BT Protection Plans. Customer Guide

Transcription

1 BT Protection Plans Customer Guide

2 Table of contents BT Protection Plans page 2 The importance of insurance page 3 Types of insurance in BT Protection Plans page 4 Term Life page 5 Total and Permanent Disablement page 6 Living Insurance page 7 Income protection for individuals page 9 Income products for business protection page 10 Optional policies page 11 Features of a BT Protection Plans policy page 12 More information about BT Protection Plans page 13 Claims we re here for you page 14 Simple steps to becoming insured page 16

3 BT provides peace of mind and comfort because you will be treated like a person, not a policy. BT offers a market leading life insurance service that is personalised, flexible and provides greater expertise at every step. This Guide is going to explain insurance, what insurance does, which types you might need and the difference insurance has made to people, just like you. BT Protection Plans can provide cover for everyone from homemakers, to medical professionals, to trade and business owners. BT Protection Plans can be tailored by you and your adviser to make sure they provide the cover that meets your needs and with the ownership structure that is right for you. This Guide provides a summary of the features and benefits of BT Protection Plans. You should read the Product Disclosure Statement and Policy Document ( PDS ) for full details of the terms, conditions and exclusions that apply before making a decision to purchase this product. The PDS is available from your financial adviser, by calling , or by visiting bt.com.au.

4 BT Protection Plans BT is part of the BT Financial Group, the wealth management arm of the Westpac Group. They have been helping Australians prepare for the best since They are insurance experts, who take a personal approach to helping customers prepare for the best outcome because they understand that life doesn t always go to plan. In 2013, the insurer of BT Protection Plans* helped 2,591 customers and their families by providing financial and rehabilitation assistance when they needed it most. Claims paid 2,591 CUSTOMERS $203,000,000 in life insurance claims to 2,591 customers (Jan Dec 2013) $105,000,000 Term Life insurance claims $69,000,000 TPD & Living insurance claims $29,000,000 Income protection claims *The insurer of BT Protection Plans is Westpac Life Insurance Services Limited

5 The importance of insurance Insurance can help provide a financial safety net to protect yourself and your loved ones should something unforeseen happen. Most people probably don t think twice about having their car and home insured. When it comes to your health, and your income, it s just as important to make sure these are adequately covered. Having the right cover in place can help protect you and the people that matter to you to avoid financial strain at the most difficult of times. The need for insurance We all want to avoid thinking about illness, injury and early death. Here are some facts and figures to remind you of just how risky life can be and why you need protection. Around 55,000 Australians suffer a heart attack each year 1 1 in 2 men and 1 in 3 women are expected to be diagnosed with cancer before the age of 85 2 Almost 2 million adults aged between have had a disability 3 Insurance can t stop these injuries and illnesses, but it can help to protect you and your loved ones from the financial consequences they can create. For example, the payments from a life insurance policy can be used to: help with day to day living costs such as bills and mortgage payments generate replacement income provide support for your family s financial needs such as your children s education assist with medical expenses and rehabilitation costs, and minimise the financial impact to your business. Having the right amount of insurance It s important that you not only have insurance but that you have the right amount of insurance. According to the Lifewise/NATSEM Underinsurance statistics, 95% of families do not have adequate levels of insurance. 4 This chronic underinsurance means the typical Australian family will lose half or more of their income following a serious illness, injury or the loss of one parent. Think about what that means for your family s lifestyle where and how you live and the educational choices available for your children. How much insurance is enough? To be sure, talk to your financial adviser. 1. Heart Foundation, statistics ( 2. Cancer Council Facts and Figures ( 3. AIHW Australia s welfare Australia s welfare no. 10. Cat. no. AUS 142. Canberra: AIHW. 4. The LIFEWISE/NATSEM Underinsurance Report, February bt.com.au 3

6 Types of insurance in BT Protection Plans BT Protection Plans offer a comprehensive range of flexible insurance solutions that can offer protection throughout different stages of your life. Your financial adviser can help you understand the types of insurance and level of cover suitable for your needs. Below is a summary of the different types of cover available and how they may be able to help. TYPES OF COVER WHAT DOES IT PAY WHERE TO FIND OUT MORE Lump sum benefits Term Life Pays a lump sum in the event of the death of an insured person or if the insured person is diagnosed with a terminal illness. Page 5 Total and Permanent Disablement (TPD) Living Insurance Monthly benefits Income protection Business Overheads Key Person Income Optional policies Needlestick Benefit 1 Children s Benefit 1 Pays a lump sum in the event that the insured person is, depending on the TPD definition selected, unlikely to work again, perform household duties again, or suffers a loss of ability due to a permanent disability. Pays a lump sum in the event the insured person suffers from a specified medical event such as cancer, stroke or heart attack. This type of insurance is sometimes referred to as trauma or critical illness insurance. Pays a monthly benefit to replace a portion of the insured person s monthly earnings if they re unable to work due to sickness or injury. Pays a monthly benefit if the insured person is unable to work due to sickness or injury, to help keep their business running. Pays a monthly benefit to the business in the event the insured person (who can be the business owner or an employee) is unable to work due to sickness or injury to help keep the business viable. Pays a lump sum if the insured person contracts HIV, hepatitis B or hepatitis C while performing the duties of a medical professional. Pays a lump sum if the insured child suffers from a children s medical event. 1. Needlestick Benefit and Children s Benefit policies may be available with another Protection Plans policy. Page 6 Page 7 Page 9 Page 10 Page 10 Page 11 Page 11 The next few pages will outline each of the different types of cover available as part of BT Protection Plans. For full details of the product features and benefits, please refer to the PDS. BT Reserve BT Protection Plans Reserve (BT Reserve) offers individuals with very high earnings and significant debt access to much higher benefit levels on TPD, Living Insurance and income protection cover. Your financial adviser can help you to determine if you re eligible for BT Reserve

7 Term Life Term Life insurance pays a one-off lump sum payment if the insured person dies or suffers a terminal illness. Terminal illness payments Because the families of those who are terminally ill often need financial assistance straight away, Term Life insurance pays a one-off lump sum known as a Terminal Illness Benefit if the insured person is diagnosed with a terminal illness with a life expectancy of less than 12 months. Do you need this cover? If you have dependants, this kind of cover can be vital to protect their future lifestyle if you no longer can. It can help to ensure they ll have all the opportunities you want for them travel, education and a good quality of life for years to come. What could the benefit be used for? Repayment of debts like mortgages, loans or credit cards. Leave a lump sum to be invested to cover the cost of your family s future needs, such as your children s education. Protect your business in the event of death of a key person or principal. Cover funeral and final expenses Create an income stream to protect and maintain your families standard of living Term Life in action Rob and Sandy had been married for eight years and were expecting their first child. Rob worked in advertising earning $110,000 a year. Sandy was a school teacher on $75,000 a year. One day, Rob phoned his financial adviser to advise he had been diagnosed with advanced cancers and was not expected to live for more than 12 months. He qualified for the Terminal Illness Benefit under his Term Life policy. The insurer paid Rob a Terminal Illness Benefit of over $615,000. Having this money made a huge difference in the last months of Rob s life. He didn t have to worry about how the family would pay their bills and mortgage repayments, instead using his energy to seek out the best possible medical treatment. This prolonged his life enough for him to enjoy the milestones of his son s first eight months of life his first smile and first words. Rob died knowing his wife and child could stay in their family home and had the money to re-plan their future. All my husband ever wanted was to make sure his wife and child had a roof over their heads, and this has now been established. Sandy left this moving message for the claims officer after receiving Rob s benefit payment. This case study is for illustrative purposes. It is loosely based on real life examples (names and some details have been altered). bt.com.au 5

8 Total and Permanent Disablement Total and Permanent Disablement pays a one-off lump sum payment if the insured person is totally and permanently disabled. Do you need this cover? Imagine what would happen if your ability to earn an income suddenly stopped. Your life would change overnight. You d be around, but unable to help. That s where Total and Permanent Disablement (TPD) insurance can help. What could the benefit be used for? Repayment of debts like mortgages, loans or credit cards. Meet rehabilitation and home modification costs. Financial support to make necessary lifestyle adjustments. Protect your business in the event that a key person or principal permanently exits the business due to total and permanent disablement. What are the TPD definitions available? There are four types of TPD cover which are called TPD definitions: own occupation TPD any occupation TPD home duties TPD, and general cover TPD. Each TPD definition offers cover for a different purpose, and has a different set of criteria that will need to be satisfied at the time of claim to be eligible for a TPD Benefit payment. For more information on the TPD definitions, please see the PDS. Your financial adviser can help you choose the TPD definition suitable for your individual needs. Total and Permanent Disablement in action Doug, 52, a barrister, and Pat, 54, a self-employed business analyst, had seen their children leave home and were focusing on saving for retirement. One night, Doug collapsed after suffering a stroke. The stroke drastically affected his core communication skills and was the end of his career as a barrister. Doug s TPD Benefit allowed him to access the best medical and rehabilitation services and meant Pat was able to stop work to become Doug s primary carer. They used part of their lump sum TPD Benefit to pay off the remaining mortgage and the balance was invested to generate funds to replace the income Doug had hoped to earn before he retired. Their insurance not only meant that Doug was able to access the best medical care it also ensured their retirement dreams were not all lost. This case study is for illustrative purposes. It is loosely based on real life examples (names and some details have been altered)

9 Living Insurance Living Insurance provides a lump sum payment if the insured person suffers from one of a defined list of specified medical events such as cancer, stroke or heart attack. Medical care is expensive increasing every year. Paying large hospital and medical bills can leave a big hole in your budget and create stresses that slow your recovery. If you are diagnosed with a specified medical event, Living Insurance pays a one-off lump sum benefit to help you meet the medical and potential lifestyle costs involved. Depending on your needs, you can apply to take out the standard Living Benefit or Living Benefit Plus, which provides cover for a wider range of specified conditions. What could the benefit be used for? Pay for medical costs. Alleviate financial stress of major expenses like mortgage repayments or rent. Financial support so you can make lifestyle changes. Financial support so you can focus on your recovery. What s covered? Living Benefit and Living Benefit Plus (full payment) The tables below outline the specified medical events covered under Living Benefit and Living Benefit Plus. The definition for each of the specified medical events is set out in the PDS. SPECIFIED MEDICAL EVENTS (FULL PAYMENT) LIVING BENEFIT LIVING BENEFIT PLUS Cancer Cancer (malignant tumours)* Prostate cancer major treatment* Heart disorders Angioplasty triple vessel* Aortic surgery Cardiomyopathy Coronary artery bypass surgery* Heart attack* Heart valve surgery Open heart surgery* Out of hospital cardiac arrest Pulmonary hypertension SPECIFIED MEDICAL EVENTS (FULL PAYMENT) LIVING BENEFIT LIVING BENEFIT PLUS Nervous system disorders Alzheimer s disease and other dementias Motor neurone disease Multiple sclerosis Muscular dystrophy Parkinson s disease Accidents Coma Major head trauma Paralysis Severe burns Body organ disorders Chronic liver disease Chronic lung disease Kidney failure Loss of sight Major organ transplant * A 3 month exclusion applies for these specified medical events. For more details of the exclusion, please see the PDS. bt.com.au 7

10 Living Insurance Continued SPECIFIED MEDICAL EVENTS (FULL PAYMENT) LIVING BENEFIT LIVING BENEFIT PLUS Blood disorders Aplastic anaemia Medically acquired HIV Occupationally acquired HIV Other events Advanced diabetes Benign brain tumour Encephalitis Intensive care Loss of hearing Loss of independent existence Loss of limbs Loss of single limb Loss of speech Meningitis Meningococcal septicaemia Pneumonectomy Severe osteoporosis Severe rheumatoid arthritis Stroke* Advancement Benefit (partial payment) The Advancement Benefit is a partial payment of your Living Benefit or Living Benefit Plus. The table below outlines the specified medical events covered under the Advancement Benefit. The definition for each of the specified medical events is set out in the PDS. SPECIFIED MEDICAL EVENTS (PARTIAL PAYMENT) Angioplasty single or double vessel* Carcinoma in situ of female organs* Carcinoma in situ of the perineum, penis or testicle* LIVING BENEFIT LIVING BENEFIT PLUS (multipayment) Diabetes complication Early stage melanoma* Loss of hearing advancement Loss of sight in one eye Loss of single limb Prostate cancer advancement* Systemic lupus erythematosus (SLE) with lupus nephritis Living Insurance in action Nadia, a self-employed married mother of two, decided to protect her family s financial position by taking out a Living Insurance policy. A couple of years later, Nadia was diagnosed with a rare form of cancer. The medical reports confirmed Nadia s medical condition and, as she satisfied all of the Living Insurance policy terms and conditions, she was paid in excess of $300,000. Nadia s decision to cover herself gave her crucial financial flexibility at a time of great stress. She used the proceeds of her claim to meet the high costs of the latest cancer treatments. Her insurance payment gave her the option to sell her business and spend more time with her family. She is now working part time and is in a good position to make a full recovery. This case study is for illustrative purposes. It is loosely based on real life examples (names and some details have been altered). * A 3 month exclusion applies for these specified medical events. For more details of the exclusion, please see the PDS

11 Income protection for individuals ` ` Income protection provides a monthly benefit to replace a portion of the income lost when the insured person is unable to work at their full capacity due to sickness or injury. Would sickness or injury affect your ability to pay the mortgage or rent, educate your children and live the lifestyle you re used to? How long could you be off work without having to draw down on savings, take out a loan or borrow from your family? Without an income, could you be sure mounting medical bills wouldn t drive you back to work before you were ready? If you are unable to work at your full capacity due to sickness or injury, income protection can replace a portion of your monthly income. What could the benefit be used for? Replace your income while you re unable to work. Pay for medical expenses. Financial support for day to day living costs such as rent or mortgage repayments. Provide for yourself and your family s financial needs such as your children s education. What are the income protection definitions available? There are three types of income protection cover which are called income protection definitions: own occupation IP home duties IP, and general cover IP. Each income protection definition offers cover for a different purpose, and has a different set of criteria that will need to be satisfied at the time of claim to be eligible for an income protection benefit. For more information on the income protection definitions, please see the PDS. Your financial adviser can help you choose the income protection definition suitable for your individual needs. Income protection for homemakers The non-income earning spouse is often overlooked when putting into place insurance arrangements, as the focus is generally on the income earner. But what would happen if you, as the homemaker, are unable to fulfil your duties at home? Your spouse would need to either reduce their work hours, leave work altogether, or pay for someone to perform the household tasks and to care for your children. Under home duties IP, you can apply for a monthly benefit of up to $5,000 per month. The benefit can be used to cover the costs of hiring someone to do the things that you can t. Income protection in action Joseph, 29, was a self-employed carpenter and his fiancée, Marcia, 28, a manager at a big four accounting firm. They were saving for their wedding and paying off their $350,000 mortgage. Joseph fell over three metres from the roof of a house he was working on. He suffered major trauma to his spine and ankle, had to stop working and eventually closed his business. Joseph applied for benefits under his income protection policy. Since then he has undergone several operations and doctors have confirmed that he will never return to his usual occupation. Joseph applied for alternative positions without success. Under the Rehabilitation Expense Benefit in his income protection policy, Joseph was able to access professional help with his CV and to improve his job seeking skills and interview techniques. Joseph s income protection insurance not only provided financial support whilst he went through the operations and physiotherapy, it also helped him return to work. This case study is for illustrative purposes. It is loosely based on real life examples (names and some details have been altered). bt.com.au 9

12 Income products for business protection BT Protection Plans offer comprehensive solutions to help your business remain viable, by protecting your business expenses and business income, in the event of sickness or injury to an insured person. Business Overheads Business Overheads pays a monthly benefit for the day to day costs of running a business, if the insured person is disabled because of sickness or injury and is unable to work at their full capacity in their business. What could the benefit be used for? Cover day to day business expenses such as rent, utility bills or insurance premiums. Keeping your business running if you cannot work. For a full list of the business expenses that can be covered under a Business Overheads policy, please see the PDS. Key Person Income Key Person Income insurance provides a monthly benefit to help the business remain viable, if its owners and/or key income generating staff are unable to work at their full capacity due to sickness or injury. What could the benefit be used for? Minimise financial impact to business cash flow. Pay for recruitment and training to replace a key person. Assist with short term repayment of debt. Protection of business assets. Assist with the key person s gradual return to work. Business Overheads in action David, 42, runs his own architecture business and handles a wide range of the key activities drawings and documents for construction plans, physical site inspections and sourcing and servicing clients. While playing squash, David broke his right collarbone and arm, rendering him unable to work. This dramatically cut into his business income and his company started running at a loss. To ensure his business was able to survive, David submitted a claim on his Business Overheads policy. His claim was accepted, allowing him to pay for a locum architect to keep things running while he recovered. Thanks to his Business Overheads policy, David could take the time he needed to recover and his business survived, without having to obtain additional finance. This case study is for illustrative purposes. It is loosely based on real life examples (names and some details have been altered)

13 Optional policies Children s Benefit and Needlestick Benefit may be available if you hold another BT Protection Plans policy. Children s Benefit Children s Benefit pays a lump sum benefit if the insured child dies, or suffers a specified children s medical event. The benefit could be used to pay for medical treatments, or for you to take time off work to care for your child. The table below outlines the children s medical events covered under the Children s Benefit. The definition for each of the children s medical event is set out in the PDS. Needlestick Benefit The Needlestick Benefit helps protect those in the medical profession from the extra risks they take every day. If you are employed as a medical professional, you can apply for a Needlestick Benefit for up to $1 million. The Needlestick Benefit is paid if the insured person is diagnosed with occupationally acquired HIV, occupationally acquired hepatitis B or occupationally acquired hepatitis C whilst working in their usual occupation. Aplastic anaemia Benign brain tumour Brain damage Cancer (malignant tumours) Cardiomyopathy Coma Encephalitis Kidney failure Loss of hearing Loss of limbs Loss of sight Loss of speech Major head trauma Major organ transplant Meningitis Meningococcal septicaemia Paralysis Severe burns Stroke Terminal illness bt.com.au 11

14 Features of a BT Protection Plans policy BT Protection Plans provide a number of important features to ensure that you are receiving the most value out of your policy. Guaranteed upgrades Should better features and benefits become available in future which don t result in an increase in premium, your policy will automatically be upgraded. At claim time, you will always have cover under the best terms applicable to your policy, from the time of commencement to the date of a sickness or injury. Any loadings, exclusions or special conditions on your policy will continue to apply. Inflation indexing Inflation can erode the real value of your benefit over time. To make sure it doesn t, the amount of certain benefits will automatically increase each year on your review date in line with the Consumer Price Index (CPI). For details of the benefits which will automatically increase, and the amount of the increase that will apply, please see the PDS. Guaranteed renewable Provided your premiums are paid when due, your BT Protection Plans policy will continue for the term specified. This means your insurance won t be cancelled if there is a change in an insured person s health, occupation or pastimes. Loyalty Benefit We want to reward clients who stick with their insurance strategy and stay with BT. To reward your loyalty, after you have held your policy for 3 years (from the commencement date), an extra 5% of your sum insured will be added to any Death Benefit, TPD Benefit, Living Benefit or Children s Benefit amount payable at the time of claim, without additional charge. For income protection, Business Overheads and Key Person Income, after you have held your policy for 3 years (from the commencement date), a Death Benefit of $50,000 will be added to your policy without additional charge. Worldwide cover 24 hours a day BT Protection Plans provide you with full coverage anytime, anywhere in the world. Multi-policy discount Take out multiple BT Protection Plans policies for the same insured person and you will receive a discount of 5% off your premium (excluding policy fee and stamp duty). Wrap and Platform Super discount If you pay your benefit premiums through a Wrap or eligible Platform Super account 1, you will receive a 10% premium discount for those premiums. 1. Your adviser can tell you which Platform Super accounts are eligible

15 More information about BT Protection Plans In addition to the financial security provided by the insurance benefit itself, BT Protection Plans offer flexibility in cover, premium structures and payment options. Structuring your cover Having the right policy structure for individual circumstances is important as it can make a difference to how much you pay for your premiums, how effectively you can manage cash flow, and most importantly, the ability to access benefits when it s needed the most. BT Protection Plans can be structured in many ways including being able to link certain benefits inside and outside superannuation, giving you the flexibility to tailor your insurance to individual circumstances. Your financial adviser can help you to decide on how to structure your cover. Premium structures There are a number of different ways to structure your premiums, depending on your needs. You are able to choose stepped premium, level premium or a combination of both. Stepped premiums Your premium is calculated each year, and will change based on the increase in the insured person s age and the sum insured at the review date. The premium will generally increase every year. Level premiums For the time period specified (eg Level 55 premium or Level 65 premium), your premium is calculated based on the insured person s age at the commencement of the policy, and will not change each year due to the increase in the insured person s age. When the specified period of time has elapsed, the premium will revert to a stepped premium structure. Please note: For both stepped and level premiums, your premiums will increase if your sum insured increases, with CPI increases, and when the policy fee is increased. Payment options You choose how you pay. To give you more financial flexibility, you can pay your BT Protection Plans premiums: by direct debit or credit card (one that is accepted by us) by cheque (if paying annually) through your Wrap account 1 by partial rollover for eligible superannuation funds and products, and through an eligible Platform Super account Payment through a Wrap account is not available for Key Person Income policies. 2. Your adviser can tell you which Platform Super accounts are eligible. bt.com.au 13

16 Claims we re here for you We understand claims can be stressful. If you do make a claim you are assigned a dedicated case manager to take care of you. Regular phone contact and even face-to-face visits ensure you get the best possible outcome. Our promise to you The Claims team for BT Protection Plans is ready to help you whenever you need it. They understand that making a claim can seem like a daunting task, that s why they do everything they can to help you through it. If you ever need to make a claim, the Claims team will always aim to: assess your claim fairly and promptly treat you with empathy and understanding, and provide honest and helpful advice about your claim. Increasing the efficiency of claims paying If you claim on your insurance, the speed with which your claim is paid is crucial. Whether the bills are coming in from your bank, the local supermarket, or from doctors and hospitals, you need to pay them promptly. You might also need money to supplement or replace lost income and change your accommodation or your lifestyle. The last thing you need when you are ill or injured is to worry about money. That s why the Claims team make constant efforts to improve the claims process. The tele-claims service for income protection products is just one example. Under this initiative, your claim is assessed over the phone once a medical certificate is received. Decisions about the claim can be made live without the delays involved in filling in forms and obtaining signatures. Rehabilitation services One key added benefit of BT Protection Plans is access to free services that help you recover from the physical and emotional effects of illness and injury. Rehabilitation services are available for customers with an income protection policy. Functional rehabilitation The functional rehabilitation services aims to help individuals recapture as much physical function as possible following a disability. These services include: personalised physical conditioning programs preventative re-injury education workplace ergonomic assessment (and modifications) home aids assessment, and the development and monitoring of a safe, sustainable return-to-work program. Psychological rehabilitation The counselling services are designed to help people make a psychological recovery from illness and injury by maximising the possibility of independent living and helping them achieve career and personal goals. These services include: psychological evaluation of a disability with clear recommendations on how to maximise a recovery adjustment-to-injury counselling assessments for specialised treatment programs, ie pain management programs for dealing with anxiety/mood disorders and addiction, and the development and monitoring of a safe, sustainable return-to-work program