. However, while you remain a member, your death, TPD cover and funeral cover continue at the level applying immediately before you became a reserved or retained member, with the cost of the insured cover being deducted from your super account. The insured amount for your death and TPD cover reduces each month from age 55 at a uniform rate so that it is nil on the last monthly adjustment date before age 65. Your funeral cover continues until age 75. Spouse members The automatic acceptance limit is not available to spouse members who must apply to the insurer for cover. Spouse members can apply for cover at the time of joining the Plan by completing the relevant section of the Application for spouse membership form or can apply for cover (or a change in cover) by subsequently completing the Change of insurance cover Reserved, Retained and Spouse Members form. Cover is subject to insurer acceptance. 4

5 Interim cover If you are eligible and being assessed by the insurer for cover (or for cover above the automatic acceptance limit) then the insurer provides interim cover for the amount of cover that it is assessing. Interim cover starts from the date you fully completed and signed the applicable insurance application form and automatically ends as soon as one of the following happens: zyour application is accepted or declined; or zthe application is withdrawn; or z90 days pass from the date the interim cover commenced; or zyou are no longer eligible for cover, or your cover ceases, under the Plan (please refer to When your cover stops on page 10). Interim cover is provided for an insured event which is caused by illness or accidental injury. Interim cover does not apply to an illness or accidental injury: zcaused by engaging in hazardous pastimes or sports that would not be covered under the insurer s normal assessment guidelines; zthat occurred prior to the date that the member was eligible for cover under the Plan; or zthat first occurred or appeared before interim cover commenced, or for which the person experienced symptoms or received medical advice/treatment before interim cover commenced, unless the person was not aware, or could not reasonably be expected to be aware, of the condition or symptoms. A benefit will not be paid under interim cover if: zthe cover applied for would have been declined by the insurer under its current assessment criteria; or zthe person lodges a claim for an event or condition that would have been excluded under the insurer s normal underwriting criteria. What happens if you don t join the Plan when you re first able to? If you didn t join the Plan when you started working with a participating employer IAG or NRMA because you exercised your right to choose another fund for your employer superannuation contributions, and you elect to join the Plan later, any insurance cover provided will be subject to acceptance by the insurer. If you would like to apply for cover, we will notify you of the insurer s requirements to underwrite your application. What happens when your salary changes If you are a permanent employee member, your insurance cover will generally automatically increase or decrease in line with salary changes up to the automatic acceptance limit. If as a result of your salary changing your cover exceeds the automatic acceptance limit, the cover above the automatic acceptance limit is subject to acceptance by the insurer. We will contact you and explain the insurer s requirements to assess you for cover above the automatic acceptance limit, up to the maximum cover level. What your insurance cover costs The cost of your cover depends on the type of cover that you have and is deducted from your super account periodically. The Plan incurs a number of costs in maintaining insured benefits and managing insurance changes and claims, which are partly recovered by retaining 5% of the premium charged to members (included in the costs set out in Table 3 and Table 4) with the balance paid to the insurer. Death and total and permanent disablement cover The cost of your death and TPD insurance cover is based on your age and amount insured, as follows: Table 3: Cost of death and TPD cover Age next birthday Annual cost per 1,000 amount insured Death and TPD Death only* Age next birthday Annual cost per 1,000 amount insured Death and TPD Death only* n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 6.70 * The Death only rate is used to calculate premiums on funeral benefits. Plan Helpline

6 Salary continuance insurance cover (permanent employee members only) The cost of your SCI cover is based on your age, amount insured and waiting period, as follows: Table 4: Cost of SCI cover Age next birthday Annual cost per 1,000 of annual insured benefit 12 week waiting period 4 week waiting period Age next birthday Annual cost per 1,000 of annual insured benefit 12 week waiting period 4 week waiting period Here s an example of how the cost of insurance is calculated Shane is turning 33 next week and is a permanent employee member and has a salary of 60,000 p.a. If Shane has the standard 2 units of cover for death and TPD, then Shane will be insured for: 10% x 32 (years to age 65) x 60,000 = 192,000 (plus 15,000 funeral cover). The cost of this cover can be calculated by multiplying the amount of Shane s cover by the age based rates for Shane s age next birthday (33) (as shown in Table 3 on page 5). Cost of Shane s death and TPD cover: 192,000 x 0.30 / 1,000 = per year. Cost of Shane s funeral cover: 15,000 x 0.20 / 1,000 = 3.00 per year. Adding these two costs together (57.60 plus 3.00), the total cost for this insurance cover would be per annum. If Shane has a standard waiting period (12 weeks) for SCI cover, then the cost of Shane s SCI cover will be 0.96 per annum for each 1,000 of insured benefit based on Shane s age (33) next birthday (as shown in Table 4 to the left): 0.96 x 85% x 60,000 / 1,000 = per year. The total cost deducted (for death, TPD cover and SCI cover) from Shane s account would be = per year. If Shane has 4 units of death and TPD cover, then Shane will be insured for 20% x 32 (years to age 65) x 60,000 = 384,000 (plus a 15,000 funeral expense benefit). The cost of this cover would be: 384,000 x 0.30 / 1,000 plus 15,000 x 0.20 / 1,000 = per year. If Shane also has a 4 week waiting period for SCI cover, then the cost of Shane s SCI cover will be 2.32 per annum for each 1,000 of insured benefit based on Shane s age (33) next birthday: 2.32 x 85% x 60,000 / 1,000 = per year. The total cost deducted (for death, TPD cover and SCI cover) from Shane s account would then be = per year. What happens if insurance costs are not paid Insurance cover will cease if there is insufficient money in your super account to cover insurance costs. If it appears likely that there will be insufficient money in your super account, the Trustee will endeavour to give you 30 days notice so that you can make additional contributions to prevent your insurance cover ceasing. 6

7 How your insured benefits are paid Death and TPD cover Subject to the terms of the policy, in the event of: zyour death; zthe insurer and the Trustee determining that you are terminally ill; or zthe insurer and the Trustee determining that you are totally and permanently disabled, any insured benefit payable by the insurer will be credited to your super account in the Plan and invested in the Cash investment option. The balance of your super account will continue to be invested in accordance with your most recent selection of investment options (or the MySuper option, if you have not made a selection). Death benefit It s important to think about who you would like to receive your account balance (which will include any insured benefit paid) if you die while a member of the Plan. You have the option of making a: znomination of preferred beneficiaries this is a way to let the Trustee know who you would prefer your death benefit to be paid to, and in what proportions, but it is not binding on the Trustee; or znon-lapsing death benefit nomination the Trustee is bound to follow a valid non-lapsing death benefit nomination to the extent that the nomination is in favour of one or more of your dependants or your legal personal representative. Nomination of preferred beneficiaries You can nominate one or more of your dependants as your preferred beneficiaries or, if you would prefer your benefit to be paid in the way set out in your Will, you can nominate your legal personal representative. You can do this by completing the Nominating your preferred beneficiaries form or, if you are already a member, by updating your beneficiaries on the Plan website While the Trustee will take your nomination of preferred beneficiaries into account, the Trustee does not have to follow your wishes. Unless you make a non-lapsing death benefit nomination, the Trustee has the final say in determining who will receive your death benefit and in which proportions. Non-lapsing death benefit nomination You can make a non-lapsing death benefit nomination in favour of one or more of your dependants or your legal personal representative by completing the Non-lapsing death benefit nomination form and signing and dating it in the presence of two adult witnesses who are not nominated as beneficiaries. If you nominate your legal personal representative, you should ensure that you have a valid, up-to-date Will. The Trustee is bound to act in accordance with a properly completed and signed non-lapsing death benefit nomination. However, if a portion of your death benefit is unable to be paid in accordance with your instructions (because the nominated person died before you, or has ceased to be a dependant) then that portion of your death benefit will be paid to your legal personal representative. Keep your death benefit nominations up-to-date It is important to keep your death benefit nominations up-to-date. You should consider completing a new nomination if your personal circumstances change; for example, if you marry, have children or divorce. The Trustee may only pay your death benefit to your dependant(s) and/or to your legal personal representative. For this purpose, your dependants are: your spouse or de facto spouse (including a same sex partner) your children (including stepchildren, adopted children and children of your de facto spouse) any other person the Trustee considers was financially dependent on you at the time of your death a person with whom you have an interdependency relationship as defined by Government legislation at the time of your death. Generally, two people have an interdependency relationship if they live together, have a close personal relationship and one or each of them provides the other with financial and domestic support as well as personal care. Your death benefit is generally tax free if it is paid to your dependants, except children over age 18 unless they were financially dependent on you when you died. For more information about how tax is applied to your super in the Plan, please see Factsheet 3, Fees, costs, tax and your super available from the Plan website, TPD benefit If you become totally and permanently disabled then your account balance (which will include any insured benefit payable) can be: 1. Paid to you* as a lump sum, after deduction of tax. (Please see Factsheet 3, Fees, costs, tax and your super for more information about how tax is applied to your super in the Plan.) 2. Used to establish an account based pension from the Plan*. (Please refer to the Retirement Income Streams PDS which is available on the Plan website, or call the Plan Helpline on ) 3. Transferred to another superannuation fund. 4. Held in the Plan in a reserved member account. Plan Helpline

8 Until you decide what you want to do, your account balance will remain in the Plan as a reserved member account. As a reserved member you will be able to select the investment option(s) in which your account balance (including the insured benefit) is invested. * If you are eligible for a TPD benefit, in some cases your benefit may need to be preserved in the Plan until you satisfy a condition of release under superannuation laws. For more information about when you can access your super, please see Factsheet 6, Receiving a benefit from your account available from the Plan website, Terminal illness benefit In the event of you becoming terminally ill, you have the same options as for a TPD benefit (as described above), with the exception of any amount that is required to remain in the Plan in order to pay the cost of any residual death cover that exceeds the terminal illness insured benefit paid. Please note that this exception only applies if you have death cover in excess of 3,000,000. Any terminal illness amount paid to you as a cash benefit is tax free. For more information about how tax is applied to your super in the Plan, please see Factsheet 3, Fees, costs, tax and your super available from the Plan website, Salary continuance insurance benefit (permanent employee members only) Subject to the terms of the policy, if the insurer and the Trustee determine that you are suffering a total disability while your SCI cover is in force, and this continues for longer than your waiting period, you will be eligible for a monthly SCI benefit. Your monthly SCI benefit is made up of a monthly income component, which is paid to you as income once PAYG tax is deducted, and a superannuation contribution component, which will be credited to your account in the Plan as an employer contribution. The costs of your SCI cover are waived during the period that a monthly SCI is payable. After a period of at least 14 days total disability, a reduced monthly benefit is payable during a period of partial disability, after you have served your waiting period. The partial disability benefit is calculated as follows: A B x C A Where: A: is your salary (or, if the insurer has not accepted cover above the automatic acceptance limit, your salary at the level at which the automatic acceptance limit (or such higher amount accepted by the insurer) applied.) B: is the greater of: - your income (including any employer superannuation contributions in excess of the standard employer superannuation contributions) while partially disabled, and - the income the insurer assesses you as being capable of earning while partially disabled. C: is your monthly total disability benefit. SCI benefits are paid after the waiting period until one of the following happens: zyou are no longer totally disabled or partially disabled zyou have received payments for 2 years zyou reach age 65 zyou are no longer under the regular and continuous care of, and following the advice and treatment recommended by, your doctor zyou fail to make reasonable efforts to follow or participate in a reasonable rehabilitation plan zthe insurer is not provided with all requested information and other evidence reasonably required to assess your claim zyou are employed under a Visa and it expires, or you permanently depart Australia (whichever is earlier) zyou are accepted by the insurer for a total and permanent disablement (TPD) benefit or terminal illness benefit (subject to having received SCI benefits for at least 3 months) zyou are imprisoned or on remand in a correctional facility. Reduction of SCI benefits Your monthly SCI benefit payments may be reduced by other payments that you are entitled to receive, including: zworkers compensation and similar benefits, but not payments in respect of medical treatment, rehabilitation and permanent impairment or permanent loss of use of a body part zsick leave payments received (however you are not required to use all your sick leave entitlements) zemployer superannuation contributions above the normal standard superannuation contribution zincome benefits under other insurance policies for disability, or zpayments for any claim for past or future economic loss arising from a claim for personal injury. Lump sum payments will be adjusted by the insurer to a monthly equivalent. 8

9 Recurring disability If you return to work after receiving a monthly SCI benefit and become totally disabled or partially disabled again within six months from the same or a related cause while your SCI cover is in force, the insurer will treat the new claim as a continuation of the earlier claim. This means that no waiting period will apply for the new claim, but the benefit will only be payable for the remainder, if any, of the benefit payment period of two years. Exclusions SCI benefits are not payable if your claim arises directly or indirectly from: zany intentional self-inflicted injury or attempted suicide, znormal and uncomplicated pregnancy or childbirth, zwar or warlike operations, zservice in the armed forces (not including service in the Australian Defence Force Reserve) of any country, or serving in an organisation which is involved in, or promotes, armed conflict, terrorism, civil commotion or unrest, or za criminal act committed by you. SCI benefits are only payable if you satisfy a condition of release under superannuation laws. For more information, please see Factsheet 6, Receiving a benefit from your account available from the Plan website, Additional benefit entitlements Under the Plan s SCI Policy, a number of additional benefits may also be paid if a monthly SCI is payable. These benefits are: Rehabilitation expense benefit The insurer (at its discretion) may pay for the cost of an approved rehabilitation program up to a maximum of two years SCI benefit. Workplace modification benefit The insurer (at its discretion) may pay for the cost of modifying your workplace (to facilitate a return to work) up to a maximum of two and half (2.5) times your monthly SCI benefit. Family carer benefit Where a member of your family leaves permanent employment to care for you while you are suffering a total disability and receiving a monthly SCI benefit, the insurer will pay your carer a monthly income calculated the lesser of: z2,000 per month, and zthe amount the insurer estimates your carer would have earned. Payment of this benefit is for a maximum of six months and commences after the waiting period. There are some restrictions on the payment of this benefit and you should confirm your carer s entitlement to this benefit based on their circumstances before they cease employment. Bereavement benefit If you die whilst in receipt of a monthly SCI benefit, the insurer will pay a lump sum amount equal to three times your monthly SCI benefit. Emergency transport benefit If you have an illness or injury that results in your suffering a totally disability then the insurer will reimburse any emergency transport costs that are not recoverable from any other source up to a maximum of 500. Plan Helpline

10 Changing your insurance cover If you are a permanent employee member Within 60 days of joining the Plan (as long as you join when you are first able to do so refer to page 5), you can: zincrease your units of cover (up to 4 units of cover) for death and TPD insurance cover up to the automatic acceptance limit by completing the relevant section of the Membership form; or zreduce your waiting period for the SCI benefit (up to the automatic acceptance limit) from 12 weeks to 4 weeks without the normal application requirements, by completing the relevant section of the Membership form. Otherwise, if you are requesting an increase in your level of death and TPD insurance cover, or to reduce your SCI cover waiting period from 12 weeks to 4 weeks, you will need to complete an Adjusting your insurance cover form. The change is subject to insurer acceptance. You can also use this form to apply to reduce your cover. The cost of insurance cover increases if you obtain higher levels of cover or your SCI cover waiting period reduces to 4 weeks. If you are a reserved, retained or spouse member You can apply to change the level of your death and TPD insurance cover by completing a Change of insurance cover Reserved, Retained and Spouse members form. If you are requesting an increase in your cover, the change is subject to insurer acceptance. Cancelling your insurance cover You can cancel your insurance cover at any time by writing to us with your request. Have your circumstances changed? Don t forget your insurance If your personal circumstances change, it s important to review your insurance cover. This includes getting married, divorced, having or adopting a child or even buying a house. When your insurance cover stops Under the insurance policies issued to the Trustee by the insurer, your death, TPD and funeral cover will cease on the earliest of the following events: (i) your 65th birthday (your 75th birthday for funeral cover) (ii) the date your choice to stop your insurance cover is implemented in the Plan (iii) 60 days after you cease to be a member of the Plan (iv) the date you commence a continuation option (please refer to table below) (v) the date your death or TPD insurance cover is paid (vi) the day before you join the armed forces (not including service in the Australian Defence Force Reserve) of any country, or join an organisation which is involved in, or promotes, armed conflict, terrorism, civil commotion or unrest (vii) the date your account balance in the Plan is insufficient to meet insurance costs. Your SCI cover will cease on the earliest of the following: (i) your 65th birthday (ii) the date your choice to stop your insurance cover is implemented in the Plan (iii) 60 days after you cease to be an permanent employee member of the Plan (iv) the date you commence a continuation option (please refer to table below) (v) the date of your death (vi) the day before you join the armed forces (not including service in the Australian Defence Force Reserve) of any country, or join an organisation which is involved in, or promotes, armed conflict, terrorism, civil commotion or unrest (vii) the date your account balance in the Plan is insufficient to meet insurance costs. Continuation option A continuation option allows you to continue some or all of your insurance cover (with a personal insurance policy issued to you by the insurer) if you leave employment with IAG or NRMA and cease to be a member of the Plan before age 60. You must apply to the insurer under this option within 60 days of your insurance under the Plan ceasing. There are a number of conditions which you must meet before the insurer will provide cover under the continuation option. To enquire about applying for a continuation option please call the Plan Helpline on

11 Your insurance cover on employer approved unpaid leave If you are a permanent employee member and take employer-approved leave without pay, including parental leave, your death, TPD and SCI cover will automatically continue for up to two years during such leave if: zyou remain employed by IAG or NRMA zinsurance costs continue to be deducted from your account in the Plan zyou do not join the armed forces (not including service in the Australian Defence Force Reserve) of any country, or do not join an organisation which is involved in, or promotes, armed conflict, terrorism, civil commotion or unrest zyou do not cancel your cover or your cover does not otherwise cease. The insurer may require advance written notice of your approved unpaid leave, so it is important that you advise the Trustee as soon as your leave without pay is approved. If you take leave without pay which is not approved, your cover stops. In the event of a TPD or SCI claim while you are travelling overseas you may be required to return to Australia at your own expense where necessary for medical treatment and/or insurer assessment. In the case of an SCI claim, if you suffer a total disability during your period of employer approved leave, your benefit will become payable from the later of the end of the waiting period and your nominated date for returning to work. If you cancel your cover, or your cover ceases, you will need to apply for insurance cover on your return to work and your application is subject to insurer acceptance. If you have any questions in relation to cover while you re on leave without pay please call the Plan Helpline on Explanation of insurance terms used in the PDS and this factsheet Accidental injury means an event where bodily injury is caused directly and solely by external and visible means, independent of all other causes. Any occupation means any employment or activity in which you are, or could be, employed with either your existing education, training and experience or with reasonable retraining and re-skilling. At work means you were actively performing, or you were capable of actively performing, all of the duties of your usual occupation for at least 30 hours per week free from any limitation due to illness or injury. Doctor means a registered medical practitioner who, in the insurer s opinion, is qualified in an appropriate specialty and is not you, your spouse or a family member, business partner, employee or employer of you. Illness means a sickness, disease or medical disorder. Important duty means a duty that involves twenty percent (20%) or more of the overall occupation tasks of your own occupation or any occupation as applicable. In the application of the total disability or partial disability definition an important duty will be determined by: zfor the first 12 months after the waiting period, the duties of your own occupation; and zfor any period after you have been in receipt of a monthly benefit for more than 12 months, the duties of any occupation which you are performing or could perform. Own occupation means the normal occupation in which you are employed immediately prior to becoming totally disabled. Partial disability or partially disabled means that immediately following a period of at least 14 consecutive days of total disability and as a direct result of the injury or illness which caused the total disability, you have returned to work in your own or another occupation and are; zcontinuously unable to perform at least one important duty; and zearning less than your salary prior to total disability; and zunder the continuous care and following regular and continuous advice for treatment from a doctor in relation to that illness or injury. Reasonable Rehabilitation Plan means a rehabilitation plan which must be: zconsistent with evidence based best treatment and practice to assist you to regain sufficient functional capability to enable a safe and sustainable return to work; zagreed to by you (and your employer where applicable) and your doctor; zentered into to support your return to work and covers treatment such as physiotherapy, psychology counselling, acupuncture and other best practice treatments for your illness or injury which is causing your claim. If a rehabilitation plan is not provided by your doctor, or if the plan which is provided does not meet the above criteria, it means a reasonable plan proposed by the insurer on specialist medical advice which meets the above criteria. Salary is generally calculated as the total value of your salary package (excluding employer super contributions), as determined by your employer (IAG or NRMA, as applicable) and notified to the Trustee. It includes (as applicable) tool of trade car allowance, regular shift allowance and district allowance, but excludes any other bonus, overtime, commission, incentive, reimbursement of expenses or other special payment (unless so decided in an exceptional case and declared in writing by your employer). Plan Helpline

12 Terminal illness means you suffer an illness which two registered medical practitioners (at least one of whom is a specialist practising in the area related to your illness) have certified, jointly or separately, is likely to result in your death within a period that ends not more than 12 months after the date of the certification and the 12 month period has not yet expired in relation to the certificates. Total and permanent disability and totally and permanently disabled (TPD) There are multiple parts to this definition under the Plan s insurance policy. The parts of the definition that apply to you depend on your category of membership. If you are a permanent employee member or a retained member, you will be assessed under one of parts (a) or (b) or (c) or (d) of the definition, as applicable, and you must also satisfy part (f) of the definition. If you are a reserved member, or spouse member, you will be assessed under one of parts (a) or (b) or (c) or (d) or (e) of the definition, as applicable, and you must also satisfy part (f) of the definition. If you are a casual employee member, you are not eligible for TPD cover. (a) Unable to engage in work You: (i) have been absent from your occupation solely through illness or injury for a period of six consecutive months (ii) have been regularly attending a doctor and undertaking medical treatment reasonably recommended by that doctor with respect to that illness or injury since ceasing work in your occupation solely through illness or injury, and (iii) are incapacitated to such an extent that, in the opinion of the insurer and the Trustee, after consideration of medical and other relevant evidence, you are, at the end of the initial period of six consecutive months absence from your occupation, unable to ever engage in or work (on a full time or part time employment basis) in any occupation for which you are reasonably suited by education, training or experience. For the purposes of part (a) of this definition: medical and other relevant evidence includes, but is not limited to: z the prospect of improvement in your capacity after treatment and rehabilitation that could reasonably be expected to be undertaken by you, and z whether reasonable retraining or re-skilling would render you able to engage in or work (on a full-time or part-time basis) in any occupation for which you are reasonably suited by education, training or experience. part time means engaged in permanent employment for at least 15 hours per week. (b) Specific loss You suffer, as a result of illness or injury: (i) the total and permanent loss of the use of two limbs; or (ii) blindness in both eyes; or (iii) the total and permanent loss 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 field is reduced to 20 degrees or less of arc. (c) Activities of daily living As a result of illness or injury, you are totally unable to perform without physical assistance of another person any two of the following activities of daily living: (i) dressing the ability to put on and take off clothing, (ii) toileting the ability to use the toilet, including getting on and off, (iii) mobility the ability to get in and out of bed and a chair, (iv) continence the ability to control bowel and bladder function, (v) feeding the ability to get food from a plate into your mouth, and you are permanently and irreversibly unable to do so for life. (d) Specific illness All of the following sub-paragraphs (i), (ii), (iii) and (iv) apply to you: (i) you were, on the date of claim, aged 65 years or less; and (ii) you are 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, tertraplegia, dementia, Alzheimer s disease, Parkinson s Disease, blindness, loss of speech, loss of hearing, chronic lung disease or severe rheumatoid arthritis (each as defined in the Medical Condition Definitions on pages 13 and 14 of this factsheet); and (iii) the insurer and the Trustee consider, on the basis of medical and other evidence satisfactory to the insurer and the trustee, that you are unlikely ever to be able to engage in any occupation, whether or not for reward; and (vi) you are likely to be so disabled for life. For the purposes of part (d) of this definition: occupation means an occupation that you can reasonably perform, on a full-time or part-time basis, based on the skills or knowledge you have acquired through previous education, training or experience. part time means engaged in permanent employment for at least 15 hours per week. 12

13 (e) Home duties You have been absent from your occupation solely through injury or illness for a period of six consecutive months and are incapacitated to such an extent that, in the insurer s and the Trustee s opinion after consideration of medical and other relevant evidence, you were, at the end of the period of six consecutive months absence from employment, unlikely to ever again attend to at least two normal physical domestic household duties. For the purposes of part (e) of this definition: normal physical domestic household duties means: (i) cleaning the family home; or (ii) shopping for food and household items; or (iii) meal preparation and laundry services; or (iv) leaving the house without the assistance of another person; or (v) looking after dependent child/children under 16 years of age or in full-time secondary education, where applicable; or (vi) providing full-time care for a disabled person(s) who is a member of your immediate family, where applicable. If you are able to perform the normal physical domestic household duties with the assistance of another person or with the use of assistive devices, you are deemed to be able to perform these duties. You must be under the regular care and attention and following the advice of a doctor for that injury or illness. Evidence that you carried out the duties on a daily basis prior to your period of disability will be required. Total disability or totally disabled means that solely, as a result of illness or injury, you are continuously: znot engaged in any occupation, paid or unpaid; and zunder the care of and following the regular and continuous advice for treatment from a doctor in relation to that illness or injury; and zunable to perform at least one important duty. Waiting period The waiting period is a period of continuous disability during which no total disability or partial disability benefits are paid. The waiting period commences on the day you first get medical advice and are confirmed to be totally disabled by a doctor. If you attempt to return to work during the waiting period, and that proves unsuccessful due to the injury or illness causing the total disability, the original waiting period will continue and be extended by the number of days you worked if: zyour waiting period is 12 weeks and you worked less than 10 days; or zyour waiting period is 4 weeks and you worked less than 5 days. Otherwise, the waiting period will start again. (f) Permanent incapacity You are incapacitated to such an extent that, in the insurer s and the Trustee s opinion (after consideration of medical and other relevant evidence) makes it unlikely that you will engage in work for reward in any occupation for which you are reasonably qualified by education, training or experience. Plan Helpline

14 Medical conditions definitions* 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 14 Condition of impaired ventricular function of variable aetiology (often not determined) resulting in significant physical impairment, i.e. Class 3 on the New York Heart Association classification of cardiac impairment. Primary Pulmonary Hypertension associated with right ventricular enlargement established by cardiac catheterisation resulting in significant permanent physical impairment to the degree of at least Class 3 of the New York Heart Association classification of cardiac impairment. Injury to the head resulting in neurological deficit causing either: za permanent loss of at least 25% whole person function (as defined in the American Medical Association publication Guides to the Evaluation of Permanent Impairment 4th Edition or an equivalent guide to the evaluation of impairment approved by us); or zthe permanent and irreversible inability to perform without the assistance of another person any one of the following activities of daily living: zdressing the ability to put on and take off clothing; ztoileting the ability to use the toilet, including getting on and off; zmobility the ability to get in and out of bed and a chair; zcontinence the ability to control bowel and bladder function; zfeeding the ability to get food from a plate into the mouth; as certified by a consultant neurologist. Motor neurone disease diagnosed by a consultant neurologist. The unequivocal diagnosis of multiple sclerosis as confirmed by a consultant neurologist and characterised by demyelination in the brain and spinal cord evidenced by Magnetic Resonance Imaging or other investigations acceptable to us. There must have been more than one episode of well-defined neurological deficit with persisting neurological abnormalities. The unequivocal diagnosis of muscular dystrophy by a consultant neurologist. The permanent loss of use of both legs or both arms, resulting from spinal cord illness or injury. The permanent loss of use of both arms and both legs resulting from spinal cord illness or injury. The total loss of function of one side of the body due to illness or injury, where such loss of function is permanent. The total loss of function of both sides of the body due to illness or injury where such loss of function is permanent. The total and permanent loss of use of both arms and both legs, together with loss of head movement, due to brain illness or injury or spinal cord illness or injury. Clinical diagnosis of dementia (including Alzheimer s disease) as confirmed by a consultant neurologist, psycho-geriatrician, psychiatrist or geriatrician. The diagnosis must confirm permanent irreversible failure of brain function resulting in significant cognitive impairment for which no other recognisable cause has been identified. Significant cognitive impairment means a deterioration in the person s Mini-Mental State Examination scores to 24 or less and deterioration would continue but for any effective treatment. Dementia related to alcohol, drug abuse or AIDS is excluded. The unequivocal diagnosis of Parkinson s disease by a consultant neurologist where the consultant neurologist confirms that the condition: zis the established cause of two or more of the following: muscular rigidity resting tremor bradykinesia and zhas caused significant progressive physical impairment, likely to continue progressing but for any treatment benefit. The person must be following the advice and treatment of a specialist neurologist. * Terms which are defined in the policy issued by the insurer to the Trustee have the meaning given in the policy and are subject to change. They are reproduced in the PDS and this factsheet only as an indication of the terms on which the insured benefits are provided at the time this factsheet is issued and are not intended to be binding on the Trustee, nor the insurer.