INSURANCE OneCare Protection for life Understanding Trauma Cover
Trauma Cover With a flexible, innovative and customer focused range of benefits, features and additional options, OnePath Life s OneCare is a leading protection solution. This simple summary can help you understand the value of OneCare. For full terms and conditions, please refer to the OneCare product disclosure statement (PDS). Why Trauma Cover? In the event you suffer a serious illness or injury like cancer, heart attack or paralysis, Trauma Cover provides you with choices. The benefits could be used to pay your medical expenses and treatment costs. You could also use it to help pay off your debts, go on a holiday, or even to make a permanent lifestyle change such as reduced working hours. How does Trauma Cover work? Trauma Cover provides a one-off payment, or regular monthly benefit, if you suffer from a listed condition including cancer, heart attack, coronary artery by-pass surgery or stroke. Benefits of this cover will be paid to the policy owner. Fast facts Minimum entry age 15 Maximum entry age 65 (60 for a level premium) Minimum amount insured $50,000 Maximum amount insured $2 million OneCare s built-in benefits Choice of two cover types OnePath Life offers a choice between two trauma cover types; Trauma Comprehensive and Trauma Premier. Trauma Comprehensive provides you with cover for 46 specified trauma conditions outlined below. Alzheimer s disease loss or paralysis of limb 2 OnePath Life Limited (OnePath Life) ABN 33 009 657 176 AFSL 238341 347 Kent Street, Sydney NSW 2000 angioplasty* # major head trauma aortic surgery* aplastic anaemia benign brain tumour major organ transplant medically acquired HIV benign tumour of the spine minor heart attack #* meningitis and/or meningococcal disease blindness motor neurone disease cancer* multiple sclerosis cardiomyopathy muscular dystrophy chronic kidney failure chronic liver disease occupationally acquired HIV open heart surgery* chronic lung disease out of hospital cardiac arrest # cognitive loss Parkinson s disease coma Pneumonectomy coronary artery by-pass surgery* deafness primary pulmonary hypertension severe burns dementia severe diabetes* encephalitis severe osteoporosis* heart attack* severe rheumatoid arthritis* heart valve surgery* stroke* intensive care systemic sclerosis* loss of independent existence terminal illness loss of speech triple vessel angioplasty* * Subject to a 90 day qualifying period before cover commences # The amount insured for angioplasty and minor heart attack are 10% of the Trauma Cover amount insured at the time of the angioplasty procedure or minor heart attack subject to a minimum of $10,000 and a maximum of $20,000. These conditions must be diagnosed and certified by a medical practitioner who is an appropriate specialist physician approved by us.
Choice of two cover types (continued) Trauma Premier This cover type provides cover for the above 46 specified trauma conditions as well as partial cover for 13 specified trauma conditions outlined below. adult insulin dependent diabetes mellitus* burns of limited extent carcinoma in situ (CIS)* chronic lymphocytic leukaemia partial blindness* partial deafness* severe endometriosis* systemic lupus erythematosus (SLE) with lupus nephritis* diagnosed benign tumour Colostomy and/or ileostomy hydrocephalus* Critical Care melanoma* The partial payment amount is calculated at 20% of the Trauma Premier Cover amount insured, subject to a maximum of $100,000. * subject to a 90 day qualifying period before cover commences These conditions must be diagnosed and certified by a medical practitioner who is an appropriate specialist physician approved by us. Instalment Benefit Limited Death Benefit Accommodation Benefit Financial Advice Benefit OnePath Life is the only company who is flexible enough to allow you to receive all or some of your Trauma benefits as instalments (monthly payments) instead of as a lump sum (one-off payment). When you select this benefit the standard premium is reduced. If you die, OnePath Life will pay $10,000 to ensure immediate expenses such as funeral costs can be taken care of (applies to stand alone Trauma Cover or Trauma Cover with optional TPD Cover only) If a medical practitioner certifies that you must remain confined to bed due to your trauma condition and: you are more than 100 kilometres from your home and an immediate family member is required to travel from their home to be with you or an immediate family member is required to travel more than 100 kilometres from their home to be with you OnePath Life will reimburse the accommodation costs for an immediate family member of up to $500 per day for a maximum of 30 days. If OnePath Life pays a trauma claim, we will reimburse up to $2,000 for the preparation of a financial plan. A financial plan can help your family maximise the value of your Trauma Cover benefit. 3
OneCare s built-in features Future Insurability Indexation Premium Freeze Life is full of exciting changes, and your needs and priorities will probably change in the years to come. So that your insurance can keep up with you, OnePath Life will allow you to increase your level of cover within specified limits without having to supply medical evidence when significant events occur. You can increase your cover if you: get married have a child (biological or adopted) take out a mortgage or increase a mortgage have a salary increase of 15% or more have a dependant child starting secondary school completes an Australian an undergraduate university degree become a carer get divorced have a spouse who dies change in tax dependency status i.e. no longer have any tax dependants. If your policy is for business purposes, you can also increase the sum insured when you: are a key person in a business and your value to the business increases are a partner or shareholder in a business and the policy supports a buy and/or sell, share purchase or business succession agreement and the value of the business increases. There is alternatively the opportunity to increase your cover every third year if you haven t increased your cover due to one of the above events in the three years prior. To ensure your insurance levels keep up with the cost of living, OnePath Life will increase your cover amount every year by 5% or the Indexation Factor; which ever is greater. Trauma premiums generally increase each year in line with your age and the insured amount. If you would prefer your premium to stay the same you can choose to use the Premium Freeze feature, which gradually reduces your amount insured. The table below illustrates how this could work. Year Age Annual premium* Cover level Year 1 30 $718.20 $500,000 Year 2 31 $718.20 $457,097 Year 3 32 $718.20 $429,918 Life Cover Buy Back* Auto Conversion Business Debt Protector * Assumes the client is male accountant, non smoker, living in NSW. This projection does not include policy fee. The above example is for illustrative purposes only. If a trauma benefit is paid, your Life Cover Benefit will be reduced by the same amount. Life Cover Buy Back allows you to reinstate your Life Cover to its original level six or 12 months after a claim depending on the condition claimed, without having to provide medical evidence. * Applies to Trauma Cover linked with Life Cover only. At age 70, OnePath Life will automatically convert your Trauma Cover to Total and Permanent Disability (TPD) Cover with a Non-working definition. TPD cover with a Non-working definition provides basic coverage at an affordable price. Note; the maximum TPD Non-working is $3 million therefore any Trauma Cover amount will be reduced to ensure the TPD maximum limits apply. This is useful where the partners or directors or a business have given personal guarantees for a business loan. The option is available to policies that have multiple lives insured under the same cover and amount. 4
OneCare s additional options Premier Maximiser Option* Premium Waiver Disability Option Business Guarantee Option Double Trauma Option* Life Cover Purchase Option* Trauma Cover Reinstatement Option* Baby Care Option The Premier Maximiser Option provides protection through extending your scope of cover by doubling the partial benefit paid on certain trauma conditions. This means that in the event of a claim being accepted, a payment of 40% of the Trauma Premier amount insured (to a maximum of $200,000) will apply to all Trauma conditions except angioplasty and minor heart attack which is 20% of the amount insured (to a maximum of $40,000). * Applies to Trauma Premier Cover If you are disabled you may find it hard to keep paying trauma premiums. With the Premium Waiver Disability Option, if you are on claim under Income Secure Cover, Business Expense Cover or Living Expense Cover, or if you are disabled for over six consecutive months, OnePath Life will waive your premium until you are no longer disabled or the policy anniversary when you are age 65. Indexation will still apply to covers for which the premiums are being waived. As your business grows, it s important your insurance cover grows with it. By including the Business Guarantee Option, you can increase the amount insured within specified limits, without having to supply further medical evidence if there has been an increase in the value of your business. If a trauma benefit is paid, your Life Cover benefit will be reduced by the same amount. The inclusion of the Double Trauma Option ensures that immediately following a full trauma claim your Life Cover is reinstated to its original level. You will never have to pay any premiums for the reinstated Life Cover following a full trauma claim. * Applies to Trauma Cover linked with Life Cover only If a trauma benefit is paid you will no longer have any and may find it more expensive to obtain Life Cover given your change in health. This feature allows you to purchase Life Cover equivalent to the value of the Trauma Benefit paid, 6 or 12 months after the claim depending on the trauma condition, without having to supply further medical evidence. * Applies to Stand Alone Trauma Cover and Trauma Cover with optional TPD Cover. The Trauma Cover Reinstatement Option allows you, 12 months after making a trauma claim, to reinstate your Trauma Cover without having to supply medical evidence. We will allow you to exercise this option multiple time for unrelated Trauma conditions. * Applies to Stand Alone Trauma Cover, Trauma Cover linked with TPD Cover and Trauma Cover linked with Life Cover This additional cost option allows women to obtain financial protection in relation to pregnancy complications, congenital abnormalities in newborns and against infant deaths. In the event of one of the listed pregnancy complications or congenital abnormalities, OnePath Life will pay $50,000* as a lump sum and in the event of an infant death, OnePath Life will pay $10,000. Pregnancy is an uncertain time and this option provides women with peace of mind as they begin the journey of parenthood. * Indexation will apply to the Complications of pregnancy and the Congenital abnormality benefit. 5
Additional protection: Extra Care Cover options You can increase your protection by topping up your cover with Extra Care Terminal Illness, Extended Needle Stick, or Accidental Death Benefits. Terminal Illness Benefit Extended Needle Stick Benefit Accidental Death Benefit The Extra Care Terminal Illness Benefit recognises the importance of financial freedom in the face of a terminal illness diagnosis. This benefit could be used to share some time away with loved ones, help eliminate the mortgage on the family home, and pay for medical and palliative care. The Terminal Illness Benefit provides a oneoff payment, or regular monthly benefit (if an instalment arrangement is taken), if you are diagnosed with a terminal illness. The Extra Care Extended Needle Stick Benefit recognises the unique risk of needle stick injury for medical professions. This benefit can be used to pay for medication, cover day-to-day living expenses, or offset any lost earnings or profit from your practice. The Extended Needle Stick Benefit can be purchased with any other cover type, and provides a one-off payment, or regular monthly benefit (if an instalment arrangement is taken), if you contract HIV or Hepatitis B or C while performing your occupation. The Extra Care Accidental Death Benefit recognises how important you are to the people around you. This benefit could be used to pay funeral costs, help eliminate debt, and create an ongoing income for your dependants. The Accidental Death Benefit provides a one-off payment, or regular monthly benefit (if an instalment arrangement is taken), in the event of your accidental death. How do you get the insurance you need? A financial adviser can show you what types of insurance are available, work out how much you need, and help ensure your cover is structured cost-effectively. 6
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Choose the award-winning protection your clients deserve, with OnePath Life s OneCare. In 2008, 2009, 2010 and 2011 OnePath has been named AFR Smart Investor s Life Company of the Year. In 2008, 2010 and 2011 OnePath has been named Risk Company of the Year at the Money Management/DEXX&R Adviser Choice Risk Awards. In 2008, 2009, 2010 and 2011 OnePath s OneCare product won the prominent five-star CANSTAR CANNEX Outstanding Value for Life Insurance award. Customer Services Phone enquiries 133 667 8.30am to 6.00pm (AEST) Email customer.risk@onepath.com.au Postal address OnePath Life GPO Box 4148 Sydney NSW 2001 OnePath Life Limited (OnePath Life) ABN 33 009 657 176 AFSL 238341 347 Kent Street, Sydney NSW 2000 OnePath Custodians Pty Limited (OnePath Custodians) ABN 12 008 508 496 AFSL 238 346 RSE L0000673 This information is current at May 2012 but is subject to change. The information provided is of a general nature and does not take into account your personal needs and financial circumstances. You should consider the appropriateness of the information, having regard to your objectives, financial situation and needs. OneCare is issued by OnePath Life Limited (OnePath Life) (ABN 33 009 657 176, AFSL 238341). Refer to the Product Disclosure Statement (PDS) for full terms and conditions. You should read the PDS available at onepath.com.au and consider whether the product is right for you. Our employees and directors receive a salary from us. They do not receive commissions; however, they may be eligible for performance related bonuses and other staff related benefits. L3899/0412 onepath.com.au