Sunsuper for life. Insurance guide. Learn more about your insurance Identify your insurance needs

Transcription

1 Sunsuper for life Insurance guide Learn more about your insurance Identify your insurance needs Preparation date: 22 June 2016 Issue date: 1 July 2016

2 INSURANCE IN YOUR SUPER Contents 1 Why have insurance? 3 2 What types of insurance can I have through Sunsuper? 6 3 How much cover do I need? 9 4 Am I eligible for insurance cover? 11 Am I eligible for Death and TPD Assist cover, and Opt In IP cover? 12 Other important eligibility Terms and Conditions 12 When does my insurance cover start? 13 5 Death and TPD cover 14 Death and TPD Assist 15 New Members options - Increase your Death and TPD Assist cover by 50% 20 White Collar cover 21 Life and Age Event options 22 Tailored Death and TPD cover 24 Conditions & Exclusions 28 6 Income Protection (IP) cover 30 New Members options - Opt In IP cover 32 White Collar IP cover 34 Tailored IP cover 35 Conditions & Exclusions 38 7 How do you apply? 41 8 Premium Rates 44 Death and TPD Assist and White Collar cover (Premium table 1) 45 New Member options 50% increase in Death & TPD Assist cover (Premium table 2) 46 Life and Age Event options cover and premiums (Premium table 3) 47 Tailored Death and TPD cover (Premium table 4) 48 New Member options Opt In IP and White Collar IP cover (Premium table 5) 49 Tailored Income Protection cover 2 year Benefit Period (Premium table 6) 50 Tailored Income Protection cover 5 year Benefit Period (Premium table 7) 51 Tailored Income Protection cover Benefit Period to age 65 (Premium table 8) 52 9 Facts about making a claim Definitions 56 Sunsuper for life Insurance guide

3 Important information This is the Sunsuper for life Insurance guide. The information in this guide forms part of the Sunsuper for life Product Disclosure Statement (PDS) issued 1 July The PDS references important information contained in this guide by. This guide may reference important information contained in the Sunsuper for life Investment guide and Sunsuper for life guide. The PDS, this guide, Sunsuper for life Investment guide and Sunsuper for life guide should be read in their entirety before making a decision to acquire or continue to hold an interest in Sunsuper. Insurance cover is provided through group life policies for Death and TPD, and Income Protection, issued by AIA Australia Limited ABN to the Trustee of the Sunsuper Superannuation Fund. In the event of a dispute the policy will override the information in the PDS and this guide. General advice disclaimer The information in the PDS and guides is general information only and doesn t take into account your personal objectives, financial situation or needs. You should consider the appropriateness of any general information in the PDS and guides having regard to your own personal objectives, financial situation and needs. You should obtain financial advice tailored to your personal circumstances. Call us if you would like to speak with one of our qualified financial planners. Protecting your privacy Sunsuper respects the privacy of the information you give us. If you require a copy of our Privacy Policy visit sunsuper.com.au/ privacy or call AIA Australia privacy AIA Australia Limited (AIA Australia) also respects your privacy. AIA Australia s handling and exchange of your personal and sensitive information is outlined in the AIA Australia Privacy Policy available at or by calling AIA Australia on Financial Services Guide (FSG) Visit sunsuper.com.au/fsg or call us on for a copy of the FSG which provides you with information about the financial services Sunsuper Pty Ltd provides and will help you decide whether to use these services sunsuper.com.au 1

4 2

5 1 Why have insurance? Even the most carefully made financial plans can fail due to unexpected circumstances So it makes sense to protect your greatest asset you! 3

6 1 WHY HAVE INSURANCE? (continued) Why should I insure through Sunsuper? Protect yourself, your family and your lifestyle Automatic cover for eligible members protecting you 24 hours a day, 7 days a week Death cover to age 70 protecting you in the event of death or terminal illness Total & Permanent Disablement (TPD) cover to age 67 helping minimise the impacts of a permanent disability Income Protection (IP) cover providing an income if you are unable to work White Collar cover get 50% more Death and TPD Assist at no additional cost. May also reduce premiums for Opt In IP cover Tailored cover you can tailor your Death, TPD and IP cover to suit your needs Your cover continues even if your job doesn t if you leave your employer your cover will continue Competitive rates providing insurance at competitive rates Tax effective insurance insurance premiums attract a tax deduction, these are passed on to you Bring your cover with you It s simple, you can apply to transfer existing Death, TPD and IP cover anytime. You may be eligible to transfer existing Death and/or TPD cover (from other super funds or insurance policies up to $1,000,000), and/or IP cover (up to $10,000 per month) to Sunsuper. Simply download and complete the Transfer of insurance cover form at sunsuper.com.au/publications/insurance and return it to us. It s important you include all required documentation. If you are thinking about transferring your existing insurance cover, make sure you compare the features and benefits, and are accepted by the insurer, before cancelling existing cover. If accepted by the insurer you will be subject to the terms and conditions outlined in the policy. 4 Sunsuper for life Insurance guide

7 Features at a glance The benefits, features and options for insurance cover in Sunsuper for life are summarised in the table below. More information on each item can be found in this guide. Features Death cover Total and Permanent Disablement (TPD) cover Income Protection cover Terminal Illness cover Default cover New Member options White Collar cover Life and Age Events Tailored cover Indexation of Tailored IP cover Worldwide cover Cover during paid and Unpaid Leave Cover during overseas employment Automatic continuation of cover Transfer of insurance cover Financial advice Claims support Early intervention Occupational Rehabilitation work is good medicine Indexation of Tailored IP benefits Binding Nominations vs Preferred Beneficiaries Description Provides a lump sum benefit on the death of a member; members can have Death only cover. This can be default cover or tailored to suit your individual circumstances and needs The term totally and permanently disabled generally means that you will be unable to ever work again in your own or any other occupation for which you are suited by training, education or experience. Receiving a TPD benefit can allow you and your dependants to pay debts or bills, provide an ongoing income or fund your special medical needs. This can be TPD Assist cover or Tailored TPD cover to suit your individual circumstances and needs Provides a replacement income where a member becomes totally or partially disabled and cannot work as a result. You can choose to opt in or tailor it to suit your individual circumstances and needs Provides a lump sum benefit where a member is diagnosed as having a Terminal Illness and automatically forms part of the Death cover Death and TPD Assist cover automatically provided to eligible members on joining Sunsuper Additional Death and TPD Assist cover and Opt In IP cover available to new members Additional Death and TPD Assist cover is available to eligible members employed in White Collar occupations at no additional cost. Opt In IP cover may also be available at a reduced cost Additional cover available for eligible members with Death and TPD Assist and White Collar cover if they experience a specified Life or Age Event, such as getting married or turning 30 You can tailor your Death, TPD and/or IP cover to suit your individual circumstances and needs Your Tailored IP cover will be automatically indexed each 1 July by a factor generally aligned to the increase in Average Weekly Ordinary Time Earnings (AWOTE) Cover is provided 24/7 anywhere in the world Death and TPD cover continues while a member is on leave; IP cover will continue for a period of 24 months during Unpaid Leave Cover continues while a member satisfies the eligibility requirement while working overseas Your Death and TPD cover continues regardless of your work status, while IP cover is subject to your employment status at the date of disablement We may agree to take over the cover provided by a previous superannuation fund or insurer and provide equivalent benefits on Sunsuper s terms and conditions To assist members to determine the amount and type of insurance cover needed and assist members with the proceeds of claims Our experienced Claims Representatives are here to help with your claim Early assistance can significantly improve your chances of making a swift recovery If you have an injury, disability or health condition we can arrange work related rehabilitation to assist you back to meaningful work When on claim your Tailored IP benefits will be indexed by the lesser of CPI or 5% on each anniversary of a continuing IP claim where your Benefit Period is greater than 2 years You can nominate your preferred beneficiaries or you can make a binding beneficiary nomination sunsuper.com.au 5

8 2 What types of Insurance can I have through Sunsuper? 6

9 What types of insurance can I have through Sunsuper? Sunsuper provides access to flexible Death, Total and Permanent Disablement (TPD) and Income Protection (IP) insurance to keep you protected 24 hours a day, 7 days a week if something unfortunate were to happen to you. You have the flexibility to make sure your cover is right for you. Sunsuper offers easy ways for you to change your cover, apply for cover or cancel your cover. Members have access to: Death cover (including Terminal Illness) If you die or become terminally ill, you or your dependants or beneficiaries may receive a lump sum. TPD Assist cover If you are suffering from long term injury or sickness we may provide early intervention and occupational rehabilitation support. Where you are Totally and Permanently Disabled and you continue to meet the TPD Assist definition, you may receive up to six annual payments over a minimum of five years to help you pay any debts and bills and fund disability related expenses such as home modifications, rehabilitation and special medical needs. In some circumstances you may receive a single lump sum payment. Opt In Income Protection cover Provides an income for up to 2 years while you are unable to work due to sickness or injury to help you pay your expenses while you focus on your health and recovery. Tailored Death, TPD & IP cover Tailor your insurance to suit your needs. Having the right level and type of cover provides some assurance of a secure financial future for you and your family. You can apply for Tailored Death cover, Tailored TPD cover or Tailored IP cover. The summary below describes the insurance you can have through Sunsuper. Death and TPD Assist cover Ineligible for default cover OR New Member Options White Collar Cover Life and Age Events need more cover? Tailored cover Tailored Death and TPD Tailored IP Increase Death and TPD Assist by 50% Add Opt In IP Additional Death and TPD Assist May reduce the cost of Opt In IP Additional Death and/or TPD Assist The insurer Insurance cover is provided through group life policies for Death and TPD, and Income Protection, issued by AIA Australia Limited ABN (AIA Australia) to the Trustee of the Sunsuper Superannuation Fund. In conjunction with either a disablement claim application or an application for additional cover, Sunsuper members may be contacted directly by an AIA Australia representative on behalf of the Fund to discuss or gather information relating to their application sunsuper.com.au 7

10 2 WHAT TYPES OF INSURANCE CAN I HAVE THROUGH SUNSUPER? (continued) Insurance in your Super-savings account Eligible members are provided with Death and TPD Assist cover (for more information refer to 4 Am I eligible for insurance cover?). On joining you can also apply for: an additional 50% Death and TPD Assist cover (New Member options), and Opt In IP cover (New Member options). If eligible, you can apply for White Collar cover at any time. White collar Death and TPD Assist cover provides 50% more cover at no additional cost. White collar IP may reduce your premiums for Opt In IP, or entitle you to more cover at no additional cost. If you require more Death and/or TPD cover than the options outlined above, and/or a different Benefit Period or Waiting Period on your Income Protection cover, this can be provided through Tailored cover. The Trustee reserves the right to limit the amount of cover provided. Any increase or change is subject to acceptance by the insurer. Satisfactory evidence of health may be required when you apply for increased or Tailored cover. It s important to review your insurance needs and check whether default insurance cover is enough. Below is a brief summary of the insurance options available through Sunsuper. Features Death & TPD Assist Opt In IP Tailored Death & TPD Tailored IP Cover provided automatically 1 Opt In 1,3 x x Type of benefit paid Lump Sum or Annual 2 Monthly income Lump Sum Monthly income Terminal Illness benefit x x Option to increase your cover by 50% 3 x x x White Collar cover 4 4 x x Occupational Rehabilitation support x Life and Age events x x x Continuation of cover if you change employer Indexation of cover x x x Option to choose a Waiting Period x x x Option to change a Benefit Period x x x 1 You must be eligible for the cover. Please refer to 4 Am I eligible for Death and TPD Assist cover, and Opt In IP cover? 2 Death cover is paid as a lump sum. The TPD Assist cover may be paid as either annual support payments or a lump sum subject to the member meeting the relevant conditions of the TPD Assist definition. Annual support payments will be paid as close as possible to 12 months apart, but actual payment dates will depend on the circumstances of each claim. 3 Within 120 days of joining Sunsuper you can apply to add an additional 50% of Death and TPD Assist cover and/or you may also apply for Opt In IP cover. Refer to New Member options. 4 Eligibility conditions apply; please refer to pages 12 (Death and TPD Assist cover) and 32 (IP cover). If you have two or more Super-savings accounts in Sunsuper for life, you will only be entitled to insurance cover from one account (with the exception of Sunsuper for life Corporate Super-savings accounts and Sunsuper for life Business Super-savings accounts). In the event of a dispute the policy will override the information in the PDS and this guide. 8 Sunsuper for life Insurance guide

11 3 Different How much cover do I need? people will have different needs depending on their individual circumstances. You may need more cover, you may want to protect yourself with Income Protection cover, or you might not want insurance at all. With Sunsuper you can apply for the cover you need. 9

12 3 HOW MUCH COVER DO I NEED? (continued) How much cover do I need? Working out how much insurance is right for you can be a difficult task. The amount of insurance you need will depend on a combination of things such as your liabilities, assets, ongoing expenses and your expected standard of living. Once you have read through this guide for details on the insurance we offer you can work through the following steps to work out how much insurance is right for you. Step 1 Step 2 Step 3 Step 4 Step 5 How much money will I need? How much money do I have? Use our Insurance needs calculator to work out your needs How much insurance do I need? Do you need some help? Generally, you should have enough money to pay all large debts and cover daily living expenses for yourself and your family for a certain period of time. As a starting point, list the current financial commitments you have. Keep in mind your insurance needs will change as your life changes. Consider your existing sources of income (other than your salary) and savings. Use this calculator to work out how much Death, Total and Permanent Disability (TPD) and Income Protection cover you may need. The calculator is available at sunsuper.com.au/calculators You may find your needs are greater than your savings. This is where insurance comes in. It can be used to meet the shortfall between your needs and your existing savings. Keep in mind that different types of cover may be paid as a lump sum or ongoing benefit payments. Call to speak to one of our phone based qualified financial planners 1 It is important to understand that using your superannuation account now for the payment of insurance premiums before retirement will impact upon your future balance when you do retire. Need help? Call to speak to one of our phone based qualified financial planners 1 who can give you simple advice about your Sunsuper account at no additional cost. If it s something more comprehensive, you can meet with one of our qualified financial planners 1 face-toface. More comprehensive advice may incur a fee. We may also refer you to an accredited external financial planner 2. 1 Sunsuper employees provide advice as representatives of Sunsuper Financial Services Pty Ltd (ABN AFSL No ) (SFS), wholly owned by the Sunsuper Superannuation Fund. 2 Sunsuper has established a panel of accredited external financial planners for our members. Sunsuper does not receive or pay any referral fees to these planners. Each of these planners will explain to you how their advice fees are determined. The accredited external financial planners are not employed by Sunsuper, and Sunsuper is not responsible for the advice provided by these planners. Section 5 Death and TPD cover, details how much Death and TPD Assist cover is provided to eligible members 10 Sunsuper for life Insurance guide

13 4 Am I eligible for insurance cover? It is very important to check your eligibility for cover. If you are not eligible for Death and Total and Permanent Disability (TPD) Assist, or Opt In IP cover you can apply for Tailored cover at any time. 11

14 4 AM I ELIGIBLE FOR INSURANCE COVER? (continued) Am I eligible for Death and TPD Assist cover, and Opt In IP cover? Types of Insurance Cover Age Eligible for cover Not eligible for cover Death You are actively employed 1 you are Self-Employed 2, or TPD Assist You are actively employed 1 you are not employed, or Opt In IP You are actively employed 1 on a permanent basis for a minimum of 15 hours per week you have previously received or are eligible to receive a Terminal Illness benefit, TPD benefit or a benefit as a result of Permanent Incapacity or a Terminal Medical Condition from Sunsuper or another fund or insurer. you are Self-Employed 2, or you are not employed, or you are a casual or contract employee 3, or you are working less than 15 hours per week, or you are employed under a work visa 3, or you have previously received or are eligible to receive a Terminal Illness benefit, TPD benefit or a benefit as a result of Permanent Incapacity or a Terminal Medical Condition from Sunsuper or another fund or insurer. 1 You will be actively employed if you satisfy the At Work definition at the date your Death, TPD Assist and Opt In IP cover starts refer to 10 Definitions for the At Work definition. 2 Self-Employed means a person who is predominantly working in their own business on a regular basis and earning an income refer to section 10 Definitions for the definition of Self-Employed Person. 3 Casuals, contractors and members employed under a work visa may apply for Tailored IP refer to 6 Income Protection cover. Other important Eligibility Terms and Conditions Death and TPD As a general rule, your eligibility for Death and TPD Assist or White Collar cover will not be assessed until you make a claim. Limited Cover will apply until you satisfy the At Work requirements for 30 consecutive days where you have joined Sunsuper and a Superannuation Guarantee (SG) contribution is received within 120 days of the date you joined your employer. Where you joined Sunsuper and an SG contribution is received more than 120 days after the date you joined your employer Limited Cover will apply to your cover for a period of 24 months and will cease to apply once you satisfy the At Work requirements for 30 consecutive days after the end of the 24 month period. If you become totally and permanently disabled you will only be eligible to make a TPD claim if you notify Sunsuper of your TPD claim within five years from your Date of Disablement. Warning: If you notify Sunsuper of your TPD claim outside this period you will be ineligible for an insurance benefit payment under TPD. If you were under age 15 when you joined Sunsuper, your Death and TPD Assist cover will commence upon receipt of an SG contribution after you turn age 15. If your insurance cover start date is more than 120 days from the date you joined your employer or you have White Collar cover, New Member Options or Life and Age Events, a Death or TPD Assist benefit will not be paid where death or total and permanent disablement is caused by suicide or any intentional self-inflicted act within 12 months of your insurance cover start date. If you have Tailored Death or TPD cover a benefit will not be paid where Death or Total and Permanent Disablement is caused by suicide or any intentional self-inflicted act within 12 months of your insurance cover start date. Members whose financial affairs are under the supervision of a third party due to their medical condition or incapacity, such as a public trustee office, are entitled to Death only cover subject to satisfying the At Work requirements. Members not satisfying the At Work requirements will not be eligible for Death or TPD Assist cover. They will also not be able to apply for New Member options, Life and Age Event options or for White Collar cover. Income Protection As a general rule, your eligibility for Opt In IP or White Collar IP cover will not be assessed until you make a claim. If you have Opt In IP or White Collar IP cover, Limited Cover will apply for the first 24 months and will apply until you satisfy the At Work requirements for 30 consecutive days after the initial 24 month period. An Income Protection benefit will not be paid if the injury or sickness is caused, wholly or partly, directly or indirectly, from: deliberate self-inflicted injury or attempted suicide or self destruction while sane or insane, uncomplicated pregnancy, childbirth or miscarriage, your deployment to a hostile environment as part of active military service, or a criminal act committed by you. You are not eligible for Opt In IP or White Collar IP cover if your financial affairs are under the supervision of a third party such as the public trustee, due to your medical condition or incapacity. Not eligible for cover If you are not eligible for Death and TPD Assist or Opt In IP cover you can apply for Tailored cover. Any application will be subject to acceptance by the insurer (satisfactory evidence of health will be required). To avoid being charged premiums for cover that you are ineligible for, please ensure that you notify us if you are ineligible or contact us if you would like to discuss whether you are eligible for Death and TPD Assist cover or Opt In IP cover. Premiums paid for the period you were deemed ineligible for cover will be refunded to your Super-savings account. Premiums will not be refunded in the instance you are ineligible to claim a TPD Assist or Tailored TPD claim due to Sunsuper not being notified of a TPD claim within five years from your Date of Disablement. 12 Sunsuper for life Insurance guide

15 Self-Employed, unemployed or unpaid Domestic Duties If you are Self-Employed, unemployed or are engaged in unpaid Domestic Duties in your own home you are eligible to apply for Tailored cover. When does my insurance cover start? The following table outlines when your cover will start and the conditions applicable to that cover. For details on how you can apply for the insurance covers listed below, please refer to 7 How do you apply?. Insurance cover or option What starts cover? Insurance cover start date 1 Special offers Some members may have other insurance offers made to them from time to time or you may be part of a group transfer from another fund. Your insurance arrangements and eligibility may differ from those contained in this guide. You will be advised if this applies to you. Limited Cover 2 At Work 3 Other important information Receipt of your first SG contribution which is within 120 days from Date Joined Employer Date Joined Employer 4 Yes 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5. Death and TPD Assist Receipt of your first SG contribution which is outside 120 days from Date Joined Employer Date of the first SG contribution 24 months 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after the initial 24 month period. Attainment of age 15 and receipt of an SG contribution Date of the first SG contribution after age 15 Yes 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5. New Member option Opt In IP New Member option additional 50% Death and TPD Assist Receipt of your first SG contribution and you select this option within 120 days of joining Sunsuper Receipt of your first SG contribution and you select this option within 120 days of joining Sunsuper Date Death and TPD Assist cover starts 24 months 30 days Not available if you select this option outside 120 days of joining Sunsuper. Date Death and TPD Assist cover starts 24 months 30 days Not available if you select this option outside 120 days of joining Sunsuper. Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after the initial 24 month period. Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after the initial 24 month period. Receipt of your first SG contribution and you select this option within 120 days of joining Sunsuper Date Death and TPD Assist cover starts 24 months 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after the initial 24 month period. White Collar cover You apply for White Collar cover outside 120 days of joining Sunsuper using the White Collar cover form and you already have Standard Death and TPD Assist cover Date of acceptance of your application by the insurer 24 months 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after the initial 24 month period. Life and Age Events Application by you not more than 180 days after the Life or Age Event Date of acceptance of your application by the insurer 24 months 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after the initial 24 month period. Restarting Standard Death and TPD after previous cover lapsed Receipt of an SG contribution Date of the SG contribution Yes 30 days Limited Cover will apply until you satisfy the At Work requirements for 30 days 5 after cover commences.. Tailored Cover Application by you at anytime Date of acceptance of your application by the insurer n/a n/a n/a 1 If Sunsuper is not notified of a Date Joined Employer your date of first SG contribution will be used to calculate your insurance cover start date. The Date Joined Employer will be checked at the time a claim is made. 2 Limited Cover please refer to 10 Definitions. 3 At Work please refer to 10 Definitions. 4 Date Joined Employer will be the first Date Joined Employer recorded on your Super-savings account from the time you are recorded as a member of the Fund days are consecutive and are inclusive of days not scheduled for work (e.g. weekends, RDOs, etc.) and days where you are not precluded from work for reasons of injury or sickness sunsuper.com.au 13

16 5 If Death and TPD cover you die your dependants or your beneficiaries may receive a lump sum. If you become Totally and Permanently Disabled (TPD) you may receive a benefit to help you pay any debts and bills and fund disability related expenses such as home modifications, rehabilitation and special medical needs. 14

17 Death and TPD Assist Death and TPD Assist cover Ineligible for default cover OR New Member Options Increase Death and TPD Assist by 50% Add Opt In IP White Collar Cover Additional Death and TPD Assist May reduce the cost of Opt In IP Life and Age Events Additional Death and/or TPD Assist need more cover? Tailored cover Tailored Death and TPD Tailored IP Death and TPD Assist Cover is provided to eligible members, without needing to undergo any medical examinations How much cover do you get and what does it cost? The amount and cost of cover depends on your age and type of cover and will generally change each year on your birthday. Death and TPD Assist cover levels (example) Your age Death cover If you die, your dependants or beneficiaries may receive a lump sum. This includes Terminal Illness Cover ($) Cost per Week ($) Death TPD Assist Male Female 15 62, , , , , , , , ,000 42, ,000 16, To find out which level of cover and premium applies to you take a look at the Premium table 1. TPD Assist cover ends at age 67. Premiums are calculated weekly and normally deducted from your Super-savings account each month so it doesn t impact your take-home pay. Will my cover change as I get older? Yes, the amount and cost of cover will generally change each year on your birthday. We will confirm your cover each year in your Annual statement. To confirm your cover amount at any time just visit Member Online or call us on TPD Assist If you are permanently disabled, you may receive occupational rehabilitation support and up to six annual support payments or in some circumstances a lump sum payment Exclusions and restrictions A Death, TPD or Terminal Illness benefit will not be paid, where caused by suicide or any intentional self-inflicted act within 12 months of your insurance cover start date where it is more than 120 days after the date you joined your employer, where you become TPD and notify Sunsuper of a claim more than 5 years after your Date of Disablement, if you are deployed to a hostile environment as part of active military service, if you are employed under the terms of a work visa and it expires, or you permanently depart Australia (whichever is earlier), if benefits have ceased after a second TPD Assist claim period, or prior to joining Sunsuper you had received a Terminal Illness benefit, TPD benefit or a benefit as a result of Permanent Incapacity or a Terminal Medical Condition. If your insurance cover start date is within 120 days of the date you joined your employer, Limited Cover will apply until you have been At Work for 30 consecutive days. Limited Cover will also apply to your Death and TPD Assist cover where your insurance cover start date is more than 120 days after the date you joined your Employer. Limited Cover will be for a period of 24 months and until you having been At Work for 30 consecutive days after the end of the 24 month period. Please refer to the definition of Limited Cover and At Work in 10 Definitions. White collar cover White collar cover entitles you to 50% more Death and TPD Assist cover at no additional cost to you. Refer to page 21 for more details sunsuper.com.au 15

18 5 DEATH AND TPD COVER (continued) What is TPD Assist cover? At Sunsuper we recognise the importance of supporting members who are sick or injured and, where appropriate, providing assistance in enabling them to return to work where they are able to. Sunsuper s TPD Assist cover is here to help minimise the impacts of long term injury or sickness that leaves you unable to ever work again. The road to recovery can be a difficult path both financially and emotionally. As your ability to earn a living is the cornerstone to your standard of living it s important to regain your capability to earn a living and where a permanent disablement prevents, having a safety net in place. The term totally and permanently disabled generally means that you will be unable to ever work again in your own or any other occupation for which you are suited by training, education or experience. If your TPD claim is approved, you are usually able to withdraw your superannuation account balance and any insured benefit, allowing you and your dependants to pay debts or bills, provide an ongoing income or fund your special medical needs. Sunsuper s TPD Assist cover provides several unique features to assist; no waiting period with TPD Assist cover there is no waiting period, with the exception of Part C of the definition relating to Activities and Part A relating to Cognitive Function. If you re employed, assistance within the first three months of your injury or sickness is essential in successful occupational rehabilitation. Not having a waiting period also avoids any delays where a specified Medical Condition or loss of limb has occurred, rehabilitation and retraining provides occupational rehabilitation support and guidance where deemed appropriate, and may be a compulsory part of the claims process. Our occupational rehabilitation consultants will collaboratively work with you, your treating health professionals, rehabilitation provider and employer to assist you in returning to work, annual support payments or lump sum payment if you are assessed as TPD your insured cover may be paid as annual support payments as long as you continue to meet the TPD Assist definition. If you are diagnosed with a specific long term debilitating injury or sickness (specified Medical Conditions) with no chance of recovery, suffer loss of limbs or loss of Cognitive Function or are unable to undertake specified Activities, your insured cover may be paid as a single lump sum payment following the initial assessment, no premium required while on a TPD Assist claim you don t have to worry about paying your Death and TPD Assist premiums. The definition of TPD Assist you will be assessed against in the event of a claim is linked to your employment status immediately prior to the Date of Disablement. In limited circumstances you will not be eligible to claim on the Death and TPD Assist insurance cover through Sunsuper. See 4 Am I eligible for insurance cover? and 10 Definitions for the Employed (TPD) definition. What happens if you believe you are totally and permanently disabled? If you believe that you may be eligible to apply for a TPD Assist claim, we are here to help you along the way. In order to lodge a claim you would need to be under the care of a Medical Practitioner and suffering from an ongoing and serious injury or sickness that is permanently preventing you from working or from performing specified Activities. See 10 Definitions for the TPD Assist definition. Our Claims Representatives are here to help you every step of the way and will confirm your eligibility to lodge a claim. Following lodgement of your claim application, the insurer will assess whether your claim is successful and whether occupational rehabilitation services would assist you in a successful return to work. Eligibility to claim If you become totally and permanently disabled you will only be eligible to make a TPD claim if you notify Sunsuper of your TPD Assist claim within five years from your Date of Disablement. Warning: If you notify Sunsuper of your TPD Assist claim outside this period you will be ineligible for an insurance benefit payment under TPD Assist. Early Intervention and occupational rehabilitation Your chances of a swift recovery and making a successful return to work are significantly improved if you have access to effective rehabilitation and support services. The sooner you are able to seek assistance from a health professional the higher the chance of a successful outcome. The approach we take will be dependent on your injury or sickness and whether rehabilitation is appropriate. For complex illnesses such as Depression, Anxiety, Back Pain and Musculoskeletal injuries early assistance can prove invaluable. Early assistance for certain illnesses such as Stroke or Cancer may not be appropriate. Where deemed appropriate, we will engage with our insurer who will help determine what, if any, occupational rehabilitation and retraining services will assist. Occupational rehabilitation may be a compulsory part of the claims process (where you are assessed against Part B of the TPD Assist definition). 16 Sunsuper for life Insurance guide

19 An effective rehabilitation plan relies on the coordination of all parties. An example is below, External Rehabilitation consultant Specialises and understands your job experience, local job availability and resources. Implements Return to Work (RTW) plan. Treating Doctor Responsible for medical treatment. Sunsuper Claimant Employer Provides information on job duties and responsibilities. Participates in suitable (RTW) plan (if applicable). Insurer s Occupational Rehabilitation consultant Main point of contact for all parties and monitors the rehabilitation programme. If you require assistance please call Sunsuper on to discuss your rehabilitation options. What does Occupational Rehabilitation involve? We understand that navigating the health system can be a daunting task, especially in times of emotional and physical stress. Though legislation does not allow us to pay for medical consultations and treatment we can provide invaluable assistance in other ways. By working closely with you, your treating health professional and your employer we will be able to design a rehabilitation program that is individually tailored to you and your needs. The approach is to work in partnership to help with your recovery and assist you in returning to work capability Some of the services available to you may include: coordination of support services with your health professional, rehabilitation provider and employer, arranging an initial assessment with your health professional who can identify your support needs, providing guidance to your treating doctor on a treatment plan, engagement of a rehabilitation provider, development and implementation of a return to work plan, including re-skilling and retraining and functional upgrading, providing guidance and work related counselling and support where secondary conditions such as mental health manifest, and job seeking advice and career guidance. What benefits are paid out if rehabilitation is unsuccessful or not appropriate for you? You may receive up to six annual support payments (each equal to one sixth of your TPD Assist cover amount) over a minimum of five years. To continue to receive payments over the period, you must continue to meet the definition of TPD and participate in any occupational rehabilitation program designed for you. Annual support payments will be paid as close as possible to 12 months apart, but actual payment dates will depend on the circumstances of each claim. You may also be able to access your Sunsuper for life account balance due to Permanent Incapacity. It s important to note that Death cover will reduce by the amount of the annual support payments paid. Any Death cover in excess of the TPD Assist cover will still continue sunsuper.com.au 17

20 5 DEATH AND TPD COVER (continued) Payment of annual support payments If you are eligible to receive a TPD benefit, the insurer may pay the annual support payment (less any applicable tax) to your Super-savings account where it will be invested in the Cash Pool. We will than contact you for payment instructions. Should we not receive payment instructions within 30 days, the payment will be invested as per your current investment strategy. Annual assessment process Should your injury or sickness continuously prevent you from working ever again, an annual assessment will be undertaken. Your claim will be reassessed as close as possible to 12 months after your prior assessment. If you are assessed as still being totally and permanently disabled an annual support payments will be paid. Where deemed appropriate, our insurer will help determine what if any ongoing rehabilitation and retraining services will assist. What happens in the event of a loss of limbs, sight or Cognitive Function? If you suffer the loss of limbs, your sight or cognitive function you may be paid a single lump sum benefit equal to the TPD Assist cover amount at the Date of Disablement. See 10 for the definitions of TPD Assist - Part A Any Death cover in excess of the TPD Assist cover will still continue. What happens if you are unable to perform specified Activities? If you are unable to perform 3 of the following Activities you may be paid a single lump sum benefit equal to the TPD Assist cover amount at the Date of Disablement. Mobility, Hearing, Communication through speech, Seeing, Lifting & carrying, and Manual dexterity. See 10 for the definitions of TPD Assist - Part C. Any Death cover in excess of the TPD Assist cover will still continue. What happens in the event of a specified Medical Condition? If you do experience a catastrophic event or are diagnosed with a long term debilitating disease with no chance of recovery you may be paid a single lump sum benefit equal to the TPD Assist cover amount at the Date of Disablement. To qualify for a single lump sum benefit payment due to a Medical Condition you must have one of the following: Primary Pulmonary Hypertension Major Head Trauma Motor Neurone Disease Multiple Sclerosis Muscular Dystrophy Dementia and Alzheimer s Disease Parkinson s Disease Chronic Lung Disease See 10 for the definitions of the various Medical Conditions, and TPD Assist Part D. Any Death cover in excess of the TPD Assist cover will still continue. Example of the annual support payment process: Tom was 40 when he was deemed totally and permanently disabled. Tom received default Death and TPD Assist cover when he joined Sunsuper, and didn t make any changes to this cover. As at the Date of Disablement he has Death and TPD Assist cover of $186,000. Following acceptance of the TPD Assist claim by the insurer he receives his initial annual support payment of $31,000 (each equal to one sixth of Tom s TPD Assist cover amount). Rehabilitation was unsuccessful and Tom continues to meet the TPD Assist definition at each New Assessment Date. Initial Approval Year 1 Assessment Year 2 Assessment Year 3 Assessment Year 4 Assessment Year 5 Assessment $31,000 $31,000 $31,000 $31,000 $31,000 $31,000 Payment Payment Payment Payment Payment Payment one two three four five six 18 Sunsuper for life Insurance guide

21 What happens if I am capable of returning to work within the five years? If you return to work or become capable of returning to work (i.e. no longer meeting the TPD Assist definition), part way through the five year payment cycle the annual support payments will cease. Any remaining Death and TPD Assist cover may continue and will be calculated in line with the cover detailed in Premium table 1, the cover provided will be based on your current age minus the total of any annual support payments paid during your claim. Premiums are adjusted accordingly. What happens after the six annual support payments are made? Where you have claimed benefits under the TPD Assist cover, and all 6 annual support payments have been made, you will cease to be covered under Death and TPD Assist cover 1. 1 Any Death cover in excess of the TPD Assist cover will still continue. What can prevent an annual support payment from being paid? Where you have previously received annual support payment\s, you may not be able to receive any more payments if: you no longer satisfy the definition of TPD Assist as assessed by the insurer, the date the TPD Assist cover reduces to nil, following payment of the full TPD Assist benefit, your death, or you are paid a Terminal Illness benefit. Recurrent events and separate claims Following a claim ceasing prior to the full six annual support payments being made, if you make, and are accepted for another claim arising from the same or related cause as the prior TPD Assist claim, the further claim will be: a) deemed to be a continuation of the original claim if made within 12 months from the date you ceased to satisfy the TPD Assist definition. annual support payments will continue unaltered, or b) treated as a separate claim if it occurred more than 12 months after ceasing to satisfy the TPD Assist definition. The annual support payments will be adjusted to the cover level at the new Date of Disablement and will be paid out as up to six annual support payments over a minimum of a five year period. If you make a claim arising from an unrelated cause as the prior TPD Assist claim, the second claim will be treated as a separate claim. The annual support payments will be adjusted to the cover level at the new Date of Disablement and will be paid out as up to six annual support payments over a minimum of a five year period. You are entitled to claim TPD Assist benefits up to a maximum of two separate claims. No premium required While on a TPD Assist claim you don t have to worry about paying your premiums for Death and TPD Assist. Following a claim ceasing the cost of any remaining cover will be calculated weekly and normally deducted from your Super-savings account each month. Example of a member being capable of returning to work Following acceptance of the TPD Assist claim by the insurer, Tom receives his initial annual support payment of $31,000 (each equal to one sixth of Tom s TPD Assist cover amount). Tom s initial rehabilitation was unsuccessful and Tom continued to meet the TPD Assist definition at the first two annual assessment dates. In year three Tom was successfully capable of returning to work and returned to active employment. Initial Approval Year 1 Assessment Year 2 Assessment Year 3 Assessment Year 4 Assessment Year 5 Assessment Claimant can not return to work Participates in rehab Claimant can not return to work Participates in rehab Claimant can not return to work Participates in rehab Claimant can return to work $31,000 $31,000 $31,000 Payment Payment Payment one two three Return to Death & TPD Assist cover 1 Tom is now 43 years old. The default Death and TPD Assist cover amount for a 43 year old is $152,000. To date he has been paid a total of $93,000 in annual support payments. His remaining Death and TPD Assist cover is calculated as $152,000-$93,000=$59, sunsuper.com.au 19

22 5 DEATH AND TPD COVER (continued) New Member options - Increase your Death and TPD Assist cover by 50% Death and TPD Assist cover New Member Options Increase Death and TPD Assist by 50% Add Opt In IP White Collar Cover Additional Death and TPD Assist May reduce the cost of Opt In IP Life and Age Events Additional Death and/or TPD Assist Ineligible for default cover OR need more cover? Tailored cover Tailored Death and TPD Tailored IP When you join Sunsuper, you have 120 days in which you can increase your cover without complicated forms and medical information. How does this New Member option work? Within 120 days of joining Sunsuper you have the opportunity to increase your Death and TPD Assist or White Collar cover by 50% for an increase in premium of 50% without complicated forms and medical information. If you increase your cover using the New Member option, and are approved by the insurer, your increased cover levels and premiums will start from the day your Death and TPD Assist cover starts. Any premiums associated with the change will be charged in addition to your default cover premiums. How do I apply for this New Member option? You can choose this option on joining Sunsuper when you join online or you can apply by completing and returning your Membership application form within the first 120 days of joining Sunsuper. How much cover do you get and what does it cost? The amount and cost of cover you receive depends on your age and type of cover and will generally change each year on your birthday. The table below is an example of increasing your Death and TPD Assist cover using the New Member option. Total cover and cost after 50% increase in Death and TPD Assist cover levels (example) Your Cover ($) Cost per Week ($) age Death TPD Assist Male Female 15 93, , , , , , , , ,000 63, ,000 24, To find out which level of cover and premium applies to you take a look at the Premium table 2. TPD Assist cover ends at age 67. Premiums are calculated weekly and normally deducted from your Super-savings account each month. Exclusions and restrictions A Death, TPD Assist or Terminal Illness benefit will not be paid, where caused by suicide or any intentional self-inflicted act within 12 months of your insurance cover start date where cover commenced more than 120 days after the date you joined your employer, where you become TPD and notify Sunsuper more than 5 years after your Date of Disablement, you are deployed to a hostile environment as part of active military service, you are employed under the terms of a work visa and it expires, or you permanently depart Australia (whichever is earlier), if benefits have ceased after a second TPD Assist claim period, or prior to joining Sunsuper you had received a Terminal Illness benefit, TPD benefit or a benefit as a result of Permanent Incapacity or a Terminal Medical Condition. Limited Cover will also apply to any increase in your Death and TPD Assist cover as a result of you choosing the New Member option. Limited Cover will be for a period of 24 months and until you having been At Work for 30 consecutive days after the end of the 24 month period. Please refer to the definition of Limited Cover and At Work in 10 Definitions. White collar cover White collar cover entitles you to 50% more Death and TPD Assist cover at no additional cost to you. Refer to page 21 for more details. 20 Sunsuper for life Insurance guide