1 Protecting you and your family Insurance guide Effective 1 April Issued by CSF Pty Limited ABN , AFSL , Trustee of the Catholic Superannuation Fund ABN
2 Contents Protecting you and your family 1 Death only and Death and TPD insurance 4 Income Protection insurance 8 Insurance other important information you 12 need to know Insurance words and terms 15 About this insurance guide Before applying for insurance cover within Catholic Super, you should carefully read this insurance guide which sets out a summary of main insurance terms and conditions under the insurance policy. Please note that while every effort has been made to ensure that the information contained in this insurance guide is accurate, the terms and conditions of the insurance policy issued by the Insurer will prevail to the extent that they are inconsistent with the information contained in this guide. The information in this insurance guide is general in nature, and does not relate to your specific individual circumstances. You should speak to your financial adviser to determine your insurance needs and whether the insurance cover offered within Catholic Super is suitable for your needs.
3 1 Protecting you and your family Why insurance cover is important for you and your family For most of us, our ability to work is our major source of income. In the event of a crisis, such as an accident or serious health issue, your regular income may no longer be available while living expenses and bills still have to be paid. Having insurance cover helps protect you and your family against the added financial burden that will arise in these circumstances and gives you peace of mind knowing your family is protected. It is particularly important to have the right level of cover if you: rely on your salary to meet your day to day living expenses have a home loan, car loan, personal loan or credit card debt support others financially insurance provides them with financial security for the future. Affordable, flexible insurance through Catholic Super Catholic Super recognises the importance of protecting you and your family. Our insurance arrangements have been carefully designed to provide simple, low cost cover, with the flexibility to change your cover as your needs change. Our insurance cover applies 24 hours a day, 7 days a week, not just when you are at work - so you have peace of mind knowing you are covered at all times. You can select from a range of cover options and apply to change your cover at any time as your needs change. One of the benefits of arranging insurance through Catholic Super is that the cost is deducted each month from your Catholic Super account. Your premiums are paid from your super account so you and your family are protected without reducing your take-home pay. The cost of insurance cover through Catholic Super is generally lower than for retail products because we buy insurance cover at a discounted bulk rate. Our bulk buying of insurance cover enables us to provide default insurance cover for our members without the need to provide health information or medical checks. We send you an annual member statement that clearly shows the amount of cover you have and the insurance premiums deducted. You can check your insurance cover at any time through Member Online, our secure internet facility for members, or by calling us on
4 2 Cover available through Catholic Super Three types of cover are available to Catholic Super members: Type of cover Benefits provided More information Death only cover Combined Death and Total & Permanent Disablement (TPD) cover Income Protection cover If you become terminally ill, provides you with a lump sum payment. In the event of your death, provides your dependants or estate with a lump sum payment. Death only cover is available until age 70. Provides you (or in the event of your death, your dependants or estate), with a lump sum payment in the event of your death, terminal illness or total and permanent disablement. Death and TPD cover is available until age 70, but you must be under the age of 64 to apply for TPD cover. Provides you with a monthly benefit replacing part of your income while you are unable to work due to illness or injury. Income Protection cover is available until age 70. More information about Death cover is on page 4. More information about Death and TPD cover is on page 4. More information about Income Protection cover is on page 8. Catholic Super insurance cover is provided by TAL Life Limited, ABN AFSL ( the Insurer ).
5 3 When does your insurance cover commence? If you join our Employer Sponsored plan within six months If you join our Employer Sponsored plan within six months of the date you commence employment with a participating employer, Default Cover will commence provided you meet the relevant eligibility criteria. Your insurance cover will commence from the latest of: the date you commence employment with an employer who is a Catholic Super participating employer the start date of the period for which the first Superannuation Guarantee contribution (SG contribution) is paid on your behalf the date 120 days before the date your SG contribution was received, or the date your employer sponsor becomes a participating employer of Catholic Super. If you are not At Work on the date your cover commences, you will receive Limited Cover for TPD and Income Protection until you are again At Work. See Insurance words and terms on pages 15 to 17 for definitions of At Work and Limited Cover. For Personal Plan members, insurance cover will commence from the date advised by Catholic Super in writing of the Insurer s acceptance, subject to a sufficient account balance to pay premiums. If you join our Employer Sponsored plan after six months If you join our Employer Sponsored plan after six months of the date you commenced employment with a participating employer, Default Cover will commence provided you meet the relevant eligibility criteria. However, you will be subject to Limited Cover for 12 months. Your insurance cover will commence from the latest of: the start date of the period for which the first SG contribution is paid on your behalf the date 120 days before the date your SG contribution was received, or the date your employer sponsor became a participating employer of Catholic Super. Limited Cover terms applicable to your Default Cover will be removed after 12 months provided you are At Work at the end of the 12 month period. If you are not At Work, Limited Cover will continue to apply until you are again At Work. See Insurance words and terms on pages 15 to 17 for definitions of At Work and Limited Cover. If you apply for insurance cover If you apply for insurance cover or to increase your existing cover, your cover will commence from the date the Insurer accepts your application. We make it easy to work out how much insurance cover you need using our simple online insurance tools To make sure you have enough insurance, it is important to look at your current circumstances and calculate how much insurance you might need if you were unable to work. In three simple steps, you can use our simple online tools to calculate and apply for just the right amount of cover. 1. Work out how much cover you need to protect you and your family using our simple online calculator 2. Once you know how much insurance you need to protect you and your family, calculate the cost using our online cost tool 3. Log in to Member Online apply for insurance cover online and receive an immediate response. We recommend you seek professional financial advice to confirm your level of cover is appropriate to your personal situation. A Catholic Financial Services Planner can assist you to identify your insurance needs and determine the appropriate level of cover for you. Call to book an appointment. A fee may apply.
6 4 Death only and Death and TPD insurance Cover you receive when you join Catholic Super Default Death and TPD cover Type of member Default cover provided when you join Catholic Super Amount of Default Death and TPD cover When your cover starts Employer Sponsored member If you are an Employer Sponsored member (your employer is a participating employer and pays your SG contributions to your Catholic Super account), you are provided with a basic level of Death and TPD cover. Your amount of Default Death and TPD cover will initially be based on your age when you become a member and will vary according to the table as your age changes. The Default cover for all ages is shown below. Age Next Birthday Amount of Default Death and TPD cover $150, $201, $189, $142, $94, $57, $43, $28, $14, $11,200 Your Default cover commences as outlined in the section When does your insurance cover commence? on page 3. You don t need to provide any health information or have a medical examination. Personal Plan member Cover is not automatically provided to a Personal Plan member, but you can apply for Death only or Death and TPD cover. Nil You can apply for cover at any time, but you will need to provide health information and be assessed by the Insurer. In addition, if you are a Personal Plan member, you will need a minimum account balance sufficient to pay the premiums before your cover can start. Changing your Death or TPD cover Increase your cover without providing health information Special offer for new Employer Sponsored members in the first 60 days of Catholic Super membership Normally when you apply for increased Death or TPD insurance cover, you need to provide additional health information and your application is assessed by the Insurer. Catholic Super offers a special opportunity for new Employer Sponsored members to double their Default Death and TPD cover in the first 60 days of joining Catholic Super without providing any additional health information. As a new Employer Sponsored member, you have until 60 days from the date you join to take advantage of this offer and apply to double your Default Death and TPD cover without providing health information. To take advantage of this special offer, simply tick the box on the Employer Sponsored Member Application, call Member Services on , or write to us at the address shown at the back of this guide. You need to act quickly, as this offer is only available for the first 60 days after you join Catholic Super. If you do take advantage of this special offer, additional insurance costs apply and your cover scale will change from default (age-based) cover to fixed cover. That means your Death and TPD sum insured will remain the same each birthday. The amount you pay for this fixed level of cover will generally increase each year. Personal Plan members are not able to apply for cover on joining or to increase their cover without providing health information.
7 5 Increase your cover when you have a major life event. You can apply to increase your Death, TPD and Income Protection cover when you experience a major life event. Life events are: Birth or adoption of a child Marriage or divorce Taking out a mortgage to purchase your home Increasing your existing mortgage to renovate or extend your home. You can apply for one life event increase per year. The maximum increase you can apply for as a result of a life event is the lesser of: 25% of your current cover $200,000 for Death and TPD cover $2,500 per month for Income Protection. Additional insurance costs apply to any increased cover. To apply for increased insurance cover following a major life event, please complete the application form available at or call Member Services on Increase your cover at any time You can apply for Death and TPD cover or to increase your existing cover at any time. You will need to provide health information and your application is subject to assessment and acceptance by the Insurer. Additional premium costs will apply and these costs are based on your age and the amount of additional insurance for which you are applying. The maximum cover you can apply for is: Type of cover Death* TPD Maximum cover available Unlimited $3 million * Death cover includes Terminal Illness cover however the maximum benefit for any Terminal Illness claim is $3 million. To apply for an increase in cover at any time, you have four options. 1. Apply online. Log on to Member Online, under the section Your Personal Details, select Insurance Details and select the Insurance Online button to launch. Follow the simple online application process and receive an answer straight away. 2. Call to request a tele-interview with the Insurer s underwriting team a representative of the Insurer will call you at a mutually convenient time and take you through the application and you will find out straight away whether your application is successful or if there is any extra information required. 3. Speak to a Catholic Financial Services Planner to discuss your insurance needs. Our Financial Planners can assist you to identify your insurance needs and determine the appropriate level of cover for you. They can also assist you to complete an insurance application or you can use one of the other options listed here to apply for additional insurance. Call or book an appointment online to speak to a Planner about your insurance needs. A fee may apply. 4. Complete the Application for Insurance Cover available on our website or by calling Reducing your cover You can reduce or cancel your cover at any time. If you cancel your cover and decide to apply again in the future, you will need to supply health information as part of your application and your application will need to be assessed by the Insurer. To reduce or cancel your cover, please write to us at the address shown at the back of this guide, or call Member Services on Before deciding to decrease or cancel your insurance cover, we strongly recommend you seek professional advice regarding the implications of such a decision. Can I change from the Default cover scale to fixed cover for Death and TPD? Yes, you are able to convert your Default (age-based) Death and TPD cover to fixed cover at any time. This means that your cover does not reduce with age. Please call us on if you would like to switch to fixed cover.
8 6 The cost of your Death and TPD cover The cost of your cover depends on your age, the type of cover and the amount of cover you have. The easiest way to calculate the cost of cover that s right for you is to use our simple online insurance cost calculator at If you would like to calculate the cost yourself, select the amount of cover you want (in multiples of $1,000) and multiply by the premium cost which applies to your age next birthday (see table below). The formula to calculate the cost of Death or TPD cover is: The amount of cover you want 1,000 x the relevant premium for your age next birthday (see table below) = annual premium cost. Example Mary is 27 (28 next birthday). Mary wants $350,000 of Death and TPD cover. Mary s annual cost is: $350,000 1,000 x the premium cost of $0.27 = $94.50 per year The cost of your insurance cover will be deducted directly from your Catholic Super account on a monthly basis in arrears from the date your insurance cover commences. The cost of your cover will alter each year on your birthday. Annual cost per $1,000 sum insured Annual cost per $1,000 sum insured Age Next Birthday Death $ Death and TPD $ Age Next Birthday Death $ Death and TPD $
9 7 Claiming a Death or TPD benefit When is a Death or TPD benefit paid? A Death benefit is paid in the event of your death. The payment is made up of the balance of your account with Catholic Super plus your insured death benefit (if approved by the Insurer). A Death benefit is generally paid to your dependants or estate, unless you have completed a Binding Death Benefit Nomination. This form is available on our website at or by calling A Terminal Illness benefit is payable if you meet the definition of Terminal Illness (see Insurance words and terms on pages 15 to 17). A TPD insured benefit is payable if you are insured for TPD cover at the time you become totally and permanently disabled and you meet the definition of TPD (see Insurance words and terms on pages 15 to 17). The TPD payment is made up of the balance in your Catholic Super account and your insured TPD benefit. There may be tax payable on TPD benefits, depending on your age, length of service and the amount of the benefit. Catholic Super will provide an outline of any tax payable if you become entitled to a TPD benefit. Exclusions Death/TPD There are some circumstances where no Death or TPD benefit is payable. For insured cover not provided as Default Cover, no benefit shall be payable where a claim arises from any of the following: Peace of mind at an affordable cost. for Death cover, suicide within the first 12 months after the commencement or reinstatement of cover, for TPD cover, an intentional self-inflicted act or intentional self-inflicted injury, or any exclusion the Insurer may apply to you as a condition of acceptance of cover. How to make a claim Our Member Services team can assist you to make a claim simply call us on
10 8 Income Protection insurance Imagine what it would be like to be off work for an extended period because of illness or injury without your regular income. After your sick pay runs out, how would you pay your living expenses and bills? Income Protection cover protects you in these circumstances by providing an income if you are unable to work temporarily or permanently through illness, injury or accident. A partial disability benefit may also be payable to you if you return to work in a reduced capacity. Cover you receive when you join Catholic Super Default Income Protection cover At the time of joining Catholic Super, Employer Sponsored members will be provided with Default Income Protection cover up to a $3,000 monthly benefit (inclusive of any SG contribution benefit), capped at 85% of your pre-disability income, with a 60 day waiting period and a 5 year benefit period. Your Default Income Protection cover will commence as outlined in the section When does your insurance cover commence? on page 3. Package Choice options for Employer Sponsored members As a new Employer Sponsored member you can select one of our Income Protection Package Choice options within 60 days of joining Catholic Super. These options allow you to shorten your waiting period or lengthen your benefit period without evidence of health, provided your election is received by Catholic Super within 60 days of the date you join. Option 1 Option 2 Option 3 60 day waiting period, to age 65 benefit payment period 30 day waiting period, 5 year benefit payment period 30 day waiting period, to age 65 benefit payment period Personal Plan members do not receive Default Income Protection cover and need to apply and provide health information for Income Protection cover. Changing your Income Protection cover Increases linked to your salary Employer Sponsored members can apply to increase their Income Protection cover without providing health information by: 1. providing us with your salary when you first join Catholic Super, and 2. letting us know when you receive a salary increase. 1. Increase your cover when you first join Catholic Super by providing your salary If you are an Employer Sponsored member and notify us of your salary when you first join Catholic Super, you will be provided with Income Protection cover of 85% of your salary, up to a maximum of $12,000 per month without providing health information. The 85% of salary benefit is made up of 75% of your earned income and up to a 10% Superannuation Contribution Benefit. If you don t provide your salary, the maximum Income Protection benefit provided under Default Cover is $3,000 per month. 2. Increase your cover when you receive a salary increase If you are an Employer Sponsored member, once a year, when you receive a salary increase, you can apply for an increase in your Income Protection cover without providing health information. To receive an automatic benefit increase you need to apply within 45 days of your salary increase and your employer will need to confirm your salary increase. You can only apply once a year for a benefit increase when you receive a pay rise, and your new level of cover must not exceed 85% of your salary, or be more than a 25% increase on your current Income Protection cover. To increase your Income Protection cover when you receive a salary increase simply complete the Application to Increase Income Protection Cover Due to Salary Increase available from or call Increasing your Income Protection insurance to provide benefits up to age 70 You can apply to upgrade your Income Protection cover to protect your income until you turn 70. You will need to provide health information and your application will be assessed by the Insurer. If you would like to apply to upgrade your Income Protection cover to provide benefits up to age 70, please call Member Services on You will need to provide health information and additional costs apply.
11 9 Increasing your Income Protection cover at any time for Employer Sponsored and Personal Plan members At any time, you can apply to increase your Income Protection cover. You will need to provide health information and your application will be assessed by the Insurer. The maximum cover you can apply for is: Type of cover Income Protection Maximum amount of cover The lower of: 85% of your salary (75% of your earned income and up to a 10% Superannuation Contribution Benefit), or $30,000 per month. To apply for an increase in cover at any time, you have four options. 1. Apply online. Log on to Member Online, under the section Your Personal Details, select Insurance Details and select the Insurance Online button to launch. Follow the simple online application process and receive an answer straight away. 2. Call to request a tele-interview with the Insurer s underwriting team - a representative of the Insurer will call you at a mutually convenient time and take you through the application and you will find out straight away whether your application is successful or if there is any extra information required. 3. Speak to a Catholic Financial Services Planner to discuss your insurance needs. Our Financial Planners can assist you to identify your insurance needs and determine the appropriate level of cover for you. They can also assist you to complete an insurance application or you can use one of the other options listed here to apply for additional insurance. Call or book an appointment online to speak to a Planner about your insurance needs. A fee may apply. 4. Complete the Application for Insurance Cover available on our website or by calling Your application is subject to assessment and acceptance by the Insurer. Additional premium costs will apply and these costs are based on your age and the amount of additional insurance for which you are applying. Reducing your cover You can reduce or cancel your cover at any time. If you cancel your cover and decide to apply again in the future, you will need to supply health information as part of your application and your application will need to be assessed by the Insurer. To reduce or cancel your cover, please write to us at the address shown at the back of this guide, or call Member Services on Before deciding to decrease or cancel your insurance cover, we strongly recommend you seek professional advice regarding the implications of such a decision. The cost of your Income Protection cover The cost of your cover depends on your age, the waiting period, benefit period and the amount of cover you have. The easiest way to calculate the cost of cover that s right for you is to use our simple online insurance cost calculator at If you would like to calculate the cost yourself, select the annual amount of cover you want (in multiples of $1000) and multiply by the premium cost which applies to your age next birthday (see table below). The formula to calculate the cost of Income Protection cover is: The annual amount of cover you want 1,000 x the relevant premium for your age, waiting period and benefit payment period (see table overleaf), = annual premium cost. Example John is 27 (28 next birthday). John wants $80,000 of Income Protection cover, with a 60 day waiting period and benefits payable for 5 years. John s annual cost is: $80,000 1,000 x the premium cost of $1.41 = $ per year
12 10 The cost of your Income Protection cover (continued) The cost of your insurance cover will be deducted directly from your Catholic Super account on a monthly basis in arrears from the date your insurance cover commences. The cost of your cover will alter each year on your birthday. Age Next Birthday Income Protection Annual cost per $1,000 annual benefit 30 day waiting period 60 day waiting period 5 year benefit ($) To age 65 ($) To age 70 ($) 5 year benefit ($) To age 65 ($) To age 70 ($) N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 18.89
13 11 Claiming an Income Protection benefit When is an Income Protection benefit paid? To qualify for an Income Protection benefit you must suffer an injury or illness and meet the definition of Total Disability or Partial Disability under the terms of the insurance policy. The current definitions of Total Disability and Partial Disability are shown in Insurance words and terms on pages 15 to 17. How is my benefit calculated? If you make a claim for Income Protection, the benefit payable will be determined by the amount of cover you hold and your Earned Income, up to the Maximum Benefit. Your Earned Income is determined differently depending upon whether you are a permanent employee, a casual employee or self-employed at the time of injury, illness or accident. These definitions are shown in Insurance words and terms on pages 15 to 17. The amount of Income Protection benefit payable to you will be reduced by the amount of any: employer funded sick leave payments worker s compensation schemes income benefits from other disability income insurance policies or superannuation funds and statutory compensation, pension, social security or similar schemes. Making a claim for a benefit If you become unable to work as a result of becoming disabled due to illness, accident or injury, please notify us as soon as possible after you become disabled. Claim forms and assistance are available by contacting us on Premium waiver While a member is receiving an Income Protection benefit, their premiums with respect to Income Protection will be waived. Recurrent disablement Within 6 months of the cessation of disability benefit payments After 6 months of the cessation of disability benefit payments If you become Totally or Partially Disabled again due to the same or a related injury or illness, within 6 months of ceasing to be disabled: the waiting period will be waived and the recurrence will be treated as a continuation of the previous claim, and the maximum Benefit Period will take into account your prior claim period (provided you are still an insured member of Catholic Super). This will be treated as a new claim and normal waiting periods apply. Benefit escalation If you receive a Total or Partial Disability benefit payment for a continuous period of 12 months or more, from each anniversary date of the commencement of benefit payments, the benefit will be increased by the lesser of: the increase in the Consumer Price Index (CPI) for that period, or 5%. Tax on benefits Income Protection insurance benefits are paid as taxable income and like salary and wages, attract Pay As You Go (PAYG) tax. The tax will be deducted from the benefit before it is paid to you, and remitted to the Australian Taxation Office. Exclusions for Income Protection cover An Income Protection benefit is not payable if your Total Disability or Partial Disability results directly or indirectly from: 1. an intentional self-inflicted act or intentional self-inflicted injury 2. uncomplicated pregnancy or childbirth 3. war or acts of war whether declared or not 4. service in the armed forces of any national or international organisation other than the Australian Army Reserves (during scheduled Army Reserve exercises but not if called up for active service), or 5. any exclusion applied to you as a condition of acceptance of your cover.
14 12 Insurance other important information you need to know Who is eligible for cover with Catholic Super? To be eligible for insurance cover within Catholic Super, you must be: an Australian resident or temporary resident* unless otherwise agreed in writing and a member of Catholic Super. Where either of the above does not apply, you may also be accepted by the Insurer in writing. If you have previously been paid a TPD benefit, or are eligible to be paid a TPD benefit from another superannuation fund or insurance policy at the time of joining Catholic Super, you are eligible for Death only cover, not combined Death and TPD cover. Duty of Disclosure Before you enter into a contract of insurance with the Insurer, you have a duty to disclose every matter that you know, or could reasonably be expected to know, that may be relevant to the Insurer s decision whether to accept the risk of insurance and, if so, on what terms. You have the same duty to disclose those matters to the Insurer before you extend, vary or reinstate a contract of insurance. Your duty however, does not require disclosure of a matter: that diminishes the risk to be undertaken by the Insurer that is of common knowledge that the Insurer knows or, in the ordinary course of its business, ought to know, or the disclosure of which is waived by the Insurer. The duty of disclosure applies even after your application for cover is completed until the Insurer s acceptance of insurance is issued in writing. If you fail to comply with your duty of disclosure and the Insurer would not have entered into the contract on any terms if the failure had not occurred, the Insurer may avoid the contract within three years of entering into it. If your non-disclosure is fraudulent, the Insurer may void the contract at any time. If the Insurer is entitled to avoid a contract of insurance, the Insurer may, within three years of entering into it, elect not to avoid it but to reduce the sum for which you have been insured, taking into account the premium that would have been payable if you had disclosed all relevant matters to the Insurer. Is there a maximum age that I can apply for cover? You can apply for Death cover and Income Protection cover provided you are under age 70. To apply for TPD cover you must be under the age of 64. Eligibility to increase your cover following a Life Event To be eligible to increase your insurance cover following a Life Event, you must: 1. be under age not be engaged in a Hazardous Occupation 3. be at work (see definition on page 15) 4. not have been absent from work due to illness or injury for (other than cold or flu) for more than six days in the 12 months preceding the date of acceptance 5. not have had an increase in cover due to a Life Event in the 12 months preceding the date of your latest application 6. not have been diagnosed with, or not suffer from, an Illness that reduces your life expectancy to less than 12 months from the date of acceptance of the application 7. not have ever been declined or had any loadings, limitations, alternative terms and/or exclusions applying to insurance cover for death only, death and total and permanent disablement or income protection (including accident or sickness) 8. not be entitled to lodge or intend to lodge or have never lodged a claim for an Illness or Injury through worker s compensation, sickness benefit, invalid pension or any insurance policy providing total and permanent disablement cover, accident or sickness cover. In addition: 1. the Insurer may accept or reject an application for Life Events Cover and cover only commences from the date of Our written acceptance 2. the Insurer may impose individual restrictions, conditions, exclusions or premium loadings to the Life Events Cover 3. Life Events Cover will be subject to the same exclusions, special conditions and limits that apply to your existing cover. * Temporary resident means a person who is residing in Australia on a temporary working visa.
15 13 Transfer of existing insurance cover into Catholic Super As an Employer Sponsored or Personal Plan member, if you are under 60 years of age, you may be eligible to transfer your existing Death, TPD and/or Income Protection insurance cover from your current employer sponsored super arrangement or individual insurance policy to Catholic Super. To transfer your existing cover to Catholic Super, you can: 1. request the transfer online through Insurance Online. Simply login to Member Online and in the section Your Personal Details select Insurance Details and launch Insurance Online. Follow the simple steps and submit your transfer request online. 2. complete the Insurance Transfer form. Download the form from our website at or call to request a copy. If your transfer is accepted, you will be provided with the equivalent level and type of cover that your previous insurer provided. If you are already a member of Catholic Super and wish to consolidate other insurance policies into Catholic Super, the transferred cover will be added in addition to all existing cover held with Catholic Super. With appropriate evidence of cover, a transfer can occur at any time. A transfer must involve benefits of the same or similar type. The maximum amount of cover available within Catholic Super after the transfer is: Death unlimited TPD $3 million Income Protection the lesser of $30,000 per month and 85% of your Earned Income at the time of transfer. You are advised not to cancel cover with your previous insurer until you are advised in writing that your insurance transfer application has been accepted by the Insurer. Additional premium costs will apply and these costs are based on your age and the amount of additional insurance which you are transferring. When will my cover cease? Your insurance cover will cease on the earliest of any one of the following situations: the date you cease to be a member of Catholic Super the date you reach the maximum insurable age for the specified cover the date of your death the date the insurance policy is terminated the date your cover is cancelled for any reason the date that Catholic Super receives your request to terminate your cover the last day of the month in respect of which the last premium deduction is made from your account, if there is insufficient money in the account to cover premiums for Income Protection cover held by an Employer Sponsored member, 12 months from the effective date of the last Participating Employer SG contribution received by Catholic Super on your behalf, unless otherwise agreed in writing by the Insurer, or the date cover ceases in accordance with the terms and conditions relating to the overseas employment and worldwide cover under the insurance policy. Can my cover recommence after ceasing? Employer Sponsored members If you have previously opted out of cover, cancelled cover or reduced your insurance cover, all future requests for cover or increases in cover will be subject to assessment and acceptance by the Insurer. If your cover ceases as a result of insufficient funds, and: a. you subsequently receive an employer sponsored SG contribution within six months of the end of the month during which cover ceased, the cover previously held will be reinstated at the type and level of cover held immediately prior to cover ceasing. In this instance, cover will recommence from the start date of the period for which the employer sponsored SG contribution is received by Catholic Super on your behalf. b. you subsequently receive an employer sponsored SG contribution more than six months from the date cover ceased, cover will recommence at the lesser of the previous type and level of cover or Default Cover. Cover will recommence from the start date of the period for which the employer sponsored SG contribution is received by Catholic Super on your behalf. If you are not At Work on the date cover recommences, Limited Cover will apply to all cover until you are again At Work. Personal Plan members There are no recommencement of cover provisions for Personal Plan members. All cover is subject to assessment and acceptance by the Insurer.
16 14 Can Spouse Members apply for insurance cover? If you are joining Catholic Super as a Spouse Member, you may apply for Death only, Death and TPD and/or Income Protection cover under the Personal Plan members insurance option. This allows you to apply for a fixed level of Death and TPD cover and Income Protection cover in multiples of $1,000. Your Insurance cover will not commence until the Insurer has assessed and accepted your application for cover and Catholic Super confirms this in writing. Interim Accident cover If you make an application for additional cover, while that application is being assessed, you will be provided with interim cover based on the cover for which you have applied (Death, TPD and/or Income Protection cover). This will provide you with cover in the event of an Accident occurring while your application is being assessed. Interim Accident cover commences from the date Catholic Super receives your application for cover, and will cease on the earliest of: a. the date your application for cover is withdrawn b. the date the Insurer declines your application for cover c. the date the Insurer accepts your application for cover d. the date the Insurer receives your acceptance of the Insurer s offer or a counter offer for cover e. the date 120 days from the date Catholic Super receives your fully completed application for cover, or f. where applicable, the date you cease to be a member of Catholic Super. The amount of benefit for the Interim Accident cover will be the lesser of: a. the proposed insured benefit, and b. $1,000,000 for Death and TPD cover, or c. $15,000 per month for Total Disability and Partial Disability. The Interim Accident cover will not be payable if: a. TPD, Total Disability or Partial Disability, can reasonably be attributed to a pre-existing condition, or b. any of the exclusions (as outlined above) apply. If you think you qualify for the Interim Accident benefit, please contact us on How does parental leave and leave without pay affect my insurance? Death, TPD and Income Protection cover will continue for members on parental leave or leave without pay subject to the ongoing payment of premiums. Cover is conditional upon the member s employer holding appropriate leave records for the member s leave including: the date the leave commences, and the expected return to work date for the member. If you have Income Protection cover, 1. in the event of Total Disability or Partial Disability whilst on leave without pay, the Earned Income definition for non-permanent employees will be used to determine any benefit payable. 2. in relation to payment of Income Protection benefits, the waiting period will commence on the date of disablement with benefits commencing upon the expiry of the waiting period. Any paid parental leave will be offset against any Income Protection benefit payment the member is eligible to receive during the parental leave period. Employment or travel overseas Members who are Australian residents are not required to advise Catholic Super or the Insurer before they commence employment overseas but cover will be subject to premiums continuing to be paid. Temporary residents who have been accepted for cover will be covered overseas for up to three months. Temporary residents employed overseas may be covered for longer than a period of three months subject to prior approval by the Insurer. For insured members of Catholic Super who are submitting a claim, or currently on a claim, from outside Australia, the Insurer may require them to return to Australia, at their expense, for assessment of the claim. Confirming how much cover you have Your annual member statement shows the amount of cover you have and any insurance premiums deducted from your account during the year. You can also check these details online at any time by using Member Online our secure internet facility for members, or by calling us on
17 Insurance words and terms 15 Accident Means an unforeseen violent, external and visible event that occurs accidentally during the period of cover. At Work This means the insured member is: a. gainfully employed, performing all of the normal duties of their usual occupation and working their normal hours without restriction due to illness or injury, or is on approved leave other than leave which is taken for reasons related to injury or illness; and b. is not receiving or claiming and/or entitled to receive or claim income support benefits from any source, including workers compensation benefits, statutory transport accident benefits and disability income benefits. For casual employees, At Work means the person is available for work and is capable of performing all the normal duties for their occupation without restriction due to illness or injury. Benefit Period The benefit period commences on the day immediately after the waiting period has concluded and the benefit will be payable for the duration of the applicable benefit period subject to continued eligibility and the relevant terms and conditions of the insurance policy. Earned Income Your Work Status Permanent Employee Non Permanent Employee (including casuals, part-time, unemployed) Self-Employed Definition of Earned Income The total package from employment last agreed between the employer and insured member immediately prior to the commencement of Total Disability which includes: any salary packaged items taken in lieu of cash, regular overtime and shift allowances (as determined by the average over the previous 12 months or the period since the insured member started their current occupation if less), and commissions, regular bonuses, fringe benefits and other monetary benefits related to employment, (as determined by the average over the previous three years or the period since the insured member started their current occupation if less). Earned income does not include employer superannuation contributions made by the employer that are not part of a salary sacrifice arrangement. The total earnings from employment averaged over the 12 months immediately prior to the commencement of Total Disability, or the period of time since the insured member joined Catholic Super, whichever is the lesser. The annual income generated by the insured member from his or her personal exertion, calculated by averaging the insured member s net income per year for the 2 years immediately preceding commencement of Total Disability or the period of time since the member commenced to be self-employed if self-employed for a period less than 2 years. Net income means the insured member s gross income from personal exertion less all expenses incurred by the insured member in earning that income.
18 16 Limited Cover Limited Cover means a member is only covered for claims arising from an illness that first becomes apparent or an injury which first occurred on or after the date the cover commenced, recommenced or increased under the policy for the member. Medical Practitioner Medical Practitioner means a Medical Practitioner legally qualified and registered to practise in Australia; who is not the insured member under the insurance policy, the owner of the insurance policy, their relative, business partner, shareholder or employee. Where the Medical Practitioner is outside Australia, he or she must have qualifications equivalent to Australian standards. Partial Disability and/or Partially Disabled Income Protection Means that immediately following a period of at least 14 consecutive calendar days of Total Disability, and as a result of the same illness or injury that caused the Total Disability, the insured member: a. is unable to perform at full capacity the duties of his or her regular occupation that the insured member was working in prior to commencement of Total Disability, and b. is working in his/her own occupation or other occupation in a reduced capacity, and c. suffers a partial loss of Earned Income, and d. is under the regular care of a Medical Practitioner, and in the Insurer s reasonable opinion, is complying with the advice and treatment given by that Medical Practitioner in relation to the cause of the Partial Disability. Partial Disability Benefit A Partial Disability Benefit is calculated by application of the following formula: Earned Income - RTEI Earned Income x Total Disability Benefit where RTEI is Return To Employment Income, and means the annualised Earned Income that the insured person is earning (calculated in accordance with the Earned Income definition above). Terminal Illness and Terminally Ill Means any condition that, in the opinion of two appropriate specialist Medical Practitioners approved by us and having regard to the current treatment or such other treatment as the insured person may reasonably be expected to receive, is likely to lead to the insured person s death within 12 months from the date the insured person is diagnosed with the condition. Total Disability and Totally Disabled Income Protection Cover Total Disability and Totally Disabled means that in the insurer s opinion the insured person, while insured, as a direct result of an Illness or Injury: a. is unable to perform at least one important income producing duty of his or her regular occupation; b. is not working in any capacity, gainfully or otherwise; and c. is under the regular care and following the advice of a Medical Practitioner and, in the Insurer s reasonable opinion, is complying with the advice and treatment given by that Medical Practitioner. Total and Permanent Disablement TPD Cover The applicable definition for TPD is assessed after the member has submitted the claim. Total and Permanent Disablement (TPD) means that in the Insurer s opinion the insured person, while insured by the Insurer: 1. is under the care of and following the advice of a Medical Practitioner; and 2. meets the Permanent Incapacity definition under Regulation 6.01 of the SIS Regulations 1994 (CTH), as amended from time to time; and 3. meets one of the following definitions Parts A,B,C,D, E or F as applicable: A. solely because of Illness or Injury has suffered the permanent loss of: (i) the use of two limbs (where limb is defined as the whole hand below the wrist or whole foot below the ankle); (ii) the total sight in both eyes; or (iii) the use of one limb and the total sight in one eye; or B. solely because of Illness or Injury: (i) has suffered at least 25% Whole Person Impairment; (ii) is not engaged in any occupation; and (iii) is disabled to such an extent as to render them unlikely to ever be engaged in any occupation for which they are reasonably suited by education, training or experience; or C. solely because of Illness or Injury is unlikely ever to be able to perform at least two of the following Activities of Daily Living: (i) Dressing the ability to put on and take off clothing without assistance; (ii) Bathing the ability to wash or shower without assistance; (iii) Toileting the ability to use the toilet, including getting on and off, without assistance; (iv) Mobility the ability to get in and out of bed and a chair without assistance; or (v) Feeding the ability to get food from a plate into the mouth without assistance; where assistance means the assistance of another person; or