BT Protection Plans Supplementary Product Disclosure Statement and Policy Addendum (SPDS) Dated 22 August 2011 This SPDS is dated 22 August 2011 and supplements the information contained in the BT Protection Plans Product Disclosure Statement and Policy Document (PDS) which has an effective date of 21 February 2011. This SPDS is issued by Westpac Life Insurance Services Limited ABN 31 003 149 157 (WLIS), Australian Financial Services Licence (AFSL) Number 233728, for all products, except for Term Life as Superannuation and BT Protection Plans paid for via SuperWrap. For Term Life as Superannuation, the issuer of the SPDS is Westpac Securities Administration Limited ABN 77 000 049 472 (WSAL), AFSL Number 233731, RSE Licence Number L0001083. WLIS and WSAL each take full responsibility for the whole of this SPDS. The PDS provides details of your cooling off rights (page 69) and our complaints handling procedures (page 71). For further information about policies paid via SuperWrap, which is part of Retirement Wrap ABN 39 827 542 991 RSE R1001327, see the BT Protection Plans (SuperWrap and SuperWrap Essentials) Insurance Booklet dated 21 February 2011, for which the issuer and trustee is BT Funds Management Limited ABN 63 002 916 458, RSE L0001090 (SuperWrap Trustee). The administrator of all policies paid via SuperWrap and Wrap and the arranger of policies paid via Wrap is BT Portfolio Services Ltd ABN 73 095 055 208 (BTPS or the administrator). You should read both the PDS and this SPDS before making a decision in relation to BT Protection Plans. If you take out cover under BT Protection Plans, your insurance contract will consist of the PDS (and Insurance Booklet for SuperWrap), this SPDS and your policy schedule or membership certificate. This SPDS has been issued in relation to the following changes: PDS Inside Cover, Who s responsible for BT Protection Plans, the following text: For further information about Policies paid via SuperWrap, see the BT Protection Plans (SuperWrap and SuperWrap Essentials) Insurance Booklet dated 21 February 2011, which is issued by the Trust Company (Superannuation) Limited ABN 49 006 421 638 AFSL No. 235 153 RSE Licence No. L0000635 (SuperWrap Trustee). For further information about Policies paid via SuperWrap, see the BT Protection Plans (SuperWrap and SuperWrap Essentials) Insurance Booklet dated 21 February 2011, which is issued by BT Funds Management Limited ABN 63 002 916 458, AFSL No. 233 724, RSE License No. L0001090 (SuperWrap Trustee). PDS Chapter 2 Summary of key features, page 14, all text in the section titled Premium Holiday is deleted and replaced with: Premium Holiday To save you the hassle of having to cancel your Policy and then having to re-apply when your circumstances change, after you have held your Policy for at least 6 months, we will allow you to suspend your Policy once in any 12 month period for a maximum of 12 months in total over the duration of the Policy if you provide us with evidence to our satisfaction, that during the relevant period you are experiencing financial hardship due to: being unemployed; being on sabbatical, maternity, paternity or long term leave from work; or your household income for the last three months reducing by 30% or more (as compared to the household income over the preceding three month period). During this period you will not have to pay premiums. However, you will not be eligible to claim for any sickness, injury, death or any other event that happens in the period that the premiums are not being paid. This benefit only applies if you are also an Insured Person. Where there is more than one Policy Owner, all Policy Owners must provide us with their agreement to exercise the Premium Holiday. 1
Acceptance of your application for a Premium Holiday will mean that your entire Policy will be suspended. This includes any Flexible Linking Plus or Income Linking Plus benefits. A sickness or injury is taken to have happened when: a doctor first gave the Insured Person advice, care or treatment or recommended that the Insured Person seek advice, care or treatment for the sickness or injury; or the Insured Person first had any symptom of the sickness or injury for which a reasonable person in the same circumstances would have sought advice, care or treatment from a doctor. PDS Chapter 2 Life, Living and TPD benefit specifics, page 27, all text in 6.3 Exclusions under the heading Funeral Advancement Benefit We will not pay a Funeral Advancement Benefit if the Insured Person commits suicide (whether sane or insane) within 13 months of the later of: the commencement date; and the date the Policy was last reinstated. This exclusion does not apply to the Policy if it replaces another similar policy issued by another insurer, or another policy issued by us, and all of the following apply: the level of cover provided by us under this Policy is the same amount, or less than, the existing cover being replaced; we were specifically told about the intended replacement of the other policy and we agreed to issue this Policy on the basis that it replaced the other policy; the other policy and equivalent benefit amount was continuously in force for at least 13 months immediately prior to the issue of this Policy; the other policy was cancelled immediately after the issue of this Policy; and no claim is pending or payable under the other policy. PDS Chapter 2 Life, Living and TPD benefit specifics, page 30, the following text in 9.3 TPD Continuation Benefit under the heading TPD Benefit: c_what we will pay If the Insured Person: suffers a sickness or injury which has prevented the Insured Person from working in their own occupation for at least 3 consecutive months; and the sickness or injury is likely to prevent the Insured Person from ever again being able to work in any occupation for which they are reasonably qualified because of education, training or experience, and which would pay remuneration at a rate greater than 25% of their earnings in the last 12 months of work. the amount we will pay is the TPD Benefit shown in the policy schedule for the Insured Person as at the date of disablement. c_what we will pay If the Insured Person suffers a sickness or injury which has prevented the Insured Person from working in their own occupation for at least 3 consecutive months; and: the sickness or injury is likely to prevent the Insured Person from ever being able to work in any occupation for which they are reasonably qualified because of education, training or experience; or if the Insured Person is able to work in an occupation for which they are reasonably qualified because of education, training or experience but the total remuneration for this occupation is less than 25% of the Insured Person s earnings in their last 12 months of work, then the amount we will pay is the TPD Benefit shown in the policy schedule for the Insured Person as at the date of disablement. 2
PDS Chapter 3 Income Products, Summary of key features, page 44, all text in the section titled Premium Holiday Premium Holiday To save you the hassle of having to cancel your Policy and then having to re-apply when your circumstances change, after you have held your Policy for at least 6 months, we will allow you to suspend your Policy once in any 12 month period for a maximum of 12 months in total over the duration of the policy if you provide us with evidence, to our satisfaction, that during the relevant period you are experiencing financial hardship due to: being unemployed; being on sabbatical, maternity, paternity or long term leave from work; or your household income for the last three months reducing by 30% or more (as compared to the household income over the preceding three month period). During this period you will not have to pay premiums. However, you will not be eligible to claim for any sickness, injury, death or any other event that happens in the period that the premiums are not being paid. This benefit only applies if you are also an Insured Person. Where there is more than one Policy Owner, all Policy Owners must provide us with their agreement to exercise the Premium Holiday. Acceptance of your application for a Premium Holiday will mean that your entire Policy will be suspended. This includes any Flexible Linking Plus or Income Linking Plus benefits. A sickness or injury is taken to have happened when: a doctor first gave the Insured Person advice, care or treatment or recommended that the Insured Person seek advice, care or treatment for the sickness or injury; or the Insured Person first had any symptom of the sickness or injury for which a reasonable person in the same circumstances would have sought advice, care or treatment from a doctor. PDS Chapter 4 Interim Accident and Sickness Cover, page 62, the entire chapter following the heading Rest easy. From the moment we receive your completed application form and personal statement you are covered by Interim Accident and Sickness Cover, and you don t even need to pay any extra premium for this cover. Some of the words in italics within this chapter have specific meanings for this chapter only. Please refer to section 4 for the definitions. 1_Commencement of Interim Accident and Sickness Cover Interim Accident and Sickness Cover commences when a fully completed application form and personal statement, which has been declared true and correct in respect of each Insured Person, has been received by us. Alternatively, you can apply for Interim Accident and Sickness Cover prior to completing your application for BT Protection Plans. This provides you with cover while you are completing your application. To apply for this you must complete the Interim Accident and Sickness Cover Certificate (signed by you and your adviser) and send it to us. In this case, Interim Accident and Sickness Cover commences on the date we receive your completed Interim Accident and Sickness Cover Certificate. In the event that you make a claim under the Interim Accident and Sickness Cover Certificate, we will require a copy of the signed and dated Statement of Advice (SOA), in which your financial adviser has recommended BT Protection Plans, to be submitted to us. For your Interim Accident and Sickness Cover to continue, you must ensure that you have completed your application form and personal statement for BT Protection Plans and that it is received by us within 10 days of the date we receive your Interim Accident and Sickness Cover Certificate. 3
2_Period of Interim Accident and Sickness Cover Interim Accident and Sickness Cover will end on the earliest of the following: 10 days from the date we received the Interim Accident and Sickness Cover Certificate if we have not received a completed application for BT Protection Plans; 90 days from the date Interim Accident and Sickness Cover commences; in respect of each Interim Benefit for each Insured Person, the date we accept the insurance application for that benefit under BT Protection Plans or you obtain alternative insurance; in respect of each Interim Benefit for each Insured Person, the date you withdraw your insurance application for that benefit under BT Protection Plans; and the date we advise you that Interim Accident and Sickness Cover has ceased. 3_Interim Benefits Interim Death Benefit The lesser of $1,000,000 or the amount of the Death Benefit applied for in respect of the Insured Person if completed application and personal statement has been submitted to us or the Death Benefit amount recommended in the SOA if completed Interim Accident and Sickness Certificate is submitted, is payable should the Insured Person die as a result of an accident or sickness whilst the Interim Accident and Sickness Cover is in force. Interim TPD Benefit The lesser of $1,000,000, the TPD Benefit applied for in respect of the Insured Person if completed application and personal statement has been submitted to us or the TPD Benefit amount recommended in the SOA if completed Interim Accident and Sickness Certificate is submitted, is payable should the Insured Person become totally & permanently disabled as a result of an accident or sickness whilst the Interim Accident and Sickness Cover is in force. The total & permanent disability definition that applies is either own occupation TPD, any occupation TPD, home duties TPD, or general cover TPD as nominated by you in your application form. Interim Living Benefit The lesser of $1,000,000, the Living Benefit applied for in respect of the Insured Person if completed application and personal statement has been submitted to us or the Living Benefit amount recommended in the SOA if completed Interim Accident and Sickness Certificate is submitted, is payable should the Insured Person suffer a specified medical event as a result of an accident or sickness whilst the Interim Accident and Sickness Cover is in force and the Insured Person subsequently survives for 14 days. The specified medical events relevant to the Interim Living Benefit are defined in the Medical Glossary. Interim Income Protection Benefit The lesser of $5,000 per month, the insured monthly disability benefit or insured monthly business overheads benefit applied for under Income Protection, Income Protection Plus or Business Overheads if completed application and personal statement has been submitted to us or recommended in the SOA if completed Interim Accident and Sickness Certificate is submitted, is payable should the Insured Person become totally disabled as a result of an accident or sickness whilst the Interim Accident and Sickness Cover is in force. The benefit accrues from the end of the waiting period applied for under the relevant Policy and ceases to accrue at the earliest of either the date the Insured Person ceases to be totally disabled or 6 months from the end of the waiting period. 4_Definitions For the purposes of Interim Accident and Sickness Cover: Sickness means a sickness or disease which first becomes apparent after the earliest of the following: the application form and personal statement was declared true and correct; or we have received your completed Interim Accident and Sickness Cover Certificate. Pre-existing conditions means any injury, sickness, illness or symptom that: a_you or the Insured Person were aware of, or a reasonable person should have been aware of; b_ the Insured Person should have sought advice or treatment (conventional or alternative) from a doctor for (in circumstances where a reasonable person would have sought advice or treatment); or c_the Insured Person had a medical consultation for or was prescribed medication or therapy for. 4
5_Exclusions A benefit will not be paid if the death, total & permanent disability, medical event, accident, injury, sickness or event giving rise to the claim is caused directly or indirectly by: an intentional, self-inflicted act or attempted suicide (whether sane or insane); an accident or sickness while the Insured Person is under the influence of alcohol or non-prescription drugs or drugs taken in excess of prescribed amounts; any act of war (whether declared or not) except where the Insured Person dies on war service; the Insured Person engaging in any sport, pastime or occupation that we would normally cover with a loading, exclusion, decline or deferral; or a pre-existing condition that existed prior to, or at the time of application or the date we received your completed Interim Accident and Sickness Cover Certificate. We will not pay a claim made under an Interim Accident and Sickness Cover Certificate if we are not in receipt of an SOA containing the BT Protection Plans recommendation made by the financial adviser for the proposed life to be insured. A benefit will not be paid if the Insured Person s occupation is one that we would not normally cover. In addition, we will take into account how the Insured Person would have been assessed in terms of definitions and benefit amounts under our underwriting rules. 6_Claims To the extent that they are relevant, the conditions in the BT Protection Plans Policy or Policies for which you have applied, that relate to the payment of a claim, apply to this cover. Only one Interim Accident and Sickness Benefit for an Insured Person will be paid in respect of any one accident or sickness. The cost of obtaining medical evidence that is required for the payment of an Interim Accident and Sickness Benefit claim is to be borne by you. The costs of further medical evidence may be borne by us, however this will be at our discretion. If you are eligible to make a claim under this cover, it will not prevent your application for a BT Protection Plans Policy continuing to be assessed. However, we will take into account the change in health of the Insured Person when assessing your application and we may decline your application or apply special loadings, conditions and exclusions. For the purposes of Policies being paid for through a SuperWrap account, if the person to be insured does not yet have funds in their SuperWrap account, we will pay the Interim Accident and Sickness Cover directly to the person to be insured. PDS Chapter 7 Medical Glossary, page 80, the definition of severe burns Severe burns Tissue injury caused by thermal, electrical or chemical agents causing third degree burns to: a_ at least 20% of the body surface area as measured by the rule of 9 or the Lund & Browder Body Surface Chart (or equivalent classification); b_both hands, requiring surgical debridement and/or grafting; or c_the face, requiring surgical debridement and/or grafting. PDS Chapter 8 Definitions, page 85, the definition of regular care of a doctor is deleted and replaced with: Regular care of a doctor means the Insured Person: has sought advice, care, and treatment from a doctor in relation to the sickness or injury that you are claiming for and is continuing to do so at such times as is reasonable in the circumstances; and is following the advice, care and treatment of the doctor. 5
PDS Chapter 8 Definitions, page 85, the following text in the definition of total disability and totally disabled: The above definition applies to occupation categories (as shown in the policy schedule) AA, A, P, S, BB during the life of a claim, and, only applies to occupation categories B, C or E for the first 2 years of a claim, after which, the Insured Person will need to demonstrate that they are, because of sickness or injury: unable to perform any occupation for which they are reasonably suited by education, training or experience; not working; and under the regular care of a doctor. The above definition applies to occupation categories (as shown in the policy schedule) AA, A, P, S, BB, B or C during the life of a claim and only applies to occupation category E for the first 2 years of a claim, after which, the Insured Person will need to demonstrate that they are, because of sickness or injury: unable to perform any occupation for which they are reasonably suited by education, training or experience; not working; and under the regular care of a doctor. PDS Chapter 8 Definitions, page 85, the first paragraph of the definition of Total & permanent disability and totally & permanently disabled a_for any occupation TPD sickness or injury which has prevented the Insured Person from working in their own occupation for at least 3 consecutive months; the 3 month period has ended before the review date on or following the Insured Person s 65th birthday; and the sickness or injury is likely to prevent the Insured Person from ever again being able to work in any occupation for which they are reasonably qualified because of education, training or experience; or if the Insured Person is able to work in an occupation for which they are reasonably qualified because of education, training or experience but the total remuneration for this occupation is less than 25% of the Insured Person s earnings in their last 12 months of work. The Insured Person will also be considered to be totally & permanently disabled if the Insured Person meets the general cover TPD definition of total & permanent disability. General cover TPD will apply if the Insured Person had permanently retired prior to the event causing disability. PDS Chapter 8 Definitions, page 86, the following paragraph of the definition of waiting period: For Income Protection Plus occupation categories AA, A, P and S, the Insured Person must be either totally disabled or partially disabled throughout the waiting period in order to keep it running. If they cease to be totally disabled or partially disabled at any time, the waiting period stops running. The waiting period will not start to run again unless the Insured Person again becomes totally disabled or partially disabled, and then it will do so from the beginning. For Income Protection Plus occupation categories AA, A, P and S, the Insured Person must be either totally disabled or partially disabled throughout the waiting period in order to keep it running. Except as otherwise stated, if the Insured Person ceases to be totally disabled or partially disabled at any time, the waiting period stops running. The waiting period will not start to run again unless the Insured Person again becomes totally disabled or partially disabled, and then it will do so from the beginning. If the Insured Person returns to work (other than in a partial capacity) for 5 consecutive days or less during the waiting period (10 consecutive days or less if the waiting period is 90 days or more), the waiting period does not stop running. Instead those days will be added to the waiting period. 6
PDS Chapter 8 Definitions, page 86, at the end the definition of waiting period add the following: If you have an Income Protection Plus Policy and a Business Overheads Policy, the Income Protection Plus waiting period definition will apply to each Policy. 7
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