MLC MasterKey Personal Super

Transcription

1 MLC MasterKey Personal Super Insurance Guide Category D members This Insurance Guide is for MLC MasterKey Personal Super members who were transferred into the MLC Super Fund from The Universal Super Scheme on 1 July 2016 and who are: (a) Insured Members who: were covered under MLC MasterKey Business Super Category 'G'; have ceased employment with a Participating Employer; and did not elect to cease their cover under the MLC Master Policy. (b) Family Insured Members who: became an Insured Member in MLC MasterKey Business Super on or after 1 July 2013; no longer met the Family Insured Member eligibility conditions; and did not elect to cease their cover under the MLC Master Policy. (c) Insured Members who became employees of a former Participating Employer in The Employee Retirement Plan (TERP) after 24 May 2013 who: were covered under MLC MasterKey Business Super; left the employment of the Participating Employer; and did not elect to cease their cover under the MLC Master Policy. (d) All members who as at 28 November 2013: did not have cover, or had never elected to cease their cover, under the MLC Master Policy; and were not employees of a Participating Employer; and were upgraded to have both Death and Total and Permanent Disablement (TPD) Cover on or after 29 November (e) All members who as at 28 November 2013: had Death-only cover under the P1002 Policy; and were not employees of an Employer as defined under the P1002 Policy; and were provided TPD Cover under the M100 Master Policy on or after 29 November Preparation date 30 September 2016 Issued by the Trustee NULIS Nominees (Australia) Limited ABN AFSL The Insurer 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. Important information The information in this document is general information only and doesn t take into account your objectives, financial situation or individual needs. Because of that, before acting on this information, you should consider its appropriateness, having regards to your objectives, financial situation and needs. For more information please contact us, speak with your financial adviser or go to the online copy of this document on mlc.com.au/pds/mkpsop Information in this document may change from time to time. Updates in relation to information that are not materially adverse may be made available on mlc.com.au but you may not be directly notified of these updates. You may, however, obtain a paper copy of these change communications on request free of charge by contacting us. Please read the latest applicable Product Disclosure Statement and any incorporated materials before making any decision about a product. Neither NAB, nor any of its related bodies corporate guarantees or accepts liability in respect of the insurance cover offered in MLC MasterKey Personal Super. An interest issued by NULIS Nominees (Australia) Limited in the Fund does not represent a deposit or liability with NAB or other related bodies corporate of NAB. Any statement made by a third party or based on a statement made by a third party in this document has been included in the form and context in which it appears with the consent of the third party, which has not been withdrawn as at the date of this document. References to mlc.com.au in the online copy of this document link directly to the additional information available. 2

3 Contents Insurance with MLC Limited 4 Insurance you select yourself 6 Death insurance 8 Death and TPD insurance 10 Income Protection insurance 15 Insurance the details 25 Definitions 30 MLC Limited (Insurer) is the insurer and receives your insurance premiums. We can change the insurer at any time if we believe this is in the best interests of members. The information in this Insurance Guide forms part of the MLC MasterKey Personal Super Product Disclosure Statement dated 30 September Together with the Fee Definitions Flyer and Investment Menu, these documents should be considered before making a decision about whether to acquire or continue to hold the product. They are available at mlc.com.au/pds/mkpsop For more information please contact us, speak with your financial adviser or go to the online copy of this document on mlc.com.au/pds/mkpsop MLC Master Policy You can find specific details about the terms and conditions of your insurance in the MLC Master Policy. A copy of the MLC Master Policy is available by contacting us. This Insurance Guide summarises the terms and conditions that apply to a claim for a Benefit with a Date of Claim occurring on or after 12 December 2011 under the MLC Master Policy. If your Date of Claim precedes this date, different terms and conditions may apply. Please contact us for further details. Proposed sale of MLC Limited In 2015 the NAB Group announced a plan to sell 80% of its insurance business (MLC Limited) to Nippon Life Insurance Company. The planned sale has not been finalised at this stage. It is proposed this sale will take place on a date between 1 October 2016 and 31 December There are no changes to the insurance benefits, terms and conditions detailed in the PDS and in this document as a result of the proposed sale. In the future, should your benefits or terms and conditions change, we'll notify you as required by law. 3

4 Insurance with MLC Limited With over 125 years of insurance experience in Australia, insurance with MLC Limited provides longterm, sustainable insurance to customers. Worldwide insurance Your insurance travels with you, which means you re covered 24 hours a day anywhere in the world. However, some additional limits apply to Income Protection benefits if you are not continuously resident in an Approved Country see the Definitions section for details. Affordable insurance Insurance through super may be tax effective for you and may be a more affordable way for you to take care of your beneficiaries. MLC MasterKey Personal Super Insurance Description of the insurance The following types of cover are available through MLC MasterKey Personal Super: Death insurance; Death and Total and Permanent Disablement (TPD) insurance; and Income Protection insurance. If you were transferred to MLC MasterKey Personal Super from MLC MasterKey Business Super as a result of you (or in the case of an eligible family member, the employee member that is your relative) ceasing employment with the relevant MLC MasterKey Business Super employer, any insurance cover you held in MLC MasterKey Business Super was transferred to MLC MasterKey Personal Super on the date your account was transferred. If you held Death or Death and TPD insurance immediately prior to the transfer, the relevant sum insured amount for you will have become a fixed amount at the time you became a member of MLC MasterKey Personal Super, at the same level as you held in MLC MasterKey Business Super as at the transfer date. For Income Protection, your maximum monthly benefit (if any) will also have been fixed at the time of your transfer to MLC MasterKey Personal Super. You will not be required to provide any further medical or other insurability evidence in relation to the transfer. You can apply to increase any such transferred amount. Any: special conditions, premium loadings, exclusions, restrictions or endorsements that applied to you in your MLC MasterKey Business Super plan; and New Events Cover that applied to you in MLC MasterKey Business Super, 4

5 continue to apply to you in MLC MasterKey Personal Super for so long as they would have applied in MLC MasterKey Business Super. See the MLC MasterKey Business Super Insurance Guide applicable to your former employer plan, which is available by contacting us, for details of any such terms and conditions. Your cover We ll tell you the amount of insurance you have each year in your Annual statement. To confirm your monthly premium, please refer to your most recent Annual Statement, or log into your account online at mlc.com.au. You can contact us to obtain a quote for the cost of insurance that will apply if you wish to change your cover. Insurance eligibility Making sure you re eligible If you are employed in an Occupation that we classify as Not Insurable, you will not be eligible for insurance. The latest Occupation ratings guide for insurance is available on mlc.com.au/occupation When we provide you with insurance, we assume you re eligible for it. So, we ll automatically deduct premiums from your account unless you tell us you re not eligible. If you don t have enough money in your super account to deduct your insurance premiums as at the first premium due date to occur after 130 days of your Commencement Date, or at any subsequent premium due date, and the outstanding premiums are not paid within 30 days of the premium due date, we ll cancel your insurance. If you make a claim and you weren t eligible, your claim will be declined and all premiums refunded. If your cover is terminated due to non-payment of premiums, you may apply for your cover to be reinstated. The Insurer may, at its discretion, reinstate cover on such terms as it determines subject to underwriting. Insurance definitions Some words in insurance have specific meanings such as Illness. You can see more about these terms in the Definitions section. 5

6 Insurance you select yourself Everybody has different needs and insurance is no exception. That s why we help you create an insurance solution to suit you and your family s needs. You can choose to apply for or change your: Death insurance Death and TPD insurance, and Income Protection insurance. Your application for cover will be subject to you providing Evidence of Insurability and acceptance by the Insurer, who may set such terms and conditions and request information as it reasonably requires. How much insurance do you need? While nobody likes to dwell on the negatives, without enough insurance you could put your, and your family s, lifestyle at risk. Your financial adviser can go through the types of insurance on offer, and assess how much you may need. Alternatively, an insurance calculator is available on mlc.com.au Then you can get on with enjoying life, rather than worrying about what may or may not happen. How much insurance can you apply for? Insurance type Death Death and TPD Income Protection You can apply for up to Unlimited. The maximum benefit limit for Terminal Illness is $3 million. Unlimited Death insurance and up to a maximum of $5 million of TPD insurance. The maximum benefit limit for Terminal Illness is $3 million. Generally up to 75% of the first $40,000 of your Monthly Income, and up to 50% of the next $40,000 of your Monthly Income. The maximum you can apply for includes any existing policies you have, including the insurance provided through your account in the Fund. Insurance consolidation You can apply to consolidate any existing insurance cover held by you through another superannuation fund or issued by another insurer (Existing Insurance Cover) with your insurance cover in MLC MasterKey Personal Super. To do this, you can access the Consolidate your insurance form available on mlc.com.au 6

7 Any application for consolidation of cover is subject to underwriting and you may be required to provide medical or other insurability evidence as part of your application. You must meet all of the following requirements to be eligible to apply for consolidation of insurance cover: your Existing Insurance Cover must have been in place for at least 12 months, you must be age 55 or younger at the date your insurance consolidation application is completed and dated, you must be At Work on: the date the insurance consolidation application is completed and dated, and the day immediately preceding the day the transferred insurance cover is due to start in MLC MasterKey Personal Super, you must not be eligible for, must not have received, and must not be applying for a total and permanent disablement or disability type benefit, permanent or temporary incapacity benefit, terminal illness benefit or a salary continuance benefit under any workers' compensation scheme, superannuation fund or insurance policy. If your insurance consolidation application is accepted by us and the Insurer, the following special conditions will apply together with any other conditions as notified to you from time to time: you must cancel your Existing Insurance Cover immediately after the transferred cover is issued, in the event you fail to cancel your Existing Insurance Cover, any benefit in relation to the transferred cover that would otherwise have become payable by the Insurer will be reduced by the amount that represents the benefit payable under the Existing Insurance Cover, and the same premium loadings and exclusions, if any, that applied to your Existing Insurance Cover will apply to the transferred cover. Replacing your existing insurance Before you consider cancelling any insurance, you need to make sure your insurance will be right for you. Please wait for us to confirm you're insured before you cancel any other existing insurance arrangements you may have. 7

8 Death insurance Helps your family pay their expenses when you can t be there. How does it work? This insurance pays a lump sum to your beneficiaries if you die, or to you if you re diagnosed with a Terminal Illness. If we pay a Terminal Illness benefit to you, your Death insurance will reduce by the amount of the payment. Where your Death insurance is greater than the amount of the Terminal Illness benefit paid, the residual Death insurance will continue, and your ongoing premiums will reduce accordingly. The amount of your benefit will be determined on the relevant Date of Claim. Eligibility To be eligible for this insurance, you must be between ages 15 and 69. Death (including Terminal Illness) insurance ends at age 70. When benefits won t be paid Self-harm For all insurance or increases to insurance commencing on and from 5 December 2014 (except Automatic Cover or automatic increases to cover): No Death Benefit is payable where the death is due to suicide within the first 24 months of starting or reinstating your insurance. No part of an increase to a Death Benefit is payable where the death is due to suicide within the first 24 months after the commencement of the increased cover. No Terminal Illness Benefit is payable where the Terminal Illness is due to any intentionally self-inflicted injury within the first 24 months of starting or reinstating your insurance. No part of an increase to a Terminal Illness Benefit is payable where the Terminal Illness is due to self-inflicted injury within the first 24 months after the commencement of the increased cover. For insurance that commenced between 1 April 2009 and 4 December 2014 (except Automatic Cover): No Death Benefit is payable where the death is due to suicide within the first 13 months of starting or reinstating insurance. No part of an increase to a Death Benefit is payable where the death is due to suicide within the first 13 months after the commencement of the increased cover. No Terminal Illness Benefit is payable where the Terminal Illness is due to any intentionally self-inflicted injury. 8

9 Pre-existing Conditions For all cover or increases to cover commencing on or after 5 December 2014: No benefit will be payable for death or Terminal Illness caused directly or indirectly by any Preexisting Condition if, prior to the most recent date you became insured under the MLC Master Policy you were paid, or were entitled to be paid, a TPD or Terminal Illness benefit from the Insurer or another superannuation fund or insurer. 9

10 Death and Total and Permanent Disablement (TPD) insurance Gives you financial security for the unexpected. How does it work? This insurance pays a lump sum if you die, are diagnosed with a Terminal Illness or become Totally and Permanently Disabled. If we pay a Terminal Illness benefit to you, your Death and TPD insurance will each reduce by the amount of the payment. Where your Death or TPD insurance is greater than the amount of the Terminal Illness benefit paid, the residual insurance will continue, and your ongoing premiums will reduce accordingly. If we pay a TPD benefit to you, your Death insurance will reduce by the amount of the payment. Where your Death insurance is greater than the amount of the TPD benefit paid, the residual Death insurance will continue, and your ongoing premiums will reduce accordingly. Your TPD Benefit or Terminal Illness Benefit can't exceed the amount of your Death Benefit, except where you previously held MLC Lifestage insurance cover before becoming a MLC MasterKey Personal Super member or where agreed by the Insurer. The amount of your benefit will be determined on the relevant Date of Claim. Eligibility To be eligible for this insurance, you must be between ages 15 and 69. TPD insurance can continue up to age 70. Your insurance may end earlier depending on the arrangements of your former employer plan. If you are age 65 or over, you will only be eligible for a TPD Benefit if you satisfy the 'Activities of Daily Living' definition of TPD (see the Definitions section for details). Eligible occupations A TPD benefit is only payable if: on the last working day prior to your Date of Claim, you were not working in an Uninsurable Occupation; or on the day prior to the Date of Claim, you were a 'Homemaker' or unemployed. When benefits won t be paid Self-harm For all insurance or increases to insurance commencing on and from 5 December 2014 (except Automatic Cover or automatic increases to cover): 10

11 No Death Benefit is payable where the death is due to suicide within the first 24 months of starting or reinstating your insurance. No part of an increase to a Death Benefit is payable where the death is due to suicide within the first 24 months after the commencement of the increased cover. No Terminal Illness Benefit or TPD Benefit is payable where the Terminal Illness or TPD (as applicable) is due to any intentionally self-inflicted injury within the first 24 months of starting or reinstating your insurance. No part of an increase to a Terminal Illness Benefit or TPD Benefit is payable where the Terminal Illness or TPD (as applicable) is due to any self-inflicted injury within the first 24 months after the commencement of the increased cover. For insurance that commenced between 1 April 2009 and 4 December 2014 (except Automatic Cover): No Death Benefit is payable where the death is due to suicide within the first 13 months of starting or reinstating insurance. No part of an increase to a Death Benefit is payable where the death is due to suicide within the first 13 months after the commencement of the increased cover. No Terminal Illness Benefit or TPD Benefit is payable where the Terminal Illness or TPD (as applicable) is due to any intentionally self-inflicted injury. Pre-existing conditions For all cover or increases to cover commencing on or after 5 December 2014: No benefit will be payable for death, TPD or Terminal Illness caused directly or indirectly by any Preexisting Condition if, prior to the most recent date you became insured under the MLC Master Policy, you were paid, or were entitled to be paid, a TPD or Terminal Illness benefit from the Insurer or another superannuation fund or insurer. Tapering of TPD Benefits If your former MLC MasterKey Business Super employer did not select an insurance formula for your former plan under which TPD insurance will remain at the same level after age 61, or the Insurer does not agree otherwise, the Insurer will reduce your TPD cover beginning from when you attain age 61 by equal amounts each year until the age your TPD insurance ends. Your former employer may have chosen to remove this reduction or the Insurer may agree in writing that that this insurance feature will not apply to your TPD insurance. If so, your TPD insurance will remain at the same level after age 61. Early payment Where it can be clearly established to the Insurer's satisfaction that you are likely to be Totally and Permanently Disabled, the Insurer may, at its discretion, pay the TPD Benefit before you are absent from your Occupation for six consecutive months (see the definition of 'Totally and Permanently Disabled' for details about when the six month period will apply). 11

12 Features of Death insurance and Death & TPD insurance Terminal Illness benefits We ll pay you a Terminal Illness benefit if you re diagnosed with a Terminal Illness. Your Terminal Illness benefit is calculated as your Death Benefit less any TPD benefit you may have already received, up to a maximum of $3 million. Your insurance (consisting of any cover you have for death, Terminal Illness or TPD) will then be reduced by the amount of this payment. Where your Death or TPD insurance is greater than the amount of the Terminal Illness benefit paid, the residual insurance will continue, and your ongoing premiums will reduce accordingly. You won t have to repay the Terminal Illness benefit if you live longer than 24 months. The amount of your Terminal Illness benefit will be determined on the relevant Date of Claim. Leave of absence/parental leave You can take up to 24 months Leave of Absence from your Employment with or without pay and keep your insurance on the same terms and conditions as if you had remained in active Employment, provided: you continue to pay your premiums, remain employed by your employer, continue to be an Insured Member of MLC MasterKey Personal Super, do not join any armed forces (excluding the Australian Defence Force Reserves not deployed overseas), and comply with the other terms of the MLC Master Policy. Your employer's approval of your leave must be in writing and be provided to the Insurer on request. You can also apply to extend this period by giving us at least 60 days notice before your Leave of Absence ends, which is subject to acceptance by the Insurer, at its discretion. Any benefit payable will be based on the level of insurance notified to and accepted by the Insurer before commencement of your Leave of Absence. If you apply for additional cover while on Leave of Absence, your application will be subject to underwriting and any additional cover will not commence until the Insurer provides written notice of acceptance and you return to work. If you do not return to your employment on or before the nominated return to work date as agreed with your employer before you went on Leave of Absence and the Insurer has not granted an extension, your insurance will continue provided premiums continue to be paid. However, your insurance will be based on your Occupation and employment status immediately prior to the Date of Claim. 12

13 Interim Accident Insurance If you apply for Death insurance or an increase in Death insurance and die as a result of, in the Insurer's opinion, an Injury occurring while your application is being assessed by the Insurer and within 365 days of the Injury occurring, a lump sum Interim Accident Benefit of the amount you have applied for will be paid. If you apply for TPD insurance or an increase in TPD insurance, you will be paid a lump sum Interim Accident Benefit of the amount you ve applied for up to a maximum of $3 million if you suffer any of the following conditions: Quadriplegia; Major Brain Injury; or the total and irreversible inability to perform at least two of the Activities of Daily Living as a result of an Injury occurring during the period of Interim Accident cover. You will be covered for an Interim Accident Benefit from the date the Insurer receives a properly completed application in the required form for the insurance or increase in insurance applied for. We must also have received superannuation contributions for your benefit for Interim Accident cover to commence. Your Interim Accident cover will cease on the earliest of the following events: on the Insurer's acceptance or rejection of your application, on the withdrawal of your application, 180 days from the commencement of your Interim Accident cover, the day you cease to be insured (where you already hold insurance) or the day you cease to meet the eligibility criteria the date the Insurer ceases to be liable under the MLC Master Policy. If your Interim Accident cover is for Death and TPD, you will only be eligible for one Interim Accident Benefit, whichever is the first you become eligible for. The Insurer will only pay out one Interim Accident Benefit for any one Accident. In respect of insurance which commenced on or after 21 November 2011, an Interim Accident benefit is not payable in certain circumstances, including: for death, Quadriplegia, Major Brain Injury or the total and irreversible inability to perform at least two of the Activities of Daily Living as a result of an Injury occurring during the period of Interim Accident cover, arising from an Injury caused by engaging in any Uninsurable or Special Risk Occupation, pastimes or sports that would not be covered under the Insurer's normal assessment guidelines, if the cover applied for would have been declined under the Insurer's normal assessment guidelines, if the application is for an event or condition that would have been excluded under the Insurer's normal underwriting process, and death, Quadriplegia, Major Brain Injury or the total and irreversible inability to perform at least two of the Activities of Daily Living as a result of an Injury occurring during the period 13

14 of Interim Accident cover, from an Injury occurring prior to the date Interim Accident cover commenced. In addition, the general exclusions in the 'When won't a benefit be paid?' sections above also apply to Interim Accident cover. The Interim Accident Certificate is available in the How to Guide on mlc.com.au/howto/mkbs Increases without medical evidence From ages 15 to 64 you can apply to increase your Death and TPD insurance without further medical evidence, subject to acceptance by the Insurer, when you: adopt or have a child get married or divorced complete your first undergraduate degree at an Australian Government-recognised institution have a dependent child who starts secondary school for the first time are granted a loan from a financial institution for your first ever purchase of a principal place of residence, are granted an increased loan from a financial institution to renovate your principal place of residence, lose a spouse through death, or become a carer for the first time, referred to as a Specific Life Event. The increase can be up to 25% of your original insurance amount, but it can t be more than $200,000 (or such other limit set by the Insurer from time to time). To apply for the increase, you must complete and return the 'Increases without medical evidence' form available on mlc.com.au, together with evidence acceptable to the Insurer of the Specific Life Event. You must also apply within 90 days of the event occurring. You can only use this feature once in any 12-month period, and up to three times in total. The Insurer may reject an application or reduce the amount applied for to the extent it exceeds the limit on the increase in insurance that can be obtained using this feature or would increase your insurance beyond $1 million (or such other amount as the Insurer may agree). No automatic increases in cover (other than under the Specific Life Event feature) will apply from the date a Specific Life Event increase becomes effective. 14

15 Income Protection insurance Helps you concentrate on getting better, without worrying about bills. How does it work? This insurance provides a monthly benefit of up to 75% of your Monthly Income while you re Totally Disabled or Partially Disabled. If you are engaged in Permanent Full Time Employment or Permanent Part Time Employment, you or your employer can choose a Benefit Period of: two years five years, or age 65, or as agreed by the Insurer. If you re engaged in Fixed-term Contract Employment and have a: two or five-year Benefit Period, as selected or agreed by the Insurer, your Benefit Period will end of the earlier of: the end of your 2 year or 5 year Benefit Period (as applicable), the end of your contracted period of employment last agreed with the employer before the date of the event leading to a claim for the benefit, or you attaining the age of 65; Benefit Period until age 65, as selected or agreed by the Insurer, your Benefit Period will end on the later of: 2 years, and the expiry of your contracted period of employment last agreed with the employer before the date of the event leading to a claim for the benefit, but subject to the maximum insurance age of 65. You can also choose from a range of Waiting Periods, being the period that you are Totally Disabled or Partially Disabled during which no Total Disability or Partial Disability Benefits are payable. The Waiting Period starts on the Date of Claim and requires the Insured Member to be Totally Disabled for at least 14 consecutive days from the start of the Waiting Period. Waiting Periods include 30, 60 and 90 days, and you can also choose a waiting period of 180 days if you have a Benefit Period of 5 years or to age 65. A Total Disability Benefit is only payable in the event you were in Covered Employment on the last working day prior to the Date of Claim, were Totally Disabled for the first 14 consecutive days of the Waiting Period, Totally or Partially Disabled for the remainder of the Waiting Period and Totally Disabled at the end of the Waiting Period. 15

16 A Partial Disability Benefit is only payable in the event you were in Covered Employment on the last working day prior to the Date of Claim, were Totally Disabled for the first 14 consecutive days of the Waiting Period, Totally or Partially Disabled for the remainder of the Waiting Period and Totally or Partially Disabled at the end of the Waiting Period. An Income Protection Benefit other than a Bereavement Benefit is payable monthly in arrears. An Income Protection Benefit payable for only part of a month will be payable at a rate of one-thirtieth of the monthly benefit payable. An Income Protection Benefit payable in relation to a particular Illness or Injury will cease on expiry of the Benefit Period applicable to the Insured Member, but only in relation to that Illness or Injury. You may also have a Superannuation Contribution Benefit, subject to you, the Trustee or your employer having submitted an application that is acceptable to the Insurer. A Superannuation Contribution Benefit provides an additional benefit paid into your MLC MasterKey Personal Super account or another complying superannuation fund of your choice, while you re Totally Disabled or Partially Disabled. Maximum monthly benefit payable The maximum monthly benefit payable to you is the lesser of the following: up to 75% of the first $40,000 of your Monthly Income, and up to 50% of the next $40,000 of your Monthly Income; and the insured percentage of your Monthly Income (which may not exceed 75%) If you have a Superannuation Contribution Benefit, an additional amount may be paid into your super account, up to a maximum of 15% of your Monthly Income. The maximum monthly benefit payable is subject to an overall total maximum benefit of $50,000 per month for the first two years of your Benefit Period, including any Superannuation Contributions Benefit. If your benefit payment continues beyond two years, the overall total maximum benefit payable is $30,000 per month for the remaining Benefit Period including any Superannuation Contribution Benefit. Total Disability Benefit If your Date of Claim is prior to 1 July 2016, the Total Disability Benefit will be your monthly benefit. If your Date of Claim is on or after 1 July 2016, the Total Disability Benefit will be the lesser of your monthly benefit or 1/12th of your Pre-Disability Income in the 12 months prior to your Total Disability. A Total Disability Benefit will commence from the expiration of the Waiting Period. 16

17 Partial Disability Benefit The Partial Disability Benefit will be calculated using the following formula: (A Actual Monthly Income) A x monthly benefit where A = the lesser of your Monthly Income, Restricted Monthly Income (if your monthly benefit is equal to either the automatic acceptance limit or the maximum monthly benefit, as the case may be), or (for a Date of Claim for Partial Disability on or after 1 July 2016) 1/3 of the Pre-Disability Income in the three months prior to your start of your initial period of Total Disability. A Partial Disability Benefit will commence at the latest of the expiration of the Waiting Period or the date you cease to be Totally Disabled if you are Partially Disabled at that date Making sure you re eligible To be eligible for Income Protection insurance you must be between ages 15 and 64 and must not be engaged in Excluded Employment. To be eligible for an Income Protection Benefit, you must be: engaged in Covered Employment, and not engaged in Excluded Employment, on the last working day prior to the Date of Claim. Income Protection insurance ends at age 65. When will benefits be reduced? Any Total or Partial Disability Benefit payable will be reduced to the extent you are, during the period of Total Disability or Partial Disability: receiving any regular income (including sick leave but excluding payments made pursuant to statutory or contractual annual leave accrued prior to the date you ceased working, long service leave or redundancy entitlements) from your employer; receiving payments made under any other similar policies, and entitled to payments made under workers compensation and/or similar legislation. This doesn t include Centrelink payments or benefits at common law, where such benefits are payable on a periodic basis (whether paid or not). The reduction will be sufficient to ensure that: the Total Disability Benefit or Partial Disability Benefit payable, together with the aggregate of the other payments or entitlements, will not exceed your insured percentage of Monthly Income. 17

18 the amount the Insurer pays in Total Disability Benefits or Partial Disability Benefits, together with the aggregate of the other payments or entitlements (including arising under the Policy other than rehabilitation expenses and Superannuation Contribution Benefits), will not exceed the amount derived by your Income Protection benefit formula. Any income from other sources which is in the form of a lump sum or is commuted for a lump sum will be treated as a monthly amount equivalent to one sixtieth of the lump sum over a period of 60 months, to calculate the reduction in monthly benefits (one twenty-fourth (1/24) over 24 months for a two year benefit period). Income from other sources does not include: income earned from investments; and any lump sum total and permanent disablement benefit. When your worker's compensation entitlement is in dispute, the Insurer will pay the full amount of the Total Disability Benefit or the Partial Disability Benefit on a conditional basis until the dispute is resolved. If you are successful and are declared entitled to workers' compensation benefits, it is a condition of this insurance cover that: you will repay to the Insurer that part of any Total Disability Benefit or Partial Disability Benefit which would otherwise not have been paid if not for the conditional payment; and the Insurer may at any time recover this amount by offsetting it against any amounts that may subsequently become due in respect of you under the Policy including any TPD Benefit or Terminal Illness Benefit. When won t Income Protection benefits be paid? Income Protection Benefits won t be paid to you for Total or Partial Disability due to: an intentional self-inflicted Injury or any attempt to commit suicide irrespective of whether you are sane or insane; normal and uncomplicated pregnancy or childbirth; any act of war (whether declared or not) or service in armed forces (not including Australian Defence Force Reserves not employed overseas); or any other event or matter in the Policy or notified by the Insurer. Benefits are available worldwide, however payment is limited to one year if you are not continuously a resident in Australia or an Approved Country. 18

19 Pre-existing conditions Where automatic acceptance applies, if you do not have New Events Cover, the Insurer will pay Income Protection Benefits for Total Disability resulting from a Pre-existing Condition. Where applicable, the Insurer will pay Income Protection Benefits in excess of the automatic acceptance limit provided the Pre-existing Condition has been disclosed to and accepted by the Insurer. For all cover commencing or increases to cover commencing on or after 5 December 2014: No Income Protection Benefit will be paid for Total Disability or Partial Disability caused directly or indirectly by any Pre-existing Condition if prior to the most recent date you became insured under the Policy, you were paid, or are entitled to be paid, a TPD or Terminal Illness benefit from us or another superannuation fund or insurer. When payments cease Payment of any monthly benefit for Total Disability will end at the earliest of: the end of your Benefit Period; when you are no longer Totally Disabled; when you attain 65 years of age; on your death; when you are no longer under the regular and continuous care of a Doctor; the date there is a failure to provide the Insurer with all requested information and other evidence reasonably required to assess your claim; or you make a fraudulent claim. Payment of any Partial Disability Benefit will end at the earliest of: when you are no longer Partially Disabled; the occurrence of any of the events that would cause a monthly benefit for Total Disability to cease (except the end of your Total Disability); or you earn a level of income equal to or greater than your Pre-Disability Income that you were earning immediately prior to the start of your Total Disability or Restricted Monthly Income (whichever is lesser). Other Overseas Travel Cover for Income Protection Benefits applies worldwide. However, Income Protection Benefits will be limited to 12 months if you are not continuously resident in an Approved Country. The 12 month limited period commences from: if you ceased to be continuously resident in an Approved Country after the start of your Total Disability, the later of the date when you last continuously resided in an Approved Country and the end of your Waiting Period; or 19

20 if you were not residing in an Approved Country as of the start of your Total Disability, the end of the Waiting Period. After the 12 month limited period, no Income Protection Benefits will be payable unless and until you return to an Approved Country. If you return to an Approved Country and are still Totally or Partially Disabled, your Income Protection Benefits may be reinstated effective from the date of your return to the Approved Country and will be payable while you are continuously resident in an Approved Country. For two year and five year Benefit Periods, the Benefit Period will only accrue while Income Protection Benefits are being paid. Features of Income Protection insurance Choice of waiting period You pay a lower premium the longer the Waiting Period. You can select a 30, 60 or 90-day Waiting Period when you apply. You also have the option of a 180-day Waiting Period if you have a Benefit Period of 5 years or to age 65. Interim Disability Accident Insurance If you are eligible for Income Protection insurance and apply for Income Protection insurance or an increase in Income Protection insurance and suffer a Total Disability which in the Insurer's opinion is a result of an Injury occurring during the period of interim cover, you will be paid an Interim Disability Accident Benefit. You will be covered for an Interim Disability Accident Benefit from the date the Insurer receives a properly completed personal statement and declaration of health to the earliest of the following dates: the date the Insurer gives notice that it accepts (on any terms) or rejects the application; the date you that your application for cover (or an increase in cover) is cancelled or withdrawn; the date you cease to be eligible for Income Protection insurance; the date cover otherwise ceases under the MLC Master Policy; or 90 days after the commencement of interim cover. The Interim Disability Accident Benefit provides a benefit of up to the monthly benefit applied for, subject to the maximum monthly benefit applicable to Income Protection insurance. For Insured Members whose cover commenced after 1 April 2009 a maximum of $50,000 per month applies. The Interim Disability Accident Benefit is payable for as long as the Total Disability continues or to the end of the Benefit Period, whichever occurs first, subject to a maximum of 2 years. 20

21 An Interim Disability Accident Benefit is not payable: for an Injury is caused by the Insured Member engaging in an Uninsurable or Special Risk Occupation pastime or sport that would not be covered under the Insurer's normal assessment guidelines; or where cover would have been declined under the Insurer's normal assessment guidelines; or where a claim is lodged for an event or condition that would have been excluded under the Insurer's normal underwriting process; or where the Injury occurs before the person becomes an Eligible Member. The Insurer will not pay more than one Benefit under this Interim Disability Accident Benefit for any one Accident to any person. The Interim Accident Certificate is available in the How to Guide on mlc.com.au/howto/mkbs Returning to work during the waiting period Prior to 29 November 2013 You can return to work during the Waiting Period for up to five days at Full Capacity without your Waiting Period being restarted. Your Waiting Period will be extended by the amount of days you return to work at Full Capacity. If you return to work for more than five days at Full Capacity, your Waiting Period will start again. These days don t have to be consecutive. On and from 29 November 2013 You can return to work during the Waiting Period, for up to: five days if your Waiting Period is not more than 30 days, or ten days if your Waiting Period is more than 30 days, without your Waiting Period being restarted. Your Waiting Period will be extended by the amount of days you return to work at Full Capacity. If you return to work at Full Capacity for more than the maximum days above, your Waiting Period will start again. These days don t have to be consecutive. Salary-linked insurance increases Your insurance may increase in line with any salary increase you receive, by up to 30% within any 12- month period provided the increase remains within automatic acceptance limits or forward underwriting limits (where applicable) and the evidence of salary increase is considered sufficient by the Insurer. The Insurer may not require you to provide Evidence of Insurability. Where your salary increase exceeds 30% or would otherwise cause the level of Income Protection Benefits to exceed the automatic acceptance limits or forward underwriting limits (where applicable), any increase will be subject to underwriting. 21

22 Insuring super contributions (Superannuation Contributions Benefits) You can insure the super contributions your employer makes for you, up to 15% of your Monthly Income, subject to you, the Trustee or your employer having submitted an application that is acceptable to the Insurer. A Superannuation Contribution Benefit provides an additional benefit paid into your MLC MasterKey Personal Super account or another complying superannuation fund of your choice, while you re Totally Disabled or Partially Disabled. The Superannuation Contribution Benefit payable is: for Total Disability, an amount equal to the Super Contribution Benefit Percentage of your Monthly Income; or for Partial Disability, an amount equal to the Super Contribution Benefit Percentage of your Monthly Income less your Actual Monthly Income in that month. The amount of the Superannuation Contribution Benefit will not exceed: 15% of your Monthly Income; or the maximum monthly benefit when combined with the Total Disability Benefit. The Superannuation Contribution Benefit shall cease to be payable when you cease to be entitled to a Total Disability or Partial Disability Benefit. CPI-linked benefits If you have a '5 year' or 'to age 65' Benefit Period and you receive monthly benefits for 12 consecutive months, the monthly benefits will be increased (indexed) annually by the lesser of 5% and the percentage increase (if any) in the CPI for the previous 12 months. This does not apply for the two-year Benefit Period. If Total Disability or Partial Disability Benefits cease to be payable, for the purposes of any future payments, Total Disability and Partial Disability Benefit entitlements will revert to the original percentage of Monthly Income or other amount replaced or varied in accordance with the other clauses of the MLC Master Policy. Rehabilitation expenses benefit Where you are being paid a Total Disability or Partial Disability Benefit, where permitted by law, the Insurer will pay for expenses which are: incurred to directly assist you to return to work in a gainful occupation or in undertaking a vocational retraining program because of your Total or Partial Disability; approved in advance in writing by the Insurer; and approved by your Doctor, such as the cost of a formal rehabilitation course or the cost of special equipment such as a motorised wheelchair to help you return to work. 22

23 The Insurer will not pay any money directly or indirectly to you or the Fund, but will pay the rehabilitation expenses to the service providers directly or provide the rehabilitation services itself. The maximum amount of rehabilitation expenses payable is six times the monthly benefit (less any amount that may be claimed from any other source as reimbursement), or such greater amount as the Insurer determines in its absolute discretion. Evidence of the cost of the rehabilitation program or other expense will be required. Bereavement Benefit If you die whilst in receipt of a Total Disability Benefit or Partial Disability Benefit and no Death Benefit is payable under this insurance cover, subject to the expiry of the Benefit Period, the Insurer will pay an amount after the date of death of: 3 months of Total Disability Benefits (Benefit Period of 2 or less years or of 5 or less years), or 6 months of Total Disability Benefits (Benefit Period to age 65). Recurring disability Your Waiting Period will not recommence if your Total Disability or Partial Disability recurs within six months of the date you ceased to be Totally or Partially Disabled due to returning to your usual Occupation or a different Occupation, provided that the cause of the recurrent Total Disability or Partial Disability is the same or related to the cause of the original Total Disability. The Policy and your Income Protection cover must both be in force when the Total or Partial Disability recurs. Regardless of whether a Total Disability or Partial Disability recurs within the 6 month period, the same Benefit Period will apply to the entire period of Total Disability and Partial Disability including the original claim and any recurrent claim where the cause of the recurrent Total Disability or Partial Disability is the same or related to the cause of the original Total Disability. If you become an Insured Member after 1 July 2016 and have a 2 or 5 year Income Protection Benefit Period, once your Benefit Period expires, a new Benefit Period will only commence if: you suffer an Injury or Illness which is different to that which caused or contributed to your Total or Partial Disability in the previous Benefit Period; and you returned to Covered Employment prior to the Date of Claim applicable to the new Benefit Period. Waiver of premiums While you receive monthly benefits, you don t pay any Income Protection insurance premiums. On cessation of payment of the Total or Partial Disability Benefit, premiums will be charged again unless your Income Protection cover has ended. Leave of absence/parental leave You can take up to 24 months Leave of Absence from your Employment with or without pay and keep your insurance on the same terms and conditions as if you had remained in active Employment, provided: 23

24 you continue to pay your premiums, remain employed by your employer, continue to be an Insured Member of MLC MasterKey Personal Super, do not join any armed forces (excluding the Australian Defence Force Reserves not deployed overseas), and comply with the other terms of the MLC Master Policy. Your employer's approval of your leave must be in writing and be provided to the Insurer on request. You can also apply to extend this period by giving us at least 60 days notice before your Leave of Absence ends, which is subject to acceptance by the Insurer, at its discretion. Any benefit payable will be based on the Monthly Income notified to and accepted by the Insurer before commencement of your Leave of Absence. If you apply for additional cover while on Leave of Absence, your application will be subject to underwriting and any additional cover will not commence until the Insurer provides written notice of acceptance and you return to work. If you do not return to your employment on or before the nominated return to work date as agreed with your employer before you went on Leave of Absence and the Insurer has not granted an extension, your insurance will continue provided premiums continue to be paid. However, your insurance will be based on your Occupation and employment status immediately prior to the Date of Claim. If you suffer a Total Disability and you are entitled to cover whilst on Leave of Absence, the Insurer will pay a benefit at the rate of your Total Disability Benefit or Partial Disability Benefit as applicable. Payment of any benefit will start from the later of: your nominated return to work date as agreed to by the employer before you go on Leave of Absence, or the date last agreed to by the employer prior to your Total Disability; and the end of the Waiting Period, and end in accordance with the 'When payments cease' section above. 24