Group Salary Continuance

Transcription

1 Group Salary Continuance Product Disclosure Statement 1 July 2011 TAL Life Limited ABN AFSL Number

2 Important information This Product Disclosure Statement (PDS) details the important terms and conditions of a Group Salary Continuance Policy issued by TAL Life Limited (TAL, we, us, our). Depending on your choice, cover is offered as a Standard Policy or an Executive Policy. We recommend that you read this PDS fully before making any decision to apply for this product. TAL takes full responsibility for the content of this PDS. The information within this PDS is current as at the date of issue. From time to time we may make changes or update information contained in this PDS, which is not materially adverse, by publishing a note of the change on our website com.au. You can also ask for a free paper copy of the updated information. This PDS does not form part of your Policy unless a Policy Schedule is attached and signed by us. Once we have agreed to issue you with group life insurance, this PDS together with the Policy Schedule and any Endorsements (for later amendments to the Policy) will form the Policy, as stated in Section 3.3. We will send you the Policy Schedule which will reflect the agreed terms and conditions. You will see there are a number of words in this PDS which are capitalised and are in bold. These words have a particular definition when used in the PDS. These definitions are found in Section 22 of this PDS. It is important you read these definitions carefully because their meanings are relevant to your decision to apply for this product and how the Policy works once issued by us. Please note we use Insured Person to refer to the person whose life is insured under the Policy. you and your refer to the Policy Owner. A Standard Policy provides insurance cover for Total Disability, Partial Disability, Interim Cover, Death Benefit and payment of rehabilitation expenses. Depending on your choice superannuation contributions may also be included in the amounts covered under a Standard Policy. In addition to the benefits provided under a Standard Policy, other valuable benefits are available under an Executive Policy. The Benefits applicable to your Policy will be set out in the Policy Schedule. Any information contained in this PDS is of a general nature only. It does not take into account individual financial situations, needs or objectives. Policy owned by a superannuation trustee Where the Policy Owner is the trustee of a superannuation fund, benefit payments are made through the fund and subject to restrictions under superannuation law. Rules relating to when superannuation benefits can be accessed are complex and you should obtain financial advice to assist you (see the next section). Need help? If you need help in deciding whether to purchase this product, and any financial products in general, we recommend that you speak to a licensed financial adviser. If you have any questions you can contact us on , or visit our website, If you do not have a financial adviser, please contact TAL and we can put you in touch with someone who can help. You can check to see if your financial adviser is licensed by visiting the MoneySmart website ( gov.au) established by the Australian Securities and Investments Commission (ASIC). Alternatively, ASIC can be contacted by telephone on or by at [email protected].

3 We take life (insurance) personally. Life insurance is an important part of a person s financial future. TAL provides high quality, comprehensive and flexible protection options. At TAL we re all about simple, innovative life solutions. TAL s offer at a glance Our easy reference table below provides a quick summary of our new product. You will need to read the terms and conditions for a full explanation of cover and limits. Benefit/Feature Brief Description Refer to Page Product enhancements No minimum hours Cover is available for eligible Permanent Employees regardless of the number 5 of hours they work each week. Contractors Cover is available for any Contractors with a written contract for services with an 5 Employer for a minimum of 15 hours per week for a continuous 6-month period. AAL uplifts Employees and members may automatically receive any increase in AAL, including those 7 that have been previously underwritten and have been declined, loaded or excluded for cover above the previous lower AAL, unless otherwise stated in the Policy Schedule. Underwriting loadings Premiums in respect of underwriting loadings are waived, reducing costs and simplifying administration. 9 Cover during paid and unpaid leave Worldwide cover Up to 24 months continuous cover whilst on employer approved leave, without the need to be approved by us. Cover is provided 24 hours a day, all year round, with no restrictions on location or time spent overseas, subject to meeting certain conditions. Product Features/Benefits Interim Cover Provides cover for both illness and injury during Underwriting. 10 Total Disability Benefit A monthly benefit will be paid if an Insured Person is unable to work due to 11 illness or injury. Partial Disability A portion of the Total Disability Benefit will be paid if an Insured Person has reduced 11 working capacity due to illness or injury. Superannuation Provides a benefit covering the cost of employer superannuation contributions for whom 12 Contribution Benefit we are paying either a Total Disability Benefit or Partial Disability Benefit. Recurring Disability A waiting period will not apply to a claim if it relates to the same or related illness or injury 13 from which a member has received a Total Disability or Partial Disability payment in the last 6 months. Rehabilitation We may pay some or all of the costs involved with a rehabilitation or return to work 13 program for an Insured Person. Death Benefit A lump sum of 3 times the Total Disability Benefit will be paid if an Insured Person dies 13 while receiving a Total Disability Benefit or a Partial Disability Benefit. Increase in claims benefit The Total Disability Benefit or a Partial Disability Benefit payable will increase each anniversary year of first payment by the lower of CPI and 5%

4 TAL s offer at a glance (continued) Benefit/Feature Brief Description Refer to Page Ancillary benefits available under the Executive Policy. Trauma Benefit A lump sum benefit will be paid if an Insured Person suffers one of the listed 15 Trauma conditions. Specific Injury Benefit A lump sum will be paid if an Insured Person suffers one of the listed Specific Injuries. 16 Nurse Care Benefit A benefit will be paid if an Insured Person is confined to bed and under the care of a 17 registered nurse, during the waiting period. Accommodation Benefit A benefit will be paid to cover accommodation costs if an Insured Person requires an 17 immediate family member to take care of them while the Insured Person is confined to bed and is staying more than 100 kilometres from home. Family Care Benefit An additional benefit will be paid where an Insured Person is Totally Disabled and 18 confined to bed, if a family member suffers a loss of income due to having to care for the Insured Person. Home Care Benefit An alternative to the Family Care Benefit, an additional benefit will be paid where an Insured Person is Totally Disabled and confined to bed, and decides to rely on a professional home carer instead of a family member. 18 Availability of cover The below table sets out the limits and choices that apply to TAL s Group Salary Continuance Life Insurance unless otherwise stated in the Policy Schedule: Minimum benefit entry age 16 Maximum benefit entry age 64 Maximum monthly benefit limit $30,000 Maximum benefit expiry age 70 Waiting periods available 30, 60, 90, 180 and 365 days Benefit periods 2 and 5 years benefits and To Age 65 cover Premium payment frequency Monthly, quarterly, half-yearly or annually

5 Table 0f Contents About TAL Section 1: Before your policy starts... 2 Section 2: When your policy starts... 3 Section 3: Policy information... 4 Section 4: Who can have insurance cover under the policy... 5 Section 5: When cover starts... 6 Section 6: Automatic acceptance... 7 Section 7: Takeover of insurance cover... 8 Section 8: Underwriting... 9 Section 9: Interim cover Section 10: Standard benefits Section 11: Additional benefits under the executive policy Section 12: Employer approved leave Section 13: Overseas cover Section 14: Restrictions on benefit payments Section 15: Extended cover Section 16: Continuation of cover option Section 17: When cover for an insured person ceases Section 18: When the policy ends Section 19: Claims Section 20: Premiums Section 21: Profit share and multinational pooling Section 22: Definitions Section 23: Trauma definitions Section 24: Additional information... 40

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7 About TAL TAL is one of Australia s leading independent life insurance specialists. Partners We are committed to making life insurance a well understood and valued part of people s lives. TAL s Group Life division is a recognised industry leader offering group insurance knowledge and expertise to all of our customers, their employees and members. The Group Life team is dedicated to the growth and development of our customers and the group insurance industry as a whole. Our focus is creating holistic solutions that enhance the insurance experience of our customers and their employees and members. Innovators TAL is committed to ensuring our customers obtain the life insurance cover that best suits their needs, quickly and easily. For the Group Life team, this means exploring all the available options to deliver the best insurance offering to our customers. We actively engage with our customers to understand their needs and the needs of their employees and members to find the solutions that work for them. Experience and depth Our Group Life team is comprised of industry experts, who have extensive experience in both the superannuation and life insurance industries. As one of the largest providers of group insurance in Australia, TAL s corporate client list extends to over 500 organisations throughout Australia. We understand the complexities of managing insurance through superannuation. Our broad experience means we are available to advise and offer product solutions to funds of any size or structure. Reliable TAL has enjoyed solid profit performance over the past several years. Awards TAL s approach to life insurance has seen us win several accolades over the past year including SuperReview s Group Insurer of the Year (2009 and 2010) and Australian Banking & Finance Magazine s Best Life Insurance Company (2009). This follows consecutive years of being finalists and winners of Money Management s Risk Company of the Year award, demonstrating our ongoing commitment to excellence in life insurance. Life Company of the Year Award 2010 WINNER Product Disclosure Statement 1

8 Section 1: Before your policy starts 1.1 Who can apply for group insurance Australian based organisations, including corporations, incorporated associations and superannuation funds can apply to TAL for a group life insurance policy to provide cover for their employees, members and their spouses. Where a Policy is issued, the applicant will be the Policy Owner. 1.2 What type of cover is available There are two types of group salary continuance policies available. There is a Standard Policy and an Executive Policy. The Policy Schedule will state whether you have a Standard Policy or an Executive Policy and what additional benefits apply to the Policy. 1.3 Content of this PDS This PDS sets out the terms and conditions relating to Benefits provided under any Policy issued by us. It explains who can be covered, when cover is provided automatically and when employees and members will need to apply for cover. This PDS also sets out the circumstances in which employees and members are entitled to apply to us for cover to continue under an individual insurance policy issued by TAL, when they are no longer covered under this Policy. 1.4 What information do we require to provide a quotation For us to provide you with group insurance we must first provide you with a quotation. So that we can provide you with a quotation, you will need to provide us with information on the group of persons to be insured. This information includes age, gender, occupation, location (including outside Australia if applicable), plan and claims history (if insured previously), as well as your insurance requirements for them. In addition, we may require further information to enable us to assess the risk more accurately and provide you with the most reasonable and sustainable price for your insurance. Once we have the information we require, we will issue you with a quotation. 1.5 Accepting our quotation To accept our quotation, you must complete the prescribed application form (including any information required by us) and submit it, together with the Deposit Premium requested by us, on or before your requested date for commencement of the Policy. Please make sure the completed application form is consistent with the quotation provided by us and accepted by you. 1.6 Other important information There are important risks which should be considered when deciding to purchase this product, including: Selected Benefits may not provide adequate financial protection for the Insured Persons covered under the Policy; Benefits may be reduced, excluded, limited or withheld under circumstances described in Section 14. The Policy or Insurance Cover may be avoided or terminated where there is a failure to comply with Section 3.8 (Policy owner obligations) or the Duty of Disclosure stated in Section 24.1, or under circumstances described in Section 18; and Any Special Conditions agreed between you and us will be stated in the Policy Schedule when it is issued. It is important you read this PDS together with any quotation you wish to accept prior to making an application for insurance with TAL. It is important that the information you provide is accurate. We reserve the right to alter or withdraw our quotation, should the information be found to be inaccurate or incomplete. You should also refer to Section 24.1 which has information about your duty of disclosure. 2 Product Disclosure Statement

9 Section 2: When your policy starts 2.1 Cooling off period We offer a 14 day cooling off period. This period starts on the date from which we agree to provide you with group insurance. This will be the Policy Commencement Date stated in the On Risk Letter and the Policy Schedule we will issue you. If you decide to cancel the policy before the end of the cooling off period, and you have not made a claim, you can provide us with a written request to cancel the Policy from the Policy Commencement Date and we will refund any premium paid. If you terminate the Policy during the cooling off period, no claim can be made and no Benefits will be payable in respect of that period. 2.2 Start of cover Insurance Cover for Eligible Persons starts as outlined in Section When insurance cover will be provided under the policy Insurance Cover will be provided under the Policy from the Policy Commencement Date once all the following events have occurred: We have issued you an On Risk Letter, advising the Policy Commencement Date; We have issued you the Policy Schedule, signed by us; and You have paid us the requested Deposit Premium. Product Disclosure Statement 3

10 Section 3: Policy information 3.1 The insurer TAL Life Limited (ABN ) (AFSL ) which is referred to in the Policy as TAL, we, us, the insurer and/or our, is registered as a life insurer under the Life Insurance Act 1995 (Cth) and is the provider of Insurance Cover under the Policy. 3.2 The policy owner All Benefits payable under the Policy are paid to the Policy Owner, unless otherwise instructed in writing by the Policy Owner. We refer to the Policy Owner as, you, or, your. 3.3 The policy Your Policy is a legal contract of insurance between you and us. The documents issued by us that make up your Policy are: This Product Disclosure Statement as at the Policy Commencement Date; The Policy Schedule signed by us; Any Endorsements or written amendments to the terms and conditions of the Policy agreed between you and us and issued by us. Whether the Policy is superannuation or non-superannuation business will be shown in the Policy Schedule as Policy Type. 3.4 Benefits This Policy provides insurance cover for Total Disability and Partial Disability. The Policy also provides for Interim Cover, Death Benefit and payment of rehabilitation expenses as built in benefits. A Superannuation Contribution Benefit may also be provided where this is stated in the Policy Schedule. In addition, other ancillary benefits may be available under an Executive Policy. 3.5 Changes to the policy Once the Policy Schedule is issued by us, any subsequent changes or variations to the terms and conditions of the Policy must be agreed and issued by us in the form of an Endorsement. 3.6 How to interpret this document In this document: words expressed in the singular include the plural and vice versa; headings have been included for ease of reference - they do not form part of the terms and conditions of the Policy; and some terms are shown in bold. Their particular meaning is explained in Section 22 and the Policy Schedule. 3.7 Policy owner acknowledgement In accepting the Policy, you acknowledge; we have relied on information provided by you and your appointed representative; you have the authority to enter into the Policy; your appointed representative (if applicable) is your agent in entering into this Policy; and if entering into the Policy as a trustee, the trust instrument authorises entry into this Policy. 3.8 Policy owner obligations Under the terms and conditions of the Policy, you agree to: comply with the Duty of Disclosure set out in Section 24.1; pay premiums in accordance with Section 20; abide by the Eligibility Conditions of the Policy set out in Section 4.1; provide us in writing on or before the next Annual Review of details of all Employees who meet the Eligibility Conditions (if details of particular Employees are not provided, they will not be eligible for cover under Automatic Acceptance); provide us in writing details of each person who no longer meets the Eligibility Conditions on or before the next Annual Review; notify us in writing of a change in any Eligible Person s employment status which results in a change from their current Membership Category on or before the next Annual Review; provide us in writing any request for a change to the Eligibility Conditions of the Policy; provide us in writing any request to provide cover for the Employees of any new company or business acquired by the Employer; supply us with all information we ask for at the commencement of the Policy, at each Annual Review, and on termination of the Policy, within 30 days of receiving our request; and provide us with all information and notices we require from you under the Policy. Where you do not comply with these obligations we may provide you with notice to terminate the Policy in accordance with Section Policy assignments The Policy can be assigned in accordance with the Life Insurance Act 1995 (Cth) with our prior written consent. If we allow the assignment, the assignee will be recorded as the new Policy Owner with all the rights, powers, duties, obligations and privileges of the original Policy Owner. 4 Product Disclosure Statement

11 Section 4: Who can have insurance cover under the policy 4.1 Eligibility conditions Insurance Cover will be provided under the Policy for all members and Employees who meet the Eligibility Criteria, the Age Criteria and the conditions for the relevant types of cover provided under the Policy, detailed in Section 4.2. This Insurance Cover is only granted if you provide us with the relevant information with respect to that member or Employee. 4.2 When insurance cover is available Generally, a person must be a Permanent Employee, or a Contractor working a minimum of 15 hours each week for a continuous 6-month period, in order to be an Eligible Person. The Eligibility Criteria applicable to your Policy will be stated in the Policy Schedule. Where the person meets all these conditions they will be an Eligible Person under this Policy. Cover for Eligible Persons starts in accordance with Section 5. Case Study Over time I began to experience some pain in my wrists. I always thought it would just clear up, but it progressively got worse. I initially saw a doctor about five years ago and was diagnosed with carpal tunnel syndrome. I found out 18 months later that the doctor had gotten it wrong. They then thought I actually had an untreated fracture in my wrist, which was now causing pain every time I even tapped a tile into place. The pain was becoming intolerable. Finally I saw an orthopaedic surgeon who diagnosed severe osteoarthritis in my wrists. He told me I wouldn t be able to work for at least six months. That sounded pretty good to begin with, but after only two months I was climbing the walls. I was going stir crazy and I knew that the longer I was away from my business the longer it would take to rebuild. After six months, with the pain not getting better, the surgeon told me that I wouldn t be able to return to tiling at all. I was really knocked around. Tiling was all I knew. What would I do? During my time off I d spoken to my TAL case manager on numerous occasions. When I told her I couldn t return to my profession she immediately started talking about retraining. It took me a little while to realise that was what I had to do. I was only 43 and now had to start over. I applied to study for a Diploma of Building Design at TAFE and was accepted. My case manager was really excited for me and I was rapt when she told me that my insurance would cover all the fees as well as my regular income protection payment. I m now six months from finishing my two years of study and really looking forward to getting on with my life. Peter TAL Income Protection insurance policy holder * * This claim s scenario is based on an actual claim received by TAL s Claims team. We have changed certain details to protect the individual s privacy. Claims are assessed against the policy terms and condiitions. Product Disclosure Statement 5

12 Section 5: When cover starts 5.1 Commencement of insurance cover TAL will provide Insurance Cover for an Eligible Person from the latest of the following: The date they first become an Eligible Person and meet the conditions for Automatic Acceptance (see Section 6); If the Policy is owned by a superannuation fund, the date of the start of the period to which the first superannuation contribution relates where it is received on time under the Superannuation Guarantee Administration Act 1992 (Cth) or the date the first superannuation contribution is received where it is not received on time under the Superannuation Guarantee Administration Act 1992 (Cth); The Takeover Date if we have agreed to provide them Insurance Cover under Takeover Terms (see Section 7); The date we advise you they have been Underwritten and accepted for Insurance Cover (see Section 8); or The date from which there is an increase in their Insurance Cover (in respect of the increased amount). Where the Eligible Person obtains cover under this Policy they will be an Insured Person. To make life insurance a well understood and valued part of people s lives 6 Product Disclosure Statement

13 Section 6: Automatic acceptance 6.1 What is automatic acceptance Automatic Acceptance means TAL will provide Eligible Persons with Insurance Cover up to an Automatic Acceptance Limit (AAL) without Underwriting. 6.2 Conditions for automatic acceptance of cover For Automatic Acceptance to be provided the following conditions must apply: The Insurance Cover is calculated according to the Insurance Formula; The Eligible Person is in a Membership Category for which an AAL applies as provided in the Policy Schedule; An AAL (other than nil ) is stated in the Policy Schedule; At least 75% of Eligible Persons have been nominated by you (and are covered) for Insurance Cover under the Policy; The Special Conditions stated in the Policy Schedule (if any) regarding the provision of Automatic Acceptance are satisfied; and If the Policy is owned by a superannuation fund, that fund is the Employer s Default Superannuation Fund. 6.3 When are eligible persons entitled to automatic acceptance Automatic Acceptance applies to Eligible Persons at the earliest of: the Policy Commencement Date where the Eligible Person was entitled to be covered at the date; or the date the Eligible Person became an Eligible Person although you must inform us at the next Annual Review of the Policy that the person had become an Eligible Person. However, where the Eligible Person is Not At Work at the Policy Commencement Date or at the date that they first become an Eligible Person under the Policy (whichever is the later), they will be provided Limited Cover. Limited Cover will apply from that date until they have returned to work and have remained At Work for 60 consecutive days, from which time Full Cover will be provided. Any Eligible Person who does not obtain cover under Automatic Acceptance by not meeting the conditions of this section will need to be Underwritten and accepted by us in writing before Insurance Cover can commence. 6.4 Future automatic increases in insurance cover Where an increase in an Insured Person s Insurance Cover is activated by the Insurance Formula, the increase in the Insurance Cover will be restricted to the higher of the AAL and any Forward Underwriting Limit that we have granted to the individual. 6.5 When the automatic acceptance limit can be changed Subject to this Section 6.5 the AAL will apply for the duration of the Premium Rate Guarantee Period. However, if there has been a change of 25% or more in the number or occupational profile of Insured Persons under the Policy or a particular Membership Category, we reserve the right to increase or decrease the amount of the AAL, by written notice to you. Any Insurance Cover already provided will not be reduced or adversely affected by any change in the AAL. 6.6 How do changes in automatic acceptance limit affect existing insurance cover Where there has been an increase in the AAL, the AAL applicable for all existing Insured Persons may be automatically increased to the new level subject to the following condition: If the cover an Insured Person receives under Automatic Acceptance increases as a result of the increase in the AAL, any existing exclusions or loadings will only apply to any cover above the new AAL. Product Disclosure Statement 7

14 Section 7: Takeover of insurance cover 7.1 What are takeover terms Takeover Terms generally apply for a new group of Eligible Persons who have previously been provided cover by another insurer. Under Takeover Terms the levels of cover under the previous policy may be continued without further Underwriting. TAL s usual practice is to adhere to FSC Group Insurance Takeover Terms under FSC Guidance Note No However, there may be certain circumstances where alternate Takeover Terms may be required. In either case, where Takeover Terms apply to any Transferring Members, the terms will be stated in the Policy Schedule. 7.2 Conditions for providing takeover terms Where Takeover Terms apply, the provision of Insurance Cover under Takeover Terms will be subject to all of the following conditions: You providing us with all the information we need about the operation and terms of the previous policy in writing including, but not limited to, names, type and amount of insurance cover and any individual underwriting acceptance terms provided by the previous insurer no later than 90 days after the Takeover Date, unless we agree otherwise; The terms and conditions of the Policy including our Maximum Benefit Limit and conditions for Automatic Acceptance of cover stated in Section 6.2 will apply; Where the AAL applicable to the previous policy is the same as the AAL applicable to this Policy, any specific exclusions and loadings applied to Insurance Cover provided by the previous insurer will continue to apply under the Policy; and Where the AAL applicable to the previous policy is lower than the AAL applicable to this Policy, the AAL applicable for all persons insured under the previous policy may be automatically increased to the new AAL level and any specific exclusions and loadings which applied to Insurance Cover provided by the previous insurer will only apply to cover above the AAL applicable to this Policy. 7.3 Waiver of underwriting premium loadings on takeover For Insurance Cover subject to Takeover Terms, TAL will not charge any additional premiums for any loadings on Underwritten Insurance Cover based on the Insurance Formula. However, any applicable loadings will continue to be recorded and additional premiums may be charged for these loadings for other purposes such as for a Continuation Option. You providing us with the names of Eligible Persons who are Not At Work due to an illness or injury on the last working day immediately prior to the Takeover Date, unless we agree otherwise; 8 Product Disclosure Statement

15 Section 8: Underwriting 8.1 When underwriting is required An Eligible Person must be Underwritten for Insurance Cover under any one or more of the following circumstances: No AAL is applicable to them under the Policy; An AAL applies but they do not satisfy the conditions for Automatic Acceptance stated in Sections 6.2 and 6.3; or They are seeking cover based on the Insurance Formula above the AAL (including when cover above the AAL is being reinstated under Section 13.3) or any Forward Underwriting Limit, in which case Underwriting will only apply to cover above that amount. 8.2 Applications for insurance cover requiring underwriting If Underwriting is required the Eligible Person must complete a Personal Statement and provide us with any information or undergo any medical examinations we request. Subject to Section 9, while being Underwritten, an Eligible Person will be provided Interim Cover. Underwriting will be completed once we have received all the additional information we might request to assess the application. A loading has been applied to any of the Insurance Cover which has been Underwritten, including any Forward Underwriting Limit; Any specific exclusion has been applied to the Insurance Cover which has been Underwritten; or We decline the application. We will also notify you in writing if: the Underwriting has not been proceeded with due to the request of the Eligible Person; or if Underwriting has been discontinued because we did not receive the information we had requested to allow us to assess the application. 8.4 Waiver of underwriting premium loadings TAL will not charge any additional premiums in respect of any loadings advised for Underwritten Insurance Cover based solely on the Insurance Formula. Any applicable loadings however, will continue to be recorded and additional premiums may be charged for these loadings for other purposes, such as for a Continuation Option. TAL will pay all costs associated with obtaining the Underwriting information we have requested, provided these costs are incurred in Australia. Any Underwriting costs incurred outside Australia will not be paid by TAL. We may, however, reimburse some or all of these costs at our discretion. 8.3 Acceptance terms of underwritten insurance cover Once Underwriting is completed we will notify you in writing of the outcome. When we do this you will also be advised if any of the following applies: The Insurance Cover which has been Underwritten has been provided without any special conditions; Any Forward Underwriting Limit has been provided; Product Disclosure Statement 9

16 Section 9: Interim cover 9.1 What is interim cover If an Eligible Person needs Underwriting, TAL will provide Interim Cover for the amount being Underwritten. Interim Cover means we will provide an Insured Person with Limited Cover for Standard Benefits for up to 90 days while they are being Underwritten. The cover will be for an illness or injury which first occurs during the Underwriting process. 9.2 Interim cover limits The Interim Cover will be limited to the lesser of the amount Underwritten and $15,000 per month, less any amount of Insurance Cover already provided under this Policy to the Eligible Person. 9.3 When interim cover starts Interim Cover starts in respect of an Eligible Person on the date we receive a completed Personal Statement from them. 9.4 When interim cover ceases Interim Cover ceases in respect of an Eligible Person on the earlier of: 90 days after we receive a completed Personal Statement from them; the date we provide notice to you of our Underwriting decision in respect of the Underwritten cover; 9.5 Duration of interim cover benefit A Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit under Interim Cover is payable once for a continuous period of up to the Benefit Period applicable to the Eligible Person. All other Benefits are payable only once under Interim Cover. 9.6 When interim cover benefits will be reduced Any Benefits payable under Interim Cover will be reduced by any applicable amounts outlined in Sections 10 and When an interim cover benefit isn t payable A Benefit under Interim Cover is not payable: for a claim arising directly or indirectly from an illness or injury which occurred or was diagnosed, or the signs or symptoms leading to diagnosis became apparent to the Eligible Person or would have become apparent to a reasonable person in the position of the Eligible Person, at any time prior to the date we receive a completed Personal Statement; or for a claim in respect of the Eligible Person which is caused directly or indirectly by suicide or self-inflicted illness or injury. the date they withdraw their application for insurance; the date they cease to be an Eligible Person; the date they reach the Benefit Expiry Age; the date a Benefit under Interim Cover becomes payable to them; the date they die; and the Policy Termination Date. 10 Product Disclosure Statement

17 Section 10: Standard benefits All Standard Benefits apply to both the Standard Policy and Executive Policy Total disability benefit A Total Disability Benefit provides financial support to an Insured Person where they are temporarily unable to work because of illness or injury and are not earning an income. When the benefit is payable We will pay a Total Disability Benefit monthly in arrears where the Insured Person has been Totally Disabled for at least 7 out of 12 consecutive days during the Waiting Period and he or she is either: Totally Disabled immediately after the end of the Waiting Period; or after receiving a Partial Disability Benefit, Totally Disabled immediately after ceasing to be Partially Disabled as a result of the same or a related cause. The Total Disability Benefit is payable for so long as the Insured Person remains Totally Disabled. The maximum period in respect of which a Total Disability Benefit is payable for the same or related illness or injury is the Benefit Period. Where a Total Disability Benefit is payable for a part of a month, we will pay 1/30th of the benefit for each day a Total Disability Benefit is payable. A Total Disability Benefit is not payable with respect to a month for which the Insured Person is claiming a Specific Injury Benefit. Amount of the benefit The amount of the Totally Disability Benefit is the percentage of Salary stated in the Policy Schedule divided by 12, subject to Section The Total Disability Benefit is reduced by any income or amounts paid or payable in respect of the relevant month to the Insured Person, including settlement or commutation amounts, in respect of any of the following: Worker s compensation or similar legislation or common law; Motor accident compensation or similar legislation or common law; Statutory or other government payments, but not including CentreLink or its successors; Sick leave; Payment by the Employer excluding annual leave, long service leave, termination payments and paid parental leave; or Income replacement benefits from another insurance policy or a superannuation fund. The Total Disability Benefit will only be reduced in respect of any lump sum payment if any portion of such a payment relates to loss of income. Any lump sums, including commutation amounts, will be divided into 1/60th for the purpose of calculating a reduction in the Total Disability Benefit. This reduction in the Total Disability Benefit will then apply over the 60 month period or the Benefit Period, whichever is the shorter. When benefit payments end Total Disability Benefit payments will end on the earliest of the following: the date the Insured Person is no longer Totally Disabled; the end of the Benefit Period for which a Total Disability Benefit and/or Partial Disability Benefit has been payable for the same or related illness or injury; the date the Insured Person dies; the date the Insured Person reaches the Benefit Expiry Age; in the case of an Insured Person who is residing or travelling outside Australia, the date 6 months after the end of Waiting Period where a Total Disability Benefit or Partial Disability Benefit has been paid or payable for those 6 months, unless they can provide supporting medical evidence to our satisfaction of continued Total Disability and/or Partial Disability from a Medical Practitioner Partial disability benefit A Partial Disability Benefit compensates the Insured Person for the reduction in income the Insured Person suffers as a result of illness or injury. When the benefit is payable If the Insured Person has been Totally Disabled for at least 7 out of 12 consecutive days during the Waiting Period, we will pay a Partial Disability Benefit monthly in arrears if either: the person is Partially Disabled immediately after the end of the Waiting Period; or the person, after receiving a Total Disability Benefit, is Partially Disabled immediately after ceasing to be Totally Disabled as a result of the same or a related cause. The Partial Disability Benefit is payable for so long as the Insured Person remains Partially Disabled. The maximum period in respect of which a Partial Disability Benefit is payable for the same or related illness or injury is the Benefit Period. Product Disclosure Statement 11

18 Section 10: Standard benefits (continued) Where a Partial Disability Benefit is payable for a part of a month, we will pay 1/30th of the benefit for each day a Partial Disability Benefit is payable. A Partial Disability Benefit is not payable with respect to a month for which the Insured Person is claiming a Specific Injury Benefit. Amount of the benefit Subject to Section 10.9, the amount of the Partial Disability Benefit payable is calculated as follows: Partial Disability Benefit = A - B x C A Where: A = The Insured Person s annual Salary at the Date of Disablement /12 B = The monthly amount earned by the Insured Person excluding annual leave, long service leave, termination payments and paid parental leave C = The Total Disability Benefit. The Partial Disability Benefit will be reduced by any income or amounts paid or payable in respect of the relevant month to the Insured Person, including settlement or commutation amounts, in respect of any of the following: Worker s compensation or similar legislation or common law; Motor accident compensation or similar legislation or common law; Statutory or other government payments, but not including CentreLink or its successors; Sick leave; or Income replacement benefits from another insurance policy or a superannuation fund. The Partial Disability Benefit will only be reduced in respect of any lump sum payment if any portion of such a payment relates to loss of income. Any lump sums, including commutation amounts, will be divided into 1/60th for the purpose of calculating a reduction in the Partial Disability Benefit. This reduction in the Partial Disability Benefit will then apply over the 60 month period or the Benefit Period, whichever is the shorter. When benefit payment ends Partial Disability Benefit payments will end on the earliest of the following: the date the Insured Person is no longer Partially Disabled; the end of the Benefit Period for which a Total Disability Benefit and/or Partial Disability Benefit has been payable for the same or related illness or injury; the date the Insured Person dies; the date the Insured Person reaches the Benefit Expiry Age; in the case of an Insured Person who is residing or travelling outside Australia, the date 6 months after the end of Waiting Period where a Total Disability Benefit or Partial Disability Benefit has been paid or payable for those 6 months, unless they can provide supporting medical evidence to our satisfaction of continued Total Disability and/or Partial Disability from a Medical Practitioner Additional benefits to cover employer superannuation contributions. You may elect to have an additional Superannuation Contribution Benefit to cover Employer superannuation contributions for your employees or members who are Eligible Persons. This benefit is only payable whilst the Insured Person is receiving a Total Disability Benefit or Partial Disability Benefit and is paid monthly in arrears in addition the Total Disability Benefit or Partial Disability Benefit. Where a Total Disability Benefit or Partial Disability Benefit is payable for a part of a month, we will pay 1/30th of the Superannuation Contribution Benefit for each day a Total Disability Benefit or Partial Disability Benefit is payable. If you have elected this option, a Superannuation Contribution Benefit will be stated in the Policy Schedule. Any Superannuation Contribution Benefit payable will only be paid directly to a complying superannuation fund and will be subject to any conditions of release under Superannuation Law. A Superannuation Contribution Benefit is not payable with respect to a month for which the Insured Person is claiming a Specific Injury Benefit. 12 Product Disclosure Statement

19 Amount of the benefit Where the Insured Person is claiming a Total Disability Benefit, the amount of the monthly Superannuation Contribution Benefit is determined by applying the percentage of Superannuation Contribution Benefit specified in the Policy Schedule to the Insured Person s Salary and then dividing by 12. Where the Insured Person is claiming a Partial Disability Benefit, the amount of the monthly Superannuation Contribution Benefit is determined by applying the percentage of Superannuation Contribution Benefit specified in the Policy Schedule to the Partial Disability Benefit amount. When benefit payment ends Superannuation Contribution Benefit payments will end on the date a Total Disability Benefit or Partial Disability Benefit is no longer payable with respect to the Insured Person Concurrent injuries and/ or illnesses If an Insured Person has more than one illness or injury causing their Total Disability or Partial Disability, even if they are related, only one Total Disability Benefit or Partial Disability Benefit will be payable during any overlapping periods of Total Disability and/or Partial Disability Recurring disability If an Insured Person has a recurrence of a Total Disability or Partial Disability as a result of the same or related injury or illness previously claimed then we will consider the recurring disability to be a continuation of the previous claim, and the Insured Person will not need to satisfy the Waiting Period again, subject to all of the following conditions: The recurrence of the Total Disability or Partial Disability occurs within 6 months of the date they were last entitled to receive a Total Disability or Partial Disability Benefit; The successive periods of Total Disability and/or Partial Disability will be regarded as continuous for the purpose of determining the remaining portion of the Benefit Period. Where the recurrence of the Total Disability and/or Partial Disability as a result of the same or related injury or illness previously claimed occurs more than 6 months after the date the Insured Person was last entitled to receive the benefit: the Insured Person will need to satisfy the Waiting Period again; we will consider the recurring disability to be a continuation of the previous claim; and the successive periods of Total Disability and/or Partial Disability will be regarded as continuous for the purpose of determining the remaining portion of the Benefit Period Rehabilitation We may agree to pay some or all of the costs involved with a rehabilitation or return to work program, approved in writing by us, for an Insured Person who has been unable to work because of an illness or injury. Any such payments will be made directly by us to the provider of any associated services or equipment and is in addition to the benefits we pay to replace the Insured Person s income Death benefit We will pay a Death Benefit if an Insured Person dies whilst a Total Disability Benefit or Partial Disability Benefit is payable. A Death Benefit is not payable if: the date of death is within 3 months of a Trauma Benefit being payable to the Insured Person; or the Insured person is receiving a Specific Injury Benefit. The amount of the Death Benefit is 3 times the Total Disability Benefit and any Superannuation Contribution Benefit which is last paid or payable for a full month. The cause of the recurring disability is the same or related to the reasons for the previous claim; and Their Insurance Cover has not ceased. Product Disclosure Statement 13

20 Section 10: Standard benefits (continued) 10.8 Waiting period The Waiting Period is the number of consecutive days stated in the Policy Schedule during which an Insured Person must be Totally Disabled and/or Partially Disabled before we start paying the Total Disability Benefit or Partial Disability Benefit and any Superannuation Contribution Benefit and two of the Executive Benefits (Family Care Benefit and Home Care Benefit). The Waiting Period will commence on the later of the following: the date an Insured Person is first certified by a Medical Practitioner in writing as being Totally Disabled; and the date an Insured Person ceases work because of illness or injury. The Insured Person must be Totally Disabled 7 out of 12 consecutive days within the Waiting Period to claim a Total Disability Benefit or a Partial Disability Benefit. The Insured Person may return to work for up to 5 days during the Waiting Period without the Waiting Period recommencing. Any days during the Waiting Period on which the Insured Person returned to work will be added to the Waiting Period. The Waiting Period will recommence if the Insured Person returns to work for more than 5 days during the Waiting Period Increasing claims benefit If a Benefit Escalation Percentage, other than nil, is stated in the Policy Schedule, and we have been paying a Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit for an Insured Person continuously for 12 months, we will increase the Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit by the lesser of: the Benefit Escalation Percentage stated; and the Indexation Percentage. Any increase to the Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit will be applied at the end of each consecutive 12 month period for which the relevant Benefit is paid. When we cease paying a Benefit for the Insured Person and they have returned to work, any future Benefit payable after their return to work will be based on their Salary, subject to the terms and conditions of the Policy. However, where an Insured Person becomes Totally Disabled or Partially Disabled during a period of unpaid leave, the Total Disability Benefit or the Partial Disability Benefit and any Superannuation Contribution Benefit will start to accrue from the later of: the day after the expiry of the Waiting Period; and the return to work date agreed with the Employer. 14 Product Disclosure Statement

21 Section 11: Additional benefits under the executive policy Whether any or all of the following Executive Benefits are provided under an Executive Policy will be stated in the Policy Schedule. The following Benefits are available under an Executive Policy: Trauma Benefit; Specific Injury Benefit; Nursing Care Benefit; Accommodation Benefit; Family Care Benefit; and Home Care Benefit Trauma benefit An Insured Person can claim a Trauma Benefit where they suffer a Trauma condition as listed. When is the benefit payable A Trauma Benefit is payable where an Insured Person is first diagnosed as having suffered a Trauma condition, as listed in the table below entitled Trauma Conditions, provided all of the following conditions are satisfied: Trauma Conditions The Trauma must have first occurred after the date they became an Insured Person for a Trauma Benefit under the Policy; The Trauma must be diagnosed by a Medical Practitioner and supported by appropriate clinical, histological and laboratory evidence; and Any specific treatment forming part of the definition of the Trauma condition must have been undertaken. A Trauma Benefit will be paid once only with respect to an Insured Person during the life time of the policy and will be paid as a lump sum. If the Insured Person suffers more than one listed Trauma condition at the same time, he or she will only be entitled to be paid for the Trauma condition which provides the greatest benefit amount. A Trauma Benefit is paid in addition to other Benefits payable, with the exception of the Death Benefit and Specific Injury Benefit. Should the Insured Person die within 3 months of a Trauma Benefit being payable, no Death Benefit as described under Section 10.7 will be payable. Heart conditions Neurological conditions Permanent conditions Organ disorders Angioplasty Alzheimer s Disease Blindness Chronic Kidney Failure Aortic Surgery Coma Loss of Hearing Chronic Liver Failure Cardiomyopathy Dementia Loss of Independent Existence Chronic Lung Failure Coronary Artery Bypass Surgery Encephalitis and Meningitis Loss of a Single Limb Major Organ Transplant Heart Attack Major Head Trauma Loss of Speech Pneumonectomy Heart Valve Surgery Meningococcal Disease Severe Burns Primary Pulmonary Hypertension Triple Vessel Angioplasty Motor Neurone Disease Multiple Sclerosis Muscular Dystrophy Paralysis Parkinson s Disease Stroke Severe Diabetes Blood disorders Cances Other events Aplastic Anaemia Benign Brain Tumour Intensive Care Medically Acquired HIV Cancer Severe Rheumatoid Arthritis Occupationally Acquired HIV Occupationally Acquired Hepatitis B or C Definitions of Trauma Conditions can be found in Section 23. Product Disclosure Statement 15

22 Section 11: Additional benefits under the executive policy (continued) Amount of the benefit The Trauma Benefit is the lesser of: 3 times the Total Disability Benefit and any Superannuation Contribution Benefit; and the amount specified for the particular Trauma condition in Section Specific injury benefit The Insured Person can claim a Specific Injury Benefit where they suffer one of these Specific Injuries listed. Unlike the Total Disability Benefit and Partial Disability Benefit, the Insured Person will not need to satisfy a Waiting Period before they are able to claim a Specific Injury Benefit. When is the benefit payable A Specific Injury Benefit will be payable from the time an Insured Person suffers a Specific Injury stated in the table below, whether or not they are working and will be payable as a lump sum. If the Insured Person suffers more than one listed Specific Injury at the same time, he or she will only be entitled to be paid for the Specific Injury which provides the greatest benefit amount. A Specific Injury Benefit is not payable with respect to a month for which the Insured Person is claiming a Total Disability Benefit or a Partial Disability Benefit, and is also not payable where the Insured Person is claiming or has claimed any other Benefits under this policy with respect to the same or related illness or injury. A person will be treated as having claimed a Specific Injury Benefit for the number of months the Specific Injury Benefit has been paid for, starting from the date the benefit first becomes payable. If the Insured Person is Totally Disabled or Partially Disabled after receiving a Specific Injury Benefit, the Insured Person may claim a Total Disability Benefit or Partial Disability Benefit once the Waiting Period is satisfied provided the period for which the Insured Person receives a Specific Injury Benefit and a Total Disability Benefit and/or Partial Disability Benefit does not exceed the Benefit Period. Amount of the benefit The amount of Specific Injury Benefit payable is determined by multiplying the Total Disability Benefit and any Superannuation Contribution Benefit by the smallest number of months out of the following: the number of months in the Benefit Period*; the number of complete months until the Insured Person reaches the Benefit Expiry Age; and the number of months listed in the table below for the relevant Specific Injury. Specific Injury Maximum number of months for which a Specific Injury Benefit payment will be paid Paralysis (diplegia, hemiplegia, paraplegia, quadriplegia, tetraplegia) 60 Loss of both feet, both hands or blindness in both eyes 24 Loss of a hand and a foot, a hand and an eye, or a foot and blindness in one eye 24 Loss of an arm or a leg 18 Loss of a foot, or a hand, or blindness in one eye 12 Loss of the thumb and the index finger on the same hand 6 Fracture of the leg above the knee, or the pelvis 3 Fracture of the upper arm or the shoulder bone 2 *The maximum period in respect of which we will pay a Total Disability Benefit, Partial Disability Benefit and/or a Specific Injury Benefit for the same or related illness or injury with respect to an Insured Person during the life time of the policy is the Benefit Period. 16 Product Disclosure Statement

23 11.3 Nursing care benefit The Nursing Care Benefit is designed to provide an Insured Person with financial support for any nursing care or hospitalisation. When is the benefit payable A Nursing Care Benefit will be payable during the Waiting Period for an Insured Person who is Totally Disabled provided a Medical Practitioner certifies all of the following: The Insured Person is under the care of a registered nurse visiting at least once a day; The Insured Person s confinement to bed is for a period of more than 48 continuous hours; and After an initial period of more than 48 hours of confinement to bed, the Insured Person requires bed rest for a substantial part of each subsequent day. A Nursing Care Benefit is payable once we receive certification by the Medical Practitioner of the above and is payable only once for the same or related illness or injury. If an Accommodation Benefit, Family Care Benefit or Home Care Benefit is being paid with respect to the same or related illness or injury or a Specific Injury Benefit has been paid for that period, a Nursing Care Benefit will not be payable with respect to the Insured Person. Amount of the benefit The Nursing Care Benefit is 1/30th of the Total Disability Benefit and any Superannuation Contribution Benefit for each day the above conditions are met, reduced by the amount of any such expense in respect of which the Insured Person is entitled to reimbursement from another source. When does the benefit payment end The Nursing Care Benefit payment ceases on the earliest of: the date the above conditions are not met; the expiry of the Waiting Period; 90 days of the Nursing Care Benefit being made; the date the Insured Person dies; and the date the Insured Person reaches the Benefit Expiry Age Accommodation benefit The Accommodation Benefit allows an immediate family member to be accommodated near the Insured Person to take care of them where the Insured Person has been relocated because of their illness or injury and is confined to a bed. When is the benefit payable An Accommodation Benefit is payable at any time, including during the Waiting Period, for an Insured Person where a family member has chosen to stay at a place near the Insured Person provided the Insured Person: a) is Totally Disabled; b) is confined to a bed due to an injury or illness for a substantial part of each day; and c) on the advice of his or her Medical Practitioner, has been relocated from home to a place more than 100 kilometres from a family member whom the Insured Person has nominated as their carer. Any such payments will be made to the Insured Person provided he or she can provide evidence to our satisfaction which demonstrates that he or she incurred the accommodation expense. The Accommodation Benefit is payable once for the same or related illness or injury. If a Nursing Care Benefit or Home Care Benefit is being paid with respect to the same or related illness or injury or a Specific Injury Benefit has been paid for that period, an Accommodation Benefit will not be payable with respect to the Insured Person. Amount of the benefit The Accommodation Benefit is payable for each night the nominated immediate family member stays at the place near the Insured Person and is the lesser of: a) the actual accommodation cost per night; and b) $250 per night s accommodation. When does the benefit payment end The Accommodation Benefit is payable once for up to 30 days in any 12 month period. Product Disclosure Statement 17

24 11.5 Family care benefit The Family Care Benefit is designed to compensate a family member upon whom the Insured Person has become totally dependent for everyday needs and who has suffered a loss of income due to having to take care of the Insured Person. When is the benefit payable A Family Care Benefit will be payable after the Waiting Period, where: a) the Insured Person is Totally Disabled; b) the Insured Person is totally dependent on an immediate family member for his or her essential needs due to an illness or injury; and c) the income of the Insured Person s family member referred to in paragraph b) is reduced as a result of having to take care of the Insured Person; and d) the Insured Person has provided evidence to our satisfaction which demonstrates the family member s loss of income whilst caring for the Insured Person during their period of disability. Any such payments will be made to the nominated family member. The Family Care Benefit is payable once for the same or related illness or injury. If a Nursing Care Benefit, or Home Care Benefit is being paid with respect to the same or related illness or injury or a Specific Injury Benefit has been paid for that period, a Family Care Benefit will not be payable with respect to the Insured Person. Amount of the benefit The Family Care Benefit is payable for each day the family member has taken care of the Insured Person and is the lesser of: a) the amount of the reduction in the family member s pre-tax monthly income calculated on a daily basis; and b) the amount equal to 50% of the Insured Person s Total Disability Benefit calculated on a daily basis Home care benefit The Home Care Benefit acts as an alternative to the Family Care Benefit where the Insured Person is confined to a bed and decides to rely on a paid professional home carer instead of a family member. When is the benefit payable A Home Care Benefit is payable after the Waiting Period, where: a) the Insured Person is Totally Disabled; b) the Insured Person is confined to a bed, other than in a hospital or a similar institution that provides nursing or home care; and c) the Insured Person is totally dependent upon a paid professional home carer. Any such payments will be made directly by us to the provider of the home care services. The Home Care Benefit is payable once for the same or related illness or injury. If an Accommodation Benefit, Nursing Care Benefit, or Home Care Benefit is being paid with respect to the same or related illness or injury or a Specific Injury Benefit has been paid for the period, an Family Care Benefit will not be payable with respect to the Insured Person. Amount of the benefit The Home Care Benefit is payable for each day the professional home carer has provided home care services and is the lesser of: a) an amount equal to the Total Disability Benefit calculated on a daily basis; and b) $150 per day reduced by the amount of any such expense in respect of which the Insured Person or the nominated family member is entitled to reimbursement from another source. When does the benefit payment end The Home Care Benefit is payable for up to 6 months as long as the above conditions are met. When does the benefit payment end The Family Care Benefit is payable for up to 3 months as long as the above conditions are met. 18 Product Disclosure Statement

25 Section 12: Employer approved leave 12.1 Continuation of insurance cover during paid leave An Insured Person s Insurance Cover will continue while they are on paid leave approved by their employer without the need for our prior approval, subject to continued payment of premiums and compliance with other conditions of the Policy Continuation of insurance cover during unpaid leave An Insured Person s Insurance cover will be provided for a continuous period of up to 24 months while they are on employer approved unpaid leave for any reason, subject to all of the following conditions (where applicable): For Employees and Contractors, there is documented agreement with the Employer of a return to work date; The period of employer approved unpaid leave commences on the first day of that leave; Continued payment of premiums during the period of unpaid leave; and The conditions of Section 17 ( When cover for an Insured Person ceases ). You must notify TAL of and receive our written agreement to extensions of cover for any unpaid leave beyond the 24 month period. Otherwise, cover will not be extended beyond the 24 month period. If any of the above conditions are not met, Insurance Cover will cease for the Insured Person on the day prior to the commencement of the agreed period of leave, subject to Section 15. In respect of any claim arising for an Insured Person during a period of unpaid leave, the Salary used to calculate any Insurance Cover based on the Insurance Formula will be that which applied to that Insured Person on their last working day prior to the commencement of their unpaid leave period. Subject to the conditions above, where the Insured Person does not return to work by the end of the 24 month period, or the end of any extended period beyond the 24 month period agreed in writing by us, all Insurance Cover will cease at the end of the relevant period, subject to Section 17 ( When cover for an Insured Person ceases ). If the person would like to reinstate their cover, they will need to be Underwritten. Where an Insured Person becomes Totally Disabled or Partially Disabled during a period of unpaid leave, the Total Disability Benefit or the Partial Disability Benefit and any Superannuation Contribution Benefit will start to accrue from the later of: the day after the expiry of the Waiting Period; and the return to work date agreed with the Employer Insurance cover when premiums were not paid during the unpaid leave If an Insured Person goes on a period of unpaid leave and premiums are not paid in respect of all or part of that period, then Insurance Cover will cease on the day prior to the commencement of the period of unpaid leave, unless cover has ceased earlier under Section 17 ( When cover for an Insured Person ceases ). If that person returns to work with their employer on the agreed return to work date after a period of unpaid leave during which the relevant premiums had not been paid (and hence cover did not continue), then cover will be reinstated subject to both of the following conditions: Limited Cover will apply to Insurance Cover up to the AAL from the date of return to work until they have been At Work for 60 consecutive days, after which time Full Cover will apply; and Underwriting is required for any Insurance Cover above the AAL (see Section 8) After operational deployment on active service as a reservist If an Eligible Person returns to work with the Employer within 12 months of their Insurance Cover ceasing because of their operational deployment on active service as a Reservist with the Australian Defence Force, their Insurance Cover, not including any Interim Cover at the date it ceased, will be reinstated once they have been At Work for 60 consecutive days. If the Eligible Person returns to work more than 12 months after their Insurance Cover ceased, Underwriting will be required. Product Disclosure Statement 19

26 Section 13: Overseas cover 13.1 What is overseas cover Insurance Cover is provided 24 hours per day, 7 days per week, regardless of the Insured Person s location as long as: the Insured Person continues to be employed by the Employer or a Related Entity; the Insured Person s premium continues to be paid to us by the Employer; and Insurance Cover has not ended under Section 17. Overseas cover is subject to Section 13, the continued payment of premium in respect of the Insured Person and compliance with the terms and conditions of this Policy. Where the Employer Related Entity starts to pay the premium in respect of an Insured Person after a period during which the relevant premiums had not been paid (and hence cover did not continue), then cover will be reinstated subject to both of the following conditions: 13.3 Assessment of a claim overseas In the case of an Insured Person who is residing or travelling outside Australia a Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit will continue for up to six months whilst overseas subject to the Insured Person satisfying any claim requirements in Section 19. After six months the Insured Person will need to provide supporting medical evidence to our satisfaction to continue receiving a Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit. Any costs incurred overseas in respect of such a claim, including tests we might require the claimant to undergo or any cost incurred in returning to Australia, will not be paid by TAL. Limited Cover will apply to Insurance Cover up to the AAL from the date the premium is paid until they have been At Work for 60 consecutive days, after which time Full Cover will apply; and Underwriting is required for any Insurance Cover above the AAL (see Section 8) Underwriting overseas We do not require an Insured Person overseas to return to Australia to be Underwritten. However, any Underwriting costs incurred overseas will not be paid by TAL. We may reimburse part or all of these costs at our discretion. 20 Product Disclosure Statement

27 Section 14: Restrictions on benefit payments 14.1 Exclusions Benefits are not payable under the Policy if the Insured Person s disablement was caused wholly or partially, directly or indirectly by any of the following: War; An intentional, self-inflicted act; or Uncomplicated pregnancy, childbirth or miscarriage unless disability continues for longer than 3 months after the pregnancy ends, in which case the disability will be considered to have commenced at the date the pregnancy ends Misstatement of age If the age of an Insured Person has been understated, the Benefit in respect of that person will be recalculated and reduced based on the amount of premium already paid and the amount of Insurance Cover that premium would have purchased if the Insurance Cover had been calculated using the correct age. If the age of the Insured Person has been overstated, the Benefit will not change and we will return any excess premium paid Non-compliance with duty of disclosure We may be legally entitled to limit or withhold Benefits, or to adjust Benefits or premiums, if you or any Insured Persons have not complied with the Duty of Disclosure as stated in Section Unpaid premiums Where the death or Date of Disablement occurs for an Insured Person during a period where premiums owing for that period remain outstanding, any Benefit payments will not be made until such time as any premiums owing have been received Overpayment of benefits We may require repayment of a Benefit if we did not reduce a Benefit payment when we would have been entitled to do so, or if we paid a Benefit which we were not obliged to pay under the terms and conditions of the Policy. We may elect to reduce future Benefit payments in lieu of such a repayment Maximum benefit limits We will limit any Total Disability Benefit, Partial Disability Benefit, and any Superannuation Contribution Benefit payable to an Insured Person with respect to a particular month to the Maximum Benefit Limit stated in the Policy Schedule. Similarly, we will limit the amount of the Total Disability Benefit used to calculate the Death Benefit, Trauma Benefit, Nursing Care Benefit, Family Care Benefit, and/or Home Care Benefit to the Maximum Benefit Limit stated in the Policy Schedule. Product Disclosure Statement 21

28 Section 15: Extended cover 15.1 What is extended cover Extended Cover is Insurance Cover which continues to be provided, without charge, for up to 60 days after the Insured Person ceases to be an Employee of the Employer. Extended Cover is subject to the conditions in this Section When does extended cover start Extended Cover for an Insured Person starts on the date they cease to be an Employee of the Employer When extended cover ceases Extended Cover ceases for an Insured Person on the earliest of: 60 days after the Insured Person ceases to be an Employee of the Employer; the Benefit Expiry Age; the date an application for a Continuation Option is accepted or declined by us (see Section 16); the date they obtain insurance for the same or similar benefits; and the date cover ends under Section 17. Case Study I really stuffed up. As I jumped, I clipped my heel on the edge of eh pool and shattered it. I needed a major operation to rebuild it and ended up with a bunch of metal plates holding the heel together. One moment of stupidity resulted in a whole world of pain and ultimately five months off work. And that was a real problem because I am a contract driver. No work means no pay. While my employers are great, I knew that they would have to get someone else to take over my contract if I couldn t do it. So the first thing that I had to do after the operation was to hire a relief driver. My contract is a daily delivery run, loading and unloading individually picked orders. This was impossible for me to do even after the plaster had come off. Due to the operation and having my leg immobilised for months, my Achilles tendon had shortened so I had to do a lot of physio. With the metal plates in my heel, I couldn t even put on my safety boots, let alone drive all day and make my deliveries. Understanding my circumstances and knowing that I was really keen to get back to work, my TAL case manager suggested that I work with a rehabilitation service. They were great. They actually sent a rehabilitation specialist to evaluate my work practices, before developing what they called a graduated return to work program. They made a number of suggestions on how I could approach my work differently, designed to minimise the pressure on my heel. Things like how I loaded my truck, how I managed the delivery process and even a suggestion on how a change in my driving position would minimise the discomfort. Without this service, which was all covered by my income protection insurance, I would have been left with two choices; to work with the pain or to spend a lot more time off work. I really appreciated my case manager suggesting this service as it really helped me get back on my feet sooner. William TAL Income Protection insurance policy holder * * This claim s scenario is based on an actual claim received by TAL s Claims team. We have changed certain details to protect the individual s privacy. Claims are assessed against the policy terms and condiitions. 22 Product Disclosure Statement

29 Section 16: Continuation of cover option 16.1 What is a continuation of cover option Where an Insured Person is no longer an Eligible Person under the Policy, because they have ceased to be an Employee of the Employer for reasons other than for illness or injury, they may apply for a Continuation Option, unless otherwise stated in the Policy Schedule. A Continuation Option allows the person to continue their Insurance Cover under an individual insurance policy issued by TAL, without the need to provide evidence of health Conditions for a continuation of cover option All of the following conditions need to be satisfied before a person can apply for a Continuation Option: They are under age 60; The premium for the individual insurance policy issued will be based on our standard individual age based rates, and will be subject to any specific exclusions and loadings applying to their Insurance Cover at the date they ceased to be an Employee of the Employer; The application for the Continuation Option must include, but is not limited to: i) Occupational information including Salary; and ii) Information regarding pastimes, residency, travel and smoking status; and Acceptance by us of any application. Where a Continuation Option is granted while the Insured Person is applying for Underwritten Cover, their application and any Interim Cover they were entitled to will be cancelled. No Benefits have been paid or are payable to them under the Policy, or any other benefits have or are being paid under any other life insurance policy; They had not ceased employment due to illness or injury; They must be commencing employment in an Occupation considered by us to be an insurable risk under the individual insurance policy; We receive their application, completed to our satisfaction, for a Continuation Option, together with the relevant premium, within 60 days of them ceasing to be an Employee of the Employer; The individual insurance policy issued will be one we consider contains the same or similar benefits, to the Insurance Cover provided on the date they ceased to be an Employee of the Employer; Product Disclosure Statement 23

30 Section 17: When cover for an insured person ceases Insurance Cover will cease for an Insured Person immediately on the earliest of: the date they reach the Benefit Expiry Age; subject to Section 15.3, the date they cease to be an Employee of the Employer; the date they ceased to be a Permanent Employee; the date they ceased to be a Contractor with a written contract of services to the Employer for a minimum of 15 hours each week for a continuous 6 month period; the date any Extended Cover provided under Section 15 ceases; the date of their Death; the date they do not meet the conditions for continuation of cover during unpaid leave stated in Section 12.2; the date they no longer meet the conditions for continuation of cover while overseas stated in Section 13; the date before they commence active service in the armed forces of any country, not including normal activities as a Reservist with the Australian Defence Force, but including operational deployment on active service with the Australian Defence Force; the date an individual life insurance policy is issued to them by TAL under a Continuation Option (see Section 16); in respect of any Interim Cover provided under Section 9, the date any Interim Cover ceases for them; the date they change Membership Category in respect of any amount of Insurance Cover based on the Insurance Formula for their previous Membership Category, which exceeds the Insurance Cover based on the Insurance Formula for their new Membership Category; the date we are advised by them or you that they no longer wish to be an Insured Person under the Policy; the date we are advised they wish to have their Insurance Cover reduced, in respect of the amount reduced; where the Policy Owner is a superannuation fund, 6 months after the last superannuation contribution received by the superannuation fund in respect of the Insured Person; the Policy Termination Date, subject to Section 18.2; or the date they no longer meet the Eligibility Criteria. The specialist voice of life insurance in Australia 24 Product Disclosure Statement

31 Section 18: When the policy ends 18.1 Duration of the terms and conditions of the policy The Policy is effective from the Policy Commencement Date and remains in effect until the earliest of: you terminating the Policy by providing us with 30 days written notice prior to the Policy Termination Date; us terminating the Policy, after having provided you at least 30 days written notice of our intention to do so, due to your failure to pay the required premiums, as set out in Section 20; us terminating the Policy, after having provided you at least 30 days written notice of our intention to do so, due to your failure to provide us with adequate information at the Annual Review of the Policy to allow us to calculate the correct premiums; us terminating the Policy, after having provided you with at least 30 days written notice of our intention to do so, if less than 10 persons have Insurance Cover (in which case we would allow those persons to apply for a Continuation Option within 60 days of the Policy Termination Date); payment of the last Benefit of the last Insured Person; us terminating the Policy, after providing you at least 30 days written notice of our intention to do so, due to your failure to comply with your obligations set out in Section 3.8; or cover ends for all Insured Persons. In the event we terminate the Policy due to your failure to pay outstanding premiums, the Policy Termination Date will be the date immediately after the end of the period for which all premiums have been paid End of insurance cover when the policy ends All Insurance Cover will end at the conclusion of the Policy Termination Date. However, if Insurance Cover applies on the Policy Termination Date and where an Insured Person: a) is Not At Work on the last working day immediately before the Policy Termination Date due to illness or injury; or b) although they were At Work on the last working day immediately before the Policy Termination Date, an event occurred in the period after the last working day and prior to the Policy Termination Date which caused the Insured Person to be Not at Work on the day after Policy Termination Date; we will continue to provide Insurance Cover for that person on and from the Policy Termination Date but only for the illness, injury or event referred to in paragraphs a) or b) which commenced before the Policy Termination Date. In these circumstances, this Insurance Cover will cease on the earliest of: the date the Insured Person is first At Work; the date cover would end under conditions in Section 17 except under the following circumstances: 6 months after the last superannuation contribution received by the superannuation fund in respect of the Insured Person where the Policy Owner is a superannuation fund; or the Policy Termination Date No value on termination The Policy has no value on termination. Product Disclosure Statement 25

32 Section 19: Claims 19.1 Conditions for payment of a claim Payment of a claim under the Policy is conditional upon all of the following conditions: Our claim requirements being met (stated in this Section 19); Any legislative requirements being met; and The person making the claim is entitled to the Benefit under the terms and conditions of the Policy Notification of a claim You should advise us of a claim for an Insured Person as soon as it is reasonably possible for you to do so. We will then provide you with the necessary forms for completion so we can assess the claim Initial claim requirements Payment of a claim is conditional upon you or the Insured Person providing proof of eligibility for a claim, and assisting us with our determination of the claim. This may include, but is not limited to, the following: Us verifying that the conditions of Automatic Acceptance of cover (where applicable) were each met; Providing us with an original or certified death certificate (if required), an original or certified birth certificate (or other proof of birth to our satisfaction) and any other documentation we believe is relevant to the claim; Us obtaining medical reports, as required, from any treating Medical Practitioners; When reasonably required by us (and at our expense), examination by a Medical Practitioner, and subject to Section 14.3, undergoing a medical examination or other test or appraisal nominated by us or providing any other relevant information; and If overseas, and requested by us, returning to Australia for assessment, at the Insured Person s expense Ongoing claim requirements The monthly ongoing assessment of a claim may include, but not be limited to, the following: A completed monthly progress claim form; A monthly attending doctor s statement and results of any tests undertaken (at the Insured Person s own expense); Us obtaining medical reports, as required, from any treating Medical Practitioners; When reasonably required by us (and at our expense), examination by a Medical Practitioner, undergoing a medical examination or other test or appraisal nominated by us or providing any other relevant information; and If overseas, and Total Disability or Partial Disability Benefits have been paid for 6 months, providing supporting medical evidence to our satisfaction of continued Total Disability and/or Partial Disability from a Medical Practitioner at the Insured Person s expense. The Insured Person must advise us, throughout the course of a claim, if they are in receipt of any income or amounts paid or payable to them, due to their disablement, as described in Sections 10 and 11. Otherwise, Section 14.6 will apply. Payment of a benefit is conditional on the Insured Person: a) being under the regular care of a Medical Practitioner; and b) complying with any medical treatment or rehabilitation program that we believe is reasonable Claim review If you or the Insured Person is not satisfied with a decision to deny a claim, you or they may refer the case to our claims resolution panel who will review the claim. You and the Insured Person then have further rights if either remains unsatisfied. Please see our Complaints Sections 24.10, and Product Disclosure Statement

33 Section 20: Premiums 20.1 Premium rates The Premium Rates used to calculate the cost of Insurance Cover and the Premium Frequency selected (annually, half-yearly, quarterly or monthly), are each stated in the Policy Schedule. You must pay at least the Minimum Premium, if any Calculation and payment of premium We will advise you of a Deposit Premium payable at the commencement of the Policy. We will then calculate the premium payable up to and including the day before the next Annual Review using the information you provide to us at the Policy Commencement Date. You will then be advised of the amount you must pay based on the Premium Frequency you have chosen and taking into account any Deposit Premium already paid for the period. At each Annual Review and at the termination of the Policy, we will recalculate the premium to reflect changes in the Insured Persons and the Insurance Cover provided over the period since the Policy Commencement Date or the last Annual Review date, whichever is the later. If, as a result of the recalculation of the premium, you have paid too much, we will use the overpayment to offset the amount against the next premium due, assuming the Policy is to be renewed. Otherwise, we will return the amount you have over paid to you When the premiums must be paid Any premium, Deposit Premium or adjustment premium we advise you is payable in respect of the Policy, will be payable within 30 days of our written notice to you When premiums are unpaid If the requested premium is not paid within 30 days of the due date, we may provide you with written notice that we will terminate the Policy if the requested premium is not received within a further 30 days. If the Policy is terminated, Insurance Cover will cease the date immediately after the end of the period for which all premiums have been paid. We reserve the right to charge interest on any premium amount due to us, which is outstanding for more than 30 days. Interest will be calculated based on the 5 year Australian Government Bond Yield, published by the Reserve Bank of Australia, plus 3% as at the date the premium amount first became due. Benefits will not be paid until any outstanding premiums are paid. To avoid such an event occurring if you have elected a Premium Frequency other than annual, a Direct Debit Agreement for premium payment should be considered. If you pay your premiums using a Direct Debit Agreement, we may reduce any Premium Frequency loadings applicable on your Policy. If, as a result of the recalculation of the premium you have not paid enough, we will advise you of the additional premium (called the adjustment premium) you owe. Premiums must be paid in respect of all Insured Persons for any period for which Insurance Cover is provided. Product Disclosure Statement 27

34 Section 20: Premiums (continued) 20.5 When we can change the premium Your Premium Rates will not change prior to the end of the Premium Rate Guarantee Period, if one is stated in the Policy Schedule, unless: a) we agree to your request for a change in the terms or conditions of the Policy, in which case we will give you at least 30 days prior written notice and any change would be effective from the date specified in the written notice; b) Australia is involved in War, whether declared or not, or the armed invasion of Australia, and we provide you written notice of such a change, in which case we will give you immediate written notice and the effective date of such a change would be the date of our written notice to you; e) the number of Insured Persons under the Policy falls below 10, in which case we will give you at least 30 days prior written notice and any change would be effective from the date specified in the written notice; and f) the information you have provided us under Section 1.4 is not accurate, in which case we will give you at least 30 days prior written notice and any change would be effective from the date specified in the written notice Waiver of premium You won t be required to pay the premium for an Insured Person during any period where a Total Disability Benefit and/or Partial Disability Benefit and any Superannuation Contribution Benefit is payable. c) there has been a change of 25% or more in the number or occupational profile of Insured Persons under the Policy or a particular Membership Category since the start of the Premium Rate Guarantee Period, in which case we will give you at least 30 days prior written notice and any change would be effective from the date specified in the written notice; d) a change to the Premium Rate is required in respect of Insurance Cover provided for any or all Insured Persons under the Policy due to any change to past, current or future Government charges relating to the Policy, in which case we will give you immediate written notice and any change would be effective from the effective date of the change in Government charges even if that change precedes any written notice we provide to you; 28 Product Disclosure Statement

35 Section 21: Profit share and multinational pooling 21.1 Profit sharing arrangements Profit sharing arrangements are generally only available for large organisations upon request. If a Policy participates in a profit sharing arrangement, the Policy Owner will share in any profits that we determine have been achieved specifically in relation to the Policy, after taking into account several factors such as premiums earned and claims incurred. You are only entitled to a profit share if your participation in profit share arrangement is stated in the Policy Schedule. The agreed conditions applying to any profit sharing arrangement and the formula determining how profit share will be calculated will be stated in the Policy Schedule Multinational pool A multinational pool facility provides the opportunity for a company, which is part of a multinational group of companies, to participate with at least one other country within the group in respect of the pooling of their respective policies. The advantage of utilising such a pooling facility may be more competitive benefits and premiums, leveraging from the economies of scale of the wider organisation. If a multinational pooling facility is provided, it will be stated in the Policy Schedule. Product Disclosure Statement 29

36 Section 22: Definitions Age Criteria means the minimum and maximum entry ages stated in the Policy Schedule. At Work means a) where the Eligible Person is: i. working at the relevant time and not on leave he or she is actively performing all the normal duties of their Occupation with the Employer without restriction or limitation due to illness or injury; or ii. on leave approved by the Employer or employer (as applicable) he or she is, in our opinion, capable of performing all the normal duties of their Occupation with their employer without restriction or limitation due to illness or injury; and b) not receiving or not entitled to receive income support benefits from any source including workers compensation benefits, statutory transport accident benefits or disability income benefits. An Eligible Person who does not meet these requirements will be described as Not At Work. Annual Review means the applicable date stated in the Policy Schedule. Automatic Acceptance see Section 6. Automatic Acceptance Limit (AAL) means the maximum amount of Insurance Cover based on the Insurance Formula, provided without Underwriting. The AAL will be stated in the Policy Schedule. Benefit/s means any one or more of the Standard Benefits or Executive Benefits. Benefit Escalation Percentage means the maximum percentage stated in the Policy Schedule by which we will increase a Total Disability Benefit or a Partial Disability Benefit payment. Benefit Expiry Age means the maximum age to which a Benefit will be provided as set out in the Policy Schedule. Benefit Period means the maximum period for which a Specific Injury and/or Total Disability Benefit and/or a Partial Disability Benefit resulting from any one or related cause is payable as stated in the Policy Schedule. The Benefit Period starts on the day after the end of the Waiting Period when the Insured Person is Totally Disabled or Partially Disabled. Continuation Option see Section 16. Contractor means an Eligible Person under a written contract of services with the Employer for a minimum of 15 hours each week for a continuous 6 month period and is, under the contract, having Salary and Superannuation Guarantee Contributions paid in respect of them. Date of Disablement means the date which a Medical Practitioner certifies in writing as the date that the Insured Person ceased work as a result of an illness or injury which is the principal cause for which a claim is made, and we are satisfied, on medical or other evidence, that this is the date that the Insured Person ceased work as a result of an illness or injury which is the principal cause for which that claim is made. Death Benefit means the benefit as described in Section Deposit Premium means the initial premium payable in the period as described in Section 20. Duty of Disclosure see Section Eligibility Conditions mean the conditions stated in Sections 4.1 and 4.2 which need to be met in order for Insurance Cover to be provided under the Policy. Eligibility Criteria means the criteria for a Membership Category stated in the Policy Schedule. Eligible Person means a person who meets all the conditions of Sections 4.1 and 4.2 and other requirements as stated in the Policy Schedule when their cover commences. Employee means a person who is Gainfully Employed by the Employer. Employer means the entity stated in the Policy Schedule employing Eligible Persons under the Policy. Employer s Default Superannuation Fund means the fund recognised as such for the purposes of the Superannuation Guarantee (Administration) Act 1992 or successor statutes. Endorsement is any written amendment to the terms and conditions of the Policy we agree with you and provide to you. 30 Product Disclosure Statement

37 Executive Benefit/s means any one or more of the benefits described in Section 11, including Nursing Care Benefit, Specific Injury Benefit, Trauma Benefit, Accommodation Benefit, Family Care Benefit and Home Care Benefit. Executive Policy means a policy providing for all of the Benefits outlined in Section 10 and at least one of the Benefits outlined in Section 11 as specified in the Policy Schedule. Extended Cover see Section 15. Forward Underwriting Limit means the maximum level, advised after Underwriting, to which Insurance Cover for an Eligible Person can increase, based on the Insurance Formula, without further Underwriting. Full Cover means Insurance Cover for any illness or injury after the person was nominated for cover, where the Insurance Cover is not affected by the date the illness became apparent or the injury occurred. Gainfully Employed means working for reward in an Occupation (which can include a contract for services ) without restriction due to illness or injury. Important Income Producing Duties means duties considered essential to producing Salary. Indexation Percentage means the percentage increase in the latest Consumer Price Index (weighted average of 8 capital cities combined) published by the Australian Bureau of Statistics as at the effective date of the calculation under this policy. If the Consumer Price Index is no longer published, we will use another index similar to it. Interim Cover see Section 9. Insurance Cover means the Benefits provided under the terms and conditions of the Policy. Insurance Formula means the calculation method for Insurance Cover elected by you and agreed by us as stated in the Policy Schedule. Insured Person means any Eligible Person for whom Insurance Cover has been provided under the terms and conditions of the Policy. Limited Cover means Insurance Cover is only payable for claims arising directly from an illness or injury which first occurs or is diagnosed or the signs or symptoms first become apparent, after the date the Insurance Cover commenced, was reinstated or increased under the Policy. Benefits arising directly or indirectly by a self-inflicted act are not payable under Limited Cover. Maximum Benefit Limit means the maximum Benefit amount we will pay in respect of an Insured Person, as stated in the Policy Schedule, subject to Section Medical Practitioner means a person who is legally qualified and registered as a medical practitioner in Australia who is not the Policy Owner or the Eligible Person, their spouse, relative, employee or business associate. If practising overseas, and not registered as a medical practitioner in Australia they must be approved by us and have qualifications equivalent to Australian standards. Chiropractors, physiotherapists, psychologists and alternative therapy providers are not regarded as Medical Practitioners. Membership Category means the common group set out in the Policy Schedule to which Eligible Persons belong because of their Occupation and/or their employment status. Minimum Average means an Insured Person who is a Contractor and has worked a minimum of 15 hours per week for the 3 months immediately prior to the Date of Disablement. The 3 month period may be adjusted as follows: Where an Insured Person returns from an agreed period of leave, it will include time prior to the commencement of the agreed period of unpaid leave if 3 complete months have not elapsed prior to the Date of Disablement. Where an Insured Person has been working for less than 3 months, the equivalent period will be the time since commencement with the Employer to the Date of Disablement. Product Disclosure Statement 31

38 Section 22: Definitions (continued) Minimum Premium is the minimum annualised premium, if any, stated in the Policy Schedule. Nursing Care means Nursing Care as described in Section Nursing Care Benefit means the benefit as described in Section Occupation means the primary duties for which the Eligible Person is paid a Salary. On Risk Letter means written advice issued by us advising we have agreed to provide Insurance Cover. Own Occupation means the Occupation in which the Insured Person has spent the majority of their time undertaking with the Employer immediately prior to the Date of Disablement. Partially Disabled and Partial Disability means an Insured Person who has been Totally Disabled for 7 out of 12 consecutive days within the Waiting Period and who, after the end of the Waiting Period is no longer Totally Disabled and is: under the regular care, and following the advice, of a Medical Practitioner; earning less than the monthly Salary they were earning immediately prior to the start of the Waiting Period, as a result of illness or injury, or is not otherwise earning an income working; and as a result of illness or injury cannot undertake their normal hours of work or is unable to perform one or more of the Important Income Producing Duties of their Occupation. Partial Disability Benefit means the benefit as described in Section Permanent Employee means the Eligible Person is Gainfully Employed by the Employer on a full time or part-time basis. Personal Statement means an application form issued by us for the purpose of Underwriting an Eligible Person for Insurance Cover. Policy means the terms and conditions in this document together with the other documents specified in Section 3.3. Policy Commencement Date means the Policy Commencement Date stated in the Policy Schedule and the On Risk Letter. Policy Owner means the Policy Owner stated in the Policy Schedule. Policy Schedule means the document issued by us to you, stating specific details relating to the Policy, including any Special Conditions. Policy Termination Date means the date the Policy ends on the earlier of when we receive written notice from you and as set out in Section Policy Type identifies the Policy as either superannuation or non-superannuation business. Premium Frequency means the frequency of premium payments, that is, annually, half-yearly, quarterly or monthly, as stated in the Policy Schedule. Premium Rate Guarantee Period means the period stated in the Policy Schedule during which Premiums Rates will not be increased by us other than in the circumstances set out in Section Premium Rates mean the premium rates stated in the Policy Schedule and used to calculate the premiums for Insurance Cover. Related Entity means a related body corporate of the Employer. Salary means the remuneration components paid by the Employer to an Eligible Person at the relevant time, as stated in the Policy Schedule. The following conditions apply: Where the Policy Schedule states that bonuses and/or commissions are included, they will be averaged over the 3 years preceding the last Annual Review date or any shorter period during which they have been paid for the Eligible Person, unless otherwise stated in the Policy Schedule; Where the Insured Person owns (either indirectly or directly) all or part of the business including all or part ownership through another legal entity, Salary shall mean the regular income earned from the Insured Person s personal exertion after the deduction of all attributable business expenses incurred in earning the income. Income will not include investment income, profit distributions or similar payments that may continue in the event of disability, unless otherwise stated in the Policy Schedule. For the purposes of determining the amount of cover used in the premium calculation in respect of an Insured Person, the relevant time is the last Annual Review. 32 Product Disclosure Statement

39 For the purposes of determining the amount of benefit a person can claim with respect to an illness or injury which occurred whilst they had cover under this policy, the relevant time is the date immediately prior to the Date of Disablement. Special Conditions means variations and modifications to the Policy agreed by us and stated in the Policy Schedule. Specific Injury means a Specific Injury as described in Section Specific Injury Benefit means the benefit as described in Section Standard Benefit means any one or more of the benefits described in Section 10, that is, Total Disability Benefit, Partial Disability Benefit, Superannuation Contribution Benefit, Rehabilitation Benefit, and Death Benefit. Standard Policy means a policy providing all of the Benefits outlined in Section 10. Superannuation Contribution Benefit means the benefit as described in Section Takeover Date means the date stated in the Policy Schedule where Takeover Terms apply. Takeover Terms means the Takeover Terms, if any, stated in the Policy Schedule, under which we agree to provide Insurance Cover as was provided for Transferring Members by a previous insurer. Totally Disabled and Total Disability mean the Insured Person, employed in a Permanent Employee capacity, or as a Contractor for the Minimum Average per week, at the Date of Disablement, directly as a result of illness or injury: has been Totally Disabled for 7 out of 12 consecutive days within the Waiting Period; is unable to perform at least one Important Income Producing Duty of his or her regular occupation; is not currently working in any occupation, whether paid or unpaid; and is under the regular care and following the advice of a Medical Practitioner. Total Disability Benefit means the benefit described in Section Transferring Member means any Eligible Person for whom we agree to provide Insurance Cover under Takeover Terms. Trauma means the Trauma as described in Section Trauma Benefit means the benefit as described in Section Underwriting and Underwritten means the process we undertake to assess an application by an Eligible Person for Insurance Cover including reference to information concerning their medical, health and employment. Waiting Period means the Waiting Period stated in the Policy Schedule as described in Section 10.8 and within which the Insured Person is Totally Disabled for 7 out of 12 consecutive days. War means an act of war, whether declared or not, armed aggression by a country or organisation resisted by any country or organisation or civil disturbance. Product Disclosure Statement 33

40 Section 23: Trauma definitions Activities of Daily Living means: Bathing - the ability to shower and bathe; Dressing - the ability to put on and take off clothing; Toileting - the ability to get on and off and use the toilet; Mobility - the ability to get in and out of bed and a chair; and Feeding - the ability to get food from a plate into the mouth. Alzheimer s Disease means the unequivocal diagnosis of Alzheimer s Disease by a consultant neurologist or geriatrician. The diagnosis must confirm dementia due to failure of brain function with cognitive impairment for which no other recognisable cause has been identified. A Mini-Mental State Examination score of 24 or less is required. Angioplasty means the actual undergoing of Coronary Artery Angioplasty to correct a narrowing or blockage of one or more coronary arteries. Payment is limited to the amount of Total Disability Benefit for one month. Aortic Surgery means surgery to repair or correct an aortic aneurysm, an obstruction of the aorta, a coarctation of the aorta or traumatic Injury to the aorta. For the purpose of this definition, aorta means the thoracic and abdominal aorta but not its branches. Aplastic Anaemia means bone marrow failure, which results in anaemia, neutropenia and thrombocytopenia requiring treatment, with at least one of the following: blood product transfusions; marrow stimulating agents; immunosuppressive agents; or bone marrow transplantation. Benign Brain Tumour means a non-cancerous tumour in the brain, which gives rise to characteristic symptoms of intracranial pressure such as papilloedema, mental symptoms, seizures and sensory impairment, resulting in: at least a permanent 25% impairment of Whole Person Function; or the Life Insured being totally and permanently unable to perform any one of the Activities of Daily Living. The presence of the underlying tumour must be confirmed by CT Scan, MRI or other imaging studies. Blindness means the permanent Loss of Sight of both eyes. Cancer means the presence of one or more malignant tumours. The malignant tumour is to be characterised by the uncontrollable growth and spread of malignant cells and the invasion and destruction of normal tissue. The following tumours are excluded: tumours showing the malignant changes of carcinoma in situ (including cervical dysplasia CIN-1, CIN-2 and CIN-3) or which are histologically described as premalignant*; all skin cancers, unless there is evidence of metastases; or the tumour is a melanoma of at least Clark level 3; or the tumour is a melanoma showing signs of ulceration; or the tumour is a melanoma of greater than 1.5mm maximum thickness as determined by examination using the Breslow method. prostatic cancers which: are histologically described as TNM Classification T1a or T1b; and are characterised by Gleason Score of 7 or less; unless major interventionalist therapy including radiotherapy, chemotherapy, biological response modifiers or any other major treatment has been required to arrest the spread of malignancy. Chronic Lymphocytic Leukaemia less than Rai Stage 1. # CIN-1, CIN-2, and CIN-3 may also be referred to or known as mild dysplasia, moderate dysplasia, and severe dysplasia; or low grade squamous intraepithelial lesion (CIN-1) and high grade squamous intraepithelial lesion (CIN-2 and CIN-3). * Carcinoma in situ of the breast or testicle is covered if it results directly in the removal of the entire breast or testicle. The procedure must be performed specifically to arrest the spread of malignancy, and be considered the appropriate and necessary treatment. 34 Product Disclosure Statement

41 Cardiomyopathy means impaired ventricular function of variable aetiology resulting in permanent 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 means end-stage renal failure presenting as chronic irreversible failure of both kidneys to function, resulting in renal transplantation or the permanent requirement for renal dialysis. Chronic Liver Failure means end-stage liver failure resulting in permanent jaundice, ascites and/or encephalopathy. Chronic Lung Failure means end-stage lung disease with a consistent pulmonary function test result of FEV1 less than 40% predicted and requiring permanent oxygen therapy. Coma means a state of unconsciousness with no reaction to external stimuli or internal needs, resulting in a documented Glasgow Coma Scale of 6 or less, for a continuous period of at least 72 hours. Coronary Artery Bypass Surgery means bypass grafting performed to correct or treat coronary artery disease. Dementia means the unequivocal diagnosis of Alzheimer s Disease or other dementia by a consultant neurologist or geriatrician. The diagnosis must confirm permanent irreversible failure of brain function with cognitive impairment for which no other recognizable cause has been identified. A Mini-Mental State Examination score of 24 or less is required. Encephalitis and Meningitis means the unequivocal diagnosis of encephalitis or meningitis where the condition is characterised by severe inflammation of the brain or the meninges of the brain resulting in permanent neurological deficit causing: at least a permanent 25% Impairment of Whole Person Function; or the Life Insured being totally and permanently unable to perform any one of the Activities of Daily Living. Heart Attack means the death of a portion of heart muscle as a result of inadequate blood supply to the relevant area. The basis of diagnosis will be: confirmatory new electrocardiogram (ECG) changes; and a diagnostic rise and fall (other than as a result of cardiac or coronary intervention) in either Troponin I in excess of 2.0ug/L or Troponin T in excess of 0.6ug/L or cardiac enzyme CK-MB. If the above criteria are not met, we will pay a claim based on satisfactory evidence that the Life Insured has unequivocally been diagnosed as having suffered a myocardial infarction resulting in: a permanent reduction in the Left Ventricular Ejection Fraction to less than 50%, measured three months or more after the event; or new pathological Q waves. At our discretion, we will also consider any other medical test result provided by a cardiologist that unequivocally diagnoses myocardial infarction of the degree of severity or greater as documented above. Heart Valve Surgery means surgery to replace or repair a cardiac valve as a consequence of a cardiac valve abnormality or a cardiac aneurysm or other cardiac defects. Product Disclosure Statement 35

42 Section 23: Trauma definitions (continued) Intensive Care means a sickness or injury has resulted in the Insured Person requiring continuous mechanical ventilation by means of tracheal intubation for ten consecutive days (24 hours per day) in an authorised intensive care unit of an acute care hospital. No amount will be paid where Intensive Care of the Insured Person results from the consumption of alcohol or the use of non prescribed drugs. Loss of Hearing means the total and irrecoverable loss of hearing, both natural and assisted, in both ears as a result of sickness or injury. Loss of Independent Existence means significant cognitive Impairment, or the total and irrecoverable loss of ability, due to sickness or injury, to perform at least two of the Activities of Daily Living without the physical assistance of another person. Loss of Sight means the total and irrecoverable loss of sight (whether aided or unaided) in an eye, as a result of sickness or injury to the extent that visual acuity in the eye, on a Snellen Scale after correction by a suitable lens is less than 6/60, or to the extent that the visual field is reduced to 10 degrees or less of arc. Loss of a Single Limb means the total and irrecoverable loss of use of one Limb where a Limb means an arm, leg, hand or foot. In respect of this definition, the hand or foot starts from the wrist or ankle joint, respectively. Loss of Speech means the total and irrecoverable loss of the ability to produce intelligible speech, as a result of permanent damage to the larynx or its nerve supply or to the speech centres of the brain, due to sickness or injury. Major Head Trauma means accidental head injury resulting in neurological deficit causing: at least a permanent 25% impairment of Whole Person Function; or the Insured Person being totally and permanently unable to perform any one of the Activities of Daily Living. Major Organ Transplant means either the undergoing of, or upon the advice of a specialist Medical Practitioner the placement on a waiting list of a Transplantation Society of Australia and New Zealand recognised transplant unit for, the human to human transplant from a donor to the Insured Person of; bone marrow; or one of the following organs or a permanent mechanical replacement of one of the following organs: kidney; heart; lung; liver; pancreas; or small bowel. The transplant of all other organs, parts of organs or any other tissue transplant is excluded. Medically-Acquired HIV means accidental infection, after the inception of the Policy, with the human immunodeficiency virus (HIV) where the virus was acquired in Australia by the Insured Person from one of the following medically necessary events conducted by a recognised and registered health professional: a blood transfusion; transfusion with blood products; organ transplant to the Insured Person; assisted reproductive techniques; or a medical procedure or operation performed by a Medical Practitioner or dentist. Notification and proof of the incident will be required via a statement from the appropriate Statutory Health Authority that the infection was medically acquired. HIV infection transmitted by any other means including sexual activity or the use of drugs, other than as prescribed by a Medical Practitioner for the Insured Person is excluded. This Trauma Condition will not apply and no payment will be made where a cure has become available or where the infected person does not take any vaccine available prior to the Trauma Condition event. Cure means an Australian Governmentapproved treatment, which renders the HIV inactive and non-infectious, or results in there being little or no impact on life expectancy. 36 Product Disclosure Statement

43 Vaccine means a preparation approved by the Australian Government and recommended for use by the Government authority to produce immunity to the HIV. Meningococcal Disease means the unequivocal diagnosis of meningococcal septicaemia resulting: in at least a permanent 25% impairment of Whole Person Function; or the Insured Person being totally and permanently unable to perform any one of the Activities of Daily Living. Motor Neurone Disease means the unequivocal diagnosis of a progressive form of debilitating Motor Neurone Disease. Multiple Sclerosis means a disease characterised by demyelination in the brain and/or spinal cord. Multiple Sclerosis must be unequivocally diagnosed. There must be more than one episode of well-defined neurological deficit with persisting neurological abnormalities. Neurological investigations such as lumbar puncture, MRI (Magnetic Resonance Imaging) evidence of lesions in the central nervous system, evoked visual responses, and evoked auditory responses are required to confirm diagnosis. Muscular Dystrophy means the unequivocal diagnosis of muscular dystrophy. Occupationally Acquired Hepatitis B or C means infection, after the inception of the Policy, with Hepatitis B or C where the infection is acquired as a result of: an accident arising out of the Insured Person s normal occupation or a malicious act of another person or persons arising out of the Insured Person s normal occupation. Proof of new Hepatitis B or C infection must be registered within six months of the accident or malicious act. Any incident giving rise to a potential claim must: be reported to the relevant authority or employer within seven days of the incident; be reported to us with proof of the incident within 30 days after the incident; and be supported by a negative Hepatitis B or C test taken within seven days of the incident.the infection must manifest itself within six months of the accident or malicious act. The infection must not have arisen from a deliberately, self-inflicted or induced cause or from sexual activity (whether as part of normal occupational duties or otherwise), or from the use of drugs not medically prescribed for the Life Insured. This Trauma Condition will not apply and no payment will be made where a cure has become available or where a medical treatment is developed and approved which makes these viruses inactive and non-infectious. Cure means an Australian Government-approved treatment which renders Hepatitis B or Hepatitis C (as applicable), inactive and non-infectious, or results in there being little or no impact on life expectancy. Hepatitis B or C infection transmitted by any other means including sexual activity or recreational intravenous drug use is excluded. Occupationally Acquired HIV means infection with the human immunodeficiency virus (HIV) where such infection arose from an Accident relating to the occupation of the Insured Person, subject to the following conditions: the Accident must have occurred after the inception of the Policy; within 30 days of the Accident, proof of its occurrence must be registered with TAL including: tests taken by a Medical Practitioner within seven days after the Accident which resulted in a sero-negative HIV result; and documents confirming any relevant authority was notified within seven days of the Accident. The infection must manifest itself as a sero-positive HIV test result within six months of the reported occurrence. The infection must not have arisen from a deliberately, self-inflicted or induced cause or from sexual activity (whether as part of normal occupational duties or otherwise), or from the use of drugs not medically prescribed for the Insured Person. We reserve the right to obtain independent tests and investigations, including the taking of blood samples from the Insured Person. This Trauma Condition will not apply and no payment will be made where a cure has become available or where the infected person does not take any vaccine available prior to the Trauma Condition event. Cure means an Australian Governmentapproved treatment which renders the HIV inactive and non-infectious, or results in there being little or no impact on life expectancy. Vaccine means a preparation approved by the Australian Government and recommended for use by the Government authority to produce immunity to the HIV. Product Disclosure Statement 37

44 Section 23: Trauma definitions (continued) Paralysis means the total and permanent loss of function of two or more limbs through sickness or injury causing permanent damage to the nervous system. This includes, but is not limited to, quadriplegia, paraplegia, diplegia and hemiplegia. Parkinson s Disease means the unequivocal diagnosis of degenerative idiopathic Parkinson s Disease 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 (e.g. secondary to medication). Pneumonectomy means the undergoing of surgery to remove an entire lung. This treatment must be deemed the most appropriate treatment and medically necessary. Primary Pulmonary Hypertension means the unequivocal diagnosis of Primary Pulmonary Hypertension with right ventricular enlargement established by investigations including cardiac catheterisation. Severe Burns means tissue Injury caused by thermal, electrical or chemical agents causing third degree or full thickness burns to at least: 20% of the body surface area as measured by the Lund and Browder Body Surface Chart; 50% of both hands, requiring surgical debridement and/or grafting; or 50% of the face, requiring surgical debridement and/or grafting. Severe Diabetes means that a certified consultant endocrinologist has confirmed that at least two of the following complications have occurred as a direct result of diabetes: severe diabetic retinopathy resulting in visual acuity (whether aided or unaided) 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 less than 28ml/min (CKD stage 4, International Chronic Kidney Disease classification). Severe Rheumatoid Arthritis means the unequivocal diagnosis of severe rheumatoid arthritis 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; and 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; 38 Product Disclosure Statement

45 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 arthridities are excluded. Stroke means a cerebrovascular event producing neurological deficit. This requires clear evidence on a CT, MRI or similar, appropriate scan or investigation that a stroke has occurred and of infarction of brain tissue, intracranial and/or subarachnoid haemorrhage. Transient ischaemic attacks, reversible neurological deficit, cerebral symptoms due to migraine, cerebral Injury resulting from trauma or hypoxia and vascular disease affecting the eye, optic nerve or vestibular functions are excluded. 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. Product Disclosure Statement 39

46 Section 24: Additional information 24.1 Duty of disclosure Before you enter into the Policy, you have a duty under the Insurance Contracts Act 1984 (Cth) to disclose to us any matter that you know, or could be reasonably expected to know, and which may affect our decision to grant Insurance Cover or the terms of that Insurance Cover. The same duty applies before the Policy is renewed, extended, varied or reinstated. This duty does not apply to a matter: that reduces our risk; is common knowledge; that we know or ought to know in the ordinary course of business; or to which we have waived a requirement for disclosure. If you do not disclose relevant matters and we would not have entered into the Policy, or agreed to any variance of the Policy, on any terms if the non-disclosure had not occurred, we may be able to avoid the Policy within 3 years of entering into it, or agreeing to the variation, as applicable. If the non-disclosure is fraudulent, we may avoid the Policy at any time. Should we be entitled to avoid the Policy, we may within 3 years of entering into it, or agreeing to the variation, as applicable, choose not to avoid it but reduce the Benefit amount to the amount of Insurance Cover, which would have been granted for the premium charged, if all relevant matters had been disclosed. This duty continues to apply until our written notification of acceptance of Insurance Cover. It also applies if you seek to extend, vary or reinstate the Policy. The duty applies to any application for Insurance Cover requiring Underwriting, before we issue our written notification of our acceptance of the application. In these circumstances the duty set out in this Section 24.1 applies to the Eligible Person and to you and a breach of the duty might result in the Eligible Person s cover being withdrawn and/or their claim being declined Privacy Personal information will be collected from you in respect of your Employees or Eligible Persons so we can provide, or arrange, for the provision of this insurance. Further personal information may be requested from your Employees or Eligible Persons or their estate at a later time, for example, at claim time. If your Employees or members do not supply the required information, we may not be able to provide the service requested, or pay the claim. By making the Policy Declaration you are agreeing to our collection, use and disclosure of your personal and sensitive information as explained in our Privacy Policy which is available on our website at or on request. In processing and administering your Employees or Eligible Persons insurance we may collect and use or disclose your personal and sensitive information to assess, verify and process your application. Your information may be collected from or disclosed to other entities including reinsurers, superannuation trustees, medical practitioners, health professionals, accountants, employers, lawyers, financial advisers, external complaints resolution bodies and as required or authorised by law. We rely on the accuracy of the information provided to us. If you think that we hold information about your Employees or Eligible Persons that is incorrect, please contact us. If for any reason we decline a request to access and/or update information, we will provide details of that reason. Under current privacy legislation, individuals generally have a right to access any personal and sensitive information we hold about them. To access that information, they should simply make a request in writing. This process enables us to confirm their identity for security reasons and to protect personal information from being sought by another person. Information relating to your right to privacy is available at the website of the Officer of the Australian Information Commissioner at: If you have any questions regarding your privacy or would like to obtain a copy of our Privacy Policy please contact our Privacy Officer. TAL Privacy Officer PO Box 142 Milsons Point NSW Product Disclosure Statement

47 24.3 Notices Any notice we give to you or you give to us, must be: in writing, by or facsimile; and to the address most recently advised by you or us, as relevant. A notice which is delivered personally, electronically ( ) or sent by facsimile is treated as being given on the day it was received and a notice which is posted is treated as being given 3 days from the date of posting. If you advise us that you have appointed an agent or broker to act on your behalf in respect of your Policy, we will give notices to that person, including premium notices, and they will be deemed to have been given to you. Any notice provided to us by your agent or broker will be deemed to have been given by you Currency All payments made in connection with the Policy must be made in Australian dollars 24.5 We may inspect your records We may inspect and take copies of any records you, your agents or representatives have, which we believe are relevant to the Policy. If we do this, we will do so during normal working hours and give you reasonable notice of the inspection. We will continue to reserve this right after termination of the Policy until the later of: 2 years after the Policy Termination Date; or the settlement of all claims under the Policy Statutory fund The Policy is issued in TAL s Statutory Fund Number 1. The Policy does not share in the distribution of any surplus of this fund or give you or any Insured Person any rights of ownership of the assets of this or any TAL statutory fund Governing law The Policy is subject to and governed by the laws of New South Wales. Australian courts have exclusive jurisdiction to hear all disputes arising from it Government taxes and charges If we are required by law to pay any tax, duty or other charges in connection with a Benefit we pay to you, which are not included in the Premium Rates, we will deduct the relevant amount from the Benefit and pay it to the proper authority. If the Policy is a superannuation policy, you should be aware that there may be restrictions imposed under superannuation regulations that prevent you from releasing a Benefit paid under the Policy to the Insured Person Taxation Taxation treatment in respect of both the premiums and the Benefits payable on insurance policies is different depending on whether or not the relevant insurance policy is under superannuation and on each individual circumstance. Where we pay the Benefit(s) to you under the Policy, you are responsible for calculating, deducting and remitting any tax payable on Benefit(s) paid to you under the Policy, unless we otherwise agree. Because of the differing taxation implications it is important you seek independent professional taxation advice relevant to your particular circumstances in determining whether you purchase a superannuation or a non-superannuation policy. Product Disclosure Statement 41

48 Section 24: Additional information (continued) Complaints We will always aim to quickly and satisfactorily answer any questions and resolve any problems or complaints you may have regarding the Policy. From time to time you may have questions about your insurance. Our customer service consultants are familiar with the product and are happy to answer any of your questions. A customer service consultant is available by calling Complaints on a nonsuperannuation group salary continuance policy If you have a complaint in relation to a policy that is not issued to you through a superannuation fund, you can write to: TAL Complaints Manager PO Box 142 Milsons Point NSW 1565 We will attempt to resolve your complaint within 45 days of the date it is received by us. If we are unable to resolve your complaint within that period, we will inform you of the delay and ask for your consent to resolve the complaint within 90 days of the date it was received Complaints on a group salary continuance policy structured through superannuation If your complaint is in relation to a policy that is issued through a superannuation fund, you should address your complaint to the trustee of that fund. That trustee will provide you with details of its complaints-handling requirements, where applicable. If your complaint has not been resolved within 90 days of the date your complaint is received by them, you may contact the Superannuation Complaints Tribunal (Tribunal). The Tribunal is an independent body established by the Federal Government to provide free advice and assistance to you and your beneficiaries to resolve certain superannuation complaints. The Tribunal can be contacted as follows: Superannuation Complaints Tribunal (SCT) Locked Bag 3060 Melbourne VIC 3001 Telephone: Fax: (03) [email protected] If your complaint has not been resolved to your satisfaction within 45 days of receiving your initial complaint to TAL (or, if you have agreed, within 90 days) you may contact the Financial Ombudsman Services (FOS). This is an industry sponsored service, which provides free advice and assistance to consumers with complaints against financial services companies, including policy owners to resolve complaints with their life insurance company. FOS is an independent and impartial body. Decisions made by FOS are binding on us. FOS can be contacted as follows: Financial Ombudsman Service (FOS) GPO Box 3 Melbourne VIC 3001 Telephone: Fax: (03) [email protected] 42 Product Disclosure Statement

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52 TAL Life Limited 80 Alfred Street South Milsons Point NSW 2061 Contact Monday to Friday 8.00am 7.00pm (AEST) Customer Service Centre F E [email protected] TALG /11