INSURANCE HANDBOOK - PEACE OF MIND FOR VICSUPER FUTURESAVER MEMBERS AND THEIR FAMILIES

INSURANCE HANDBOOK - PEACE OF MIND FOR VICSUPER FUTURESAVER MEMBERS AND THEIR FAMILIES
Insurance
   handbook
             Peace of mind for
VicSuper FutureSaver members
             and their families


                  1 January 2015
INSURANCE HANDBOOK - PEACE OF MIND FOR VICSUPER FUTURESAVER MEMBERS AND THEIR FAMILIES
Contents
Insurance handbook




                                                                                                                                  Contents


                                                                                                                                  Section                                            Page
    Need help with the                                                                                                        1 Introduction                                              3
    calculations?                                                                                                                 Why have insurance cover?                               3
                                                                                                                                  Your choice of cover                                    4
    Take advantage of our online                                                                                                  Insurance health check – things to                      5
    insurance calculators to work out                                                                                             consider
    your premium and level of cover.                                                                                          2 Automatic cover and changing your                         6
    Visit vicsuper.com.au/calculators                                                                                           cover
                                                                                                                                  Cover when you join the fund                            6
                                                                                                                                  Making changes to cover                                 7
                                                                                                                              3 Death and TPD cover                                     10
                                                                                                                              4 General information about death                         14
                                                                                                                                and TPD cover
                                                                                                                              5 Income protection cover                                 18
                                                                                                                              6 General information about income                        21
                                                                                                                                protection cover
                                                                                                                              7 Own approved occupation – TPD      25
                                                                                                                                cover (EmployeeSaver members only)
                                                                                                                              8 Glossary                                                27
                                                                                                                              9 Approved occupation table                               28
                                                                                                                              10 VicSuper privacy information                           29
                                                                                                                                  Form                                                  31




Insurance cover described in this handbook is provided under group life insurance and group salary continuance policies issued and underwritten by the National Mutual Life Association of
Australasia Limited trading as AMP (the Insurer) ABN 72 004 020 437. Australian Financial Services Licence No. 234 649. This handbook is intended to be a guide to the insurance cover
available through VicSuper under the policies, however, all cover is subject to the precise terms and conditions of those policies. Examples provided are for illustration purposes only. Your
personal circumstances are likely to be different and more complex than the examples used.


2
INSURANCE HANDBOOK - PEACE OF MIND FOR VICSUPER FUTURESAVER MEMBERS AND THEIR FAMILIES
Introduction | Section 1
                                                                                         Insurance handbook




Why have insurance cover?


                We think nothing of insuring our cars. They’re expensive to replace, and we
                accept that there’s a chance they could be involved in an accident.
                Yet the majority of us don’t consider the possibility of something happening to us.
                Unfortunately, the risks are every bit as real, but we often don’t want to confront them.
                An injury or illness could have a devastating effect on your finances and the likelihood may
                be greater than you have considered.
                If you died or became permanently or temporarily disabled tomorrow, would your family be
                able to cope financially?
                • how would you pay the mortgage or rent?
                • could you pay for your children’s education?
                • would your business survive?
                • who would pay for the costs of ongoing care?
                Just like car insurance or house and contents insurance, you take out death and total and
                permanent disablement cover or income protection cover in the hope that you’ll never need
                to claim on it. But isn’t it better to know that you have a safety net there if you need it?
                VicSuper’s insurance is provided under group policies making premiums competitive with
                those you could get as an individual. The best part of having insurance through your super, is
                that premiums are deducted from your superannuation account, not your take home pay.
                Cover is provided 24 hours a day, 7 days a week, all around the world.


                 Important information
                 Different insurance arrangements apply depending on the type of account you hold as a
                 member of VicSuper FutureSaver. If you joined VicSuper through a VicSuper participating
                 employer, you are an EmployeeSaver member. If you joined VicSuper as an individual,
                 you are a PersonalSaver member. This Insurance handbook outlines the insurance
                 arrangements that apply to these two types of memberships.




                                                                                                               3
INSURANCE HANDBOOK - PEACE OF MIND FOR VICSUPER FUTURESAVER MEMBERS AND THEIR FAMILIES
Section 1 | Introduction
Insurance handbook




Your choice of cover


VicSuper provides members with                    Occupation categories                          Need help with the calculations?
three types of insurance cover.                                                                  Take advantage of our online
                                                  Depending on the type of insurance cover,
Death only cover - Death only cover is            there are three occupation categories that     insurance calculators to work out your
designed to assist your family with financial     may apply: general occupation, approved        premium and level of cover.
security if you die. If your circumstances suit   occupation and own approved occupation.        Visit vicsuper.com.au/calculators
death only cover and you’d like to take up
                                                  General occupation: if your gross annual
this option, you can choose between
                                                  salary (ie before tax and excluding
unit-based and fixed death only cover (see
                                                  employer superannuation guarantee
page 10 for more details).
                                                  contributions) is less than $75,000 or your
Death and TPD (Total and Permanent                occupation is not listed on page 28, general
Disablement) cover - Death and TPD                occupation rates will apply. EmployeeSaver
cover is designed to assist you and your          members are provided with the general
family with financial security if you die or      occupation category with their automatic
become permanently disabled. A TPD                income protection cover.
benefit provides you with a lump sum
                                                  Approved occupation: if your gross annual
benefit if you are unable to work for health
                                                  salary (ie before tax and excluding
reasons and medical evidence indicates it is
                                                  employer superannuation guarantee
unlikely that you’ll ever work again. You can
                                                  contributions) is $75,000 or more and you
choose between unit-based cover and fixed
                                                  work in one of the occupations listed on
cover (see page 10 for more details).
                                                  page 28, you may apply for the approved
Income protection - Income protection             occupation category.
cover provides you with replacement
                                                  Own approved occupation: if you meet
income if injury or illness impacts on your
                                                  the approved occupation criteria above, and
earning capacity, causing you either total or
                                                  you choose a benefit period of five years or
partial disability. Income protection
                                                  to age 65 in respect of your income
payments are paid monthly for your chosen
                                                  protection cover, you may choose to pay a
benefit period of up to two years, 5 years or
                                                  higher premium to be covered for your own
to age 65. Waiting periods apply. See page
                                                  approved occupation.
18 for more details.




4
Introduction | Section 1
                                                                                                                Insurance handbook




Insurance health check – things to consider


Step 1:                                 Step 3:                                         Need some advice?
Review your insurance                   Apply for, or change your cover                 VicSuper’s advice team are here to help you
arrangements                            You can use the Insurance request form          work out the type and level of cover to best
•		do you currently have death, TPD     attached to the back of this handbook or go     suit your needs. A VicSuper express advice
   and/or income protection cover?      to vicsuper.com.au/insurance to apply for       team member can contact you via phone to
•		should you have any of these types   insurance, or increase, decrease, or transfer   discuss your situation. Contact the Member
   of insurance?                        your existing cover, or cancel any existing     Centre on 1300 366 216 to make a booking.
•		how much cover do you need?          cover you have.
                                                                                        Duty of disclosure
                                        VicSuper EmployeeSaver members can take
                                                                                        You have a legal responsibility to disclose
Step 2:                                 advantage of the special insurance offer
                                                                                        any information that may affect the
Consider your options                   period to increase their cover with minimal
                                                                                        assessment of your insurance application to
•		unit-based death and TPD cover or    underwriting requirements. See page 7
                                                                                        VicSuper and the Insurer. If you fail to
   death only cover                     for details.
                                                                                        comply with your duty of disclosure and the
•		fixed death and TPD cover or death                                                   Insurer would not have entered into the
   only cover                           Step 4:                                         contract on any terms if the failure had not
•		income protection cover.             Reassess from time to time                      occurred, the Insurer may avoid the contract
                                        The level and type of cover you need will       within three years of entering into it. If your
                                        depend on your personal circumstances           non disclosure is fraudulent, the Insurer
                                        and financial commitments. Do you have a        may avoid the contract at any time. An
                                        family? Have you purchased a new house?         Insurer who is entitled to avoid a contract of
                                        As your needs and circumstances change,         life insurance may, within three years of
                                        you should review your insurance                entering into it, select not to avoid it but to
                                        arrangements regularly to ensure that they      reduce the sum that you have been insured
                                        continue to match your needs.                   for in accordance with a formula that takes
                                                                                        into account the premium that would be
                                                                                        payable if you had disclosed all relevant
                                                                                        matters to the insurer.




                                                                                                                                     5
Section 2 | Automatic cover and changing your cover
Insurance handbook




Cover when you join the fund


EmployeeSaver members                           Limited cover                                      PersonalSaver members
– default cover                                 Limited cover of one unit of death and TPD         You do not receive insurance cover when
                                                cover (and no income protection) applies if        you join VicSuper as a PersonalSaver
Eligible new VicSuper EmployeeSaver
                                                you meet the conditions listed in a), b) and       member. You can, however, apply for the
members under age 65 automatically
                                                c) in the first column, but one or more of         type of cover that best suits your
receive default cover, subject to the
                                                the following apply to you:                        circumstances. See page 8 for more details.
conditions outlined in the insurance policy.
                                                •		you have previously been paid or are
Default cover provides you with six units of
                                                   entitled to be paid a TPD benefit or
unit-based death and TPD cover and six
                                                   terminal illness benefit from VicSuper’s
                                                                                                   Cover start date
units of income protection cover ($3,000
                                                   Insurer, another fund or insurance policy;      EmployeeSaver
per month) with a 90 day waiting period
                                                   or                                              Cover starts for new EmployeeSaver
and two year benefit period, provided:
                                                •		you have joined the fund whilst in receipt      members who are eligible for default cover
a)		VicSuper receives at least one
                                                   of worker’s compensation benefits,              from the later of:
    superannuation guarantee (SG)
                                                   statutory accident compensation scheme          • the date you commenced employment
    contribution for you from your
                                                   payments or any other disability income            with your VicSuper participating
    participating employer; and
                                                   benefit; or                                        employer, and
b)		you become a member before the later of:
                                                • you have:                                        • the earliest date in the pay period
   – six months from the date you most
                                                   – elected to join VicSuper after initially         covered by the first SG contribution
      recently commenced employment with
                                                     not joining VicSuper under choice of             received for you from your VicSuper
      your participating employer; or
                                                     fund legislation when you were still             participating employer.
   – six months from the date you first
                                                     working for the same participating
      became eligible to receive SG                                                                Where cover is subject to underwriting
                                                     employer; or
      contributions from your participating                                                        requirements, cover will commence from
                                                   – re-joined VicSuper after previously
      employer; or                                                                                 the date cover is accepted by the Insurer.
                                                     exiting the fund under choice of fund
   – (if applicable) three months from the                                                         Some members may be subject to limited
                                                     legislation when you were still working
      date your participating employer first                                                       cover as noted on this page.
                                                     for the same participating employer.
      nominated VicSuper as the default
      fund for their SG contributions; and      Limited cover means you are only covered           PersonalSaver
c)		for TPD cover, you are “at work” from the   for illness that first becomes apparent, or an     PersonalSaver members do not receive
    date your cover commences (that is, not     injury that first occurs, after the date limited   automatic insurance cover, and any cover
    on leave due to illness or injury).         cover commences. You can only apply for            applied for is subject to underwriting
                                                additional cover by being fully underwritten       requirements. If approved by the Insurer,
Members aged 65 to 69 when they join            by the Insurer.                                    cover will commence on the date the
VicSuper EmployeeSaver will receive six
                                                If you are unsure whether you currently            Insurer provides written notification of
units of death only cover, provided they
                                                have insurance cover, please contact one of        acceptance of your application, provided
satisfy the conditions listed under a) and b)
                                                our experienced superannuation consultants         there are sufficient funds in your account at
above. That is, TPD and income protection
                                                on 1300 366 216, who will be happy to              that time to pay for the premiums. If you do
cover is not provided to new members
                                                assist you. Alternatively, you can login to        not have any funds in your account at the
aged 65 or more.
                                                VicSuper MembersOnline to check your               time of acceptance, you will not be covered
If you do not meet the conditions listed        insurance cover at any time – simply visit         until such time as we receive sufficient
above, default cover does not apply. To         our website at vicsuper.com.au to login.           funds in your account.
obtain cover you will need to complete the
Insurance request form or alternatively
complete the Insurance application form
online at vicsuper.com.au/insurance
(refer to page 8 for details).
Even if you meet the conditions listed above,
some members may be subject to limited
cover of only one unit of death and TPD
cover (and no income protection cover).




6
Automatic cover and changing your cover | Section 2
                                                                                                                                Insurance handbook




Making changes to cover


There is a range of different options for insurance cover through VicSuper; this allows you to tailor your cover to meet your individual circumstances.
Your options are outlined below:
 Cover type                                  Premiums
 • Unit based cover for death and TPD        $1.07 per unit per week
 • Unit based cover for death only           $0.39 per unit per week
 • Fixed cover for death and TPD             Fixed cover premiums vary depending on your age. The annual premiums per $1,000 sum insured
                                             per occupation category are listed in Table 2 on page 13
 • Fixed cover for death only
 • Income protection                         Income protection premiums vary depending on your age, occupation category, waiting period and
                                             benefit period. The cost per unit per week is listed in Table 3 on page 20. Each unit of cover is
                                             worth $500 sum insured per month.

For death only or death and TPD cover, you          Your options within the special insurance           Simply complete the attached Insurance
can choose either unit-based or fixed cover,        offer period are -                                  request form and return it to VicSuper before
but you cannot have a combination of both.          •		Unit-based cover: you can increase your          your special insurance offer period ends or
You can also have income protection cover              death and TPD cover to a total of eight          alternatively you can cancel your insurance
in addition to your unit-based or fixed cover,         units (including your default cover) if you      online at vicsuper.com.au/insurance
or by itself.                                          complete (and meet all the conditions            You can transfer your unit-based cover to
                                                       in) a Good Health Declaration.                   fixed cover at any time, if you complete
Special insurance offer period                      •		Fixed cover: you can increase your               (and meet all the conditions in) the Good
(EmployeeSaver members)                                automatic unit-based death and TPD               Health Declaration.
                                                       cover to up to eight units (as described
Take advantage of your special insurance               above) and then transfer your unit-based         You can still change your cover outside your
offer period to increase your cover with               cover to the equivalent amount of fixed          special insurance offer period , however any
minimal underwriting requirements.                     cover, if you complete (and meet all the         increase in cover will be subject to
                                                       conditions in) a Good Health Declaration.        underwriting requirements. Refer to page 8
For new EmployeeSaver members starting                                                                  for further detail.
                                                       You can increase your cover during the
work with a VicSuper participating employer,
                                                       special insurance offer period and then          Also at any time, if you are eligible, you may
the special insurance offer period is 60 days
                                                       transfer to fixed cover at a                     elect an approved occupation category for
from the date of your VicSuper letter
                                                       later date, if you wish, however you will        your fixed death and TPD cover, and
confirming your insurance cover.
                                                       need to complete the Good Health                 approved or own approved occupation
Action you can take                                    Declaration again.                               category for your income protection cover.
During your special insurance offer period          •		Income protection cover: you can                 To do so, simply complete the Insurance
there are opportunities to make changes to             increase your income protection cover up         request form including the Employer
your cover with minimal underwriting                   to eight units (including your default           Certification.
requirements, which means you may not                  cover) worth $4,000 per month if you             If you would like more information regarding
need to complete lengthy forms or undergo              complete (and meet all the conditions            the special insurance offer period, please
medical tests.                                         in) a Good Health Declaration and                call our Member Centre on 1300 366 216.
                                                       statement of earnings. You can also
Once you elect to make a change to your                reduce your default waiting period of
death and TPD or income protection cover,              90 days to 60 or 30 days by completing
your special insurance offer period ends.              the same Good Health Declaration.
                                                       You can extend your benefit period from
                                                       two years to five years by completing the
                                                       Insurer’s Abbreviated Personal Statement
                                                       in addition to the Insurance request form.
                                                    •		Cancelling cover: if you cancel your
                                                       cover before the special insurance offer
                                                       period ends, any premiums deducted
                                                       from your account will be refunded.




                                                                                                                                                     7
Section 2 | Automatic cover and changing your cover
Insurance handbook




Underwriting requirements when making changes to your cover                                                                         Transferring death and TPD
                                                                                                                                    unit-based cover to fixed cover
Depending on the type and level of cover you are applying for, you will need to complete the
Insurance request form and may also need to complete the Insurer’s Abbreviated Personal
                                                                                                                                    (and vice versa)
Statement or Personal Statement as follows:                                                                                         Any insurance cover you have under the
                                                                                                                                    unit-based option can be transferred to an
 Total death and TPD cover amount                               Underwriting requirement                                            equivalent level of fixed cover if you
                                                                                                                                    complete (and meet all the conditions in)
 Up to $515,000 (or unit-based equivalent)                      The Insurer’s Abbreviated Personal Statement2
                                                                                                                                    a Good Health Declaration.
 Above $515,000 (or unit-based                                  The Insurer’s Personal Statement3                                   If you have fixed cover and wish to transfer
 equivalent)                                                                                                                        to unit based cover, you can do this without
 Transfer current amount of unit-based                          Good Health Declaration1                                            having to complete any underwriting
 cover to fixed cover                                                                                                               requirements. If you make this transfer,
                                                                                                                                    you will be provided with an equivalent
 Total income protection cover amount                           Underwriting requirement                                            number of units, rounded up to the nearest
 or change in cover                                                                                                                 whole unit.
 Up to 10 units with a 2 year benefit period                    The Insurer’s Abbreviated Personal Statement2                       Changes to occupation category
 and 90 day waiting period (EmployeeSaver
 members only)                                                                                                                      To apply for cover under the approved
                                                                                                                                    occupation or own approved occupation
 Any other change (including taking up                          The Insurer’s Personal Statement3                                   (income protection only) categories, please
 income protection)                                                                                                                 complete the Insurance request form and
1 If you cannot satisfy the conditions of the Good Health Declaration you will be required to complete the Insurer’s                ensure the Employer Certification section is
  Abbreviated Personal Statement, which is available from vicsuper.com.au/forms                                                     completed correctly.
2 If you cannot satisfy the conditions of the Insurer’s Abbreviated Personal Statement you will be required to complete the         If you were in the own approved occupation
  Insurer’s Personal Statement, which is available from vicsuper.com.au/forms
                                                                                                                                    category for TPD cover prior to 1 July 2014,
3 Depending on the information you provide in the Insurer’s Personal Statement, you may be asked to have a medical
  examination or blood tests. The cost of any medicals, reports or pathology tests that are required to verify your health during   you can still make changes to your cover
  the underwriting process will be paid for by the Insurer.                                                                         (increase or decrease), and keep the own
                                                                                                                                    approved occupation category. See page 25
Apply online                                                        The Insurer may impose special conditions                       for further information and premium rates.
You can make changes to your insurance                              such as premium loadings, restrictions and/                     High risk occupations
cover online, using the online insurance                            or exclusions, or may decline your
                                                                    application for cover or additional cover                       Applications for additional insurance cover
application forms available at vicsuper.com.                                                                                        and longer benefit periods may be declined
au/insurance. These online forms include                            entirely. If a premium loading, restriction
                                                                    and/or exclusion applies to your insurance                      due to your current occupation. The Insurer
the underwriting requirements as outlined                                                                                           will not consider applications for certain
in the table above.                                                 cover and you would like this reviewed by
                                                                    the Insurer, you may need to cover the                          high-risk occupations such as, prison
For VicSuper EmployeeSaver members                                  costs of any medical evidence required to                       officers, members of armed forces and
within their special insurance offer period,                        have your cover reassessed.                                     police forces, members who work in and
the underwriting requirements listed may                                                                                            around mining sites and members who
not be required.                                                    Your increased insurance cover is effective                     work with explosives or hazardous materials
                                                                    from the date it is approved by the Insurer                     or waste. Some self-employed members
You can decrease your death and TPD and                             in writing and will continue, provided that                     are also considered high-risk (depending on
income protection cover at any time without                         you have sufficient funds in your account to                    a number of factors) and applications may
having to complete any of the underwriting                          pay for the premiums at all times. You can                      be declined on this basis. If you need
requirements. With your income protection                           top up your account at any time by making                       further information, please call our Member
cover, you can also reduce your benefit                             a personal contribution.                                        Centre on 1300 366 216.
period or increase your waiting period
without having to complete any of the                               For PersonalSaver members, if you do not
underwriting requirements.                                          have any money in your account at the time
                                                                    of acceptance, you will not be covered until
                                                                    such time as we receive sufficient funds into
                                                                    your account.
                                                                    If you don’t already have TPD cover, you
                                                                    must be under age 65 when applying for
                                                                    new or increased TPD cover.



8
Automatic cover and changing your cover | Section 2
                                                                                                                             Insurance handbook




Interim cover                                       Life events cover (death only or                 •		you must disclose any exclusions that
                                                    death and TPD cover)                                apply to the cover
Interim cover for accidental death, or
disablement caused by accidental injury is          As you go through life, certain events may       •		no loadings apply to the cover
provided while your application for new or          change the level of insurance cover you          •		you subsequently cancel that cover
additional cover is being assessed by the           require – for example, when you buy your            within 60 days of receiving confirmation
Insurer. Interim cover commences from the           first house or have a child.                        from VicSuper of the transfer.
date VicSuper receives your application, the                                                         The maximum amount of cover you will
                                                    With life events cover, you can increase your
Insurer’s Abbreviated Personal Statement                                                             have is the greater of the cover with either
                                                    insured level of death only cover, or death
and/or Personal Statement until the                                                                  your transferring fund or the cover in
                                                    and TPD cover, by the equivalent of two
earliest of:                                                                                         VicSuper. It is not the total of the combined
                                                    units per 12-month period (or equivalent
•		the date the Insurer accepts or limits the       dollar value for fixed cover) without            cover. You cannot transfer any income
   application                                      completing any underwriting requirements,        protection cover to VicSuper.
•		20 business days after an application is         to a maximum of six additional units over        For more information and conditions please
   declined                                         the life of your cover, when:                    call our Member Centre on 1300 366 216.
•		the application is withdrawn                     •		you marry or register a de facto
•		60 days from the date the interim cover             relationship (including same sex)             Cancelling cover
   commenced, or                                    •		you divorce or register a separation from     You can cancel your insurance cover at
•		the cover is stopped under the terms of             a marriage or de facto relationship           any time by logging on to VicSuper
   the policy.                                      •		you have a child or adopt a child             MembersOnline, completing the Insurance
The amount of interim cover available is the        •		you take out a mortgage on the initial        request form or by completing the online
lesser of the amount of cover you have                 purchase of a primary residence               application at vicsuper.com.au/insurance.
applied for, and:                                                                                    Your insurance cancellation will be effective
                                                    •		you increase an existing mortgage on
                                                                                                     from the day you elect to cancel cover if
•		interim cover for accidental death:                 your primary residence for renovations/
                                                                                                     you are completing it online, or the day
   $5 million                                          extension (the mortgage increase must
                                                                                                     VicSuper receives your written notification.
•		interim cover for accidental TPD: up to             be $50,000 or more)
   $5 million (however, under the ‘unable           •		your child turns 12
                                                                                                      EmployeeSaver members
   to work’ definition of TPD the maximum           •		you reach the first anniversary of a
   benefit is $3.09 million)                                                                          Remember, even if you have not applied
                                                       marriage or de facto relationship, or
                                                                                                      for insurance, you may have been
•		interim cover for accidental injury              •		you have been separated from a
                                                                                                      automatically covered for six units of death
   (income protection): $30,000 per month              marriage or de-facto relationship for
                                                                                                      and TPD cover and six units of income
   for a maximum of 2 years.                           12 months.
                                                                                                      protection cover when you joined your
No benefit will be payable under interim            You must apply for your life event increase       VicSuper participating employer. If you
cover where:                                        within 2 months of the event occurring. Any       cancel your cover before your special
•		death was caused by suicide, or                  additional cover obtained under a life event      insurance offer period ends, you will receive
   intentional self-injury, including               will be subject to the same premium               a full refund of premiums deducted
   intentionally contracted infection by            loadings, restrictions and/or exclusions          since your insurance cover commenced.
   bacteria or virus, or any attempt thereat; or    applicable to any other cover you may have.
•		disablement was caused by attempted              Please refer to the Life events application      Re-commencement of cover
   suicide, or intentional self-injury, including   form for further specific details, eligibility
                                                    criteria and evidence required (available        If you have previously cancelled your cover
   intentionally contracted infection by
                                                    from vicsuper.com.au/forms).                     you will need to reapply for cover by
   bacteria or virus, or any attempt thereat.
                                                                                                     completing an Insurance request form and
The maximum amount of interim cover is              Transferring cover from another                  the Insurer’s Personal Statement. Cover will
limited to $1 million (for death or TPD) and        fund                                             recommence from the date your request is
$10,000 per month (for income protection)           If you have death and TPD cover with             approved by the Insurer in writing, provided
where death or disablement was as a result          another superannuation fund, you may be          you have sufficient funds in your account to
of, or associated with:                             able to transfer that cover into VicSuper        pay the premiums.
•		making or attempting to make a flight in         provided that:
    an aircraft (other than as a passenger for      •		cover has been underwritten using a
    whom a fare or fee has been paid, or as             Personal Statement
    a passenger in an aircraft under charter),
                                                    •		the other superannuation fund is an
    or
                                                        employer-sponsored fund
•		taking intoxicating liquor or drugs.




                                                                                                                                                      9
Section 3 | Death and TPD cover
Insurance handbook




Death and TPD cover


Death and TPD cover is intended to provide      Fixed cover                                     What is the cost of death and TPD
a lump sum benefit to you if you become                                                         cover?
                                                Fixed cover is different from unit-based
permanently disabled, or to your family if
                                                cover in that the level of cover remains the
you pass away. You can elect death only                                                          Unit-based cover       Fixed cover
                                                same, but premiums generally increase as
cover, or death and TPD cover. You cannot
                                                you grow older. With fixed cover, you can        Death and TPD          Annual premiums
have a higher amount of TPD cover than
                                                choose your level of cover to suit your          cover - $1.07 per      are based on your
your death cover. All death and TPD cover
                                                needs. Fixed cover enables you to apply for      unit per week          age last birthday
ceases at age 70. In the event of a claim,
                                                a level of cover you may not be able to                                 per $1,000 sum
the amount you are covered for is based on                                                       Death only cover
                                                reach under unit-based cover. See the                                   insured and the
your sum insured at the date of death                                                            - $0.39 per unit
                                                maximum limits below. If you already have                               occupation
or TPD.                                                                                          per week
                                                unit-based cover you may transfer your                                  category (general
VicSuper has two different types of death       existing level of unit-based cover to fixed                             or approved) that
and TPD cover – unit-based cover and            cover if you complete (and meet all the                                 is applicable to
fixed cover.                                    conditions in) a Good Health Declaration.                               you. See Table 2
Unit-based cover                                Reduction of fixed TPD cover                                            on page 13 for the
                                                                                                                        premium rates for
With unit-based cover, your total amount of     It is important to note that under fixed                                all cover types and
cover depends on your age and the number        cover, between the ages of 60 and 64 the                                ages.
of units you have. You can select up to a       TPD component of your fixed cover will
maximum of 60 units of death only or            reduce by 1/60th per month (or part
death and TPD cover (subject to                 thereof) of the total amount of your benefit    Premiums are deducted directly from your
underwriting requirements). Under               at age 60. From age 64 there is no further      VicSuper account at the end of each month
unit-based cover, the cost of cover remains     reduction but a TPD benefit will only be        in arrears and when you close your account.
the same but your level of cover decreases      payable from age 65 if you suffer a             Premium rates apply until 30 June 2015.
on a sliding scale relative to your age once    permanent disability and you meet the           General and approved occupation
you reach age 36. The amount of cover for       Specific Loss or Future Care conditions of      categories
each unit is outlined in Table 1 on page 12.    the TPD definition (see page 14). The
                                                maximum TPD benefit payable from age            Under fixed death only or death and TPD
 EmployeeSaver members                          66 is $250,000. If you become terminally        cover, if your gross annual salary is $75,000
                                                ill or pass away after age 60, the full death   or more, and you work in one of the
 Six units of death and TPD cover are
                                                benefit would be paid. See page 11 for          approved occupations set out on page 28,
 automatically provided to eligible new
                                                an example.                                     you may be eligible for the approved
 EmployeeSaver members under the age
                                                                                                occupation rate. If you earn less than
 of 65 when they join the fund. Eligible        Indexation of fixed cover                       $75,000 or your occupation is not listed,
 new members aged 65 to 69 when
                                                Fixed death and TPD cover will be indexed       the general occupation rate will apply.
 they join the fund will receive six units of
                                                to ensure benefits keep pace with inflation.    If you work part-time, you can use your full
 death only cover. The automatic cover is
                                                Cover will automatically increase on 1 July     time equivalent gross annual salary to
 subject to eligibility criteria outlined on
                                                each year by the lesser of CPI and 7.5%,        determine your eligibility for the approved
 page 6, and some members may be
                                                subject to the maximum cover amounts. If        occupation category.
 subject to limited cover - see page 6.
                                                you wish, you can opt out of these              Maximum cover limits
                                                increases by completing the Insurance
                                                request form which is attached to the back      The maximum amounts of death and
                                                of this handbook. If you opt out of the CPI     TPD insurance cover you can apply for
                                                increase, you will be required to complete      are as follows:
                                                the underwriting requirements if you want       • death: unlimited
                                                to opt back in at a later date.                 • TPD: up to $5 million (however, under
                                                                                                   the ‘Unable to Work’ definition of TPD
                                                                                                   the maximum benefit is $3.09 million).
                                                                                                For unit-based cover, the maximum number
                                                                                                of units allowed is 60. If the amount of
                                                                                                cover you require is in excess of 60 units
                                                                                                then you will need to apply for fixed cover.




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Death and TPD cover | Section 3
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Example calculations
The table below provides examples of how to calculate your level of cover and premium.

 Example 1 - Unit-based cover                                           Example 2 - Fixed cover

 Luke is 37 years old and wants 10 units of death and TPD cover.        Jennifer is 45 years old and earns a gross annual salary of $68,000
                                                                        per year. As Jennifer’s salary is under $75,000 she falls under the
 His level of cover will be:
                                                                        general occupation category.
   $46,000 (sum insured for age 37)
 		        x 10 units of cover                                          She wants $250,000 of death and TPD cover.
 		        = $460,000

 His premium is calculated as follows:                                  Jennifer’s premium is calculated as follows:
   $1.07 x 10 units of cover                                              The rate for death and TPD cover under the general category for a
 		      = $10.70 per week                                                45 year old is $3.15 per $1,000 sum insured.
 			 or $557.93 per year, calculated as follows:
                                                                        The annual premium will be
 			 $10.70 ÷ 7 x 365
                                                                          $3.15 x 250,000
 		      = $557.93
                                                                        			 ÷ 1,000
                                                                        			 = $787.50
                                                                        This premium will increase each year on Jennifer’s birthday.

 Example 3 - Fixed cover TPD reduction from age 60

 From age 60 to 64, the TPD component of fixed cover reduces by 1/60th per month (or part thereof) of the total amount of cover at age
 60. For example:
   Grace is age 63 and 4 months old and had $900,000 fixed death and TPD cover when she was age 60. The monthly TPD cover
   reduction is calculated as follows:
 			 $900,000 x 1/60
 		      = $15,000

 This means the cover will reduce by $15,000 per month (or part thereof) after Grace turns 60.
   Months from age 60 to 63 and 4 months = 40
 			 40 months x $15,000
 		 = $600,000
   The reduced TPD benefit therefore is
 			 $900,000 – $600,000
 		      = $300,000

 If Grace were to cease work due to disability and was deemed to be totally and permanently disabled at this age, the TPD benefit payable
 would be $300,000. If however, Grace became terminally ill or passed away at this age, the full $900,000 benefit would be payable.
 By age 64 Grace’s TPD benefit would have reduced to $180,000. There is no further reduction from age 64. The maximum TPD benefit
 from age 66 is $250,000 but this will not impact on Grace.


 Need help with the calculations?
 Use our online insurance calculators to work out your premium and
 level of cover. Visit vicsuper.com.au/calculators




                                                                                                                                              11
Section 3 | Death and TPD cover
Insurance handbook



Table 1: Unit-based death only and death and TPD cover
Premiums and sum insured per unit apply until 31 December 2015.

     Age last birthday       Cover for one unit ($)        Default cover ($) for eligible
                                                         EmployeeSaver members (6 units)
          14-35                     51,500                             309,000
            36                      46,000                             276,000
            37                      46,000                             276,000
            38                      45,500                             273,000
            39                      45,500                             273,000
            40                      40,500                             243,000
            41                      40,500                             243,000
            42                      40,000                             240,000
            43                      35,000                             210,000
            44                      29,000                             174,000
            45                      24,000                             144,000
            46                      20,000                             120,000
            47                      17,000                             102,000
            48                      15,000                               90,000
            49                      13,000                               78,000
            50                      11,000                               66,000
            51                      10,000                               60,000
            52                       9,000                               54,000
            53                       8,000                               48,000
            54                        7,000                              42,000
            55                       6,200                               37,200
            56                       5,500                               33,000
            57                        4,750                              28,500
            58                       4,250                               25,500
            59                        3,750                              22,500
            60                       3,500                               21,000
            61                       3,000                               18,000
            62                       2,500                               15,000
            63                       2,000                               12,000
            64                        1,750                              10,500
            65                       1,500                                9,000
            66                       1,400                                8,400
            67                       1,350                                8,100
            68                       1,250                                7,500
            69                        1,150                               6,900
            70                            0                                    0

If you join VicSuper on or after your 65th birthday, TPD cover is not available.




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Table 2: Fixed cover premiums for death only and death and TPD cover
Annual rates per $1,000 sum insured. Premiums apply until 31 December 2015. For own approved occupation rates, see Section 7, page 26.

   Age last                        General occupation                                           Approved occupation
   birthday
                       Death only ($)              Death and TPD ($)                Death only ($)              Death and TPD ($)
      14                    0.55                          0.79                           0.45                          0.64
      15                    0.55                          0.79                           0.45                          0.64
      16                    0.64                          0.91                           0.52                          0.75
      17                    0.68                          0.97                           0.55                          0.79
      18                    0.76                          1.08                           0.58                          0.83
      19                    0.74                          1.06                           0.58                          0.83
      20                    0.66                          0.95                           0.53                          0.77
      21                    0.64                          0.91                           0.52                          0.75
      22                    0.58                          0.83                           0.48                          0.68
      23                    0.56                          0.81                           0.47                          0.66
      24                    0.52                          0.75                           0.42                          0.60
      25                    0.50                          0.70                           0.39                          0.56
      26                    0.47                          0.66                           0.37                          0.54
      27                    0.48                          0.68                           0.37                          0.54
      28                    0.48                          0.68                           0.39                          0.56
      29                    0.50                          0.70                           0.39                          0.56
      30                    0.52                          0.75                           0.40                          0.58
      31                    0.52                          0.75                           0.43                          0.62
      32                    0.58                          0.83                           0.48                          0.68
      33                    0.64                          0.91                           0.52                          0.75
      34                    0.68                          0.97                           0.55                          0.79
      35                    0.77                          1.10                           0.60                          0.87
      36                    0.85                          1.24                           0.64                          0.95
      37                    0.92                          1.35                           0.72                          1.10
      38                    1.05                          1.53                           0.81                          1.24
      39                    1.11                          1.72                           0.87                          1.39
      40                    1.24                          1.93                           0.97                          1.55
      41                    1.32                          2.15                           1.06                          1.72
      42                    1.43                          2.36                           1.14                          1.88
      43                    1.50                          2.57                           1.19                          2.05
      44                    1.64                          2.84                           1.30                          2.26
      45                    1.75                          3.15                           1.42                          2.53
      46                    1.88                          3.52                           1.53                          2.77
      47                    2.06                          3.97                           1.67                          3.17
      48                    2.30                          4.49                           1.87                          3.58
      49                    2.54                          5.11                           2.06                          4.08
      50                    2.80                          5.80                           2.30                          4.64
      51                    3.09                          6.54                           2.54                          5.22
      52                    3.36                          7.29                           2.77                          5.82
      53                    3.62                          8.05                           2.99                          6.46
      54                    3.96                          8.98                           3.28                          7.20
      55                    4.28                         10.18                           3.56                          8.14
      56                    4.67                         11.51                           3.90                          9.21
      57                    5.04                         12.98                           4.23                         10.37
      58                    5.47                         14.61                           4.62                         11.70
      59                    5.92                         16.58                           5.02                         13.27
      60                    6.78                         18.98                           5.75                         15.19
      61                    7.78                         21.82                           6.60                         17.45
      62                    8.90                         25.19                           7.57                         20.16
      63                   10.21                         29.17                           8.68                         23.33
      64                   11.67                         33.72                           9.95                         26.99
      65                   13.14                         38.48                          11.19                         30.80
      66                   14.73                         43.72                          12.54                         35.00
      67                   16.49                         49.62                          14.02                         39.70
      68                   18.32                         56.10                          15.60                         44.90
      69                   20.30                         63.26                          17.28                         50.65
      70                       0                             0                              0                             0

                                                                                                                                         13
Section 4 | General information about death and TPD cover
Insurance handbook




General information about
death and TPD cover

What is Total and Permanent                       Part (a) Specific Loss                           Part (c) Unable to Work
Disablement (TPD)?                                You suffer an injury or illness which first      While you were engaged in regular
                                                  became apparent after becoming insured in        remunerative work, you suffer an injury or
Under the TPD rules, in most cases you
                                                  VicSuper, and, as a result of the injury or      illness that stops you from working in any
would be assessed under the ‘Unable to
                                                  illness, you have suffered the total loss of     business, occupation or regular duties
Work’ definition (Part (c) below) when
                                                  (or total loss of the use of):                   continuously for the TPD waiting period.
claiming a benefit. However, a benefit may
                                                  •		both hands or feet, or
also be payable under the Specific Loss
                                                  •		one hand and one foot, or                      Members who had TPD cover prior to
(Part (a)) or Future Care (Part (b))
definitions as well as being unable to work.      •		the sight of both eyes, or                     1 July 2014
The relevant definitions are set out below.       •		one hand or foot and the sight in one          If you had TPD cover prior to 1 July
                                                      eye,                                          2014, there are some differences in the
Total and Permanent Disablement means                                                               definition of TPD as follows:
                                                  in circumstances where the loss will never
you suffer a permanent disability (as                                                               • 		If you meet the definition in Parts (a)
                                                  be regained.
defined below) and:                                                                                     or (b), permanent disability will not
•		you meet the definition of Parts (a) or        Part (b) Future Care                                  be subject to the Insurer’s opinion as
   (b) below, or                                  When all of the following apply to you:               to your likelihood to ever work in or
•		at the time you suffered the injury or         •		You suffer an injury or illness which first        attend to regular remunerative work
   illness you were engaged in regular               occurs after becoming insured under the            for which you are reasonably fitted by
   remunerative work (as defined below)              Insurer’s policy, and                              education, training or experience.
   as a full-time employee (as defined            •		Because of that injury or illness, in the      • 		If you had elected own approved
   below), and meet the definition of                Insurer’s opinion, you are permanently             occupation TPD, permanent disability
   Part (c).                                         unable to perform at least two of the five         instead means in the Insurer’s opinion
This means if you are aged 65 or more                “Activities of Daily Living” listed below,         you have become incapacitated by
and/or not engaged in regular                        without assistance from another person:            injury or illness to such an extent that
remunerative work as a full-time                     – bathing/showering,                               you unlikely to ever work in or attend
employee:                                            – dressing/undressing,                             your own occupation.
• the definition of TPD means you suffer a           – eating/drinking,
   permanent disability and you meet                 – using the toilet to maintain personal       If you meet the definition of TPD under the
   either the Specific Loss (Part (a)) or              hygiene,                                    Insurer’s policy, the insured benefit will be
   Future Care (Part (b)) definitions below;         – getting in and out of bed, a chair, a       paid to VicSuper and can be paid to you
   and                                                 wheelchair or moving from place to          provided you meet a condition of release
• you cannot be paid a TPD benefit if you              place by walking, a wheelchair or with      under the Superannuation Industry
   only meet the Unable to Work (Part (c))             a walking aid.                              (Supervision) Act 1993 (Cwlth). This would
   definition.                                                                                     generally be on the grounds of permanent
                                                                                                   incapacity.
 Permanent disability means, after considering all evidence which the Insurer believes is
 necessary to reach their view, in their opinion you have become incapacitated by injury or        In the case where VicSuper determines a
 illness (whether physical or mental) to such an extent that you are unlikely to ever be able      condition of release has not been met, the
 to, work in any business, occupation or regular duties, whether paid or unpaid, for which         TPD benefit will be placed in your VicSuper
 you are reasonably fitted by education, training or experience.                                   account until such time as a condition of
                                                                                                   release is met. An example of this may be
 Full-time employee means:                                                                         where you have elected the own approved
 • a permanent employee required to work 10 hours or more per week as part of their                occupation category and in the Insurer’s
    normal duties, or                                                                              opinion you are unlikely to ever work in
 • any other employee who has worked for the employer an average of 10 hours or more               your own occupation ever again, however
    per week over a period of 12 consecutive months, or where the employee has worked              you may be able to work in a different type
    for the employer for less than 12 consecutive months the employee has worked an                of occupation.
    average of 10 hours or more per week for the employer from the date he or she
                                                                                                   TPD benefits are generally paid as a lump
    commenced working for the employer.
                                                                                                   sum, however you may like to consider
 Regular remunerative work means, you were engaged in regular remunerative work if                 beginning a VicSuper Pension or you can
 you are doing work in any employment, business or occupation. You must be doing the               leave the lump sum amount in your
 work for reward – or hope of reward – of any type.                                                VicSuper account and make partial
                                                                                                   withdrawals when required. A VicSuper
                                                                                                   Financial Planner may be able to assist you
                                                                                                   in making the right decision for you, based
                                                                                                   on your circumstances.


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What is the waiting period                     Exclusions or exceptions for                   If you are travelling overseas, or have
                                                                                              moved overseas, your cover will continue.
for a TPD claim?                               death and TPD cover                            However a benefit is not payable for
TPD benefits are subject to waiting periods    There are currently no blanket pre-existing    death, accidental death, terminal illness
as below.                                      condition exclusions. However, depending       or TPD caused by an act of war whilst you
                                               on the health evidence supplied during the     are overseas.
Day one TPD                                    application process, individual special
                                                                                              In the event of a TPD or terminal illness
If you are diagnosed by a medical              conditions such as exclusions, restrictions
                                                                                              claim you may be required to return to
practitioner (as defined below) as suffering   and/or premium loadings may apply to your
                                                                                              Australia at your own expense for medical
one of the conditions listed below, the        death and/or TPD cover.
                                                                                              treatment or assessment. A benefit for TPD
Insurer will waive the TPD waiting period
                                                                                              or terminal illness may not be payable if
when assessing a claim made under the          Cover during leave without                     you do not return to Australia.
‘Unable to Work’ definition of TPD. This
means you can apply to claim your benefit      pay, including parental leave
immediately. The conditions are:               If you are on leave without pay for reasons    Leaving a participating
• Alzheimer’s disease and other dementias      other than injury or illness, including        employer (EmployeeSaver
• Cardiomyopathy                               parental leave, your death only or death and   members)
• Diplegia                                     TPD cover can continue for up to a
                                               maximum of seven years provided that:          If you leave your VicSuper participating
• Hemiplegia                                                                                  employer, but you remain an EmployeeSaver
• Lung disease                                 • your employer has approved in writing
                                                   your period of leave, and                  member, your death and TPD cover
• Major head injury                                                                           continues provided that you continue to
                                               • you have sufficient funds in your
• Motor neurone disease                                                                       meet policy conditions including having
                                                   VicSuper account to pay for the
• Multiple sclerosis                                                                          sufficient funds in your account to meet the
                                                   premiums at all times.
• Muscular dystrophy                                                                          premiums at all times.
• Paraplegia                                   If you would like cover for longer than
• Parkinson’s disease
                                               seven years, you must notify the Insurer in    When does cover stop?
                                               writing before commencing the leave
• Permanent blindness                                                                         Your death only or death and TPD cover will
                                               without pay period. You will receive written
• Permanent deafness                           notification from the Insurer regarding this   cease at the earliest of the following
• Permanent loss of speech                     leave and if it will be covered under          situations:
• Primary pulmonary hypertension               the policy.                                    •		once there are insufficient funds in your
• Quadriplegia                                                                                    FutureSaver account to meet your
                                               If you’re on leave without pay, including          premiums
• Severe rheumatoid arthritis                  parental leave, the Insurer may decline
• Tetraplegia.                                                                                •		you advise VicSuper to cancel your cover
                                               requests to increase or make changes to
                                               your TPD cover until you return to work.       •		your FutureSaver account is closed
Medical practitioner means, a registered
                                                                                              •		you turn age 70
medical practitioner who is appropriately
                                                                                              •		a death, TPD or terminal illness benefit is
qualified to treat the person insured for      Overseas cover                                     paid
their injury or illness. The medical
                                               Your death only and death and TPD cover        •		you cease to be eligible for cover under
practitioner cannot be the person insured or
                                               will continue for a maximum of three years         VicSuper’s governing rules
their family member, business partner,
                                               while you are overseas for the purpose of      •		you are on unpaid leave for longer than
employee or employer.
                                               the participating employer provided that any       the agreed period of time (usually seven
Three month waiting period                     details of your temporary overseas                 years but may be extended with the
A three month waiting period will apply if     arrangements required by the Insurer are           Insurer’s agreement)
your claim is being assessed under the         made available when requested. However a
                                                                                              •		you make a fraudulent claim.
`Unable to Work’ (Part (c)) TPD definition     benefit is not payable for death, accidental
and you are not suffering one of the           death, terminal illness or TPD caused by an
conditions listed under ‘Day one TPD’          act of war whilst you are overseas for the     Account closure
above.                                         purpose of your employer. If your overseas     If your FutureSaver account is closed, there
                                               temporary employment is extended beyond        is no option to continue your insurance
No waiting period                              three years you must provide advance           cover provided by the Insurer.
There is no waiting period for a TPD benefit   written notification to VicSuper to ensure
under the ‘Specific Loss’ (Part (a)) or        you remain covered. Depending on the
‘Future Care’ (Part (b)) definitions.          circumstances, the Insurer may increase the
                                               premium and/or apply special conditions.



                                                                                                                                         15
Section 4 | General information about death and TPD cover
Insurance handbook




Making a death or TPD claim                       Making a TPD claim                               3.		VicSuper receives and reviews your
                                                  There are a number of steps involved in              documentation
Making a claim on your insurance cover can                                                         		Once all required information has been
be a lengthy process, however VicSuper is         making a TPD claim, and the claim process
                                                  can sometimes be quite lengthy. The                  received by VicSuper (including the
committed to assisting members to ensure                                                               Employer Statement), all documentation
a claim is made as simple as possible. You        sooner you notify VicSuper of your illness or
                                                  injury, the better. A delay in lodging your          is sent to the Insurer for assessment. If
don’t necessarily need to engage in advice                                                             further information is required prior to
from a legal professional to make a claim;        claim may complicate and extend the
                                                  assessment process. Generally your sum               the claim being sent to the Insurer,
VicSuper works hard with our Insurer to                                                                VicSuper will contact you.
ensure the best possible outcome for the          insured is calculated at the date you ceased
member is achieved, as quickly as possible.       work due to illness or injury (ie the date you   4. The Insurer assesses your claim
                                                  were last physically at work) and your age at    		During the assessment process by the
Making a death claim                              that time.                                          Insurer you may be asked directly by the
For a death benefit to be claimed, VicSuper       The steps below outline what is involved in         Insurer to provide additional information
must be notified and appropriate paperwork        the TPD claim process.                              or attend an independent medical
will then be forwarded to your dependents                                                             examination, or they may ask your
or your executor to complete. The insured         1.		Contact the VicSuper Member Centre              medical practitioner, employer or other
benefit paid will be based on the sum                 to discuss your situation                       insurers for further information. Any
insured at the date of death, in addition to      		During this phone call, you will be asked         additional medical reports or examinations
the account balance (applicable premiums              a series of questions, including your           will be paid for by the Insurer.
and fees will be deducted).                           personal details and member number,
                                                      the date you last worked prior to your       5. The Insurer makes a decision
Making a terminal illness claim                       illness or injury, the name of your last     		After considering all the information
You are insured for terminal illness as part          employer and the nature of your illness         provided, the Insurer will make a decision
of your death only cover and death and                or injury.                                      to accept, defer or decline your claim.
TPD cover, which is an advance payment of                                                             This decision is based on whether, in
                                                  2.		Claim documentation will be sent                their opinion, you meet the definition of
the death benefit. Terminal illness means             to you
any illness in which you are not expected to                                                          TPD under the policy. The Insurer will
                                                  		Following your initial contact with               notify VicSuper of the decision.
live more than 12 months regardless of any            VicSuper, initial claim documentation will
treatment undertaken.                                 be sent to you. All forms need to be         6. VicSuper reviews the Insurer’s decision
You will need to get two registered medical           completed with as much detail as             		VicSuper is obliged to act in the best
practitioners to certify that you are suffering       possible in order for your claim to be          interests of all members and therefore
from an illness that is likely to result in           assessed by the Insurer. The                    will review the Insurer’s decision.
death within 12 months of certification. At           documentation will include                      VicSuper will either agree or disagree
least one of the registered medical                  – Disability Claim form, including a             with the Insurer’s decision to accept,
practitioners must be a specialist practicing           requirement to provide certified proof        defer or decline your claim.
in the area related to the illness. There is no         of identity                                   – Accept – if your claim is accepted
waiting period for a terminal illness benefit.       – Member Statement                                 VicSuper will notify you and you can
                                                     – Medical Practitioner Statement                   elect to either take all or part of your
Provided that the Insurer agrees with the                                                               benefit in cash, leave part or all of your
certification, a benefit will be payable            Any costs incurred for completing the               benefit in a new VicSuper FutureSaver
calculated on the latest date of the                initial documentation will be at your own           account, roll your benefit to a VicSuper
certificates provided by the medical                expense. Initial assessment of your claim           Pension or rollover to another
practitioners.                                      can begin during the waiting period.                superannuation fund. Whatever you
The terminal illness benefit is the amount of       Your employer will also be contacted at             decide, you will be required to
your insured death benefit and your super           this stage to complete an Employer                  complete one final form indicating your
account balance (applicable premiums and            Statement. This statement includes                  preference.
fees will be deducted).                             information about the type of work and            – Defer – if VicSuper agrees with the
                                                    duties of your role prior to your illness or        Insurer’s decision to defer your claim
                                                    injury, your period of employment                   until the extent of your illness or injury
                                                    including your last day at work and any             can be further assessed, we will notify
                                                    other relevant employment related                   you in writing. In some cases, you may
                                                    information.                                        be given the opportunity to provide
                                                                                                        further evidence to support your claim,
                                                                                                        which may result in another
                                                                                                        assessment prior to the end of the
                                                                                                        deferral period.


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– Decline – If VicSuper agrees with the          If VicSuper disagrees with the Insurer’s
  Insurer’s decision to decline your claim,       decision to defer or decline your claim,     Superannuation Complaints
  we will write to you outlining the              we may ask for further medical evidence      Tribunal (SCT)
  reasons for the decline. You will be            or ask the Insurer to re-consider their      To ensure you retain your right to
  provided with all the medical evidence          decision.                                    ultimately complain to the SCT if you are
  used to come to this decision, and be       7. If you disagree with the decision made        dissatisfied with the outcome of your
  given the opportunity to provide a          		Following the review of the Insurer’s          TPD claim, you must ensure your claim
  further submission in the form of               decision, if you disagree with the           for the payment of a TPD benefit is
  medical evidence to support your                decision made or how your claim has          made to the Trustee (VicSuper) within
  claim. Your claim will then be further          been managed, you can lodge a                2 years of you permanently ceasing
  assessed by both the Insurer and                complaint in writing to VicSuper. VicSuper   employment, and your claim is made to
  VicSuper, and either agree to continue          has 90 days in which to respond to your      the SCT within 4 years of the Trustee’s
  assessment or uphold the original               complaint. If you are still concerned        decision about your claim.
  decline decision.                               about the response or the management
                                                  of your claim you can contact the
                                                  Superannuation Complaints Tribunal.




                                                                                                                                      17
Section 5 | Income protection cover
Insurance handbook




Income protection cover


Income protection cover is designed to provide you with replacement income in the event that an injury or illness
impacts your earning capacity and causes total or partial disability. The value of income protection cover is stated in
units. Each unit of cover is worth $500 per month. Income protection cover ceases at age 65.

Eligibility for income                          Your cover will not automatically increase to     Benefit waiting period
                                                reflect a change to your salary. If your salary
protection cover                                increases you may apply for an increase in        You can apply for a benefit waiting period of
You are eligible for income protection cover    cover up to 75% of your new gross annual          30, 60 or 90 days. No benefit will be paid
provided that you are:                          salary plus 10% superannuation                    during the waiting period. The waiting
•		an employed or self-employed VicSuper        contributions (to a maximum of $30,000            period starts when a medical practitioner,
   FutureSaver member, and                      per month inclusive of superannuation             after examining you for the relevant illness
                                                contributions). Any increase in cover is          or injury, certifies that you are totally
•		working at least 10 hours per week, and
                                                subject to completing underwriting                disabled. You should consider your ability to
•		aged 14 years or older but under age 65,
                                                requirements. Therefore, you should               support yourself through sick leave, annual
   and
                                                consider your level of cover from time to         leave and personal savings, along with the
•		legally permitted to reside and work for                                                       cost of premiums, in determining the most
   reward in Australia.                         time to reflect salary movements.
                                                                                                  appropriate waiting period for you.
                                                 Default income protection cover –
How much income protection                       EmployeeSaver members                            Electing income protection
cover can I apply for?                           Eligible new EmployeeSaver members               cover under the own
You can apply for income protection cover        are automatically provided with six units        approved occupation
for up to 75% of your gross annual salary        ($3,000 per month) of income
or active business income if you are
                                                                                                  category
                                                 protection cover with a 90 day waiting
self-employed at the time of application,        period and a two year benefit period             To be eligible for cover under the own
plus 10% superannuation contributions,           subject to the eligibility criteria on page      approved occupation category, you must
subject to a maximum of $30,000 per              6 being met.                                     satisfy the approved occupation criteria of a
month (inclusive of superannuation                                                                gross annual salary of at least $75,000 and
                                                 If your gross annual salary is below             work in one of the approved occupations
contributions).
                                                 $42,350, the $3,000 per month                    listed on page 28. The own approved
Gross annual salary means annual salary          automatic cover will be more than you            occupation category only applies to benefit
before tax and excludes commissions,             are entitled to receive in the event of a        periods of five years or to age 65.
bonuses, investment, interest income and         claim. You should consider whether this
employer SG contributions you were               level of cover is appropriate for you.           In the event of an income protection claim
receiving immediately before the date you                                                         under the own approved occupation
ceased work as a result of injury or illness.                                                     category, you will be entitled to the income
For members employed in a casual capacity       Benefit payment period                            protection benefit if the Insurer considers
the annual salary is calculated as the                                                            that you are unable to undertake the regular
                                                You can apply for a benefit payment period
average salary earned in the previous 12                                                          duties of your own occupation, rather than
                                                of up to two years, up to five years or up
months immediately before the date you                                                            any occupation. This may appeal to you if
                                                until age 65. If you make a successful
ceased work as a result of injury or illness.                                                     you work in a specialised occupation and
                                                income protection claim you will receive
                                                                                                  your earning capacity would be significantly
In the event of a successful claim, income      benefit payments for your selected benefit
                                                                                                  less in any other field.
protection benefits will be limited to the      payment period, subject to you meeting the
lesser of the amount of cover you have          criteria for ongoing payment of a benefit.
applied for and 75% of your gross annual        Benefits are paid monthly in arrears.             What will income protection
salary at the time of disability, plus 10%      A two year benefit period has a lower
                                                                                                  cover cost me?
superannuation contributions, to a              premium than a five year benefit period or        Income protection premiums are calculated
maximum of $30,000 per month inclusive          a benefit period to age 65.                       based on your age last birthday, level of
of superannuation contributions.                                                                  cover, the benefit period, the waiting period
This means, if you have a higher level of                                                         and the occupation category (general,
cover and your salary decreases, you will                                                         approved or own approved).
not receive the higher level of income                                                            Table 3 on page 20 shows how much
protection cover.                                                                                 income protection insurance will cost you
                                                                                                  per week for each unit of cover (each unit
                                                                                                  of cover is worth $500 per month).




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