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Five Year Mortgage Repayment Insurance. Product Disclosure Statement and Policy Document. - PDF
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1 Five Year Mortgage Repayment Insurance Product Disclosure Statement and Policy Document.
2 Preparation Date: 04/07/2012
3 Table of contents page Section A About this insurance 3 The insurers 3 Purpose of the insurance 3 Choice of cover 4 About this insurance 4 Our agreement with you 5 Section B Your cover 7 Tables of benefits and limits 7 Part 1 Death cover 7 Part 2 Disability cover 7 Part 3 Unemployment cover 9 Optional insurance 10 Who can apply 10 How to apply 11 Your premium 12 Commission 13 Some situations are not covered 13 Words with special meanings 16 Loan settlement cover 22 Interim cover 24 Conditions of cover 26 Non-Renewable 26 Re-application for cover 26 Continuity of cover 26 1
4 page Changes to your policy 27 Cooling off and cancellation rights 27 Cancellation of the policy 28 When the policy begins and ends 28 Making a claim 30 Section C Other important information 32 Your Duty of Disclosure 32 Privacy Notice 33 Complaints and disputes 34 Changes to the PDS 35 Financial Claims Scheme 35 Taxation 35 Phoning for assistance and confirmation of transactions 36 2
5 Section A About this Insurance The insurers Allianz Australia Insurance Limited ABN , AFS Licence No (Allianz) is the insurer of the Disability cover and Unemployment cover and is only responsible for these general insurance covers under the policy issued by it. Allianz Australia Life Insurance Limited ABN AFS Licence No (Allianz Life) is the insurer of the Death cover and is only responsible for this life insurance cover under the policy issued by it. Allianz acts as Allianz Life s agent in offering and administering the Death cover. Full details of the insurers are found on page 21. References to we, our or us only apply to Allianz and Allianz Life for the insurance cover each issues and is responsible for in their own right. Purpose of the insurance Allianz Five Year Mortgage Repayment Insurance is consumer credit insurance that is designed to meet (up to the maximum policy benefits): your mortgage repayments while you are unable to work due to injury or illness (we call this Disability cover), your mortgage repayments while you are involuntarily unemployed (we call this Unemployment cover), the outstanding balance of your mortgage if you should die (we call this Death cover). 3
6 We pay all benefit payments directly to the financial institution you have your loan agreement with. Please note the above covered events: are specifically defined (see Words with special meanings on pages 16 to 21); and must occur during the period of insurance (which will not exceed 5 years) in order for a claim to be payable. We exclude any pre-existing condition under the Death and Disability covers (see definition of what we consider a pre existing condition on page 19). While the policy is in force you are covered 24 hours a day, 7 days a week and 365 days a year. Choice of cover You can apply for any one of the following combinations of cover: Death, Disability and Unemployment, Disability and Unemployment, Death and Disability, Disability only, or Death only. Loan settlement cover is automatically included with every combination of cover. About this insurance This is an important document. You should read it carefully before making a decision to purchase this insurance. It will help you to: decide whether this insurance will meet your needs (including extent of cover and limitations); and compare it with other products you may be considering. 4
7 Please note that any recommendation or opinion in this document is of a general nature only and does not take into account your objectives, financial situation or needs. You need to decide if this insurance is right for you and you should read all of the documents that make up the policy to ensure you have the cover you need. Our agreement with you Where we agree to enter into a policy with you it is a contract of insurance between us and you. The policy consists of: this document, which sets out the standard terms of your cover, including its conditions, limitations and exclusions; your current policy schedule issued by us. The schedule is a separate document that shows the insurance details relevant to you. It may include additional terms, conditions, limitations and exclusions relevant to you that amend the standard terms of this document. Only those sections shown as covered in your policy schedule are insured. Any new or replacement policy schedule we may send you, detailing changes to your insurance or the period of insurance, will become the current policy schedule, which you should carefully read and retain; and any other change to the terms of the policy otherwise advised by us in writing (such as an endorsement or Supplementary Product Disclosure Statement). These written changes may vary or modify the above documents. These are all important documents and should be carefully read together as if they were one document and kept in a safe place for future reference as a reminder of the cover you hold. 5
8 When you enter into the policy you confirm and warrant that you have read or will read the policy documents when provided to you. We reserve the right to change the terms of the policy where permitted to do so by law. 6
9 Section B Your cover Table of benefits and limits The following cover only applies if the policy schedule shows that it applies and you have paid or agreed to pay the premium for it. Some situations are not covered, see pages 13 to 15. Each cover noted is subject to further terms, conditions, exclusions and limitations that are not listed in this table which may be included in this document or in another document which makes up your policy. Certain terms used in the policy have special meanings (see Words with special meanings on pages 16 to 21). Part 1 Death Cover If you die during the period of insurance we will pay to your financial institution the net balance due and payable by you under your loan agreement as at the date of your death. The maximum benefit we will pay for all insureds combined is the lesser of : a) $750,000; or b) the net balance due and payable under the loan agreement when it was first entered into; or c) the net balance due and payable under the loan agreement as at the date of your death. Part 2 Disability Cover If you become disabled during the period of insurance and your disablement continues for at least 21 consecutive days during the period of insurance, for each day that you are disabled we will pay to your financial institution a daily benefit at the rate of 1/30th of the lesser of the minimum monthly repayment amount required: 7
10 8 a) under the loan agreement when it was first entered into; or b) under the loan agreement on the date you became disabled; or c) on a net balance due and payable under a loan of $750,000. The maximum benefits under (a) or (b) may be increased by up to 10% if: the minimum monthly repayment amount required under the loan agreement has been increased or an increase has been contracted, prior to the time you become aware or a reasonable person in the circumstances would have become aware, of any injury or illness that results in your disability, and The increase to the minimum monthly repayment amount is not due to default of loan repayments. This does not apply to the maximum monthly benefit payable under (c) above. If your disability is caused by mental illness, our payment will continue for as long as you are disabled until we have made 12 monthly repayments (whether or not consecutive) in respect of all such claims for each insured. If your disability is caused by something else, our payment will continue for as long as you are disabled until we have made 24 monthly repayments (whether or not consecutive) in respect of all disability claims for each insured. We will only pay one benefit in respect of the same period, regardless of whether: one insured is both unemployed and disabled; or more than one insured is disabled and/or unemployed.
11 If you return to permanent employment for less than 30 days between successive periods of disability that occur during the period of insurance, we will treat this as one continuous period of disability. We will not pay for the time you were employed between the successive periods. Part 3 Unemployment Cover If you become unemployed during the period of insurance and your unemployment continues for at least 21 consecutive days during the period of insurance, we will pay to your financial institution a daily benefit at the rate of 1/30th of the lesser of: a) $3,000 per month; or b) the minimum monthly repayment amount required: (i) under the loan agreement when it was first entered into; or (ii) under the loan agreement on the date you became unemployed; or (iii) under a loan agreement with a net balance due and payable of $750,000. The maximum benefits under (b) (i) or (b)(ii) may be increased by up to 10% if: the minimum monthly repayment amount required under the loan agreement has been increased or an increase has been contracted, prior to the time you become aware or a reasonable person in the circumstances would have become aware of your becoming unemployed or your impending unemployment, and the increase to the minimum monthly repayment amount is not due to default of loan repayments. 9
12 This does not apply to the maximum monthly benefit payable under (a) or (b) (iii) above. We will only pay one benefit in respect of the same period, regardless of whether: one insured is both unemployed and disabled; or more than one insured is disabled and/or unemployed. Our payment will continue for as long as you are unemployed up to a maximum period of 120 days per claim or $10,000 for all unemployment claims for each insured, whichever comes first. If you return to permanent employment for less than 30 days between successive periods of unemployment that occur during the period of insurance, we will treat this as one continuous period of unemployment. We will not pay for the time you were employed between the successive periods and we will pay a maximum of 120 days benefit for the combined period. Optional insurance You are not obliged to purchase this insurance, nor is it a condition of your loan agreement approval. You can arrange similar insurance (often known as consumer credit insurance) with any insurer you wish. Who can apply You can apply if: you are aged more than 16 years, and not yet turned 60 years; and you are applying for or have a mortgage; and you are a permanent resident of Australia; and 10
13 your total combined current cover for all consumer credit insurance policies issued by us, including this application, is less than $750,000. For Disability and Unemployment cover, you must be permanently employed and working (see pages 18 to 19 for the full definition). This requires you (amongst other things) to be employed for at least 15 hours per week. It does not include payments from carers or disability pensions, or employment entitlements such as workers compensation. To apply for Unemployment cover you cannot be self employed or employed on a seasonal, temporary or non-renewable contract nature. How to apply Step 1 Read these documents carefully Before you apply for this insurance it is important that you read this document and any other policy documents we give you carefully, so that you understand what we cover and its terms, conditions, exclusions and limitations that apply. You need to decide if the limits, type and level of cover(s) are appropriate for you and cover your potential loss. Step 2 Complete and submit the proposal You must complete and submit our proposal to apply. In applying you need to be truthful and comply with your Duty of Disclosure as set out on pages 32 to 33. It is important that you comply with your Duty of Disclosure as failure to comply can result in cancellation of your policy and/or non-payment or reduction of a claim. While a medical examination is not required to apply for this cover, medical examinations or clinical records may be required for us to assess your claim. 11
14 Step 3 When we issue final cover Where you are not required by us to complete a medical questionnaire because you have answered no to the questions posed by us in our proposal about pre-existing medical conditions we will automatically issue you with final cover from the effective date. We issue you with a policy schedule confirming this. Where you are required by us to complete a medical questionnaire because you have answered yes to any of the questions posed by us in our proposal about pre-existing medical conditions we will not enter into final cover with you unless otherwise agreed in writing by us after receipt of your medical information. Instead, we provide you with Interim cover for the cover you selected in your proposal from the effective date and on the terms set out in Interim cover on pages 24 to 25. If you have provided additional information on a medical questionnaire, we may call you to find out more information or use this information to apply additional exclusions to your policy or decline the application for final cover for one or all insureds. Please note: Until the effective date we also provide you with interim Loan settlement cover for the cover you selected in your proposal on the terms set out in Loan settlement cover on pages 22 to 23. This cover will end as at the effective date unless the Loan settlement cover has ended earlier in accordance with its terms. Your premium We advise what the premium is and the method of payment acceptable to us, either before or at the time the insurance is issued. The policy schedule contains the details of the premium. The premium amount varies depending on certain factors, such as the level of cover you select, your loan amount, our costs and other information you provide to us when applying for this insurance. The premium amount also includes 12
15 amounts that take into account our obligation to pay any relevant compulsory government charges, taxes or levies (for example, Stamp Duty and GST where applicable) in relation to your policy. You must ensure your premium is paid on time. We may cancel this policy if you fail to pay your premium by the time we require. An instalment premium outstanding for at least 14 days allows us to refuse to pay a claim under the Disability cover and Unemployment cover where relevant. Commission Our agents receive a commission for arranging this insurance and do so on our behalf and not yours. The aggregate commission payable to all agents is 20% of the total premium amount payable, excluding Stamp Duty and government charges. Some situations are not covered We will not pay any claim for Death, Disability or Unemployment cover that is caused by, arises from, or is in any way connected with: a) a pre-existing condition; b) your failure to follow the advice of a registered medical practitioner, that directly or indirectly results in a claim, or directly or indirectly extends the duration of a disability claim; c) a deliberately self-inflicted injury or illness (including suicide or attempted suicide), whether suffering from mental illness or not: within 13 months of the effective date for Death cover; or during the period of insurance for Disability or Unemployment cover; d) your alcoholism or alcohol abuse, drug addiction or drug abuse or your consumption or use of 13
16 intoxicating liquor, narcotics or drugs (except drugs administered by or taken in accordance with the advice of a registered medical practitioner); e) you taking part in a criminal or illegal act; or f) war or warlike activities. For Death, Disability or Unemployment cover you are not covered for any increase in the amount outstanding under the loan agreement where the increase or redraw occurs after you become aware or a reasonable person in the circumstances should have been aware, of any illness or injury or impending unemployment that results in your claim. This limitation will not apply where you were contracted to the increase before you became aware or should reasonably have been aware of the illness or injury or impending unemployment. For Death cover we will not pay more than one claim, even if the policy covers more than one insured. For Disability or Unemployment cover, we will not pay: a) more than one benefit at one time regardless of whether: (i) one insured is both unemployed and disabled; or (ii) more than one insured is disabled and/or unemployed. b) any claim that is caused by, arises from or is in any way connected with childbirth, abortion or pregnancy (except for direct, severe medical complications requiring hospital admission, where you will be covered until medically certified as fit to return to work, apart from your childcare obligations); c) any claim that is caused by, arises from, or is in any way connected with you taking part in a riot or civil commotion; or d) any claim that is caused by, arises from, or is in any way connected with terrorism; or 14
17 e) any claim that is caused by, arises from, or is in any way connected with nuclear radiation. We will not pay any claim for Unemployment cover, if: a) you were not engaged in permanent employment or were self-employed on the effective date of the period of insurance; b) you were not engaged in permanent employment for at least 21 consecutive working days immediately prior to any period of unemployment; c) before this contract was entered into you had knowledge or warning of any proposed or actual termination or decrease in work available to you and this resulted in your unemployment; d) you are unemployed because you ceased employment of a casual, seasonal or temporary nature; e) your unemployment is caused by the end of a nonrenewable contract that was limited to a specified work period or the expiration of a specified task or period of work, including the ending of your apprenticeship indenture; f) you voluntarily become unemployed, including where you resign, reach retirement, accept voluntary redundancy, early retirement or abandon your employment, or where you are self-employed and you voluntarily cease trading or you wind up or sell your business; g) your unemployment is caused by any injury, illness, sickness or disease; h) your unemployment is due to dismissal for any form of misconduct; or f) your claim is caused by, arises from or is in any way connected with your taking part in a strike or lockout. 15
18 Words with special meanings The following words have the meaning set out below when they appear in this document and your policy schedule. disabled, disability and disablement means the period a registered medical practitioner has advised that you are unable to attend or engage in your usual permanent employment for at least 15 hours per week because you have suffered an injury or an illness and, where requested by us, this advice has been verified by a registered medical practitioner chosen by us. However, where disablement extends beyond 12 months, then the above advice must be that you are unable to engage in any profession, business or occupation for which you are reasonably qualified by way of training, education or experience. effective date means: where we issue you with final cover the effective date shown on the policy schedule for the final cover; or where we issue you with Interim cover the effective date shown on the Interim cover schedule (see Interim cover section at pages 24 to 25). final cover means cover that is not Interim cover or Loan settlement cover, which has been issued under the process as set out under How to apply: Step 3 When we issue final cover on page 12. financial institution means the financial institution shown on the policy schedule. illness means illness, sickness or disease that first manifests itself during the period of insurance and does not include any injury. 16
19 For the purposes of this definition an illness will first manifest itself on the earlier of: a) the date a registered medical practitioner agreed by us, diagnoses the illness or symptoms of the illness, whichever is earlier; b) the date a registered medical practitioner agreed by us reasonably considers the symptoms of the illness first occurred or manifested; c) the date you first became aware of the illness or symptoms of the illness, whichever is the earlier; d) the date a reasonable person in the circumstances would have been aware of the illness or symptoms of the illness, whichever is the earlier; and e) the date you first received medical treatment for the illness or symptoms of the illness, whichever is the earlier. injury means bodily injury caused solely by accidental, external and visible means that first occurs during the period of insurance and does not include any illness. For the purposes of this definition, an injury will first occur on the earlier of: a) the date the injury occurred; b) the date a registered medical practitioner agreed by us, reasonably diagnoses as the most likely date of the injury; c) the date you first became aware of the injury or a reasonable person in the circumstances would have been aware of the injury; d) the date you first received medical treatment for the injury; and e) the date nominated in information provided to us (including but not limited to reports from relevant government authorities or workers compensation insurance) as the date the injury was sustained. 17
20 loan agreement means the loan agreement shown on the policy schedule. Loan settlement cover start date means the date when your loan is unconditionally approved by your financial institution, and you have: signed and submitted the proposal declaration to us or our representative, and (if required) signed and submitted the medical questionnaire to us or our representative. mental illness means any psychiatric illness, mental illness, personality disorder or nervous disorder, including but not limited to depression, stress and anxiety. net balance due and payable means the amount outstanding under the loan agreement at the date of your death (where Death cover applies) or the date you are disabled (where Disability cover applies) or unemployed (where Unemployment cover applies) plus any interest charges accrued for up to two (2) months after that date. This amount does not include any arrears in loan repayments in excess of two (2) months. period of insurance means the period of time beginning on the effective date and ending on the earlier of the expiry date shown on the policy schedule or the date the policy ends (see When the policy begins and ends on pages 28 to 29). For the period applicable to Loan settlement cover and Interim cover, see Loan settlement cover section and Interim cover section on pages 22 to 25. permanently employed and working/ permanent employment means being employed on a permanent and regular basis and receiving monetary benefits from personal physical exertion, for more than 15 hours per week. You may be: working for wages or income; or self-employed. 18
21 Permanently employed and working does not include payments: not derived from personal physical exertion; or from carers or disability pensions, or employment entitlements such as workers compensation. permanent resident of Australia means a person who resides in Australia and has permission to remain permanently in Australia either because they are: an Australian or New Zealand citizen; the holder of visa that enables them to permanently reside in Australia or New Zealand; or a protected special category visa holder. policy means this document, the policy schedule, any endorsement and/or any other document that we tell you forms part of our agreement with you. policy schedule means the relevant policy schedule for your policy that we give you which specifies details such as the covers which apply, the policy number, loan amounts and premium. It also includes any documents that we and you agree in writing will form part of the policy schedule. pre-existing condition means any injury or illness, including symptoms, treatment or advice or side effect of that treatment or advice, or other condition relating to your health: a) of which you were aware or a reasonable person in the circumstances would have been aware or could have been expected to be aware, and which was present, continuing, being suffered from or experienced; or b) for which you sought or received or for which a reasonable person in the circumstances would have sought or received, medical advice or treatment from a registered medical practitioner or other health professional; within the 12 month period immediately before your loan settlement cover start date. 19
22 premium means the amount paid or payable by you for the cover(s) shown as applicable on the policy schedule. registered medical practitioner means a person who is legally entitled to practice medicine by virtue of appropriate registration with the appropriate authority in the relevant State or Territory in which they are providing the relevant medical advice who is not your spouse (including someone legally recognised in Australia as your de facto partner), member of your family or your business associate, and acting within the scope of their registration and pursuant to relevant laws. self-employed means you are an independent contractor or you are employed by yourself or by a company or business over which you, or an immediate family member of yours, can exercise control. terrorism means (a) any act of terrorism arising directly or indirectly out of or in any way connected with biological, chemical, radioactive, or nuclear pollution or contamination or explosion; or (b) any action in controlling, preventing, suppressing, retaliating against, or responding to any act referred to in (a) above. An act of terrorism includes, but is not limited to, any act, preparation in respect of action or threat of action, designed to: (a) influence a government or any political division within it for any purpose, and/or (b) influence or intimidate the public or any section of the public with the intention of advancing a political, religious, ideological or similar purpose. unconditionally approved, unconditional approval means your financial institution has provided formal written approval of the loan agreement for which you applied. unemployed and unemployment means a period during which you are registered and certified as unemployed by Centrelink or such other equivalent Commonwealth Government Authority, after you have been made involuntarily unemployed. You do not need 20
23 to be in receipt of government unemployment benefits to be considered unemployed under this policy. usual permanent employment means you are employed with: the same employer and performing the same or varied employment duties to your permanent employment immediately prior to your disablement; or any employer and performing a role similar, or equivalent to, your permanent employment immediately prior to your disablement. war or warlike activities means war (including war service), hostilities or warlike operations (whether war be declared or not), military activity (other than normal peacetime activity), rebellion, civil war, revolution, insurrection, military or usurped power, invasion, act of foreign enemy or popular or military rising. we, our or us means: Allianz Australia Insurance Limited, AFS Licence No , ABN which issues the insurance for the Disability and Unemployment covers only, Allianz Australia Life Insurance Limited, AFS Licence No , ABN which issues the insurance for the Death cover only. you or your or insured means the insured person or persons named on the policy schedule. 21
24 Loan settlement cover We will provide you with interim Loan settlement cover for the cover you selected in your proposal in accordance with the terms set out in this document, but subject to the following: The Loan settlement cover (period of insurance) will start on your loan settlement cover start date (as defined on page 18), and end on the earliest of the following dates: a) 60 days from the your loan settlement cover start date; b) the effective date; c) the date we advise you that your application for final cover has been declined: d) the date we cancel your Loan settlement cover; e) the date you obtain replacement cover from us or another insurer; f) the date your cover ends in accordance with the terms of this document; g) the date you withdraw your application for final cover. A failure to submit any required medical questionnaire within 14 days of signing the Proposal Declaration is treated as a withdrawal of your application (unless otherwise agreed in writing by us); or h) the date your loan money is advanced (the settlement date of your loan). When your Loan settlement cover ends under (a) (h) above, all benefit entitlements under Loan settlement cover will cease. Subject to the above start and end dates, the Loan settlement cover is subject to the terms set out in this document, including the exclusions as set out under 22
25 Some situations are not covered on pages 13 to 15, and the Table of benefits and limits on pages 7 to 10. In addition no claim will be paid that is directly or indirectly caused by any injury or illness, including symptoms or side effect of those, or other condition relating to your health or employment which, either before or on the loan settlement cover start date: a) you were aware of or disclosed to us; or b) a reasonable person in the circumstances would have been aware of; or c) you received advice or treatment from a health professional for. Under this Loan settlement cover, we only provide cover for the amounts specified under the loan agreement when you first entered into it. Benefits under Loan settlement cover will only be paid from the effective date. You will not be charged any additional premium for this period of cover prior to the effective date. 23
26 Interim cover When you have answered yes to the questions asked by us on the proposal about pre-existing medical conditions, you are required by us to complete a medical questionnaire. In this case, we will not enter into final cover with you unless otherwise agreed in writing by us after receipt of your medical information. Instead, we provide you with Interim cover for the cover you selected in your proposal for the period of insurance starting on the effective date shown on the Interim cover schedule and ending on the earliest of the following dates: a) 60 days from the effective date, unless otherwise agreed in writing by us; b) the date we advise you that your application for final cover has been declined; c) the date we cancel your interim cover; d) the date you obtain replacement cover from us or another insurer; e) the date your final cover ends in accordance with the terms of this document; or f) the date you withdraw your application for final cover. A failure to submit any required Medical Questionnaire within 14 days of signing the Proposal Declaration is treated as a withdrawal of your application (unless otherwise agreed in writing by us). When your Interim cover ends under (a) (f) above, all benefit entitlements under the Interim cover will cease. Subject to the above start and end dates, this Interim cover is subject to the terms set out in this document including the exclusions as set out under Some situations are not covered on pages 13 to 15. In addition no claim will be paid that is directly or indirectly caused 24
27 by any injury or illness, including symptoms or side effect of those, or other condition relating to your health or employment which, either before or on the loan settlement cover start date: a) you were aware of or disclosed to us; or b) a reasonable person in the circumstances would have been aware of; or c) you received advice or treatment from a health professional for. 25
28 Conditions of cover Each of the below conditions apply only to the extent that the relevant insurer of the cover in question is able to rely on the condition in relation to the cover provided by them. Non-Renewable This is non-renewable insurance, and the period of insurance will not continue beyond five (5) years. Please be aware that all cover will cease when the policy ends (see When the policy begins and ends on pages 28 to 29). Re-application for cover After your policy has ended (see When the policy begins and ends on pages 28 to 29) you may be eligible to apply for further cover (see Who can apply on pages 10 to 11). This application will be treated as a new application for cover and acceptance will be subject to our standard acceptance criteria and the terms and conditions of the insurance policy applicable at that time. This means that acceptance of a previous policy does not mean your new application will be accepted. Continuity of cover If you are not entitled to claim under this policy for death or disablement solely because of a pre-existing condition and you would have been able to claim for the death or disablement under a previous cancelled policy held with us; if: the above cancelled policy was cancelled solely as a result of you re-financing or varying the terms of your loan agreement; and the above cancelled policy has not yet reached its expiry date as at the date of your claim, 26
29 we will cover you under this policy for the above death or disablement claim (provided it is otherwise covered under the other policy terms and conditions) and pay the lesser of: a) the relevant benefits payable under this policy; or b) the benefits that would have been payable under the cancelled policy until the expiry date of the period of insurance provided by that policy. This continuity of cover is subject to your having complied with your statutory Duty of Disclosure at the time of applying for your current cover and your previous, cancelled policy. Changes to your policy Nothing in your policy with us may be changed unless we agree to the changes in writing. Cooling off and cancellation rights You have a cooling off period of thirty days from the effective date of your final cover. During this period you can return your policy and receive a refund of your premium unless you have made a claim or the period of insurance has ended or a covered event that will start and end within the cooling off period has started. We may deduct from your refund amount any reasonable administrative and transaction costs incurred by us that are reasonably related to you buying and cancelling your policy and any government taxes or duties we cannot recover. After the cooling off period has ended, you still have cancellation rights. (refer to Cancellation of the policy on page 28, for full details). 27
30 Cancellation of the policy a) In addition to your cooling off rights (see Cooling off and cancellation rights on page 27), you may cancel your policy with us or any part of it at any time by notifying your financial institution. If the policy has been issued to more than one person each person must sign the notice. b) We have the right to cancel your policy with us where permitted by law. c) If you or we cancel the policy after the cooling off period, we may deduct a proportion of the premium for time on risk and reasonable administrative costs related to the acquisition and termination of the policy subject to and in accordance with any relevant legislation, together with any government taxes or duties that we cannot recover. When the policy begins and ends The policy begins on the effective date. The policy will end at the earliest of the following: a) the fifth anniversary of the effective date, which is the expiry date shown on the policy schedule; b) where final cover has not been issued, the date your Interim cover ends as set out under Interim cover on pages 24 to 25; c) the date the policy is cancelled; d) the date the mortgage under the loan agreement is repaid, discharged, refinanced, restructured, foreclosed or terminated; e) the date the loan agreement is varied or cancelled; f) the date your indebtedness under the loan agreement is transferred to someone else; 28
31 g) the date you turn 65 years of age. When this policy insures joint insureds, cover for each individual insured will cease when that person turns 65 years of age; h) the date you cease to be a permanent resident of Australia; or i) the date we have paid to your financial institution the lesser of the net balance due and payable by you under the loan agreement or $750,000. Benefits being paid in respect of Disability or Unemployment during the period of insurance will continue to be paid up to the end of the relevant benefit period subject to continuing certification that you are disabled or unemployed. Payment of disability or unemployment benefits after the policy has ended, does not extend your cover or make you eligible to lodge a claim for other benefits after the policy ends. 29
32 Making a claim To make a claim, you or your estate s legal representative must: 1. call us on and we will send the appropriate claim form. We must be notified as soon as possible after the claim event has occurred. We should be notified of a claim within 3 months after the claim event has occurred, as lodgement after this time may delay the assessment of your claim 2. fully complete our claim form and return it to us together with any written statements, medical certificates and any other relevant evidence we may reasonably ask for. In addition, a) in support of your claim, you or your estate must, at your own or your estate s expense, provide to us, or cooperate with us, in our collection of any information (including medical certificates, clinical records, records from relevant government authorities, reports of physical examinations or certificates of unemployment) that we may reasonably ask for. For instance, for death claims we require proof in a form satisfactory to us as to your identity, the fact and cause of your death and the existence of the loan agreement. For unemployment claims we will require proof that you have became involuntarily unemployed. For Disability claims we will require proof of ongoing disability, such as medical certificates. b) we may ask you to attend a medical examination relating to a claim. If so, you must reasonably assist us in doing so. We will pay the cost of any examination we ask you to attend. 30
33 c) for us to continue paying the disability benefit or unemployment benefit, you must at your own expense provide to us ongoing proof, as we may reasonably ask for, that you are still disabled or unemployed. If you do not comply with these conditions, including providing the required documentation in as soon as reasonably possible, your claim payment may be delayed or we may be able to refuse to pay or reduce a claim. 31
34 Section C Other important information Death cover forms part of the No. 1 Statutory Fund of Allianz Life and it does not have a surrender value, nor does it entitle you to participate in our profits. Your Duty of Disclosure Before you enter into the policy with us, the Insurance Contracts Act 1984 (the Act) requires you to provide us with the information we need to enable us to decide whether and on what terms your application for insurance is acceptable and to calculate how much premium is required for your insurance. The Act imposes a different duty the first time you enter into the policy with us to that which applies when you vary, extend, reinstate or replace the policy. We set these two duties out below. Your Duty of Disclosure when you enter into the policy with us for the first time You will be asked various questions when you first apply for the policy. When you answer these questions, you must: give us honest and complete answers; tell us everything that you know; and tell us everything that a reasonable person in the circumstances could be expected to tell us. Your Duty of Disclosure when you vary, extend, reinstate or replace the policy When you vary, extend, reinstate or replace the policy, your duty is to tell us before the renewal, variation, extension, reinstatement or replacement is made, every matter which: 32
35 you know; or a reasonable person in the circumstances could be expected to know, is relevant to our decision whether to insure you and whether any special conditions need to apply to the policy. What you do not need to tell us for either duty You do not need to tell us about any matter: that diminishes our risk; that is of common knowledge; that we know or should know as an insurer; or that we tell you we do not need to know. Who does the duty apply to? The Duty of Disclosure applies to you and everyone that is an insured under the policy. If you provide information for another insured, it is as if they provided it to us. What happens if the Duty of Disclosure is not complied with? If the Duty of Disclosure is not complied with we may cancel the policy and/or reduce the amount we pay if you make a claim. If fraud is involved, we may treat the policy as if it never existed, and pay nothing. Privacy Notice Privacy Act 1988 Information Unless the context otherwise provides, in this Privacy clause we our or us means Allianz and Allianz Life. We collect your personal information directly from you where reasonably practicable or if not, from other sources. We collect it to provide our various services 33
36 and products (e.g. to market, arrange and administer insurance and to handle and settle claims) and to conduct market or customer research. We also use it to develop and identify services of our related companies and alliance partners that may interest you (but you can opt out of this by calling the Allianz Direct Marketing Privacy Service Line on EST 8am-6pm, Monday to Friday or indicate your decision in the appropriate area of the Privacy section of our website at www. allianz.com.au). If you do not provide the information we require we may not be able to provide you with this service. We disclose information to third parties who assist us in the above (e.g. insurers, insurance intermediaries, insurance reference bureaus, related companies, our advisers, persons involved in claims, external claims data collectors and verifiers, your agents and other persons where required by law). We also provide this information to financiers if we have a relationship or insurance scheme in place with them under which you purchased your policy. We prohibit them from using it for purposes other than those we supplied it for. Where you provide us with information about another person for the above purposes, you must tell us if you haven t got their consent to this. If you wish to gain access to your personal information (including to correct or update it), have a complaint about a breach of your privacy, a query on how your personal information is collected or used, or any other query relating to privacy, contact us on EST 8am-6pm, Monday to Friday. Complaints and disputes If you are dissatisfied with our services in any way contact us and we will attempt to resolve the matter in accordance with our Internal Dispute Resolution procedures. To obtain a copy of our procedures contact us on
37 A dispute can be referred to the Financial Ombudsman Service (FOS) subject to its terms of reference. It provides a free and independent dispute resolution service for consumers who have general insurance disputes falling within its terms and its contact details are: The Financial Ombudsman Service Phone: Post: GPO Box 3, Melbourne, Victoria 3001 Website: Changes to the PDS Information in this document that is not materially adverse from the point of view of a reasonable person considering whether to buy this insurance may change from time to time where permitted by law. We record any such changes and you can obtain a paper copy of any updated information free of charge by contacting us. Financial Claims Scheme In the unlikely event Allianz Australia Insurance Limited was to become insolvent and could not meet its obligations under this Policy, a person entitled to claim may be entitled to payment under the Financial Claims Scheme. Access to the Scheme is subject to eligibility criteria and for more information see APRA website at and the APRA hotline on Taxation Generally premiums payable for this policy are not tax deductable and tax will not generally be payable on any benefit paid to individuals under your policy. Please refer any tax enquiries to your tax adviser who can take into consideration your personal circumstances. 35
38 Phoning for assistance and confirmation of transactions If you need to confirm any policy transactions or clarify any of the information contained in this document or if you have any other queries, please use the contact details on the back cover. For all other general enquiries please call your Financial Institution. Text
40 For all general enquiries please call your Financial Institution For all claims enquiries please call Allianz on allianz.com.au The insurers: Allianz Australia Insurance Limited (Allianz) ABN AFS Licence No Market Street Sydney NSW 2000 Allianz Australia Life Insurance Limited (Allianz Life) ABN AFS Licence No Market Street Sydney NSW 2000 Part 2 Disability cover and Part 3 Unemployment cover are issued by Allianz Australia Insurance Limited ABN (Allianz) AFS Licence No Part 1 Death cover is issued by Allianz Australia Life Insurance Limited ABN (Allianz Life) AFS Licence No Allianz acts as Allianz Life s agent in offering and administering the Part 1 Death cover. POL085FI 10/12