Insurance booklet. Personal division. Contents. Issued 1 December 2013

Transcription

1 Contents 1. Death, Terminal Illness and Total and Permanent Disablement Cover 3 2. Income Protection 9 Insurance booklet Personal division Issued 1 December 2013 The information in this document forms part of the Product Disclosure Statement for Club Plus Super Personal Division dated 1 December An application to apply for insurance cover or increase your existing cover is on the back of this booklet. by your side for over 25 years

2 This Personal Insurance booklet relates to the Personal Product Disclosure Statement (dated 1 December 2013) as shown below. Contents 1. About Club Plus Super 2 2. How super works 2 3. Benefits of investing with Club Plus Super 3 4. Risks of super 3 5. How we invest your money 4 6. Fees and costs 5 7. How super is taxed 6 8. Insurance in your super 6 9. How to open an account 8 Personal division Product Disclosure Statement Issued 1 December 2013 An application to join is on the back of this booklet. by your side for over 25 years The insurance is arranged by Club Plus Super and is provided by The Colonial Mutual Life Assurance Society Limited ABN AFS Licence (referred to in this booklet as CommInsure ). This Personal Division Insurance Booklet should be read as a guide only. The full policy terms and conditions are outlined in the Fund policy documents issued by CMLA (CommInsure) which can be obtained on request from Club Plus Super. All cover provided is subject to the terms and conditions contained in the policy documents. The full terms and conditions contained in the policies take precedence over this guide. Please read all of this section to ensure that you understand how your insurance works and when you are covered. If you have any questions please call the Member Hotline on This Insurance Booklet for Club Plus Super Personal Division is issued by Club Plus Superannuation Pty Ltd ABN Australian Financial Services Licence No , as Trustee for the Club Plus Superannuation Scheme ABN Club Plus Superannuation Pty Limited holds Registerable Superannuation Entity Licence No.L and Club Plus Superannuation holds Fund Registration No. R The information in this Booklet is only a guide. It does not take into account your particular goals, financial situation or needs. Before acting on information you should consider the appropriateness of the information having regard to your particular goals, financial situation and needs. We recommend that you speak with a qualified and independent financial adviser. The issue of this Booklet is authorised solely by Club Plus Superannuation Pty Ltd (Trustee, we and us). No other person or company (whether or not related to the Trustee) is responsible for any information contained in the Booklet. If you would like to consult a qualified financial planner before making your decision, you can obtain no commission based professional financial advice from Club Plus Financial Planning on a range of financial issues including superannuation, retirement planning, wealth creation, income protection and personal life insurance. Club Plus Financial Planning Pty Ltd (Club Plus Financial Planning), ABN acting as Corporate Authorised Representative # of Adviser Network Pty Ltd, ABN ( Licensee ). The Licensee holds a current Australian Financial Services Licence # and is responsible for the financial services provided to you.

3 Death, Terminal Illness and Total and Permanent Disablement Cover As a new member of the Personal Division of Club Plus Super, you will be offered one unit of Death, Terminal Illness and TPD insurance cover, without medical assessment, up to age 70 at a cost of $1.50 per week. This offer will be made with your Welcome Letter when Club Plus Super advises you of your membership number and must be taken up within 60 days of the new member Welcome Letter. This is known as auto cover. The level of cover is based on your age and decreases each birthday (see table). You can vary this level of unitised cover by choosing to fix cover, remove cover for TPD by electing for Death Only cover or increase the level of unitised or fixed cover. Health and medical evidence is not required for auto cover however it will be subject to a three year pre-existing medical condition exclusion and a three year suicide exclusion (see page 5). Applications for cover after 60 days or for more than one unit of cover are subject to medical underwriting and CommInsure s approval. If you wish to increase your cover, you will need to complete the Personal Statement form. Where you are covered for Death, Terminal Illness and TPD, you can only claim one insurance benefit. For example, if you become Totally and Permanently Disabled and you claim a TPD insurance benefit and you die after receiving the TPD benefit, your beneficiaries are not entitled to claim a Death or Terminal Illness insurance benefit. Your cover for Death, Terminal Illness and TPD insurance cover costs $1.50 per week per unit of cover. Insurance premiums are deducted from your account on the last Friday of each month and forwarded to Club Plus Super s Life Insurer, CommInsure. The amount of insurance cover you have will depend on your age. To check the value of each unit of Death, Terminal Illness and TPD Insurance cover for your age please refer to the table to the right. Members who have Death, Terminal Illness and TPD insurance are covered 24 hours a day, 7 days a week anywhere in the world provided there are sufficient funds in their account to continue paying premiums. When does cover start? Once a new member application has been received by Club Plus Super, a Welcome Letter and Special Offer form will be sent. The Special Offer Form allows eligible new members to apply for one unit of Death, Terminal Illness and TPD cover without having to provide evidence of health or other underwriting ( auto cover ). To take advantage of the Special Offer, the form will need to be completed and returned within 60 days of the date of the Welcome Letter. Auto cover will start from the date we receive the Special Offer form provided it is within 60 days of the date of the Welcome Letter. Cover in excess of auto cover will commence from the date CommInsure agree to provide cover. What is the level of cover? The following table shows the level of cover for one unit of Death, Terminal Illness and TPD insurance cover, according to the Member s age. Where the Member obtains additional units of cover, the number of units of cover is multiplied by the amount shown in the table. Age Death & TPD Cover (one unit) $ Age Death & TPD Cover (one unit) $ , , , , , , , , , , , , , , , , , , , , , , , , , , nil 3

4 Death, Terminal Illness and Total and Permanent Disablement Cover (cont.) When does cover end? Your Death, Terminal Illness and TPD insurance cover will continue under Club Plus Super until one of the following happens: a Death, Terminal Illness or Total and Permanent Disablement Insurance benefit becomes payable; or you die; or you reach the cover expiry age which at present is age 70; or the date we receive your written request for cover to end; or the date you cease to be a member of the Club Plus Super Personal Division; or the date you no longer have sufficient funds in your account to cover the cost of the next insurance premium; or the date you join any armed forces, other than the Australian Armed Forces Reserves; or the policy terminates. If your cover ends because you no longer have sufficient funds in your account to cover the cost of the next insurance premium deduction, you may be eligible to have cover reinstated. You will need to make a contribution to the fund within 6 months of your cover ceasing that is sufficient to cover the cost of your next premium deduction. When does cover start if I apply for additional cover? All applications for additional cover will start from the date the insurer advises acceptance in writing. However, the insurer will provide accidental Death and accidental TPD cover while an application for cover, or an increase in cover, is being assessed. Under this type of cover, the Death or Total and Permanent Disablement must occur within 60 days of the accident. Interim Accident Cover is available for death or total and permanent disablement resultant from a bodily injury caused solely and directly by accidental, external and visible means, independent of any other cause. Interim Accident Cover is available to the lesser amount of the insurance you have requested on your application and $1,000,000. Interim Accident Cover is provided for applications other than auto cover and it applies from the date that CommInsure receives your application for Death, Terminal Illness and Total & Permanent Disablement Insurance and will end on the earliest of the following dates: the date you withdraw your request for cover; the date CommInsure accepts your application for the cover; the date CommInsure rejects your application for the cover; and 60 days from the data we are notified of your request for the cover. If cover is reinstated but you are not in active employment on the reinstatement date, the reinstated cover will be provided on a limited cover basis from the reinstatement date until you have returned to active employment for 2 consecutive months. However, please note that you will never be covered for anything that happens or first becomes apparent from the date the cover ended up to the reinstatement date. If your cover ends for any other reason or if you are not eligible for reinstatement of cover and you later wish to restart your cover, you will need to apply for cover by completing a Personal Statement form. This form must include evidence of health, satisfactory to the insurer and must be accepted in writing by CommInsure. Note If your application for additional cover is declined, any existing insurance cover under Club Plus Super is not affected. Do you want additional cover? Additional cover can be applied for at any time provided that your total amount of insured cover does not exceed $2,000,000. If you wish to apply for additional Death, Terminal Illness and TPD Cover, you will need to complete the Personal Statement form. 4

5 Exclusions No benefit will be paid if your Death, Terminal Illness or Total and Permanent Disablement is caused directly or indirectly by an act of war which occurs outside of Australia. In the event that the World Health Organisation declares a Level 5 Pandemic situation, no benefit will be payable where a member dies within 30 days of cover commencing, and the sole or dominant cause of the member s death is a pandemic illness (or a condition which arose as a direct consequence of a pandemic illness). Auto cover exclusions Cover will not be provided for claims resulting from an injury or illness caused directly or indirectly as a result of: intentional self-inflicted injury or infection, suicide or attempt at suicide (whether or not the person is sane at the time) and the date of the self-inflicted injury or infection, suicide or attempted suicide, occurs within three years of the date the auto cover started or restarted a pre-existing medical condition and your death, terminal illness or the incident date of Total and Permanent disablement occurs within three years of the date auto cover started or restarted. What is a pre-existing medical condition? A pre-existing medical condition is an injury, illness, condition or related symptom that has occurred prior to your cover starting and has contributed to the cause of claim. This also includes any secondary conditions that may arise. An injury, illness, condition or related symptom includes any event: that you (or a reasonable person in your position) was aware of, or should have been aware of; or for which you had, or were intending to have a medical consultation; or for which a reasonable person in your circumstances would have had a medical consultation. Medical consultation means any activity undertaken for the detection, treatment or management of an illness, injury, medical condition or related symptom, including but not limited to the application of prescribed drugs or therapy (whether conventional or alternative). What is the cost? Death, Terminal Illness and TPD insurance cover costs $1.50 per unit per week, while Death Only Cover (including Terminal Illness cover) costs $0.90 per unit per week. The cost is deducted from your account balance on the last Friday of each month. If your account balance is insufficient to cover your next insurance premium, you will be notified that there are insufficient funds to cover the cost of the insurance premium. If no further contribution is made, your cover will end. Your cover will be dependent on: A. the number of units of insurance you successfully apply for; and B. your age. The maximum cover you can apply for is $2,000,000. Example Bernie, aged 53, with four units of cover suffered a serious accident that resulted in the permanent loss of sight in both eyes. Upon successful admission of his claim, Bernie would be entitled to $70,000 (4 units x $17,500). Death only cover A member who does not wish to have TPD cover can cancel this by changing to Death Only Cover, which is $0.90 per unit per week. This cover may also be suitable for a member who requires more Death cover than TPD cover. Example James, aged 38, requires approximately $500,000 Death insurance and $100,000 TPD insurance. Therefore, James decides to take the following: 1 unit of Death and TPD ($131,500). 3 units of Death Only cover ($394,500). Fixed Cover The value of a unit of Death, Terminal Illness and TPD cover gradually decreases as you get older. If you do not want your cover to reduce as you get older, you can apply for Fixed Cover. When you apply for Fixed Cover, the number of units of cover you have will be converted to Fixed Cover in multiples of the nearest $1,000. Fixing your cover means the sum insured will remain the same each year, however, the insurance premium deducted from your account will increase each year. 5

6 Death, Terminal Illness and Total and Permanent Disablement Cover (cont.) How to calculate the weekly premium cost for fixed cover The table on page 7 shows the applicable premium multiplier to be used in calculating the relevant cost per week dependent on age. To calculate the premium, fill in the relevant sections (a), (b), (c), (d) for the cover required. Then transfer these amounts into the relevant calculation below. Example Using the previous example, James decides to fix his cover, therefore, his unitised cover will be rounded up to the nearest $1,000. Cover amount required Premium multiplier based on age Death & TPD required (James) Death only cover required (a) $132,000 (b) $395,000 (c) (d) Death & TPD required; (a) $ (c) Death only cover required. (b) $ (d) Death & TPD Premium calculation Example (a) $132,000 $1,000 x (c) = $1.51 (Premium per week) (a) $ x (c) $1,000 = $ (Premium per week) Death & TPD Premium calculation Example (b) $395,000 $1,000 x (d) = $2.70 (Premium per week) (b) $ x (d) $1,000 = $ (Premium per week) 6

7 Fixed Cover Premium cost ($) per week per $1,000 Sum Insured Current Age Death & TPD Death Only Current Age Death & TPD Death Only n/a n/a You can switch between unitised and fixed cover at any time by completing the Insurance Variation form. The value of your unitised cover will be rounded up to the nearest $1,000 for Fixed Cover. If you want more Fixed Cover, you will have to apply and you will need to provide health information by completing a Personal Statement form. Once you have Fixed Cover, you can switch back to unitised cover and the amount of Fixed Cover you have will be rounded down to the nearest number of units. Insurance definitions Certain words have specific meanings in relation to the policy terms and conditions. The policy documents detail all of the definitions. A few of those used in this Insurance Booklet are detailed here. Terminal Illness Under Club Plus Super s current policy you will be considered to suffer from a Terminal Illness if you suffer from an illness which: A medical practitioner (who is accepted by the insurer as an accepted medical practitioner under the policy), specialising in your sickness certifies in writing will, despite reasonable medical treatment, lead to your death within 12 months of the date of the certification; and CommInsure is satisfied, on medical or other evidence, will despite reasonable medical treatment lead to your death within 12 months of the date of this certification. If you believe your illness satisfies the above definition, you can lodge a claim by completing a claim form, available on request from Club Plus Super and providing medical evidence specifying the nature of your illness. Importantly, however, under superannuation law, you will only be able to be paid your Terminal Illness benefit from the fund if you are Permanently Incapacitated or you satisfy one of the other conditions of release. Total and Permanent Disablement (TPD) Under Club Plus Super s current policy you will be considered Totally and Permanently Disabled if, in the opinion of the insurer, you meet one of the following criteria: 1. You suffer, as a result of injury or illness, the loss of or use of two limbs or the loss of sight of both eyes, or the loss of one limb and the sight of one eye (where limb is defined as the whole hand or whole foot); or 2. You were employed at any time during the 12 months immediately before the incident date, and having been absent from your occupation (the activity in which you were employed) with the employer, through injury or illness for six consecutive months from the incident date, and have provided proof to the satisfaction of CommInsure that you have become incapacitated to such an extent as to render you unlikely ever to engage in any gainful profession, trade or occupation for which you are reasonably qualified by education, training and experience; or 7

8 Death, Terminal Illness and Total and Permanent Disablement Cover (cont.) 3. As a result of injury or illness, you are totally unable to perform without the physical assistance of another person, any two of the following activities of daily living (and you are permanently and irreversibly unable to so do for life): 4 i. Dressing the ability to put on and take off clothing; ii. Toileting the ability to use the toilet, including getting on and off; iii. Mobility the ability to get in and out of bed and a chair; iv. Continence the ability to control bowel and bladder function; v. Feeding the ability to get food from a plate into the mouth; and i. you have not been employed in the 12 months immediately before the incident date, and during that time you were capable of performing full-time unpaid domestic duties (even if you were not actually performing such duties); and ii. As a result of illness or injury, you have been unable to perform domestic duties for six consecutive months from the incident date, and having provided proof to the satisfaction of the Insurer that you are unlikely ever to be able to engage in unpaid domestic duties, or any occupation for which you are reasonably suited by education, training or experience; and iii. you are so incapacitated that you are unable to leave your home without the assistance of another person; or 4. 5 as a result of illness or injury, you are totally and permanently unable to perform at least four of the following activities of daily work: i. Bending The ability to bend, kneel or squat to pick something up from the floor and straighten up again. ii. Communicating The ability to: clearly hear with or without a hearing aid or alternative aid if required; comprehend and express yourself by spoken or written language with clarity; and successfully function on a day to day basis and in a work environment. iii. Vision (reading) The ability to read, with or without correction with suitable lenses, to the extent that an ophthalmologist can certify that: visual acuity is equal to, or better than, 6/48 in both eyes; or constriction is within or greater than 20 degrees of fixation in the eye with the better vision. iv. Walking The ability to walk more than 200m on a level surface without stopping due to breathlessness, angina or severe pain elsewhere in the body. v. Lifting The ability to lift, carry or otherwise move objects weighing up to 5kg using either or both hands. vi. Manual Dexterity The ability, with reasonable precision and success, to: use at least one hand, its thumb and fingers, including the ability to pick up and manipulate small objects; and use a keyboard. You must be undergoing appropriate treatment/care prescribed by a medical practitioner specialising in your illness or injury and any claim must be supported by medical or other evidence. Incident date means the later of: A. the date on which a medical practitioner examines you and certifies in writing that you suffer from the illness or injury that is the principal cause of your disablement; and B. the date you ceased all work, and must occur while you are covered under the insurance policy. If you believe you satisfy the above definition, you can lodge a claim by completing a claim form, available on request from Club Plus Super, and providing medical evidence specifying the nature of your injury or illness. Due to legal requirements, the claims assessment process is often complicated and it may be some time before your TPD benefit is paid. In accordance with the insurance policy, you must have been absent from work for three or six consecutive months from the incident date before CommInsure can determine whether you meet the definition of TPD in the policy. Active Employment To be in Active Employment you must be employed to carry out identifiable duties by an employer and in CommInsure s opinion you are not restricted by injury or illness from being capable of carrying out the identifiable duties of your current and normal occupation on a full time basis. What is Limited Cover? Members on Limited Cover are only insured for claims that arise from an illness that first becomes apparent or an injury that first occurs on or after the date cover last commenced, recommenced or increased (i.e. therefore excluding pre-existing illnesses or injuries). The amount of your Limited Cover will be one unit of Death, Terminal Illness and Total and Permanent Disablement cover. 8

9 Income Protection Short Term Income Protection Club Plus Super Short Term Income Protection insurance will provide you with a replacement for your income for up to two years in the event that a sickness or injury prevents you from working. Short Term Income Protection Insurance is available to cover up to 90% of your income plus 9.25% SG contributions (maximum benefit payment of $30,000 per month). Cover of up to $5,000 per month (including SG benefit) is available to new eligible members of the Personal Division of Club Plus Super without underwriting and is referred to as auto cover. Health and medical evidence is not required, provided cover is taken up within 60 days of receiving your Welcome Letter. Auto cover will be subject to a three year pre-existing medical condition exclusion (see page 11). Applications for cover after 60 days or for amounts over $5,000 per month are subject to medical underwriting and CommInsure s approval. If you wish to have this insurance you must complete the Personal Statement form. Additional benefits include: Recurrent Disability Benefit the waiting period will not apply if you claim for the same or related cause within 6 months of last being on claim. Death Benefit members covered under this policy will receive a one-off benefit equivalent to one week s disability benefit if they pass away whilst being on claim for income protection. Partial Income Protection Benefits you can continue to work on a part-time basis during your recovery and you may still be eligible to receive benefits under this plan. Do I need income protection if I am already covered for Total and Permanent Disablement? The two types of insurance cover you for different circumstances. The main differences are: Total and Permanent Disablement This insurance covers you in the event that you suffer an illness or accident that permanently prevents you from working at any occupation that it is reasonable to expect you to perform. The benefit is payable as a lump sum, and you can take out up to $2,000,000 worth of cover with Club Plus Super. Income Protection Insurance This insurance covers you in the event that you suffer a sickness or injury that temporarily prevents you from working at full capacity in your current occupation. The benefit is generally payable as a monthly payment (plus Superannuation Guarantee) and the Short Term Income Protection is only payable for a period of up to 24 months. When will cover commence? As with auto cover for Death, Terminal Illness and TPD, the Special Offer form provided with your Welcome Letter, allows eligible new members to apply for up to $5,000 of Short Term Income Protection cover without having to provide evidence of health or other underwriting. To take advantage of this, the Special Offer form will need to be completed and returned within 60 days of the date of the Welcome Letter. For auto cover, cover commences from the date of application provided you meet the eligibility criteria. Cover that is not auto cover commences for you under the Club Plus Short Term Income Protection policy on receiving notice in writing from CommInsure that it agrees to provide the requested cover. When are you covered? You will be covered 24 hours a day, seven days a week, worldwide, provided that: A. you meet the eligibility criteria and your application is for less than $5,000 and meets the requirements of auto cover; or B. the insurer has accepted your application for Short Term Income Protection insurance; and C. you have not caused your cover to effectively cease as stated in the section below ( When does cover cease? ). When does cover cease? Your cover ceases when one of the following events occurs: The date you reach the age of 70; or The date you cease to be a member of the Club Plus Super Personal Division; or The date we receive a request from you to cancel the cover; or The date you join any Armed Forces (except the Australian Armed Forces Reserve); or The date on which your account balance is insufficient to cover the next premium deduction; or You die; or The policy terminates. If cover is reinstated but you are not in active employment on the reinstatement date, the reinstated cover will be provided on a limited cover basis from the reinstatement date until you have returned to active employment for 2 consecutive months. Please note that cover will continue even if you are receiving income protection payments as a result of a sickness or injury. It is recommended that before making any decision regarding your insurance coverage that you seek advice from a qualified financial adviser. Please note that this information is of a general nature and is intended only as a brief guide to the policy. Actual terms and conditions etc. will be governed by the policy document, which is available on request. 9

10 Income Protection (cont.) When will I be eligible to claim? You must be disabled for the waiting period of 21 days before any Short Term Income Protection Benefit will be paid. The waiting period starts on the date a medical practitioner certifies you are disabled. You must be totally disabled for at least 14 out of the first 19 consecutive days to qualify for any Short Term Income Protection benefit. How much does cover cost? The cost of Short Term Income Protection Insurance will be equal to 0.69% of the insured income, based either on auto cover or the gross annual income that you advise when completing the Personal Statement. Premiums are collected on a monthly basis. Example: Joanne is self-employed and earns $60,000 per year ($5,000 per month). She will pay $34.50 per month in Income Protection insurance premiums. This means, for $414 per year, Joanne will be covered for up to $54,000 per year (90% of her annual salary) plus $5,550 as a Superannuation Guarantee contribution, if she was unable to work due to injury or illness. What is income? The amount of benefit you are entitled to is determined by the category of work that generates your income: Category 1 If you are employed on a casual basis, work as an independent contractor, or earn an income from a business you directly own part or all of, income means the annual remuneration earned by you from all regular occupations. If you directly own all or part of the business in which you perform personal exertion, your income is the total amount earned by that business for the relevant period as a direct result of your personal exertion, less your share of business expenses, but before the deduction of income tax, for that business for the same period. Category 2 Where you do not fall within Category 1, income means the annual remuneration earned from working for their employer (and includes any packaged elements not received directly by the member as taxable earnings, overtime and allowances) but excludes any directors fees, bonuses, compulsory employer superannuation entitlements, commission, investment income or profit distributions. Please note that the following conditions apply: The maximum period that a benefit will be paid in respect of any sickness or injury is 24 months; The amount payable will be reduced by any other payments received, e.g. sick leave, Workers Compensation, and any benefits payable under another income protection policy; Superannuation Guarantee contributions of 9.25% of the insured income will be paid into your Club Plus Super account on your behalf for the duration of the claim payment period; Insurance premiums will continue to be deducted and your Income Protection insurance cover will be maintained throughout the payment period; You will be covered until you turn 70 years of age. 10

11 Long term Income Protection Your Short Term Income Protection cover provides benefit payments for up to 24 months for sickness or injury after an initial waiting period of 21 days. You have the option to take up Long Term Income Protection which provides cover of up to 75% of income plus 9.25% SG, has a waiting period of two years, with payments payable while you are totally or partially disabled, up to age 65, complementing the Short Term Income Protection Cover. If you have Long Term Income Protection, you will be covered until: you die; there are insufficient funds in your Club Plus Super member account to deduct premiums; the date you reach the age of 65; you are no longer a member of the Club Plus Super Personal Division; the date you join any Armed Forces (except the Australian Armed Forces Reserve); the date we receive a request from you to cancel cover; the policy terminates. To apply for Long Term Income Protection, you will need to complete the Personal Statement form. Exclusions Cover will not be provided for claims resulting from an injury or illness caused directly or indirectly as a result of: intentional self-inflicted injury or infection, or attempt at suicide (whether or not the person is sane at the time). For auto cover, this exclusion will only apply for 3 years from the date auto cover started or restarted; a pre-existing medical condition which occurs within three years of the date auto cover started or restarted; normal pregnancy or childbirth; or war. What is a pre-existing medical condition? A pre-existing medical condition is an injury, illness, condition or related symptom that has occurred prior to your cover starting and has contributed to the cause of claim. This also includes any secondary conditions that may arise. An injury, illness, condition or related symptom includes any event: that you (or a reasonable person in your position) was aware of, or should have been aware of; or for which you had, or were intending to have a medical consultation; or for which a reasonable person in your circumstances would have had a medical consultation. Medical consultation means any activity undertaken for the detection, treatment or management of an illness, injury, medical condition or related symptom, including but not limited to the application of prescribed drugs or therapy (whether conventional or alternative). Additional insurance benefits The additional insurance benefits are provided and underwritten by CommInsure and include Rehabilitation Expense Assistance, Household Duty Assistance, Accommodation Benefit and Transportation Benefit as listed below: 1. Rehabilitation Expense Assistance CommInsure will cover approved rehabilitation expenses whilst you are on claim under the Income Protection policy. The rehabilitation costs must be approved by a medical practitioner as being necessary to assist you in returning to work and be approved by CommInsure in advance of them being incurred. The maximum amount payable will be 24 times your monthly cover amount. Rehabilitation costs will be paid directly to the provider and are made in addition to your monthly benefit payments whilst under claim. 2. Recurrent Disability Benefit The waiting period will not apply if you claim for the same or related cause within 6 months of last being on claim. However, it is important to note that where this benefit is received, the insurer will treat this as a continuation of the original claim and add both periods of claim together to determine when the two year benefit payment period ends. 3. Household Duty Assistance CommInsure will pay you a benefit in the event that you qualify for income protection insurance and your non-working spouse or partner has been injured and is therefore unable to perform household duties. The benefit will be $200 per week, payable from the week after your spouse or partner has been injured, and for a maximum of 10 weeks. 4. Accommodation Benefit CommInsure will pay you $250 per day if: A. you are injured or become disabled whilst you are away from home (by more than 100km) and a medical practitioner advises you to remain there; or B. your medical practitioner advises you to travel to a place more than 100km from your residence for treatment of the illness/ injury; and C. you are confined to bed; and D. an immediate member of your family is accommodated near to you, away from their place of residence. 5. Transportation Benefit CommInsure will pay a set benefit of $250 towards transportation expenses if, as a result of a condition that leads to your total disability, you require emergency transportation to a hospital within Australia. 11

12 Income Protection (cont.) How much does Long Term Income Protection Cover cost? The cost for Long Term Income Protection is calculated using the premium multiplier from the table below. Long Term Income Protection weekly premium rates per $100 of monthly benefit Age Next Birthday Male Female Age Next Birthday Male Female

13 Example: Jake will be 22 years old on his next birthday and earns $60,000 per year ($5,000 per month). Under Long Term Income Protection he can be covered for up to 75% of income ($45,000 per year or $3,750 per month) plus SG ($5,500 per year or $ per month). Therefore his total monthly benefit is $4, The premium states weekly premium rate per $100 of monthly benefit. The calculation will therefore be based on the total monthly benefit of $4, (75% of salary plus SG). The calculation is x 42 = $1.78 per week. Example (Jake) $60,000 x 75% (Gross salary) = (a) $45,000 $60,000 x 9.25% (Gross salary) = (b) $5,550 (a) $45,000 + (b) $5,550 = (c) $50,550 (c) $50,550 / 12 = (d) $4, $4, / 100 x = $1.78 per week Sum Insured $ x 75% (Gross salary) = (a) $ Superannuation Guarantee (SG) $ x 9.25% (Gross salary) = (b) $ Annual Total Benefit (a) $ + (b) $ = (c) $ Monthly Benefit (c) $ / 12 = (d) $ Weekly Premium (d) $ Your example /100 x (premium multiplier) = $ per week How do I claim a benefit? Claims for benefits are to be made in writing. The claim form is available from or by calling Every claim for an Income Protection Benefit under the insurance policy shall be made in the form prescribed by CommInsure and shall be accompanied by such evidence of sickness, accident and resulting injury and/or death as CommInsure may determine. No notice period is required before a benefit is payable, but no benefit is payable until CommInsure has assessed the claim and agreed that a benefit should be payable under these Rules. All certificates and evidence required by CommInsure to assess your claim shall be furnished as required at the Insured Person s expense. CommInsure will, upon receipt of a notice of claim furnish such forms as are usually required by CommInsure for filing Proof of Claim. Written Proof of Claim must be furnished to CommInsure at their office within ninety (90) days after the date of the Event. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to do so, provided that the proof is furnished as soon as is reasonably possible and in no event except in the absence of legal capacity, later than twelve (12) calendar months from the time it would normally be required. Insurance definitions Certain words have specific meanings in relation to the policy terms and conditions. The policy documents detail all of the definitions. A few of those used in this Insurance Booklet are detailed here. Totally disabled You will be considered totally disabled if, because of illness or injury, you are: A. Unable to perform at least one income producing duty of your own occupation; B. Under the regular care of, and following the advice of, a medical practitioner; and C. Not working in any occupation, whether or not for reward. Partially disabled Please send completed form to: CommInsure Claims Team P O Box 322 Silverwater NSW 2128 You will be considered partially disabled if you are not totally disabled but, because of injury or illness, you: A. have been totally disabled for at least 14 days; B. are unable to work in your own occupation at full capacity immediately after you became totally disabled because of the illness or injury that caused your total disability; C. are working in your own occupation in a reduced capacity or working in another occupation; D. earn a monthly income that is less than your pre-disability income; and E. are under the regular care of, and following the advice of, a medical practitioner. 13

14 contact us Locked Bag 5007, Parramatta, NSW, 2124 employer hotline: member hotline: pension hotline: financial planning: Registered address: Locked Bag 5007 Parramatta NSW 2124 Club Plus Superannuation Pty Limited ABN , AFSL No , RSEL No. L as trustee of Club Plus Superannuation Scheme ABN , RSE Registration No. R This information is for illustrative purposes only and does not take into account any personal financial circumstances. CP/INS/BKT /12 ISS2 by your side for over 25 years CJ/PERS/INS/BKT /13 ISS4

15 Personal statement Please complete this form if you wish to apply for insurance cover or increase your existing cover with Club Plus Super. All members must complete Section A and B and other relevant sections as indicated on the form. Return your signed and completed form to: Club Plus Super, Locked Bag 5007, Parramatta NSW 2124 Section A - Your details Membership number Surname Given name(s) Name of superannuation fund CLUB PLUS SUPER Salary or yearly remuneration Occupation Employer Date of birth / / 1. What is your: Height cm or ft/in Weight kg or st/lb 2. Have you smoked in the last 12 months? No Yes If yes, please indicate what you smoke What is your average? per day per week or per year 3. Do you drink alcohol? No Yes If yes, please provide the average number of standard drinks consumed: per day per week or per year This application, if accepted by the insurer, will replace any existing level and type of insurance cover you currently hold in Club Plus Super. The insurer may require you to undertake a blood test or attend a medical examination at the insurer s expense. Please note: any existing cover will not be affected should your application be declined. I wish to apply for / increase my cover to the following: (mark one or more of the boxes below) Unitised cover Death and TPD Death only number of units number of units Fixed cover* Death and TPD $,000 Death only $,000 *Fixed cover must be in multiples of $1,000. I wish to apply for / increase my cover to the following: (mark one or more of the boxes below) Short-term Income Protection $,000 per annum Long-term Income Protection $,000 per annum member hotline: website: address: Locked Bag 5007, Parramatta NSW 2124 member hotline: website: address: Locked Bag 5007, Parramatta NSW 2124 CommInsure is registered business name of The Colonial Mutual Life Assurance Society Limited ABN CommInsure is a registered 809 AFSL business (CMLA)Club name of The Plus Colonial Superannuation Mutual Life Pty Assurance Limited ABN Society Limited ABN RSE Licence 021 number 809 AFSL L , (CMLA)Club AFSL Plus as Superannuation trustee of Club Pty Plus Limited Superannuation ABN Scheme 217 ABN 990 RSE Licence 115 number 088, RSE L , Registration AFSL number R as trustee of Club Plus Superannuation Scheme ABN Personal , - Member RSE Registration Insurance number Booklet R

16 Personal statement page 2 Section B - Personal statement 1. Do you engage in any hazardous pastimes or pursuits such as, but not limited to, football (other than touch or Oztag), motorised sports, parachuting, hang-gliding, abseiling, mountaineering activities, aviation (other than a fare paying passenger), scuba diving or any sport(s) in a professional capacity? No Yes A 2. Have you: a) Recently applied for or do you have a policy for life, total and permanent disability, trauma or salary continuance? No Yes B b) Ever had an application for life, disability, trauma, accident or sickness insurance on your life declined, deferred or accepted with a loading, exclusion or special terms? No Yes B c) Ever claimed a lump sum or accident or sickness benefit from any insurance policy, including but not limited to superannuation, workers compensation, disability pension or Veterans Affairs? No Yes B 3. Have you ever received medical advice, been treated for or diagnosed with back, neck, hip, shoulder, knee or elbow complaints, sciatica, disc or spine complaints, injury of any joint, bones or muscle, arthritis, gout or repetitive strain injury (RSI)? 4. Have you ever received medical advice, been treated for or diagnosed with depression or a mental disorder, including but not limited to stress, anxiety, chronic tiredness or lethargy, panic attacks, post traumatic stress, behavioural or nervous disorder, myalgia or fibromyalgia or chronic fatigue syndrome? No Yes C No Yes D 5. Have you received medical advice, undergone any treatment, investigation or operation for, or had: a) High blood pressure or raised cholesterol? No Yes E b) Cyst, mole, sunspots or melanoma? No Yes F 6. Have you: a) Taken any illegal drugs in the last five years? No Yes* b) Been advised or received counselling or treatment for alcohol or substance abuse? No Yes* c) Been infected with or tested positive for HIV/AIDS, Hepatitis B and/or C? No Yes* d) In the last five years, ever engaged in unprotected male to male sexual intercourse or worked as or engaged the services of a prostitute? No Yes* 7. Have you received medical advice, undergone any treatment, investigation or operation for, or had: a) Heart complaint, stroke or neurological disorder, including multiple sclerosis? No Yes G b) Cancer, leukaemia, diabetes or chronic kidney complaint? No Yes G c) Asthma (other than childhood), bronchitis or any other lung complaint requiring hospitalisation? No Yes G 8. Apart from anything already stated: a) Are you considering seeking medical advice, treatment, tests or surgery in the future? No Yes G b) Have you, in the last five years, received any medical advice, any medical treatment, investigation or had any operation not mentioned above (apart from colds, flu, contraceptive advice)? No Yes G 9. To the best of your knowledge, have any of your natural parents, brothers or sisters suffered from or been diagnosed with: a) Heart or circulatory problems, stroke, high blood pressure, diabetes? No Yes H b) Depression or any other mental illness? No Yes H c) Cancer of any type? No Yes H d) Huntington s disease, muscular dystrophy, polycystic kidney disease or any other hereditary disease? No Yes H Have you answered yes to any questions (1 to 5) or (7 to 9) in Section B? No Go straight to Section E. Do not complete Section C or D. Yes For each yes answer you must complete a corresponding questionnaire, as noted in the column beside your yes answer above. Proceed to relevant questionnaire in Section C. *If you have answered `yes to question 6, a confidential questionnaire will be sent to you.

17 Personal statement page 3 Section C - Questionnaire A - Pastimes questionnaire Only complete if you answered yes to question 1 of Section B Personal statement 1. Do you engage in any of the following hazardous pastimes or pursuits? a) Flying (other than as a fare paying passenger on a commercial airline) No Yes b) Underwater diving (scuba) If yes (i) do you dive more than 40 metres in depth? No Yes (ii) do you dive alone? No Yes c) Football of any code (other than touch or Oztag) No Yes d) Motor sports of any kind, e.g. motor cross, rally driving, ocean racing, motor car or bike racing No Yes e) Trail bike riding No Yes f) Any other sport or hazardous activity, e.g. parachuting, hang-gliding, body contact sports, para-gliding, competitive water sports or recreations involving heights. No Yes If you have answered yes to any of the above questions, please answer the following questions: What are the activity(ies) you engage in? At what level do you participate? (tick ( ) the appropriate box) Recreational only (non competition) Recreational with competition Semi-professional/professional Number of times you participate on average in this activity(ies) per annum, e.g. hours flown, number of dives, events. Do you receive income from participating in this activity(ies)? No Yes Section B - Insurance history questionnaire Only complete if you answered yes to any part of question 2 of Section B Personal statement 1. Other than this application, do you have or have you recently applied for life, total and permanent disability, trauma, or salary continuance on your life with CommInsure, or any other insurance company? If yes, please provide details below: No Yes Insurance company Type of cover Insurance benefit To be replaced? Date commenced $ No Yes / / $ No Yes / / $ No Yes / / 2. Has an application for life, total and permanent disability, trauma, or salary continuance on your life ever been declined, deferred or accepted with a loading, exclusion or special terms? If yes, please provide details below: Insurance company When was the decision made on the application? Terms offered and reason No Yes 3. Are you claiming or have you ever claimed a benefit from any source, e.g. TPD benefit, from any superannuation fund, Workers Compensation, Disability Pension, Veterans Affairs or any other insurance policy providing accident or sickness benefits? If yes, please provide details below: No Yes Benefit type/source/reason for claim Date commenced Claim amount Date finalised / / $ / / / / $ / / / / $ / /

18 Personal statement page 4 Questionnaire C - Joint/musculoskeletal questionnaire Questionnaire D - Mental health questionnaire Only complete if you answered yes to question 3 of Section B Personal statement 1. Nature of complaint (doctor s diagnosis), e.g. sciatica, back pain, broken bone. Only complete if you answered yes to question 4 of Section B Personal statement 1. Please provide details of the condition (doctor s diagnosis): 2. Location of complaint, e.g. lower back, right knee, sciatic nerve. 3. When did symptoms first begin? 4. Cause of condition, e.g. lifting, car accident, fall in workplace, unknown. 2. Please indicate the reason or cause by ticking the appropriate box(es): Bereavement/family illness Marital problems Post natal Work related Other (please specify) 3. Date symptoms first commenced: 5. Was an x-ray or scan taken? No Yes If yes, please complete the details below: / / 4. Have the symptoms ceased? Date of most recent test Details of results of tests taken: / / No Yes If yes, please provide the date symptoms ceased: / / 5. Have you taken or are you taking medication? 6. Is the nature of the condition degenerative or a disc problem? No Yes 7. Are you still undergoing treatment or experiencing symptoms? No If no, please complete the details below: Yes Date symptoms ceased Date treatment ceased / / / / 8. Have you been off work as a result of this complaint or been unable to perform your normal day to day activities? No Yes If yes, please indicate period(s) off work: No Yes If yes, please provide details of the type of medication, including dosage: 6. Are you currently taking medication? No Yes 7. Have you ever been hospitalised? No Yes If yes, please indicate period(s) hospitalised: 8. Did the condition ever cause you to take time off work? No Yes If yes, please indicate period(s) off work 9. Do you have any residual, ongoing effects or restrictions as a result of this condition? No Yes If yes, please provide dates and details: 9. Has your ability to perform daily activities been restricted in any way? No Yes If yes, please provide dates and details: 10. Is your treating doctor different from your usual doctor? No Yes If yes, please complete the details below: Name of doctor 10. Is your treating doctor different from your usual doctor? No Yes If yes, please complete the details below: Name of doctor Doctor s address Doctor s address State Postcode State Postcode Phone number Fax number Phone number Fax number

19 Personal statement page 5 Questionnaire E - High blood pressure Raised cholesterol questionnaire Questionnaire F - Cysts, moles, sunspots or skin lesion questionnaire Only complete if you answered yes to question 5a of Section B Personal statement Only complete if you answered yes to question 5b of Section B Personal statement 1. Name of condition High blood pressure Raised cholesterol 2. When were you first diagnosed with this condition? 1. Please provide type: Cyst Mole Sunspot Skin lesion Melanoma Other Basal cell carcinoma please specify: 3. Do you have any problems or complications resulting from this condition? e.g. heart disease, chest pain? No Yes If yes, please provide details: 4. Are you taking regular medication for this condition? 2. Location of growth(s) Face/head Back/shoulder Arm/leg 3. When was this? Chest/front No Yes If yes, please provide details, including dosage: 4. Was/were the growth(s) removed? 5. Blood pressure When was your last blood pressure reading? / / Was it considered to be well controlled, e.g. less than 140/90? No Yes Don t know Cholesterol When was your last cholesterol reading? / / What was the result of your last cholesterol reading? 2.0 to 5.9 mmol 6.0 to 6.9 mmol 7.0 or above Don t know 6. Is your treating doctor different from your usual doctor? No Yes If yes, please complete the details below: Name of doctor No Yes If yes, please complete below: When was it removed? Number of growths removed: One Three Two More / / Method of removal: Frozen/burnt off Surgical/cut out 5. Was/were the growth(s) reported as cancerous (malignant)? No Yes If yes, were any further tests, investigations, treatments, follow up or re-excision required? No Yes If yes, please provide dates and details of further tests, investigations, treatments, follow up or re-excision: Doctor s address State Phone number Postcode Fax number 6. Is your treating doctor different from your usual doctor? No Yes If yes, please complete the details below: Name of doctor Doctor s address State Phone number Postcode Fax number

20 Personal statement page 6 Questionanaire G - Personal and medical details questionnaire Only complete if you answered yes to any part of question 7 and/or 8 of Section B Personal statement 1. When did you last consult a doctor? Within the last month 1 to 3 months ago 3 to 6 months ago 6 to 12 months ago 12 months to 2 years ago a) What was the reason for this consultation? Over 2 years ago b) What was the result/outcome from your last consultation? (tick ( ) the appropriate box) Referral to specialist/health professional Ongoing treatment e.g. Ventolin inhaler Tests conducted results pending Routine tests conducted results all clear/normal All clear/normal/full recovery no tests or prescribed treatment required (other than contraceptive and cold/flu medication) c) Was the doctor/medical centre consulted, your usual doctor/medical centre? No Yes Name of doctor Not fully recovered yet If you have been a patient of this doctor for less than 12 months, please provide details of your previous doctor/medical centres: Doctor s address State Postcode Phone number Fax number 2. This question is for females only, otherwise please continue to question 3. a) Are you currently pregnant? No Yes If yes, what is the due date for your baby? / / b) Have you ever had any complications with pregnancy or childbirth? (e.g. diabetes, ectopic pregnancy) No Yes If yes, please provide details and dates below c) Have you ever had an abnormal result for any of the following tests? i) Pap smear No Yes ii) Breast ultrasound No Yes iii) Mammogram No Yes If yes, please provide details and dates below d) Have you ever had a breast lump or breast cyst (even if you have not consulted a doctor)? No Yes If yes, please provide details including dates and results of treatments.