Product Update - Sandvik Australia Superannuation Plan

Transcription

1 Product Update - Sandvik Australia Superannuation Plan CHANGES TO INSURANCE 1 JULY 2014 Please read the content of this product update carefully as it contains updated information about the insurance that is available to you, offered through the ANZ Smart Choice Super Colonial Mutual Life Assurance Society Limited (trading as CommInsure) Insurance Guide which forms part of the ANZ Smart Choice Super Employer PDS dated 11 November These changes apply to any new insurance provided to you from 1 July What is changing? There will be changes to the conditions that apply to allow the payment of the following benefits: Terminal Illness; and Total and Permanent Disability. Please see What are the new definitions? below for further details. What is the reason for the changes? From 1 July 2014, changes to the Superannuation Industry (Supervision) Act 1993 (SIS Act) mean that a trustee of a superannuation fund can only provide new insurance cover to members where the insured event is consistent with a relevant SIS Act Condition of Release. These changes mean that the Trustee has updated the insurance policy for your product so that all Total and Permanent Disability (TPD) and Terminal Illness payments are only allowable in the event that the claiming member also satisfies a condition of release. The implication of this is that certain definitions have changed and are shown below. When do the changes apply and who do they apply to? These insurance definition changes apply to all new cover provided to new and existing members from 1 July For an existing member who has continuously held a type of cover (ie: Terminal Illness and TPD) which was established before 1 July 2014, that cover will not be affected by these changes and the member will continue to be covered by and be able to claim under the previous policy terms. Increases to existing cover held as at 30 June are also not impacted by these changes. What are the new definitions? For a Terminal Illness Benefit to be paid, all of the following conditions will apply: the person suffers a sickness; at least two medical practitioners, one of whom specialises in the sickness from which the person suffers, have certified, jointly or separately in writing, that the person will, despite reasonable medical treatment, die from the sickness within a period ( the certification period ) that ends not more than 12 months after the date of the certification; the insurer is satisfied from medical or other evidence that the person will, despite reasonable medical treatment, die from the sickness within the certification period; and, for each of the certificates, the certification period has not ended. anz.com 1

2 The sickness that the person suffers from must occur, and the date of the certification must take place, while the person is insured under the policy. A Medical Practitioner is a person, acceptable to the Insurer, who is registered and practising as a medical practitioner in Australia other than: a. the insured member; b. the insured member s direct family member, including a spouse or partner, parent, sibling or child; c. the insured member s business partner, associate, employer or employee; or d. a person who practises in the same medical centre or clinic as the insured member. For a Total and Permanent Disability Benefit to be paid, the following conditions will apply: A 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; and in the opinion of the insurer, the person is permanently and irreversibly unable to do so for life and we consider, on the basis of medical and other evidence satisfactory to us, the person is unlikely to ever be able to be able to engage in any occupation whether or not for reward where: OR the 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 an arc as certified by an Ophthalmologist. (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: a. dressing the ability to put on and take off clothing; b. toileting the ability to use the toilet, getting on and off; c. mobility the ability to get in and out of bed and a chair; d. continence the ability to control bowel and bladder function; e. feeding the ability to get food from a plate into the mouth; and in the Insurer s opinion, the person is permanently and irreversibly unable to do so for life and the Insurer considers, on the basis of medical and other evidence satisfactory to the Insurer, the person is unlikely to ever be able to engage in any occupation whether or not for reward OR (c) all of the following paragraphs (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 anz.com 2

3 rheumatoid arthritis (each as defined in the Schedule of Medical Condition Definitions set out at the end of the policy); iii. in the Insurer s opinion, on the basis of medical and other evidence satisfactory to the Insurer, the person is unlikely to ever be able to engage in any occupation whether or not for reward; and iv. the person is likely to be so disabled for life; OR (d) the person: i. was immediately before the date of disablement, an employee of the employer on a permanent basis and for at least the minimum hours; ii. iii. was, on the date of disablement, aged 65 years of less; and as a result of illness or injury, has been absent from all work for 6 consecutive months from the date of disablement and the Insurer considers, on the basis of medical and other evidence satisfactory to the Insurer, 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 skills and knowledge the person has acquired through previous education, training or experience. What do I need to do? There is nothing that you need to do, however should you have any questions, or require further information, please: Speak to your financial adviser Call Customer Services on (Option 1), weekdays between 8.30am and 6.30pm (AEST) anzsmartchoice@anz.com This information is current at July 2014 but may be subject to change. This information is issued by OnePath Custodians Pty Limited (ABN , RSE L ). The information is of a general nature and does not take into account an investor's personal needs, financial circumstances or objectives. Before acquiring, disposing or deciding whether to continue to hold the product/s, investors should consider the relevant Product Disclosure Statement (PDS), this information and any other Product Updates which are available at anz.com or by calling Customer Services. anz.com 3

4 ANZ Smart Choice Super Colonial Mutual Life Assurance Society Limited (trading as CommInsure) INSURANCE GUIDE 25 NOVEMBER 2013 Death and Total and Permanent Disablement Cover

5 ANZ Smart Choice Super Entity details in this Insurance Guide Name of legal entity Registered numbers Abbreviated terms used throughout this Guide OnePath MasterFund ABN RSE R SFN Fund OnePath Custodians Pty Limited ABN AFSL RSE L OnePath Custodians, Trustee, us, we, our OnePath Life Limited ABN AFSL OnePath Life The Colonial Mutual Life Assurance Society Limited (trading as CommInsure) ABN AFSL Insurer Australia and New Zealand Banking Group Limited ABN AFSL ANZ Important information When an employer joins ANZ Smart Choice Super, nominated employees become members of the Fund. OnePath Custodians is the Trustee of the Fund and the issuer of this Guide. The issuer is a wholly owned subsidiary of ANZ. ANZ is an authorised deposit taking institution (Bank) under the Banking Act 1959 (Cth). Although the issuer of this product is owned by ANZ, it is not a Bank. Except as described in this Guide, an investment in ANZ Smart Choice Super is not a deposit or other liability of ANZ or its related group companies and none of them stands behind or guarantees the issuer or the capital or performance of the investment. An investment in ANZ Smart Choice Super is subject to investment risk, including possible repayment delays and loss of income and principal invested. The information provided in this Guide is of a general nature and has been prepared without taking into account your objectives, financial situation or needs. Before acting on the advice, you should consider the appropriateness of the advice, having regard to your objectives, financial situation and needs. You should obtain a copy of the PDS for ANZ Smart Choice Super before making any decision about whether to acquire, or continue to hold, the product. You can obtain a copy of the PDS by contacting Customer Services on The Fund is governed by a trust deed (Trust Deed). Together with superannuation law, the Fund s Trust Deed sets out the rules and procedures under which the Fund operates and the Trustee s duties and obligations. If there is any inconsistency between the Trust Deed and the PDS or this Guide, the terms of the Trust Deed prevail. A copy of the Trust Deed is available from the issuer free of charge. The Trustee invests all contributions in a master life policy issued by OnePath Life which then invests in selected investment funds. The master life policy is governed by the Life Insurance Act 1995 and is a contract between the Trustee and OnePath Life. OnePath Life is required to conduct its business in accordance with the law and give priority to the interests of policy holders, invest all of the assets it receives from the Trustee in statutory funds approved by the Australian Prudential Regulation Authority (APRA) and comply with the prescribed capital and solvency standards. OnePath Life is also the administrator of the Fund. If an employer has selected insurance cover as part of ANZ Smart Choice Super, the insurance cover is provided by OnePath Life or another insurer approved by the Trustee. In the case of this Insurance Guide, cover is provided by The Colonial Mutual Life Assurance Society Limited (trading as CommInsure) (Insurer) under group policies issued to the Trustee. In respect of such policies, the Trustee reserves the right to change insurer, or vary the benefits or insurance fee rates from time to time. Where the Insurer imposes loadings or exclusions as a result of the member s health, pastimes or other individual circumstances, the Insurer will write to the Trustee and provide specific details relating to the member s cover. The Trustee will advise the member where this occurs. The Trustee is responsible for the contents of this Insurance Guide. Trustee contact details OnePath Custodians Pty Limited ABN AFSL RSE L Pitt Street Sydney NSW 2000 GPO Box 5107 Sydney NSW 2001 Phone Website anz.com/smartchoice anzsmartchoice@anz.com

6 The following information in this document forms part of the Product Disclosure Statement (PDS) dated 11 November 2013 for ANZ Smart Choice Super. Its purpose is to give you more information and/or specific terms and conditions referred to in the PDS. You should consider all that information before making a decision about ANZ Smart Choice Super. If you invest in ANZ Smart Choice Super, you can access a copy of the PDS and any matter that is applied, adopted or incorporated in the PDS from our website at anz.com/smartchoice. Alternatively, you can request a copy of all information (including this Insurance Guide) free of charge by contacting Customer Services. The information provided in this Insurance Guide is general information only and does not take account of your personal financial situation or needs. You should obtain financial advice tailored to your personal circumstances. The insurance cover outlined in this Guide is provided by The Colonial Mutual Life Assurance Society Limited (trading as CommInsure) under a group policy issued to the Trustee. 2 3 Contents 1. Insurance in ANZ Smart Choice Super 4 2. Insurance cover available 4 3. Eligibility criteria 4 4. Maximum benefit 4 5. When cover commences 5 6. Establishing cover 5 7. Interim Accident Cover 6 8. Benefits 6 9. Insurance risks Insurance fees Exclusions When cover ends Leave of absence Overseas Cover Continuation of cover How to make a claim Duty of disclosure Schedule of medical condition definitions 12

7 Insurance in ANZ Smart Choice Super This Guide has been prepared to provide information about the insurance the Employer has arranged on behalf of their employees who are members of ANZ Smart Choice Super. It explains the benefits provided by the Trustee (policy owner) for those members of ANZ Smart Choice Super who are insured. If the Employer Plan has no insurance, the Welcome Letter will not show an insurance benefit. This Guide outlines, in general terms, all the relevant information, including the types of benefits, risks and claim processes that relate to insurance that the Insurer may provide to members of ANZ Smart Choice Super. Where information is contained in another part of the PDS, this will not be duplicated as part of this Guide. This Guide sets out the terms of such insurance policy and is not a legally binding contract of insurance with the Insurer. Each Policy, Policy Schedule and endorsements to the Policy form the complete terms and conditions between the Insurer and the Trustee. It is important to note that the specific benefits relevant to the plan and members are outlined in the Welcome Letter. If a Welcome Letter has not been provided, please contact Customer Services on To view, manage and consolidate your super, simply register for ANZ Internet Banking and our smartphone app, ANZ gomoney, by calling Customer Services or visiting an ANZ branch. If you are an existing ANZ Internet Banking customer, simply log in and enter your new account number in the Link/Delink a personal account option under Update Details. Any material alteration to the terms and conditions outlined in this Guide will be advised in writing. Insurance cover available The Employer can select Death Only or Death and Total and Permanent Disability (TPD) Cover for their superannuation plan, and has the flexibility to offer different Death Only or Death and TPD benefits to different categories of members. If the Employer does not choose insurance for the Employer Plan or the member s category of membership, insurance cover may still be available while they are a member of the Employer Plan. Further detail on the application process is outlined in this Guide. Members may be able to apply for other insurance options through ANZ Smart Choice Super other than the benefits nominated by the Employer for their category of membership, through the Insurer nominated by the Employer. Further detail on the application process is outlined on page 5 of this Guide. Generally, if a member is eligible for insurance, they will be covered 24 hours a day, 365 days a year, worldwide. In all cases, insurance cover is subject to acceptance and to the terms and conditions of the insurance policy issued by the Insurer. In the event of any inconsistency between the terms and conditions of the insurance policy and this Guide, the relevant policy terms will prevail. The Trustee may change insurers and/or terms (including insurance fee rates) of the insurance cover at any time. Details of the type of insurance cover and the value of cover will be shown on the member s Welcome Letter and subsequent Annual Statements each year, and in writing at other times during the year (where necessary). Eligibility criteria A member can become covered for insurance through ANZ Smart Choice Super (provided the Employer has selected one or more insurance options) if they meet all of the following criteria: are aged less than the benefit expiry age (age 65, unless otherwise indicated in the Welcome Letter) are an employee of the Employer be employed on a Full-time or Permanent Part-time basis satisfy any other eligibility criteria that apply to the plan. Note: Contract and casual employees or employees not working at least 15 hours per week will be limited to Death Only cover. There may be different categories of insured persons under the policy. Further information on eligibility, specific to the category of membership applicable to the member, will be provided in the Welcome Letter issued upon joining ANZ Smart Choice Super. Full-time means a member is performing all the normal duties of his or her Occupation and is working at least 35 hours per week. Part-time means a member is performing all the normal duties of his or her Occupation and is working at least 15 hours per week. Maximum benefit The maximum insurance cover available is: $5 million for Death and Terminal Illness Cover $2 million for TPD Cover. Note: A member s TPD Cover cannot exceed their Death Cover. TPD Cover only is not available.

8 When cover commences The time at which cover commences will vary depending upon the way the Employer has established insurance cover. The differing ways in which insurance can be obtained are explained below. Establishing cover The Employer will set up insurance cover on the member s behalf. Provided the member is eligible for cover, there are two ways insurance cover can be established: automatic acceptance individual member application. Automatic acceptance When the Employer established insurance cover for their plan within ANZ Smart Choice Super, they may have been provided with an Automatic Acceptance Limit (AAL). An AAL is the maximum amount of cover available without the member needing to provide evidence of good health. The Insurer will only agree to provide an AAL where there is a clearly defined, objective criteria chosen by the Employer and agreed by the policy owner and by them (the Insurer). Whether or not the member is eligible for the AAL depends on a number of factors, including but not limited to: joining the plan in accordance with the eligibility criteria being under the age of 65 years on the day they were first eligible for cover being At Work on the date they first satisfy the eligibility criteria satisfying any other terms that apply to the plan. Occupation means an occupation that the member can perform, on a Full-time or Part-time basis, based on the skills and knowledge the member has acquired through previous education, training or experience. The member s Welcome Letter issued upon joining ANZ Smart Choice Super will show the type and amount of cover that applies. If insurance cover is not shown on the Welcome Letter, then insurance cover can be obtained by following the individual member application process below. Individual member application The member will be required to submit an application with the Insurer if: automatic acceptance terms do not apply to the plan the member is not eligible for an AAL they require cover in excess of the AAL. Note: Additional voluntary cover may be available. If so, insurance fees in respect of the additional cover amount will be incurred by the member. Customer Services can be contacted on to obtain further details on how to access additional cover. Insurance cover may also be applied for through OnePath Life for members upon ceasing employment with the Employer. Please refer to the Application for insurance cover in ANZ Smart Choice Super with OnePath Life on page 10 of this Guide. To apply for cover, the member should complete and return the Insurance Application form available from anz.com/smartchoice 4 5 At Work means: (a) the member is actively performing all the duties and work hours of his or her usual Occupation free from any limitation due to illness or injury and is not entitled to or receiving income support benefits from any source including workers compensation benefits, statutory transport accident benefits and disability income benefits, or (b) the member (i) is on employer approved leave for reasons other than illness or injury, and (ii) was on the last working day for the member immediately before he or she commenced the employer approved leave: actively performing all the duties and work hours of his or her usual Occupation free from any limitation due to illness or injury, and not entitled to or receiving income support benefits from any source including workers compensation benefits, statutory transport accident benefits and disability income benefits. A member who does not meet this definition is described as being not At Work. The member will be contacted by Customer Services with any additional evidence that may be required. If the member applies for insurance cover or any variation in cover and the application is assessed and accepted by the Insurer, their cover, or variation in cover, will commence on the date that the application is assessed and accepted by the Insurer. While the application is being processed, the member may be eligible for Interim Accident Cover. For further details please see the next page. Insurance only members If members have chosen to have their super contributions paid to an external superannuation fund but have kept their insurance cover within ANZ Smart Choice Super, they should be aware that their cover will remain in force and insurance fees will continue to be deducted, provided a minimum account balance is maintained. In the event that a minimum balance is not maintained but the Employer has elected cover to continue, it will only apply while the member remains an employee.

9 Interim Accident Cover If an application for Death Only Cover, Death and TPD Cover or an application for an increase in cover is made, the Insurer provides Accidental Death or Accidental Total and Permanent Disablement (TPD) Cover at the same level as the cover applied for, or the difference between the level of increased cover applied for and the current level of cover, up to a maximum benefit level of $1 million. Interim Accident Cover commences from the day an application for cover is received by the Insurer, and continues until the earlier of the following: the date the member withdraws the application for cover the date the Insurer accepts the member s application for cover on standard or special terms the date the Insurer rejects the member s application for the cover the date the Insurer cancels the Interim Accident Cover 120 days from the date the Insurer receives the member s application for cover. There is no separate insurance fee for Interim Accident Cover. In the event that an application is accepted, insurance fees will be charged from the effective date of any cover the insurer approves. If an application for cover is not accepted, no insurance fees will be charged for the period in which Interim Accident Cover was provided. Interim Accident Cover for a member is subject to the same exclusions, limitations, restrictions and claim procedures that apply to the member under the policy. If a claim is made under Interim Accident Cover, the insured person s application for cover is automatically cancelled. Benefits The benefit amount may be different for each type of cover and may depend on various factors, including: the selection(s) made when the Employer established the plan with ANZ Smart Choice Super the member s age whether the member has applied for an increase in cover, and the increase has been accepted, limited or declined whether the amount insured has been reduced by any other amount paid. For example, the Death benefit is reduced by any Terminal Illness Benefit paid in respect of the member any maximum limits which may apply. Note: If a benefit is calculated using the member s salary, the Employer must notify us of all salary changes as they occur. If we are not notified of a change in salary, and no additional insurance fee has been paid, in the event of a claim the Insurer may pay a lower benefit based on the salary previously advised, or the salary at the last review date. Who the benefit is paid to The insurance cover is provided by the Insurer. The insurance policy is issued to the Trustee and cover is offered to members of ANZ Smart Choice Super. Any claims made on the policy must be made through the Trustee as the policy owner. Where the Insurer admits the claim, the insurance benefit proceeds are paid to the Trustee. Where a condition of release is met, the insurance benefit proceeds will be allocated to the member s account. If the Insurer rejects, reduces or defers a claim, the Trustee may reduce the benefit payable to take into account the Insurer s refusal, reduction or deferral. If the Trustee is unable to release a member s benefit, the insurance benefit proceeds will remain in the member s account and paid when a condition of release is met. Until then, the insurance benefit proceeds will be invested in accordance with the member s investment strategy profile. For more information on conditions of release refer to the Additional Information Guide, which forms a part of the PDS. Death Cover The Death Benefit will be paid, by the Insurer, if the member dies: after the Insurer accepts the claim while the policy is in force before the cover ends before the benefit expiry age for the Death Benefit is reached. The benefit amount The Death Benefit is the sum insured (if any) plus the account balance. Refer to the Welcome Letter to find the amount of the Death Benefit and the formula used to determine the Death Benefit. Terminal illness A Terminal Illness Benefit will be paid by the Insurer, if the member becomes terminally ill: after the Insurer accepts the claim while the policy is in force before the cover ends before the benefit expiry age for the Death Benefit is reached. The benefit amount The Terminal Illness Benefit is an advance payment of the Death Benefit, allowing the member to access the benefit upon the member being diagnosed with a terminal illness.

10 A member is regarded as terminally ill when a Medical Practitioner, specialising in the member s illness, certifies in writing that the illness will (despite reasonable medical treatment) lead to the member s death within 12 months of the date of the certification. For this benefit to be paid, the Insurer needs to be satisfied with this evidence; the illness from which the member suffers must occur, the date of certification whilst the member is covered under the policy. Death cover ceases for a member upon payment of the Terminal Illness Benefit. Medical Practitioner means a person, acceptable to the Insurer, who is registered and practising as a Medical Practitioner in Australia, other than the member, the member s spouse or partner, parent, child or sibling or the member s business partner, associate or employee. The Insurer may accept a similarly qualified person who is registered and practising as a Medical Practitioner in another country. Total and Permanent Disablement (TPD) Benefit Total and Permanent Disablement (TPD) Cover is only available where Death Cover is also selected by the Employer. TPD Cover is only available in conjunction with Death Cover and cannot be for an amount greater than the level of the Death Cover. The TPD Benefit (if it applies) will be paid if the member is Totally and Permanently Disabled (refer to definition on this page). The member must have ceased work as a result of the injury or illness giving rise to the total and permanent disablement while the policy is in force and before the first to occur of: the cover ending the member returning to work on a Full-time or Part-time basis the member reaching the benefit expiry age for the TPD Benefit or the Death Benefit, whichever is the earlier the benefit expiry age for the Death Benefit is reached. The member will be requested to provide evidence of their disability to enable us to determine whether or not they qualify for the payment of the TPD benefit. The benefit amount The TPD Benefit is the sum insured (if any) plus the account balance. Refer to the Welcome Letter to find the amount of the TPD Benefit and the formula used to determine the TPD Benefit. The amount of cover is determined as at the Date of Disablement of the member. Additional Death benefit If a TPD benefit is payable in respect of a member and the member dies within 12 months of his or her Total and Permanent Disablement, and the amount of the member s cover for Death exceeds the amount applied for Total and Permanent Disablement, then the Insurer will pay in addition to the benefit payable on the member s Total and Permanent Disablement, a benefit equal to the difference between the TPD Benefit and the Death Benefit. Date of Disablement means the later of the date a Medical Practitioner examines the member and certifies in writing the member suffers an illness or injury that is the principal cause of the member s total and permanent disablement for which the member has made a claim, and the date the member ceases all work. Totally and Permanently Disabled means one of the following applies: (a) the member suffers, as a result of injury or illness: the total and permanent loss of the use of two limbs blindness in both eyes, or 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 the 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. or (b) the member is, as a result of injury or illness, 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 member is permanently and irreversibly unable to do so for life. 6 7

11 or (c) all of the following apply to the member: the member was, on the Date of Disablement, aged 65 years or less the member 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 defined in the Schedule of Medical Condition Definitions set out at the back of this Insurance Guide) the Insurer considers, on the basis of medical and other evidence satisfactory to it the member is unlikely ever to be able to engage in any Occupation, whether or not for reward, and the member is likely to be so disabled for life. or (d) the member: was, immediately before the Date of Disablement, an employee of the Employer on a Permanent basis and for at least the Minimum hours was, on the Date of Disablement aged 65 years or less, and as a result of illness or injury, has been absent from all work for six consecutive months from the Date of Disablement and the Insurer considers, on the basis of medical and other evidence satisfactory to the Insurer, the member is unlikely ever to be able to engage in any Occupation, whether or not for reward. Minimum hours means 15 hours per week or any other number of hours per week the Insurer agrees to in writing. Insurance risks If the Employer has included insurance as part of their superannuation arrangements, under ANZ Smart Choice Super, there are a number of insurance risks members should be aware of: If the insurance fees are not paid to the Insurer within 60 days of the due date, the Insurer may cancel or terminate the insurance cover by written notice to the Trustee. If the Insurer does this, the insurance cover will be terminated effective 60 days after the insurance fee due date and no further insurance cover will be provided to members. Where insurance cover is provided by an insurer other than OnePath Life, the member should be aware that such cover will not automatically continue when they leave the Employer. If members are transferred to an Eligible Rollover Fund (ERF) or the Australian Taxation Office (ATO), their cover will cease (see the Additional Information Guide for more details). The amount or type of insurance cover selected by the Employer may not be sufficient to provide adequate insurance cover in the event of injury or illness. The member s insurance fee or benefit may be adjusted if the member s age is misstated. If a benefit is calculated using the member s salary while they are in the Employer s Plan, we are reliant upon the Employer s notification of any salary changes. Where we are not notified of a change in salary and no additional insurance fee is paid, in the event of a claim the Insurer may pay a lower benefit based on the salary that was previously advised or salary at the last review date. If the member or Employer does not disclose to the Insurer every matter that they know or could reasonably be expected to know, that would be relevant to the Insurer s decision whether to accept the risk of the insurance and if so, on what terms, the Insurer may void the contract within three years of entering into it. If the member s or Employer s non-disclosure is fraudulent, the Insurer may void the contract at any time. Refer to page 11 of this Guide for more details on the duty of disclosure. Insurance fees The insurance fees applicable will depend on a variety of factors including: the type and level of cover the member s age any relevant rating factors applicable to the Employer s Plan the member s health and pastimes (where they apply individually).

12 Insurance fees are calculated annually and are deducted monthly in advance from the member s account balance. The actual insurance fees payable will be advised in the Welcome Letter provided upon joining ANZ Smart Choice Super, and then for each subsequent year in the Annual Statement issued as at 30 June. If the Employer pays insurance fees on the member s behalf, insurance fees will first be deducted from the member s account balance and then a reimbursement into the member s account will occur from the Employer as an employer additional contribution. If a member leaves the Employer prior to the Employer making an insurance fee payment, then the member is liable for the insurance fee incurred. Further, whilst in employment, should the Employer not pay the agreed insurance fee, the member becomes liable for the payment. Insurance fees are subject to variation at any time and members will be provided with the appropriate prior notice before an increase takes effect. Taxes and expenses The insurance fees are inclusive of any: administration fees charged by the Insurer Federal, State or Territory taxes, or other government charges expenses incurred in administering any function required by a Federal, State or Territory government under any legislation in relation to the policy. There is no GST charged on the insurance fees payable for the cover. The Insurer may vary or otherwise adjust any amounts (including but not limited to insurance fees, charges and benefits) under the insurance policies in the manner and to the extent the Insurer determines to be appropriate to take account of the tax. Exclusions War The Insurer will not pay a Death, Terminal Illness or, where applicable, a TPD benefit for a member, if the member s death, terminal illness or Total and Permanent Disablement, is caused directly or indirectly by War, unless the Insurer agrees in writing to specifically provide cover for this event for the member. However, in the event of the member s death, this condition does not exclude the payment of a benefit for a member if they die on War service (as defined in the Life Insurance Act 1995). the death occurs within 30 days of the Death Cover starting, restarting or increasing with the Insurer s written acceptance (but only the increased benefit is not payable). Pandemic Illness means an illness in respect of which a pandemic alert, advisory, notification, declaration or other similar publication is issued by the Australian Government or the World Health Organisation. When cover ends The member s cover will cease, without the member necessarily being notified, on the earliest of the following events: 60 days after the member s account balance is insufficient to meet the cost of insurance fees the date the policy ends the date the member reaches the benefit expiry age (refer to the Welcome Letter) the date any benefit becomes payable for the member under the policy the member is no longer an employee or contractor of the Employer the member departs Australia to work overseas, subject to the conditions outlined under Overseas Cover if the member goes on leave without pay and any of the Leave of absence requirements below are satisfied, the date on which the insured person has continuously been on leave without pay for 12 months after the leave commenced if the member goes on leave without pay and any of the leave without pay requirements are not satisfied, the date on which such leave commences upon the member s request to cancel cover. Leave of absence Insurance cover will continue under the policy when the member takes a period of leave without pay from their Occupation, provided: the member is employed on a Permanent basis immediately before they go on leave without pay the member s Employer approves the period of leave in writing before the member goes on leave, and the applicable insurance fees for the member s cover continues to be paid. 8 9 War includes any act of war (whether declared or not), revolution, invasion, rebellion or civil unrest. Pandemic Illness The Insurer will not pay a benefit for death caused directly or indirectly by a Pandemic Illness or any other condition which is directly to indirectly caused by, or related to, the Pandemic Illness where: the Insurer has given at least 14 days written prior notice of operation of this Pandemic Illness exclusion, and Permanent basis means the member is an employee of the Employer under a contract of employment that: a. is of indefinite duration or a fixed term of more than 12 months b. requires the member to perform identifiable duties c. requires the member to work a regular number of hours each week, and d. requires the Employer to pay superannuation contributions in respect of the member.

13 Overseas Cover Worldwide cover is subject to the member seeking the written consent of the Insurer prior to the member s departure from Australia. In the event of a Terminal Illness or TPD claim, the Insurer may require the member to return to Australia for medical assessment. Payment of any Terminal Illness or TPD benefit is conditional on the member returning to Australia for assessment. The Insurer will generally pay the costs of any medical assessment that may be required. However, this does not include the cost of return travel to Australia for assessment. Please refer to How to make a claim on this page for further information. Continuation of cover Leaving an employer Please refer to When cover ends on page 9, for details of when cover will cease. When the Employer notifies us that the member has ceased employment they will continue to remain in ANZ Smart Choice Super. However, as the Employer Plan s insurance cover is not provided by OnePath Life, insurance cover will not continue upon the member s termination of employment with the Employer. Continuation option If a member ceases to be an employee of the Employer for reasons other than injury or illness, the member may exercise a continuation option with the Insurer. This means the member may apply for an individual Death Only or Death and TPD policy for an amount equal to or less than the Death Only or Death and TPD Benefit that the member was insured for under the Employer Plan. Continuation of cover is not automatic. The member must apply for the new individual policy with the correct insurance fees, within 60 days of leaving service with the Employer. For the continuation option, medical evidence will not be required, provided the member: is under age 60 at the date they left service was employed on a Permanent basis for at least 15 hours per week when they left service was and is not entitled to receive a Death, Terminal Illness or TPD Benefit at the time of applying for the individual policy must not join any armed forces (other than the Australian Armed Forces Reserves) before the date the individual policy is issued. The amount of cover under the policy cannot exceed the benefit entitlement under the Employer Plan. The terms and conditions of the insurance cover under the individual policy may be different to those that apply under this policy. The insurance fee rates may also be higher and will not be deducted from the member s ANZ Smart Choice Super account. Any restrictions, limitations or insurance fee loadings that applied under this policy will apply under the individual policy. Alternatively, members can consider insurance cover with OnePath Life. Application for insurance cover in ANZ Smart Choice Super with OnePath Life Eligible members who have left their employment, but remain members of ANZ Smart Choice Super may apply for one of the following five, cover options: 1. Death Only 2. Death and TPD 3. Income Protection (IP) 4. Death Only and IP 5. Death and TPD and IP. Did you know? You can apply in writing as follows: A member will need to complete the Short Form Personal Health Statement for Death or Death and TPD Cover application up to and including $1 million. A member will need to complete the Full Personal Health Statement for all IP applications and Death and TPD insurance applications in excess of $1 million. OnePath Life will advise the member should additional health evidence be required. Cover does not start until OnePath Life has advised the member in writing that their application has been accepted. All conditions of the insurance cover and the insurance fee rates will be advised upon acceptance. The terms of the cover (including the eligibility conditions) provided under ANZ Smart Choice Super for Death and TPD and IP Cover are set out in the ANZ Smart Choice Super, OnePath Life Insurance Guides. Members should consider the relevant ANZ Smart Choice Super, OnePath Life Insurance Guide before deciding whether to apply for insurance cover with OnePath Life. The Insurance Guides can be accessed at anz.com/smartchoice How to make a claim Hopefully, a claim will never need to be made, but in the event that it does, the process has been made as easy as possible. For more information about making a claim: contact Customer Services on Customer Services at anzsmartchoice@anz.com visit the website at anz.com/smartchoice

14 The Insurer requires the member, Employer or the policy owner to notify them in writing of any claim as soon as it is reasonably practicable to do so. If the Insurer does not receive notice in writing within a reasonable timeframe of the event giving rise to the claim, they may reduce or refuse to pay the benefit to the extent their assessment of the claim is prejudiced. The Insurer will generally send the policy owner or the Employer claim forms as soon as reasonably possible after receiving notice of a claim. The sending of claim forms does not constitute an admission of liability in respect of any claim lodged. Claim forms must be completed as soon as it is reasonably practicable for the member or legal personal representative to do so. The proof the member must provide is at the member s own expense. Payment of the claim is conditional upon the member being under the regular care of, and following the advice and treatment recommended by, the member s Medical Practitioner. When reasonably required by the Insurer (and at their expense), the member may be required to: be examined by a Medical Practitioner nominated by the Insurer who must confirm the condition undergo medical and/or vocational assessment and/or rehabilitation be interviewed agree to an audit of the member s financial circumstances The Insurer generally asks for medical information and evidence to enable the claim to be assessed. If a claim is lodged, the member may be required to be interviewed and attend medical and vocational assessments and rehabilitation with Medical Practitioners and other parties nominated by the Insurer. The member, the Employer and the policy owner are also required to provide the member s eligibility for benefits. For members who are residing or travelling overseas, in the event of a claim the Insurer may require the member to return to Australia for medical treatment and assessment. The Insurer will not pay any costs relating to the member s return to Australia. Payment of the claim For the Insurer to pay a claim, proof, in a form which is subject to their verification, must be provided for all of the following: where the member was accepted (or an increase of the insured benefit was accepted) under automatic acceptance that the member, Employer and the policy owner met all of the Insurer s requirements the member s disability or other entitlement to claim the applicable insured benefit the member s age the member s salary and, if applicable, pre-disability salary any relevant payments during the period in which benefits are payable. Payment of the claim is conditional upon the member, Employer, and the policy owner establishing entitlement with the Insurer by: providing medical reports from treating medical practitioners when reasonably required by the Insurer (and at its expense), being examined by a Medical Practitioner it nominates who must confirm the condition providing pathology, blood tests, x-rays or other appropriate evidence providing any further information the Insurer needs in order to establish the entitlement to a benefit. Duty of disclosure Before members become insured under a contract of life insurance, the Trustee has a duty of disclosure to the Insurer, under the Insurance Contracts Act In order for the Trustee to comply with its duty, the member must disclose every matter that they know, or could be reasonably expected to know that is relevant to the Insurer s decision whether to accept the risk of insurance and, if so, on what terms. This duty of disclosure applies where a member establishes cover under the Individual member application process, and includes changing their insurance cover or applying for new cover. The Trustee s duty, however, does not require disclosure of a matter that: diminishes the risk to be undertaken by the Insurer is of common knowledge the Insurer knows, or in the ordinary course of its business ought to know is waived by the Insurer. This duty of disclosure continues to apply until the Insurer notifies the Trustee in writing that it accepts or declines the cover (or any change in cover) for which the member has applied. Non-disclosure If the duty of disclosure is not complied with and the Insurer would not have provided the insurance cover in respect of the member on any terms if the failure had not occurred, the Insurer may avoid the cover within three years of entering into it. If the non-disclosure is fraudulent, the Insurer may avoid the cover at any time. An insurer who is entitled to avoid insurance cover may, within three years of entering into it, elect not to avoid it but to reduce the sum that the member has been insured for, in accordance with a formula that takes into account the insurance fees that would have been payable if they had disclosed all relevant matters to the Insurer. The duty of disclosure continues until the Insurer accepts (or declines) the member s application and confirmation is issued in writing.

15 Schedule of medical condition definitions Cardiomyopathy Primary pulmonary hypertension Major head trauma 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: a 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 the Insurer), or the permanent and irreversible inability to perform without the assistance of another person any one 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, as certified by a consultant neurologist. Motor neurone disease Multiple sclerosis Muscular dystrophy Paraplegia Quadriplegia Hemiplegia Diplegia Tetraplegia 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 the Insurer. 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.