Document ID: chunk:federal_register_of_legislation:F2018L01496:body:0:p11
Version: federal_register_of_legislation:F2018L01496
Segment Type: other
Provision Reference: 
Character Range: 27427–30471

only applies to instances that result in new covers.
(b)          New Business should exclude the following specific circumstances:
(i)            Automated premium and/or Sum Insured increases on existing covers, such as age-related premium increases for a stepped premium product or automatic CPI increases; and
(ii)         Reinstatement or cover buybacks.
(c)          Paragraphs 22(a) and (b) primarily relate to Individual Insurance contracts. In respect of Group Insurance contracts, it is the commencement of a new Policy Contract that should be reported under New Business, and not the impact of individuals joining the Group Insurance arrangement. Similarly, the effect of benefit changes at a member level should be excluded from New Business.
23.         'Lapses' refer to Policy Contracts (or underlying benefits) being discontinued.
(a)          Lapses should include the following specific circumstances:
(i)            Policies cancelled and replaced by a new Policy Contract;
(ii)         Policies cancelled due to the non-payment of premiums;
(iii)       Cancellation of the policy during the cooling-off period;
(iv)        Partial lapses where there are decreases in Sum Insured or premium on existing covers should be included in the Lapses component of Annual Premium and Sum Insured, but not in Lives Insured and Policy Contracts; and
(v)          Any contract that was discontinued during the Reporting Period, other than through a claim and not explicitly covered in the circumstances listed above.
(b)          Lapses should exclude the following specific circumstances:
(i)            Instances of the contract being discontinued as a result of the Life Insured dying, or another lump sum claim of the types covered by this collection;
(ii)         Instances of the Policy Contract or benefit reaching the end of its contractual term, including where this is defined in terms of the age of the Life Insured; and
(iii)       Policies later cancelled by the insurer from inception, e.g. in the event of misrepresentation or non-disclosure.
(c)          Paragraphs 23(a) and (b) primarily relate to Individual Insurance contracts. In respect of Group Insurance contracts, it is the cancelation of the full contract that should be reported under Lapses and not the impact of individuals leaving the Group Insurance arrangement. Similarly, the effect of benefit changes at a member level should be excluded from Lapses.
24.         'Disputes' are defined to only include claims-related disputes. It includes disputes where a claim decision has been made, but the claims outcome is challenged or questioned, as well as disputes related to the claims process.
25.         'Waiting period' (usually in respect of TPD or DII) refers to a defined period after the Claim Event (defined in paragraph 42) that must expire before benefit payments will commence.
26.         'On Sale Status' refers to whether a product is still open for sale. Distinction is made between:
(a)          Open for sale: Products that are open for sale