Group Insurance. Product Disclosure Statement. pr tect. Depend on our people to. your people

Transcription

1 Group Insurance Product Disclosure Statement pr tect Depend on our people to your people This booklet contains Product Disclosure Statements for: Group Life Group Salary Continuance Issue number 9, 28 June 2014

2 Contents Insurance overview 1 Group Life Insurance Policy: a snapshot 3 Group Life Insurance Policy: the detail 4 Group Salary Continuance Policy: a snapshot 10 Group Salary Continuance Policy: the detail 12 Additional information: Group Life and 20 Group Salary Continuance Trauma definitions 28 Definitions 31 Products in these Product Disclosure Statements have been available since 20 August 2012.

3 Insurance overview Definitions in this document This document contains defined terms which have a specific meaning. Terms that have a specific meaning are shown in italics. Please ensure that you refer to the Definitions section at the back of this document for full details on the defined terms. In this Product Disclosure Statement (PDS) and any relevant policy documentation, any references to us, we, our or the Insurer mean The National Mutual Life Association of Australasia Limited (NMLA) ABN AFS Licence No The NMLA is the issuer of this PDS and financial products described in this PDS. When referring in this document to the policy, we mean: the policy the schedule the Application form and any other associated papers any special conditions, exclusions or endorsements to the policy any notices issued or received by us under the policy, and any individual applications for cover by an eligible person, as the context requires. Unless otherwise specified, you or your refers to the policy owner who is either an employer that is a company or the trustee of a complying superannuation fund. Where the policy owner is the trustee of a complying superannuation fund, the employer refers to the employer sponsor of that fund. A person insured refers to a person who is either an insured employee of an employer where the policy is employer owned, or a member of a complying superannuation fund for a trustee owned policy. Information contained in this booklet This booklet provides a summary of the important terms and conditions of the Group Insurance products available from AMP. There are sections specific to each product, as well as sections with information that apply to all products. This information will help you to decide whether these products will meet your needs, as well as assist you in comparing the types of cover available with others that you may be considering. You should read this information in conjunction with the Policy Document and Policy Schedule (issued once we provide you with a quotation), which sets out in detail the terms and conditions of the cover and features under your policy and forms the basis of the contract between you as the policy owner and us as the Insurer. Before acting on the information in this PDS, you should consider the appropriateness of this information and consult a financial adviser. About AMP s Group Insurance AMP is a specialist risk Insurer and a leader in the Australian group insurance marketplace. We have been a significant force in the life insurance industry for more than 160 years and have a proven track record in the market. We are committed to meeting our clients needs for group insurance in a challenging superannuation and life insurance marketplace. AMP s brand and reputation are acknowledged as a leader in the Australian financial services market. AMP provides group insurance cover for more than 1,200,000 Australians. In addition, in 2013 AMP paid a total of $850.4 million in individual and group insurance claims. 1 One policy covers a number of people Our policies provide cover for a group of people with a shared commonality, such as a group of employees or complying superannuation fund members, and because these people are insured under the one contract of insurance, there can only be one policy owner. These are known as Group Insurance policies. Group Insurance policies vary in this way from the more common individual insurance policy. Rather than a contract existing between each person that is covered, there is only one contract between the policy owner and us. The terms and conditions of the insurance for persons insured are defined on a group basis rather than individually and the premiums are paid collectively to us. Which Group Insurance products are described in this document? Each product offered (Group Life (GL) insurance or Group Salary Continuance (GSC)) by AMP is a separate contract of insurance. You can combine the products you buy with a range of optional benefits. The two types of products available are: Group Life GL insurance includes death only or death and total and permanent disability cover. Death cover provides a lump-sum benefit upon death or terminal illness. Total and permanent disability (TPD) cover provides a lump-sum benefit if a person insured becomes totally and permanently disabled. GL insurance is outlined in the Group Life Insurance Policy section. 1 Source: Claims Paid 2013, AMP Life Limited and The National Mutual Life Association of Australasia Limited Claims. This figure includes insurance available through superannuation products and is net of tax. 1

4 Group Salary Continuance GSC insurance provides a person insured with a replacement income benefit if they are disabled and unable to work due to sickness or injury. GSC insurance is outlined in the Group Salary Continuance Policy section. The Additional information Group Life and Group Salary Continuance section applies to both GL and GSC. The Trauma definitions section applies to GSC. The Definitions section applies to both GL and GSC. When incorrect information is given to us We rely on the information provided to us in order to assess whether we will provide insurance cover for a person insured. If the information provided is not correct, in some circumstances we may be legally entitled not to pay the benefit. We may also be legally entitled not to pay the benefit if you have not complied with your duty of disclosure. The duty of disclosure is set out in the Application form you complete for a group insurance policy with us, in the forms completed when each person insured applies for cover, and in this PDS. The duty of disclosure applies not only to you in respect of your completion of the Application form for cover but also to any application for cover by each person insured as well as to any increase in the benefit of a person insured. Your duty of disclosure Before you enter into any contract of insurance with an Insurer, you have a duty to disclose to the Insurer every matter that you know, or a reasonable person in the circumstances could be expected to know, is relevant to the Insurer s decision whether to accept the risk and, if so, on what terms. You have the same duty to disclose those matters to the Insurer before they extend, vary or reinstate a contract of life insurance. However, your duty of disclosure does not require disclosure of a matter: that diminishes the risk to be undertaken by the Insurer that is of common knowledge that the Insurer knows or, in the ordinary course of its business, ought to know, or where the Insurer has waived disclosure. The duty of disclosure continues until you are informed that your application for insurance is accepted or declined. Non-disclosure If you fail to comply with your duty of disclosure or make a misstatement of relevant information and the Insurer would not have entered into the contract if the failure had not occurred, the Insurer may avoid the contract within three years of entering into it. If your non-disclosure or misstatement is fraudulent, the Insurer may avoid the contract at any time. If the Insurer is entitled to avoid a contract of life insurance the Insurer may, within three years of entering into it, elect by written notice not to avoid it but to reduce the sum you have been insured for in accordance with a formula that takes into account the premium that would have been payable if you had disclosed all relevant information to the Insurer. For cover other than death cover: the Insurer can elect to reduce the sum insured according to the formula referred to above at any time not just within the first three years of entering into the contract, or if the Insurer has not avoided the contract or varied the sum insured, it can vary the contract in a way that places the Insurer in the same position it would have been if the nondisclosure or misrepresentation had not occurred. Treatment of policies in exercising our rights In exercising its rights the Insurer has to treat some policies as comprising two or more separate contracts of life insurance and elect whether to apply their rights to each of them separately. A policy must be treated as if it comprises two or more contracts of life insurance if any of the following apply: it includes two or more different groups of provisions, there are two or more lives insured, or underwritten cover together with cover which is not underwritten, or is underwritten on different terms, applying to a life insured. 2

5 Group Life Insurance Policy: a snapshot This section forms part of the PDS for GL and should be considered in conjunction with the Additional information Group Life and Group Salary Continuance section and the Definitions section. GL pays a lump-sum benefit in the event of death, terminal illness or TPD, which can be used for any purpose including: paying off the mortgage or any other debts that may affect a person insured s family s financial future paying for funeral costs paying for child care or home help providing a reserve to use as income should the family income stop paying for disability-related costs including rehabilitation, or paying for changes to the person insured s and/or dependant s lifestyle, for example, to refit their home. Group Life insurance benefits and options The table below provides a summary of the cover available: Benefit Benefit description Superannuation Non-superannuation Death benefit Provides a benefit payment in the event of death. Terminal illness benefit Extended cover Interim cover Guaranteed renewable contract 24 hour worldwide cover We will make an advance payment of the death benefit if a person insured is terminally ill and has less than 12 months to live. Provides cover where a person insured leaves employment with the employer and ceases to be eligible for cover under the policy. Provides limited cover where a person insured or an eligible person who has not yet been accepted for cover is being underwritten. Provided the premiums are paid and the terms and conditions of the policy are met, we guarantee to renew the policy each year. Cover for a person insured is provided 24 hours a day depending on the circumstances of overseas travel. The following options are available through GL at an additional cost: Optional benefit Benefit description Superannuation Non-superannuation TPD benefit Life events cover Continuation option Provides a benefit if a person insured becomes totally and permanently disabled. Allows persons insured to increase their benefit without underwriting when any of the following events take place: marriage, divorce, birth or adoption of a child, taking out a mortgage on a primary residence, increasing a mortgage on a primary residence for renovations/ extension or a child turning 12. Allows persons insured who leave employment and cease to be eligible for cover under your Group Insurance policy to continue their cover under an individual insurance plan. 3

6 Group Life Insurance Policy: the detail The policy GL pays a lump-sum benefit if a person insured dies or is diagnosed with a terminal illness and has 12 months or less to live. TPD is also available as an optional benefit. GL insurance policies can provide benefits through a complying superannuation fund (superannuation policy) where a superannuation trustee owns the policy or a non superannuation policy (ordinary policy) where an employer (or like entity) owns the policy. Premiums for non-superannuation policies are paid into our No. 1 Statutory Fund. Premiums for superannuation policies are paid into our No. 4 Statutory Fund. The policy has no cash surrender value and neither you, nor a person insured, have access to ownership or any rights over the assets of the applicable statutory fund. Who can become a person insured? A person can become a person insured if they satisfy the eligibility criteria for cover under the policy, which you set (and we agreed), and the person is: a full-time permanent employee, or a contractor. The person must also be: aged 15 years or more, but less than age 70 for death cover and age 65 for TPD cover, on the day they were first eligible for cover, and an Australian resident. Cover will be granted in one of three ways: 1. The automatic acceptance terms. 2. The transfer terms, or 3. The underwriting terms. For further information on automatic acceptance terms, transfer terms and underwriting terms, please refer to the Additional information Group Life and Group Salary Continuance section of this PDS. Availability of cover Death benefits Entry age Maximum expiry age Maximum benefit amount Minimum number of persons insured per policy Minimum annual premium 15th to 70th birthday 80th birthday Unlimited (i) 10 $5,000 pa (ii) (i) Subject to automatic acceptance and underwriting terms. (ii) Exclusive of commission. Death benefit Death cover provides a lump-sum benefit in the event that a person insured dies. Terminal illness benefit If a person insured is diagnosed as terminally ill, we will make an advanced payment of the death benefit. The terminal illness benefit is an advance payment of the death benefit. The amount of the benefit we pay is what would have been applied when the person insured was first diagnosed as terminally ill. Extended cover If a person insured is no longer eligible for cover because they have left their employer and: the person insured did not cease work with the employer for reasons of injury or sickness, and we are not paying you, or you are not entitled to a benefit under the policy for the person insured, then we will automatically extend the person insured s existing cover free of charge. This is referred to as extended cover. Extended cover stops on the earlier of: 60 days after cover would have otherwise stopped the date the person insured attains the cover expiry age the date the person insured commences employment with a new employer the date the person insured makes a fraudulent claim, or the date a personal insurance plan issued by us under a continuation option (as described on page 8) commences in respect of the person insured. 4

7 In addition to the above, the following also applies to superannuation policies: in the case of the person insured directing the employer to remit all or part of their employer superannuation contributions to a superannuation fund other than the fund through which cover is provided under the policy, extended cover will cease on the date the first contribution has been remitted to the person insured s fund of choice (unless all premiums are fully funded by the employer and paid in addition to SG contributions). Interim cover If underwriting terms apply to an eligible person or a person insured because: automatic acceptance terms do not apply cover exceeds the automatic acceptance limit or the further underwriting limit, or they had applied for voluntary insurance or a voluntary increase to their cover, then we will provide them with interim cover in the event of accidental death. Interim cover starts from the date we receive the written application, in the form approved by us, for all, or the relevant part of the cover that is subject to underwriting terms in respect of the person insured or eligible person. The amount of the benefit provided under interim cover is equal to the amount of the benefit that is applied for, up to a maximum amount of $1.5 million. Interim cover automatically ends as soon as one of the following happens: we accept or limit the application for the benefit which is subject to underwriting terms 20 business days after we decline the application for the benefit which is subject to underwriting terms you, the person insured or eligible person withdraw the application for the benefit which is subject to underwriting terms 60 days pass from the date interim cover commenced, or cover stops due to any of the events listed in When cover for a person insured stops. In all other ways, the conditions of the policy apply to interim cover including the continued payment of the premium. Worldwide cover Cover for a person insured is available 24 hours a day, anywhere in the world, subject to the conditions outlined under Cover during overseas employment and travel. Optional benefits The following benefits may be applied for at an additional cost: TPD benefit Death cover continuation option, and TPD cover continuation option. Total and permanent disability benefit Availability of cover TPD benefits Entry age Maximum expiry age Age 80 Maximum benefit amount 15th to 65th birthday $5 million (i) (i) A maximum benefit amount of $3 million may be paid when a person insured satisfies part (a) Unlikely to work as per the TPD definition. When the benefit is greater than $3 million, the amount in excess of $3 million may only be paid when the person insured satisfies parts (b) Specific Loss or (c) Future Care, of the TPD definition. The TPD sum insured may be reduced from the 60th to 70th birthdays. See the conditions outlined under Reduction of TPD benefits for more details. From the person insured s 65th birthday, the maximum TPD benefit is $3 million. From the person insured s 70th birthday, the maximum TPD benefit is $250,000, and it will only be paid when the person insured satisfies parts (b) or (c) of the TPD definition. If a person insured meets the definition of TPD as outlined below, we will pay a TPD benefit. The person insured is TPD if they are: a. unlikely to work ( any occupation or own occupation ) b. suffers a specific loss, or c. requires future care. Part (a) of the TPD definition is only available to persons insured who are permanently employed and who work at least 15 hours per week, and contractors in specific circumstances. For a contractor to be eligible for part (a) of the TPD definition, they must have worked an average of 15 hours or more per week over a period of three consecutive months up to the date they became totally and permanently disabled. If a contractor has worked for a period of less than three consecutive months, the contractor will still be eligible for TPD cover provided they worked an average of 15 hours or more per week from the date the contract with the employer commenced to the date they became totally and permanently disabled. a. Unlikely to work is dependent upon which version of the TPD definition applies under the policy and means: If an any occupation version applies: When all of the following apply to the person insured: an injury or sickness stops the person insured working in any business, occupation or regular duties continuously for the TPD waiting period, and as at the conclusion of the TPD waiting period, after considering all evidence which we believe is necessary to reach our view, in our opinion the person insured is unlikely ever to be able to work in any business, occupation or regular duties, whether paid or unpaid, for which they are reasonably qualified by education, training or experience. 5

8 or For the purpose of this part of the definition, it is immaterial whether the person insured can perform the business, occupation or regular duties on a full time, part-time or casual basis even if they worked on a full-time basis immediately prior to the cessation of work. If an own occupation version applies: When all of the following apply to the person insured: an injury or sickness stops the person insured working in their own occupation continuously for the TPD waiting period, and as at the conclusion of the TPD waiting period, after considering all evidence which we believe is necessary to reach our view, in our opinion the person insured is unlikely ever to be able to work in their own occupation. Own occupation means the occupation or regular duties in which the person insured has spent the most amount of time engaged in with the employer during the 12 months prior to the last day at work. For the purpose of this part of the definition, it is immaterial whether the person insured can perform their occupation or regular duties on a full-time, part-time or casual basis even if they worked on a full-time basis immediately prior to the cessation of work. b. suffers a specific loss or T he person insured has suffered an injury or sickness which first became apparent while they were a person insured and as a result of the injury or sickness has suffered the total loss of (or total loss of the use of): both hands or feet one hand and one foot the sight of both eyes, or one hand or one foot and the sight in one eye in circumstances where the loss will never be regained. c. requires future care When all the following apply to the person insured: 1. The person insured suffers an injury or sickness which first occurs while they are a person insured, and 2. Because of that injury or sickness, in our opinion, the person insured is permanently unable to perform at least two of the five activities of daily living listed below, without assistance from another person: bathing/showering dressing/undressing eating/drinking using the toilet to maintain personal hygiene, or getting in and out of bed, a chair, a wheelchair or moving from place to place by walking, a wheelchair or with a walking aid. Day one total and permanent disablement benefit If the person insured has been diagnosed by a medical practitioner as suffering from one of the listed medical conditions below, we will waive the TPD waiting period when assessing a claim made under part (a) Unlikely to work, as per the TPD definition. The medical conditions are: Alzheimer s disease and other dementias Cardiomyopathy Diplegia Hemiplegia Lung disease Major head injury Motor neurone disease Multiple sclerosis Muscular dystrophy Paraplegia Parkinson s disease Permanent blindness Permanent deafness Permanent loss of speech Primary pulmonary hypertension Quadriplegia Severe rheumatoid arthritis Tetraplegia. Life events cover The option to increase death and/or TPD cover is available as an optional feature as part of the GL policy. When a person insured can increase their benefit The person insured can increase their benefit if they: get married get divorced have a child (including through adoption) take out a mortgage on the initial purchase of a primary residence increase an existing mortgage on their primary residence for renovations/extension (increase for renovations/ extension must be for at least $50,000), or have a child and the child turns 12. The application for an increase, including all required evidence, must be received by the policy owner in the required format, as agreed by us and the policy owner, within 60 days of the event occurring. Alternative application periods may apply as agreed by us. 6

9 The required evidence is set out in the table below: Event Marriage Divorce Birth or adoption of a child Taking out a mortgage on the initial purchase of a primary residence Increasing existing mortgage on primary residence for renovations/ extension Child turns 12 Evidence (i) Certified copy of marriage certificate Certified copy of divorce certificate/decree absolute Certified copy of child s birth certificate or adoption certificate with name of the person insured appearing as mother/father Letter from lender showing the identity of the lender and confirming: a. the amount of the loan to purchase the person insured s principal place of residence, and b. the loan has been drawndown (not just approved), and a statutory declaration declaring that the mortgaged property is the person insured s principal place of residence. Letter from lender showing the identity of the lender and confirming: a. the amount of the increase in the loan to extend or renovate the principal place of residence of the person insured, and b. the loan has been drawndown (not just approved), and a statutory declaration declaring that the mortgaged property is the person insured s principal place of residence and that the increase is for renovations/extension. Certified copy of child s birth certificate or adoption certificate with name of the person insured appearing as mother/father. (i) Evidence must be certified as a true copy of the original by an authorised person, including one the following: Justice of the Peace Commissioner of Declarations Lawyer Notary Doctor CPA or Chartered Accountant Bank Manager. It is the policy owner s responsibility to retain the above evidence and to supply any evidence requested by us during the life of the policy or upon claim of a benefit. We will decline to pay the part of the benefit relating to increases under life events cover for which unsatisfactory evidence is provided. Conditions of acceptance of an increase To be eligible to apply for a benefit increase the person insured must be under the age of 65 on the date of the event. When a person insured increases their benefit because they have increased their mortgage for renovations/an extension, for the first six months from the date the benefit was increased, only cover for accidental death and accidental total and permanent disability will be provided on the amount of the increase. Persons insured may increase their benefit up to a maximum of three times under this option. It is the policy owner s responsibility to ensure the person insured has not increased their benefit more than three times under the life events cover option. If a person insured increases their benefit more than three times under the life events cover option, we will decline to pay the part of the benefit which relates to more than three increases, even if we have been receiving premiums. We will refund all premiums received in relation to the declined part of the benefit. Where a person insured increases their benefit by a fixed dollar amount, the amount of their TPD benefit will reduce as described under the section Reduction of TPD benefits. The policy owner or person insured must not have made or be eligible to make a claim for TPD, total disability or terminal illness on any policy held with us. Persons insured may only apply for a benefit increase as the result of one event in a 12 month period. We will not pay the part of the benefit which was obtained under this option if, within 13 months from the date the additional benefit commenced: the person insured s death, accidental death, terminal illness, TPD or accidental total and permanent disablement was caused by suicide or attempted suicide, or the person insured s sickness or injury was caused by the person insured on purpose. Amount of benefit increases The maximum amount of each increase is contained in the additional options section of the policy schedule. The total amount of benefit increases under this option is limited to $450,000 over the lifetime of each person insured. Effective date of increase The increase applies from the day a completed application together with required evidence is received by the policy owner. Application of automatic acceptance limits and further underwriting limits Persons insured under the automatic acceptance limit. Persons insured under the automatic acceptance limit can exercise the option to increase cover. The automatic acceptance limit will continue to apply. Persons insured whose increase will increase their benefit over the automatic acceptance limit. Persons insured may increase their benefit over the automatic acceptance limit without underwriting. Any further increases are subject to underwriting, unless they are again for a life event. Persons insured restricted to the automatic acceptance limit due to non-receipt of health evidence. Persons insured limited to the automatic acceptance limit due to non-receipt of medical evidence previously requested for underwriting, are eligible for the life events increase. Increases may be applied without underwriting. Any further increases will be subject to underwriting unless they are again for a life event. 7

10 Persons insured limited to the automatic acceptance limit due to previous underwriting. Persons insured who have been restricted to the automatic acceptance limit because of health evidence previously provided for underwriting, are not eligible for life events increases. Persons insured who have had loadings or exclusions applied to their benefits, may increase their benefits but the same loadings and exclusions will apply to the increase in benefits. Persons insured with further underwriting limits. Where the further underwriting limit is higher than the existing benefit plus the life events increase, the person insured may increase their benefits and the existing further underwriting limit will continue to apply. Where the further underwriting limit is lower than the existing benefit plus the life events increase, the person insured may increase their benefits for the full amount of the life events increase without underwriting. Any further increases will be subject to underwriting unless they are again for a life event. Persons insured who have had loadings or exclusions applied to their benefits, may increase their benefits. However, the same loadings and exclusions will apply to the increase in benefits. Death cover continuation option The option to continue death cover under an Individual Insurance plan is available as an optional feature of the GL policy. It is available to persons insured aged less than 65 who have ceased employment with the employer. The following conditions apply for continuation options: the person insured must apply for an Individual Insurance plan with us within 60 days of the date cover ceases under the GL insurance policy (had extended cover not applied) the person insured has stopped working for the employer, and the amount of the cover applied for is not more than the amount of the benefit which applied to the person insured under the GL policy immediately before cover stopped. As part of the application process, we will ask questions and seek disclosure from the person insured for any information we consider relevant which does not relate to medical information in regard to the person insured, and based on our assessment, we may refuse the application. We may offer insurance on any terms acceptable to us, including equivalent special terms or premium loadings equivalent to those that applied under the GL policy. A continuation option will not apply: if the person insured has stopped working for the employer in any business, occupation or regular duties because of injury or sickness if we are paying, or the person insured is entitled to or becomes entitled to, a benefit under the GL policy if the person insured is aged 65 or greater if the person insured has previously taken out similar insurance with us under a continuation option if the person insured s premium amount under the Individual Insurance plan applied for is less than the minimum premium we set for the purpose of this option from time to time to the amount of the benefit under the GL policy for the person insured that is more than the maximum amount we set for the purpose of the continuation option from time to time, or if we have given written notice to you that this option is to cease operating. TPD cover continuation option In addition to the conditions for the death cover continuation option, the following also applies to exercising a TPD continuation option: the person insured must be aged 55 or less, and must be at work at the time of applying for the Individual Insurance plan and permanently employed to work at least 25 hours per week. Additional information Renewal guaranteed We will guarantee to renew the policy annually, subject to: the minimum number of persons insured and the minimum premium, that we advise from time to time, being met any premium due being paid to us in accordance with the policy terms and conditions, and you abiding by the terms and conditions of the policy. Limitations The GL policy may contain certain exclusions or limitations. As each policy is catered to the needs of different groups, you should carefully check your policy schedule and policy document to see if any exclusions or limitations apply. Exclusion for war We will not pay a benefit if the person insured s death, accidental death, terminal illness or TPD was caused by an act of war while the person insured was overseas for the purposes of their employment. Exclusions for voluntary cover We will not pay a benefit or part of a benefit if, within 13 months from the date the person insured s voluntary insurance cover, or increase to the person insured s amount of voluntary insurance, commenced: the person insured s death, accidental death, terminal illness or TPD was caused by suicide or attempted suicide, or the person insured s sickness or injury was caused by the person insured on purpose. 8

11 Reduction of TPD benefits Where the benefit formula for TPD reduces the amount of the TPD benefit to nil by the cover expiry age for a person insured, there will be no additional reduction in the amount of the benefit or change in the definition of the TPD benefit. Where the benefit formula for TPD does not reduce the amount of the TPD benefit to nil by the cover expiry age for a person insured, the following conditions will apply: the amount of the TPD benefit assessable under parts (a), (b) or (c) of the TPD definition will reduce from the person insured s 60th birthday. This reduction will be 1/120th of the amount of the TPD benefit assessable under parts (a), (b) or (c) of the TPD definition times the number of completed and partial months since the person insured s 60th birthday, each month until nil at the person insured s 70th birthday, and where the cover expiry age is greater than age 70, the reduction process will cease on the person insured s 69th birthday. If TPD tapering does not apply, the amount of the TPD benefit assessable under parts (b) or (c) only of the TPD definition will be increased by the amount of reduction nominated in the previous paragraph. Where TPD cover for a person insured under the policy commences after the person insured s 60th birthday, the amount of the reduction will be consistent with that which would have applied had the person insured been covered since the start of the TPD benefit reduction process. We may apply a reduction for a period longer or shorter than 10 years or ceasing prior to age 70 if requested by you and agreed to by us. If we do this we will notify you in writing of the terms of any such agreement. In such cases, the rate of TPD benefit reduction shall be adjusted proportionately, but shall not be less than that which would have applied had the standard conditions been applied. Where underwriting terms apply to the TPD benefit for a person insured and the amount of benefit has been restricted to a fixed dollar amount (as notified by us in writing), any reduction in the benefit is applied to the lesser of this restricted fixed dollar amount or the amount of benefit calculated by the benefit formula for the person insured. When cover for a person insured stops Cover for a person insured will stop as soon as one of the following happens: the person insured attains the cover expiry age the person insured ceases to be a contractor the date any benefit becomes payable for the person insured under the GL policy the person insured no longer meets the eligibility criteria you do not pay the premium for the person insured when due when the person insured is on unpaid leave as described under Unpaid leave or employed/travels overseas as described under Cover during overseas employment and travel for longer than the period of time that we have agreed to provide cover the person insured makes a fraudulent claim the date the policy is terminated, or when the policy ends. In addition to the above, the following also applies under superannuation policies: in the case of the person insured directing the employer to remit all or part of their employer superannuation contributions to a superannuation fund other than the fund through which cover is provided under the policy, cover will cease on the date the first contribution has been remitted to the person insured s fund of choice (unless all premiums are fully funded by the employer and paid in addition to SG contributions). In some circumstances extended cover may apply. The policy owner can end the policy The policy owner can end the policy by giving us one month s written notice on their company letterhead, or we can agree on an earlier time in writing. We can end the policy We can end the policy, or cover in respect of a person insured, by giving you one month s written notice, as soon as any of the following happens: the annual premium falls below the minimum annual premium the number of persons insured falls below the minimum number of persons insured we are not provided, within 30 days of us advising you in writing, with all of the information we need to verify cover for a person insured and premiums paid or payable you do not pay the relevant premium or any adjustment premiums within 45 days of the due date less than 75% of eligible persons are covered under the policy, or you do not provide any other information we require to operate the policy effectively. You must inform the persons insured of the notice to terminate as soon as possible, but in any event within 10 working days of receipt of our written notice to you. 9

12 Group Salary Continuance Policy: a snapshot This section forms part of the PDS for GSC and should be considered in conjunction with the Additional information Group Life and Group Salary Continuance section, the Trauma definitions section and the Definitions section. GSC provides persons insured with a replacement income stream of up to a maximum of 75% of $480,000 pa of income (as defined under the policy) plus an employer superannuation contribution benefit (if applicable), if they are unable to work due to sickness or injury. GSC is designed to help pay for day-to-day living expenses such as food, utility bills, rent or home maintenance costs, mortgage or other debt repayments, while a person insured is not earning an income due to sickness or injury. GSC benefits and options The table below provides a summary of the cover available: Benefit Benefit description Superannuation Non-superannuation Total disability benefit Partial disability benefit Extended cover Provides a benefit if the person insured is unable to work due to sickness or injury. Pays a benefit if the person insured can only work in a reduced capacity due to sickness or injury after 14 consecutive days of total disablement. Provides cover where a person insured leaves employment with the employer and ceases to be eligible for cover under the policy. Death benefit Pays a lump-sum benefit upon death. Recurrent disability benefit Interim cover Guaranteed renewable contract 24 hour worldwide cover Employer superannuation contribution benefit We will continue to pay a benefit where a person insured returns to work and there is a recurrence of the disability. Provides a benefit while a person insured or an eligible person is being underwritten. Provided the premiums are paid and the terms and conditions of the policy are met, we guarantee to renew the policy each year. Cover for a person insured is provided 24 hours a day depending on the circumstances of overseas travel. Provides a benefit to cover the cost of employer superannuation contributions payable in respect of a person insured for whom we are paying you a monthly benefit. No 10

13 The GSC policy also provides the following options at an additional cost: Benefit Benefit description Superannuation Non-superannuation Continuation option Escalation benefit Nursing care benefit Family carer benefit Trauma benefit Allows persons insured who leave employment and cease to be eligible for cover under your Group Insurance policy to continue their cover under a personal Income Protection plan. The monthly benefit amount will increase each year by the lower of the annual percentage increase in the CPI or the policy escalation percentage (5% or 7.5%). Provides a benefit where a daily amount is paid for up to the length of the waiting period, subject to a maximum of 90 days, to help with nursing expenses where the person insured requires the continuous full-time care of a registered nurse. Provides a benefit if a person insured s family member stops earning all of their own income because the family member stops working in order to care for the person insured who is totally disabled. Provides a benefit if a person insured suffers a specific sickness or injury, after cover first commences for the person insured, for the period set out in the respective tables, or the benefit period, whichever is the lesser, and no waiting period will apply. No No No 11

14 Group Salary Continuance Policy: the detail The policy GSC provides a total disability benefit if a person insured meets the definition of totally disabled and is unable to work due to sickness or injury after the waiting period. It also provides a partial disability benefit if a person insured meets the definition of partial disablement and has a reduced capacity to work due to sickness or injury after the waiting period. Available under the policy is a range of waiting periods and benefit periods that enable you to tailor your costs and the cover provided under the policy. GSC policies can either be related to a superannuation product (superannuation policy), where a superannuation trustee owns the policy or a non-superannuation policy (ordinary policy) where an employer (or like entity) owns the policy. Premiums for non-superannuation policies are paid into our No. 1 Statutory Fund. Premiums for superannuation policies are paid into our No. 4 Statutory Fund. The policy has no cash surrender value and neither you, nor a person insured, have access to ownership or any rights over the assets of the applicable statutory fund. Who can become a person insured? A person can become a person insured if they satisfy the eligibility criteria for cover under the policy, which you set (and we agreed), and the person is: a full-time permanent employee, or a contractor. To be eligible for a benefit a contractor must have worked an average of 15 hours or more per week over a period of three consecutive months up to the date they became totally disabled, partially disabled or suffered a listed specific sickness or specific injury, if applicable. If a contractor has worked for a period of less than three consecutive months, the contractor will still be eligible for a benefit, provided they worked an average of 15 hours or more per week from the date the contract with the employer commenced to the date they became totally disabled, partially disabled or suffered a listed specific sickness or specific injury. The person must also be: aged 15 years or more, but less than age 65, on the day they were first eligible for cover, and an Australian resident. Cover will be granted in one of three ways: 1. The automatic acceptance terms. 2. The transfer terms, or 3. The underwriting terms. For further information on automatic acceptance terms, transfer terms and underwriting terms, please refer to the Additional information Group Life and Group Salary Continuance section of this PDS. Availability of cover Entry age Maximum expiry age Minimum number of persons insured per policy Minimum annual premium (excluding stamp duty) Maximum sum insured 75% of $480,000 pa income. Cover up to $50,000 per month is available in some circumstances. (i) Exclusive of stamp duty and commission. Total disability benefit 15th to 65th birthday 65th birthday 10 $10,000 pa (i) $30,000 per month If we assess a person insured as totally disabled, we will pay the total disability benefit from the end of the waiting period. Totally disabled means: i. If the policy includes the any occupation version the following applies: A person insured is totally disabled if, because of an injury or sickness: a. For the first two years of a claim they are: not capable of doing the important duties of their regular occupation not working in any occupation (whether paid or unpaid), and under medical care. b. After the first two years of a claim, because of the same injury or sickness, is: not capable of performing any occupation (whether paid or unpaid) for which they are reasonably suited by education, training or experience not working in any occupation (whether paid or unpaid), and under medical care. 12

15 ii. If the policy includes the own occupation version, the following applies: A person insured is totally disabled if, because of an injury or sickness, they are: not capable of doing the important duties of their regular occupation not working in any occupation (whether paid or unpaid), and under medical care. If a person insured is totally disabled, we will pay you a benefit. We will pay at the end of each month until the earliest of the events described under When benefits for a person insured stops. We don t start paying as soon as the person insured is disabled. You have to wait until the end of the waiting period. The waiting period starts when a medical practitioner, after examining the person insured for the relevant sickness or injury, certifies that they are totally disabled. We do not pay a benefit for total disability for any period of time during the waiting period. The benefit period begins from the end of the waiting period. The amount of the total disability benefit The total disability benefit is paid to you at the end of each month in which you are entitled to be paid. For part of a month, we pay you 1/30th of the monthly benefit for each day you are entitled to be paid the total disability benefit under the policy. The amount of the benefit will be: the monthly benefit, plus the employer superannuation contribution benefit (if any), less any offset. Partial disability benefit If, after at least 14 consecutive days of total disability (even if during the waiting period), the person insured s health improves, but they are partially disabled, after the waiting period, we will pay a reduced benefit. Payments however will not commence until after the waiting period. The amount we pay is worked out by applying the formula: A B A x C less offset Where: A equals the person insured s income at the benefit calculation date. B is the person insured s actual disability salary (from any source) during the month in which they are partially disabled. If this amount is a loss, then B will equal zero. C is the benefit amount which would otherwise be payable on total disablement, as may be varied in accordance with the policy provisions. Maximum benefits and other information The benefit will be subject to the maximum benefit and any underwriting terms, if applicable. Where the maximum benefit amount is greater than $30,000 per month, after a person insured has received a benefit for two years, the maximum benefit amount will be reduced to $30,000 per month for the remainder of the benefit period for that claim. In the event that we are by law required to pay any tax, duty or impost in connection with the benefit payable to you, we will deduct the amount concerned from the benefit and pay it to the proper authority. The meaning of total disablement depends on which definition of total disability the person insured has under the policy. The definition of total disablement may vary in respect of each particular category of persons insured. Extended cover Extended cover is only available to non-superannuation policies. If a person insured is no longer eligible for cover because they have left their employer and: the person insured did not cease work with the employer for reasons of injury or sickness, and we are not paying you, or you are not entitled to a benefit under the policy for the person insured, then we will automatically provide, free of charge, cover to the person insured for total disability, partial disability or a listed specific sickness or specific injury, if applicable, that is solely caused by accidental injury. This is referred to as extended cover. Extended cover stops on the earlier of: 60 days after cover would have otherwise stopped the date the person insured attains the cover expiry age the date the person insured commences employment with a new employer the date the person insured makes a fraudulent claim, or the date a personal Income Protection plan issued by us under a continuation option commences in respect of the person insured. Death benefit If a person insured dies before the cover expiry age and we are paying you a benefit as at the date of death for that person insured because they are totally disabled, or if we have been paying a Trauma benefit for at least 30 days as a result of a listed specific sickness or specific injury, then subject to the terms of the policy we will pay you a lump-sum amount equal to three months benefit for total disability. 13

16 Recurrent disablement benefit If, following a payment for a disability claim for a person insured, they return to their usual pre-disability duties and work hours and a recurrence of total or partial disability for the same or related cause occurs within six months of the last period of disablement, we will treat this as a continuation of the earlier claim and will pay until the balance of the remaining benefit period (if any). The waiting period will not apply again in this instance. However, if the person insured returns to their usual pre disability duties and work hours for at least six months, and is not in receipt of and/or not entitled to claim income support benefits from any source, we will treat this as a separate claim and the waiting period and benefit period will start again. Interim accidental injury cover If underwriting terms apply to an eligible person or a person insured because: automatic acceptance terms do not apply the benefit exceeds the automatic acceptance limit or the further underwriting limit, or they have applied for voluntary insurance or a voluntary increase to their insurance, then we will provide them with interim cover for total disability caused by accidental injury which lasts for at least the length of the waiting period. Interim cover starts from the date we receive the written application, in the form approved by us, for all, or the relevant part of, the benefit which is subject to underwriting terms, in respect of the person insured or eligible person. The amount of benefit provided is the amount of benefit applied for, up to a maximum amount of $10,000 per month. The maximum benefit period under interim accidental injury cover for a person insured or eligible person is two years. Interim accidental injury cover automatically ends as soon as one of the following happens: we accept or limit the application for the benefit which is subject to underwriting terms 20 business days after we decline the application for the benefit which is subject to underwriting terms you, the person insured or the eligible person withdraws the application for the benefit which is subject to underwriting terms 60 days pass from the date interim accidental injury cover commenced, or cover stops due to any of the events listed in When cover for a person insured stops occurring. In all other ways, the conditions of the policy apply to interim accidental injury cover, including the continued payment of premiums. Worldwide cover Cover for a person insured is available 24 hours a day, anywhere in the world, subject to the conditions outlined under Cover during overseas employment and travel. Employer superannuation contributions benefit If elected by you as a feature of the policy, the employer superannuation contributions benefit will be paid in the event of total disability, partial disability or a listed specific sickness or specific injury, if applicable. It is paid in addition to the monthly benefit, subject to the maximum sum insured. This benefit is to cover the cost of employer superannuation contributions payable in respect of the person insured. Upon receipt of a benefit you must ensure that the part of the benefit which comprises the employer superannuation contributions benefit, if any, is paid by you, for the person insured, to a complying superannuation fund under the Superannuation Industry (Supervision) Act 1993, as amended. The employer superannuation contributions benefit will stop on the date that the earlier of the following occurs: the person insured s employment with their employer ceases, or when they are no longer a member of a complying superannuation fund under the Superannuation Industry (Supervision) Act 1993, as amended. Maximum monthly benefit The maximum monthly benefit we will pay including the employer superannuation contribution benefit is $30,000. In some circumstances, we will agree to higher amounts of up to $50,000. Optional benefits You can elect further protection, at an additional cost, through the options listed below. Some of these optional extras are not available to superannuation policies. The options are: Cover to age 70 benefit Escalation benefit Continuation option Nursing care benefit Family carer benefit Trauma benefit. 14

17 Cover to age 70 benefit The option to provide benefits to age 70 is available as an optional feature of the GSC policy. The following conditions apply to this benefit: Where a person insured, having completed the waiting period, commences their benefit period after their 63rd birthday, then the benefit will be paid until the earliest of: two years, or their 70th birthday. From the person insured s 65th birthday: the maximum benefit amount shall be set at $10,000 per month, including any claim being paid at that time, and they will be ineligible to claim any benefit for nursing care, family carer or trauma. If they are currently receiving any such benefit, it will cease. Escalation benefit If we have been paying a benefit for a person insured for 12 consecutive months, the benefit will increase to keep in line with inflation while the person insured is on claim. The benefit will increase by the lower of the CPI and 5% or 7.5%, as applicable under the policy. However, we will not pay more than the maximum monthly benefit of $30,000. Continuation option The option to continue salary continuance cover under a personal Income Protection plan is available as an optional feature of the GSC policy. It is available to persons insured aged less than 60 who have ceased employment with the employer. The following conditions apply for continuation options: the person insured must apply for a personal Income Protection plan within 60 days of the date cover ceases under the GSC policy (had extended cover not applied) the person insured has stopped working for the employer the person insured is at work and permanently employed to work at least 25 hours per week at the time of applying for a personal Income Protection plan the amount of the benefit applied for is not more than the amount of the benefit which applied to the person insured under the GSC policy immediately before cover stopped, and the waiting period, benefit period and escalation percentage (if any) under the personal Income Protection plan is the same as that which applied to the person insured under the GSC policy immediately before cover stopped. As part of the application process, we will ask questions and seek disclosure from the person insured for any information we consider relevant which does not relate to medical information in regards to the person insured, and based on our assessment, we may refuse the application. We may offer insurance on any terms acceptable to us, including premium loadings or equivalent special terms to those that applied under the GSC policy. A continuation option will not apply: if the person insured has stopped working for the employer in any business, occupation or regular duties because of injury or sickness if we are paying, or the person insured is entitled to or becomes entitled to, a benefit under the GSC policy if the person insured is aged 60 or greater if the person insured has previously taken out similar insurance with us under a continuation option if the person insured s premium amount under a personal Income Protection plan applied for with us is less than the minimum premium we set for the purpose of this option to the amount of the benefit under the GSC policy for the person insured which is more than the maximum amount we set for the purpose of the continuation option, or if we have given written notice to you that this option is to cease operating. Nursing care benefit This benefit is only available to non-superannuation policies. If a person insured is totally disabled, continuously confined to bed and certified by a medical practitioner to require the fulltime and continuous care of a registered nurse for more than two consecutive days during the waiting period, we will pay a daily amount for the length of the waiting period, subject to a maximum of 90 days, to help with nursing expenses. For each day (after the first two days) that the person insured is continuously confined to a bed and needs the continuous full-time care of a registered nurse during the waiting period, we will pay 1/30th of the monthly benefit, up to a maximum of $500 per day, for a maximum of 90 days. The nurse cannot be you, your family member, business partner, employee or employer, nor can it be the person insured or their family member, business partner, employee or employer. This benefit is not available if the person is receiving or has received a benefit as a result of a listed specific sickness or specific injury (see below). Family carer benefit This benefit is only available to non-superannuation policies. We will pay the family carer benefit if the person insured has been receiving total disability benefits for more than 60 days and a family member ceases permanent employment to care for a person insured while the person insured is totally disabled. We will pay this benefit for up to six months and each month we will pay the lower of: the amount we estimate the person insured s family member would have earned if the person insured had not been disabled, or $2,000. However, the family member must not have been employed by the person insured or be an employee of an entity which the person insured owns or owned. 15

18 Trauma benefit This benefit is only available to non-superannuation policies. If a person insured suffers a specific sickness listed in Table 1 or Table 2 or a specific injury listed in Table 3, we will pay a benefit for the period of time shown. A waiting period does not apply in respect to trauma benefits. We will not pay for longer than the benefit period that applies to the policy. We will pay the trauma benefit from the date: the specific sickness was diagnosed by a medical practitioner, or the person insured attended a medical practitioner, after the specific injury happened. We will pay the trauma benefit once only for each type of specific sickness or specific injury. Specific sickness trauma benefit If the waiting period for a person insured is 90 days or less, and they suffer a specific sickness listed in Table 1, for the first time since cover commenced, we will pay a trauma benefit monthly and in arrears for a fixed period. If the waiting period for a person insured is more than 90 days no benefit is payable for these specific sicknesses. Table 1 Specific sickness (6 month maximum benefit period) Cancer Chronic kidney failure Coronary artery surgery Heart attack Heart valve surgery Major organ transplant Severe burns Stroke In addition, if the waiting period for a person insured is 30 days or less, and they suffer a specific sickness listed in Table 2, we will pay you a trauma benefit monthly and in arrears for a maximum of three months. If the waiting period for a person insured is more than 30 days, no trauma benefit is payable for a sickness listed in Table 2. Table 2 Specific sickness (3 month maximum benefit period) Advanced diabetes Alzheimer s disease and other dementias Aplastic anaemia Benign brain tumour Blindness Cardiac arrest Cardiomyopathy Chronic liver disease Coma Deafness Encephalitis Loss of capacity for independent living Loss of speech Lung disease Major head injury Medically acquired HIV infection Motor neurone disease Multiple sclerosis Muscular dystrophy Parkinson s disease Pneumonectomy Primary pulmonary hypertension Severe rheumatoid arthritis Surgery of the aorta Triple vessel angioplasty Please refer to Trauma Definitions section. The fixed maximum period we will pay you a benefit is six months for each sickness listed in Table 1 and three months for each sickness listed in Table 2. Specific injury trauma benefit If the waiting period for a person insured is 180 days or less, and they suffer a specific injury listed in Table 3 below, we will pay a trauma benefit monthly and in arrears. If the waiting period for a person insured is more than 180 days, no benefit is payable for these specific injuries. The period we will pay a benefit for is set out in Table 3. If the benefit period for total disability benefits is less than the maximum fixed period indicated in Table 3, payments will cease at the expiry of the benefit period. 16

19 Table 3 Specific injury benefit Total and permanent loss of use of: the person insured s arms and legs due to spinal cord injury or disease quadriplegia the person insured s legs due to spinal cord injury or disease paraplegia both sides of the person insured s body due to spinal cord injury or disease diplegia one side of the person insured s body due to spinal cord injury or disease hemiplegia Maximum period we pay you for 60 months 60 months 60 months 60 months both hands or both feet 24 months entire sight in both eyes 24 months one hand and one foot 24 months one hand and entire sight in one eye 24 months one foot and entire sight in one eye 24 months one arm or one leg 18 months one hand 12 months one foot 12 months entire sight in one eye 12 months thumb and index finger from same hand 6 months Fracture requiring a pin, traction, a plaster cast or other immobilising structure of the person insured s: thigh shaft 3 months pelvis except coccyx 3 months skull, except bones of nose or face 2 months upper arm, including elbow and shoulder 2 months shoulder blade 2 months lower leg, including ankle but excluding knee cap and foot 2 months knee cap 2 months collar bone 1.5 months hand, excluding fingers 1.5 months foot, excluding toes 1.5 months lower arm, including wrist but excluding elbow and hand 1.5 months We will stop paying the trauma benefit if the person insured dies or reaches the cover expiry age. If, after the benefit period set out in either Table 1, Table 2 or Table 3 (as applicable) ends, the person insured continues to be disabled, we will pay you the appropriate benefit for total disablement or partial disablement as applicable. If this applies, we will pay the benefit from the end of the waiting period. Where the benefit period for total disablement or partial disablement is for a specific time (such as two or five years), the total period paid for the trauma benefit shall count as part of that benefit period. Additional information Waiting period The waiting period for a salary continuance benefit commences at the start of total disability, and must expire before a person insured can begin receiving a benefit. You choose the waiting period to apply and the premiums will reflect the waiting period (shorter waiting periods are generally more expensive). Waiting periods available under a GSC policy are 30, 60, 90 or 180 days. Alternate waiting periods may be available upon request. There is no waiting period for a trauma benefit. Where a person insured returns to work in the waiting period, we may extend or restart the waiting period. If the person insured returns to their usual pre-disability duties and work hours during the waiting period, other than as part of a rehabilitation program approved by us, for: less than six consecutive working days, if the waiting period is 30 days or less, or less than ten consecutive working days, if the waiting period is more than 30 days, and then total disability or partial disability recurs, the waiting period is extended by the number of working days they returned to work. The waiting period does not start again. If the person insured returns to their usual pre-disability duties and work hours during the waiting period, other than as part of a rehabilitation program approved by us, for: six or more consecutive working days, if the waiting period is 30 days or less, or ten or more consecutive working days, if the waiting period is more than 30 days, and then total disability or partial disability recurs, the waiting period starts again. If the person insured returns to their usual pre-disability duties and work hours during the waiting period as part of a rehabilitation program approved by us, the waiting period is not extended. Benefit period The benefit period is the maximum period for which benefits are payable for any one claim. You choose the benefit period to apply and the premiums will reflect the benefit period (longer benefit periods are generally more expensive). The benefit periods available under a GSC policy are two years, five years, to age 60 or to age 65. Alternate benefit periods may be available upon request. The maximum benefit period for contractors is two years. 17

20 Rehabilitation expenses and workplace modification If the person insured is totally disabled for at least the length of the waiting period, we may require the person insured to undergo, at our expense (up to a maximum of six payments of the monthly benefit) rehabilitation that is designed to assist the person insured in returning to full-time work provided that a medical practitioner states in writing that the person insured has capacity to participate in rehabilitation. Costs will be paid directly to the third-party provider. Similarly, if the person insured s workplace needs to be modified to allow them to return to paid work after being totally disabled, we may, at our absolute discretion, decide to pay the costs incurred in modifying the person insured s workplace. Costs will be paid directly to the third-party provider. However, we will only do this if the person insured has been totally disabled for at least the length of the waiting period. Also, we must approve in writing the workplace that is to be modified. We will pay the lowest of: 2.5 times the monthly benefit for the person insured the actual cost incurred in modifying the workplace, and $5,000 for any one person insured. Renewal guaranteed We will guarantee to renew the policy annually, subject to: the minimum number of persons insured and the minimum premium that we advise from time to time, being met any premium due being paid to us in accordance with the policy terms and conditions, and you abiding by the terms and conditions of the policy. Limitations The GSC policy may contain certain exclusions or limitations. As each policy is catered to the needs of different groups, you should carefully check your policy schedule and policy document to see if any exclusions or limitations apply. When a benefit will not be paid We will not pay a benefit if a person insured s total or partial disability or listed specific sickness or specific injury, if applicable, was caused by: pregnancy, childbirth or miscarriage, if they are uncomplicated attempted suicide (while sane or insane) or intentionally self-inflicted injury an act of war, or the person insured s service in the armed services of any country or international organisation. More than one benefit at a time We will pay only one benefit for total disability, partial disability or a listed specific sickness or specific injury, if applicable, at a time. If the person insured is totally disabled, partially disabled or suffers a listed specific sickness or specific injury, if applicable, because of more than one injury or sickness, or both, we will only pay a benefit for either one injury or one sickness, even if the sicknesses or injuries are related, and we will decide what injury or sickness we pay the benefit for, based on medical and other evidence. We will pay the benefit which results in the payment of the greatest amount. If we have paid a benefit for total disability, then subject to the recurrent disablement benefit terms, the person insured must be at work before we will accept a subsequent claim for total disability. In addition to the above, the following also applies to nonsuperannuation policies only: We will not pay the nursing care benefit at the same time as we are paying for a listed specific sickness or specific injury, if applicable, for a person insured. When benefits for a person insured stop We stop paying a benefit for a person insured at the earliest of: the date the person insured ceases to be totally disabled or partially disabled (as applicable) the date the person insured attains the cover expiry age the date the person insured commences a period of incarceration or is otherwise detained as a result of committing a criminal act the person insured makes a fraudulent claim the date the benefit period for the cause of the disability ends the person insured ceases being under medical care the person insured refusing to return to Australia from overseas for medical treatment or assessment for a person insured who is totally disabled, they refuse to undertake treatment or rehabilitation which could, in our opinion, be expected to assist their ability to return to any occupation or their own occupation on any basis, depending on the applicable definition of total disablement as described in the schedule for a person insured who is partially disabled, they refuse to undertake treatment or rehabilitation which could, in our opinion, be expected to assist their ability to return to any occupation in an increased capacity or their own occupation in an increased capacity, depending on the applicable definition of total disablement, as described in the schedule for a person insured who is totally disabled, in our opinion they fail to take all steps to return to any occupation or their own occupation (as applicable) if they have the capacity to do so 18

21 for a person insured who is partially disabled, in our opinion they fail to take all the steps to return to any occupation or their own occupation (as applicable) on a full-time basis, if they have the capacity to do so you or the person insured failing to make available to us medical, financial or other evidence required to assess the claim, that we have requested in writing, or the date the person insured dies. When the reason for stopping payments no longer applies, payments will resume, provided that: the person insured continues to be totally disabled or partially disabled (as applicable), and cover under the policy has not stopped. Where the person insured has remained totally disabled or partially disabled (as applicable) for the duration of the period for which payments were stopped, we will treat the resumption of payments as a continuation of the same benefit period where no waiting period applies. Back payment will not be made for the period in which payments stopped and the original benefit period end date will continue to apply. In addition to the above clauses, we will also stop paying a benefit for a person insured, where the words Benefits cease on total and permanent disablement appear in the additional options section of the schedule, at the earliest of: where the person insured has received or, in our opinion, is entitled to receive a lump-sum payment from us as a result of them having become totally and permanently disabled as defined under a Group Insurance policy issued by us, or you or the person insured failing to make available to us medical, financial or other evidence we have requested in writing, to assess whether or not the person insured is totally and permanently disabled. When cover for a person insured stops Cover for a person insured will stop at the earliest of: when a person insured reaches the cover expiry age the person insured ceasing to be employed by the employer as a permanent employee or as a contractor (extended cover may apply) the person insured ceasing to work at least 15 hours each week the person insured dies the person insured no longer meeting the eligibility criteria when you do not pay the premium for the person insured, unless you are being paid a benefit for the person insured and premiums are waived during total disablement when the person insured is on unpaid leave as described under Unpaid leave or is employed/travels overseas as described under Cover during overseas employment and travel for longer than the period of time that we have agreed to provide cover if the person insured makes a fraudulent claim the date the policy is terminated, or when the policy ends. In addition, the following also applies under superannuation policies: in the case of the person insured directing the employer to remit all or part of their employer superannuation contributions to a superannuation fund other than the fund through which cover is provided under the policy, cover will cease on the date the first contribution has been remitted to the person insured s fund of choice (unless all premiums are fully funded by the employer and paid in addition to SG contributions). The policy owner can end the policy The policy owner can end the policy by giving us one month s notice in writing, or we can agree on an earlier time in writing. We can end the policy We can end the policy, or cover in respect of a person insured, by giving you one month s written notice, as soon as any of the following happens: your annual premium falls below the minimum annual premium the number of persons insured falls below the minimum number of persons insured we are not provided, within 30 days of us advising you in writing, with all information we need to verify a person insured s benefit and premiums paid or payable you do not pay the relevant premium or any adjustment premiums within 45 days of the due date less than 75% of eligible persons are covered under the policy, or you do not provide any other information we require to operate the policy effectively. You must inform the persons insured of the notice to terminate as soon as possible, but in any event within 10 working days of receipt of our written notice to you. 19

22 Additional information: Group Life and Group Salary Continuance This section forms part of the PDS for each of the products described in this booklet and should be considered in conjunction with the individual part of the PDS for each product. Information about your policy: Benefits under super In certain circumstances a benefit may not be permitted to be released from the fund unless the member satisfies a condition of release as defined under superannuation legislation. Automatic acceptance terms An eligible person may be granted cover under automatic acceptance (without the need for medical or other evidence) provided all of the following terms are satisfied: the amount specified for the automatic acceptance limit in the schedule is anything other than nil there are at least 10 persons insured in the applicable category of persons insured the eligible person was at work on the policy commencement date or on the day eligibility criteria was first met, or at some other time we advise you in writing we are the only provider of insurance under automatic acceptance for the risk covered by the policy at least 75% of eligible persons are covered under the policy at all times, and any other terms that we specify in writing have been met and we agree have been met. In the case of GSC and TPD cover, the following conditions must also be satisfied: they were aged at least 15 but less than age 65 (or the cover expiry age if this is less than age 65) on the day they first met the eligibility criteria for GSC or TPD cover, and in the case of death cover (including terminal illness), the eligible person must be aged at least 15 but less than age 70 (or the cover expiry age if this is less than age 70) on the day they first met the eligibility criteria for death cover. For non-superannuation policies the eligible person must become a person insured from the day eligibility criteria was first met. For superannuation policies the eligible person must become a person insured no earlier than the date they first met the eligibility criteria and no later than 120 days after this date. Also, the fund must be the default fund for all eligible persons and persons insured. Where the eligible person was not at work on the policy commencement date or on the day eligibility criteria was first met, the following conditions apply: For death and terminal illness cover, he or she will be provided with cover from the policy commencement date or the day eligibility criteria was first met (as applicable). For TPD and GSC cover, he or she will be provided with cover from the policy commencement date or the day eligibility criteria was first met (as applicable) for other than a cause in relation to the medical condition or any directly or indirectly related condition arising from sickness or injury, which has caused him or her to be not at work on the policy commencement date or the day he or she first met the eligibility criteria. After he or she returns to being at work for at least 30 consecutive days within 90 days of the policy commencement date or the day eligibility criteria was first met, they will receive cover for all causes under automatic acceptance. If he or she do not return to being at work for at least 30 consecutive days within 90 days of the policy commencement date or the day eligibility criteria was first met, they will not be eligible for cover under automatic acceptance. Automatic acceptance of changes in the benefit amount for a person insured The person insured s benefit (calculated using the benefit formula) will increase without the need for the person insured to provide any medical or other evidence up to the lesser of: the automatic acceptance limit, or 30% of the person insured s benefit in any 12 month period. We can, in some cases, waive the restriction under the second bullet point above. However, unless we agree to waive these requirements, if a person insured s benefit exceeds the automatic acceptance limit, or cover is required above an increase of 30% of the person insured s benefit in any 12 month period, we will require the person insured to be underwritten for that part of the benefit that is in excess of the automatic acceptance limit or the increase over 30%. If the person insured does not respond to our request for underwriting information, their benefit will be restricted to the automatic acceptance limit or an increase of 30%, as applicable, until they submit the underwriting information. Changes in the automatic acceptance limit Where there is a change in the automatic acceptance limit, we will notify you in writing of the effective date of this change. 20

23 A change in the automatic acceptance limit will have the following effects on existing persons insured from the effective date of the change: for persons insured who have previously been accepted for cover via underwriting terms, any acceptance decision including any relevant conditions such as a premium loading, exclusion, restriction, further underwriting limit or other special conditions on the accepted amount of the benefit will remain unchanged regardless of any change to the automatic acceptance limit, even if the new automatic acceptance limit is higher than their further underwriting limit for persons insured who are at work on the effective date of an increase in the automatic acceptance limit, other than for persons insured with a further underwriting limit, that new automatic acceptance limit will apply from the effective date for persons insured who are not at work on the effective date of an increase in the automatic acceptance limit, this new automatic acceptance limit will apply from the date he or she is at work where the automatic acceptance limit decreases, other than for persons insured with a further underwriting limit, this new automatic acceptance limit will apply for all persons insured from the effective date, regardless of at work status, and for persons insured with an amount of benefit higher than the new automatic acceptance limit, should their amount of benefit subsequently increase, this increased amount of benefit will be subject to underwriting terms. Where the increase in the amount of benefit is accepted, a further underwriting limit may be granted and the person insured will not generally be required to be re-underwritten for subsequent increases in the amount of benefit until their amount of benefit exceeds this further underwriting limit. For eligible persons who meet the automatic acceptance terms (as described above) and who become a person insured on, or after the effective date of a change in the automatic acceptance limit, this new automatic acceptance limit will apply from the date they first commenced cover. Transfer terms If all of the following apply, then we may, at our discretion, offer transfer terms: the policy is replacing a previous policy issued by an Insurer other than us the previous policy is a Group Insurance policy the previous policy, in our opinion, confirmed in writing, provides insurance for similar insured events you provide all the information we request about the operation and terms of the previous policy (including underwriting decisions of the Insurer of the previous policy) within 90 days of the policy commencement date under the previous policy, there are at least 10 people with insurance for similar insured events under each category of persons insured (if applicable), and we are satisfied we have been provided with adequate information to assess whether we wish to offer group transfer terms. You will be notified in writing if group transfer terms are offered by us. The transfer terms specific to death, TPD and GSC cover are as follows: Death cover transfer terms The eligible person will be provided with an amount of death cover from the policy commencement date equal to the insured amount which would have been payable under the previous policy on the day immediately before the policy commencement date in the event they died ( Previous Death Policy Cover ) if, and only if: a. the policy provides for death cover in respect of the eligible person in the event of their death b. the eligible person was eligible, under the previous policy, to receive a lump-sum payment if they had died on the day immediately before the policy commencement date, and c. all conditions of the policy have been complied with (for example, the payment of premium). If the Previous Death Policy Cover is less than the proposed amount of the death cover under the policy, but more than the automatic acceptance limit, underwriting terms will apply to the part of the proposed death cover under the policy which exceeds the automatic acceptance limit. The amount of benefit payable in the event of the person insured s death under the policy will not at any time exceed the maximum benefit amount. TPD cover and GSC cover transfer terms If transfer terms are offered by us, the following applies: 1. Per s ons at work on the day before the policy commencement date. An eligible person who is at work on the day immediately preceding the policy commencement date will be provided with an amount of TPD cover or GSC cover, as applicable, from the policy commencement date equal to the insured amount which would have been payable under the previous policy on the day immediately before the policy commencement date in the event they were totally and permanently disabled or totally disabled in the case of GSC, as defined under the previous policy ( Previous Policy Cover ) if, and only if: a. the policy provides TPD cover or total disability cover, if applicable, in respect of the eligible person in the event of their TPD or total disability b. the eligible person was eligible, under the previous policy, to receive a lump-sum payment, if they had become totally and permanently disabled or an income replacement payment if they had become totally disabled, as defined under the previous policy, on the day immediately before the policy commencement date, and c. all conditions of the policy have been complied with (for example, the payment of premiums). 21

24 2. Persons not at work on the day before the policy commencement date. An eligible person who is not at work on the day immediately preceding the policy commencement date because of sickness or injury, will be provided, under the policy, with an amount of TPD cover or GSC cover, as applicable, from the policy commencement date but, only for new events cover up to the amount of the Previous Policy Cover. This restricted cover will apply in respect of the eligible person until the day they return to be at work on or after the policy commencement date. At that time, the commencement of TPD cover or GSC cover will apply as described in condition 1 above titled Persons at work on the day before the policy commencement date. If the Previous Policy Cover is less than the proposed amount of TPD cover or GSC cover under the policy but more than the automatic acceptance limit, underwriting terms apply to the part of the proposed TPD cover or GSC cover which exceeds the automatic acceptance limit. The amount of benefit payable in the event of TPD or GSC under the policy will not at any time exceed the maximum benefit amounts. Future increases in the benefit under transfer terms If the Insurer of the previous policy had approved future increases in death, TPD or GSC cover for an eligible person, then underwriting terms will not apply to increases in the benefit under the policy, up to the level approved by the Insurer of the previous policy, and in accordance with the benefit formula, except that no such increase can exceed 30% in any 12 month period, unless previously agreed to in writing by us. We may choose to provide cover as a result of future increases approved by the Insurer of the previous policy on the same or similar terms (as notified to you in writing by us), including applying any premium loading, exclusions or any other conditions which the Insurer of the previous policy placed on the cover of the person insured. Underwriting terms If automatic acceptance terms and transfer terms do not apply, the person insured or the eligible person will be required to complete underwriting forms provided by us so we can assess the cover. We will notify the person insured or the eligible person when cover commences and of any further underwriting limits. We will notify you of our decision in writing, including any loadings, restrictions or exclusions applied to the person insured s benefit. Unpaid leave If a person insured commences unpaid leave, including parental leave, for reasons other than sickness or injury, they will continue to be covered in the event of death, TPD and GSC (as applicable). We will continue to provide the applicable cover during unpaid leave on the following conditions: If a person insured takes unpaid parental leave approved in writing by their employer, before they commence the period of unpaid leave, we will continue to provide cover under this policy for the person insured for a period up to 24 months, provided we continue to receive premiums in respect of that person insured. If a person insured takes unpaid leave for reasons other than sickness or injury or parental leave, approved in writing by their employer before they commenced the period of unpaid leave, we will continue to provide cover under the policy, for the person insured, for a period up to 12 months. We must continue to receive premiums in respect of that person insured during the period of unpaid leave, and If a person insured takes unpaid leave for reasons other than for sickness or injury for a period longer than 12 months or parental leave for a period longer than 24 months, we must be notified in writing before they commenced the period of unpaid leave and have given our written approval to provide cover under the policy to the person insured for the extended period. We must continue to receive premiums in respect of that person insured during the period of unpaid leave. In the event of a claim for a benefit other than for death benefits: we may require a person insured who is overseas to return to Australia at their expense (where necessary) for medical treatment or assessment and we may not pay a benefit if the person insured does not return to Australia, and for a person insured with TPD cover who is disabled during the period of unpaid leave, the waiting period for TPD will not commence until after the specified return date that was approved by the employer, or where applicable, us, prior to the commencement of unpaid leave. The employer must keep appropriate records of the proposed date of return to work in this regard and provide such documents to us upon our request. In addition, for a person insured with total disablement cover under the GSC policy: the waiting period will commence on the date we receive a medical certificate from a medical practitioner stating that the person insured is unable to work due to sickness or injury, and benefit payments will not commence until after the specified return date that was approved by the employer, or where applicable, us, prior to the commencement of unpaid leave. The employer must keep appropriate records of the proposed date of return to work in this regard and provide such documents to us upon our request. If any of the conditions outlined under When cover for a person insured stops for GL and GSC respectively, occur in respect of the person insured before the end of the proposed period of unpaid leave, cover will cease in respect of that person insured, and we will refund you any portion of premium overpaid. 22

25 Cover following parental leave If the person insured returns to work within 12 months of the date that they commenced parental leave (whether paid or unpaid) and works reduced hours as compared to the hours worked immediately prior to the commencement of the parental leave (other than for reasons of injury or sickness), we will continue to provide death and TPD cover calculated using the income equivalent to the hours they worked prior to the commencement of the parental leave. For example, if a person insured who previously worked full time returns to work on a part-time basis, in the case of a claim their benefit will be calculated using a full-time equivalent income. This higher benefit will be offered for 12 months from the date they initially went on leave. During this period, the person insured must be working at least 15 hours per week to be eligible for part (a) of the TPD definition (Unlikely to work). Premiums payable will be based on a benefit calculated using the person insured s actual income during this time. At the expiration of 12 months since the person first went on parental leave (whether paid or unpaid), and where the person insured has returned to work, any benefit payable will be based on the person insured s actual income at that time. For GSC, any benefit payable will at all times be based on the person insured s actual income. Cover during overseas employment and travel We will continue to provide cover for a person insured who is an Australian resident up to the next premium guarantee date while they are outside of Australia for the purposes of the employer. You do not need to provide us with prior notification, however, the following conditions apply: Any details regarding the person insured s temporary overseas arrangements we require are made available to us when we request them, and In the event of a claim for TPD or GSC, we may require the person insured to return to Australia (at their own expense) for medical treatment and assessment, and we will not pay a claim if the person insured does not return to Australia. We may continue cover for longer periods, provided we are told in advance and approve in writing. We reserve the right to impose conditions on the cover and review cover at the end of this period. We will not pay a benefit if the person insured s death, accidental death, terminal illness or TPD was caused by an act of war while the person insured was overseas for the purposes of their employer. Important note for policies held under superannuation You should be aware that a benefit may not be permitted to be released from the fund unless the person insured satisfies requirements in relation to the payment of benefits as defined under superannuation laws. We recommend that you seek independent expert advice if you have any concerns about whether a benefit may be paid from the fund. Applying for a Group Insurance policy Step 1 Requesting a quotation Our policies are very flexible, and you can tailor the features and costs to best suit your needs. We are able to prepare multiple quotations if necessary to help you decide on your final policy features and costs. If you wish to request a quotation, please contact an AMP Business Development Manager. The quotation will take into account aspects including the number of eligible persons, the total benefit amount insured, gender and occupation profile, past claims and membership history (if applicable) of the eligible persons and any product design options you may nominate to be included. This information is essential for the completion of a quotation, and it is important that it is provided accurately and in full. Your quotation pack Once we have completed the quotation, we will send you a quotation pack, which contains the following: quotation policy schedule(s) an Application form relevant policy document(s) Group Insurance Product Disclosure Statement, and Group Insurance material and other important documents. The quotation policy schedule outlines all the specific features of your policy based on your quotation request specifications and provides easy cross-references to the related areas in the policy document. Step 2 Accepting a quotation If you proceed in purchasing a GL policy and/or a GSC policy (if selected) from us, you will need to complete the Application form supplied in the quotation pack and return it to us along with a deposit premium cheque and any other information we request. Once we accept your application, we will forward to you a final policy schedule, which will form part of your final policy document. To ensure your application is processed efficiently, please make sure that all the information and details have been completed where requested. Your financial adviser will be able to assist if required. 23

26 Step 3 Where to send your completed Application form Once you have completed the Application form, please send it, along with the full deposit premium cheque to: AMP Operations Group Insurance Administration GPO Box 4927VV MELBOURNE VIC 8001 Once we have received and accepted your Application form and first premium, you will receive a final policy schedule, which should be combined with the policy document you received at quotation stage. You should read these documents carefully and contact your financial adviser, or us, if you have any concerns. Alterations Once your policy commences, you can apply to make an alteration to your policy and the benefit. In this instance, the premium rates applied to your policies may need to be reviewed. Your financial adviser can assist you at this time. Cooling-off period Once you have received the policy from us, you have 21 days to check that the policy meets your needs. This is known as the cooling-off period. Within this period you may cancel your policy from the policy commencement date and we will refund your premiums and any fees paid, less any tax we are, or have been required to pay, which has not been refunded to us. Premiums and charges What you have to pay You must pay the premium for all periods during which the policy has been in force, including any period of interim cover. In the event that we are by law required to pay any tax, duty or impost in connection with any premiums payable under the policy, we will increase your premium by the relevant amount and then pay the tax, duty or impost to the proper authority. We will calculate the premium payable from the policy commencement date and on each renewal date. You must give us the information we request in order to calculate the premium. We may otherwise agree that you will calculate the premium, in which case we will confirm the terms of this arrangement in writing. The premium rates used to calculate the premium are set out in your policy. Premium structure There are three premium structures available: 1. Table of premium rates We take into account the age, gender, past claims experience (if any) and occupation profile of the persons insured when determining this table of rates. Where a table of premium rates applies, each person insured will be charged a different rate based on their age next birthday and gender. Rates may be on a unisex basis if you request it and we agree. 2. Unit rate If you request it and we agree in writing we will charge the premium based on a unit rate. This means each person insured pays the same premium rate for cover. A unit rate is applied to the total sum insured of all persons insured to calculate the total cost of insurance. 3. Units of cover Under this structure, cover is a fixed amount for all members at certain age groups. The premium applied is a dollar value per unit of cover per week. For example a unit of cover for a member aged 30 next birthday could be $50,000 at a cost of $1.00 per unit of cover per week. In the event there is a change in federal, state or territory taxes, duties or other legislative changes that increases our costs under your policy, we will increase the premium payable by you, by the relevant amount. When we can change the premium We can change the premium rates by giving you written notice: at any time after the premium guarantee date which is set out in the schedule if Australia is involved in war if there has been a 25% change in the number of persons insured under the policy since the commencement of the rate guarantee period, which is the period of time from the date we notify you as the effective commencement date to the premium rates until the premium guarantee date, as set out in the schedule if there has been a significant change in the circumstances you advised and on which we relied in setting the premium rate for your policy if there is a change in federal, state or territory taxes or duties or other legislative changes that increases our costs under your policy, or if in the case of GL policies, the percentage of the total number of persons insured for TPD who are not employed as full-time permanent employees exceeds 20%. Minimum premium The minimum annual premium for each policy is $25,000 (not including stamp duty for GSC policies). 24

27 How we calculate your premium You must keep accurate records which are necessary for us to be able to calculate the premiums effectively and accurately. Prior to each renewal date we will supply a premium estimate, which must be paid by the premium due date set out in the schedule. At each renewal date, and on termination of the policy, we will calculate the premium to reflect changes in the number of persons insured, their ages, their aggregate genders, their amounts of cover and the type of cover over the period since the policy began, or since the last renewal date, as the case may be. We will do this by requesting information on all persons insured including: name date of birth AMP s benefit category gender date joined company sum insured, and date joined plan. You must supply this information when we request it. If, as a result of the recalculation of the premium, you have paid too much, we will pay you the over-payment or use it to offset the next premium due. If, as a result of the recalculation of the premium, you have not paid enough, we will notify you (in writing) of the additional premium you owe. We refer to this additional premium as the premium adjustment. Where we have agreed in writing that you will calculate the premium, we will review your calculations by way of an audit at each renewal date (or at the some other agreed time). If the policy ends, you will not be entitled to any refund of premium in respect of a period of insurance cover for which you have already paid premiums except as set out above. When the premium must be paid The premium is due on the premium due date, which is set out in the schedule. The adjustment premium is due on the date indicated in the notice advising the adjustment premiums. We may charge interest on any amount due to us outstanding for more than 30 days. Applying for benefits How to apply for benefits under your policy You must tell us as soon as possible after the person insured s injury, disablement or death occurs. We will then send you the relevant benefit application forms as soon as possible. Alternatively, you can contact your financial adviser. Completing a claim form Death benefits Before we can assess a death claim, we require the completion of the death claim documents. Terminal illness, total and permanent disablement or salary continuance benefits Before we can assess a person insured s eligibility for benefits, we will need the person insured to complete a claim form. A claim form provides us with key information regarding the nature of the application. To avoid delays, it is important that the person insured completes and returns the relevant forms as soon as possible. Please ensure that all details requested on the claim form are complete and accurate, and where requested, any supporting documentation is attached to the application for benefits. Submission of an incomplete form will result in delays to the application being assessed. Should a person insured applying for benefits require any assistance in completing a claim form, please contact our Customer Service Centre on Assessing an application for benefits When assessing a claim, we will review the circumstances surrounding the claim, in conjunction with the terms and conditions of the policy. It may be necessary for us to obtain further information in order to assess the claim. Death benefits To assess a claim for death benefits, we will ask you to provide the following: completed death claim document an originally certified copy of the birth certificate an originally certified copy of the marriage certificate where applicable certification of the person insured s age, and an originally certified copy of the death certificate. Terminal illness, total and permanent disablement and salary continuance benefits We may ask the person insured or you for more information such as: proof about the insured person s health any underwriting evidence completed proof of the at work status for the person insured at the time of first becoming insured, or any other information in relation to the claim. We may also choose a medical practitioner or other health professional to examine the person insured. The person insured must provide the necessary information and allow themselves to be interviewed and examined. 25

28 Where possible, we will notify you of any outstanding requirements to minimise delays in the application for a benefit being processed. Benefit payments We will notify you in writing of the outcome of the application for a benefit. Where we have established that the person insured s benefit application has met the terms and conditions of the policy, we will arrange for the benefit to be paid to you. Mis-statement of age If a person insured s age is mis-stated, we reserve the right to adjust premiums or the benefit based on the correct age. Claims after termination If the policy or cover is terminated (whether for all persons insured or any number of person insured), we will only pay a claim if: the event on which the claim is payable occurred before the policy is terminated, and any premium arrears have been paid up to the date the policy is terminated. If, after the policy ends, we have to continue paying you a benefit, the policy conditions which specifically relate to those claim payments will continue to apply until we stop making claim payments. We will reduce or decline to pay a benefit We will decline to pay, or reduce a benefit which we may otherwise pay to you: where we have not received notice as soon as reasonably possible after the person insured first became disabled, in circumstances where such a delay has prejudiced our ability to assess and manage a claim if the policy claim requirements have not been complied with by you, an employer or a person insured if the person insured is in jail, or otherwise detained, as a result of a criminal act if the person insured makes a fraudulent claim, or if a premium due for all persons insured has not been paid by the premium due date set out in the schedule. Enquiries and privacy Enquiries If you have any enquiries about your policy, please contact your financial adviser or our Customer Service Centre on from anywhere in Australia for the cost of a local call. Complaints resolution If you or a person insured has a complaint, please advise AMP in writing, stating the precise nature of your complaint and the name and number of the policy. The Service Centre address is: Operations Group Insurance Administration Group Insurance Manager GPO Box 4927VV MELBOURNE VIC 8001 If you are not satisfied with our handling of the complaint, there are two external complaints organisations that can assist you or the person insured. The Financial Ombudsman Service (FOS) is available to you or a person insured. FOS is governed by an Independent Council, which reports directly to the Federal Minister for Consumer Affairs. FOS can be contacted on For persons insured under a superannuation policy, the Superannuation Complaints Tribunal (SCT) is an independent tribunal established by the Commonwealth Government to deal with complaints about superannuation funds. The SCT can be contacted on Alternatively, they can write to: The Manager Superannuation Complaints Tribunal Locked Mail Bag 3060 GPO MELBOURNE VIC 3001 Privacy use and disclosure of personal information When you collect personal information in respect of an eligible person or person insured for us, you must make the relevant person concerned aware: that the information will be disclosed to us of the uses which that information will be put to by us, and of the entities to which we may disclose that information. You must advise the relevant person that: they are entitled to request reasonable access to information we have about them, and we reserve the right to charge an administration fee for collating the information they request. The privacy of your personal information is important to you, the relevant person and also to us. We will only collect information about the person and their immediate family background which is necessary for the purposes of assessing their application for insurance or assessing any claim you may make under the policy in connection with them. This includes information about health, financial situation, occupation and lifestyle. We may collect personal information directly from the person, you or your financial adviser. 26

29 We may also collect personal information if it is required or authorised by law, including the Superannuation Industry (Supervision) Act 1993, the Corporations Act 2001 and the Anti- Money Laundering and Counter-Terrorism Financing (AML/CTF) Act Our main purpose in collecting personal information is so we can establish and manage insurance for eligible persons and persons insured under the policy. If the information necessary to establish their insurance is not provided, then we may not be able to provide it. We may also use this information for related purposes for example, enhancing customer service and product options and providing persons with ongoing information about opportunities that may be useful for your financial needs through direct marketing. These may include investment, retirement, financial planning, banking, credit, life and general insurance products and enhanced customer services that may be made available by us, other members of the AMP group, or by your financial adviser. If, at any time, persons do not want to receive this information, they can opt out by telephoning our Customer Service Centre on We usually disclose information of this kind to: other members of the AMP group your financial adviser or broker (if any) the owner of the plan parents or guardians, if a person is under age 18 external service suppliers who may be located in Australia or overseas, who supply administrative, financial or other services to assist the AMP group in providing services. From March 2014, a list of countries where these providers are likely to be located can be accessed via our Privacy Policy the Australian Transaction Reports and Analysis Centre (AUSTRAC) where required by our anti-money laundering compliance plan the Australian Taxation Office (ATO) to conduct searches on the ATO s Lost Member Register for lost superannuation anyone you or the person has authorised or if required by law. If sensitive information, such as health information, is collected in relation to this financial product, then additional restrictions apply. NMLA may collect health information using a third party provider. The primary purpose for obtaining this health information is for the Insurer, NMLA, to assess the person insured s application for new or additional insurance. NMLA may also use this information for directly related purposes for example, deciding whether more information is needed, arranging reinsurance, assessing further applications and processing claims. NMLA may disclose this type of health information to: the financial adviser or broker responsible for the plan parents or guardians, if a person is under age 18 the owner of the plan NMLA s reinsurers medical practitioners any person NMLA considers necessary to help either assess claims or resolve complaints anyone you or the person has authorised or if required by law. Aspects of the person s health information may be provided to you in resolving terms of acceptance or if the standard plan rates are varied. NMLA and/or its health screening provider may also speak to a third party for the sole purpose of arranging a health screening appointment for the person. This third party may include a spouse, family member, personal assistant, financial planner or other relevant party. Under the current AMP Privacy Policy persons may access personal information about them held by the AMP group. The AMP Privacy Policy sets out the AMP group s policies on management of personal information, including information about how you can access your personal information, seek to have any corrections made on inaccurate, incomplete or out-of-date information, how you can make a complaint about privacy, and information about how we deal with such complaints. The AMP Privacy Policy can be obtained online at amp.com.au or by calling our Customer Service Centre on

30 Trauma definitions Advanced diabetes means severe diabetes mellitus, either insulin or non-insulin dependent, as certified by a consultant endocrinologist and resulting in at least two of the following: severe diabetic retinopathy resulting in visual acuity uncorrected and corrected of 6/36 or worse in both eyes severe diabetic neuropathy causing motor and/or autonomic impairment diabetic gangrene leading to surgical intervention, or severe diabetic nephropathy causing chronic irreversible renal impairment (as measured by a corrected creatinine clearance below the laboratory s measured normal range). Alzheimer s disease and other dementias means an unequivocal clinical diagnosis of dementia (including Alzheimer s disease) resulting in significant cognitive impairment. Significant cognitive impairment means a deterioration in the Life Insured s Mini-Mental State Examination scores to 24 or less. Aplastic anaemia means permanent bone marrow failure which results in anaemia, neutropaenia and thrombocytopaenia requiring treatment, with at least one of the following: blood product transfusions marrow stimulating agents bone marrow transplantation, or immunosuppressive agents. Benign brain tumour a non-cancerous tumour in the brain that gives rise to characteristic symptoms of increased intracranial pressure such as papilledema, mental symptoms, seizures and sensory impairment. The tumour must result in neurological deficit, resulting in: at least 25% permanent impairment of whole body function, or the person insured being totally and permanently unable to perform at least one of the activities of daily living. The presence of the underlying tumour must be confirmed by imaging studies such as CT scan or MRI. The following are excluded: cysts granulomas malformations in or of the arteries or veins of the brain haematomas, and tumours in the pituitary gland or spine. Blindness means the permanent loss of sight in both eyes as a result of disease, illness or injury to the extent that visual acuity is 6/60 or less in both eyes, or to the extent that visual field is reduced to 20 degrees or less of arc irrespective of corrected visual acuity. Cancer as defined in this policy means an abnormal growth of cells that is confirmed on pathology tests to include the uncontrolled spread of malignant cells and the invasion and destruction of normal tissue. The term cancer includes leukaemia, lymphomas such as Hodgkin s disease, malignant tumours of the body and melanomas greater than or equal to Clark Level 3 or greater than or equal to 1.5 mm depth of invasion or where the melanoma is showing signs of ulceration, unless excluded below: carcinoma in situ of the breast where the tumour is classified as TNM stage Tis unless requiring surgery that results in the removal of the entire breast all other tumours classified as carcinoma in situ melanomas that are both less than Clark Level 3 and less than 1.5 mm in thickness (unless there is histological evidence of ulceration) other skin cancers unless there has been evidence of spread (that is, metastasis) to other parts of the body prostate tumours classified as T1 (all categories) under the TNM (or equivalent) classification system unless prostatectomy is performed lymphocytic leukaemia less than Rai stage I tumours that occur within the 90 day qualifying period, and tumours that recur outside the 90 day qualifying period unless the recurrence can be shown to be unrelated. Cardiac arrest that is the sudden breakdown of the heart s pumping function where it: is due to asystole or ventricular fibrillation, and is not associated with any clinical procedure, and is documented by electrocardiographic (ECG) changes, and occurs outside a hospital or other medical facility. Cardiomyopathy means impairment of the ventricular function of variable aetiology resulting in significant and irreversible physical impairment to the degree of at least Class 3 of the New York Heart Association classification of cardiac impairment. Chronic kidney failure chronic irreversible failure of both kidneys requiring either permanent renal dialysis or kidney transplantation. Chronic liver disease means end stage liver failure resulting in: permanent jaundice, and ascites or encephalopathy. Coma means the failure of cerebral function as shown by total unarousable unresponsiveness to all external stimuli persisting continuously with the use of a life support system for a period of at least three days. Coma directly resulting from alcohol or drug abuse is excluded. 28

31 Coronary artery bypass surgery means coronary artery bypass grafting surgery, which is considered medically necessary to treat coronary artery disease but does not include: angioplasty intra-arterial procedures laser techniques, or other non-surgical techniques. Deafness the total, irreversible and irreparable loss of hearing, both natural and assisted, in both ears as a result of disease, illness or injury. Encephalitis means the severe inflammation of brain substance that results in significant and permanent neurological sequelae: with at least 25% impairment of whole body function, or the person insured being totally and permanently unable to perform at least one of the activities of daily living. Encephalitis as a result of HIV infection is excluded. Heart attack means the death of an area of heart muscle due to lack of adequate blood supply where: there are diagnostic changes in relevant cardiac enzymes or biomarkers in the days following the heart attack, and there are typical new ischaemic changes in the electrocardiograph (ECG): new ST-T changes or new left bundle branch block (LBBB). If the above criteria are not met, we will pay a claim based on satisfactory evidence that the person insured has unequivocally been diagnosed as having suffered a heart attack resulting in: a permanent reduction in the left ventricular ejection fraction to less than 50% measured in the three months or more after the event, or new pathological Q waves. Other acute coronary syndromes including, but not limited to, angina pectoris are excluded. Heart valve surgery the undergoing of heart surgery to replace or repair a heart valve as a consequence of a heart valve defect. Angioplasty, intra-arterial procedures and other non-surgical techniques are excluded. Loss of capacity for independent living means that as a result of an injury or sickness, you are permanently unable to perform at least two of the activities of daily living without assistance. Please refer to the activities of daily living definition. Loss of speech total and permanent loss of the ability to produce intelligible speech as a result of permanent damage to the larynx or its nerve supply from the speech centres of the brain, whether caused by injury, tumour or sickness. Lung disease chronic lung disease requiring permanent supplementary oxygen. For the purposes of this definition, the criteria for requiring supplementary oxygen will be an arterial blood oxygen partial pressure of 55 mmol/l or less, while breathing room air. Major head injury means cerebral injury caused by external trauma which results in permanent neurological deficit and causes at least 25% impairment of whole body function. Major organ transplant means: the receipt of a transplant of human bone marrow or whole human organs, or upon specialist medical advice and proof of being placed on an official Australian acute care hospital waiting list, approved by us, to undergo necessary organ transplant, or undergoing permanent mechanical replacement for one or more of the following human organs: heart, lung, liver, kidney, pancreas or small bowel. Medically acquired HIV infection is the accidental infection with the Human Immunodeficiency Virus (HIV) after the start of this plan, which in our opinion arose from one of the following medically necessary events which must have occurred to you while in Australia by a recognised and registered health professional: a blood transfusion transfusion with blood products organ transplant to you assisted reproductive techniques, or a medical procedure or operation performed by a doctor. Notification and proof of the incident will be required via a statement from the appropriate statutory health authority that the infection is medically acquired. HIV infection transmitted by any other means including sexual activity or recreational intravenous drug use is specifically excluded. This benefit will not apply in the event that any medical cure is found for AIDS or the effects of the HIV virus or a medical treatment is developed that results in the prevention of the occurrence of AIDS. Cure means any treatment that renders the HIV inactive or non infectious. All testing must be conducted by Australian Government approved specialist pathology laboratories. If required by us, we must be given access to all blood and body fluid samples tested and we must be allowed to independently test them. We may require that blood and body fluid collection and diagnostic testing be repeated. All evidence provided must be acceptable to us. Motor neurone disease means unequivocal diagnosis of motor neurone disease by a consultant neurologist and confirmed by neurological investigations. Multiple sclerosis means the unequivocal diagnosis of multiple sclerosis confirmed by a consultant neurologist where there has been more than one episode of well defined neurological deficit with persisting neurological abnormalities. The neurological deficit must involve motor and sensory function. Muscular dystrophy means the unequivocal diagnosis of muscular dystrophy, confirmed by a consultant neurologist. 29

32 Parkinson s disease means an unequivocal diagnosis of degenerative idiopathic Parkinson s disease confirmed by a consultant neurologist, as characterised by the clinical manifestation of one or more of the following: rigidity tremor, and akinesia resulting in the degeneration of the nigrostriatal system. All other types of Parkinsonism are excluded (for example, secondary to medication). Pneumonectomy the excision of an entire lung when deemed medically necessary by an appropriate specialist and supported by our medical advisers. Primary pulmonary hypertension means primary pulmonary hypertension with right ventricular enlargement established by investigations including cardiac catheterisation. Severe burns means third degree burns to 20% or more of the body surface, or to the whole of the face or the whole of both hands requiring surgical debridement and/or grafting. Severe rheumatoid arthritis means the unequivocal diagnosis of severe rheumatoid arthritis confirmed by a rheumatologist. The diagnosis must be supported by, and evidence, all of the following criteria: at least a six week history of severe rheumatoid arthritis which involves three or more of the following joint areas: proximal interphalangeal joints in the hands metacarpophalangeal joints in the hands metatarsophalangeal joints in the foot, wrist, elbow, knee, or ankle simultaneous bilateral and symmetrical joint soft tissue swelling or fluid (not bony overgrowth alone) typical rheumatoid joint deformity, and at least two of the following criteria: morning stiffness rheumatoid nodules erosions seen on x-ray imaging the presence of either a positive rheumatoid factor or the serological markers consistent with the diagnosis of severe rheumatoid arthritis. Degenerative osteoarthritis and all other arthritides are excluded. Stroke means the damage of brain tissue as a result of a cerebrovascular incident caused by haemorrhage, embolism, or thrombosis, associated with the sudden onset of objective neurological deficit. The incident must be demonstrated by Magnetic Resonance Imaging (MRI), Computerised Tomography (CT), or other reliable imaging techniques approved by us. Excluded: transient ischaemic attack cerebral symptoms associated with reversible neurological deficit cerebrovascular disorder of the eye or optic nerve symptoms due to migraine or headache, and brain tissue damage caused by head injury. Surgery of the aorta means surgery performed to correct any narrowing, dissection, or aneurysm of the thoracic or abdominal aorta but does not include angioplasty, intraarterial procedures or other non-surgical techniques. Triple vessel angioplasty means the actual undergoing for the first time of coronary artery angioplasty to correct a narrowing or blockage of three or more coronary arteries within the same procedure. Angiographic evidence, indicating obstruction of three or more coronary arteries, is required to confirm the need for this procedure. 30

33 Definitions Accidental death means death that: is the result of accidental injury occurs within 90 days of sustaining such injury, and is independent of any other cause. We won t pay where accidental death was caused by suicide, whether sane or insane, and death as a result of, or associated with: intentional self-injury, including intentionally contracted infection by bacteria or virus, or any attempt thereas making or attempting to make a flight in an aircraft (otherwise than as a passenger for whom a fare or fee has been paid, or as a passenger in an aircraft under charter) taking intoxicating liquor or drugs, or an accident which occurred before the policy commencement date. Accidental injury an injury of an eligible person or person insured which first occurred after cover for the eligible person or person insured began under the policy, including any interim cover, and is caused directly and solely because of an accidental event which was violent, external and visible and which was not caused by attempted suicide, or self-inflicted by the person on purpose. Accidental total and permanent disablement means total and permanent disablement which: is the result of accidental injury occurs within 90 days of sustaining such injury, and is independent of any other cause. We won t pay where accidental total and permanent disablement was caused by attempted suicide, and total and permanent disablement as a result of, or associated with: intentional self-injury, including intentionally contracted infection by bacteria or virus, or any attempt thereas making or attempting to make a flight in an aircraft (otherwise than as a passenger for whom a fare or fee has been paid, or as a passenger in an aircraft under charter) taking intoxicating liquor or drugs, or an accident which occurred before the policy commencement date. Activities of daily living are: bathing/showering dressing/undressing eating/drinking using the toilet to maintain personal hygiene, or getting in and out of bed, a chair, a wheelchair or moving from place to place by walking, a wheelchair or with a walking aid. At work the person is properly performing all their duties and work hours (without limitation) of usual paid employment with the employer and is not in receipt of and/or entitled to claim income support benefits from any source including worker s compensation, statutory transport accident benefits or disability income benefits, or is on employer approved leave for reasons other than sickness or injury, and was on the day immediately preceding the first day of employer approved leave properly performing all their duties and work hours (without limitation) of usual paid employment. A person insured who does not meet this definition is correspondingly described as being not at work. Australian resident means an eligible person or person insured who is legally permitted to reside and work for reward in Australia. Automatic acceptance is described on page 20. Automatic acceptance limit means the automatic acceptance limit specified in the schedule. The automatic acceptance limit may vary depending on the types and amount of cover. Benefit a sum-insured amount based on the benefit formula which may become payable by us to you in respect of a person insured who has been nominated by you and accepted by us for that cover provided the applicable terms and conditions of the policy are met. Benefit calculation date the date described in the schedule. Benefit formula the formula used for calculating the amount of the benefit for a person insured as described in the schedule. Benefit period the period indicated in the schedule. The benefit period starts from the date you are first entitled to be paid the benefit. Contractor means a person who: is not an permanent employee of the employer is performing work in connection with a contract entered into with the employer is contracted to work for a period of at least 12 months, and is personally performing all the normal and usual duties of their work. Cover expiry age the age death cover, TPD cover (if applicable) or GSC cover expires as indicated in the schedule. 31

34 CPI the Australian National All Groups Consumer Price Index rated average of eight capital cities combined. We use the last publicised index for the 12 months ending 30 September each year. However, we may use the index published for a more recent 12 month period and/or another rate index which we believe more fairly and accurately reflects changes in the cost of living. Default fund a fund which is the fund that the employer will contribute to if the employee does not make a choice within the meaning of section 32P(1)(c) of the Superannuation Guarantee Administration Act 1992 (Cth). Disability and disabled for the purposes of GSC means total disability and/or partial disability as the context requires. Disability salary the monthly amount earned by the person insured as a result of their own personal exertion (other than benefits received under the policy) during any period we are paying you or you are entitled to be a benefit for the person insured under the policy, including but not limited to taxable earnings, employer Superannuation Guarantee entitlements and any amount which, in our opinion, the person insured could be reasonably expected to earn while disabled. Eligibility criteria the criteria described in the schedule. Eligible person a proposed person insured who meets the eligibility criteria. Employer an employer participating in the policy as described in the schedule and, in relation to an eligible person or person insured means the employer employing that person. Where the owner of the policy is a partnership, the employer means the partners in that partnership. For GL insurance policies, an employer also means the employer engaging a person insured as an independent contractor (as regarded by law) as the case may be. Employer superannuation contributions benefit as described in the schedule. Escalation percentage the percentage described in the schedule. Family member in relation to the person insured, their spouse (including legal spouse, de-facto or same-sex partner), mother, father, mother-in-law, father-in-law, child (including adopted child, a step-child or an ex-nuptial child). Full-time a person is required to work 15 hours or more per week as part of their normal duties. Further underwriting limit in respect of a person insured, the amount (if any) which we last notified you up to which we will accept future increase in the benefit. Underwriting terms will not apply to these increases. Important duties are one or more duties which are important and essential in producing income. Income 1. In the case of a person insured who owns part, or all of a business, practice or partnership that is the employer, means: the amount that is generated by the business due to the person insured s own personal exertion activity, after all expenses in earning that amount have been deducted and, for persons insured employed by the employer for two consecutive years or more, the average of the last two years we have not been paying you a benefit under the policy for the person insured, and for persons insured employed by the employer for less than two years, the average of the period we have not been paying you a benefit under the policy for the person insured, but does not include any commissions, bonuses, investment and interest income and employer Superannuation Guarantee entitlements. 2. In the case of a person insured who does not own part or all of a business, practice or partnership, means the total remuneration given to the person insured by the employer including fringe benefits, but excludes any commissions, bonuses, investment and interest income and employer Superannuation Guarantee entitlements. Where the benefit calculation date is last day at work, income is the person insured s monthly income earned from working for the employer immediately before a benefit became payable by us in respect of the person insured. Where the benefit calculation date is last renewal date, income is the person insured s monthly income earned from working for the employer at the most recent renewal date that we have confirmed in writing to you. Medical care the person insured must be receiving and following treatment or advice recommended by a medical practitioner who has personally assessed them and been provided with full clinical details of their case, and the person insured will continue to be reviewed in these circumstances on at least a monthly basis unless otherwise agreed by us. Medical practitioner a registered medical practitioner who is appropriately qualified to treat the person insured s injury or sickness. The medical practitioner cannot be you or your family member, business partner, employee or employer nor can it be the person insured or their family member, business partner, employee or employer. Monthly benefit the amount of the monthly benefit is calculated as a percentage of the person insured s income. You can decide on the percentage of income that will be used by us for calculating the monthly benefit, at the time of establishing the policy however, we must first agree in writing. The monthly benefit for a person insured may be limited as a result of either underwriting terms or transfer terms. If there are different categories of persons insured, a different percentage of income may apply for each category. 32

35 New events cover cover for TPD disablement, total disablement or a listed specific sickness or specific injury, if applicable, other than a cause in relation to the medical condition or any directly or indirectly related condition arising from sickness or injury which has caused the person insured either: to be not at work on the working day immediately preceding the policy commencement date, or in respect of an sickness or injury occurring in the period after the last day at work and prior to the policy commencement date, to be not at work or to be working in a reduced capacity on the policy commencement date. Offset 1. Amounts paid or payable in relation to the sickness or injury of the person insured including: any amount which is paid under any other disablement, injury or sickness insurance policy you or the person insured holds with us or any other insurance company (except for lump sum, TPD or lump sum superannuation payment) any amount which is paid under common law actions for loss of earnings, past and future workers compensation or any other equivalent payments in respect of lost income (whether under legislation or not) statutory accident compensation scheme payments any social security payments or entitlements, and any Department of Veteran Affairs payments or entitlements, plus 2. Any sick leave received by the person insured at the same time we are paying you a benefit in respect of a person insured plus 3. Any other income received by the person insured that is not as a result of the person insured s own exertion earned from the employer at the same time as they are receiving a benefit from us but excluding any investment income plus if the words Employer superannuation contributions benefit appear in the additional options section of the schedule: 4. Any paid amount designed to replace in whole or part the compulsory employer Superannuation Guarantee, a person insured would have received had they not been disabled. Note, this offset condition number 4 is applied to the employer superannuation contributions benefit (if applicable). Part-time means a person is required to work less than 15 hours per week as part of their normal duties. Partially disabled means the person insured is partially disabled if, immediately after being totally disabled for at least 14 days, they are not able to perform one or more of the important duties of their occupation and, because of the disability, the person insured s income for the work he or she does is less than the amount of their pre-disability income. The person insured must be under the regular care of a medical practitioner. Partial disablement, partial disability and partially disabled shall have a corresponding meaning. Permanent employee a person who is employed by the employer on a permanent basis. Person insured means an eligible person who we have agreed to insure under the terms and conditions of the policy and for whom you have paid all premiums due. Policy commencement date the date specified in the schedule. Previous policy a Group Insurance policy providing Group Insurance cover, that was in force the day immediately preceding the policy commencement date that the policy is replacing. Rehabilitation occupational rehabilitation for the purpose of returning the person insured to employment. Occupational rehabilitation includes initial rehabilitation assessment, functional assessment, workplace assessment, vocational assessment and vocational training. Any occupational rehabilitation must be as part of a return to work program approved by us. Renewal date the date specified in the schedule. Schedule the schedule attached to the policy and issued at the commencement of the policy, or as varied in accordance with the terms of the policy. Terminal illness means any illness which, in our opinion, will result in the death of the person insured within 12 months, regardless of any treatment that might be undertaken. Our decision will be based on medical evidence provided to us by the person insured s doctor, and any other such evidence that we may require. The sickness resulting in the terminal illness must occur, and the date any medical practitioner first certifies the person insured as being terminally ill must take place, while the person insured is covered under the policy. Terminal illness and terminally ill shall have a corresponding meaning. The fund the superannuation fund as described in the schedule. Totally disabled is as described on pages 5 to 6, and for the purposes of TPD means as the context requires. Total disablement, total disability and totally disabled shall have a corresponding meaning. 33

36 TPD waiting period this is the period of time required to qualify for part (a) of the TPD definition and is listed in the schedule. The standard period is 3 months. Underwriting terms we will only agree to provide cover for an eligible person or an increase in the benefit for a person insured when we are satisfied they have met our underwriting requirements. We may impose conditions on any cover or part of it that is subject to underwriting terms. Voluntary insurance a. any person insured who has cover called voluntary insurance in the schedule, and b. any cover or increase in cover elected by the person insured unless an increase is by virtue of a further underwriting limit or the operation of a benefit formula. The definition above applies only to GL policies. Waiting period the number of consecutive days (shown in the schedule) for which a person insured must be totally disabled or partially disabled, as the case may be, before his or her benefit becomes payable under the policy. If there is more that one category of persons insured, the waiting period for a person insured is that specified in the schedule for their category. The waiting period may be extended in certain circumstances. War includes, but is not limited to, war, (declared or undeclared) or war related activities, revolution, invasion or rebellion or civil unrest. 34

37 Contact us phone web amp.com.au The National Mutual Life Association of Australasia Limited ABN AFS Licence No GPO Box MELBOURNE VIC /14