Customer information brochure Group insurance

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1 As a group insurance specialist with a global presence, we can develop tailored and sustainable insurance solutions for your members. Customer information brochure Group insurance Issued by Hannover Life Re of Australasia Ltd Information as of July 2018 Hannover Re 1

2 A strong, reliable partner When you partner with us you'll soon discover you have access to extensive resources, skills and expertise across all areas of our business. Hannover Life Re of Australasia Ltd is one of Australia s largest life insurance providers, covering millions of Australians through a group policy arranged by their superannuation fund or their employer. We take a consultative approach to working with our business partners and always look for innovative and creative solutions that will deliver the highest level of member satisfaction. We re here to look after your most important asset your members. We treat everyone with care and compassion. Hannover Re 2

3 80% of Hannover Re s Life & Health staff operate directly in the local markets. Our focus remains the same as it was when we first started in Australia back in to develop genuine long-term partnerships with our clients and to be someone they can trust. Hannover Life Re of Australasia is a wholly-owned subsidiary of Hannover Re, one of the largest and most financially sound reinsurance groups in the world. Our Hannover Re Group network is present on all continents with around 3,300 employees. Both Hannover Life Re of Australasia and our parent are rated AA- by Standard and Poor s (very strong), with A.M Best awarding Hannover Re a financial strength rating of A+ (superior). These ratings have been consistently stable for more than a decade. Hannover Re 3

4 How we make a difference We pave the way for our clients' success. This brochure offers you an insight into our solutions and services and how our strong collaborative partnership approach will align these to your objectives. Service delivered by an expert team Our team includes some of the industry s most experienced insurance professionals. We have the technical expertise to assist you. Each client will have a dedicated team that will provide open communication and the highest level of service and support. More on page 10 Products the latest innovative thinking As a global leader, we offer clients access to the latest developments and solutions from around the world, tailored to local needs. We constantly enhance our products to ensure cover is sustainable, affordable, accessible and easy to understand - now and in the future. More on page 8 Hannover Re 4

5 Technology information at your fingertips One of our core principles is transparency. The hr Hub allows clients, consultants and administrators to monitor each individual underwriting application or claim from start to finish. More on page 6 Underwriting the easy way Our clients have access to our online Member Application System underwriting tool called hr Maz. Applications can be completed and submitted electronically with decisions provided in real-time. More on page 12 Claims handled fairly and efficiently Our claims philosophy is simple - we assess all claims with fairness and compassion, and pay benefits as quickly as possible. Our goal is to assist members through this difficult time. More on page 15 Hannover Re 5

6 Market leading technology We make doing business easy. With a team that includes some of the industry s most experienced insurance professionals, we have the necessary technical expertise and advanced systems to make things easy. The Hannover Re Hub (hr Hub) Our market leading system allows you to monitor each individual underwriting application or claim from one central point. So when a member asks you a question, they get an answer fast with the latest information. The hr Hub is available 24 hours a day, 7 days a week, and lets you: Initiate new claims & underwriting applications and upload documentation directly into the hr Hub Upload and download claims & underwriting documents Search and view comprehensive case information Track the daily progress of a member s claims or underwriting application Generate and tailor reports Receive electronic reminders via an automated followup process Access new movements and nominate date ranges to review past movements Create personal watch lists to receive automatic s about important cases Download underwriting and claim forms in editable PDF format The hr Hub can be securely accessed at For help, including login details, please us at hubsupport@hlra.com.au Online underwriting Reporting Workflow systems We make doing business easy Claims & underwriting tracking Electronic upload & download via hr Hub Enhanced security & privacy Hannover Re 6

7 We are committed to making ongoing improvements to our technology solutions, including: Upload capabilities to third parties More flexible SLA reporting Reflexive online claims Member direct solutions Trustee specific reporting Enhanced dynamic reporting Expanded functionality Reporting The hr Hub lets clients, consultants and administrators download tailored reports directly from our system, including: Claims summaries, claims status reports and finalised claims reports Underwriting summaries, underwriting status reports and finalised underwriting reports Claims management system (CMS) Our claims management system works behind the scenes allowing for concurrent actions. The system provides: Faster claims processing and turnaround times Improved reporting Live uploading of claim status and information into the hr Hub Electronic claim files Underwriting workflow We utilise an internal end to end underwriting service using our paperless administration system. Workflow is integrated into the hr Hub, our client facing system, which allows our business partners to access to the underwriting status of applications submitted and to track its ongoing progress. Online underwriting member application system (hr Maz) Members are able to complete an underwriting application online and in most cases get an immediate decision. Our member application system hr Maz dramatically simplifies and enhances the underwriting experience, and allows easy tracking and reporting of underwriting applications. hr Maz is also capable of providing automatic updates electronically to your administration system. hr Maz forms part of our integrated underwriting infrastructure. As an internally developed system it is hosted and supported within our office allowing us to provide a fast and responsive service. hr Maz is deployed in a variety of different client environments depending on their business requirements and product design. Hannover Re 7

8 Flexible products We offer a variety of product features that can be tailored to meet your requirements. Here s an overview of possible product features. We have a fully flexible product design approach and all products can be tailored to meet your requirements. We constantly enhance our offering to ensure cover stays sustainable, affordable, accessible and easy to understand - now and in the future. Group Life (GL) Agreed benefit formula Total and permanent disablement Working whilst overseas Employer approved leave Choice of formula Choice of definitions 5 years worldwide cover 2 years Interim accident cover 90 days, up to AUD 1,500,000 Extended cover 60 days Continuation option Within 60 days of ceasing employment, up to AUD 1,000,000 TPD waiting period Minimum entry age Maximum entry age Cover expiry age Minimum cover Maximum cover Minimum annual premium Guarantee period Payment frequency Joint policy discount Voluntary cover Multinational pooling Premium experience rebate 3 months, waived for Immediate Assessment Conditions 15 years of age Prior to the member s 67th birthday Option: 65 or 70 years of age No minimum Unlimited for Death, AUD 3m for TPD and AUD 3m for Terminal Illness AUD 15,000 p/a excluding brokerage, GST and other charges 3 years 2% loading for monthly, half yearly or quarterly 4% discount to the lower of the GL or GIP premium Additional voluntary cover is available Exclusive partner of Swiss Life (approval required) Self-experience is available Hannover Re 8

9 Group Income Protection (GIP) Total disability benefit Choice of definition Partial disability benefit 7 out of 12 consecutive days of Total Disability Benefit indexation Annual increase by the lesser of CPI or 5% Death benefit whilst on claim Recurrent disability benefit Rehabilitation benefit Workplace modification benefit Benefit whilst overseas Premium whilst on claim Working whilst overseas Employer approved leave Interim accident cover Extended cover Continuation option Employer super contribution 3 times the Monthly Benefit Waiting period waived if disability recurs within 6 months No limit on pre-approved rehabilitation benefits No limit on pre-approved workplace modifications 6 months whilst overseas, continuing once in Australia Premium waived whilst receiving Total Disability benefits 5 years worldwide cover 2 years 90 days, up to AUD 15,000 p/m for 24 months 60 days Within 60 days of ceasing employment, up to AUD 30,000 p/m Option: Up to 15% of salary Waiting period Option: 30 days, 60 days or 90 days Benefit period Option: 2 years, 5 years, To Age 60 or To Age 65 Enhanced benefits (non-super) Minimum entry age Maximum entry age Cover expiry age Option: Home Care Benefit, Nursing Care Benefit, Specific Injury Benefit or Medical Catastrophe Benefit 15 years of age Prior to the member s 67th birthday Option: 65 or 70 years of age Minimum cover No minimum Maximum cover AUD 30,000 p/m, with AUD 10,000 p/m between age 65 and 70 Minimum annual premium Guarantee period Payment frequency Joint policy discount Multinational pooling Premium experience rebate AUD 15,000 p/a excluding brokerage, GST and other charges 3 years 2% loading for monthly, half yearly or quarterly 4% discount to the lower of the GL or GIP premium Exclusive partner of Swiss Life (approval required) Self-experience (only when combined with GL) Hannover Re 9

10 Superior service Insurance is built on trust. We ve grown into one of the world s most respected insurers by keeping promises to our clients. We treat everyone with care and compassion. We do things promptly. We go beyond expectations. To us, superior service is a way of life. Administration Telephone enquiry Written correspondence Installation review or annual review 24 hours 5 days 10 days Underwriting Set up of a new application or additional information onto our system Assessment of a new application or additional information Follow up of requirements (occurs from the date we received the application) Reassessment of an application or exclusion 2 days 2 days 10 days 5 days Claims Set up of a new claim or additional information onto our system Assessment of an admitted claim or additional information Follow up of requirements (occurs from the date of our last request) Payments Assessment of a declined claim or reassessment (for TPD claims this occurs from the date the procedural fairness period ends) 24 hours 5 days 20 days 2 days 10 days Our service standards are measured in business days, starting from when all necessary requirements have been received Hannover Re 10

11 Administration We are committed to providing the highest levels of quality service. We pride ourselves on our ability to deliver what we promise, it s the way we do business and it s our culture. New policy To establish a new policy we need: A completed application form including a certificate of attendance. Member data containing name, payroll number, date of birth, gender, state of residence, occupation, membership category, date commenced employment, date joined the policy and the sum insured at the date the policy commenced. The previous insurer s underwriting terms if the policy is transferring to us. This must include all members who have been accepted, declined, restricted, excluded or loaded for cover above the previous insurer s automatic acceptance level, including any forward underwriting level. Payment of the deposit premium by the due date. Details of all members who have been seconded overseas by their employer to work. Annual reviews At each annual review date we need: Member data containing name, payroll number, date of birth, gender, state of residence, occupation, membership category, date commenced employment, date joined the policy and the sum insured at the annual review date. The date cover commenced and level of cover for any new members that joined the policy during the year. The date cover ceased for any members that left the policy during the year. Details of any changes to a member s insurance since the previous annual review. Details of all members who have been seconded overseas by their employer to work. Details of any member who has amended their details since the previous annual review. Keeping us informed You should let us know immediately if: A member exceeds the agreed automatic acceptance limit or forward underwriting limit. This allows us to underwrite and insure the member at the earliest opportunity. A member joins the policy outside of the eligibility or automatic acceptance rules. A member elects any voluntary cover (where available). A member is working overseas or is on employerapproved leave outside the agreed terms. Hannover Re 11

12 How we underwrite Our underwriting philosophy is to keep it simple. We will always assess an application using the information at hand to minimise any inconvenience to members in having to ask for third party medical evidence. How we keep it simple Requesting necessary information up front. Working in partnership with clients, consultants and administrators. Making decisions that optimise both member experience and sustainability. Applying a can-do approach, including how we apply exclusions, loadings or restrictions. Automatic acceptance level The automatic acceptance level (AAL) is the maximum amount of cover a member can receive without having to submit medical evidence. We tailor the AAL for each policy and aim to provide the majority of members with automatic cover to their full entitlement. In most cases we will only need health evidence for cover above the AAL, voluntary cover or where a member joins outside the commencement of cover policy terms. Automatic uplift to the AAL If we increase the AAL then it will apply to all existing members where an AAL currently applies even if they have previously been declined, excluded or loaded for cover above the previous AAL. Any exclusions, premium loading, limitations, special terms, conditions or restrictions will continue to apply above the new AAL. New members New members can generally be covered up to the AAL at standard rates without health evidence if: They satisfy our requirements, including eligibility, and commenced cover on the date they first met those requirements They are at work when their cover commenced. If they do not meet this requirement, then new events cover will apply until the date they have been at work for 30 consecutive days. Insured cover subject to special terms If we offer cover subject to special terms, conditions, restrictions, exclusions or premium loading, the member will be required to accept these terms and cover will commence from the date that their acceptance is received by us, provided that this acceptance is within 28 days of the date of our offer. From the date of our offer, we will provide additional interim accident cover for the lesser of 28 days or the date that the member accepts or refuses this offer. Any exclusions, premium loading, limitations, special terms, conditions or restrictions will apply above the AAL. Unified Healthcare Group (UHG) We have appointed Unified Healthcare Group (UHG) to manage the collection of medical and other evidence for assessing insurance applications. UHG can arrange pathology tests (bloods) and other health screening services at a time and place convenient to the member, including the member s work or home. If requested, the results of the tests can be provided to the member s usual doctor to assist with the overall management of their health. These services are free to you and the member. Hannover Re 12

13 Health evidence for underwriting Our philosophy when underwriting is to offer exclusions and loadings so that we can provide as many members as possible for cover. If an AAL applies, any exclusion or loading will only apply to the portion of cover that was underwritten. The evidence we need for underwriting is shown below. We reserve the right to alter these requirements or ask for any additional information we believe is necessary based on a member s individual circumstances. Group Life & Total and Permanent Disablement To age 44 (current age) Sum insured Up to AUD 2,500,000 AUD 2,500,001 AUD 3,500,000 AUD 3,500,001 AUD 5,000,000 AUD 5,000,001 + Evidence of health + Bloods + GP Medical exam + Bloods + GP Medical exam + Personal Medical Attendants Report (PMAR) + Bloods + GP Medical exam + Personal Medical Attendants Report (PMAR) + Full Blood Count (FBC) + Exercise ECG Death only cover. TPD & Terminal Illness cover is only available to AUD 3,000,000. Group Life & Total and Permanent Disablement Age 45 + Sum insured Up to AUD 1,500,000 AUD 1,500,001 AUD 2,500,000 AUD 2,500,001 AUD 3,500,000 AUD 3,500,001 AUD 5,000,000 AUD 5,000,001 + Evidence of health + Bloods + Bloods + GP Medical exam + Bloods + GP Medical exam + Personal Medical Attendants Report (PMAR) + Bloods + GP Medical exam + Personal Medical Attendants Report (PMAR) + Full Blood Count (FBC) + Exercise ECG Death only cover. TPD & Terminal Illness cover is only available to AUD 3,000,000. Group Income Protection (GIP) Sum insured (per month) Up to AUD 12,000 AUD 12,001 AUD 15,000 AUD 15,001 AUD 20,000 Evidence of health + Bloods + Bloods + Personal Medical Attendants Report (PMAR) AUD 20, Bloods + GP Medical exam + Personal Medical Attendants Report (PMAR) Bloods include: HIV, Hepatitis B & C Serology, Multiple Biochemical Analysis including Liver Function test, Renal Function test, Fasting Glucose test and Lipid profile. All blood test can be taken from one sample. Hannover Re 13

14 Our process for underwriting This map shows our standard process for assessing paper underwriting applications. Please keep in mind a different process applies to online applications through the hr Hub. We can customise our process to meet your specific needs, in response to changing market conditions, new methodologies or for the particular circumstances of an application. Some steps may occur concurrently. Member Policy Owner Hannover Life Re of Australasia Hannover Re 14

15 How we manage claims We recognise it s important to provide assistance throughout the claim journey and to make a decision quickly. Because of this we focus on how best to support the member when they need it most. Fairness and compassion We treat each member with integrity and compassion and we ensure all decisions are fair and reasonable. We achieve this by: Allocating each claim to a dedicated assessor who is responsible from start to finish. Ensuring genuine claims are paid as quickly as possible. Being transparent and communicating openly. Reaching conclusions based on facts and sound reasoning. Helping members get better and return to work safely by providing a range of support services as part of their income protection claim. Working with the member, their doctor and employer to assist with recovery. Establishing agreed times for the delivery of service and reports. Monitoring our assessments with an internal quality verification process. Dedicated claim assessor We allocate each claim to a dedicated claim assessor who is responsible for the claim from start to finish. All claim assessors only have a medium size portfolio to allow them to support the member. To ensure the best chance of positive outcomes being achieved, we triage every claim based on the member s condition before allocating it to the most suitable claims assessor. This ensures the claim assessor has the experience and expertise to support the member throughout the claim process. Ease of the claims process Holistic support with recovery & rehabilitation Dedicated & professional staff Best practice framework Fair decisions with timely payment Proactive & open communication Empathy, sensitivity & transparency Hannover Re 15

16 Direct contact with members Our preference, particularly for income protection claims, is for the claim assessor to have direct contact with the member. We have found this a positive approach that improves the member s experience. All calls direct with the member are recorded to safeguard information. Early intervention We are very supportive of a framework which promotes the early notification of a claim during the waiting period ( Day 1 ) so we can assess the need for rehabilitation and coordinate a return to work strategy, where possible. The assessment of a claim often requires advanced specialist skills based on current medical treatments so we have engaged several external companies to complement our internal claim team s expertise. Our in-house rehabilitation consultants will liaise with specialist rehabilitation service providers who offer highly personalised support and ongoing management to assist the member s recovery. Procedural fairness We are committed to assessing all claims fairly. We will send a procedural fairness letter to you 30 days prior to reaching our decision. The letter will contain details of the evidence we have obtained and should be forwarded immediately to the member. The claim will be re-assessed by the original claims assessor if further information is received. If no additional information is received within 30 days, we will proceed with making a decision and a written report explaining the reason for our decision will be provided to you. Review forum and committee We provide a Claims Review Forum and a Claims Review Committee to ensure any claim dispute is re-assessed thoroughly and independently and that the decision is fair and reasonable. Where you disagree with our decision, we will require a written objection stating the basis of the disagreement and any supporting evidence. The claim will then be reviewed by the original claims assessor and may be referred to our Claims Review Forum. The Claims Review Forum consists of our National Claims Manager and other senior claims assessors. If you are still not satisfied with our decision after our reassessment of the claim you are able to request for the claim be reviewed by the Claims Review Committee. The Claims Review Committee consists of senior management employees from a variety of business units within Hannover Life Re of Australasia. Litigated claims Where defending a matter on your behalf does not prejudice Hannover Life Re of Australasia, we will manage the litigation provided you sign our Indemnity Letter. This service will be provided at our expense. We proudly support SuperFriend SuperFriend is a nationwide initiative aimed at improving the mental health and wellbeing of industry superannuation fund members, employers and staff. For more information visit Hannover Re 16

17 Rehabilitation a smoother road to recovery After lodging a claim the member can access a range of support services to help them get better and return to work safely. While returning to work is not always easy, work is generally good for health and wellbeing and that long-term work absence, work disability and unemployment typically have a negative impact on health and wellbeing. That is why our policy includes an approved rehabilitation benefit where at our discretion we may pay the cost of a program, device or a functional/work conditioning program certified by a doctor or other health professional. There is no maximum limit on the amount of rehabilitation we can provide to a member, subject to our prior approval. Our in-house rehabilitation consultants will liaise with specialist rehabilitation service providers and in consultation with the member, their doctor and the employer to develop positive fully-accredited rehabilitation programs tailored with consideration to all relevant information including medical capacity, education, training and experience. We may also instruct an external provider to assist with liaising with the member and the appropriate medical specialist to agree on a unified medical management program. Our in-house rehabilitation consultants will monitor the member s progress to ensure the rehabilitation plan remains effective and beneficial. Here to assist members. Hannover Re 17

18 Our process for rehabilitation Hannover Re 18

19 The information we need to assess a claim We have standard requirements for assessing claims, some of which may incur a cost. These costs are the member s responsibility, although we will pay for any additional evidence that we request. Initial requirements for all claim types Certified identification that includes the member s age (i.e. driver s licence or passport). Confirmation of membership, application, date of the last premium and agreed benefit. A copy of the member s underwriting application if a previous insurer accepted them for their cover. Any test results or additional medical evidence. The additional requirements depending on the type of claim: Death claim A certified copy of the member s death certificate. If a member dies whilst overseas, we require an English translation of their death certificate, a certified copy of all passport pages and a certified copy of their travel itinerary. Terminal illness benefit (TIB) claim Claim Forms: Member s Statement, GP s Medical Report, Specialist Medical Report with test results. Total and permanent disablement (TPD) claim Claim Forms: Member s Statement, Employer s Statement, Medical Report with test results. If the notification date of the claim to Hannover Life Re of Australasia is more than 18 months after the incident date, we will also require a copy of the member s tax returns since the incident date. Group income protection (GIP) claim Initial GIP Claim Forms: Member s Statement, Employer s Statement, Medical Report with test results. Ongoing GIP Claim Forms: Progress Claim Form (Member s Statement) and Progress Medical Report. We may also require proof of the member s income or income history, including but not limited to the member s full tax returns. Ongoing requirements for group income protection claims Once a GIP claim is accepted, and the first monthly benefit has been paid, the member will need to provide us with a periodical Progress Claim Form and a periodical Progress Medical Report. We may also require additional information. If the member continues to be employed, the employer will remain responsible for any taxation and liaising with the member, unless we agree to another process. If a member is no longer employed, or we have agreed to manage this process, we will calculate any tax to be deducted from the benefit and provide an annual Payment Summary. We will consider liaising directly with them but only if we have received the following information within 90 days from the date they left employment: An original Tax File Number Declaration form available from the ATO website. Section A must be completed by the member and the form returned to us. The member s contact details including address and telephone number. The member s bank account details. The date the benefit is to be paid to the member. Where we are providing a Superannuation Contribution Benefit, all relevant membership and contact details of their fund. We may also require proof of the member s income or income history including, but not limited to, the member s full tax returns. Hannover Re 19

20 How we assess claims The process maps outline our standard guidelines for the assessment of Death, TPD and GIP claims. Some actions may occur concurrently rather than sequentially and we reserve the right to modify these guidelines at any time in light of evolving market conditions, new methodologies or with regard to the particular circumstances surrounding a claim. We are also able to customise our guidelines to meet each client s specific needs. Our process for death claims Member s Representative Policy Owner Hannover Life Re of Australasia Hannover Re 20

21 Our process for TPD claims Member Policy Owner Hannover Life Re of Australasia Hannover Re 21

22 Our process for income protection claims Member Policy Owner Hannover Life Re of Australasia Hannover Re 22

23 Get in touch today Call our group insurance team on Tel Marketing (new business) For business development, quotes, product design or policy document enquiries, please contact: Client Relationships (existing clients) To get in touch with the team responsible for the coordination of services to existing clients, reporting and ongoing relationship management, please contact: Administration If you require assistance with the installation, renewal or ongoing administration of your policy, please contact your dedicated Group Risk Administrator: Underwriting All applications and supporting documents, as well as general questions about an underwriting case, can be sent to: Claims If you need to submit a claim, or if you have a general question about our claim requirements, assessment process or payments, please contact a member of our Claims Administration team: groupclaims@hlra.com.au Hannover Re 23

24 Your global partner We have built an international organisation, with a presence on all continents. Central to our approach is an understanding that each country is unique, with its own legislative framework, culture and business parameters. Support is close at hand from local experts who understand your market and speak your language in more ways than one. And at the same time you can tap into the rich resources, skills and experience available across our cross-border operations. World-wide presence of Hannover Re group Africa Abidjan, Johannesburg The Americas Charlotte, Denver, Hamilton, Mexico-City, New York, Orlando, Toronto Asia Hong Kong, Kuala Lumpur, Manama, Mumbai, Seoul, Shanghai, Taipei, Tokyo Australia Sydney Europe Dublin, Hannover, London, Madrid, Milan, Paris, Stockholm Published by Hannover Life Re of Australasia Ltd ABN Member of the Hannover Re Group Hannover Re 24