IMPORTANT NOTICE. This policy is issued on the basis of information disclosed by you to us

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1 IMPORTANT NOTICE We provide our financial services under the terms and conditions noted in our Financial Services Guide issued to you. If you do not have one of these documents, please phone us on or visit our website. You must read this document before proceeding and by proceeding you represent and warrant you have received and read it. The following is a summary of cover only. For full terms and conditions including definitions, conditions, other limits and exclusions, please refer to your Policy Document or Product Disclosure Statement. We would like to remind you, that if this policy is cancellable and you cancel before the expiry date, we may refund the unused premium less our fee and commission. The Insurer or Agency may also impose a fee on cancellation. Any errors identified in the summary below must be reported to your Account Manager for amendment. PERSONAL ACCIDENT & SICKNESS INSURANCE GROUP POLICY VOLUNTEER WORKERS This policy is issued on the basis of information disclosed by you to us INSURED PERSON: (Australia) COVERING: AGE LIMITS: 1. Members 2. Orana Rangers 3. Supporters 4. Trefoil Guild Members 5. Women of Substance 6. Support Group Members 7. Voluntary Workers, including cover whilst participating in authorised Guide activities to which their voluntary work relates 8. Invitees being relatives and friends of insured guide persons listed under 1,2,3,4 & 5 above whilst participating in authorised Guide activities, other than Guide activities open to the general public On the understanding that an injury resulting in a payable event occurs while the insured person: - is engaged in a Youth activity; or - is acting as an official at, or otherwise assisting in the conduct of, a youth activity; or - is acting in his or her capacity as an elected or appointed offical of a youth organisation; or - is travelling directly to or from the place where those activities are taking place. This Policy will only cover the insured persons who are over 4 years and under 91 years of age, provided that no permanent total disablement under the table of benefits is payable for insured persons over 65 years of age GEOGRAPHICAL LIMIT: Australia Wide Reference: GLP CHE K / Page No. 1

2 AGGREGATE LIMIT OF LIABILITY: $ 1,000,000 Non Schedule Airflights/Charter/Helicopter Aggregate Limit of Liability $ 500,000 Scheduled Aircraft $ 500,000 Helicopter $ 500,000 OVER AGE 65 LIMITS: It is hereby Declared and Agreed that Section A Events 2 & 3 are deleted for non-income earners and persons over the age of sixty five (65) years BENEFITS AND SUMS INSURED: Injury Only Death and Capital Benefits 1-30 $ 100,000 Weekly Injury Benefit 100% of Income to Max of $ 1,500 Injury Assistance Benefit 100% of Income to Max of $ 1,500 ENDORSEMENTS: Additional cover for non medicare medical expenses and out of pocket expenses Payable Condition; Injury resulting in medical expenses Compensation Insurer will pay; 100% of medical expenses incurred up to a maximum amount of $1,000 Payable Condition; Injury resulting in out of pocket travelling or personal expenses Compensation Insurer will pay; 100% of out of pocket expenses incurred up to a maximum amount of $1,000 ADDITIONAL BENEFITS CONTAINED WITHIN THIS POLICY: Broken Bones Additioal Capital Benefit - up to $5,000 Disappearance Additional Capital Benefit - alligned to Death Benefit with section A Lifestyle modification Additional Capital Benefit - up to $20,000 Rehabilitation Additional Benefit (resulting from Injury) - up to $ 5,000 DESCRIPTION OF VOLUNTARY WORK: Reference: GLP CHE K / Page No. 2

3 For the purpose of this Policy, Voluntary Work includes an insured person being engaged in officially sanctioned activities of and include travelling directly to or from the above activities and residence or place of employment, staying away from home for the purposes of participating in such activities, or acting in any voluntary administrative capacity in support of such activities BENEFIT PERIOD: 104 Week(s) - Weekly Benefits - Injury 52 Week(s) - Injury Assistance Benefits DEDUCTIBLE: 7 Day(s) POLICY WORDING: QBE Voluntary Worker Policy (QM ) COMPENSATION TABLES: Compensation Table Capital Benefits INJURY RESULTING IN PAYABLE CONDITION % OF CAPITAL BENEFIT 1. Death 100% 2. Permanent Total Disablement - persons seventy (70)years and under 100% 3. Permanent Disability not otherwise provided 75% 4. Permanent Paraplegia - persons 70 to 80 years 100% 5. Permanent Quadriplegia - persons 70 to 80 years 100% 6. Permanent unsound mind to the extent of legal incapacity 100% 7. Permanent and incurable paralysis of all limbs 100% 8. Permanent total loss of the entire sight of one or both eyes 100% 9. Permanent total loss of hearing in both ears 100% 10. Permanent total loss of use of both hands 100% 11. Permanent total loss of use of both arms 100% 12. Permanent total loss of use the use of both feet 100% 13. Permanent total loss of the use of both legs 100% 14. Permanent total loss of use of one hand and one foot 100% 15. Permanent total loss of use of one hand and one arm 100% 16. Permanent total loss of the lens of one eye 50% 17. Permanent total loss of the hearing in one ear 50% 18. Permanent total loss of use of one foot or one leg 50% 19. Permanent total loss of use of four Reference: GLP CHE K / Page No. 3

4 fingers and one thumb either hand 75% 20. Permanent total loss of use of four fingers of either hand 40% 21. Permanent total loss of use of one thumb 30% 22. Permanent total loss of the use of one thumb one joint 15% 23. Permanent total loss of use of a finger, three joints 10% 24. Permanent total loss of use of a finger, two joints 8% 25. Permanent total loss of use of a finger, one joint 5% 26. Permanent total loss of use of all the toes on one foot 15% 27. Permanent total loss of use of great toe, both joints 5% 28. Permanent total loss of use of great toe, one joint 3% 29. Permanent total loss of use of other toe (each toe) 1% 30. Third degree burns and/or resultant disfugurement which covers more than 40% of the entire body 50% Broken Bones Additional Capital Benefits PAYABLE CONDITION % OF CAPITAL BENEFIT 1. Neck, Skull, Spine 100% 2. Hip 75% 3. Jaw, Pelvis, Leg, Ankle or Knee 50% 4. Cheekbone or Shoulder 30% 5. Arm, Elbow or Wrist 10% 6. Nose or Collarbone 20% 7. Foot or Hand 5% 8. Additional in the case of established non union of any of the above breaks 5% Weekly Benefits - Injury PAYABLE CONDITION COMPENSATION 1. Total Disablement (Weekly Benefit) As per Schedule 2. Partial Disablement (Weekly Benefit) 30% Injury Assistance Benefits PAYABLE CONDITION As per policy wording EXTENSIONS AUTOMATICALLY INCLUDED: Reference: GLP CHE K / Page No. 4

5 Conditions/Extensions as per Policy EXCLUSIONS: WHAT WE WILL NOT PAY We will not pay for any claim under this section of the policy if the claim arises directly our of any of the following: - any medical condition for which the insured person has required treatment or advice from a doctor, chiropractor, physiotherapost, naturopath, psychologiest or psychiatrist in the six months before the commencement date of their cover - illness - expenses incurred for which a medicare benefit is payable. The general and additional exclusions set out under "When you are not covered" in this policy may also affect your claim. - any payable condition claims must occur within 12 months of the date of injury. - The compensation we pay will be reduced by amounts paid or payable from any statutory transport accident scheme or statutory workers' compensation scheme or private health insurance. Terrorism Exclusion applies Exclusions as per Policy The invitation to renew is on the basis that you have not been affected by sickness, disease, physical defect or infirmity within the previous 12 months. We refer you to the Duty of Disclosure on the reverse. This policy may be cancelled by You at any time by giving Us written notice. AFA shall retain a portion of the premium calculated at their usual short-term rates for the time the Poicy has been in force. AFA may cancel this policy at any time if You have been in breach of any of its conditions or any other reason available to them at law. Upon cancellation by AFA. AFA shall refund a proportion of the premium paid calculated on the unexpired period of insurance. IMPORTANT NOTICE Cooling Off Period - Financial Services Reform Act (March 2002) A 14 day Cooling Off Period applies on certain policies to retail clients (as defined in the Act). Please ask your Account Manager to provide information regarding which policies these are and how the Cooling Off Period applies. PRIVACY STATEMENT We are committed to protecting your privacy. We maintain a Privacy Policy Reference: GLP CHE K / Page No. 5

6 and act under its guidelines. You can view it on our Website or you can ask us for a copy to be sent to you. You can also check the information we hold about you at any time. INSURER POLICY NUMBER PROPORTION QBE Insurance (Australia) Ltd 41A029354PAD % 628 Bourke Street MELBOURNE VIC 3000 Reference: GLP CHE K / Page No. 6