Product Disclosure Statement and Policy Document

Transcription

1 Product Disclosure Statement and Policy Document Call or visit coles.com.au/insurance Life Insurance Issue: 01 June 2015 Issued by: MetLife Insurance Limited Phone: Coles Life Insurance 1

2 Who is the Insurer of Coles Life Insurance? Coles Life Insurance is underwritten and issued by MetLife Insurance Limited (MetLife) ABN , Australian Financial Services Licence No , Level 9, 2 Park Street, Sydney NSW MetLife has sole responsibility for the PDS along with the assessment and payment of claims, and only MetLife as the insurer can issue, vary or cancel Coles Life Insurance policies. What is the role of Coles Financial Services in relation to Coles Life Insurance? Coles Life Insurance is promoted and distributed by Coles Financial Services Pty Ltd (ABN ), ABN , Authorised Representative No (Coles), 800 Toorak Road, Tooronga, Melbourne VIC Coles has been appointed as an authorised representative of MetLife. Coles is a wholly owned subsidiary of Wesfarmers Limited ABN Welcome to Coles Life Insurance Welcome to Coles Life Insurance. We believe life insurance doesn t need to be complicated or expensive, which is why we offer affordable, easy-to-understand protection for you and your loved ones. Plus, we re backed by MetLife, one of the world s largest insurers with over 90 million customers worldwide, so rest assured that you and your loved ones are in safe hands. Please read through this Product Disclosure Statement and Policy Document carefully and if you have any questions about your cover please call us on , we ll be happy to help you. ABOUT THE INSURER MetLife MetLife Insurance Limited (MetLife), an affiliate of MetLife, Inc., is a specialist provider of life insurance to affinity partners, superannuation trustees and employers in Australia. MetLife has expertise in designing and executing both direct insurance programs for partners customers and insurance solutions to meet the needs of specific member groups. MetLife has been a specialist provider of life risk insurance products in Australia since MetLife, Inc. (NYSE: MET) is a leading global provider of insurance, annuities and employee benefit programs, servicing 90 million customers. Through its subsidiaries and affiliates MetLife, Inc. holds leading market positions in the United States, Japan, Latin America, Asia Pacific, Europe and the Middle East. Coles is a trademark of Coles Financial Services Pty Ltd (ABN ) used by MetLife Insurance Limited under licence. 2 Coles Life Insurance

3 Contents Explaining the Product Disclosure Statement EXPLAINING THE PRODUCT DISCLOSURE STATEMENT 1 How to read this document 1 What documents make up my Policy? 1 Updating Our PDS 1 Introducing Coles Life Insurance 2 Who can apply? 2 COVER AMOUNTS 2 Large Cover Level discount 3 PREMIUM OPTIONS 3 Stepped Premium 3 Level Premium 3 COVER BENEFITS 4 Life Cover Benefit 4 Life Cover for Accidents only 4 Terminal Illness Benefit 4 Funeral Advancement Benefit 4 Future Life Events Benefit 5 Can I adjust my Cover Level? 5 Can I reduce my level of cover? 5 Can I increase my level of cover? 6 What isn t covered under my Policy? 6 Accidental Injury Cover 6 What if I suffer multiple injuries? 7 What if I have Osteoporosis? 8 Can I submit multiple Dislocation claims? 8 What is not covered under Accidental Injury? 8 When will Accidental Injury Cover end? 9 Kids Cover 9 What if my child suffers a Fracture? 9 What if my child becomes seriously ill or dies? 10 When will my Policy commence? 11 When will my policy end? 11 Choosing my Policy beneficiary(ies) 11 How to make a claim? 12 Indexation Benefit 12 Guaranteed renewable 12 Premium payment options 12 Are my premiums or benefits taxed? 12 Cooling off period 13 Your duty of disclosure 13 Your Privacy 14 Government taxes and charges 14 Non-payment or late payment of premium 15 Reinstating a lapsed policy 15 Are there any risks in taking out a Life Insurance Policy? 15 Policy ownership 15 Customer Service and Dispute Resolution 16 Statutory funds 16 Australian currency 16 No cash value 16 Applicable law 16 GLOSSARY 17 Direct Debit Request Service Agreement 22 This Product Disclosure Statement and Policy Document (PDS) is designed to help you decide if Coles Life Insurance is right for you. Any advice given in the PDS is general advice and does not take into account your individual objectives, financial situation or needs. You should read this PDS and consider if Coles Life Insurance is right for you. Some PDS s can be difficult to read with a lot of information and legal jargon. We have tried to make this document easy for you, the Insured Person who is also the Policy Owner, to read with plain language. This document includes the Policy terms and conditions. So there are no hidden surprises as all the important information of this product is in the one place - this document. How to read this document We, us and our means MetLife Insurance Limited ABN AFSL You and your means the Policy Owner who is also the Insured Person who has been accepted by us and is shown in your Schedule. Some words or expressions have special meaning. They begin with capital letters and their meaning is explained in the Glossary (page 17) section of this PDS. What documents make up my Policy? If you decide to purchase Coles Life Insurance, your Policy will consist of the following documents: this PDS and any Supplementary Product Disclosure Statement (SPDS) we may subsequently provide to you; your Schedule; your application; and any other endorsements or other notices we may give you in writing. Please keep these documents in a safe place. Updating Our PDS All the information contained in this PDS is current at the time of issue. We may change or update any information from time to time. If the change is not materially adverse, we may notify you about the change by posting an update on If we make a change to your Policy which is adverse to you, we will, if you make a claim, assess your claim on the terms of the Policy before the change took place. 4 Coles Life Insurance Coles Life Insurance 1

4 Introducing Coles Life Insurance Coles Life Insurance is designed to provide affordable financial protection for you and your loved ones by providing a lump sum payment in the event of your death or if you become terminally ill. There are also other great features available under Coles Life Insurance: Advance payment of $10,000 to assist with costs associated with arranging a funeral or other similar expenses. Cover Levels ranging from $100,000 to $1 million. Freedom to increase your Cover Level without the need for health and lifestyle assessments for specified life events through the Future Life Events Benefit. A choice between Stepped or Level premium options to best suit your financial situation. Optional Accidental Injury Cover provides a payment if you suffer a listed injury, which can help you with medical expenses. Optional Indexation Benefit to ensure your Cover Level stays in line with inflation. Optional Kids Cover - to provide parents with peace of mind against life s ups and downs. Your Policy is guaranteed for the life of your Policy, as long as your Premiums are maintained. Cover 24 hours a day, world-wide. Flexible payment options - fortnightly, monthly or yearly. No Policy expiry age. Who can apply? To apply for Coles Life Insurance, you must: be aged between 18 and 55; and have received this PDS in Australia; and be an Australian citizen or New Zealand citizen or permanent resident and residing in Australia at the time of applying; or be aged between 18 and 55; and hold a current 457 Visa and currently reside in Australia. Large Cover Level discount If you have chosen a Cover Level of $500,000 or greater you will automatically receive a 20% discount off your Premiums. Premium Options There are two ways of calculating your premiums which is more suitable for you? Stepped Premium The Premium is calculated each year based on your age and will generally increase as you get older and if the Indexation Benefit is selected (see page 12). Your Premium is guaranteed not to change for 12 months from your Policy Commencement Date. We may change the premium rate for all policies of the same kind by providing you with at least 30 days written notice. If we adjust our premium rates, you will be charged the new Premium from your next Policy Anniversary. Level Premium The Premium is calculated based on your age when your Policy commences and will remain the same until the Policy Anniversary after your 60th birthday (unless the Indexation Benefit on page 12 is selected). On the Policy Anniversary after your 60th birthday, your Premium will automatically convert to Stepped Premium. Any increases or decreases to your Cover Level will automatically result in your Premiums being adjusted to reflect the new Cover Amount. The diagram below provides an example of premium across the Stepped and Level Premium options: MONTHLY PREMIUM Cover Amounts Depending on the level of cover you think you need, you can apply for as little as $100,000 or as much as $1,000,000. The most we will pay across all Coles Life Insurance Policies issued by us for the same Insured Person is $1,000,000 (plus indexation) Stepped Level AGE The above example diagram is based on a 35 year old female, non smoker, with a Cover Level of $500,000 at standard rates. 2 Coles Life Insurance Coles Life Insurance 3

5 Your Premium pays for your Policy, government fees and charges and administration costs. The premium rate is based on the following factors: your age, gender, smoking status, any applicable health loadings and any discounts that we may apply, in our discretion, from time to time. Deciding which premium structure is up to you and may depend on your lifestyle at the time. However, you do have the option of changing your premium structure anytime during the life of your Policy. If you wish to do so, please call us on Cover Benefits Life Cover Benefit This benefit will provide a lump sum payment on your death to your Nominated Beneficiary(ies) or your Legal Personal Representative of your estate. Life Cover for Accidents only Depending on the health information you provide when you apply for Coles Life Insurance, there may be situations where we will offer you Coles Life Insurance for claims arising from Accidents only. If you accept this offer, the terms will be clearly stated in your Schedule. The maximum Cover Amount for Life Cover for Accidents only is $500,000 (plus indexation). Terminal Illness Benefit If you are diagnosed with a Terminal Illness, we will advance your Life Cover Benefit to you to provide you with financial support. You can use this payment however you wish. Payment of the Life Cover Benefit, as a result of a Terminal Illness claim, will end your Policy. Terminal Illness: means a Sickness which you have been diagnosed with, that in our opinion, having considered any evidence we may require, means that your life expectancy is not greater than 12 months, regardless of any available treatment. If a claim for a Terminal Illness Benefit is made and you die before the benefit is paid, a claim for a Life Cover Benefit will instead be assessed. Funeral Advancement Benefit A Funeral Advancement Benefit means we will advance $10,000 of your Life Cover Benefit, when we receive satisfactory evidence, to your Primary Beneficiary (if applicable, Choosing my beneficary(ies) section on page 11, or to your Legal Personal Representative. This benefit can assist with the cost of funeral expenses and is usually paid within 24 hours of receiving the necessary claim requirements ( How to make a claim section on page 12). A payment of the Funeral Advancement Benefit is not an acceptance to pay the balance of the Life Cover Benefit under this Policy. Can I adjust my Cover Level? Future Life Events Benefit This benefit allows you to increase your Cover Amount without the need for more health questions as long as: you are aged 55 years or younger; and your current Life Cover Benefit Cover Amount is a minimum of $200,000, this benefit allows you to increase your Life Cover Benefit Cover Amount by $100,000 when the following life events occur (and we have received evidence of the event occurring): your 2nd Policy Anniversary; you get married; if you or your Partner gives birth or adopts a Child; when your Child starts high school for the first time; you purchase a home; or your Partner dies. It s easy to apply for this benefit, simply contact us on for a Future Life Events Benefit application form, complete it and return it to us. The following conditions apply: you can increase your Cover Level using the Future Life Events Benefit up to 5 times over the life of the Policy; your application for a Future Life Events Benefit must be made within 12 months after the event occurring; your original Policy terms will apply to the increased Cover Amount; your Premium will be adjusted based on the increased Cover Amount; any increases will be subject to the maximum cover limit (see the Cover Amount on page 2 or $500,000 if Life Cover for Accident only applies); and this benefit cannot be applied for if you are entitled to make, or are receiving or seeking payment of, a claim under any Coles life insurance policies. Can I reduce my level of cover? Yes, Coles Life Insurance provides you with the flexibility to reduce your Cover Level to a minimum of $100,000 at any time. After your 60th birthday you can request to have your Cover Amount as low as $50, Coles Life Insurance Coles Life Insurance 5

6 Can I increase my level of cover? You can apply to increase your cover at any time. If we agree to increase your Cover Amount, it will be subject to the entry age, maximum cover limits and our acceptance of your health and lifestyle responses. If you ever want to change your Cover Amount, call Coles Life Insurance Customer Service Centre on and we will be happy to help you. What isn t covered under my Policy? It s important to let you know what isn t covered under your Policy. We will not pay any Life Cover, Terminal Illness, Funeral Advancement Benefits if the event giving rise to the claim, directly or indirectly, is as a result of an intentional self-inflicted act within 13 months of your Policy Commencement Date, the date of reinstatement or the date you increased your cover (in respect of the increased portion of cover including increases under the Future Life Events Benefit and Indexation Benefit). To see what isn t covered under Accidental Injury Cover, please refer to page 8. To see what isn t covered under Kids Cover, please refer to page 10. Accidental Injury Cover Accidental Injury Cover is an optional benefit that provides a Specified Cover Amount if you suffer a Specified Injury as a result of an Accident. A separate premium will be charged if this option is selected. The amount that is paid depends on the type of Specified Injury. See the table below for all the details. Specified Injury Specified Cover Amount Loss of limbs or sight $50,000 Single loss of limb or eye $25,000 Fractures Hip $10,000 Pelvis (excluding sacrum) Thigh shaft Skull (excluding bones of the face or nose) $7,500 Lower leg (excluding foot), kneecap or ankle $5,000 Vertebrae Arm (including elbow, excluding wrist) $4,000 Sternum Collarbone $1,500 Foot (including heel, excluding toes) Hand (excluding thumbs and fingers) Jaw (excluding cheekbone) Shoulder blade Wrist Cheekbone $500 Coccyx Eye socket Nose Rib or ribs Sacrum Dislocation Hip $7,500 Ankle, elbow, knee, wrist $1,500 Shoulder $500 Burns Severe burns to at least 20% of body surface or 50% $25,000 of face Severe burns to at least 4% but less than 20% of body $15,000 surface Severe burns to at least 50% of hand surface of either $8,000 hand What if I suffer multiple injuries? If you suffer more than one of the injuries (as listed above) at the same time, we will only pay a benefit for the Specified Injury with the higher Specified Cover Amount. Example: If you were to Dislocate your ankle and Fracture your nose as a result of the same Accident, we will only pay for the Dislocated ankle as it is the higher lump sum payment. 6 Coles Life Insurance Coles Life Insurance 7

7 What if I have Osteoporosis? If you have been diagnosed with Osteoporosis before your Policy Commencement Date, the maximum number of claims which can be made for the listed Fractures over the life of the Policy is 2. If you are diagnosed with Osteoporosis after your Policy Commencement Date, the maximum number of claims which can be made for the listed Fractures following that diagnosis is 2, including (if applicable) the claim we paid which led to the diagnosis of Osteoporosis. Can I submit multiple Dislocation claims? A Specified Cover Amount for Dislocations of the same body part will only be paid once over the life of the Policy. Example: If you Dislocated your right shoulder and a payment is made, we won t pay any subsequent claims for a right shoulder Dislocation. What is not covered under Accidental Injury? We will not pay any Accidental Injury Specified Cover Amount if your Specified Injury is as a direct or indirect result of: your intentional self-inflicted act; you working in an occupation: at heights above 15 metres; underground in the mining industry; while carrying a firearm; with explosives; offshore in the oil, gas or petroleum industry; or overseas as part of your service in the armed forces. you attempting to engage in or engaging in: aviation or aerial pursuit activities other than as a fare paying passenger on a commercial airline on regular scheduled flights; riding on or driving in any motorised vehicle engaged in any race, speed or reliability trial on any waterway, racing course, speedway or racing track; mountaineering, abseiling, rock climbing, canyoning; or diving to a depth of 45 metres or more, potholing, wreck diving or diving in a cave. you being under the influence of alcohol or drugs, other than those prescribed by a registered doctor and taken as directed. When will Accidental Injury Cover end? Accidental Injury Cover will end on the earliest of the following events: you asking us to cancel the Accidental Injury Cover; the date the Policy is cancelled due to non-payment of outstanding premiums or in accordance with our legal rights; your Policy ends due to a payment of the Life Cover Benefit or the Terminal Illness Benefit; your 85 th birthday; or you are paid a Specified Cover Amount for loss of limbs or sight. Kids Cover Kids Cover is an optional benefit that provides protection for each of your children or grandchildren aged between 2 and 17 (inclusive) at the time of application. A separate premium will be charged for each Child you decide to insure. To complete the application you must have a detailed knowledge of each Child s medical history. If this is not the case, please make appropriate enquiries about the Child s medical history before applying for Kids Cover. What if my child suffers a Fracture? For each Fractured arm, leg or skull the Insured Child suffers we will pay you a lump sum payment of $500. The maximum number of Fractures we will cover over the life of the Kids Cover policy is 10 and any payment made for Fractures won t reduce any other payment made under Kids Cover. 8 Coles Life Insurance Coles Life Insurance 9

8 What if my child becomes seriously ill or dies? We will provide a lump sum payment of $25,000 to you if the Insured Child dies or is diagnosed by a Registered Doctor as suffering from any of the events below: Blindness Brain damage Cancer (including leukaemia)* Cardiomyopathy Chronic kidney failure Deafness Encephalitis Intracranial brain tumour with impairment Loss of speech * Cover for Cancer (including leukaemia) will not start until 90 days after the Policy Commencement Date or the date the Kids Cover commences for the Insured Child. A lump sum illness payment of $25,000 will only be paid once per Insured Child. If your Policy ends (see the When will my Policy end section on page 11) and the Insured Child is under the age of 21, the Kids Cover can be transferred to another Policy of their parent, grandparent or legal guardian. If Kids Cover isn t transferred to another Policy, it will end. For an explanation of each of the events listed above, it is important you read the Glossary on page 17 of this PDS. What is not covered under Kids Cover? We will not pay any benefit if the event giving rise to the claim was caused directly or indirectly by: the intentional act of the Policy Owner or their Partner, the Insured Child s parent, legal guardian or their Partners; or a congenital condition affecting the Insured Child. When will Kids Cover end? Kids Cover will end on the earliest of the following events: the date your Policy ceases; the Insured Child turns age 21; Major head trauma Major organ failure Meningitis Meningococcal disease Paralysis Serious accidental injury Severe burns Single loss of limb or eye Terminal illness you asking us to cancel the Kids Cover benefit; the date the Policy is cancelled due to non-payment of outstanding premiums or in accordance with our legal rights; the date you have reached the maximum number of claims in respect of the insured child; or the date the Insured Child dies. When will my Policy commence? Your Policy will commence once your application has been accepted by us and we have received correct payment details. You will receive a schedule detailing the level of cover, the terms for which you have been approved and the date on which cover commenced. When will my Policy end? Your Policy will end on the earliest of the following events: you asking us to cancel the Policy; the date the Policy is cancelled due to non-payment of outstanding premiums or in accordance with our legal rights; the date the Terminal Illness Benefit is paid; or the date you die. Choosing my Policy beneficiary(ies) You can nominate who will receive the benefit payment in the event of your death. You may select up to five beneficiaries and the proportion of benefit each will receive. You are able to nominate your beneficiaries by completing and sending us the Nominations of Beneficiaries form which we will send you. You can change your nominations at any time and this form will set out the terms that apply to your nomination including who you can nominate (for example, your Partner or Children) and in what proportions. If you choose not to nominate any beneficiaries, payment of your benefits will be paid to the Legal Personal Representative of your estate. A Nomination of Beneficiaries form is available by calling us on Once you have completed the form you will need to return it to us. A nomination will not be binding until we have confirmed it to you in writing. 10 Coles Life Insurance Coles Life Insurance 11

9 How to make a claim? If you, your beneficiary(ies), family or your estate need to make a claim, you/they should contact us as soon as possible on We will send out a claims pack, which sets out in detail the information that is needed by us to assess and complete a claim. All amounts payable will be paid to you, your nominated beneficiary(ies) or your Legal Personal Representative. Payment of a benefit under this Policy will depend on the evidence to support the claim, to our satisfaction, as we may reasonably require. To ensure we are able to assess the claim quickly and accurately, please ensure we are provided with all the requirements set-out in the claims pack we provide. We must be fully satisfied with the information provided before a payment can be made. Indexation Benefit If you believe that your cover is sufficient to meet your needs, your cover will remain the same year on year. However, each year you have the option to accept the Indexation Benefit. If you accept the Indexation Benefit, your Cover Level will increase by the Indexation Factor (including the Kids Cover illness benefit and Accidental Injury Cover if selected, see page 6) and your Premiums will be adjusted accordingly. Guaranteed renewable As long as you have paid the Premiums when due, this Policy will automatically continue until the cover ends (see the When will my Policy end? section end on page 11). This guarantee applies regardless of any change in your health or personal circumstances. Premium payment options You can choose to pay your Premiums fortnightly, monthly or annually by direct debit from your nominated account or credit card (VISA or MasterCard). There are no additional fees or charges regardless of how you choose to pay your Premiums. Your Premium, the premium structure and the premium frequency you have chosen are stated in your Schedule. Are my Premiums or benefits taxed? Under current laws, benefits paid for the Life Cover, Terminal Illness and Funeral Advancement Benefits and Kids Cover and Accidental Injury Cover under this policy will not be assessed for income tax purposes and the Premiums are not tax deductible. Goods and Services Tax (GST) does not apply to the Premium. If the laws are altered, we reserve the right to increase Premiums or charges to reflect any applicable GST or any other Government taxes and charges that may be introduced. This information is based on current interpretation of tax law. If you have any concerns, we recommend you seek advice from a qualified professional in relation to your circumstances. Cooling off period Coles Life Insurance comes with a 30 day Cooling Off Period, which starts from the Policy Commencement Date, so that you have the time to review your Policy and ensure that it meets your needs. If you change your mind and wish to cancel your Policy during this time, provided that you have not made a claim, you will be entitled to a full refund of any Premiums paid on your policy. Your duty of disclosure Your duty of disclosure Before you enter into a life insurance contract, you have a duty to tell us anything that you know, or could reasonably be expected to know, may affect our decision to insure you and on what terms. You have this duty until we agree to insure you. You have the same duty before you extend, vary or reinstate the contract. You do not need to tell us anything that: reduces the risk we insure you for; or is common knowledge; or we know or should know as an insurer; or we waive your duty to tell us about. If you do not tell us something In exercising the following rights, we may consider whether different types of cover can constitute separate contracts of life insurance. If they do, we may apply the following rights separately to each type of cover. If you do not tell us anything you are required to, and we would not have insured you if you had told us, we may avoid the contract within 3 years of entering into it. 12 Coles Life Insurance Coles Life Insurance 13

10 If we choose not to avoid the contract, we may, at any time, reduce the amount you have been insured for. This would be worked out using a formula that takes into account the premium that would have been payable if you had told us everything you should have. However, if the contract has a surrender value, or provides cover on death, we may only exercise this right within 3 years of entering into the contract. If we choose not to avoid the contract or reduce the amount you have been insured for, we may, at any time vary the contract in a way that places us in the same position we would have been in if you had told us everything you should have. However, this right does not apply if the contract has a surrender value or provides cover on death. If your failure to tell us is fraudulent, we may refuse to pay a claim and treat the contract as if it never existed. Your Privacy We collect, use and retain personal information in accordance with the Australian Privacy Principles and the Privacy Act 1988 (Cth). We collect, use, process and store personal information and, in some cases, sensitive information about you, in order to comply with our legal obligations, to assess your application for insurance cover, to administer the insurance cover provided, to enhance customer service or products and to manage claims. If you do not agree to provide us with the information, we may not be able to process your application, administer your cover or assess your claims. In dealing with us, you agree to us using and disclosing your personal information as set out in this section and in our Privacy Policy. For further information about how we and Coles Financial Services handle your personal information, details of how you can access or correct the information we hold about you or make a complaint, you can access our Privacy Policy at insurance or contact us on Government taxes and charges We will pay any stamp duty, tax, excise or other charges of the Commonwealth, or of a State or Territory Government, which may apply to this Policy. However, we reserve the right to pass on these charges through the premium, and have the right to increase the premium to cover any increase in, or addition to, these charges. We will provide you with at least 30 days written notice of any changes. Non-payment or late payment of Premium If we do not receive the Premium payment when it s due, you will be sent a letter and allowed a grace period of 30 days beyond the Premium due date to pay the Premium. If you don t pay the Premium by the end of the grace period stated in your letter, your Policy will lapse (i.e. your Policy will be cancelled and you will no longer be covered). If this happens and you want to continue the cover at a later time, you will need to apply to have your policy reinstated. If a claim is payable after your Premium is due, but before your Policy lapses, we will pay the claim in line with the relevant Policy conditions. If this occurs, any outstanding Premiums will be deducted from the claim amount. Reinstating a lapsed Policy To apply to reinstate a lapsed Policy contact us on We may ask you to complete a reinstatement assessment and you will also be required to pay any premium that is in arrears. We will not pay claims for death or illness which occur in the time between a policy lapsing and it being reinstated. Are there any risks in taking out a Life Insurance Policy? Some of the risks with taking out a life insurance Policy include: the Policy may not suit your needs; the Cover Level may be insufficient; if we do not receive the Premiums when due, we may cancel the Policy in accordance with our legal rights and may not assess any claim that arises from an event which occurs after the cancellation date. It is important you ensure that the Policy meets your needs both now and into the future. You may wish to seek assistance from a financial adviser if you are not sure if this product suits your personal circumstances. Policy ownership The Insured Person listed in the Schedule is also the Policy Owner. There can only be one Policy Owner. You may not assign or transfer the ownership of your Policy. 14 Coles Life Insurance Coles Life Insurance 15

11 Customer Service and Dispute Resolution If you have an enquiry, wish to notify us of a change to your Policy (e.g. contact details), or if you have a complaint, please contact Coles Life Insurance on or write to Coles Life Insurance, GPO Box 4217, Sydney NSW We will strive to achieve the highest standard of customer service. If you have a complaint and you are not satisfied with our response, the Financial Ombudsman Service (FOS), an independent and impartial body, offers a free dispute resolution service. FOS can be contacted on , or write to The Executive Officer, Financial Ombudsman Service, GPO Box 3, Melbourne VIC 3001, or to info@fos.org.au. Statutory funds Legislation requires that life insurance companies in Australia divide their life insurance business between one or more statutory funds. Premiums for this Policy will be paid into MetLife s No. 1 Statutory Fund and any claims paid under this Policy will be paid from this fund. Australian currency All premiums and benefits payable under this Policy will be paid in Australian currency. No cash value Coles Life Insurance is not a savings plan and does not have investment cash or surrender value, it provides insurance cover only. If you pay your Premium fortnightly or monthly and you cancel your Policy after the cooling off period, you will not receive any Premium refund. If you pay your Premium annually and cancel your Policy after the cooling off period, you will receive a pro-rata premium refund. Applicable law This Policy is governed by the law that applies within the state of New South Wales. Glossary WHAT OUR WORDS MEAN This Policy uses words that have special meanings. To make sure you are aware of these words and their meanings, please see the below for more information. Accident: means an unintended and unexpected event which solely and directly causes Injury as a result of violent, external and visible means. Accidental Death: means death as a result of an Accident, and not attributable to any other event. The bodily Injury must have been sustained whilst this Policy is current and no earlier than 12 months before the date of death. Cover Amount / Level: means the amount of cover you apply for, and we accept, as varied (for example if you apply for a decrease or through increases under the Indexation Benefit or the Future Life Events Benefit) by agreement. Dislocation: means damage to a joint where one or more bones are completely out of place. It excludes partial dislocations, for example where the bone ends are out of place but still touching. Fracture: means the disruption in the continuity of the bone, with or without displacement, confirmed by radiographic or scanning technique. Stress fractures are excluded. Indexation Factor: means the percentage change in the consumer price index (CPI) which is the weighted average of the 8 Australian capital cities combined as published by the Australian Bureau of Statistics or anybody which succeeds it and in respect of the 12 month period finishing on 30 September. The Indexation Factor will be applied from 1 March the following year. If the CPI is not published by this date, the Indexation Factor will be calculated on a retail price index which we consider most nearly replaces it. Injury: means physical damage to your body which occurs while cover for the applicable benefit is in force under this Policy. Insured Child: means a child who has been accepted by us and is listed in your Schedule as the insured child under Kids Cover. 16 Coles Life Insurance Coles Life Insurance 17

12 Insured Person: means the person who has been accepted by us and is listed in your Schedule as the Insured Person under the Policy. Legal Personal Representative: is the executor or administrator of your estate, or any other person(s) who is authorised by law to administer and distribute your estate. Loss of limbs or sight: means the total and permanent loss of use of: both feet; both hands; the sight in both eyes (to the extent of 6/60 or less); or any combination of at least two of: a hand, a foot or sight in an eye (to the extent of 6/60 or less). Nominated Beneficiary(ies): is the person(s) you nominate using the Nomination of Beneficiaries form to receive the Life Cover Benefit and Funeral Advancement Benefit under your Policy. Partner: means a person living with you as your spouse on a domestic basis in good faith. He or she can be the same sex as you. Policy: means your Coles Life Insurance policy, which consists of the PDS and any SPDS, your Schedule, your application and other endorsements or other notices we may give you in writing. Policy Anniversary: the anniversary of the Policy Commencement Date. Policy Commencement Date: means the date we accept your application for cover as shown in your Schedule. Policy Owner: means the person listed in your Schedule as the owner of this Policy. Premium: the amount you pay us for the insurance. Primary Beneficiary: is the person you list first in your Nomination of Beneficiaries form. Registered Doctor: is a doctor who is legally qualified and properly registered. The doctor cannot be you or a member of your family. If practising outside Australia, the doctor must have qualifications equivalent to Australian Standards. Schedule: a document issued by us which shows important information about your Policy, including your Policy number, Premiums, special conditions (if applicable) and Policy Commencement Date. Sickness: means an Illness or disease you suffer while cover for the applicable benefit was in force under this Policy. Specified Cover Amount: means the amount payable under Accidental Injury Cover (if it applies to your Policy), as stated in this document (PDS), relating to the Specified Injury under the Policy. Specified Injury: means an Injury for which a Specified Cover Amount may be paid under Accidental Injury Cover (if it applies to your Policy). Terminal Illness: means a Sickness which you have been diagnosed with, that in our opinion, having considered any evidence we may require, means that your life expectancy is not greater than 12 months, regardless of any available treatment. We, us and our: means MetLife Insurance Limited ABN AFSL You and your: means the Policy Owner who is also the Insured Person who has been accepted by us and is shown in your Schedule. Your Child/Children: means your birth, adopted, step child, grandchild or someone who is your child within the meaning of the Family Law Act ACCIDENTAL INJURY COVER MEDICAL DEFINITIONS Dislocate: means damage to a joint where one or more bones are completely out of place. It excludes partial dislocations, for example where the bone ends are out of place but still touching. Fracture: means the disruption in the continuity of the bone, with or without displacement, confirmed by radiographic or scanning technique. Stress fractures are excluded. Osteoperosis: means a condition where the bones become brittle and fragile from loss of tissue KIDS COVER MEDICAL DEFINITION Blindness: means the complete and irrecoverable loss of the sight of both eyes (whether aided or unaided) as a result of Sickness or Injury. Brain damage: means as a result of an Accident, Sickness or Injury, the Insured Child suffers brain damage causing neurological and/or cognitive deficit, which results in the Insured Child suffering at least 20% permanent impairment of whole person function*. Cancer: means the presence of one or more malignant tumours including malignant lymphoma, Hodgkin s disease, leukaemia, multiple myeloma, malignant bone marrow disorders and melanomas greater than or equal to Clark Level 3 or greater than or equal to 1.5mm depth of invasion or where melanoma is showing signs of ulceration as determined by histological examination. 18 Coles Life Insurance Coles Life Insurance 19

13 The following tumours are excluded: Tumours which are histologically described as pre-malignant or show the malignant changes of carcinoma in situ. Melanomas which : have no evidence of ulceration are less than Clark Level 3, and are less than 1.5mm depth of invasion, as determined by histological examination. All other types of skin cancers unless they have metastasised. Cardiomyopathy: means the impaired ventricular function of variable aetiology, resulting in permanent and irreversible physical impairment. Chronic kidney failure: means the end stage renal failure presenting as chronic irreversible failure of the function of both kidneys. Congenital condition: means one which develops during pregnancy or is diagnosed shortly after birth. Deafness: means the total and permanent loss of hearing, both natural and assisted, from both ears as a result of sickness or injury. Assisted hearing is not excluded if the loss of hearing is treated by cochlear implant. Encephalitis: means the unequivocal diagnosis of encephalitis where the condition is characterised by severe inflammation of the brain, that results in the Insured Child suffering at least 25% permanent impairment of whole person function*. Fracture: means the disruption in the continuity of the bone, with or without displacement, confirmed by radiographic or scanning technique. Stress fractures are excluded. Intracranial brain tumour with impairment: means the diagnosis of a non-cancerous tumour either in the brain tissue or between the brain tissue and the cranium giving rise to symptoms of increased intracranial pressure such as papilloedoma, mental symptoms, seizures, sensory impairment and motor impairment. Loss of speech: means the total loss of speech both natural and assisted for at least six months and the subsequent diagnosis that loss of speech both natural and assisted will be total and permanent. Loss of speech related to any psychological causes is excluded. Major head trauma: means any injury to the head which results in the Insured Child suffering at least 25% permanent impairment of whole person function*. Major organ failure: means the Insured Child suffering major organ failure resulting in either an organ transplant, or on specialist medical advice the Insured Child is placed on an official Australian acute care hospital waiting list to undergo organ transplant, from a human donor of one or more of the following: kidney heart liver lung pancreas, or bone marrow. Meningitis or Meningococcal disease: means the unequivocal diagnosis of meningitis where the condition is characterised by severe inflammation of the meninges of the brain or septicaemia, that results in the Insured Child suffering at least 25% permanent impairment of whole person function*. Paralysis: means the total and permanent loss of use of one or more limbs resulting from spinal cord injury or disease, or from brain injury or disease. Serious accidental injury: means Injury which has resulted in the Insured Child being confined to an acute care hospital for a period of 30 consecutive days (24 hours per day) under the full-time care of a Registered Doctor. Severe burns: means Accidental burns that involve damage or destruction of the skin to its full depth through to the underlying tissue. Single loss of limb or eye: means the total and permanent loss of use of: one foot; one hand; or sight in one eye. Terminal illness: means a Sickness which the Insured Child have been diagnosed with, that in our opinion, having considered any evidence we may require, means that the Insured Child life expectancy is not greater than 12 months, regardless of any available treatment. * As defined in the American Medical Association publication Guides to the Evaluation of Permanent Impairment, 5th Edition. 20 Coles Life Insurance Coles Life Insurance 21

14 Direct Debit Request Service Agreement The following terms and conditions relate to the use of direct debit payments from your nominated account or credit card. You (or the Account Holder if different to you) will need to keep this document with your records. 1) You are responsible for ensuring the nominated account can accept direct debits and there are sufficient clear funds available in the nominated account to permit payments on the due date. 2) MetLife will initiate debits from your nominated account or credit card in accordance with your application form. 3) MetLife agrees to provide no less than 14 days notice to you if it proposes to vary these arrangements. 4) You may request deferment of, or alteration to, the agreed drawing schedule by writing to: Coles Life Insurance, GPO Box 4217, Sydney NSW MetLife reserves the right to decline this request. 5) You (or the Account Holder if different to you) can cancel, defer the direct debit, or suspend an individual debit from taking place under it by notifying MetLife by telephone, fax, or in writing. you need to allow MetLife 14 days to process any cancellation, deferment or suspension. 6) In the event you disagree with any debit under the arrangement with MetLife, you should call us on or write directly to The Dispute Resolutions Officer at the address in point 4. 7) Direct debits will be done on the same date of the relevant month unless otherwise agreed. When the due date for payment falls on a day that is not a business day, MetLife will debit your account on the next business day. 8) In the event that your financial institution refuses to pay any direct debit made under the arrangement, MetLife will write to you requesting alternative payment. 9) MetLife will keep any information (including your account details) in your Direct Debit Request confidential. We will make reasonable efforts to keep any such information that we have about you secure and to ensure that any of our employees or agents who have access to information about you do not make any unauthorised use, modification, reproduction or disclosure of that information. We will only disclose information that we have above you: a. to the extent specifically required by law; or b. for the purpose of this agreement (including disclosing information in connection with any query or claim). 10) Initially, you should direct any request for stops or cancellations to MetLife. How to contact us Phone: lifeinsurance@colesfinancialservices.com.au www: Mail: Coles Life Insurance, GPO Box 4217, Sydney NSW Coles Life Insurance Coles Life Insurance 23

15 COLES LIFE INSURANCE Product Disclosure Statement and Policy Document LIFE INSURANCE Issue Date: 01 June 2015 Issued by: MetLife Insurance Limited Phone: MET /15 24 Coles Life Insurance