Application Form and Insurance Information

Transcription

1 Application Form and Insurance Information Family Day Care Australia Educator Insurance 9

2 Insurance Application Form If paying by phone you do not need to complete this form. Applicant Details The family day care Approved Service Provider you are registered with: Your title: First name: Last name: Address: Suburb: State: Postcode: Date of birth: Phone: (home) Phone: (mobile) Fax: Have you ever held public liability insurance for your family day care service with a different insurer? Yes No If YES, which insurer: Period of continuous cover: to I understand that I can withdraw my consent to the use of my personal information for the purposes of receiving marketing and promotional materials at any time by contacting Family Day Care Australia on freecall Your membership package refer to pages 4-6 for package information and pricing. Tick your selected option. Family day care (and FDC + IHC) Out of home care (FDC + OOHC) In home care (only) 12 month policy 3 month kick start* 12 month policy 3 month kick start* 12 month policy 3 month kick start* *A kick start package can only ever be used once by an educator. NB: FDCA members receive significant discounts on premiums and individual products do incur a surcharge. Policy start date please commence my policy on Select the date of your first schedule parent interview or, the expiry date of your existing policy. If we receive this application form after that date we will back date your policy to the specified date, as long as it is within 30 days and there have been no incidents during that time. If we receive this application more than 30 days from your specified start date, we will start the policy from the date we receive the completed application. Duty of Disclosure and Declaration I declare that a) I have read and understood Family Day Care Australia s Financial Services Guide, Privacy Policy, Duty of Disclosure and Product Disclosure Statement for Personal Accident Insurance for Children, if this product has been selected. b) I have read and understood the Direct Debit Conditions and, should I choose to pay by instalment I agree to be bound by those Conditions. C) I authorise Family Day Care Australia to give to or obtain from any relevant authority, any information relating to my insurances. Before you enter into a general insurance with an insurer, you have a duty under the Insurance Contracts Act 1984, to disclose to the insurer every matter which you know, or could reasonably be expected to know, is relevant to the insurer s decision whether to accept the risk of the insurance and, if so, on what terms. You have the same duty to disclose those matters to the insurer before you renew, vary or reinstate a contract of general insurance, Your duty however does not require disclosure of any matter: that diminishes the risk to be undertaken by the insurer, that is of common knowledge, that your insurer knows, or in the course of his business, ought to know and as to which compliance to your duty is waived by the insurer. The questions below are a mandatory requirement of your application. They must be answered. Yes Yes Yes No No No If yes please provide details on an attached sheet. 1. Has any insurer ever cancelled, declined or refused to renew or imposed special conditions on any of your insurances? 2. During the last 5 years have any claims been made or threatened against you that might have been insured under the insurance policies you are applying for? 3. Are you aware of any circumstances which have already occurred that might result in a claim under the insurance policies you are applying for or are you aware of any impending infringement notice or fine under the Education and Care Services National Law or any other relevant Act? Declaration signature Date Return by post, fax or Post: PO BOX 571, Go sford NSW 2250 Fax: memberservices@fdca.com.au Family Day Car Australia ABN AFSL Agents Authority: an agent is a person you authorise to act on your behalf. I authorise (agents name) to act as my agent in relation to my FDC business insurances. Agent s 10 Family signature: Day Care Australia Educator Insurance Agent s date of birth:

3 Annual Payment Form If you have selected a Kick Start Package you must pay the full amount (you cannot pay by instalments). The amount you will be charged will be based on the package you have selected and in line with the Package Pricing If you have selected a Kick Start Package you must pay the full amount (you cannot pay by instalments). Chart on page 8 of this booklet. The amount you will be charged will be based on the package you have selected and in line with the Package Pricing The annual full payment option is a one off payment of the premium due. Chart on page 8 of this booklet. The monthly instalments option is a business loan agreement between you and the Premium Funder. The loan is repaid over 10 monthly instalments and includes additional administration fees. How would you like to pay? Select your payment option. How would you like tomonthly pay? Select your payment option. Annual full payment instalments 1. Credit Card We will debit your selected package fee from the nominated credit card. Complete and return this form. 1. Credit Card We will debit your selected package fee from the nominated credit card. Complete and return this form. Card Type: Card Type: MasterCard MasterCard Visa Visa Name of Cardholder Name of Cardholder Card Number Card Number Expiry Date Expiry Date Signature Signature Date Signed Date Signed CVV *What s this? CVV *What s this? *CVV is the 3-digit code on the back of your card *CVV is the 3-digit code on the back of your card OR OR 2. Bank Account Direct Debit We will debit your selected package fee from the nominated account. Complete and return this form. 2. Electronic Funds Transfer (EFT) Name of bank If you wish to pay by direct deposit, please call Family Day Care Australia on Branch Branch Number (BSB) Name of account holder Account number OR Signature Date Signed 3. Cheque or Money Order tick the box below and return this form OR by post with your chequemoney order. Enclosed is a chequemoney order made payable to Family Day Care Australia. 3. Cheque or Money Order tick the box below and return this form by post with your chequemoney order. Enclosed is a chequemoney order made payable to Family Day Care Australia. Return by post, fax or Post: PO BOX 571, Gosford NSW 2250 Fax: memberservices@fdca.com.au Family Day Care Australia ABN AFSL Return by post, fax or Post: PO BOX 571, Gosford NSW 2250 Fax: Family Day Care Australia Educator Insurance 11 memberservices@fdca.com.au Family Day Care Australia ABN AFSL

4 Insurance Payment Options Monthly instalments payment form Complete this application form in blue or black pen and return to: Family Day Care Australia, PO Box 571, Gosford NSW 2250 or fax to (02) DO NOT USE THIS FORM IF YOU HAVE SELECTED A KICK START PACKAGE Family Day Care Australia has contracted Premier Funding Services Pty. Limited (ABN ) to offer business loans to its member educators to assist in the payment of FDCA membership and Insurance packages. When choosing to pay by monthly instalments through Premier Funding Services you are entering into a business loan agreement. Upon receipt of this application form, Premier Funding Services will set up a loan for the amount you indicate below and will then pay the full annual amount of the insurance and membership package to Family Day Care Australia. The loan is then repaid by you over 10 monthly instalments. Premier Funding Services will charge an initial set up fee of $15 and collection fees of $6 per month over ten months. See overleaf for full terms and conditions. PLEASE COMPLETE ALL THREE STEPS BELOW AND SIGN IN STEP 2 AND STEP 3 WHERE INDICATED. STEP 1: YOUR DETAILS ( You are the educator taking out the direct debit service agreement) YOUR FIRST NAME YOUR LAST NAME YOUR ADDRESS SUBURB STATE POSTCODE TELEPHONE NUMBER COORDINATION UNIT NAME STEP 2: YOUR LOAN APPLICATION I am applying to Premier Funding Services for a direct debit service agreement as per the selected Insurance Package to pay Family Day Care Australia for my insurance and membership package. I authorise Premier Funding Services to make ten monthly debits from my nominated bank account or credit card to repay the loan. I understand that the first monthly instalment will include a $15 loan establishment fee and every monthly instalment will include a $6 collection fee. I acknowledge that monthly debits will occur on either on the policy start date on my completed FDCA membership and Insurance package application form, or the next business day, if your policy start date has passed (only up to 30 days). I declare that before completing this form I have read and understood the Premier Funding Services Direct Debit Request Service Agreement (Payment Plan) Terms and Conditions (overleaf). I authorise Premier Funding Services to give or to obtain from Family Day Care Australia any information relating to the package financed under the Direct Debit Request Service Agreement. I understand, acknowledge and agree that (a) should I default on my payments that Premier Funding Services has the legal right to cancel my insurance policy back to the last successful date of payment leaving me without insurance cover; (b) should I cancel the package I am still liable to pay the full minimum amount payable; and (c) Premier Funding Services will pay to me any refund owing less applicable cancellation fees. YOUR SIGNATURE X DATE STEP 3: YOUR PAYMENT OPTIONS Please note that there is a 1.5% credit card surcharge for each credit card transaction We request and authorise Premier Funding Services (User id No )to arrange a debit to your nominated account any amount Premier Funding Services has deemed payable by you under any agreement you have with PFS. By signing and or providing us with a valid instruction in respect to your Direct Debit Request Service Agreement you have understood and agreed to the terms and conditions governing the debit arrangements between you and PFS as set out in your Direct Debit Request Service Agreement. OPTION 1 - YOUR CREDIT CARD OPTION 2 BANK ACCOUNT DETAILS Visa Mastercard Bank: Branch: CARDHOLDER S NAME (please print) ACCOUNT HOLDER S NAME (please print) CREDIT CARD NUMBER (16 digits) BSB NUMBER (must be 6 digits) ACCOUNT NUMBER (no more than 9 digits) EXPIRY DATE CARDHOLDER S SIGNATURE X ACCOUNT HOLDER S SIGNATURE X (If joint account and both must sign, then both signatures are required) 12 Family Day Care Australia Educator Insurance

5 Business Loan Master Agreement Payment Plan January 2015 TERMS AND CONDITIONS 1. The Business Loan Master Agreement Payment Plan (the payment plan) is provided by Premier Funding Services Pty Limited (PFS) ABN This is a Master Agreement and as such all future insurance policies placed with Family Day Care Australia will be paid for via direct debit of your nominated bank account until PFS are instructed to cease use of this direct debit facility. 3. Monthly repayment amounts set out in the Payment Plan Schedule include a $15 loan establishment fee and a monthly transaction fee of $6 charged by PFS. Monthly repayments made on VISA or Mastercard will attract a 1.5% credit card surcharge for each transaction. 4. PFS will pay your membership and insurance package (the package) in full on your behalf to Family Day Care Australia and will take security over the Package including any refund of premium payable in the event of loan default. 5. By entering into this Payment Plan you have agreed to pay PFS all monthly repayments in their entirety as and when they fall due. 13. There are certain non refundable components within you Package. If your Package is cancelled for any reason PFS will continue to debit your financial institution or credit card until the non-refundable charges, plus your public liability insurance for the policy period and all PFS charges have been paid in full. Any refund following cancellation is payable to PFS and these funds may reduce or cease the monthly repayments. 14. In the event of cancellation a fee may be charged by PFS which will be no greater than $30. A cancellation refund amount of less than $20 will not be refunded to you. 15. PFS will disburse the funds as outlined in the insurance schedule to Family day Care Australia within their agreed credit terms. 1.5% Commission is payable by PFS to Family Day Care Australia in relation to this Payment Plan. 16. To contact PFS phone them on or , write to them PO Box 369, Port Melbourne VIC or them at admin@premierfunding.com.au 6. The first due date will occur on the date specified start date or next business day. A debit date that falls on a weekend or a public holiday in metropolitan Victoria will be debited on the next working day. 7. You are responsible to ensure that sufficient cleared funds are available for the direct debit transaction or that sufficient credit is available on your credit card for the Payment Plan transaction. 8. If the Payment Plan transaction fails due to insufficient funds, account closure, incorrect account number or other such fault that you have not advised PFS about, we will attempt to re-draw the outstanding amount after 4 business days from the dishonoured payment. In addition to re-drawing the outstanding amount you will be charged a dishonour fee of $25 each time. This is in addition to any fees your bank may charge you. 9. A dishonoured payment or a payment in arrears constitutes a default event under this Payment Plan. Your payments must be kept in advance at all times. PFS will only tolerate two dishonoured payments throughout the period of the Payment Plan before taking steps to cancel the Package. 10. In the event of a default PFS, as holder of the rights to the Package, can cancel the Package and receive any applicable refund to service your debt. Where applicable the cancellation of the Package may be backdated to ensure a sufficient refund is payable for the outstanding debt. 11. In the event of a default PFS will notify you in writing of their intent to cancel the Package, allowing seven days from the date of the notification for you to remedy the situation. 12. Should you no longer require this Package you may request to cancel the Package in writing with Family Day Care Australia. Your letter must state your full name, address, client code, the Package you cancelling and the effective date of cancellation which will usually be your last day of the service. Send the cancellation letter to Family Day Care Australia, PO Box 571, Gosford NSW Family Day Care Australia will advise PFS of the date of cancellation. Family Day Care Australia Educator Insurance 13

6 Financial Services Guide January 2015 (V18) This Financial Services Guide (FSG) contains important information to assist you in deciding whether to use our services and includes: 1. Who we are and who we act for 2. Types of services we provide 3. Your Duty of disclosure 4. Product Disclosure Statement (PDS) 5. Insuring the interest of other parties 6. Change of risk or circumstances 7. Terms of the insurance contract 8. Insurers rights following a claim 9. Insurers 10. Access to your information 11. Payment for our services 12. Cooling off period 13. Potential conflicts of interest 14. Complaints policy 15. Insurance Brokers Code of Practice 16. Compensation arrangements for clients losses 17. How to contact us 1. Who we are and who we act for Family Day Care Australia Limited (FDCA) ABN AFSL is the national association for family day care. As an insurance broker we act on your behalf. FDCA has appointed Imalia CareCover Pty Ltd (Imalia CareCover) to act as our authorised representative (AR ). Imalia CareCover acts on behalf of FDCA, and therefore also acts on your behalf. 2. Types of services we provide We can provide general product advice and arrange general insurance products. Imalia CareCover is authorised to provide general advice on, and (deal) in, Public Liability Insurance, Management Liability Insurance, Personal Accident Insurance for Children and Carers, Property and Motor Insurance. Imalia CareCover carries out the day to day policy administration and management activities on behalf of FDCA. Any advice we provide is general in nature and we do not take into account your personal needs or financial objectives. Before you decide to purchase general insurance products from us you need to consider if the advice and relevant product is right for your circumstances as we have not done this. We act as a referrer only for Income Protection and Superannuation. In making any referral we do not advise or represent that their products and services are right for you and take no responsibility for the products and services they may provide to you. You need to make your own decision based on the information they provide. Premium funding is available for certain FDCA products and enables you to spread your payment over instalments rather than pay it in a lump sum; however you will have to pay a fee to the premium funder. When we offer you premium funding we act on behalf of the premium funder, not you. We do not provide personal advice or represent that any of the funder s products and services are right for you or that they are the most appropriate. You need to make your own decision based on the information provided. 3. Your Duty of disclosure Before you enter into a contract of general insurance with an Insurer, you have a duty under the Insurance Contracts Act 1984, to disclose to the Insurer every matter that you know, or could reasonably be expected to know, is relevant to the Insurer s decision whether to accept the risk of the insurance and, if so, on what terms. You have the same duty to disclose those matters to the Insurer before you renew, vary or reinstate a contract of general insurance. Your duty however does not require disclosure of any matter that diminishes the risk to be undertaken by the Insurer, that is of common knowledge, that your insurer knows or, in the course of their 14 Family business Day ought Care to Australia know, as Educator which compliance Insurance with your duty is waived by the insurer. Non-Disclosure and Misrepresentation If you fail to disclose any matter, which you were under a duty to disclose to the insurer or you made a misrepresentation to the insurer before this Policy was entered into, the Insurer may be entitled to reduce its liability under the Contract in respect of a claim or may cancel the contract. If your non disclosure is fraudulent, the Insurer may also have the option of voiding the contract from its beginning. Contracts of Insurance are subject to the doctrine of utmost good faith. Failure to adhere to this may prejudice any claim. 4. Product Disclosure Statement If you ask us to arrange personal accident insurance for carers or children, motor vehicle or home and contents insurance we will provide you with a Product Disclosure Statement (PDS) unless you already have an up to date version. It is prepared by the insurer and is designed to help you make an informed decision about the financial product. 5. Insuring the interest of other parties If you require the interest of a party other than the named insured to be covered, you MUST request this. Most Policy conditions will exclude indemnity to other parties. 6. Change of risk or circumstances It is important that you advise us of any location changes, business activities or any departure from your normal form of business. 7. Terms of the insurance contract By taking out this insurance you agree that: a) You have read and understood FDCA s Financial Services Guide and Duty of Disclosure, Privacy Policy and the relevant Product Disclosure Statements if Personal Accident for Children or Carers, Motor Vehicle and Home & Contents insurances have been selected. b) You have read and understood the Premium Funding Payment and Instalment Plan Terms and Conditions and you agree to be bound by these Terms and Conditions. c) You authorise FDCA (ABN ) to give to or obtain from any relevant authority or the Service you are registered with, any information relating to the status of the insurances you have selected. d) You understand that: i) any statement made in the application will be treated by us as a statement made by all the people insured ii) the insurances and membership are only valid if you are registered with an Australian Government Funded Family Day Care scheme or In-Home Care service e) If you are a FDCA member, you agree to be bound by the constitution and by-laws of FDCA f) The insurances and membership are non-transferable 8. Insurer s rights following a claim Under the policy the insurer is entitled on the happening of any accident, injury, loss or damage to undertake in your name and on your behalf the conduct, control and settlement of any proceedings and to take proceedings at their own expense and for their own benefit but in your name to recover property or secure indemnity or contribution in respect of anything insured in this Policy. 9. Insurers Your Insurances are only arranged with Insurers that are authorised under the Insurance Act 1973 to conduct insurance business in Australia. Although the insurers are subject to the supervision of the Australian Prudential Regulation Authority (APRA), we are not in a position to guarantee that any insurer will at all times be in a position to pay claims as and when they occur and we disclaim any liability for losses that you may not be able to recover from your insurers. 10. Privacy We are committed to protecting your privacy. We use the information you provide to advise about and assist with your insurance needs. We provide your information to insurance companies and agents that provide insurance quotes and offer insurance terms to you or the companies that deal with your insurance claim (such as loss assessors and claims administrators) as well as contractors or partners who supply services to us or our members. We also provide details of your insurance status to the Service that you are registered with (including providing your Certificate of

7 Insurance) as well as Regulatory Authorities if requested. Your information may be given to an overseas insurer (like Lloyd s of London) if we are seeking insurance terms from an overseas insurer or to reinsurers who are located overseas. We will try to tell you where those companies are located at the time of advising you and if necessary, seek your consent before disclosing your information to them. We do not trade, rent or sell your information. If you don t provide us with full information, we can t properly advise you, seek insurance terms for you or assist with claims and you can breach your duty of disclosure. For more information about how to access the personal information we hold about you, how to have the information corrected and how to complain if you think we have breached the privacy law, ask us for a copy of our Privacy Policy or visit our website. 11. Payment for our services When we place insurance for you we receive commission from the insurer (including renewals and some variations to the policy). The commission is a percentage of the insurer s base premium (i.e. excluding stamp duty, fire services levy, GST or any other government charges, taxes, fees or levies). The commission rate varies between 0-30%. Different insurers can agree to pay us different commission rates for the same type of products. The rates also vary for each product type. FDCA may sometimes receive additional remuneration from insurers though profit commissions on insurance products. Because the amount of the commission earned may vary depending on the performance of the portfolio over a period of time, the amount of possible commission attributable to any policy will not be known at the time of placement. FDCA pays to Imalia CareCover a fee equal to 35% of the commission we receive for the policy administration and management services it provides to us. We receive between 0-30% commission from Income Protection and Superannuation referrals. The commission does not represent our profit margin as it also reimburses us for administrative and other expenses we incur in providing our services. The commission is included in the premium amount detailed on your invoice and we receive it when you pay the premium or at a later time as agreed with the insurer. You may cancel your policy at any time and under certain circumstances, you may be eligible for a refund. If you advise us in writing within 14 days of the inception date of the policy and no care has taken place, we will refund the full premiums of certain products less a cancellation fee of $ Beyond this 14 day term, Membership, Telephone Legal Advice, Personal Accident for Children and Kick Start Packages are non refundable. A proportion of your Public Liability Insurance may be eligible for refund beyond the 14 day term, less fees, commissions and government charges. No refunds are available on the Educator Management Liability Insurance Policy. We also have standard administrationpolicy handling fees which are charged in addition to the premium for the insurance to cover the cost of services for preparation and distribution of FDCA documentation and other services we provide to our members. The FDCA fee ranges between $0-$300 per policy and is noted in the documentation we send you. They are non-refundable. If you pay annually and cancel or vary your insurance package mid-term, FDCA will retain $25 (including GST) for our expenses in relation to the cancellation andor variation. If we have an agreement from you to direct debit your account and the agreed payment dishonours, we will charge you $30 (including GST) for our expenses in relation to the dishonour. If you are not a member of FDCA we will charge you a non-member fee of $ to arrange your insurance packages. 13. Potential Conflicts of Interest FDCA and its staff may also receive soft dollar benefits from insurers and other service providers and can include entertainment or small gifts. There are no other associations or relationships with insurers which may influence us in providing our services. 14. Complaints Policy FDCA have developed a Complaints and Dispute Resolution Process which is fair, efficient and accessible to all our clients. If you would like to make a complaint about the services provided by FDCA or Imalia Care Cover you should telephone FDCA on free call , or if you wish you can put your complaint in writing for referral to the complaints officer. The complaints officer will acknowledge your complaint in writing as soon as it is received by FDCA. We will respond to your complaint within 5 business days of receipt by FDCA. If the complaint is not resolved to your satisfaction you can refer the matter to the Financial Ombudsman Service Limited (FOS) au which is a national scheme for consumers. Its aim is to resolve disputes between clients, brokers and insurance companies. Contact them at Financial Ombudsman Service Limited GPO Box 3, Melbourne VIC 3001 Telephone: E: info@fos.org.au 15. Insurance Brokers Code of Practice FDCA subscribes to the National Insurance Brokers Association Code of Practice (The Code). The code sets out standards for Brokers to follow when dealing with clients. The code is available at Compensation arrangements for clients losses FDCA has a professional indemnity insurance policy (PI policy) in place. The PI policy covers FDCA, Imalia CareCover and their representatives (including ex employees and representatives) for claims made against them by clients as a result of their conduct in the provision of financial services. 17. How to contact us Family Day Care Australia Limited PO Box 571, Gosford NSW 2250 Telephone: Fax: E: memberservices@fdca.com.au W: This FSG Version was prepared on 1 September 2014 by Family Day Care Australia Limited ABN: , AFSL No: Please keep this document for your reference and any future dealings with us. All commission and fees assist to support the work of FDCA. When you pay us your premium it will be banked into our trust account. We retain the commission from the premium you pay us and remit the balance to the insurer. We may earn interest on the premium while it is in our trust account and retain any interest earned on the premium. If we arrange premium funding for you we are paid a commission of between 0-3% of the funded premium. From time to time FDCA provide sponsorship andor financial support to various Associations and co-ordination units of up to 10% of the annual premium. 12. Cooling off period A cooling off period may apply to an insurance policy issued to you as a retail client. During the period you may return the policy. If a cooling off period applies to your policy the details of your rights are included in the relevant Product Disclosure Statement. FSGv Family Day Care Australia Educator Insurance 15

8 Product Disclosure Statement Group Personal Accident Policy - Personal Accident for Children London Australia Underwriting Pty Ltd London Australia Underwriting Pty Ltd, ABN , is a coverholder for certain Underwriters at Lloyd s. London Australia Underwriting Pty Ltd has the authority to bind this Policy on their behalf. Your Duty of Disclosure Section 21 of the Insurance Contracts Act 1984 provides that before you enter into a contract of general insurance with an insurer, you have a duty to disclose to the insurer every matter that you know, or could reasonably be expected to know, is relevant to the insurer s decision whether to accept the risk of the insurance and, if so, upon what terms. You have the same duty to disclose those matters to the insurer before you renew, extend, vary or reinstate a contract of general insurance. Your duty, however, does not require disclosure of any matter: i) That diminishes the risk to be undertaken by the insurer; ii) That is of common knowledge; iii) That your insurer knows, or in the ordinary course of its business, ought to know; As to which compliance with your duty of disclosure is waived by the insurer. Non-Disclosure If you fail to comply with your duty of disclosure, the insurer may be entitled to reduce its liability under the contract in respect of a claim or may cancel the contract. If your non-disclosure is fraudulent, the insurer may also have the option of avoiding the contract from its beginning. Privacy Statement London Australia Underwriting Pty Ltd is bound by the obligations of the Privacy Act 1988 (as amended) regarding the collection, use, disclosure and handling of personal information. We will protect the privacy of your personal information. We collect personal information about you to enable us to provide you with relevant products and services, to assess your application for insurance and, if a contract is entered into, to enable us to provide, administer, and manage your policy, and to investigate and handle any claims under your policy. We may disclose your information to third parties (who may be located overseas), such as certain Underwriters at Lloyd s, lawyers, claims adjusters and others appointed by London Australia Underwriting Pty Ltd or by certain Underwriters at Lloyd s to assist us and them in providing relevant products and services. We may also disclose your information to people listed as co-insured on your policy and to your agents. By providing your personal information to us, you consent to us making these disclosures. If you do not provide all or part of the information required, we may not be able to provide you with our products and services, consider your application for insurance, administer your policy or assess or handle claims under your policy and you may breach your Duty of Disclosure. When you provide us with personal information about other individuals, we rely upon you to have made them aware of that disclosure and of the terms of the London Australia Underwriting Pty Ltd Privacy Statement and to obtain their consent. For a copy of the London Australia Underwriting Pty Ltd Privacy Statement or to request access to your personal information, contact the Privacy Officer at London Australia Underwriting Pty Ltd by feedback@ lauw.com.au or by mail at the address shown on this Policy. General Insurance Code of Practice The Policy complies with the Insurance Council of Australia s General Insurance Code of Practice, apart from claims adjusted outside of Australia. London Australia Underwriting Pty Ltd and Underwriters at Lloyd s proudly support the General Insurance Code of Practice. The purpose of the Code is to raise standards of practice and service in the general insurance industry. Complaints Handling Any enquiry or complaint relating to this insurance should be referred to London Australia Underwriting Pty Ltd in the first instance. We have an internal dispute resolution process to assist you and information about our complaints handling procedure is available upon request. If this does not resolve the matter or you are not satisfied with the way a complaint has been dealt with, you should contact: Lloyd s Australia Ltd Suite 2, Level 21 Angel Place 123 Pitt Street Sydney NSW 2000 Telephone Number: (02) Facsimile Number: (02) idraustralia@lloyds.com Complaints that cannot be resolved by Lloyd s Australia Ltd may be referred to the Financial Ombudsman Service. Further details will be provided at the appropriate stage of the complaints process. Provided the premium has been paid by the insured, underwriters will provide to the insured the insurance detailed in this Policy document, schedule and any attaching memoranda or endorsements subject to the terms, conditions, limitations and exclusions this Policy. DEFINITIONS The terms that appear in bold type in this Policy are defined in section below: Accident(al) shall mean a single and unexpected external event, not being the unintended consequence of an intended act, which occurs at an identifiable time and place. Benefit means the sums stated in the schedule of compensation being the maximum amount payable by the underwriters. Benefit period means the maximum period for which temporary total disablement and temporary partial disablement benefits are payable due to any one bodily injury. The benefit commences at the end of the deferment period. Biological means any pathogenic (disease producing) micro-organism(s) andor biologically produced toxin(s) (including genetically modified organisms and chemically synthesised toxins) which can cause illness and or death in humans, animals andor plants. Bodily injury means a specific non-psychiatric injury which is sustained by the insured person during the Policy period and is caused by an accident and which solely and independently of any other cause, causes the insured person death or disablement (permanent or temporary). Chemical means any toxic or poisonous chemicals, or their precursors which when suitably disseminated, produces incapacitating, damaging or lethal effects on people, animals, plants or material property. Child(ren) means any person who is unmarried and under 18 years old or under 23 years old if in full-time education. Deferment period means the period at the commencement of temporary total disablement or temporary partial disablement for which no benefit is payable. Excess means the amount payable by the insured. Excursion means a short trip or journey, travelling away from the location to a specific destination and returning to the location organised by the insured person for the benefit of children registered to their care. Insured means: 1. The firm(s), organisation(s), or company(companies) stated in the schedule; 2. The partner(s) of the firm(s) or company(companies) stated in the schedule where such firm(s) or company(companies) are partnerships; 3. The principal individual in the event that the firm(s) or company companies stated in the schedule is a sole practitioner. Insured person means the insured persons as stated in the applicable Evidence of Cover. 16 Family Day Care Australia Educator Insurance Limit of indemnity means the maximum amount of underwriter s liability.

9 Location means the place where the insured person carries out day care services for children. Loss of hearing means permanent and total loss of hearing. Permanent Disablement Schedule of Benefits Permanent Disablement Percentage payable Loss of limb means: 1. in the case of a lower limb loss by physical severance at or above the ankle or permanent and total loss of use of a complete foot or leg; 2. in the case of an upper limb loss by physical severance of the four fingers at or above the meta carp phalangeal joints or permanent and total loss of use of a complete hand or arm. Loss of sight means: 1. permanent and total loss of sight in both eyes if an insured person s name is added to the Register of Blind Persons on the authority of a fully qualified ophthalmic specialist; 2. in one eye if the degree of sight remaining after correction is 360 or less on the Snellen Scale. Loss of speech means total and permanent loss of speech. Medical practitioner means a person who is recognised by the laws of the jurisdiction in which treatment is received by the child as qualified to treat the bodily injury and who is not a relative of the child. Operative time means the period of time during which an insured person is covered by this Policy as stated in the schedule. Paraplegia means the permanent total paralysis of the two lower limbs, bladder and rectum. Permanent country of residence means the country in which the insured person has permanently resided for a period of 12 months or longer. Permanent disablement means permanent and irrecoverable disablement as listed in the schedule of compensation.as certified by a legally qualified medical practitioner. Premium means the amount stated in the schedule. Policy period means the period stated in the schedule. Qualified carer means a person that has completed the necessary tertiary nursing qualifications and is a registered nurse. Registered healthcare practitioner means a fully qualified and licensed member of the medical profession who is approved by the governing medical association of the country in which the healthcare practitioner practices and who is not the insured person, an associate of the insured person or a member of the insured person s family. Schedule means the document entitled SCHEDULE to the Policy that relates to this Policy. Tetraplegia means the permanent and total paralysis of the two upper limbs and two lower limbs. Temporary partial disablement means disablement which prevents the insured person from carry out the majority of their usual occupation. Underwriters mean certain Lloyd s Underwriters and any other participating insurance companies. Tetraplegia or paraplegia 100% Loss of Limb(s) one or more 100% Loss of Sight in one or both eyes 100% Loss of Hearing in both ears 100% Loss of Hearing in one ear 25% Loss of Speech 50% Loss of thumb 20% Loss of forefinger or big toe 15% Loss of any other finger or toe 10% Permanent loss of use of back or spine (excluding neck or cervical spine) 40% without cord involvement Permanent loss of use of hip, knee or ankle 40% Permanent loss of use of neck or cervical vertebrae without cord involvement 30% Permanent loss of functional use of shoulder, elbow or wrist 20% Broken Bone Benefits caused directly and solely by accidental bodily injury: $5,000 a) Neck, skull or spine $2,000 b) Hip or pelvis $2,000 c) Facial bone or bones, nose or jaw $2,000 d) Collarbone, breastbone, ribribs or shoulder $2,000 e) Leg, ankle or knee $1,000 f) Arm, elbow or wrist $1,000 g) Hand (not finger or thumb) or foot (not toe or ankle) $5,000 h) Finger, thumb or toe. Maximum compensation any one accident Loss of or damage to teeth: a) $500 per tooth b) $50 per accident a) Permanent or second teeth ; c) $100 per tooth b) Damage not included in a) above c) Damage to first teeth Total amount payable shall not exceed AUD$2,000 War means war, civil war, invasion, act of foreign enemies, hostilities (whether declared or not), rebellion, revolution, insurrection, military or usurped power. PERSONAL ACCIDENT Underwriters shall pay the insured an amount appropriate to the benefit listed in the schedule and corresponding Permanent Disablement Schedule of Benefits if a child(ren) whilst in the care of an insured person attending at the location or an excursion sustains accidental bodily injury whilst engaged on authorised activities provided that the accident giving rise to the bodily injury occurs during the operative time and within the policy period. Family Day Care Australia Educator Insurance 17

10 PERSONAL ACCIDENT EXTENSIONS 1. Out of pocket expenses Underwriters will pay the insured expenses necessarily incurred solely and directly from accidental bodily injury sustained and not recoverable from any other source, but excluding hospital and or medical costs where legislation prohibits in Australia the refund of such fees or costs. The maximum amount payable hereunder shall not exceed AUD$5, Weekly carer s benefit If bodily injury prevents the child from attending the centre and requires the child to be cared for at home or elsewhere in accordance with the instructions of a qualified medical practitioner underwriters will pay either: (a)loss of income incurred by the child s parent or guardian if heshe is unable engage in hisher usual employment in order to care for the child, or (b)the expenses necessarily incurred in engaging a qualified carer during the hours that the child would otherwise have attended family day care; to a maximum of AUD$200 for each day that the child is unable to attend their usual family day care centre and AUD$5,000 with a deferment period of 3 days and maximum benefit period of 52 weeks. PERSONAL ACCIDENT EXCLUSIONS Underwriters will not pay for losses resulting directly or indirectly from: 1. Flying except as a full fare paying passenger in a scheduled or charter flight; 2. Racing of any type; 3. The insured person s exposure to danger, hazardous activity or extreme sports except in the course of hisher employment or in an attempt to save human life; 4. Any pre-existing degenerative process or gradually operating cause. 5. Any benefit for the first 3 days that the child is unable to attend their normal family day care centre. 6. Any benefit during the Policy Period that the child s parent or guardian is entitled to paid carer s leave from hisher employer. 7. Weekly carer benefits, where the child is admitted or being cared for in a hospital. 8. Any benefit from the date the qualified medical practitioner considers that the child no longer requires care. PERSONAL ACCIDENT CONDITIONS 1. Any permanent disablement not specifically defined in the table above shall be calculated by assessing the disablement relative to the permanent disablement schedule of benefits above without reference to the insured person s occupation. 2. In the event of an insured person sustaining bodily injury that results in permanent disablement under more than one benefit the total amount payable shall not exceed 100% permanent disablement amount stated in the schedule. 3. If a claim is payable for the loss of a part of the body further claims for any component part cannot also be made. 4. No payment will be made for permanent disability deemed by underwriters to be 5% disability or less. GENERAL EXCLUSIONS Underwriters will not have any liability under this Policy for, or directly or indirectly arising out of, or in any way involving: 1. An insured person who is deemed to be under instruction from or employed by the armed forces of any country, and which arises from the active participation of that insured person within the theatre of war. 2. Being under the influence of any drug or controlled substance (other than drugs legally prescribed by a registered healthcare practitioner and used as directed by the registered healthcare practitioner). 18 Family Day Care Australia Educator Insurance 3. The discharge, explosion, or use of any weapon designed or intended to cause death or serious injury, whether or not employing nuclear fission or fusion, or chemical, biological, radioactive or similar agents, by any party at any time for any reason. 4. Ionising radiation or contamination by radioactivity from any nuclear fuel or waste from the combustion of nuclear fuel. 5. Suicide or attempted suicide, and parasuicidal behaviour. 6. War in the Australia and permanent country of residence. GENERAL CONDITIONS 1. Assignment This Policy cannot be assigned without the prior written consent of underwriters. 2. Avoidance by underwriters If underwriters are entitled to avoid this Policy they may elect to give notice to the insured that underwriters regards this Policy as being in full force and effect, except that no indemnity will be given under this Policy that arises from or is related to the ground(s) that entitled underwriters to avoid this Policy. 3. Cancellation This Policy may be cancelled by the insured at any time by giving underwriters written notice, in which case underwriters shall retain a proportion of the premium calculated at short-term rates for the time the Policy has been in force. Underwriters may cancel this Policy in accordance with the provisions of the Insurance Contracts Act 1984 (Cth). Upon cancellation by underwriters, underwriters shall refund a proportion of the premium paid calculated by reference to the unexpired period of Insurance. However no such refund shall be forthcoming where a claim or circumstances which may give rise to a claim have been notified under this Policy. 4. Medical Notes It is a pre-condition to underwriters' liability to pay compensation under this Policy, that all medical records, notes, and correspondence referring to the subject of a claim or a related pre-existing condition of an insured person subject of a claim, be made available on request to any medical adviser appointed by or on behalf of underwriters and that such medical adviser or advisers shall, for the purpose of reviewing the claim, be allowed so often as may be deemed necessary to make examination of the insured person. 5. Fraud Concealment Any fraud, concealment, or deliberate misstatement or non-disclosure either in the proposal on which this Policy is based or in relation to any other matter affecting this Policy or in connection with the making of any claim hereunder shall this Policy entitle underwriters to either reduce their liability under the Policy or cancel the Policy from its inception, subject to the relevant provisions of the Insurance Contracts Act 1984 (Cth). 6. Claim Notification the insured must ensure that underwriters are notified as soon as practicable, but in any event no later than 12 months after the accident, of any: (a)claim; (b)circumstance(s) of which the insured becomes aware which is (or are) likely to give rise to a claim; Such notification shall include full details of the accident or event giving rise to the claim, circumstance(s) likely to give rise to a claim. Failure to notify underwriters as soon as practicable may result in the claim being declined or payment reduced. Notify claims to London Australia Underwriting Pty Ltd, C- TBA Or; TBA 7. Contribution Any matter in respect of which the insured is (or but for the existence of this Policy would be) entitled to indemnity under any other contract of insurance, except where such other insurance is written as specific excess insurance to provide an indemnity in excess of the amount payable under this Policy.

11 8. Dispute Resolution In the event of a dispute arising under this Policy, underwriters, at the request of the Insured Person, will submit to the jurisdiction of any competent Court in the Commonwealth of Australia. Such dispute shall be determined in accordance with the law and practice applicable in such Court. Any summons notice or process to be served upon the Underwriters may be served upon; Lloyd s General Representative in Australia Suite 2, Level 21 Angel Place 123 Pitt Street Sydney NSW 2000 who has authority to accept service and to enter an appearance on behalf of underwriters, and who is directed at the request of the insured to give a written undertaking to the insured to appear on behalf of underwriters. If a suit is instituted against underwriters, underwriters agree to abide by the final decision of such Court or any competent Appellate Court. 9. Duty to cooperate As a condition precedent to the right to be indemnified under this Policy the insured must: (a) Promptly provide to underwriters full details concerning any claim andor any circumstance(s) likely to give rise to a claim andor any matter(s) where the insured has requested to be indemnified under this Policy; (b) Promptly and on a continuous basis provide such co-operation and assistance as underwriters and their representatives, legal advisers andor agents may reasonably require; (c) Provide, at the Insured s own expense, to underwriters such certificates, information and evidence as they may from time to time reasonably require. (d)undergo an independent medical examination when requested by the underwriters, the cost for said medical examination will be paid by the underwriters. 10. Eligibility 14. Premium payment (a) As a condition precedent to the right to be indemnified under this Policy the insured undertakes that premium will be paid in full to underwriters within 60 days of inception of this Policy (or, in respect of instalment premiums, when due). (b) If the premium has not been so paid by the sixtieth day from the inception of this Policy (and, in respect of instalment premiums, by the date they are due) underwriters shall have the right to cancel this Policy ab initio by notifying the insured via its insurance agent in writing. In the event of cancellation, premium is due to underwriters on a pro rata basis for the period that underwriters is on risk but the full policy premium shall be payable to underwriters in the event that any claim(s), circumstance(s) or loss(es) are notified prior to the date of termination. (c) Where the premium is to be paid through a London Market Bureau, payment to underwriters will be deemed to occur on the day of delivery of a premium advice note to the Bureau. 15. Proposal form The proposal and all information contained within it, submitted by the insured or their representative to underwriters shall be the basis of, and be incorporated into, this Policy. 16. Several liability The obligations of each insurance company and Lloyd s syndicate (including the underwriters thereof) shall be several and not joint and shall be solely to the extent of that company s or syndicate s individual subscription. No such company or syndicate shall be responsible for the subscription of any other such company or syndicate who for any reason does not satisfy all or part of its obligations hereunder. 17. Subrogation Underwriters shall be subrogated to all the rights of recovery of the insured against any third party before or after any indemnity is given under this Policy provided always that underwriters shall not exercise any such rights against any insured person unless the loss in respect of which indemnity is provided under this Policy was caused or contributed to by the insured person. The insured shall, promptly and without charge, provide such assistance as underwriters may reasonably require in any subrogation. To be eligible to benefit from cover under this Policy insured persons must be under the age of 75 years unless otherwise agreed by underwriters. 11. Governing law This Policy is governed by, and interpreted in accordance with, the laws of the Commonwealth of Australia and the State or Territory where the Policy was issued. Disputes relating to interpretation of this Policy must be submitted to the exclusive jurisdiction of the Courts of that State or Territory. 12. Interest No benefit shall carry interest. 13. Interpretation (a) Reference to any Act, statute or statutory provision shall include a reference to that provision as amended, re-enacted or replaced from time to time whether before or after the date of the inception of this Policy; (b) If any term, condition, exclusion or endorsement or part thereof is found to be invalid or unenforceable the remainder shall be in full force and effect; (c) The headings herein are for reference only and shall not be considered when determining the meaning of this Policy. Family Day Care Australia Educator Insurance 19