Private ruling: Income - assessable - insurance policy benefits
Date of advice: 12 August 2015
Published: August 2015
Ruling period: Year ended 30 June 2014
Date scheme commenced: 1 July 2013

Ruling: Q1: Is the lump sum Specific Illness Benefit payment that you received assessable income? | A1: No.

Relevant facts and circumstances: You are the beneficiary of a salary continuance policy. In addition to providing for possible periodic benefits, the policy also provides for payment of a Specific Illness Benefit if an insured event occurs to the insured. The benefit amount is specified in your policy. The terms of your policy states that under an agreed value cover the Specific Illness Benefit will be the insured monthly benefit multiplied by the period of cover for the specific injury. In your case the sum insured under your income protection policy was $X per month. Your policy states the following: The Specific Illness Benefit is a lump sum benefit equal to 12 times the monthly benefit (subject to a maximum benefit of $X per month) which applied to the Insured Member at the time the Insured Member suffers the Specific Illness. Specific Illness means any of the following conditions: Cancer, chronic kidney failure, coronary artery disease requiring by-pass surgery, diplegia, heart attack, major organ transplant, paraplegia, quadriplegia, stroke and tetraplegia. You were diagnosed and treated for a condition, which was covered by the Specific Illness Benefit cover of your insurance policy. In the relevant financial year your insurer paid you a lump sum amount representing 12 times the monthly benefit amount.

Relevant legislative provisions: Income Tax Assessment Act 1997 subsection 6-1(1) | Income Tax Assessment Act 1997 section 6-5 | Income Tax Assessment Act 1997 section 6-10 | Income Tax Assessment Act 1997 section 10-5 | Income Tax Assessment Act 1997 subsection 6-15(1) | Income Tax Assessment Act 1997 paragraph 118-37(1)(b)

Reasons for decision: Summary: Assessable income consists of ordinary income and statutory income under subsection 6-1(1) of the Income Tax Assessment Act 1997 (ITAA 1997). Ordinary income Subsection 6-5(1) of the ITAA 1997 provides that assessable income includes income according to ordinary concepts, which is called ordinary income. Ordinary income has generally been held to include three categories, namely, income from rendering personal services, income from property and income from carrying on a business. Other characteristics of income that have evolved from case law include receipts that: • are earned • are expected • are relied upon, and • have an element of periodicity, recurrence or regularity. The lump sum payment of the Specific Illness Benefit was not earned by you as it does not directly relate to services performed. Rather the lump sum relates to personal circumstances that have arisen during your life. The payment is also a one-off payment and thus does not have an element of recurrence or regularity. Although the payment can be said to be expected, and perhaps relied upon, this expectation arises from the investment in insurance, rather than from a relationship with personal services performed. The lump sum payment of the Specific Illness Benefit is not considered ordinary income and is therefore not assessable under section 6-5 of the ITAA 1997. Statutory income Section 6-10 of the ITAA 1997 provides that amounts that are not ordinary income but are included in assessable income by specific provisions of the income tax law, are called statutory income. These specific provisions of the income tax law are listed in section 10-5 of the ITAA 1997, and include the capital gains tax (CGT) provisions. Taxation Ruling TR 95/35 deals with the capital gains treatment of compensation receipts. The Ruling provides that an insured's right of indemnity under a policy of insurance falls within the definition of a right to seek compensation. The whole of the settlement amount is thus treated as capital proceeds from a CGT event happening to the taxpayer's right to seek compensation. However, paragraph 118-37(1)(b) of the ITAA 1997 disregards a capital gain made from a CGT event where the amount relates to compensation or damages received for any 'wrong, injury or illness you suffer personally'. Therefore any capital gain made from the CGT event happening to your right to seek benefits (compensation) under your risk insurance policy is disregarded under paragraph 118-37(1)(b) of the ITAA 1997. The lump sum payment of the Specific Illness Benefit that you received under your Salary Continuance Plan is therefore not statutory income. Subsection 6-15(1) of the ITAA 1997 provides that if an amount is not ordinary or statutory income it is not assessable income. Consequently no part of the amount you received is included in your assessable income.