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Core Super MySuper. Insurance & Other Important Information 3 August PDF
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1 Core Super MySuper Insurance & Other Important Information 3 August 2015 As a Core Super MySuper member you have Income Protection as well as Life and Total and Permanent Disablement [TPD] Insurance available to you. The information in this document forms part of the Product Disclosure Statement [PDS] for Core Super MySuper dated 3 August 2015 and should be read in conjunction with the PDS. You should consider this information and the information in the PDS before making a decision to invest in Intrust Super s Core Super product. Issued by IS Industry Fund Pty Ltd MySuper Unique Identifier: ABN: AFSL No: RSE Licence No: L Intrust Super ABN USI/SPIN: HPP0100AU RSE Registration No: R
2 [ 2 ] intrust.com.au Life and TPD cover Default Life and TPD cover When you first join Core Super MySuper, the following basic Life and TPD Insurance cover is provided automatically, without the need for you to supply medical evidence [subject to the conditions relating to commencement of cover outlined under the heading When does your Life and TPD Insurance start? ]: 2 units of Life and TPD Insurance at a cost of $4.00 per week [$2.00 per unit] Unless you choose not to, you will receive the Default Cover when you join. Default Cover: means 2 units of cover, based on your age, as shown in the table on the right. Additionally, you may elect to receive an additional two [2] units of Life and TPD Insurance without medical evidence where a completed and signed Membership Application is received by Intrust Super within 180 days of you being First Eligible to join and you are in Active Employment on the day your cover commences. See When does your Life and TPD Insurance start?. You may choose not to have any cover or reduce your level of cover by indicating this on your Membership Application Form or by writing to Intrust Super at anytime. However, if you choose to cancel your cover or reduce your level of cover and decide to take up insurance at a later date, or increase your cover at later date, you will need to provide medical evidence. The insurer will advise you of the evidence required at the time of your application. When a Death or Total and Permanent Disablement claim is accepted, your benefit will equal your account balance plus any insurance benefit paid by the Insurer. All claims are subject to the Trustee and Insurer s approval according to the relevant legislation, the Fund s Trust Deed and the insurance policy. Payments may also be taxed. When does your Life and TPD Insurance start? Your Life and TPD Insurance starts when; you join Core Super MySuper within 180 days of becoming First Eligible and a fully completed and signed Membership Application is received by Intrust Super within that time. Where Intrust Super receives only your name, date of birth, address and date of commencement, but no Membership Application you will receive Default Cover but no additional units of cover; and you receive an employer contribution into your account within 180 days of becoming First Eligible to join us; and you are not entitled to or have not been paid a TPD benefit from any superannuation Fund or life insurance policy [whether under Intrust Super or otherwise]. If this provision is not satisfied, then you will be eligible for Life Insurance only; and you are in Active Employment with your Intrust Super contributing employer on the date that your cover commences. However, if you are not in Active Employment on the date your cover commences, you are still eligible for Limited Cover for 12 months; and the Eligible Person is not applying for, entitled to, or has not been paid a terminal illness benefit from any superannuation fund or life insurance policy. If this provision is not satisfied, then the Eligible Person is not eligible for any cover. When the above eligibility requirements have been met, cover commences on the first day of the period for which the employer contribution relates. NB: If you join Intrust Super outside 180 days of becoming First Eligible, and where the other conditions relating to commencement of cover have been met, you will still receive cover but it will be Limited Cover for 12 months. First Eligible: means the later of when your employer becomes a participating employer [i.e. an employer who makes or agrees to make contributions to the Fund, abides by the rules of the Fund and is allocated a Fund membership number] and the date your employer first becomes liable to pay the Superannuation Guarantee Charge for you. Active Employment: means you are gainfully employed [including being on employer-approved leave, except leave caused by illness or injury] and attending work and performing your normal duties and hours without restriction due to illness or injury. Limited Cover: means cover for an illness diagnosed or an injury that occurred on or after the date that your cover commences. Core Super MySuper option Life and TPD cover per unit Age last birthday Cover per unit 16 to 39 $150, $141, $134, $127, $120, $113, $105, $98, $91, $84, $77, $70, $63, $56, $48, $41, $38, $34, $30, $27, $23, $20, $16, $13, $9, $5, Nil
3 Total and Permanent Disablement Insurance Your ability to earn an income is probably your greatest financial asset. Imagine the stress associated with suffering a serious injury or illness that permanently prevents you from earning a living. Core Super MySuper lets you combine Total and Permanent Disablement [TPD] Insurance with your Life Insurance. Please note that your TPD Insurance cannot exceed the amount of Life Insurance you have within Core Super MySuper. If eligible, TPD benefits are paid in the event that you become totally and permanently disabled. The definition of TPD varies depending on whether you are gainfully employed or not as at the date accepted by the Insurer as your date of disablement. What is Total and Permanent Disablement? Total and Permanent Disablement is covered by this policy for an Insured Person who is: [a] Aged less than 65 and is gainfully employed and working 15 or more hours each week within the 6 months prior to the Date of Disablement, is determined under either Part 1, Part 2, Part 3, Part 4 or Part 5, [b] Aged less than 65 and who was not gainfully employed or is working less than 15 hours each week within the 6 months prior to the Date of Disablement, is determined under either Part 3, Part 4 or Part 5. Total and Permanent Disablement means: Part 1 Unlikely to Return to Work The Insured Person is unable to do any work as a result of Injury or Illness for 3 consecutive months and in our opinion at the end of that 3 months they continue to be so disabled that they are in our opinion unlikely to resume their previous occupation at any time in the future and will be unlikely at any time in the future to perform any Other Occupation. Part 2 Permanent Impairment The Insured Person is engaged in gainful employment when suffering an Injury or Illness and, as a result of that Injury or Illness, they: [a] Suffer a permanent impairment of at least 25% of whole person function as defined in the American Medical Association publication Guides to the Evaluation of Permanent Impairment, 4th edition, or any other recognised standard we agree, and [b] Are disabled to such an extent, as a result of this impairment, that the Insured Person is unlikely ever again to be able to engage in any occupation, business, profession or employment for which the Insured Person is reasonably fitted by education, training or experience. Part 3 Loss of Use Of The Insured Person suffers the total, permanent and irrecoverable loss of: [a] The use of 2 limbs, or [b] The sight of both eyes, or [c] The use of 1 limb and sight of 1 eye. Part 4 Cognitive Loss The Insured Person, as a result of Illness or Injury, suffers Cognitive Loss. Part 5 Activities of Daily Living The Insured Person suffers an Illness or Injury, that in our opinion: [a] Totally and irreversibly prevents them from performing 2 of the Activities of Daily Living without assistance from another adult person for at least 3 consecutive months, and [b] Since they became ill or injured, they have been under the regular care and attention of a Doctor for that Illness or Injury, and [c] In our opinion, the Illness or Injury means that they are unlikely to ever again be able to perform at least 2 of the Activities of Daily Living without assistance from another adult person. Alignment of Total and Permanent Disablement benefits with the Superannuation Industry (Supervision) Act 1993 Effective from 1 January 2014 or such earlier date as we agree with the Proposer, an Insured Person must be disabled to such an extent, as a result of that Illness or Injury, that the Insured Person is unlikely ever again to be able to engage in any occupation, business, profession or employment, for which they are reasonably suited by their education, training or experience, in order to satisfy part 3, 4 or 5. We will waive our usual 3 month Total and Permanent Disablement waiting period and provide immediate assessment where a member is suffering Paralysis and all claim requirements have been received by us. Terminal Illness Benefit Where the Insurer is satisfied that you have been diagnosed with a Terminal Illness you may be eligible for a Terminal Illness benefit. A Terminal Illness benefit will be the lesser of your agreed benefit and $3M. In these circumstances, the Insurer will pay the Agreed Benefit at your date of death less any Terminal Illness benefit that has already been paid. To apply for a Terminal Illness benefit medical reports must be supplied to the Insurer. Terminal Illness: means a disease or condition that, in the opinion of two registered Doctors approved by us, is likely to lead to the Insured Person s death within a period of 24 months [the Certification Period] from the date the Doctor provides certification in respect of the Terminal Illness and the Certification Period must not have ended. At least one of the registered Doctors must be a specialist in the field to which the Terminal Illness relates. [ 3 ] CORE INSURANCE 3 Aug 2015
4 [ 4 ] intrust.com.au More cover when you need it In addition to the automatic cover you receive on joining, for specific life events such as marriage, divorce, taking out a mortgage for your permanent residence of $100,000 or more, or you or your partner giving birth to or adopting a child, you can apply for an additional unit of Life and TPD Insurance cover, generally without providing any additional medical evidence. You can only ever increase cover once for each of these events. To receive this upgrade you must: be less than 55 years old when you apply; only apply to increase your cover once for any of the nominated events; have not taken advantage of this offer in the last 12 months; not have existing cover that is subject to any special loadings or exclusions, and you must not have been previously declined cover under the Policy; and apply for the cover increase within 60 days of the life event happening and provide evidence that it has in fact occurred. If this additional cover is accepted and a claim arises within the first six months, a payment will only be made in respect of that additional cover if it results from accidental bodily injury and otherwise satisfies the Insurer s requirements. Contact us for a better understanding of what this means, but in much simplified terms it means Death or Total and Permanent Disablement by visible, violent and external means. Contact us to take up this offer. We ll write to you as soon as the additional cover starts. Naturally, there are some rules and conditions attached to Life Insurance. We ve highlighted the most important rules and conditions in the Snapshot of your Life and TPD cover on the following page, but for more details please contact us and we ll happily answer your questions or send you a copy of the policy document. Account-based premium deductions There are two important points to note that result from the account-based premium deductions: 1. If an employer who was previously making contributions on your behalf ceases those contributions and your account balance falls below $1,200, your insurance cover will cease. This situation would most likely arise where you have left the [previously contributing] employer s service and you do not have another employer contributing to Core Super on your behalf. 2. Where you do not have employer contributions paid on your behalf and your balance falls below $1,200, and your cover ceases as a result of that, you may still have your cover reinstated to the Default Cover or to the level of cover you held immediately prior the cessation of your cover, whichever is greater. This could occur if the same or new employer contributes within six months of the end of the month that the cover ceased. Where this payment is received outside of this time, you will have cover reinstated to the Default level of cover [2 units of combined Life and TPD cover], provided you are in Active Employment on the day cover recommences. If you are not in Active Employment on the day cover commences, you will receive Limited Cover for 12 months. Other things to know about insurance Don t lose your cover The essential point to note here is that where you want your Life Insurance to continue after you leave your current contributing employer, then [subject to your situation being one of the two points under the Account based premium deductions heading] you must ensure that your account balance does not fall below $1,200, and that the available amount is sufficient to pay the necessary premium. While all that sounds rather complicated, it is important that you are aware of the details of the Life Insurance available to you. Account-based premium deductions provide more security for you as a Core Super member. Exclusions If a claim results from any self-injury or suicide any Life Insurance will be reduced to 25% of one unit of cover, regardless of the amount of cover you have purchased. No payment will be made if the claim is the result of you actively participating in any militant activities. Overseas residence Life or Life and TPD cover may continue if you are working overseas so long as you remain a member of the Fund and premiums continue to be paid during your period of overseas residence. The period of overseas residence where cover may continue cannot be longer than three years. Prior approval must be gained from the Insurer for cover to apply for periods of overseas residence longer than three years. Cover does not apply in countries that are considered a Hazardous Destination [i.e. a country that is listed on the Department of Foreign Affairs and Trade website [ under advised against all travel ]. Where you are residing overseas, the Insurer reserves the right to ask you to return to Australia at your own expense in the event that you lodge a claim for TPD or a Terminal Illness.
5 Snapshot of your Life and TPD cover When your cover starts When the eligibility requirements have been met, cover commences on the first day of the period for which the employer contribution relates. What it costs For Life Insurance only a low $1.10 per unit per week. For combined Life and TPD Insurance a low $2.00 per unit per week. This is taken from your account balance each month. When your cover stops You are no longer covered by Life or Life and TPD Insurance when any of the following occur: You turn 65 years old. If an employer who was previously making contributions on your behalf ceases those contributions and your account balance falls below $1,200 then your insurance will cease. If this applies, cover will stop on the last day of the month in respect of which the last premium was paid. You join any country s armed forces [with the exception of the Australian Defence Forces Reserve]. You close your account and are no longer an Intrust Super member. Subject to being paid a Terminal Illness benefit, when the Insurer admits a claim for a benefit to you. You reside overseas outside the terms agreed with the Insurer. When all cover under the Policy with the Insurer stops. How much Life and TPD cover you can have Up to 4 units of automatic cover are available for eligible members, subject to the commencement of cover rules. All cover above this must be applied for. Applied for cover may be granted for Life Insurance up to the number of units where the last unit granted takes the value of the cover from below $10M to above $10M. Applied for cover may be granted for TPD Insurance up to the number of units where the last unit granted takes the value of the cover from below $3M to above $3M. Our Insurer will assess your request for extra units before granting any additional cover. To apply for extra cover, send us a completed Statement of Personal Health. The Insurer will let you know in writing if they need any more information from you, and whether they agree to insure you. While your application is being assessed, you will be covered by Accident Cover. Accident Cover: provides you with cover in the event of your death, if that cover would have been available to you as an Insured person under the Policy. [ 5 ] CORE INSURANCE 3 Aug 2015
6 [ 6 ] intrust.com.au Income Protection Insurance PayGuard Insurance PayGuard Income Protection Insurance We re looking out for you by helping you protect one of your most important assets your ability to work and earn money. We call this PayGuard and as the name suggests it can substantially replace your pay if Sickness or Injury stops you from doing your job. Up to 90% of the income you received before you got sick or injured [up to a maximum of $50,000 per month] may be paid, for up to two years*, if you meet the conditions for a PayGuard payment. You don t even have to worry about your super payments as PayGuard will provide a superannuation benefit of an amount equal to 10% of the benefit paid into your Intrust Super account. *Maximum benefit of 52 weeks for Mental Conditions Cover 24/7 You are covered 24 hours a day, seven days a week [work-related events are only covered within Australia] as long as your current employer is paying contributions into your Intrust Super account for you. That s another reason to make sure that when you change jobs, your new employer pays into your Intrust Super account. You don t need to fill in any complicated forms or undergo any medical tests to be covered. Your cover is automatically provided when you first join. If you don t want this cover just indicate on your Membership Application that you do not wish to take it up. You can also opt out at any time by writing to us. Naturally, there are rules and conditions attached to PayGuard. We ve highlighted the major ones in the Snapshot of your PayGuard Insurance on the following page but for more details please contact us and we ll happily answer your questions or send you a copy of the policy document. Flexible waiting periods The default waiting period is 21 days. However, you can choose to increase this waiting period from 21 days to up to 90 days, which will result in a lower premium [see table below]. If you would like to increase your waiting period in return for a lower premium, please indicate this on your Membership Application. Waiting period Premium 21 days [default] 0.700% of your income 30 days 0.635% of your income 45 days 0.560% of your income 90 days 0.420% of your income If you choose to reduce your waiting period [e.g. from 30 days back to 21 days], you will not be covered for any Pre-existing Sickness for the days between the previous higher waiting period and the new waiting period. This exclusion will apply until you ve had two years of Continuous Cover from the date you chose to reduce your waiting period. Incentives for long-term cover As an added bonus for our loyal members, if you ve had continuous PayGuard Insurance cover for two years or more and have not made a claim, your benefit payment effective start date will be backdated to commence up to 21 days earlier than it would have done had you not held such continuous cover without claim [the table below explains how the loyalty bonus works]. Years of Continuous Cover with no claim Benefit payment effective start date backdated by Less than 2 years 0 days 2 years but less than 4 years 7 days 4 years but less than 6 years 14 days More than 6 years 21 days
7 Actively at Work: means you are considered to be genuinely performing all the duties of your usual occupation and capable of working your usual hours without restriction for your Admitted Employer. If you are on paid annual leave, paid sick leave or long service leave, you will also be considered to be Actively at Work provided that leave is not in connection to the Injury or Sickness that leads to the Disablement, and, you are Actively at Work for the full week prior to that leave.. Admitted Employer: means an employer who makes employer superannuation contributions to Intrust Super on your behalf. Continuous Cover: means an unbroken period of time that you have been covered under the Policy. If you cease cover, your Continuous Cover period ends on that date. If you recommence cover under the Policy, your new Continuous Cover period commences on the date your cover recommences. Injury: means a physical injury caused by a violent, external and visible means which occurs fortuitously whilst this insurance is in force and which results in payment of any of the benefits specified in the Policy, within 12 calendar months from the date of its occurrence, but does not include any condition which is a Sickness. Maximum Benefit Period [Injury]: 104 weeks or to the date you turn 65 years, whichever occurs first. If you re aged 65 and above: 52 weeks or to the date you turn 70 years, whichever occurs first. If you are on claim when you turn 65 years, you will receive an additional 52 weeks but only to a maximum of 104 weeks total benefit. Maximum Benefit Period [Sickness]: 104 weeks or to the date you turn 65 years, whichever occurs first. If you re aged 65 and above: 12 weeks or to the date you turn 70 years, whichever occurs first. If you are on claim when you turn 65 years, you will receive an additional 12 weeks but only to a maximum of 104 weeks total benefit. Maximum Benefit Period [Mental Condition] is restricted to 52 weeks [or to the date the INSURED PERSON reaches the Maximum Age Limit, whichever occurs first] for Disablement caused by a MENTAL CONDITION. Medical Practitioner: means a medical practitioner legally qualified and registered to practice in Australia who is a person other than you, your relatives, business partners, shareholders or employees. Where you are outside Australia, the medical practitioner must have qualifications which are recognised by the Australian Medical Association as equivalent with those required of a medical practitioner registered to practice in Australia. In this situation onus of proof lies with the Insured Member. Mental Condition: means an Insured Person suffering from: Stress related conditions; and/or Any psychological conditions; and/or. Physical fatigue conditions caused by stress related or psychological conditions: The above includes but is not limited to: depression; neurosis; psychosis; mental or emotional stress or anxiety conditions; or mental disease and associated disorders. Pre-existing Sickness: means any sickness that an Insured Member is having or has had treatment for or advice for treatment for and has not ceased all treatment or advice with the agreement of a Medical Practitioner prior to the date of commencement, recommencement or increase of his or her cover under the Policy. However, such condition will be covered provided: you have, with the agreement of a Medical Practitioner, ceased all treatment or advice for at least six months during the policy period; or you have had two years of Continuous Cover under the Policy prior to the time of your disablement and had been Actively at Work prior to the Total Disablement which leads to the claim. Professional Sporting Activities: means participating in any sporting activity, including training for that activity, where you earn more than 50% [including any sponsorship you receive] of your annual gross income from that activity. Sickness: means a state of being ill which is first contracted or which you first become aware of while this insurance is in force and which continues for a period of not less than the waiting period and excludes any Pre-existing Sickness and Injury. Total Disablement: means that as a result of Injury or Sickness, you are prevented from engaging in your usual occupation with your Admitted Employer in Australia for which you are a member of Intrust Super. You must be Actively at Work at the time the said Injury or Sickness occurs, and must be under the regular care of and acting in accordance with the instructions or professional advice of a Medical Practitioner. [ 7 ] CORE INSURANCE 3 Aug 2015
8 [ 8 ] intrust.com.au Snapshot of your PayGuard Insurance What cover you get Up to 90% of your income [up to a maximum of $50,000 per month] can be replaced for up to 104 weeks*. Once the Maximum Benefit Period expires no further benefit is payable if the further disability is caused by the same Injury or Sickness. The waiting period starts from when you are first unable to work, on the advice of a Medical Practitioner. *Maximum benefit of 52 weeks for Mental Conditions What it costs Premiums are deducted from your employer s contributions and are calculated as 0.70% of your income for super purposes. For example, if you earn $250 per week, your gross weekly premium will be $1.75 and if you earn $500 per week, your gross weekly premium will be $3.50. You can also choose to increase your waiting period, which will result in a lower premium. Extended Cover for members over 65 Members aged between may be eligible for cover in relation to claims for Injury. The maximum benefit is limited to 52 weeks after the expiry of the waiting period. Members aged between may be eligible for cover in relation to claims for Sickness. The maximum benefit is limited to 12 weeks after the expiry of the waiting period. When you can receive a PayGuard payment A PayGuard payment is made when the Insurer determines that you have suffered Total Disablement. This means that due to Injury or Sickness you are wholly and continuously unable to engage in your usual occupation in Australia. You must also be under the regular care of and be following the instructions or professional advice of a Medical Practitioner. A partial payment may be made if you suffer temporary partial disablement that prevents you from carrying out a substantial part of the normal duties of your usual occupation in Australia. How payments are worked out Your income is your average weekly income over the previous 12 months, before personal deductions & income tax and including all overtime and all allowances, actually paid to you. Payments are calculated weekly and paid fortnightly in arrears. Once your claim is accepted, you will receive 1/7th of the weekly payment for each day you are unable to work due to Sickness or Injury. It is important to know PayGuard payments are reduced by the amount of any statutory income benefit [i.e. Worker s Compensation] that you receive. Also, if you receive a not-at-work related payment like sick leave, your PayGuard payment will be reduced by this amount. When payments stop Payments will stop when any of the following happen: You return to work. You have received the maximum PayGuard benefit applicable. You are deemed fit to return to work by a Medical Practitioner. You turn 70 years old. You die. You are receiving any statutory benefit like Workers Compensation and that payment stops because you are medically able to return to work. Please note that if your statutory benefits cease but you are medically unable to return to work, you will continue to receive a benefit, up to the Maximum Benefit Period, with respect to the Injury/ Sickness from which you received the statutory benefits, equal to 65% of your income, provided you are assessed by an independent Medical Practitioner who then confirms the Insured Member is medically unable to return to work. When cover stops Cover ceases when any of the following occur: You elect in writing to no longer have this cover. You turn 70 years old. You are no longer employed by an Admitted Employer [i.e. an employer who makes superannuation contributions on your behalf]. You cease to be a member of Intrust Super. Coverage under the policy continues for a period of no more than thirty [30] days from the date you cease employment with your current Admitted Employer provided that you have accepted a position with another Admitted Employer prior to ceasing your employment. If you do not have a position to go to with another Employer and cease employment, then cover will cease under this Policy on the date you leave the employment. Remember you must remain a member of Intrust Super at all times and your new employer must be contributing superannuation guarantee contributions to your Intrust Super account in order for your cover to continue.
9 Exclusions This Policy does not apply to any Injury/ Sickness directly caused by or resulting from the following: Any consequence of war, invasion or civil war. Intentional self-inflicted Injury or Sickness, including any attempt at suicide. Pregnancy, childbirth or miscarriage other than: a. A complication arising from pregnancy which requires hospitalisation for greater than 24 hours within the first thirty-three [33] weeks of pregnancy. All benefit payments will cease at the date of birth and/or termination of the pregnancy. No benefit shall be payable for any complications arising after the thirty-third week of pregnancy. OR b. A new Injury or Sickness which occurs during childbirth or miscarriage. The waiting period will commence from the conclusion of the government s and/or employer s paid maternity leave benefit period, whichever is greater. No benefits shall be payable during any period of maternity leave. Any Pre-existing Sickness. Any act which results in an Insured Member being charged by the police. Should the Insured Member subsequently be found not guilty of the act in question, this exclusion will not apply. Being a pilot or crew member of any aircraft, or engaging in any aerial activity except as a passenger in a properly licensed aircraft. Any Professional Sporting Activities. Any Injury that occurs prior to the Period of Insurance. [ 9 ] CORE INSURANCE 3 Aug 2015
10 Keep in touch It s important that you tell us if you change your address so that you continue to get all the information issued by Intrust Super and so your account doesn t become lost. You can do this via MemberAccess or using any of the contact details listed on the left. Not yet registered for MemberAccess? Visit intrust.com.au today to get started. At the click of a button you have access to your account balance, contact details and much more. Visit Level 15, 324 Queen Street Brisbane QLD 4000 Mail GPO Box 1416 Brisbane QLD 4001 Fax Connect with us facebook.com/intrustsuperfund twitter.com/intrustsuper HP/IBR/INS /15 ISS13
Group Personal Accident and Sickness Policy. Intrust Super Fund
Group Personal Accident and Sickness Policy For Intrust Super Fund Windsor Income Protection Pty Ltd ACN: 147 905 888 AFS Licence No: 400598 Contents Important Notices... 3 Your Duty of Disclosure... 3