Insurance Guide Date of issue: 1 December 2012

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1 Phone: / Fax: Insurance Guide Date of issue: 1 December 2012 The information in this document forms part of the Product Disclosure Statement for MTAA Super dated 1 December 2012 issued by Motor Trades Association of Australia Superannuation Fund Pty Ltd (ABN , AFSL ) of Level 3, 39 Brisbane Ave Barton ACT 2600, the Trustee of the MTAA Superannuation Fund (ABN ). Insurance in your super MTAA Super offers a range of insurance options to protect you and your family from financial hardship if you are unable to work for a long period due to sickness or injury, or become permanently disabled or die. The benefits of insurance as part of your superannuation arrangements include the following: Cost savings. MTAA Super uses its purchasing power and has negotiated a group insurance policy on behalf of its members. Cover is tax-effective. You do not pay for it with your after-tax income since premiums are deducted directly from your superannuation account. Types of cover MTAA Super offers three types of cover to members. Death cover Death-only cover provides an insured lump-sum benefit in the event of your death or a terminal illness. Total and permanent disability (TPD) cover TPD cover provides for an insured lump-sum benefit if you become totally and permanently disabled or suffer a terminal illness. Income protection Income protection insurance will pay a benefit, usually monthly, if you are unable to work because of illness or injury. Contents Matching Cover...2 Death and TPD cover...3 Default cover...3 Limited Cover...4 Changing your cover...5 Work Scales...6 Unitised Cover...6 Fixed Cover...8 Income Protection Insurance...13 Calculating the cost of cover Income Protection unitised scales.15 Important information about your insurance cover...21 Privacy policy: group risk insurer Forms Application for additional Insurance...25 Application to change your work scale...31 Matching Insurance Cover...33 Application to increase cover on joining

2 Matching cover Want to join MTAA Super and change your super fund without losing your existing levels of insurance cover? MTAA Super offers members the ability to apply to match their cover to the insurance design available. This means you may be able to consolidate your super accounts and not have to pay additional fees for keeping your insurance open in another fund. You must satisfy a number of conditions and these are outlined in the Matching insurance cover form on Page 33. Do not cancel your existing insurance until you have received written notification that your cover has been accepted. To apply, fill in the MATCHING INSURANCE COVER FORM on Page 33. This form outlines all conditions and any restrictions regarding cover. 2

3 Death and Total and Permanent Disablement cover Default cover Cover when you join MTAA Super New MTAA Super members are automatically provided with default cover (subject to terms and conditions). The level of cover provided to you is based on your age when you become a member and may change in line with your age. Some new members will not be eligible for default cover (see page 4). The table below sets out the cost and the number of units of cover that are provided for your age when you join: COVER WHEN YOU JOIN MTAA SUPER Your age next birthday when you join MTAA Super Death Units General Scale TPD Units General Scale Cost of Cover ($0.50 per unit) $3.00 per week $4.00 per week $6.00 per week There are different types of work scales depending on the type of work you do. We classify them as General; Non-manual and Professional. The amount of cover you are eligible to receive will be different depending on the work scale applicable to you. It s important you let the Fund know if you are eligible for nonmanual or professional cover. See page 6 for more information. How to calculate your default level of cover? Go to the unitised scales table on page 7 Look at the row corresponding to your age next birthday. Then, look at the box in the column that corresponds to the work scale that applies to you. (See page 6 to find out what the different work scales mean). The amount in that box is the level of cover per unit. Multiply the amount of cover in that box by the number of units you are eligible for. Not enough cover to meet your needs? Why not look at the other options available to you. The level of cover provided under the unitised benefit scales varies with age. Your insurance needs will vary with time, too, so we recommend that you review your insurance regularly to ensure that the level of cover provided remains sufficient to meet your needs. Max is aged 29 next birthday. He works in an office environment and is eligible to apply for the non-manual work scale. As a member of MTAA Super, he will receive 6 units of death and 6 units of TPD cover: $67,750 X 6 = $406,500. His default level of cover is $406,500 of Death and TPD insurance at a cost of $6.00 per week. Cover changes as you stay with MTAA Super Insurance can t be one size fits all and your needs change from when you are just entering the workforce to when you take out a mortgage and have children. This is why we have introduced aged based default insurance scales. This means: If you turn 21 while you are a member and you haven t changed your Death & TPD cover, your default level of death cover will increase to three units If you turn 26 while you are a member and you haven t changed your Death & TPD cover, your default level of Death and TPD cover will increase to 6 units. 3

4 When does default cover start? Your default cover will begin for eligible members on the earlier of: the start of the contribution period from which your first on-time employer contribution is received (up to a maximum of 180 days prior to the cash received date); and the effective date of your account balance with MTAA Super being greater than zero. It is important to ensure that your employer pays ongoing contributions to your account and on time. Are you eligible for default cover? To be eligible for the default death and total and permanent disability cover when you join, you must: be between 15 and 69 years of age have not received a TPD benefit through a superannuation fund or insurance policy at any time previously; and not be currently claiming or be eligible to claim a TPD benefit. Please contact MTAA Super if you are not eligible for default insurance cover for any reason other than age. Limited cover If you are an eligible Employer Supported Member who joins MTAA Super as a new member and you meet the following conditions: your employer s first employer contribution to your account is received within 6 months of you commencing employment with your employer; and you are in Active Employment when default cover commences. The default cover you receive will not be subject to Limited Cover. If you are an Employer Supported Member not in Active Employment on the date the cover commences you will receive Limited Cover until you return to Active Employment. Once you return to Active Employment the Limited Cover restriction will be removed. For all other members who do not meet the conditions above you will receive Limited Cover for the first 24 months. Should you be in Active Employment after the expiry of this 24 month period Limited Cover will be removed. Employer Supported Member Any member who receives an employer (Superannuation Guarantee) contribution from their employer. Definitions Limited Cover Limited Cover means a member is covered only for an injury that first occurred or an illness that first became apparent on or after the day cover began. Active Employment Employer Supported Members A person in Active Employment is a person who is employed by an employer and who, in the insurer s opinion, is capable of performing their identifiable duties without restriction as a result of any illness or injury for at least 35 hours a week (whether or not they are actually working those hours). Active Employment All other members A person in Active Employment is a person who in the insurer s opinion is capable of performing their identifiable work duties without restriction as a result of any illness or injury for at least 35 hours a week (whether or not they are actually working those hours). 4

5 Changing your cover You can apply to increase, decrease or cancel your cover at any time. Increase your cover: without providing evidence of health You may be eligible to increase your cover without the need to provide evidence of health to the insurer in two ways: You first join MTAA Super When you first join MTAA Super you may be eligible to increase your cover without the need to provide health evidence. To apply, fill in the APPLICATION TO INCREASE COVER ON JOINING FORM on page 37. This form outlines all conditions and any restrictions regarding cover. Your life changes If you already have at least default cover with MTAA Super you can apply to increase your Death and TPD cover by up to 3 units on the General Scale within 60 days of one of the following events occurring: you get married you have a child or adopt a child you take out a mortgage to purchase or build your home you get divorced. If you are not in Active Employment at the time you apply for this increase, Limited Cover will apply to the amount of additional cover until you return to work, and have been in active employment. This increase in cover cannot result in you holding more death or TPD cover than your applicable Automatic Acceptance Limit, which for members aged 54 or less is $800,000. To apply, fill in the LIFE EVENTS COVER FORM on our website. This form outlines all conditions and any restrictions regarding cover. Increase your cover: when you need to As a member of MTAA Super you can apply for additional death or TPD cover at any time. The maximum total amount of cover you can apply for: Death cover: $5,000,000 TPD cover: $3,000,000 To increase your cover, please fill in the APPLICATION FOR ADDITIONAL INSURANCE on page 25. Reduce or cancel your cover You can reduce or cancel your insurance cover at any time by writing to MTAA Super. You can also elect to hold death-only or TPD only cover at any time. 5

6 Jenny is 35 years old and is an administration assistant. She works in an office and qualifies for the non-manual work scale. She has 6 units of death cover: Her age next birthday is 36. Given she is eligible for non-manual cover, if she applies to change this cover and the insurer accepts that she is eligible, her cover will increase without an increase to the amount deducted from her superannuation account each week. General work scale Jenny will receive $49,000 of death cover for each unit. She has 6 units of cover: $49,000 X 6 = $294,000 Jenny is insured for $294,000 Non-manual work scale Jenny will receive $69,600 of death cover for each unit. She has 6 units of cover: $69,600 X 6 = $417,600 Jenny is insured for $417,600 Jenny could get more death cover, for the same cost per week by filling in the APPLICATION TO CHANGE YOUR WORK SCALE on page 31. Why not look at the other options available to you. Work scales: General, Non-Manual or Professional? MTAA Super offers members three types of insurance benefit scales on which to base their benefit levels. What is the general work scale? This scale is available to everyone but is generally used by members who work in a trade environment. Unless you apply (and are accepted) for the non-manual or professional scale, the general scale will apply to your insurance cover. Are you eligible for the non-manual work scale? If you work entirely in an office environment, and do not perform manual duties or work in a hazardous environment, or do not spend more than 20 per cent of your working time outside an office environment, then you are eligible to apply for the non-manual scale. Are you eligible for the professional work scale? If you are a white-collar professional and perform no manual work (e.g doctor, lawyer, accountant) you may be eligible for the professional scale. Usually these occupations require tertiary qualifications or are senior management positions within your organisation and also earn at least $120,000 per annum. Unitised or Fixed cover You can choose to have your death or TPD cover as either unitised or fixed cover, although there are conditions you might have to satisfy. You cannot have a combination of unitised and fixed cover for death and TPD. Unitised cover Unitised cover is based on an insurance benefit scale that determines the amount of money you will receive if you become eligible to claim a benefit for death or TPD. The levels of cover vary according to your age, but the cost for each unit remains the same regardless of your age. See page 14 to find out how to calculate unitised cover. The cost of unitised cover The charges for unitised death and TPD insurance cover are as follows: Death only: Total & Permanent Disability: Death & TPD cover: $0.50 per unit per week $0.50 per unit per week $1.00 per unit per week Unitised Scales: Death and Total & Permanent Disability The table on page 7 shows the amount of insurance cover provided by a (1) unit of cover based on your age and your work scale. Your work scale depends on the sort of work you do. See the section Work Scales above for more information. 6

7 UNITISED SCALES: DEATH AND TOTAL & PERMANENT DISABILITY (1 UNIT OF COVER) Age Next Birthday General Work scale Non-Manual Work scale Professional Work scale $27,500 $39,100 $59, $28,400 $40,300 $61, $30,500 $43,300 $65, $34,100 $48,400 $73, $39,400 $55,900 $84, $42,900 $60,950 $92, $45,900 $65,200 $98, $47,700 $67,750 $102, $48,900 $69,400 $105, $49,500 $70,300 $106, $49,600 $70,400 $106, $49,500 $70,300 $106, $49,500 $70,300 $106, $49,300 $70,000 $106, $49,000 $69,600 $105, $48,700 $69,200 $104, $48,000 $68,200 $103, $45,800 $65,000 $98, $43,400 $61,600 $93, $41,000 $58,200 $88, $38,800 $55,100 $83, $36,800 $52,300 $79, $34,600 $49,100 $74, $32,600 $46,300 $70, $30,400 $43,200 $65, $28,300 $40,200 $60, $26,100 $37,100 $56, $24,000 $34,100 $51, $21,800 $31,000 $46, $19,700 $28,000 $42, $17,500 $24,900 $37, $15,300 $21,700 $32, $13,700 $19,500 $29, $11,500 $16,300 $24, $9,460 $13,420 $20, $8,250 $11,770 $17, $7,260 $10,340 $15, $6,600 $9,400 $14, $5,850 $8,300 $12, $5,500 $7,810 $11, $5,170 $7,370 $11, $4,850 $6,900 $10, $4,400 $6,270 $9, $4,070 $5,830 $8,750 66* $3,750 $5,300 $8,060 67* $3,300 $4,730 $7,100 68* $2,970 $4,200 $6,390 69* $2,650 $3,800 $5,700 70* $2,200 $3,100 $4,730 Sam is a mechanic and aged 27 next birthday. He has 6 units of death cover. As a mechanic, he works in a manual environment and is eligible for the general work scale. Death cover is 6 units X $0.50 = $3.00 per week The total cost of cover is $3.00 per week 1 unit of death cover for his age next birthday (27) is $42,900 (on the general work scale) $42,900 x 6 units = $257,400 $3.00 per week covers Sam for $257,400 death cover * Activities of Daily Living (ADL) definition of TPD applies from 65th birthday. See Features of total and permanent disability insurance on page 11 for more information. 7

8 Fixed cover If you don t want your insurance cover to reduce each year, you can retain a fixed level of cover. Fixed cover allows you to choose the level of cover you want in multiples of $1,000. Your chosen level of cover will not vary with your age and will remain the same each year until you reach age 70 for death-only or death plus TPD cover. Your premium will, however, vary each year according to your age. If you are eligible to apply for the non-manual or professional scale, fill in the APPLICATION TO CHANGE YOUR WORKSCALE FORM on page 31. Please note that the insurer must accept that you are eligible in order for the non-manual or professional scale to apply. The cost of fixed cover To calculate the cost of fixed Death or TPD cover: The amount of cover / 1,000 X premium for your age (within your work scale) = weekly premium cost. Fixed Scales: Death and Total & Permanent Disability The table on page 9 shows the weekly cost for $1,000 of fixed Death and TPD cover based on your age and your work scale. Your work scale depends on the sort of work you do. See page 6 for more information. 8

9 FIXED SCALES: DEATH AND TOTAL & PERMANENT DISABILITY Age Next Birthday General Work scale Non Manual Work scale Professional Work scale Death TPD Death TPD Death TPD $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ * $ $ $ $ $ $ * $ $ $ $ $ $ * $ $ $ $ $ $ * $ $ $ $ $ $ * $ $ $ $ $ $ Tony is aged 32 next birthday and would like to apply for $500,000 worth of death cover. Tony is an accountant and meets the eligibility criteria for the professional work scale. Tony has calculated the cost of his cover as: $500,000 / 1,000 X $ = $2.35 per week Tony will pay $2.35 per week for $500,000 of death cover. It s important to note, that if Tony fixes his level of cover the insurance premium deducted from his account will increase each year. * Activities of Daily Living (ADL) definition of TPD applies from 65th birthday. See Features of total and permanent disability insurance on page 11 for more information. 9

10 What happens after you apply for cover? You will receive confirmation it is under consideration. This confirmation will be in the form of either a letter or a phone call, and will generally be received within 6 business days. You may be contacted directly by phone or letter by the Fund s insurer MetLife and/ or their medical provider United Health Group (UHG) seeking further information or to arrange a medical examination or blood test. (Note that medical examinations required by the insurer are usually paid for by the insurer). If you wish to supply additional information to support your application, this will be at your own expense. Cover will not become operative until all the information the insurer requires has been received, considered and accepted by the insurer. During this post-application process you will be covered for up to 90 days of interim accident cover while the insurer is making its determination. See below for more information. You will receive a letter informing you whether or not cover has been granted. If your cover has been granted, the date that the cover begins and any special terms that apply will be noted. You have a 14-day period from notification of acceptance of additional insurance cover in which to review the terms and conditions of coverage. You can cancel your additional insurance by writing to MTAA Super during this period. Any insurance charge paid during that time will be refunded to your MTAA Super account. Interim death and TPD accident cover When you apply for additional insurance, you will be covered for interim accident cover from the date MTAA Super receives your application. Interim accident cover provides you with accident cover for any increased cover amount for which you have applied above your current cover with MTAA Super. Interim Accident cover will cease on one of the following events occurring: your application is withdrawn, accepted or rejected, 90 days has passed since MTAA Super received your application. Where interim accident cover applies, we will provide cover for the increased insured amount but only if the condition which gives rise to a benefit is the sole and direct result of accidental bodily injury occurring whilst the interim accident cover is in force and is not affected by a pre-existing condition. Please note: Interim accident cover is subject to the lesser of the amount applied for and $2m for Death and TPD. 10

11 Definitions What is Death cover? Death cover provides for an insurance benefit that is payable to your dependants or your legal personal representative on your death, so long as you are a member of MTAA Super and receiving insurance cover at the time of your death. Death insurance is not available to members aged 70 years or more. Your death cover can also be paid to you should you suffer a terminal illness. What is total and permanent disability (TPD) cover? TPD cover provides for an insurance benefit if you become totally and permanently disabled. Before paying any TPD insurance benefit, the Trustee must be satisfied that the amount is able to be released from the Fund under superannuation legislation. TPD insurance is not available to members who are aged 70 years or more. The definition of total and permanent disability varies according to your employment status and age at the time of becoming disabled: If you were employed at any time during the six months before your date of disablement and aged less than 65: total and permanent disability means: The member having, as a result of injury or illness, been unable to work for an initial period of six consecutive months and in the insurer s opinion, having become incapacitated to such an extent as to render the member unlikely ever to engage in or work for reward in any occupation or work he or she is reasonably capable of performing by reason of education, training or experience. The Activities of Daily Living (ADL) definition states that if the insured member was not employed at any time during the six months before the Date of Disablement or the member is aged from 65 to 69, total and permanent disability means: As a result of injury or illness, the member has become permanently unable to perform the basic activities normally undertaken as part of everyday life. This will be evidenced by the insurer being satisfied that the member is permanently unable to engage in any two of the following activities: bathing to shower or bathe dressing to dress or undress toileting to use the toilet, including getting onto it and off feeding to eat and drink mobility to get into or out of bed or a chair or wheelchair continence to control bladder and bowel function. If the insured person can perform the activity on their own by using special equipment, they will be considered able to perform that activity. Where the insured member is engaged in full-time unpaid domestic duties in their own residence, total and permanent disability means: As a result of illness or accident, the member is under the care of a medical practitioner and is unable to perform their normal domestic duties or leave their residence unaided and has not engaged in or worked for reward in any occupation or work for six consecutive months. 11

12 Definitions At the end of the six months, the member continues to be so disabled that he or she is, in the insurer s opinion, unlikely to perform his or her normal domestic duties at any time in the future and is unlikely at any time in the future to ever engage in or work for reward in any occupation or work he or she is reasonably capable of performing by reason of education, training and experience. In all cases a member will be considered for a total and permanent disability benefit if he or she permanently suffers the loss of the use of two limbs or the loss of the sight of both eyes or the loss of the use of one limb and a loss of sight in one eye (where limb is defined as the whole hand or whole foot). Date of Disablement means the later of: The date when a medical practitioner examines the insured member and certifies in writing that the member is disabled; and the date the insured member ceases all work. This date does not apply should a member suffer the loss of the use of two limbs or the loss of sight of both eyes or the loss of the use of one limb and the loss of sight of one eye. What is Terminal Illness? A member who is insured for death or Total and Permanent Disablement suffers from a sickness which: (a) Two medical practitioners, specialising in the insured member s sickness, certifies in writing, will despite reasonable medical treatment lead to the insured member s death within 12 months of the date of the certification and (b) the insurer is satisfied, on medical or other evidence, will despite reasonable medical treatment lead to the insured member s death within 12 months of the date of the certification referred to in paragraph (a). The sickness from which the insured member suffers must occur, and the date of the certification referred to in paragraph (a) must be made, while the insured member is covered under the policy and must be current at the time the claim is lodged. The Terminal Illness Benefit will be based on the member s higher insured cover for Death or Total and Permanent Disablement at the time they meet the Terminal illness definition defined above. Eligibility for Terminal Illness or Total and Permanent Disability (TPD) In order to be considered for a Terminal Illness or TPD benefit, a member must complete and return the relevant claim forms. Domestic duties means: Duties normally performed by a person who remains at home and is not working in regular employment for income. 12

13 Income Protection Insurance Why consider income protection? It is highly probable that your most important financial asset is your ability to earn an income. But, although most people insure their homes, cars and other valuables, few consider insuring their income. Income protection insurance will pay a benefit for a specified benefit period, usually monthly in arrears, if you are unable to work after the qualifying period because of illness or injury. This can provide security in a person s time of need. Who can apply? MTAA Super members who are actively engaged in full-time, part-time, casual or contracted employment, either as an employee or as a self employed person and are performing normal occupational duties are eligible to apply for income protection insurance. A member who is not at work on their commencement date with their employer will still be considered to be performing normal occupational duties if the member is employed and the absence is for reasons other than illness or injury. You are not eligible if you are: working less than 15 hours per week aged 65 years or more not an Australian citizen or permanent resident engaged in an occupation that the insurer does not cover. If this is the case, the insurer will notify you. Members of MTAA Super can apply for income protection cover with the following features: up to 85 per cent of your pre-disability income (with up to 75 per cent of your predisability income paid directly to you (less PAYG) and any balance (up to 10 per cent) payable as superannuation contributions to your MTAA Super account), subject to a maximum benefit of $25,000 per month. a benefit period of two years, five years or until age 65. cover in units of $250 per month, with a minimum of three units required waiting periods of 30 days, 60 days and 90 days The cost of cover is dependent on your age, insured benefit amount, occupational category (general, non-manual or professional), chosen waiting period and chosen benefit period. See page 16 for more information. A rehabilitation expense benefit which pays the costs of a rehabilitation program that a medical practitioner certifies is necessary for your rehabilitation and that, in the insurer s opinion, may help you return to employment. The age 65 benefit period also provides indexation of your monthly benefit on the anniversary of your first benefit payment. Your benefit will be increased by the lesser of CPI and 5%. It is very important that you read this document carefully to understand the costs involved, any exclusions or limitations, and when an income protection claim may be payable under the policy. 13

14 How much cover can you apply for? The maximum amount you can apply for is a benefit equal to the lesser of: 75 per cent of your pre-disablement monthly income, and 10 per cent of your pre-disablement monthly income paid as a contribution to your MTAA Super account $25,000 a month. The minimum level of cover available is three units. Calculating the cost of cover To calculate the level of cover you want, take the following steps. Step 1 Calculate the figure that corresponds to 85% of your monthly average gross income. If this amount exceeds $25,000, use the figure $25,000 instead. See the definition of income on page 16 to find out what is classified as income. Step 2 Divide the figure from step 1 by $250. This gives you the number of units you need in order to receive the maximum benefit you are eligible for. Write the number of units down. Round up to the nearest unit. Step 3 Choose the benefit scale that applies to you: general non-manual professional If you are unsure, see page 6. Step 4 Choose the benefit period you would like to be covered for: 2 years 5 years Aged 65 Step 5 Select your age band from the table that applies to you. Step 6 Select your preferred waiting period: 30 days 60 days 90 days. Step 7 Write down the cost per unit of cover per week for your age band that falls within your preferred waiting period. Step 8 Multiply the figure from step 7 by the number of units you determined in step 2. The answer is the standard weekly premium for the income protection cover you want. You can adjust the cost of your premium by choosing a different waiting period or benefit period or by changing the number of units you select. When you reach a birthday that moves you into the next age band your insurance cost will change. 14

15 Income Protection unitised scales WEEKLY COST PER $250 MONTHLY BENEFIT 2 YEAR BENEFIT Age Next Birthday General Work scale Non Manual Work scale Professional Work scale 30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days 16 to 20 $ $ $ $ $ $ $ $ $ to 25 $ $ $ $ $ $ $ $ $ to 30 $ $ $ $ $ $ $ $ $ to 35 $ $ $ $ $ $ $ $ $ to 40 $ $ $ $ $ $ $ $ $ to 45 $ $ $ $ $ $ $ $ $ to 50 $ $ $ $ $ $ $ $ $ to 55 $ $ $ $ $ $ $ $ $ to 60 $ $ $ $ $ $ $ $ $ to 65 $ $ $ $ $ $ $ $ $ YEAR BENEFIT Age Next Birthday General Work scale Non Manual Work scale Professional Work scale 30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days 16 to 20 $ $ $ $ $ $ $ $ $ to 25 $ $ $ $ $ $ $ $ $ to 30 $ $ $ $ $ $ $ $ $ to 35 $ $ $ $ $ $ $ $ $ to 40 $ $ $ $ $ $ $ $ $ to 45 $ $ $ $ $ $ $ $ $ to 50 $ $ $ $ $ $ $ $ $ to 55 $ $ $ $ $ $ $ $ $ to 60 $ $ $ $ $ $ $ $ $ to 65 $ $ $ $ $ $ $ $ $ TO AGE 65 BENEFIT PERIOD (ANNUAL INDEXATION AT THE LESSER OF CPI & 5%) Age Next Birthday General Work scale Non Manual Work scale Professional Work scale 30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days 16 to 20 $ $ $ $ $ $ $ $ $ to 25 $ $ $ $ $ $ $ $ $ to 30 $ $ $ $ $ $ $ $ $ to 35 $ $ $ $ $ $ $ $ $ to 40 $ $ $ $ $ $ $ $ $ to 45 $ $ $ $ $ $ $ $ $ to 50 $ $ $ $ $ $ $ $ $ to 55 $ $ $ $ $ $ $ $ $ to 60 $ $ $ $ $ $ $ $ $ to 65 $ $ $ $ $ $ $ $ $

16 Your circumstances will probably change with time, so it is wise to regularly review the number of income protection insurance units you have, to make sure your level of cover is sufficient to provide the protection you need. What waiting period is best for me? In choosing your waiting period you might wish to consider: how long you could afford to be without an income for example, if you qualify for sick leave or have other forms of savings or income on which you could rely; the amount you are willing to pay and to have deducted from your MTAA Super account in income protection insurance premiums. Generally, the longer the waiting period, the lower the premium. No benefit is payable during the waiting period. Once insurance is in place, if you want to reduce your waiting period say, from 90 days to 30 days you must complete a new application form, and be assessed by the insurer. You can choose a longer waiting period simply by writing to the Fund. The waiting period you nominate begins when a doctor who has examined you certifies that you are Disabled, as defined on page 18. You need to be Disabled or Partially Disabled on each day during the waiting period. The calculation of the waiting period is also subject to the following rules: you must be Disabled for at least 7 out of the first 12 working days of the waiting period to qualify for an income protection benefit; if you return to work at full capacity during the waiting period, the waiting period starts again unless you return to work only once and it is for a period of no more than 5 consecutive days. If you return to work only once for a period of 5 consecutive days or less, the number of days worked will be added to the waiting period. What benefit period is best for me? In choosing your benefit period you might want to consider the following: whether it will take a short period (two years) or a medium period (five years) for you and your family to adjust your budget and finances in order to survive without your income; alternatively you may not want your family to adjust and would like a income for the long term (aged 65) the amount you are willing to pay and have deducted from your MTAA Super account in income protection insurance premiums. The shorter the benefit period, the lower the premium. Definitions Income and monthly income definitions Income means the total monthly value of income received by the insured member from his or her usual occupation, averaged over the most recent 12-month period or since the insured member started their occupation, if the period is less than 12-months. Salary package items taken instead of cash are included as salary where the insured member, would be required to pay for that item in the event of total or partial disability. Regular over-time and shift allowances will be averaged over the previous 12-month period or since the insured member started their occupation, if the period is less than 12 months. 16

17 Definitions Performance related commission, bonuses and other monetary benefits will be averaged over the lesser of previous 3 years, or since the insured member started his or her current occupation. Where the insured member directly or indirectly owns all or part of the business from which he or she earns his or her usual income, income will be calculated as the total amount earned by the business over the financial year as a direct result of the insured member s personal exertion or activities through his or her usual occupation, less his or her share of business expenses, but before the deduction of income tax, for that business (or the relevant proportion for part of a financial year). The income calculated in accordance with these principles is divided by 12 to get the monthly income. For casual and contract workers, salary will be averaged over the previous 6 month period, rather than 12 months. When does cover for income protection commence? Your cover will commence when the insurer has accepted your application for cover. Interim Disability by Accident cover If you apply for income protection cover but you are not eligible for cover automatically, you may be eligible for interim disability by accident cover while the insurer considers your application. The insurer will pay you a disability by accident benefit if you suffer an injury which results in your being Disabled or Partially Disabled during this period. The amount payable will be equivalent to the Disability benefit, Partial Disability benefit or superannuation contribution benefit as applicable, except that the amount of the benefit will be the lesser of: 85% of your monthly income; or the amount of cover you requested in the fully completed application for cover; or $15,000 per month. No Disability by Accident benefit will be payable if any of the following occurred before you suffer the injury: the insurer has accepted (on any terms) or rejected your application for income protection cover; or you withdraw your request for income protection cover; or 90 days have passed from the date the insurer receives your application for income protection; or an exclusion to cover applies (see the section Are there any exclusions? on page 20). Payment of the interim disability by accident benefit is subject to all the relevant terms and conditions of MTAA Super s Policy with MetLife. 17

18 Definitions What does Disabled and Partially Disabled mean for the purposes of income protection cover? An insured person is Disabled if, solely as a result of injury or illness, occurring while income protection cover is in force: The insured person is unable to perform at least one duty of the insured person s occupation which generates at least 20% of the insured person s monthly income, as confirmed by a medical practitioner. The insured person is not engaged in any occupation, whether or not for reward. The insured person is receiving regular treatment from and following the advice of a medical practitioner. An insured person is Partially Disabled if they: have been Disabled for at least 7 days out of the first 12 working days of the waiting period; and are unable to work in their occupation at full capacity as a result of the Illness or Injury resulting in Disability; and are working in their occupation or any other occupation but only in a limited capacity; and are earning an income less than their monthly income (as calculated in accordance with the policy terms); and are under the regular care and following the advice of a medical practitioner. How will my benefit be calculated? Your income protection benefit will be the lesser of: the maximum benefit of $25,000 a month; or the amount accepted and agreed to in writing by the insurer; or 85 per cent of your pre-disability income (with 75 per cent of that income being payable directly to you (less PAYG) and the balance being payable as superannuation contributions to your MTAA Super account). The benefit will be subject to any other terms and conditions specified in this document. When will I receive my monthly disability benefit? If you are Disabled for longer than your waiting period and meet the eligibility requirements, you will receive your monthly disability benefit. If you are Partially Disabled for longer than your waiting period and meet the eligibility requirements, you will receive your monthly partial disability benefit. Also, if you are Disabled or Partially Disabled for longer than your waiting period and meet the eligibility requirements, you will receive your superannuation contribution benefit (if applicable). See above for the definitions of Disabled and Partially Disabled. You are eligible to make a claim if: you satisfy all the insurer s claim requirements; the waiting period you chose has expired; and cover has not ceased in accordance with the terms of the policy. The first monthly benefit payment is paid one month after the end of the waiting period; further payments are subsequently paid monthly in arrears. The insurer will waive income protection premiums while an income protection benefit is being received by you. Please note that while an income protection benefit is being paid, the insurer may require medical reports and examinations to verify your continued disability. 18

19 What if I am on leave without pay? If an insured member becomes sick or injured while on leave without pay, no income protection benefit will be paid until the later of: the time when the member s leave without pay is to cease (in accordance with their employer s written notification); or the expiry of the waiting period. If the employer does not provide a written notification on cessation of the leave without pay period, the insurer will assume that the leave without pay period is 24 months. What happens if I return to work after I am disabled? If you return to work after you become disabled you might be eligible to receive a partial disability benefit. To receive a partial disability benefit, you must be Partially Disabled after the waiting period has ended. See the above definition of Partially Disabled above. If you are eligible for a partial benefit the benefit will be calculated in proportion to the income you are losing as a result of your limited capacity to engage in your normal occupation and the monthly benefit you would receive if you were totally disabled. The proportion will vary according to the number of units chosen and your income at the time of your claim. A partial disability benefit will cease to be payable when you are capable of earning your pre-disability salary, you return to normal duties or if one of the other events listed below in the section When does the benefit period end? occurs. What is the rehabilitation expense benefit? The rehabilitation expense benefit is payable if you become totally or partially disabled, the insurer approves the rehabilitation expenses before they are incurred and if the rehabilitation expenses are incurred directly to assist you to return to work in any gainful occupation or to undertake vocational retraining. The amount of the rehabilitation expense benefit is up to six times your disability monthly benefit and it will be paid directly to the providers of rehabilitation services to reimburse costs. When does the benefit period end? The benefit period will end on the earlier of: the end of the benefit period you selected when you reach age 65 when you are no longer totally or partially disabled. when you die What happens if the disability returns? If, after being totally disabled or partially disabled, you return to work and within six months the same disablement recurs, this will be regarded as a continuation of the same claim and no waiting period will apply. The benefit period will, however, be limited to the unused portion of the benefit period that applied in respect of the earlier claim. If, after being totally disabled or partially disabled, you return to work and subsequently experience a different disablement, you will need to submit a new claim. The maximum length of time a benefit for a disability or partial disability from any one or related illness or injury will be limited to the benefit period selected. 19

20 What happens if I am overseas while receiving an income protection benefit? If you reside outside Australia benefits will be payable for a maximum period of 12 months. However, if you reside in Canada, New Zealand, the United Kingdom, the USA or any other country to which the insurer agrees, benefits will be payable to the length of your chosen benefit period. Are there any exclusions? No income protection benefit is payable to you if your injury or illness is caused directly or indirectly by one of the following: any act of war whether or not declared including war, terrorism, civil commotion, act or invasion, rebellion or revolution service in any armed forces an intentional self-inflicted injury or any attempt to commit suicide normal and uncomplicated pregnancy, caesarean birth, threatened miscarriage, participation in in-vitro fertilisation or other medically assisted fertilisation techniques and normal discomforts of pregnancy, including but not limited to morning sickness, back ache, varicose veins, ankle swelling and bladder problems. The insurer may reduce or refuse to pay a benefit in any of the following circumstances: if premiums have not been paid for your cover if you or MTAA Super do not comply with the insurer s claim requirements if the insurer s assessment or management of the claim is prejudiced by not receiving or delaying notice of a claim. The insurer may also refuse to pay a benefit for an undisclosed pre-existing condition in some circumstances. Offsets for other payments If you receive a payment or payments (including settlement or commutation amounts) from any of the following sources, the amount of the benefit will be reduced by the amount of the other payment(s): any amount of income (other than benefits under the MTAA Super income protection policy) and the commutation of any income paid or payable in respect of your Disability, Partial Disability or Disability by Accident, including any amounts payable: through workers compensation social security or other statutory or government payments paid sick leave in respect of loss of income, whether under legislation or otherwsie under any statutory accident compensation scheme any disability, injury or illness policy (other than lump sum total and permanent disablement) the amount of income the insurer believes you could reasonably be expected to earn in your occupation while Disabled or Partially Disabled. 20

21 Important information about your insurance cover When does cover stop? Your insurance cover with MTAA Super will cease in any of the following circumstances: MTAA Super receives your written request to cancel your insurance cover. You cease to be a member of MTAA Super. You die (except that any liability to pay a Death Benefit or Death by Accident Benefit shall remain). A terminal illness benefit is paid.* A total and permanent disablement benefit is paid. If, however, you have more death cover than TPD cover you will continue to have death cover but the amount will be limited to the difference between your original death cover less the amount of TPD benefit paid, providing that you maintain an account balance sufficient to pay for premiums due. For example, if you have $250,000 Death cover and $100,000 TPD cover and a TPD benefit is paid to you, you will continue to have $150,000 Death cover.* Your account is transferred to another fund (including an eligible rollover fund), or the Australian Taxation Office. The day before you commence duty in the armed services of any country (other than the Australian Armed Forces Reserve where you are not on active duty outside Australia). You do not have sufficient money in your account to meet the cost of insurance premiums. Cover will cease on the last day of the month in respect of which the last premium deduction is made from your account. In the case of death, terminal illness and total and permanent disability cover, the day you reach 70 years of age. In the case of income protection cover, the day you reach 65 years of age. The Trustee is unable to renew or maintain the Fund s insurance policy on acceptable terms. What if I need to travel overseas? MTAA Super insurance cover is provided 24 hours a day, seven days a week and applies worldwide. If you plan to travel outside Australia, you should be aware an exclusion applies on all claims that were caused by war, or war like activity. However, you may be required by our insurer to return to Australia at your own expense to be assessed for a Total and Permanent Disablement or Terminal Illness Benefit and the period during which an income protection benefit is payable will be limited to 12 months unless you are continuously a resident in Australia, New Zealand, the United Kingdom, the United States of America or another country agreed by the insurer. * If you have Income Protection cover, providing you maintain a balance sufficient to pay premiums, that cover will not cease in these events. 21

22 Can I recommence my cover? If you cancel your death, TPD or income protection cover or cover ceases for you for any reason (other than Australian Army Reserve duty), your insurance cover will not be reinstated until you complete an Application for additional insurance form and the insurer accepts your application. If you are a member receiving employer contributions and your cover ceased because you had insufficient money in your account to pay the premium, and then employer contributions recommence for you: your cover will be reinstated at your previous level and type if an on-time employer contribution is paid for the month following the month in which cover ceased otherwise, your cover will be automatically reinstated at the lower of your previous type and level of cover and the default cover under the general scale for any other employment period after cessation of cover. When your cover recommences you will need to be in Active Employment or all cover will be on a Limited Cover basis until you return to Active Employment. All other members must complete a personal statement and declaration of health to recommence cover. You need to reapply for your cover to be provided as a non-manual or professional member. Cover Issued by MetLife Insurance cover for death, total and permanent disability, terminal illness and income protection is provided to members of MTAA Super who are accepted for cover under an insurance policy issued by MetLife Insurance Limited (ABN , AFSL ). MetLife issued the insurance policies to the Trustee of MTAA Super. MTAA Super reserves the right to vary or discontinue death, total and permanent disability, terminal illness and income protection insurance at any time. It also reserves the right to change the insurer and policy at any time with notice. All insurance cover with MTAA Super is subject to acceptance by the Fund s insurer. 22

23 Privacy policy: group risk insurer MetLife Insurance Limited ABN , AFSL The Trustee of MTAA Super has chosen MetLife Insurance Limited ( MetLife ) to provide the group risk insurance cover for the Fund. The personal information you provide to us in connection to any insurance application will be provided to MetLife. MetLife is committed to ensuring the confidentiality and security of your personal information; its privacy policy, detailing how it handles personal information, is available on request or can be downloaded from You may ask for access to information the insurer holds about you or the policy by contacting the MetLife Privacy Officer at the address shown at the end of this section. In the event you make a claim, the Insurer reserves the right to investigate the claim including but not limited to conducting surveillance and requesting information from third parties and examinations. Please assist MTAA Super and its insurer by contacting MTAA Super if any of your personal information is incorrect, has changed or requires updating. MTAA Super has established group insurance policies that provide the benefits set out herein. If you are eligible for cover, it might be necessary for the insurer to: collect personal information from you collect some personal information about you from your employer or MTAA Super disclose some of your personal information to your employer or MTAA Super in order to manage and administer the group risk insurance policies. Further, in order to manage and administer the group risk insurance policies, it might be necessary for the insurer to disclose your personal information to certain third parties, some of which might be situated outside Australia. If you do not consent to such disclosure the insurer will be unable to process your application, administer your insurance, process a claim, and provide to you products and services. Among the types of individuals and organisations to whom the insurer might routinely disclose your personal information are doctors, medical services, surveillance organisations, and other organisations providing services in the collection, collation or assessment of personal information (including health information) for the purpose of underwriting or assessing your application or assessing any claims. The insurer will disclose your personal information to these organisations so as to enable them to provide specified management and administration services. The insurer collects health information with your consent. The insurer will disclose your health information only to service providers such as doctors, reinsurers and assessors who are directly involved in collecting, collating or assessing such information for the purpose of underwriting or assessing your application or assessing any claim. The insurer might also be required to provide copies of your health information to the Trustee of MTAA Super (or its appointed administrator who administers your insurance cover on the Trustee s behalf) for purposes such as verifying a decision made by the insurers in accordance with obligations imposed by law. The insurer will not disclose your health information for any other purpose. The insurer will also disclose your personal information in circumstances where it is required by law to do so. Note that provisions in family law legislation enable certain persons to request information about a member s interest in a superannuation fund. The insurer might, if requested, be required to provide information about your interest in a superannuation fund to your spouse or a person who intends to enter into an agreement with you about splitting your superannuation interests in the event of marriage separation. The request must be in a form prescribed by law. The law prevents the insurer from telling you about any such request for information. 23

24 If you have any questions about MetLife s privacy policy, write to or telephone MetLife: Privacy Officer MetLife Insurance Limited PO Box 3319 Sydney NSW 2001 Telephone or [email protected] 24

25 APPLICATION FOR ADDITIONAL INSURANCE If you want to apply for additional insurance cover you must complete the sections of this form that relate to the cover you require, including Sections F, G and H. If you wish to apply for non-manual or professional cover as well, complete Section B. Please use capital letters. Section A Member details MTAA Super membership number (if known) Title Miss Ms Mrs Mr Other (please specify) Given name(s) Family name Address Suburb State/Territory Postcode Telephone (home) Telephone (work) Telephone (mobile) Preferred contact Time Date of birth / / Place of birth Your MTAA Super employer (if applicable) Present occupation Duties performed Are you a permanent resident of Australia Yes No Section B Complete this section only if you are applying for either non-manual or professional cover If you want to apply to have your insurance cover that is, death-only, death plus TPD and/or income protection insurance as either non-manual or professional cover you must answer the questions that follow: Eligibility for non-manual cover 1. Are your occupational duties of a clerical, administrative, management or professional nature and performed entirely in an office environment (excluding travel time between offices)? Yes No 2. Do you perform any work duties of a manual nature or work within a hazardous environment? Examples of work in a hazardous environment are work in a mechanical workshop, work on a factory or warehouse floor, work on construction or mining sites, and working with chemicals in a laboratory. Yes No 3. Do you spend more than 20 percent of your working time that is, over eight hours a week in a 40-hour week, on average outside an office environment? Yes No If you have answered Yes, No, No to the above questions, you are eligible for non manual cover. Eligibility for professional cover In addition to the requirements set out for non-manual cover, please answer the following: 1. Do you hold a tertiary qualification relevant to your current occupation or are you a member of a professional body relevant to your current occupation or a member of your organisation s senior management team? Yes No 2. Do you work 100% within an office environment and earn $120,000 per annum or more? Yes No If you have answered Yes to both of the above questions, you are eligible for professional cover. These questions relate to all work duties you perform as an employee for all of the employers you work for, or as a partner in a partnership or a sole trader. n Eligibility for non-manual or professional cover is subject to acceptance by the insurer. n If accepted, all cover held with MTAA Super will be subject to the appropriate rate non-manual or professional. n If the insurer rejects your application for non-manual or professional cover, you will be advised of the premium scales which apply to your cover with MTAA Super. 25

26 Section C Complete this section to apply for additional Death and TPD cover Please indicate which option you require and the type and level of cover for your chosen option. You may choose only one option. Option 1: Unitised Cover Please indicate the number of units you require in total including your existing cover: n Death cover ($0.50 per week per unit) n TPD cover ($0.50 per week per unit) Death units TPD units Option 2: Fixed Cover: Please indicate the total level of cover you require (in multiples of $1000) including your existing cover: n Death cover $ n TPD cover $ n Your total cover cannot exceed $5,000,000 for death and $3,000,000 for TPD. n Any cover or increase in cover is subject to your application being accepted. n If the insurer does not accept your application you will retain your current level of cover. n If the insurer accepts your application, this new cover will replace the level of cover you currently have with MTAA Super. As such, you should apply for the total number of units or total amount of cover that you require. n You cannot hold a combination of unitised and fixed cover at the same time. Section D Complete this section to apply for income protection cover The weekly per unit-cost for income protection cover will depend on your age next birthday, the waiting period/benefit period you choose, and whether you are eligible for the general, non-manual or professional premium scales. See the premium rate tables on page 16 of the Insurance Document. What is your salary? $ How much Income Protection cover would you like? (maximum of 85% of salary): 75% salary + 10% Super Contribution (rounded up to nearest unit) 75% salary only (rounded up to nearest unit) Other amount please advise number of units required What Waiting Period would you like? 30 days 60 days 90 days What Benefit Period would you like? 2 Year 5 Year To age 65 Do you work more than 15 hours per week? Yes No (you are not eligible for income protection cover) Section E Insurance History 1. Has an application for Life, Trauma, TPD or Disability insurance on your life ever been declined, deferred or accepted with a loading or exclusion or any other special condition or terms? Yes No 2. Have you ever made a claim for or received sickness, accident or disability benefits, Workers Compensation, or any other form of compensation due to illness or injury? Yes No 3. Do you currently have or are you applying for any other insurance cover? Yes No 26

27 Section E Insurance History Continued If Yes to Q.3, please give details in the table below. Product/Type Total amount of cover To be replaced by this cover Life insurance $ Total and permanent disability $ Income protection $ Yes Yes Yes No No No Section F Medical History You must complete this section. The information you provide will be treated in strict confidence and will be used or disclosed only for matters relating to your insurance entitlements. If this section is not completed the insurer will be unable to process your insurance application and your requested level of insurance cover might be denied. Personal Details 1. What is your height? cm What is your weight? kg 2. Have you smoked in the last 12 months? Yes No Medical History 1. In the last 3 years have you suffered from, been diagnosed with or sought medical advice or treatment for any of the following? Please tick all boxes that apply. Headache or Migraine Lung or Breathing Conditions Eyesight Conditions (eg. tension or cluster headaches (eg. asthma, sleep apnoea) (does not incl. contact lenses or glasses for near or far sightedness) or migraines) Ear or Hearing Conditions Gout Trapped Nerves (eg. hearing loss, tinnitus (eg. carpal tunnel syndrome, pinched nerve, tennis elbow) or swimmer s ear) Infectious Diseases (excl. cold & flu) Muscle, Tendon or Ligament Problems None of the conditions listed above If you have selected any of the above conditions please give details in the table below. Condition Details (incl. dates, symptoms, treatment) 2. In the last 5 years have you suffered from, been diagnosed with or sought medical advice or treatment for any of the following? Please tick all boxes that apply. High Blood Pressure High Cholesterol Chronic Fatigue / Fibromyalgia None of the conditions listed above If you have selected any of the above conditions please give details in the table below. Condition Details (incl. dates, symptoms, treatment) 27

28 3. Have you ever suffered from, been diagnosed with or sought medical advice or treatment for any of the following? Please tick all boxes that apply. Bone, Joint or Limb Conditions Back Pain Digestive Conditions Brain or Nerve Conditions Psychological or Cancer, Cyst, Growth or Tumour (incl. stroke) Emotional Conditions Thyroid Conditions Skin Disorder Genitourinary Conditions Auto Immune Diseases Heart Related Conditions Kidney or Liver Conditions Diabetes Blood Conditions None of the conditions listed above If you have selected any of the above activities please give details in the table below. Condition Details (incl. dates, symptoms, treatment) 4. Are you currently pregnant? (Females Only) Yes No 5. What is the name of your usual doctor/medical Centre? Address: Contact Number: Section G Family History 1. Has any parent, brother, sister or child been diagnosed under the age of 55 years, with any of the following conditions: Alzheimer s Disease, Cancer, Dementia, Diabetes, Familial Polyposis, Heart Disease, Huntington s Disease, Polycystic Kidney Disease, Multiple Sclerosis, Muscular Dystrophy, Stroke or any inherited or hereditary disease? If Yes, please give details in the table below. Yes No Unknown Relationship to proposed insured Age at diagnosis Specific condition(s) Section H Lifestyle 1. Do you have firm plans to travel or reside in another country other than New Zealand, America, Canada, the United Kingdom or Europe? If Yes, please give details in the table below. Yes No Country Length of stay 28

29 2. Do you regularly engage in or intend to engage in any of the following hazardous activities (not already disclosed in your occupation)? Please tick all boxes that apply. Water Sports Motor Sports Sky Sports (eg. underwater diving, rock fishing) (eg. motorcycle, auto, motor boat) (eg. skydiving, hang gliding, parachuting, ballooning) Aviation (eg. other than as a fare paying passenger Horse Sports (eg. polo, horse riding, Combat Sports or Martial Arts on a commercial airline) rodeo, dressage, jumping) (eg. martial arts, boxing, fencing) Field Sports (eg. Hockey or football of any code Hunting (of any kind) Any Activity Not Mentioned including touch or tag and soccer) (eg. abseiling, base jumping, caving, free climbing, outdoor rock climbing) None of the activities listed above Please provide details for any of the activities you have selected above: Activity Details 3. Have you within the last 5 years used any drugs that were not prescribed to you (other than those drugs available over the counter)? Yes No If Yes, please give details in the table below. Drug / Medicine Reason for Use 4. Do you drink six or more alcoholic drinks, on four or more occasions per week? Yes No 5. Do you currently have HIV (Human Immunodeficiency Virus) that causes AIDS (Acquired Immune Deficiency Syndrome)? Yes No If No, are you in a high risk category for contracting HIV? Yes No 6. Other than already disclosed in this application, do you presently suffer from any condition, injury or illness, which you suspect may require medical advice or treatment in the future? Yes No If Yes, please provide details below. Condition Details (incl. dates, symptoms, treatment) 29

30 Section I Your duty of disclosure Before you become insured under a contract of life insurance the Trustee has a duty to disclose, under the Insurance Contracts Act In order for the Trustee to comply with this duty, you must disclose in this application form, every matter that you know, or could reasonably be expected to know, is relevant to the insurer s decision whether to accept the risk of the insurance and, if so, on what terms. The duty of disclosure also applies before cover is renewed, varied or reinstated. The duty does not, however, require disclosure of a matter: n that diminishes the risk to be undertaken by the insurer n as to which the duty of disclosure is waived by the insurer n that the insurer knows, or in the ordinary course of its business, ought to know n that is common knowledge. Non-disclosure If the duty of disclosure is not complied with and the insurer would not have provided the insurance cover on any terms if the failure had not occurred, the insurer may void the cover within three years of entering into it. If the non-disclosure is fraudulent, the insurer may void the cover at any time. An insurer who is entitled to void insurance cover may, within three years of entering into it, elect not to void it but to reduce the sum you have been insured for in accordance with a formula that takes into account the premium that would have been payable if you had disclosed all relevant matters to the insurer. The duty of disclosure continues until the insurer accepts (or declines) your application and issues confirmation in writing. Please ensure that all applicable questions are fully answered. As a member of MTAA Super, you may ask to see the information that insurer holds about you and have it corrected if required. Declaration I declare the following: n I have read and carefully considered the questions in this application and all answers provided are true and correct. n I have told the insurer everything I know that could affect its decision to accept my application. n I have read the duty of disclosure and understand my obligations as outlined above. Furthermore, I acknowledge that: n I have read and understood the privacy statements appearing on pages 23 and 24 of the Insurance document. I accept that the collection, use and disclosure of my personal information is necessary for the purpose of the administration and maintenance of insurance under MTAA Super s insurance policies. n I understand that the insurer, the Fund Administrator and the Trustee will not be able to process my application or administer my insurance under the Fund s insurance policies without this consent. n If I do not complete this application correctly, or I do not sign and date this form, my application will be invalid and will not be considered by the insurer. I authorise any hospital, doctor or other person who has treated or examined me to give to the insurer or any organisation duly appointed by them, any information on my illness or injury, medical history, consultation, prescription or treatment or copies of all hospital or medical reports. A photocopy of this authorisation is as valid as the original. I agree to provide further medical authorities if requested. Member signature Date / / This application must be received by MTAA Super within 30 days of the date on which you sign it. Return the completed, signed and dated application to: MTAA Super Insurance Services, Locked Bag 15, Haymarket NSW A representative of MetLife Insurance Limited may contact you in regards to your application. An Industry SuperFund Telephone Fax [email protected] Web Postal Address Locked Bag 15, Haymarket NSW 1236 Trustee: Motor Trades Association of Australia Superannuation Fund Pty Ltd ABN AFSL MTAA Superannuation Fund ABN SPIN MTA0100AU 30

31 APPLICATION TO CHANGE YOUR WORKSCALE If you wish to apply to change your current MTAA Super insurance cover from general to either non-manual or professional cover as well as apply for additional insurance cover, you must complete the Application for additional insurance form. If however, you simply wish to change your existing MTAA Super insurance cover from general to non-manual or professional cover, please complete all the sections in this application form. MTAA Super membership number (if known) Title Miss Ms Mrs Mr Other (please specify) Given name(s) Family name Address Suburb State/Territory Postcode Telephone (home) Telephone (work) Telephone (mobile) Date of birth / / Your MTAA Super employer (if applicable) Present occupation Section B Eligibility to change your workscale Eligibility for non manual cover In order to qualify for the non-manual benefits scale, (if you have unitised cover), for your death-only and death plus TPD cover, and for non-manual premiums for fixed cover and income protection cover (if applicable), you must be employed and be able to perform all your normal work duties and work your normal hours without restriction due to injury or illness. You must also confirm, by your answers to the following questions, 1, 2 and 3 below, that you either work entirely in an office environment, or if you do not, that you do not perform any duties of a manual nature, that you do not work in a hazardous environment, and that you do not spend more than 20 percent of your working time outside of an office environment. If you have income protection cover, you must also confirm that you are working at least 15 hours a week on average. 1. Are your occupational duties of a clerical, administrative, management or professional nature and undertaken entirely within an office environment, (excluding travel time between offices)? Yes No 2. Do you perform any work duties of a manual nature or work within a hazardous environment? Examples of hazardous environments include work in a mechanical workshop, work on a factory or warehouse floor, work on a construction or mining site, and chemical work in a laboratory. Yes No 3. Do you spend more than 20 percent of your working time for example over 8 hours per week in a 40 hour week on average outside an office environment? Yes No 4. Are you restricted, due to illness or injury from carrying out the identifiable 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 35 hours per week. Yes No If you have answered Yes (1), No (2), No (3) and No (4) to the above questions you are eligible for non-manual cover. Eligibility for professional cover In addition to the requirements set out for non-manual cover, please answer the following: 1. Do you hold a tertiary qualification relevant to your current occupation or are you a member of a professional body relevant to your current occupation or a member of your organisation s senior management team? Yes No 2. Do you work 100% within an office environment and earn $120,000 per annum or more? Yes No If you have answered Yes to both of the above questions, you are eligible for professional cover. These questions relate to all work duties you perform as an employee for all of the employers you work for, or as a partner in a partnership or a sole trader. n Eligibility for non-manual or professional cover is subject to acceptance by the insurer. n If accepted, all cover held with MTAA Super will be subject to the appropriate rate non-manual or professional. n If the insurer rejects your application for non-manual or professional cover, you will be advised of the premium scales which apply to your cover with MTAA Super. 31

32 Section C Your duty of disclosure Before you become insured under a contract of life insurance, the Trustee has a duty to disclose, under the Insurance Contracts Act In order for the Trustee to comply with this duty, you must disclose in this application form, every matter that you know, or could reasonably be expected to know, is relevant to the insurer s decision whether to accept the risk of the insurance and, if so, on what terms. The duty of disclosure also applies before cover is renewed, varied or reinstated. The duty does not, however, require disclosure of a matter: n that diminishes the risk to be undertaken by the insurer n as to which the duty of disclosure is waived by the insurer n that the insurer knows, or in the ordinary course of his/her business ought to know n that is common knowledge. Non-disclosure If the duty of disclosure is not complied with and the insurer would not have provided the insurance cover on any terms if that failure had not occurred, the insurer may void the cover within three years of entering into it. If the non-disclosure is fraudulent, the insurer may void the cover at any time. An insurer who is entitled to void insurance cover may, within three years of entering into it, elect not to void it but to reduce the sum that you have been insured for in accordance with a formula that takes into account the premium that would have been payable had you disclosed all relevant matters to the insurer. The duty of disclosure continues until the insurer accepts (or declines) your application and issues confirmation in writing. Please ensure that all applicable questions are answered in full. As a member of MTAA Super, you may ask to see the information that the insurer holds about you and have it corrected if required. Declaration I declare the following: n I have read and carefully considered the questions appearing in the section entitled Eligibility to change your workscale and all answers provided are true and correct; n I have told the insurer everything I know that could affect their decision to accept my application. n I have read the duty of disclosure and understand my obligations as outlined above. Furthermore I acknowledge that if I do not complete this application correctly, or I do not sign and date this form, my application will be invalid and will not be considered by the insurer. Member signature Date / / This application must be received by MTAA Super within 30 days of the date on which you sign it. Return the completed, signed and dated application to MTAA Super Insurance Services, Locked Bag 15, Haymarket NSW An Industry SuperFund Telephone Fax [email protected] Web Postal Address Locked Bag 15, Haymarket NSW 1236 Trustee: Motor Trades Association of Australia Superannuation Fund Pty Ltd ABN AFSL MTAA Superannuation Fund ABN SPIN MTA0100AU 32

33 MATCHING INSURANCE COVER Complete this form if you wish to transfer insurance cover from another provider to MTAA Super. Before completing the member details in Section A, please review the health requirements in Section D to check your eligibility for matching cover. Death, TPD and income protection cover for MTAA Super is provided under insurance policies issued by MetLife Insurance Limited ABN AFSL Death only or death plus TPD cover Should your application be accepted, your cover which is to be matched will be in addition to any current cover with MTAA Super. You will be provided cover on a fixed level basis and your transferring cover will be rounded up to the next $1,000 subject to a maximum of $1,000,000. Income protection cover If your application is accepted, the amount of income protection cover will be replaced by an equivalent number of units (rounded up) subject to the maximum transferable insured benefit of $10,000 per month. If the waiting period you have with your current fund is not available with MTAA Super, you will be allocated the next highest waiting period available under MTAA Super; for example if your waiting period with your current fund is 45 days, you would be allocated a 60 day waiting period with MTAA Super. As MTAA Super offers either a 2 year, 5 year or to age 65 benefit period, your cover may be rounded down to the next lowest benefit period if your current benefit period does not match one of these benefit periods. We will contact you to discuss your options if your current benefit period does not match one of these benefit periods or you have current cover with MTAA Super. Section A Member details MTAA Super membership number (if known) Title Miss Ms Mrs Mr Other (please specify) Given name(s) Family name Address Suburb State/Territory Postcode Telephone (home) Telephone (work) Telephone (mobile) Date of birth / / Section B Current cover details Name of current cover provider Member / Policy Number 1) Please confirm that all of the following statements are true and correct: a) The existing cover under my current fund or insurer will be cancelled upon approval from MTAA Super that cover can be transferred. b) I will not be transferring the cover under my current fund to any other division/section or to any other fund or insurer, other than MTAA Super. c) I will not effect a continuation option, or subsequently reinstate cover within my current fund or insurer. I confirm that all three statements are true and correct and agree to abide by these requirements: Yes No If No MTAA Super will be unable to match your existing level of cover. 2) I confirm that my current level and type of cover under my current fund or insurer is as follows: a) Death Sum Insured to be transferred (please note the maximum total cover that can be transferred is $1,000,000) b) TPD Sum Insured to be transferred (please note the maximum total cover that can be transferred is $1,000,000) c) Monthly Income Protection Benefit (please note the maximum total cover that can be transferred is $10,000 per month) d) Income Protection waiting period days e) Income Protection benefit period 2 years 5 years To age 65 Other If you are applying to match your income protection cover, what is your annual insurable income (salary)

34 3) Is your cover under the current fund or insurer subject to any premium loading, exclusion or restriction in relation to any medical condition or other conditions? Yes No If Yes please provide full details: Please note if you have answered Yes to question 3, the insurer will, where possible, provide the same terms and conditions and will provide confirmation in writing of the terms to be provided under MTAA Super. Section C Complete this section to apply for additional Death and TPD cover I have attached documentary evidence of the above cover for example a copy of the most recent benefit statement or letter from the current fund/insurer confirming the level and type of cover and the acceptance terms. Yes No If No MTAA Super will be unable to match your existing level of cover. Section D Health questions 1) Are you restricted, due to illness or injury from carrying out the identifiable 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 35 hours per week. Yes No 2) Have you ever been paid, or are you eligible to be paid, or have you lodged a claim for a total and permanent disablement benefit from MTAA Super, another superannuation fund or under a life insurance policy? Yes No 3) Have you been diagnosed with an illness that reduces your life expectancy to less than 3 years? Yes No If you have answered No to all of the above questions MTAA Super should be able to match your current cover. However, please wait for written confirmation from MTAA Super before taking any action to cancel your current cover. If you answered Yes to any of these questions MTAA Super will not be able to match your cover but still may be able to offer you cover if you complete an Application for additional insurance form. Please note an application for additional insurance does not need to be restricted to your current levels of cover. Section E Your duty of disclosure Your duty of disclosure Before you become insured under a contract of life insurance, the Trustee has a duty to disclose, under the Insurance Contracts Act In order for the Trustee to comply with this duty, you must disclose in this application form, every matter that you could reasonably be expected to know, is relevant to the insurer s decision whether to accept the risk of the insurance and, if so, on what terms. The duty of disclosure also applies before cover is renewed, varied or reinstated. The duty does not, however, require disclosure of a matter: that diminishes the risk to be undertaken by the insurer as to which compliance with your duty is waived by the insurer that your insurer knows, or in the ordinary course of its business, ought to know that is of common knowledge. Non-disclosure If the duty of disclosure is not complied with and the insurer would not have provided the insurance cover on any terms if the failure had not occurred, the insurer may void the cover within three years of entering into it. If the non-disclosure is fraudulent, the insurer may void the cover at any time. An insurer who is entitled to void insurance cover may, within three years of entering into it, elect not to void it but to reduce the sum that you have been insured for in accordance with a formula that takes into account the premium that would have been payable if you had disclosed all relevant matters to the insurer. The duty of disclosure continues until the insurer accepts (or declines) your application and issues confirmation in writing. Please ensure that all applicable questions are fully answered. As a member of MTAA Super you may ask to see the information that the insurer holds about you and have it corrected if required. Declaration I declare the following: I have read and understood the conditions of cover that include: I must be able to answer No to questions 1, 2 and 3 in Section D of this application. I must provide documentary evidence of my insurance cover with my current insurer or fund. I have read and carefully considered the questions and statements in Section B of this application and I undertake to abide by these requirements. All answers provided are true and correct. I have read and understood the duty of disclosure and non-disclosure sections above and I have not withheld any information that might affect the insurer s decision as to whether or not to accept my application for cover and on what terms. Furthermore I acknowledge that if I do not complete this application form correctly, or I do not sign and date the form, I will not be eligible to replace my existing cover with my current insurer or fund within MTAA Super.

35 If the insurer accepts my application, the level of cover I have with my current insurer or fund will be replaced with: fixed cover for death-only or death plus TPD cover (rounded up to the next $1,000) as applicable to a maximum total of $1,000,000. This will be in addition to my current cover with MTAA Super, provided that my total cover does not exceed the maximum allowable by MTAA Super. units of income protection cover sufficient to replace the level of cover I had with my current fund or 75 percent of my current gross annual salary, (plus up to an additional 10 per cent of salary for superannuation contributions, if applicable) whichever is lesser, up to a maximum monthly benefit total of $10,000. I also acknowledge the following: Once I am allocated cover under MTAA Super, my future cover will be governed by the terms of the MTAA Super insurance arrangements, regardless of the basis of cover that applied under my former fund. My replacement cover will commence at the earlier of the following events: the date of the first employer contribution being received after the Matching insurance cover is approved; the date the Matching insurance cover form is received and my MTAA Super account is greater than zero; the date of receipt of the first personal contribution after the Matching insurance cover form is approved; the date of exit from the Fund for which cover is being matched occurs subject to approval of the Matching insurance cover application. MTAA Super and the insurer may make inquiries to verify the answers I have provided. These inquiries can be made at any time including when MTAA Super and the insurer are considering this application or at the time of any claim that I may make. Should it become apparent to MTAA Super or the insurer that I have not fulfilled the requirements that I confirmed in Section B, any insured benefit payable to me or my estate from MTAA Super might, as a consequence of my failure to abide by the conditions, be reduced by the insured amount paid or payable by the other insurer or fund, an associated section or division of that insurer or fund, or any policy issued under any option I exercised. However, this will not affect the payment of benefits under any insurance cover I had with MTAA Super before my application for matching insurance cover was accepted. Member signature Date / / Please return the completed, signed and dated form to MTAA Super, Locked Bag 15, Haymarket NSW 1236 An Industry SuperFund Telephone Fax [email protected] Web Postal Address Locked Bag 15, Haymarket NSW 1236 Trustee: Motor Trades Association of Australia Superannuation Fund Pty Ltd ABN AFSL MTAA Superannuation Fund ABN SPIN MTA0100AU /12

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37 APPLICATION TO INCREASE INSURANCE COVER ON JOINING (EMPLOYER SUPPORTED MEMBERS ONLY) Section A Member details MTAA Super membership number (if known) Title Miss Ms Mrs Mr Other (please specify) Given name(s) Family name Address Suburb State/Territory Postcode Telephone (home) Telephone (work) Telephone (mobile) Date of birth / / Please read the Insurance document before completing this form. All eligible new members will receive a default amount of insurance cover as per the below table: Your age next birthday when you join MTAA Super Death Units General Scale TPD Units General Scale Cost of Cover ($0.50 per unit) $3.00 per week $4.00 per week $6.00 per week Section B Additional insurance cover Complete this section if you are an employer-supported member joining MTAA Super for the first time and wish to apply for additional insurance cover for death, Total and Permanent Disablement (TPD) and Income Protection cover. In order for you to be eligible this application must be received by MTAA Super within six months of the date on which you commenced employment with your employer. 1) Are you restricted, due to illness or injury from carrying out the identifiable 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 35 hours per week. Yes No 2) Have you ever been paid, or are you eligible to be paid, or have you lodged a claim for a total and permanent disablement benefit from MTAA Super, another superannuation fund or under a life insurance policy? Yes No 3) Have you been diagnosed with an illness that reduces your life expectancy to less than 3 years? Yes No If you have answered No to all questions above and you have met all other eligibility criteria. You are able to select cover up to the following Automatic Acceptance Levels. Age Next Birthday Death & TPD Cover General Income Protection Cover Non Manual Income Protection Cover* Professional Income Protection Cover* 16 to 55 $800,000 $8,000 per month $10,000 per month $12,000 per month 56 $340,560 $8,000 per month $10,000 per month $12,000 per month 57 $297,000 $8,000 per month $10,000 per month $12,000 per month 58 $261,360 $8,000 per month $10,000 per month $12,000 per month 59 $237,600 $8,000 per month $10,000 per month $12,000 per month 60 $210,600 $8,000 per month $10,000 per month $12,000 per month 61 $198,000 $8,000 per month $10,000 per month $12,000 per month 62 $186,120 $8,000 per month $10,000 per month $12,000 per month 63 $174,600 $8,000 per month $10,000 per month $12,000 per month 64 $158,400 $8,000 per month $10,000 per month $12,000 per month 65 $146,520 $8,000 per month $10,000 per month $12,000 per month Default Cover $8,000 per month $10,000 per month $12,000 per month * you must apply for Professional or Non Manual rates in order to be eligible for these rates. 37

38 Section C Death and TPD Cover Please indicate the total Death and TPD cover you require: Type of cover (please circle) Death TPD Total Amount of Cover required (multiples of $1,000) Type of Cover (please circle) Unitised / Fixed (If you selected unitised, your cover will be rounded up to nearest unit) Section D Income Protection Cover Please indicate the total level of Income Protection cover you require: What is your salary? $ How much Income Protection cover would you like? (maximum of 85% of salary): 75% salary + 10% Super Contribution (rounded up to nearest unit) 75% salary only (rounded up to nearest unit) Other amount - please advise number of units required Income Protection units are $250 per month What Waiting Period would you like? 30 days 60 days 90 days What Benefit Period would you like? 2 Year 5 Year Do you work on average more than 15 hours per week? Yes No (you are not eligible for income protection cover) You will receive written confirmation of your cover from MTAA Super. Section E Your duty of disclosure Before you become insured under a contract of life insurance, the Trustee has a duty to disclose under the Insurance Contracts Act In order for the Trustee to comply with this requirement, you must disclose in the space provided below every matter that you know, or could reasonably be expected to know, is relevant to the insurer s decision whether to accept the risk of the insurance and, if so, on what terms. The duty of disclosure also applies before cover is renewed, varied or reinstated. It does not, however, require disclosure of a matter: n that diminishes the risk to be undertaken by the insurer n that is common knowledge n that the insurer knows or, in the ordinary course of its business, ought to know n as to which the duty of disclosure is waived by the insurer. If the duty of disclosure is not complied with and the insurer would not have provided the insurance cover on any terms if the failure had not occurred, the insurer may void the cover within three years of entering into it. If the non-disclosure is fraudulent, the insurer may void the cover at any time. An insurer who is entitled to void insurance cover may, within three years of entering into it, elect not to void it but to reduce the sum you have been insured for, in accordance with a formula that takes into account the premium that would have been payable had you disclosed all relevant matters to the insurer. The duty of disclosure continues until the insurer accepts (or declines) your application and confirmation is issued in writing. Please ensure that all applicable questions are fully answered. As a member of MTAA Super, you may ask to see the information the insurer holds about you and have it corrected if necessary. 38

39 Section F Acknowledgment and signature This form must be signed and dated. I hereby: n apply to the Trustee for admission as a member of MTAA Super under the terms and conditions in the Trust Deed by which the Fund was established n acknowledge having received and read and understood the MTAA Super Member Product Disclosure Statement and acknowledge that the Trust Deed prevails if there is an inconsistency with the Member Product Disclosure Statement. n acknowledge that the Trustee cannot provide me with advice about my benefits, investments, insurance and any taxation implications that takes into account my personal circumstances and that I should speak to an appropriately qualified adviser if I require such advice n acknowledge that the Trustee may be required under taxation and superannuation legislation to deduct additional tax from my benefits and refuse or refund contributions made by or on my behalf and, in doing so, may make any adjustments to my account it considers necessary or appropriate n acknowledge that the Trustee does not guarantee my investment in MTAA Super n acknowledge having read and understood the privacy statements in the MTAA Super Member Product Disclosure Statement and consent to my personal information being collected and used in accordance with these n declare that I have read and carefully considered all questions and that the answers I have provided are true and correct n declare that I have read and understood the duty of disclosure section and have not withheld any statement that could affect the insurer s decision whether to accept my application for cover n acknowledge that, if I do not complete this application correctly or I do not sign and date this form, my application for cover above the default level of cover will be invalid and will not be considered by the insurer. Member signature Date / / Please return the completed, signed and dated form to MTAA Super, Locked Bag 15, Haymarket NSW 1236 An Industry SuperFund Telephone Fax [email protected] Web Postal Address Locked Bag 15, Haymarket NSW 1236 Trustee: Motor Trades Association of Australia Superannuation Fund Pty Ltd ABN AFSL MTAA Superannuation Fund ABN SPIN MTA0100AU 39

40 An Industry SuperFund Telephone Fax Web Postal Address Locked Bag 15, Haymarket NSW 1236 Trustee: Motor Trades Association of Australia Superannuation Fund Pty Ltd ABN AFSL MTAA Superannuation Fund ABN SPIN MTA0100AU The information provided in this document is general only and does not take into account your personal financial situation or needs. You should therefore consider obtaining financial advice that is tailored to your personal circumstances from a licensed financial adviser /12