Plum Super Plum Personal Plan Insurance Guide (eligible family members)

Transcription

1 Plum Super Plum Personal Plan Insurance Guide (eligible family members) Preparation date 30 September 2017 Issued by the Trustee NULIS Nominees (Australia) Limited ABN AFSL The Insurer Insurance is issued by MLC Limited ABN AFSL The Fund MLC Super Fund ABN

2 This guide gives you information about the insurance available through your super. A financial adviser can help you decide if this insurance is right for you. Or, you can assess if you have adequate insurance using our free advice calculator, available when you log in to plum.com.au

3 Contents Your insurance in the Plum Personal Plan 1 Death and TPD cover 2 SCI Cover 5 Cost of insurance 8 The information in this Insurance Guide forms part of the Product Disclosure Statement (PDS) dated 30 September Together with the Investment Menu and Fee Brochure, these documents should be considered before making a final decision to invest. They are available when you log in to plum.com.au

4 Your insurance We offer flexible insurance in the Plum Personal Plan so you can make sure you have the cover that suits your needs MLC Limited (MLC) is the insurer (Insurer) in the Plum Personal Plan. Types of cover You will automatically receive a level of death and total and permanent disablement (TPD) cover when we accept your application to join the Plum Personal Plan, subject to your eligibility. This automatic death and TPD cover is Limited cover for the first 12 months after the date you first become eligible. If you do not meet the eligibility requirements for automatic cover you will only be able to access cover via application and meeting the Insurer underwriting requirements. The following additional cover is also available through the Plum Personal Plan: death cover; TPD cover; and SCI cover to protect your income. Making sure you re eligible for cover You are eligible for automatic death and TPD cover if you: are under age 65; are an Australian resident or are eligible to work in Australia. Limited cover means you are covered for claims arising from: an illness that first become apparent; or an injury which first occurred; on or after the date you first became eligible for cover. Employed means, being engaged in Regular employment for at least 14 hours per week, but does not include being engaged on a temporary or seasonal basis. You can apply for SCI cover if you are working at least 14 hours per week and under age 65. Overriding insurance policy Payment of an insured benefit is subject to the terms and conditions of the applicable insurance policy. This guide provides a summary of the main features of the insurance policy covering the Plum Personal Plan. Other conditions may apply. This guide should not be relied upon as a full and complete description of the terms and conditions of the insurance cover. Your benefit may be reduced if the Insurer refuses or restricts your cover or does not pay out all or part of the insured benefit when a claim is made. Contact us on for a copy of the Plum Personal Plan s insurance policy. Changing your cover You can change or cancel your insurance cover at any time, simply complete the Insurance form Plum Personal Plan. Any request to increase your cover will be subject to health evidence being provided to and accepted by the Insurer. To provide health evidence you will need to complete the personal statement available at plum.com.au or contact us on If we need any further information from you we will let you know. Your new level of cover will commence from the date the Insurer accepts your application. The Insurer may decline or place conditions or restrictions on your insurance cover as result of its assessment of the health evidence you provide. If you cancel your cover your insurance will cease on the day we receive your request. If you decrease or cancel your insurance cover and later change your mind, you can reinstate your insurance, but you will need to provide satisfactory health evidence. About your premium Premiums are deducted monthly by equal instalments from your account balance. Changing your level of cover will change the level of insurance premiums deducted from your account. If the Insurer accepts your request for cover, the insurance premiums will be payable from the date your new level of cover commences. If you reduce your cover we will reduce your premiums from the date we receive your request. If your salary decreases or you cease to be eligible for SCI insurance, you should let us know as soon as possible so we can reduce or cancel your cover and premiums. Premium refunds will not be payable if you have not advised us of information that will reduce your SCI entitlements. Details of premiums are available in the Cost of insurance section in this guide. 1

5 Death and TPD cover Death and TPD cover can help you and your family remain financially secure if the unexpected happens. Death and TPD cover If eligible this cover provides a lump sum benefit to your beneficiaries if you die or to you if you are diagnosed with a terminal illness or suffer total and permanent disablement. Death and TPD insurance cover is based on your age as shown in the table below. It will remain a fixed amount, unless you change it, or you turn 61 for TPD cover. Death cover TPD cover Death cover TPD cover , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,500 97, , , ,000 85, , , ,000 76, , , ,500 68, , , ,000 60, , , ,000 54, , , ,000 48, , , ,500 40, , , ,000 33,000 You can apply for additional death and TPD insurance cover of a fixed dollar amount at any time, up to a maximum insured benefit limit of $5 million for TPD cover. Reduction of TPD cover from age 61 Your TPD cover will reduce after you turn 61 according to the following example: TPD cover amount 60 $50, $40, $30, $20, $10, Nil Example of a death benefit John is aged 30 (31 age ) and his account balance is $60,000. He has death cover of $382,500. John s death benefit would be: Death cover $382,500 Account $60,000 Death benefit $442,500 Example of a TPD benefit John is aged 30 (31 age ) and his account balance is $60,000. He has TPD cover of $400,000. John s TPD benefit would be: TPD cover $400,000 Account $60,000 TPD benefit $460,000 2

6 Additional features of death and TPD insurance Cover while overseas Insurance consolidation Interim accident cover Life events cover Terminal illness benefit If you are an Australian resident your cover will generally continue while you are overseas provided premiums continue to be paid. You may be required by the Insurer to return to Australia at your own expense where necessary for medical treatment or assessment. You can apply to add the insurance from your other super/insurance providers to the insurance you have with us. To do this, go to plum.com.au to access the Transfer your insurance form. If you have an accident and you die or suffer total and permanent disablement while the Insurer is assessing your application for cover the Insurer will pay you a lump sum benefit equal to the amount of death and TPD cover you ve applied for. Accidental TPD cover is subject to a maximum of $2 million, and is payable if you suffer from any of the following conditions as a result of accidental injury: quadriplegia; or major brain injury; or the total and irreversible inability to perform at least two Activities of Daily Living, outlined in the Definition of TPD section of this guide. Interim accident cover will cease on the earliest of; from the date the Insurer receives your fully completed application for cover, or the day your request for cover is withdrawn, approved or declined by the Insurer. You may be able to increase your death or TPD cover without providing medical evidence, if you apply within of one of the following life events occurring: Life event Document required you have or adopt a child. A certified copy of the birth certificate or adopting papers. you get married or divorced. A certified copy of your marriage certificate or divorce papers. you complete your first undergraduate degree A certified copy of the graduation at a government recognised institution. confirmation from the Australian university. you have a child who starts secondary A certified copy of the enrolment school. confirmation from the secondary school. you are granted a home loan on the initial A certified copy of the loan documents from purchase of a principal place of residence the mortgage lender, including the amount of the drawdown loan. home renovation on principal place of A letter from a lender confirming the amount residence of the drawdown loan to cover the cost of the renovation. You can increase your cover by the greater of 25% of your current death or TPD cover and $200,000. The total amount of all life event increases is $1 million. Cover is subject to proof of the event taking place being provided to and accepted by the Insurer. You are able to apply for life events cover once in any 12 month period, and up to three times in total while you remain a member of the Plum Personal Plan. To apply for life events cover you will need to complete the Increase without medical evidence form available at plum.com.au or contact us on The Insurer will pay your insured death cover if you are diagnosed with a Terminal illness, subject to a maximum of $3 million. Where you have an insured death benefit which is higher than $3 million, the difference between $2 million and your insured amount will become your new death cover. Premiums will be required to be paid on the reduced level of insurance cover. You must remain a member of the Fund to maintain the residual death insurance cover. Terminal illness means an illness or injury that, in the opinion of the Insurer, after consideration of medical evidence, including certification by two medical practitioners (at least one of which is a specialist in the relevant area), would reasonably be expected to reduce your life expectancy to not more than 24 months. Your reduced life expectancy must occur while you are covered by the insurance policy and for each of the certificates, the certification period has not ended. 3

7 Definition of TPD You are considered to be totally and permanently disabled if the Insurer is satisfied that at least one of the following options is applicable to you: Employment status Permanently at least 14 hours per week Less than 14 hours per week Definition of TPD (a) You 1. have been absent from your Occupation solely through injury or Illness for six consecutive months, 2. have been regularly attending an appropriately qualified Medical Practitioner and undertaking medical treatment reasonably recommended by an appropriately qualified Medical Practitioner with respect to that injury or Illness since ceasing work in your Occupation solely through injury or Illness, and 3. are incapacitated to such an extent that, in the Insurer s opinion, after consideration of medical and other relevant evidence, you were at the end of the initial period of six consecutive months absence from your Occupation, unable to ever engage in or work in any Occupation on a full-time or part-time basis, for which you re reasonably suited by education, training or experience For the purpose of this definition medical and other relevant evidence includes, but is not limited to: the prospect of improvement in your capacity after treatment and rehabilitation that could reasonably be expected to be undertaken by you, and whether reasonable retraining or reskilling would render you able to engage in or work in any Occupation on a full-time or part-time basis (b) You have been absent from your occupation solely through Injury or Illness for six consecutive months and after which time you have, in the Insurer s opinion after consideration of all evidence obtained, suffered a total and irreversible inability to perform at least two of the Activities of Daily Living without the physical help of someone else. These activities include: bathing and/or showering; or dressing; or moving from place to place including in and out of bed and in and out of a chair; or eating or drinking; or using the toilet. OR (c) Where your occupation is classified as home duties, having been incapacitated through injury or Illness for six consecutive months and after which time you are rendered, in the insurer s opinion, after consideration of all evidence obtained, permanently unable to do any normal physical domestic 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 disability will be required. Additional definitions Illness Injury Medical Practitioner Occupation means a sickness, disease or disorder. means bodily injury. means a registered Medical Practitioner who is qualified in an appropriate specialty in the Insurer s opinion. This can t be you, your spouse or a family member, business partner, employee or employer. means the employment or activity in which the Member is principally employed. 4

8 SCI cover SCI cover protects your income while you are temporarily unable to work due to illness or injury. SCI cover SCI cover is available to you through the Plan if you are a permanently working at least 14 hours per week and you are under age 65, subject to health evidence being provided to and accepted by the insurer. SCI cover provides you with a replacement income of up to: The lesser of: your SCI insured cover, or 75% of your actual salary at date of claim subject to to a maximum of $50,000 per month. This is paid monthly in arrears while you are totally disabled for up to your nominated benefit period following the end of your nominated waiting period. You can select your SCI cover from the options below: Waiting period Benefit period 30, 60 or 2 years 30, 60, 90 or 180 days 5 years 30, 60, 90 or 180 days To age 65 Your nominated waiting period commences from the date you re disabled by an injury or illness. It is important that you regularly review your SCI cover to ensure it is aligned with your salary. You may be paying premiums for higher cover than you are eligible to claim. Any increase in your SCI cover or changes to your waiting period or benefit period will be subject to health evidence being provided to and accepted by the Insurer, including if you reduce your cover and subsequently reinstate it. Example of a SCI benefit From our earlier example, John has an insured salary of $55,000 p.a. If John were to become totally and temporarily disabled, his insured benefit would be: 75% x $55,000 = $41,250 p.a. ($3, per month) less John s applicable rate of pay as you go (PAYG) tax. Claiming SCI You are considered to be totally and temporarily disabled (and therefore eligible to apply for a SCI benefit) if after your nominated waiting period the Insurer is satisfied that because of Injury or Illness you are continuously: unable to perform your own occupation; and not otherwise gainfully employed or engaged in any gainful business or activity. Own occupation means the employment in which you are principally employed, where employment means being engaged in regular permanent employment for at least 15 hours per week not including temporary or seasonal basis employment. Financial evidence will be required to confirm your salary and other benefit entitlements at the time of a claim. Your maximum monthly benefit will be based on your income at the date of your disablement. We won t pay more than your insured amount received. The monthly SCI benefit payable will be the lesser of: the monthly benefit for which premiums have been paid for; and 75% of your salary at the time of disablement. When will benefits be reduced? Your SCI benefit will be reduced proportionately by benefits received or amounts that you are expected to receive from other sources, so that your total benefit does not exceed 75% of your insured annual salary (as applicable). Therefore, any benefits you may be entitled to from other sources such as (but not limited to) other disability benefits, workers compensation, or other compensation benefits will be considered when determining the amount of your SCI benefit. When won t a SCI benefit be paid? Benefits are not payable if your disability or loss arises directly or indirectly from: any intentional self-inflicted injury or any attempt to commit suicide; normal and uncomplicated pregnancy or childbirth; service in the armed forces; war or warlike operations; or any other event or matter referred to in the insurance policy. When do SCI payments cease? If payable, your benefit will continue until the earliest of the following: the date your disability ceases; the date you turn 65; you are no longer under the care of a doctor; nominated benefit payments have been made for your benefit period; the date of your death; you fail to provide all requested information reasonably required to continue your claim; or you make a fraudulent claim. 5

9 Additional features of SCI insurance Bereavement benefit Cover while overseas Interim accident cover Partial disability benefit Payable on your death during receipt of a SCI benefit. This benefit will be paid as a lump sum amount equivalent to two times your monthly benefit from the date of your death, subject to the expiry of your nominated benefit period. Your cover will generally continue while you are overseas provided premiums continue to be paid. Your benefit will only be provided in full for the countries listed below*. For other countries SCI benefits will be paid for up to 12 months only, unless you return to Australia. *Countries allowed: Hong Kong, New Zealand, Singapore, Japan, Switzerland, Belgium, Denmark, France, Germany, Italy, Netherlands, Sweden, the United Kingdom, the United States of America, Canada, or any other country agreed in writing. You may be required by the Insurer to return to Australia at your own expense where necessary for medical treatment or assessment. If you have an accident and suffer temporary disablement while the Insurer is assessing your application for SCI cover the Insurer will pay your monthly benefit, subject to a limit of $10,000 per month. Interim accident cover will commence from the date the Insurer receives a fully completed personal statement and declaration of health from you. Interim accident cover will cease on the earliest of; from the date the Insurer receives your fully completed application, or the day your request for cover is withdrawn, approved or declined by the Insurer. You may be considered partially disabled when, after your waiting period has ended and following a period of at least 14 days of total disability, you are only capable of returning to work on a partial basis at reduced earnings. Your partial benefit is calculated as follows: Recurring disability benefit A B x C A where: A is your earned monthly income, up to your insured benefit, immediately prior to becoming totally disabled; B is the actual monthly income earned by you during the month in which you became partially disabled; and C is your insured monthly benefit. This benefit will be payable for up to the maximum benefit period you nominated while you remain partially disabled. If you were paid a SCI benefit and your disability from the same or a related illness or injury recurs within six months of your return to full time work, we will waive your waiting period and treat your disability as a continuation of the original disability. Benefits will be payable for up to the remainder of your nominated benefit period while you remain disabled. 6

10 Additional features of SCI insurance Rehabilitation expenses benefit Waiver of premiums When might you need to provide health evidence? You may, in certain circumstances, be required to provide health evidence to the Insurer, including: if you apply for cover or apply to increase your cover; if you cease to be a member of the Plum Personal Plan and then subsequently re-join the Plum Personal Plan and apply for cover; if your insured amount is reduced to nil for a period of time, and later reinstated; if you change your SCI waiting and benefit period; or any other circumstances outlined in the policy. We will advise you if health evidence is required. This may be in the form of a personal medical statement and/or various medical examinations as required. The Insurer may decline or place conditions or restrictions on your insurance cover as a result of this medical evidence. Your sum insured could be reduced or a benefit declined by the Insurer if you provide inadequate medical evidence or false or misleading information to the Insurer. Whilst you are suffering a disability the Insurer will reimburse you for rehabilitation expenses, such as the cost of a rehabilitation course or special equipment, to help you return to work. The maximum amount reimbursed is equal to six times your monthly benefit. The Insurer must approve these rehabilitation expenses in writing. Your premiums will be waived while you are in receipt of an SCI benefit. Cessation of insurance cover Death, TPD and SCI cover ceases immediately under the insurance policy, on the earliest of the following: you reach age 65; the day you cease to be a member of the Plum Personal Plan; the date of your death; the date a terminal illness benefit equal to your death cover is paid; your account balance becomes insufficient to pay a premium instalment; the day before you commence duty with the armed forces of any country (excluding the Australian Army Reserve); for SCI cover, you are unemployed or on leave of absence for greater than one year; for SCI cover, you permanently retire from the workforce; you make a fraudulent claim; you request to cancel your cover; and any other terms under the group insurance policy. If you have SCI cover with either the two year or five year benefit period, it will end on the date the insurer pays a lump sum Total and Permanent Disablement (TPD) or Terminal Illness benefit. Any existing SCI claim will continue to be paid if you continue to be disabled due to the same Illness or injury but after the end of your current claim, no further claim will be paid. 7

11 Cost of insurance The premiums associated with your insurance cover are deducted monthly by equal instalments from your account. Premiums are based on the type and amount of insurance cover and your age. The actual premium calculated for you may vary slightly due to rounding and is inclusive of any statutory charges including stamp duty. Death and TPD premiums Death and TPD premiums are calculated as follows: (Amount of cover $1,000) x premium x Gender factor Gender Factor Male 1.00 Female 0.80 Death Annual cost of each $1,000 cover TPD Death TPD

12 SCI premiums SCI premiums are calculated as follows: (SCI cover $1,000) x premium Annual Cost of each $1000 cover for maximum 2 year benefit period Male Annual Cost of each $1000 cover for maximum 2 year benefit period Female

13 Annual Cost of each $1000 cover for maximum 2 year benefit period Male Annual Cost of each $1000 cover for maximum 2 year benefit period Female

14 Annual Cost of each $1000 cover for maximum 2 year benefit period Male Annual Cost of each $1000 cover for maximum 2 year benefit period Female

15 Annual Cost of each $1000 cover for maximum 5 year benefit period Male Annual Cost of each $1000 cover for maximum 5 year benefit period Female

16 Annual Cost of each $1000 cover for maximum 5 year benefit period Male Annual Cost of each $1000 cover for maximum 5 year benefit period Female

17 Annual Cost of each $1000 cover for maximum 5 year benefit period Male Annual Cost of each $1000 cover for maximum 5 year benefit period Female

18 Annual Cost of each $1000 cover for maximum 5 year benefit period Male 180 days 180 days Annual Cost of each $1000 cover for maximum 5 year benefit period Female 180 days 180 days

19 Annual Cost of each $1000 cover for benefit period to age 65 Male Annual Cost of each $1000 cover for benefit period to age 65 Female

20 Annual Cost of each $1000 cover for benefit period to age 65 Male Annual Cost of each $1000 cover for benefit period to age 65 Female

21 Annual Cost of each $1000 cover for benefit period to age 65 Male Annual Cost of each $1000 cover for benefit period to age 65 Female

22 Annual Cost of each $1000 cover for benefit period to age 65 Male 180 days 180 days Annual Cost of each $1000 cover for benefit period to age 65 Female 180 days 180 days Example of premiums Death cover In our earlier example John, aged 30 (31 age ) had death cover of $382,500. John s death cover premium would be calculated as follows: ($382,500 $1,000) x $0.497 x 1.00= $ p.a. or ($15.84 per month) TPD cover In our earlier example John, aged 30 (31 age ) had death cover of $400,000. John s TPD cover premium would be calculated as follows: ($400,000 $1,000) x $0.211 x 1.00= $84.40 p.a. or ($7.03 per month) SCI cover In our earlier example John, aged 30 (31 ) had SCI cover of $41,250 p.a. This amount of insurance cover that has been used is a two year benefit period, 90 day waiting period. John s SCI premium would be calculated as follows: ($41,250 $1,000) x $1.416 = $58.41 p.a. or ($4.87 per month) 19

23 Contact us For more information visit plum.com.au or call us on between 8am and 7pm AEST (8pm daylight savings times), Monday to Friday. Postal address Plum Super GPO Box 63 Melbourne VIC 3001 Registered office Ground Floor, MLC Building Miller Street NULIS Nominees (Australia) Limited ABN AFSL Part of the National Australia Bank Group of Companies. An investment with NULIS Nominees (Australia) Limited is not a deposit or liability of, and is not guaranteed by National Australia Bank Limited ABN AFSL (NAB). NAB does not guarantee or otherwise accept any liability in respect of this product.