personal income insurance product disclosure statement and policy Preparation date: 26/03/2004

Transcription

1 personal income insrance prodct disclosre statement and policy Preparation date: 26/03/2004 personal income Insrer CGU Insrance Limited ABN AFS Licence No

2 This is an important docment. If yo cannot read and nderstand English, please se an interpreter to explain it to yo before entering into this contract of insrance.

3 This Prodct Disclosre Statement (PDS) contains important information reqired nder the Financial Services Reform Act To assist yo to locate specific items in the policy wording, a table of contents is provided on page 5 and an index is provided on page 13. Introdction Who is the insrer CGU Insrance Limited is the insrer of the insrance policy. Or Astralian Bsiness Nmber is Or Astralian Financial Services Licence Nmber is In this booklet the insrer is called we, s or or. How to contact s Yo may contact s by any of the following ways: In person at any CGU Insrance office. By telephone on: ACT (02) NSW (02) NT (08) QLD (07) SA (08) TAS (03) VIC (03) WA (08) By writing to s at CGU Insrance, GPO Box 9902 in yor capital city. Prodct Disclosre Statement By on or website The prpose of this PDS This PDS has been prepared to assist yo in nderstanding the insrance policy and making an informed choice abot yor insrance reqirements. This PDS sets ot the significant featres of the insrance policy inclding its benefits and risks and information abot how the insrance premim is calclated. Yo still need to read the policy wording which commences on page 4 for a fll description of the terms, conditions and limitations of the insrance policy. General Insrance Code of Practice CGU Insrance prodly spports the General Insrance Code of Practice. The prpose of the Code is to raise the standards of practice and service in the general insrance indstry. Details abot the Code are shown in the policy wording nder General Insrance Code of Practice on page 4. Brochres on the Code are available from yor nearest CGU Insrance office. Yor cooling-off period We will refnd all premim paid for cover nder the insrance policy if yo reqest cancellation of the insrance policy within 21 days of its commencement. To do this, yo mst advise s in writing and retrn the schedle to yor nearest CGU Insrance office. Yo will not receive a refnd if yo have made a claim nder the insrance policy. Details abot the cooling-off period are shown in the policy wording nder CGU Insrance Triple Garantee on page 4. What to do if yo have a dispte If yo have a concern abot the insrance policy, or decision on yor claim, or service or the service of or athorised representatives, loss adjsters or investigators, yo may access or internal dispte resoltion process. To do so, please contact yor nearest CGU Insrance office. In the event we are nable to resolve yor concern throgh or internal dispte resoltion process, yo may then reqest the matter be reviewed by the Insrance Ombdsman Service. This is a free service available to yo by calling The scheme is administered by Insrance Ombdsman Service Limited ABN Details abot the dispte resoltion system are shown in the policy wording nder Or service commitment on page 11. Yor privacy We treat yor personal information with care. We will not release yor personal information to anyone else other than another insrer, an insrance reference service or as permitted or reqired by law. In the event of a claim, we may disclose information to and/or collect additional information abot yo from investigators or legal advisers. Details abot yor privacy are shown nder The way we handle yor personal information on page 4. Yor dty of disclosre We rely pon the information yo provide to s when yo apply for insrance, and when yo renew, change or reinstate yor policy. Yo mst tell s everything that yo know, or shold know, cold affect or decision to insre yo and/or the terms on which we insre yo. Details abot disclosre information are shown in the policy wording nder What yo need to tell s on page 6 and What yo need not tell s on page 6. How to apply for insrance Complete or application form. If we accept yor application for insrance, yo will receive a schedle that sets ot details of the insrance yo have taken ot. 1

4 How to make a claim To make a claim, please contact yor nearest CGU Insrance office, or call when something happens that yo believe yo can claim for. Details abot making a claim are shown in the policy wording nder How to make a claim on page 10. Taxation information CGU Insrance shows all taxes and charges as separate items on all schedles. Significant featres and benefits of this policy A choice of Personal Accident or Personal Accident and Illness covers. Personal Accident covers inclde: Accidental death. Total or partial permanent loss of limbs, sight or hearing. A capital benefit for temporary or permanent incapacity to perform any occpation for at least one year. A weekly benefit if the insred person is incapable of carrying ot all or some of the sal dties of the insred person s sal occpation. For details of these benefits, refer to the policy wording nder Events A1-A3 and C1-C17 on page 8. Illness cover incldes: A weekly benefit for total incapacity to carry ot dties of the insred person s sal occpation for 7 days or more. A capital benefit if the insred person becomes totally and incrably blind or completely and permanently paralysed in any two limbs. For details of these benefits, refer to the policy wording Events B1 and B2 on page 8. Weekly benefits for incapacity to carry ot sal dties of the insred person s sal occpation will be indexed by any increase in the Consmer Price Index dring the period of insrance. Exclsions Or insrance is designed to provide protection for yo in the event of something happening which has been insred against. Under some circmstances, this policy will not provide any insrance cover to yo. For example, we will not pay claims for events which are cased by or made more serios by: Any deliberate or self-inflicted injry. The insred person being nder the inflence of or addicted to alcohol. Elective cosmetic srgery or recovery following elective cosmetic srgery. Any sexally transmitted or transmissible disease. The insred person taking part in a sporting activity for which he/she receives a fee or reward exceeding $100 per year. The insred person taking part in aerial activities. This lists some of the events that are not covered by this insrance, and for fll details of all relevant policy exclsions yo shold read the policy wording and schedle to make yorself aware of all the exclsions that apply. In the policy wording yo shold refer to When we will pay on page 8, Words that have a special meaning on pages 6 and 7, the 'Table of cover' on page 8, Limits to the cover on page 9 and When we will not pay on page 9. It is important that yo are aware of these exclsions and so yo shold read them. There are things that yo mst do in order for yor insrance cover to apply. For example, yo mst pay the premim. In the policy wording we show what yo need to do nder What yo are reqired to do for s on page 10. Significant risks Change in occpation Yo mst tell s in writing as soon as possible if there is any change in the occpation, dties, work-related activities or pastimes of the insred person dring the period of insrance which cold affect the risk of injry, accident, illness or disease. We may decide to discontine cover or to apply an additional premim. Change in health of insred person Yo mst make sre that the insred person, as soon as possible after he or she sffers any injry or contracts any illness or disease, obtains and follows medical advice from a medical practitioner. Medical advice after injry, illness or disease Yo mst tell s in writing before each renewal of this policy if the insred person has been affected by any injry, illness, disease, or physical or mental abnormality. 2

5 We will not atomatically renew the cover if the insred person: has reached the age of 55, if events B1 and B2 on page 8 are covered; or has reached the age of 65. If we decide not to renew this policy, we will tell yo in writing. If we invite renewal, we will tell yo of any changes to the cover. Disclosre Yo have certain disclosre obligations that yo need to comply with. Failre to comply with these obligations may have conseqences in terms of yor insrance cover or in the event that yo make a claim. Yor disclosre obligations and the conseqences of not complying with these obligations are otlined in the policy wording nder What yo need to tell s on page 6 and What will happen if yo do not tell s on page 6. Costs The premim payable by yo will be shown on yor schedle. The key factors that inflence the premim calclation are reflected in the qestions asked, and information soght, at the time of yor enqiry or application for insrance. These inclde factors relating to previos medical history, whether yo contine to sffer from any previos accidents or illnesses, yor height, weight and gender, yor occpation, yor claims history, the type of cover and the limits selected and the variations selected (sch as the excess period). Premims are sbject to Commonwealth and State taxes and/or charges. These inclde the Goods and Services Tax and stamp dty. The amont of these taxes and/or charges will be shown on yor schedle. Excesses The amont of any benefit payable nder this policy may be redced by an excess period. An excess is a period of time for which we will not pay any benefits. The amont of each excess will be shown on yor schedle. The description of the excess period and the circmstances in which it will be applied are shown in the policy wording nder Words that have a special meaning on pages 6 and 7, and nder Variation 3 Excess period for weekly benefits on page 11. In most instances yo can select at the time of yor enqiry or application for insrance the amont of policy excess yo wish to apply shold yo have a claim. When yo select a higher policy excess period, we will normally redce the amont of premim we charge yo. In some instances we will impose the period of excess that will apply shold yo have a claim. In deciding to impose an excess period, we take into consideration a nmber of factors in setting the excess period. These inclde factors relating to the type of cover yo reqire, the occpation of the insred person, and the insred person and insred s previos insrance and claims history. At the time of yor enqiry or application for insrance, the period of the excess will be advised to yo. 3

6 Personal Income Insrance Policy Please read this policy before yo apply for insrance. This policy sets ot the terms, conditions and limits that apply for the insrance we make available to yo. If we accept yor application for insrance, yo will receive a schedle that sets ot details of the insrance yo have taken ot. Or agreement with yo is made p of yor application, this policy, and the schedles and endorsements we send to yo. Endorsements are notices we send to confirm any change to yor insrance. Keep this policy in a safe place. Yo may want to refer to it from time to time. If yo need more information abot this insrance policy, please contact or agent or yor broker. We are happy to give yo personal attention and service in relation to this or any other insrance enqiry. General Insrance Code of Practice CGU prodly spports the General Insrance Code of Practice. The prpose of the Code is to raise the standards of practice and service in the general insrance indstry. The code aims to improve: The qality, comprehension and accracy of policy docments and other information provided to consmers. Employee and representative training and spervision. Claims handling and dispte resoltion. Brochres on the Code are available from yor nearest CGU office. Money Back Garantee Yo have 21 days after yo receive yor nmbered policy schedle to be sre yo have the cover yo reqire. If it is not the cover yo reqire, yo can cancel the policy. To do this, yo mst advise s in writing and retrn the schedle to yor nearest CGU Insrance office. Yo will receive a fll refnd of the premim paid, providing nothing has occrred for which a claim is payable nder the policy. The way we handle yor personal information We collect personal information from yo for the prpose of providing yo with insrance prodcts and services, and processing and assessing claims. Yo can choose not to provide this information, however, we may not be able to process yor reqests. We may disclose information we hold abot yo to other insrers, an insrance reference service or as reqired by law. In the event of a claim, we may disclose information to and/or collect additional information abot yo from investigators and/or legal advisers. If yo wish to pdate or access the information we hold abot yo, contact s. CGU Insrance Triple Garantee Or garantee assres yo of qality insrance and service at all times. Service Garantee We will provide yo with the highest standards of service. Fair Dealing Garantee We will meet any claims covered by yor policy fairly and promptly. 4

7 Table of contents Yor policy Cover What yo need to tell s 6 What yo need not tell s 6 What will happen if yo do not tell s 6 Important notices 6 When yo are insred 6 Who is insred by this policy 6 Who is the insrer 6 Words that have a special meaning 6 When we will pay 8 Table of cover 8 Limits to the cover 9 Age limits 9 When we will not pay 9 Important information Yo cannot give yor rights away 10 What yo are reqired to do for s 10 Cancelling yor policy before the de date 10 Retrn of premim if yor policy is cancelled before the de date 10 How to make a claim 10 Special condition 11 Variations 1A. Weekly benefits limit 11 1B. Weekly benefits limit, pls ongoing bsiness expenses Non-working hors only cover Excess period for weekly benefits Paid sporting activity Exclding specific injry, illness or disease 11 Or service commitment 11 Policy index Inside back cover 5

8 Yor policy What yo need to tell s Yo mst tell s everything that yo know, or shold know, cold affect or decision to insre yo and/ or the terms on which we insre yo. Yo mst do this when yo apply for a policy, when yo renew yor policy and when yo change or reinstate yor policy. When we ask yo specific qestions, yo mst answer these qestions trthflly and in a way that a reasonable person in the circmstances wold answer them. It is important that every person who will be insred by the policy answers all qestions in this way. These reqirements are part of the Insrance Contracts Act What yo need not tell s Yo do not need to tell s anything that: Redces or risk. Is of common knowledge. We know, or as an insrer shold already know. We tell yo that we do not want to know. What will happen if yo do not tell s If yo withhold relevant information or yo do not answer or qestions in the way we have described, we can redce the amont we pay yo for yor claim, or we can cancel yor policy. If yor failre to tell s is fradlent, or yor answers are ntrthfl, we can treat yor policy as if it never existed. Important notices 1. Claims This policy does not cover any accidents or events that happened before the commencement of the period of insrance. 2. Excess period The excess period, if there is one shown in the schedle, is the nmber of weeks at the beginning of each separate claim for which we will not pay any weekly benefits. 3. Cover Please note, in relation to: Death This policy can cover death by accident. It cannot cover death by illness or disease. Hernia This policy does not cover hernia, except where the insrance granted incldes total incapacity as a reslt of illness or disease. Cosmetic srgery This policy does not cover any event cased by, or made more serios by, elective cosmetic srgery or recovery from elective cosmetic srgery. Sexally transmissible disease This policy does not cover any event cased by, or made more serios by, any sexally transmitted or transmissible disease. When yo are insred Yor insrance begins when we accept yor application. The commencement date of yor insrance will be shown on the schedle we will send yo. The insrance applies for the period for which yo have paid s (or agreed to pay s) the premim. Yo may pay yor premim by cash, cheqe or credit card. If yor cheqe or credit card is dishonored by yor financial instittion, yo are not insred. Who is insred by this policy The names of the persons who are insred by this policy are set ot in the schedle. The person whose name is set ot in the schedle as 'the insred' is the person who takes ot the policy and to whom any benefits of the policy are paid. This person is referred to as 'yo' ('yor') in this policy booklet, bt may be referred to as 'the insred' in the schedle and other docments. The person identified in the schedle as the 'insred person' is the person against whose injry or illness yo are insring. Yo (the insred) and the insred person do not have to be the same person. There may be more than one insred person shown in the schedle. Who is the insrer CGU Insrance Limited is the insrer. Or Astralian Bsiness Nmber is Or Astralian Financial Services Licence Nmber is In this policy the insrer is referred to as 'we','s' or 'or'. Words that have a special meaning In this policy there are words that have a special meaning. These words are listed below. Benefit(s) means the amont calclated by mltiplying the percentage shown as the benefit for the event as set ot in the 'Table of cover' on page 8 of this booklet, by the amont shown on yor schedle. For events A1, A2 or B1, we will increase this in line with any increase dring the period of insrance in the Astralian Brea of Statistics Consmer Price 6

9 Event(s) Insred person Medical practitioner Occpation Period of insrance Personal weekly income Schedle Index (all Grops), commonly called the CPI, for payments made after the pdated CPI is issed. means the event(s) set ot in the 'Table of cover' on page 8 of this booklet. means the person identified as the insred person in yor schedle. See also nder 'Who is insred by this policy', above. means a doctor in general practice who is qalified and licensed to practise medicine in the place where he or she is practising, or a specialist medical doctor to whom the insred person is referred by sch a doctor in general practice. means any trade, bsiness, profession or employment. means the period between the dates stated on yor schedle, for which the insrance cover applies. means the average weekly income earned by the insred person (after dedcting the average weekly expenses incrred in earning that income) over the period that the insred person has been continosly engaged in his or her occpation, or over 52 weeks, whichever is the shorter period, immediately before the date that the event happened. This is only sed in Variations 1A and 1B on page 11 of this booklet. means the docment we give yo which sets ot the details of yor insrance cover. Yo receive a schedle when yo first take ot yor insrance and again when the policy is renewed or changed. 7

10 Cover When we will pay If any of the events, set ot in the 'Table of cover', happens to the insred person dring the period of insrance, we will pay yo the benefit set ot next to that event. Yor schedle sets ot which of the events are covered and the amont of the benefits. Events A1 to A3 and C1 to C17 mst reslt solely and directly from an injry sffered by the insred person, in an identifiable accident, which occrred not more than one year before the event. Events B1 and B2 mst reslt solely and directly from an illness or disease. We will not pay the benefit for event A3 or B2 ntil the condition for which yo are claiming has contined for at least one year. Please also refer to the 'Limits to the cover', 'Age limits' and 'When we will not pay' on page 9. Table of cover The Events The Benefits A1 The insred person becoming totally incapable of carrying ot 100% of the weekly amont specified for events A1 and all of the sal dties of his or her sal occpation. There A2 in the schedle, for each week of contining mst be no sal dties at all that the insred person can incapacity. carry ot. A2 The insred person becoming totally incapable of carrying ot 25% some of the sal dties of his or her sal occpation. A3 The insred person becoming totally and permanently 100% of the amont specified for event A3 in the incapable of carrying ot any occpation at all. There mst schedle, as one lmp sm. be no dties and no occpation at all that the insred person can carry ot. B1 The insred person becoming totally incapable of carrying 100% of the weekly amont specified for event B1 in the ot all of the sal dties of his or her sal occpation for a schedle, for each week of contining incapacity. period of seven days or more. There mst be no sal dties at all that the insred person can carry ot. B2 The insred person becoming totally and incrably blind or 100% of the amont specified for event B2 in the completely and permanently paralysed in any two limbs. schedle, as one lmp sm. C1 Death. 100% of the amont specified for events C1 to C17 in the C2 Total and irrecoverable loss of all sight in both eyes. 100% schedle, as one lmp sm. C3 Total and permanent loss of the se of both hands. 100% C4 Total and permanent loss of the se of both feet. 100% C5 Total and permanent loss of the se of one hand and one 100% foot. C6 Total and permanent loss of the se of one arm or the 80% greater part of one arm. C7 Total and permanent loss of the se of one leg. 75% C8 Total and irrecoverable loss of all sight in one eye as well as 75% irrecoverable loss of at least 50% of the sight of the other eye. C9 Total and permanent loss of the se of one hand, or for 70% fingers and the thmb of one hand, or the lower part of one arm. C10 Total and permanent loss of the se of one foot or the lower 60% part of one leg. C11 Total and permanent loss of hearing. 50% C12 Total and irrecoverable loss of the lens of, or of all sight in, 20% one of two eyes. C13 Brns or disfigrement of more than 50% of the body. 20% C14 Total and permanent loss of the se of either phalanx of 15% either thmb. each C15 Total and permanent loss of the se of any phalanx of any 4% finger. each C16 Total and permanent loss of the se of any toe other than 6% a great toe, or either phalanx of either great toe. each C17 Total and permanent loss of hearing in one ear. 15% 8

11 Limits to the cover 1. We will only pay benefits for a maximm of 104 weeks for: (a) events A1 and A2 as a reslt of any one accidental injry; or (b) event B1 as a reslt of any one illness or disease. If the insred person retrns to the sal dties of his/her sal occpation and then sffers an aggravation or relapse of the original injry, illness or disease, we will treat this aggravation or relapse as a contination of the original claim and not as a new claim. The time in between, when the insred person retrned to his or her sal dties, will not cont toward the limit of 104 weeks. 2. We will only pay benefits for one of the events A1 or A2 or B1 for the same period of time. 3. If yo have made a claim for any of events C1 to C17, the most we will pay for event A3, as a reslt of the same accidental injry, is the amont, if any, by which the benefit for event A3 is more than the amont already claimed. 4. If more than one of events C1 to C17 happens to the insred person dring the period of insrance, we will only pay for the event which has the greatest benefits. The most we will pay is 100% of the amont specified for events C1 to C17 in the schedle. Age limits We will not atomatically renew this cover if the insred person: 1. Has reached the age of Has reached the age of 55 if events B1 or B2 are covered. If we decide not to renew this policy, we will tell yo in writing. If we invite renewal, we will tell yo of any changes to the cover. 6. Any sexally transmitted or transmissible disease. 7. Any illness or disease that existed before this cover commenced. 8. Any illness or disease that the insred person contracted within 28 days after this cover commenced. 9. Any injry sffered in an accident which occrred before this cover commenced. 10. The insred person taking part in a sporting activity for which he or she receives a fee or reward exceeding $100 per year in vale. 11. The insred person taking part in aerial activities. This does not apply to a fare-paying passenger on a reglar pblic transport commercial, or chartered, flight in an aircraft, the operation of which is reglated by statte controlling the carriage of passengers. Some activities that are not covered in any circmstances are piloting or acting as a member of the crew of any aircraft; or being in, on, or sspended from (even as a fare-paying passenger) a balloon, airship, gyrocopter, gyroplane, gyroglider, parasail, parachte, weight shift controlled aeroplane, hang-glider, ltralight aircraft, sperlight aircraft, microlight aircraft or minimm aircraft (whether or not fitted with an engine). 12. The insred person taking part in a riot or civil commotion, or a criminal act. 13. War or warlike activity, whether or not war is declared. 14. Acts of foreign enemies, hostilities, terrorism, rebellion, insrrection or revoltion. 15. Anything radioactive or involving nclear energy or nclear weapons material. When we will not pay We will not pay claims for any event which is cased by, or made more serios by: 1. Any deliberately self-inflicted injry. 2. Any deliberate taking of poisonos sbstances or drgs except as prescribed by a medical practitioner. 3. The insred person being nder the inflence of, or addicted to, alcohol. 4. Elective cosmetic srgery or recovery following elective cosmetic srgery. 5. Hernia, except where yor schedle shows yo have cover for event B1. 9

12 Important information Yo cannot give yor rights away We will only pay benefits to yo or to yor personal legal representative. Yo cannot give anyone else an interest in this policy withot or written consent. What yo are reqired to do for s 1. Yo mst comply with the conditions of this policy and yo mst co-operate with s in exercising or rights. 2. Yo mst pay s the premim for this insrance. 3. (a) Yo mst tell s in writing, as soon as possible, of anything that changes the facts or circmstances relating to yor insrance. (b) Yo mst tell s in writing, as soon as possible, if there is any change in the occpation, dties, habits or pastimes of the insred person. (c) Yo mst tell s in writing, before each renewal of this policy, if the insred person has been affected by any injry, illness or disease, or physical or mental abnormality. We may decide to discontine or change the cover or apply an additional premim. 4. Yo mst make sre that the insred person obtains and follows medical advice from a medical practitioner, as soon as reasonably possible after he or she sffers any injry, or contracts any illness or disease. Cancelling yor policy before the de date Yo can cancel this policy at any time. To do this yo mst ask s in writing to cancel yor policy. The policy will end when we receive yor reqest. We can cancel this policy if yo do any of the following: 1. Make a misleading statement to s when yo apply for yor insrance. 2. Fail to tell s anything yo shold tell s when yo apply for this policy, renew this policy or when yo change or reinstate this policy. 3. Fail to comply with the conditions of this policy. 4. Fail to pay the premim for this insrance. 5. Are not fair and open in yor dealings with s. 6. Make a claim dring the period of this policy that is not tre. The claim does not have to be against this policy and can be with s or another insrance company. We may also cancel this policy if there is a change in the circmstances of the risk dring the period of insrance. If we cancel this policy, we will tell yo in writing. Retrn of premim if yor policy is cancelled before the de date If yor policy is cancelled before the de date, we will retrn to yo the premim except as set ot below: 1. If a claim has been made for any of events A3, B2 or C1 to C13, we will keep the premim for events A3, B2 and C1 to C If a claim has been made for any of events A1, A2 or B1 for a period of incapacity of 26 weeks or more, we will keep the premim for events A1, A2 and B1. 3. We will also keep the premim, other than as set ot in 1. and 2. above, for the period that the policy was in force. How to make a claim 1. Yo mst tell s in writing as soon as possible after the insred person sffers any injry, illness or disease that may reslt in a claim. 2. Yo mst pay the cost, if any, of certificates, reports or other evidence that we may reqire (except as in 3., below, and the 'Special condition', on page 11). Or claim forms inclde certificates of incapacity to be filled in on behalf of the insred person. We will only consider an initial certificate of incapacity from a medical practitioner. We may reqire additional spporting proof if yo are claiming for any period of incapacity before the date on which the initial certificate was issed. We will tell yo if we need yo to provide any other specific information. We will consider certificates of contining incapacity from a medical practitioner or from a registered physiotherapist, registered chiropractor or registered osteopath if appropriate to the insred person s injry, illness or disease. 3. Yo mst ensre that the insred person is available as reqired for examination by any medical practitioner(s) chosen by s. We will pay for the examination(s). 10

13 Special condition When an insred person dies, we may reqire a post-mortem examination. We will pay for this examination. Variations These variations do not apply to yor policy nless shown on yor schedle. We may apply these or other variations. 1A. Weekly benefits limit The most we will pay for events A1, A2 or B1 is 84% of the redction in the insred person s personal weekly income, reslting from the event, which is not replaced from any other sorce. 1B. Weekly benefits limit, pls ongoing bsiness expenses The most we will pay for events A1, A2 or B1 is 84% of the redction in the insred person s personal weekly income, reslting from the event, which is not replaced from any other sorce, pls, for each week of contining incapacity, 1/52nd of the share of the annal expenses which: (a) are the ongoing expenses of a bsiness in which the insred person is a proprietor or partner; and (b) are normally paid from the gross billings attribtable to the personal efforts of the insred person; and (c) the insred person mst contine to meet. This extended cover is still limited, in total, to the weekly amont specified in yor schedle for the relevant event. Yo can apply for a higher weekly amont. 2. Non-working hors only cover We will not pay any benefits for events A1 to A3 and C1 to C17, if the accidental injry is sffered by the insred person while engaging in any occpation. Also, we will not pay any benefits for any events if any workers compensation payments are available. 3. Excess period for weekly benefits We will redce the period for which we pay yo benefits for events A1, A2 and B1, by not paying benefits for the nmber of weeks shown in yor schedle as the excess period. This excess period will apply at the beginning of each separate claim. As a reslt, the maximm period of 104 weeks set ot in item 1 nder 'Limits to the cover' on page 9, or as modified by any other variation or endorsement, is redced by the nmber of weeks in the excess period. 4. Paid sporting activity Item 10. nder 'When we will not pay' on page 9 will not apply. 5. Exclding specific injry, illness or disease We will not pay claims for any event which is cased by, or made more serios by, any injry, illness or disease, or physical or mental abnormality, noted in yor schedle. Or service commitment CGU Insrance is prod of its service standards and spports the General Insrance Code of Practice. In the nlikely event that yo are not satisfied with the way in which we have dealt with yo, as part of or commitment to cstomer service, we have an internal dispte resoltion process in place to deal with any complaint yo may have. If yo are not satisfied with any of the following, please contact yor nearest CGU Insrance office. One of or prodcts. Or service. The service of or athorised representatives, loss adjsters or investigators. Or decision on yor claim. Or staff will help yo in any way they can. If they are nable to satisfy yo, they will refer the matter to the appropriate manager who will immediately deal with the matter. If the manager cannot resolve the matter, the manager will escalate the matter to or internal dispte resoltion staff. Or internal dispte resoltion staff will review the matter and will try to reach a satisfactory otcome. Once their review has been completed, they will advise yo of or final decision within 15 working days. If they need longer, they will contact yo and explain 11

14 the reasons why. Or internal dispte resoltion process is a free service to yo. If yo do not agree with or final decision, the matter may be reviewed throgh the Insrance Ombdsman Service. The scheme is administered by Insrance Ombdsman Service Limited ABN The scheme is an external body that is independent of this company. It will investigate the matter and make its decision at no cost to yo. Access to the Insrance Ombdsman Service is not available to yo if yor staff nmbers or bsiness trnover exceeds the jrisdictional limits of the Insrance Ombdsman Service Limited. We can advise yo of these limits or they can be confirmed by calling the Insrance Ombdsman Service Limited on Brochres otlining or internal dispte resoltion process are available from yor nearest CGU Insrance office. 12

15 Policy index Occpation 7, 8, 9, 11 Osteopath 10 Abnormality (physical, mental) 11 Aerial activities 9 Age 9 Aggravation 9 Alcohol 9 Arm 8 Benefits 6, 8 Blindness 8 Brns 8 Bsiness expenses 11 Cancellation 10 Certificates (medical) 10 Chiropractor 10 Civil commotion 9 Consmer Price Index (CPI) 7 Contination (aggravation, relapse) 9 Cosmetic srgery 6, 9 Cover 8, 9 Death 6, 8, 11 Disease 8, 9 Doctor 7, 10 Drgs 9 Ear 8 Events 7, 8, 9 Evidence 10 Excess period 6, 11 Eye 8 Feet 8 Finger 8 Flying 9 Foot 8 Paralysis 8 Pastimes 9 Period of insrance 7 Personal weekly income 7, 11 Physical abnormality 11 Physiotherapist 10 Poison 9 Post-mortem examination 11 Pre-existing illness, disease 9 Proof 11 Radioactivity 9 Relapse 9 Renewal 9 Riot 9 Schedle 7 Self-inflicted injry 9 Sexally transmitted disease 6, 9 Sight 8 Sport 9 Table of cover 9 Terrorism 10 Thmb 9 Toe 9 War 10 Weeks maximm 9, 11 Workers compensation 11 Yo/insred 6 Hand 8 Hearing 8 Hernia 6, 8, 9 Illness 8, 9 Injry 8, 9 Insred/yo 7 Insred person 7 Leg 8 Limits 9 Medical certificates 10 Medical practitioner 7, 10 Mental abnormality 11 Non-working hors cover 11 Nclear energy, weapons 9 13

16 Insrer CGU Insrance Limited ABN AFS Licence No C0013 REV8 8/06