Get your super and insurance together in one place

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1 Get your super and insurance together in one place Is your insurance everywhere? If you have more than one super account, chances are you also have insurance cover in some of those accounts. Imagine if you or your loved ones had to make a separate claim on your cover in each account. And, think of the fees you could be paying and the impact this may have on your retirement savings. Bring it all together There is an easier way. If you would like to have your insurance cover in one place, use this form to consolidate your insurance cover with AMP. Eligibility criteria You can consolidate your insurance if: you are consolidating your total super account and insurance from your existing superannuation product(s) to AMP, if you are employed you nominate your AMP super account as your choice of fund for the super your employer contributes for you (Superannuation Guarantee Contributions), and you are working at the time of application. As only certain types of products are eligible to use this insurance consolidation offer, talk to your planner to determine if this offer is right for you. Insurance cover types You can apply to consolidate the following insurance cover types: cover up to a maximum total cover of 1 million. Total and Permanent Disablement () up to a maximum total cover of 1 million. Temporary Salary Continuance () up to a maximum monthly benefit of 8,000 or 75% of your monthly income. For cover above these limits, you will need to complete a separate application and be assessed by AMP s underwriters. Next steps 1. Obtain recent evidence of your insurance information from your existing superannuation fund(s). This information will also help you to complete the form. 2. Fill in the attached Insurance Consolidation application form. 3. If consolidating insurance from a non-amp super fund, attach a statement from your previous super fund(s) which is dated within 60 days of your application and confirms: Type (eg, ) of existing cover and insured amount/ monthly benefit. For, the waiting period(s) and benefit period(s) applicable to the existing cover. Any special terms, premium loadings and/or exclusions (including exclusions for pre-existing conditions) that apply to the existing cover. If your evidence is older than 60 days, please complete the additional declaration in Section 4. The evidence of insurance cannot be older than 12 months. 4. If AMP is not currently receiving your Superannuation Guarantee contributions, complete a Choice of Fund form to nominate your AMP super account as your chosen fund. Give this form to your employer. 5. Complete the Request to Transfer Whole Balance of Superannuation Benefits between Funds form and send this form to AMP with the Insurance Consolidation application form. 6. After AMP Life has accepted your new cover, and confirmed this in writing, you must cancel the existing cover with your previous super fund(s) within 30 days. Note when you transfer your super across your insurance is likely to be cancelled automatically with the closure of your old account(s). Insurance consolidation FAQs What product terms and conditions will apply? AMP product premiums, terms and conditions will apply to the consolidated cover and these may be different from your existing cover. Any exclusions, loadings and pre-existing condition exclusions that apply under your previous cover will continue to apply with AMP. Note you will not be eligible to consolidate your existing cover if you have more than one non-amp exclusion (includes pre-existing condition exclusions) or a premium loading over 100%. How do I obtain an up-to-date statement from my previous super fund(s)? A good place to get this information is your last member statement from your super fund(s) or from your online information. If your member statement does not contain the information we require, you may need to ask your super fund(s) to provide you with a letter setting out the details. What is an exclusion? An exclusion is applied to an insured person s cover when the insured person has a pre-existing condition or is involved in an activity or pastime (eg motor racing) that presents an increased risk that an insurer chooses not to cover. This is usually disclosed before or when you take out the insurance. If an exclusion applies, the insurer may reduce or refuse to pay a benefit. Any exclusion that applies to your existing cover will continue to apply to your new cover.

2 What is a Pre-Existing Condition (PEC) exclusion? The is a product rule, usually applied by an insurer to all holders of a specific type of insurance, which limits the right of insured persons to claim a benefit for pre-existing illnesses or injuries. Not all superannuation products will have a. A is different from an exclusion that has been applied to you as an individual as it is often applied to the product or a group you belong to. Any that applies to your existing cover will continue to apply to your new cover in your AMP account. What is a premium loading? A premium loading is an extra cost (usually expressed as a percentage) which is added to the standard premium rate. A premium loading is applied when an insured person has a health condition (eg chronic back injury) or is involved in an activity that presents an increased chance of making an insurance claim. Any premium loading that applies to your existing cover will continue to apply to your new cover in your AMP account. Why isn t my Temporary Salary Continuance () benefit period/waiting period available in the insurance consolidation application form? AMP only offers the following combinations of waiting periods and benefit periods: Benefit periods AMP offers a choice of a 2 year or To age 65 benefit period. If your existing cover has a benefit period that we do not offer (eg 5 years), you must choose a shorter benefit period offered by AMP. Note that if your existing cover has a benefit period of less than you will not be eligible to consolidate this cover. Waiting periods AMP offers waiting periods of 4, 8, 13 or 26 weeks. If you have a benefit period, we also offer a 104 week waiting period. If your existing cover has a waiting period that we do not offer (eg one year), you must choose a longer waiting period offered by AMP. Note that if your existing cover has a waiting period of more than you will not be eligible to consolidate this cover. What happens to my super contributions? Our Super Contribution option will apply in the AMP product you are consolidating into if your benefit in your former fund included superannuation contributions. You can opt out by contacting AMP. For more information speak to your planner or read the Product Disclosure Statement (PDS). How does my insurance keep pace with inflation? Our Indexation feature is automatically applied to your cover if the AMP product you are consolidating into has this feature selected. You can opt out by contacting AMP. For more information speak to your planner or read the PDS. Need further assistance? For more information on how to complete your application speak to your financial planner or call AMP on Learn more about AMP insurance at Important note This information is general in nature and does not take into account your personal objectives, financial situation or needs. Before you make any investment decision, it is important that you consider these matters and read the Product Disclosure Statement available by contacting AMP. Issued by AMP Superannuation Limited ABN , AFSL No , RSE Licence No. L , the trustee of the AMP Superannuation Savings Trust ABN , RSE Registration No. R NS /11

3 Please staple all relevant material together Insurance Consolidation application form Office/Planner use only Financial Planner number Plan number Request ID Use this form to apply to consolidate insurance cover from either an eligible AMP superannuation product or from a superannuation product outside of AMP. Mark boxes with ( ) where appropriate, otherwise use block letters. Leave a box between words. Which AMP product are you applying to consolidate your insurance into? AMP Flexible Super Flexible Lifetime - Super 1. ELIGIBILITY QUESTIONNAIRE a) Have you, or any other person applying for cover on your life, ever previously been declined cover by any insurer for any form of life insurance or disability cover? No Yes b) Have you been advised by a doctor that you have an illness or injury that will reduce your life expectancy to less than 12 months? No Yes c) Have you, or any other person or entity, ever made or been entitled to make a claim on your behalf for benefits under: a life or superannuation insurance policy workers compensation, or a statutory compensation scheme. Have you ever had an illness or injury preventing you from being able to work for more than 4 weeks in the past (whether you were working or not)? No Yes d) Are you restricted, due to injury or illness, from carrying out any of the duties of your current and normal occupation on a full-time basis (even if you are not currently working on a full-time basis)? Full-time basis is considered to be at least 30 hours per week even though you may not actually be currently working that number of hours. No Yes If you answered Yes to any of the questions above you will not be eligible to consolidate your existing cover. If you still wish to apply for insurance, you will need to complete a separate application form and be assessed by AMP. For more information speak to your financial planner or call AMP on MEMBER DETAILS AMP Member number - Super account you are consolidating TO AMP Member number - Product you are consolidating FROM* *Not applicable for non-amp super funds Title First name Surname Address for communication Unit No. Street No. Street name Suburb State Postcode Phone Number Address Date of birth Sex What is your current salary (annual gross before tax)? Male Female Have you smoked tobacco or any other substance or used nicotine replacement products within the last 12 months? No Yes Please indicate your employment status Employed Self-employed Issued by AMP Superannuation Limited ABN , AFSL No , RSE Licence No. L , the trustee of the AMP Superannuation Savings Trust ABN , RSE Registration No. R Registered trade mark of AMP Life Limited ABN NS7206 (08/11) A1 of 4

4 WHICH OF THE FOLLOWING BEST DESCRIBES YOUR PRIMARY OCCUPATION? Select One Description of occupation types Examples White collar Light blue collar Heavy blue collar Hazardous All white collar workers and office professionals where duties are of a sedentary nature. Includes white collar workers whose duties are not always limited to an office environment, who may be required to travel or who require customer contact outside an office environment. Occupations involving light manual work performed by skilled crafts people or licensed trades people, and those supervising manual work, with some involvement in light manual work only. Heavy manual work performed by skilled workers. Light manual work performed by unskilled workers. Heavy manual work performed by unskilled workers or those involved in hazardous duties. In this category, you are only eligible to consolidate cover. 3. WHAT INSURANCE WOULD YOU LIKE TO CONSOLIDATE? Accountant, administrator, clerk, computer programmer, dentist, doctor, physiotherapist, receptionist, sales representative, teacher. (Excludes pilot and cabin crew, police, military) Carpenter, chef, café proprietor, driving instructor, electrician, hairdresser, jeweller, locksmith, mechanic, newsagent, nurse, painter, panel beater, tiler, upholsterer. (Excludes pilot and cabin crew, police, military) Concreter, cleaner, ceiling fixer, car detailer, greengrocer, market gardener, postman, sales assistant - fast food, storeman, waiter/waitress. (Excludes pilot and cabin crew, police, military) Abalone/rescue diver, ammunition worker, asbestos worker, diving instructor, explosives worker, flying instructor, horse breaker/jockey, scaffolder, underground miner. (Includes pilot and cabin crew, police, military). For this section you will need an up-to-date statement from your existing super fund(s) confirming the type, amount and additional terms (eg premium loadings/exclusions) of your existing cover. If consolidating insurance from a non-amp super fund, you must attach the statement to this form. 3.1 Provide details of the and cover you are applying to consolidate: FULL NAME OF SUPER FUND AND PRODUCT WHERE EXISTING COVER IS HELD QUICK CHECK DEATH COVER AMOUNT(S) COVER AMOUNT(S) Total amount of cover + + total value of cover in the AMP product you are consolidating into cannot be greater than 1 million 1 million 3.2 Provide details of the cover you are applying to consolidate (if applicable) total value of cover in the AMP product you are consolidating into cannot be greater than Complete this section ONLY if you are applying to consolidate cover into AMP Flexible Super - Flexible Protection or Flexible Lifetime Super. Otherwise continue to section 4. Helpful Hints Remember, in order to be eligible for this offer: Your total monthly benefit after consolidation is limited to 75% of your monthly income and cannot exceed 8,000 per month. You must choose a waiting period which is the same or greater than what you already have. You must choose a benefit period which is the same or shorter than what you already have. A2 of 4

5 FULL NAME OF SUPER FUND AND PRODUCT WHERE EXISTING COVER IS HELD Total amount of cover MONTHLY BENEFIT AMOUNT(S) CHOOSE YOUR WAITING PERIOD CHOOSE YOUR BENEFIT PERIOD Does your existing cover include a superannuation contribution option? No Yes (Refer to your member statement or your super fund for this information) 4. EXCLUSIONS AND LOADINGS (CONSOLIDATING FROM A NON-AMP SUPER FUND ONLY) Complete this section ONLY if you are consolidating your insurance from a non-amp super fund. Otherwise continue to section Does your existing cover: a) Have any premium loadings? No Yes b) Have any exclusions in regards to medical or other conditions (including pastimes)? No Yes c) Have any pre-existing condition exclusions s (such as cover for new events only)? No Yes Complete this question ONLY if you answered Yes to any of the questions in 4.1 above. 4.2 List the details of the loadings, exclusions or pre-existing condition (PEC) exclusions s. If you require additional space to complete this section, please attach relevant details on a separate page. Note: You will not be eligible to consolidate your existing cover if you have more than one non-amp exclusion or PEC or premium loading over 100%. If you still wish to apply for insurance, you will need to complete a separate application and be assessed by AMP. Any loading, exclusion or pre-existing condition exclusion that applies to your existing cover will continue to apply to your new cover in your AMP account. FULL NAME OF SUPER FUND AND PRODUCT WHERE EXISTING COVER IS HELD COVER TYPE EXPLAIN THE LOADING (% OR ), EXCLUSION OR PRE-EXISTING CONDITION EXCLUSION OR RESTRICTION A3 of 4

6 4.3 Declaration for evidence older than 60 days but less than 12 months To complete if your evidence from your non-amp super fund is more than 60 days old (it must be current within 12 months). I, (name), declare that the attached statement from (name of super fund) accurately describes my insurance cover with this fund and the cover remains current and has not been altered, reduced or cancelled in any way since the date of the statement. 5. AGREEMENT AND DECLARATION 1. I confirm that I have been given and have read, or have had the opportunity to read, the flyer Get your super and insurance together in one place, the latest Product Disclosure Statement (PDS) for the AMP superannuation product I am consolidating my insurance cover to, as well as any Fact Sheets, supplements or updates to that PDS. 2. I understand that the new cover, if accepted by AMP Life, will be subject to the standard terms and conditions of the AMP product as described in the current PDS, including any special terms described in any Supplementary PDS or PDS update which apply to the consolidated cover. I have considered and understand the differences between these terms and conditions and the terms and conditions which apply to my existing cover. I understand that the total amount of cover will be converted into a fixed amount and will no longer be formula-based (if it was previously formula-based). 3. To the best of my knowledge, information and belief, the information provided in this form and in any other documents I provide for the purpose of this application is accurate and complete even if the information has been written by someone else. 4. By completing and signing this application form, I declare that I: Have read the information in the PDS about my duty of disclosure when applying for insurance, and understand that my duty of disclosure continues after completion of this form until the time AMP advises me in writing that it has accepted the risk. Have complied with my duty of disclosure when applying to consolidate my insurance cover. Will advise AMP of any change to my health or occupation or any other matters that could be relevant to AMP, prior to any insurance benefit being increased or added to my plan. Agree to provide AMP with access to the health and/or financial evidence I provided to the former fund or its insurer in my application for cover and authorise the former fund or its insurer to provide AMP with this information. 5. I confirm that I complied with my duty of disclosure when applying for the existing cover, and if I was required to give answers when I applied for the Existing Cover, the answers I gave were accurate and complete. Note: Your application will be considered on the understanding that you intend to cancel any existing cover, and that you will do so within 30 days of the acceptance by AMP Life of this application. Failure to do so may render invalid a claim on your AMP plan. If this application is to replace a current AMP plan, the plan to be replaced will cease and a new plan will start. Before proceeding, you should be aware of the implications that consolidating your superannuation may have on your existing insurance cover. 6. The new cover is subject to acceptance by AMP Life and that cover does not start until I am notified in writing by AMP. 7. I understand that the premium rates for the new cover may be different to the premium rates for the existing cover. I understand that I can obtain a premium quote from my financial planner or AMP before applying for the new cover. 8. I understand that I cannot receive a Terminal Illness benefit or Total and Permanent Disablement benefit (including benefits paid under the definition for professionals, senior managers and home duties) in cash or to commence a pension unless I am eligible to access my super benefit. 9. I have read the Privacy Information in the PDS and agree to the various uses and exchanges of my personal information and acknowledge my right to access personal information held about me by the AMP group. Signature of Member Date Checklist I have completed all relevant sections of this Insurance Consolidation application form I have completed the Choice of Fund form and provided the signed form directly to my employer (if you are self-employed, or AMP is currently receiving your Superannuation Guarantee contributions this statement does not apply) I have completed the Request to Transfer Whole Balance of Superannuation Benefits between Funds form and I have attached this to my application If consolidating from a non-amp super fund, I have attached a recent super statement which outlines details of my existing cover. ADDRESS FOR RETURN - Complete this form and return to: New Business Applications Reply Paid PARRAMATTA NSW 2124 A4 of 4

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