insurance guide - ngs super · insurance guide 3 this guide is for: new members who join ngs super...
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INSURANCE GUIDE 1
INSURANCE
GUIDE
NGS Super Insurance Guide Issued 1 April 2020
This document forms part of the Product Disclosure Statement dated 1 April 2020
INSURANCE GUIDE 2
ABOUT THIS INSURANCE GUIDE
Important informationYou should consider all the information contained in the Product Disclosure Statement dated 1 April 2020 and incorporated fact sheets before making a decision about insurance with NGS Super. Please read this document carefully. Your cover depends on your eligibility, TAL agreeing to provide you with this cover, and the terms and conditions of the Policy.
The information provided in this Guide is general information only and does not take into account your objectives, financial situation or needs. Before making a financial decision, please assess the appropriateness of the information to your individual circumstances and consider seeking professional advice.
NGS Super Pty Limited, ABN 73 549 180 515 is the trustee of NGS Super (Fund) and has partnered with TAL Life Limited, ABN 70 050 109 450, AFSL 237848, (TAL) a registered life insurer. TAL and the Trustee of NGS Super agreed to enter into a group insurance arrangement for the purpose of providing Life/TI, TPD and IP insurance cover to eligible Members of the Fund from 1 June 2017.
If there is any inconsistency between this guide and the Insurance Policy, the full terms and conditions contained in the relevant Policy will prevail to the extent of the inconsistency.
NGS Financial Planning Pty Ltd, ABN 89 134 620 518, is a corporate authorised representative #394909 of Guideway Financial Services Pty Ltd, ABN 46 156 498 538, AFSL #420367 and offers financial planning services on behalf of NGS Super ABN 73 549 180 515.
You should refer to the Product Disclosure Statement (PDS), Guides and Fact sheets at ngssuper.com.au/PDS or request a copy from us on 1300 133 177.
CONTENTS1. NGS Super Insurance Guide .................................................................................................................... Page 3
2. Your cover through NGS Super ............................................................................................................... Page 4
3. Managing your insurance ......................................................................................................................... Page 5
4. NGS Super Default Cover ....................................................................................................................... Page 6-7
5. Your Default Cover category ................................................................................................................... Page 8
6. Are there any limitations on my Default Cover ..................................................................................... Page 9
7. Default Cover levels over time ................................................................................................................ Pages 10-11
8. Your cover in practice ................................................................................................................................ Page 12
9. Life/TI and TPD cover................................................................................................................................ Page 13
10. Income Protection cover ........................................................................................................................... Page 14
11. Life/TI and TPD Fixed Cover option ....................................................................................................... Page 15
12. Your IP cover in detail – Member options ............................................................................................... Page 16
13. Applying for and changing cover ............................................................................................................ Page 17-18
14. Can I transfer other insurance cover I have?........................................................................................... Page 19
15. What is life event cover ............................................................................................................................. Page 20
16. When does cover cease ............................................................................................................................ Page 21-22
17. Cover for your flexible work patterns ...................................................................................................... Page 23
18. Making a claim ........................................................................................................................................... Page 24-25
19. Terminal illness claim ................................................................................................................................. Page 26
20. Benefit payments ....................................................................................................................................... Page 27
21. Insurance cover tables and costs ............................................................................................................. Pages 28-39
22. Glossary: Definitions .................................................................................................................................. Pages 40-45
INSURANCE GUIDE 3
This Guide is for: ▪ new members who join NGS Super on
or after 1 April 2020, or ▪ existing members who don’t currently
have insurance and wish to apply for cover, or who wish to make changes to their cover.
It sets out the most important things you need to know about your cover, including what you’re covered for, options for you to vary your cover, what you can claim, how to make a claim, risks and costs.
Important informationThere may be words in this Guide you may not be familiar with. To help you understand these terms, we have defined them on pages 40-45 and they are in bold and italicised throughout the Guide.
1. NGS SUPER INSURANCE GUIDE
Worldwide coverYour cover will continue anywhere in the world, 24 hours per day, seven days per week, and your benefit payment will be subject to the terms of your cover.
Ex-QIEC Super membersIf you are an Ex-QIEC Super member and on 3 May 2019 you had insurance cover within QIEC Super, please refer to the Insurance Transition Guide for Ex-QIEC Super members dated 6 May 2019 for the terms and conditions that relate to your insurance cover unless you have changed your cover since becoming an NGS Super member.
INSURANCE GUIDE 4
Protecting your biggest asset – you!While most of us insure our homes and cars, we forget about the most important thing of all – our ongoing ability to work and earn an income.
And because life doesn’t always go to plan, insurance is there so you can feel more comfortable knowing whatever happens, you’ve got something to protect the assets you’ve worked hard for and the dreams you have yet to achieve.
NGS Super offers a range of flexible insurance options designed to provide protection for you and your beneficiaries (such as loved ones) against financial hardship if you are unable to work for a long period due to sickness or injury, become permanently disabled or die.
Three important types of financial protectionAs a member of NGS Super, you have access to three important types of financial protection:
▪ Life (including Terminal Illness – TI) cover can provide a lump sum in the event you die or become terminally ill;
▪ Total and Permanent Disablement (TPD) cover can provide a lump sum if you are permanently unable to work due to illness or injury; and
▪ Income Protection (IP) cover can provide you with an income if you are temporarily (or permanently) unable to work due to an illness or injury.
If you die, become terminally ill or totally and permanently disabled, Life, TI and TPD cover can provide a lump sum to help protect your family’s financial situation through the tough times.
Note that any Life cover you have will be reduced by the amount of any TPD or Terminal Illness benefit payment made. Please refer to page 27 for more details.
If you suffer an accident or illness that stops you from working, IP cover can provide up to 90% (including up to 10% super contribution) of your Pre-Incapacity Income, giving you the financial assurance to concentrate on your health.
If you become totally and permanently disabled, and have both:
▪ income protection cover, and ▪ total and permanent disablement
cover,
then both benefits, subject to claim approval, are payable.
Flexibility to suit your lifestyle When you join NGS Super, you will receive a Welcome Letter which includes details of your insurance category which determines your level of Default Cover if eligible.
We offer Default Cover that is a needs-based insurance package to protect you throughout your working life. If you are eligible to receive Default Cover, it will change automatically depending on your age and as you approach retirement.
Your IP and TPD benefits are designed to work together, as one provides a regular income and the other provides a lump sum payment. A long-term IP Benefit Payment Period (up to 5 years) will help meet any future living expenses through regular income payments. A TPD benefit will help you manage other financial costs associated with a permanent inability to work through a lump sum payment amount. These may include alterations to your home, or ongoing medical costs.
You also have the option to vary the level of your cover/s (up or down) at any time to suit your current needs, subject to application approval.
2. YOUR COVER THROUGH NGS SUPER
Special offer to increase your Default CoverYou first become eligible for Default Cover either:
▪ by opting-in to receive Default Cover. This election is to be done within 120 days of the date of your Welcome Letter and successfully completing the Insurance New Member Option form, or
▪ when your account balance is more than $6,000, and you are at least 25 years of age.
You can apply to increase your Default Cover by satisfactorily completing a few health questions within 120 days of first being eligible for Default Cover by completing the Insurance New Member Option form available at ngssuper.com.au/forms
INSURANCE GUIDE 5
3. MANAGING YOUR INSURANCE
Seek adviceIf you are thinking about reviewing your insurance, consider obtaining professional advice to understand what you need and the cost for your personal situation.
We offer:
▪ insurance advice limited to your NGS Super cover at no cost over the phone through our Financial Advice Helpline, or
▪ low-cost tailored advice through NGS Financial Planning for insurance held inside and outside of superannuation.
To make an appointment phone us on 1300 133 177 or complete the Financial planning enquiry form on our website at ngssuper.com.au/financial-planning
Partnering with TALWe’ve partnered with TAL, a leading Australian life insurer, to provide you with insurance cover specifically designed to meet the needs of all our members. Like NGS Super, TAL understands that you are at the heart of everything we do. TAL has been protecting people for over 140 years, and today they insure almost four million Australians.
Making managing your insurance easy for youWe make applying to change your insurance cover in NGS Super simple.
Simply log in to your account via ngssuper.com.au/MOL and go to the Insurance page and navigate to the TAL insurance portal button.
Through the TAL insurance portal you can apply to:
▪ decrease or cancel your insurance cover ▪ change your insurance category, and if accepted this may reduce your
insurance premiums and in some cases, increase your sum insured ▪ fix your insurance cover ▪ take advantage of the options available to you for a limited time when you
receive Default Cover ▪ increase your insurance cover through underwriting ▪ increase your insurance cover due to a Life Event ▪ transfer cover from another insurance provider including another
superannuation fund ▪ be underwritten for insurance cover if you are not eligible to receive Default Cover
▪ make a claim; and ▪ make an Inactive Account Election to Opt-in to keep cover even if your
account becomes Inactive.
You can also see how a previous application is progressing and upload additional information if requested, and submit an insurance claim.
TAL insurance portal w
How much is enough? The NGS Super Default Cover package is designed to provide you with a level of protection that changes automatically throughout your stages of life.
But life can change quickly – you may marry, get a salary increase, have a baby or buy a house! So from time to time, you may want to adjust your level of cover.
Not sure by how much? Try our Insurance quote calculator at ngssuper.com.au/calculators or speak to one of our NGS Financial Planners or call our Customer Service Team on 1300 133 177.
Made easy for you
INSURANCE GUIDE 6
4. NGS SUPER DEFAULT COVER
* If you do not satisfactorily answer the health questions and you choose to submit your form, you will not then be eligible for Default Cover, even once you are over age 25 and have an account balance of greater than $6,000. You can apply for insurance cover by completing an Insurance Increase Cover form which includes a Personal Statement or by applying online through your Member Online account. Your application for cover will be subject to acceptance by the insurer and you will no longer be eligible for Default Cover.
^ If you were an existing member of NGS Super at 1 June 2017, and at that date were aged 60 or above, the maximum age at which any 5-year IP benefit will expire is at age 65.
Insurance premiums will be deducted weekly in arrears from your account until cover ceases.
Default Cover
FeaturesLife (includes Terminal Illness)
Total and Permanent Disablement (TPD)
Income Protection (IP) If you are unable to work because of an injury or illness
Eligibility age 15-69 15-64 15-66
Fund criteria You are an employee of an employer who makes superannuation contributions to NGS Super on your behalf.
Insured amount Aged based cover sum insured amount that changes over time depending on your age.
Type of benefit paid Lump sum Lump sum Monthly income (up to 90% of your Pre-Incapacity Income which includes up to 10% super contribution)
90 day Waiting Period Benefit Payment Period of up to 5 years, subject to the maximum cover expiry age
Cover expiry age 75 67 67^
When is insurance provided?
When you first become an eligible member. This means if joining from 1 April 2020:
1. and elect to opt-in to receive Default Cover by successfully completing the Insurance New Member Options form* within 120 days of your Welcome Letter. You will need to elect to opt into cover if you:
- are under age 25, or
- have an account balance less than $6,000. OR
2. provided automatically (no health evidence) when you have attained:
- at least age 25, and
- an account balance greater than $6,000.
Commencement of automatic cover
Default Cover starts on the later of:
a) the date that you become first eligible, and b) the beginning of the period to which the first employer contribution is received after you become first eligible.
Limited Cover Limited Cover may apply.
Active employment You will need to meet the Active Employment definition to remove Limited Cover.
Other important information Refer to page 9 for other important information relating to Default Cover.
INSURANCE GUIDE 7
Active Employment means
▪ you are employed to carry out identifiable duties,
▪ you are actively performing or capable of performing those duties, and
▪ in TAL’s opinion, you are not restricted by illness or injury from carrying out those duties for at least 30 hours per week, or the duties of your usual occupation, even if you are then not working on a full time basis.
Limited Cover means you are only covered for life/terminal illness, disability (TPD) and/or income protection arising from an illness that first becomes apparent or an injury that first occurs on or after the date your cover last commenced, recommenced or increased under the Policy.
Active Employment
Example: Meet Jane
Prior to starting her new job, Jane had arranged a holiday and was on leave without pay during her first week at her new job and when cover commenced. At the end of her holiday, Jane returned to work.
Jane’s insurance cover is full cover because she was in Active Employment when cover commenced.
Despite not being at work when insurance cover commenced, Jane is considered to have been in Active Employment for that period because she was capable of working at least 30 hours per week.
Age based eligibility
Jane started working as a school administrator when she was 65. Jane first joins NGS Super when commencing her new employment. Jane is given Life / TI cover and IP cover when she joins NGS Super but is not eligible for TPD cover because she is older than 64.
Can I apply for cover if I am not eligible to receive Default Cover, or apply for additional cover? If you do not meet the eligibility requirements for Default Cover, or you want to increase or change your cover, you can apply for cover. You’ll need to provide Evidence Of Good Health for TAL to assess and other conditions may also apply. You will receive Fixed Cover if TAL agrees to provide insurance. Cover is also subject to you having enough money in your Accumulation account to pay the ongoing cost of premiums.
You can apply through Member Online, or by completing an Insurance Increase Cover form which includes a Personal Statement available on our website. Your cover will start on the date TAL accepts your application.
4. NGS SUPER DEFAULT COVER (continued)
Not in Active Employment
Example: Meet Emma
Emma was accepted for a new teaching position. Emma’s new employer contributed to NGS Super on her behalf and Emma was given default insurance cover.
Emma had previously been diagnosed with a degenerative disease which prevented her from going to work on her first day of employment (and therefore when her insurance cover commenced). Emma’s cover will be Limited Cover until she has been in Active Employment for at least 14 consecutive days.
While her cover is Limited Cover, Emma will be unable to claim in relation to any pre-existing illnesses or injuries.
Cover commencing more than 120 days after employment started
Example: Meet Noah
Noah joined NGS Super and was given Limited Cover because his first SG Contribution was paid to NGS Super more than a year after commencing work with his employer.
Noah’s cover will continue to be Limited Cover until two years has passed, at which point it will only become full cover after he has been in Active Employment for 14 consecutive days.
Noah was diagnosed with a disease prior to his cover commencing in NGS Super.
If Noah becomes Totally and Permanently Disabled in relation to the disease whilst he is on Limited Cover, he will be ineligible to claim a TPD benefit in relation to the disease.
However, if Noah becomes Totally and Permanently Disabled as a result of the disease after his cover becomes full cover, he will be eligible to claim in relation to the disease (subject to other terms and conditions).
INSURANCE GUIDE 8
Your Default CategoryIf you are an eligible NGS Accumulation account member, you will automatically receive one of two default categories that make up the NGS Default Cover package:
▪ NGS General, or ▪ NGS Plus.
The category you receive (NGS General or NGS Plus) depends on your employer’s insurance category in NGS Super, when you first join the Fund. This will be detailed in your Welcome Letter. The amount of cover you receive depends on your age when you first become an eligible member.
NGS Plus members and NGS General members can apply to join NGS Select (which offers reduced premium rates) as outlined in the table below.
Default categories
Your Employer Default Category
I work for an employer who has registered with NGS Super and who is:
▪ a school, a kindergarten, a P & C Association, or other body which provides education as its primary function; or
▪ a credit union, bank or other employer in the finance sector.
Your Default Category is NGS Plus.
You can apply to change your category to:
▪ NGS Select if: - your duties are limited to professional, managerial, teaching, administrative, clerical,
secretarial or similar ‘white collar’ tasks which do not involve manual work and are undertaken entirely (or at least 80%) within an office environment or classroom (excluding workshops); and
- your earnings* are $100,000 or more per annum.
You can apply online or by completing the Insurance Change Insurance Category form.
I work for an employer who operates in the aged, health and community care sectors; or
I work for an employer who is not:
▪ a school, a kindergarten, a P & C Association, or other body which provides education as its primary function; or
▪ a credit union, bank or other employer in the finance sector; or
I work for an employer who has not registered with NGS Super.
Your Default Category is NGS General.
If your duties are limited to professional, managerial, teaching, administrative, clerical, secretarial or similar ‘white collar’ tasks which do not involve manual work and are undertaken entirely (or at least 80%) within an office environment or classroom (excluding workshops), you can apply to change your category to:
▪ NGS Plus if your earnings* are less than $100,000 per annum, or
▪ NGS Select if your earnings* are $100,000 or more per annum.
You can apply online or by completing the Insurance Change Insurance Category form.
You can apply to change your default category through your Member Online account at ngssuper.com.au/MOL or by completing the Insurance Change Insurance Category form.
If you change your job or there is an increase in your salary in the future, you may also be eligible to apply to change your category. For example, if you join NGS Super and receive NGS General cover, you can apply to change your category to NGS Plus as long as your new job satisfies the NGS Plus requirements and subject to acceptance by TAL.
Special conditions apply if you are in the NGS General category and your Default Cover Multiple is not 1 or if you are on Fixed Cover. Further details can be found on the Insurance Change Insurance Category form.
5. YOUR DEFAULT CATEGORY
If you work for a school, kindergarten, P&C Association or other body which provides education as its primary function; or a credit union, bank or other employer in the finance sector, and you have been classified as NGS General, please complete the Insurance Change Insurance Category form to change your Default Category.
If accepted by TAL, changing your Default Category from NGS General to NGS Plus or NGS Select will result in a cheaper premium rate and in some cases an increase in your sum insured.
* Earnings that count for the $100,000 are in line with the earnings that count for Pre-Incapacity Income.
INSURANCE GUIDE 9
6. ARE THERE ANY LIMITATIONS ON MY DEFAULT COVERAre there any limitations on my Default Cover?Your Default Cover will be limited in the following circumstances:
If you have made a Default Cover Election to Opt-in, for Default Cover, where your employer contribution is received:
▪ within 120 days of the Default Cover Election to Opt-in, full cover will apply, ▪ outside of 120 days of the Default Cover Election to Opt-in, Limited Cover will
apply for 12 months. After 12 months, Limited Cover will continue until you have been in Active Employment for 14 consecutive days.
If you have not made an election and your Default Cover commences when you are an eligible member, your cover will be limited where your employer contribution is received:
▪ within 120 days of Cover Commencement Letter, your cover is Limited Cover until you have been in Active Employment for 14 consecutive days,
▪ outside of 120 days of the Cover Commencement Letter, your cover is Limited Cover for 24 months. After 24 months Limited Cover will remain until you have been in Active Employment for 14 consecutive days.
Your Default Cover will also be limited in the following circumstances:
▪ if your cover starts after you have received, or while you are receiving, or are entitled to receive, or are making a claim for benefits in relation to an illness or injury from any source, including the following: - benefits payable under a superannuation fund in respect of your
permanent incapacity or Terminal Medical Condition (both as defined in superannuation law),
- Total and Permanent Disablement or Terminal Illness type benefits from any superannuation fund or insurance company
then you will only be entitled to Life only cover and IP cover, both of which will be Limited Cover until you are underwritten and accepted by TAL. If these circumstances apply to you on joining, you will need to notify NGS Super;
▪ if in the five years prior to your Default Cover starting, you have claimed, or are eligible to claim, any income replacement benefit (the same or similar to NGS Super IP) under any insurance policy for a particular illness or injury, you won’t be eligible to receive any Income Protection benefit for the same or related illness or injury until you’ve been in Active Employment for 14 consecutive days after the date your cover with NGS Super starts.
You will not be eligible for automatic Default Cover where you are already an existing member of NGS Super. This includes if:
▪ you currently have an existing NGS Accumulation account (ie you are opening a second Accumulation account) or
▪ your NGS Accumulation account is established due to a transfer of funds from an existing NGS Income account or NGS Transition to Retirement account (regardless of whether you will have an employer that will commence making contributions to an NGS Accumulation account on your behalf).
INSURANCE GUIDE 10
Life/Terminal Illness default cover
NGS Plus/Select ($ cover)
NGS General ($ cover)
Total and Permanent Disability (TPD) default cover
NGS Plus/Select ($ cover)
NGS General ($ cover)
The following graphs show the Default Cover levels for Life/Terminal Illness cover and Total and Permanent Disability (TPD) cover and illustrate how these change over time – please refer to cover tables from page 28 for specific details of Default Cover amounts and premiums.
Your Life/TI and TPD cover options
Within 120 days of becoming eligible for Default Cover, you can apply to increase your Default Cover (subject to eligibility questions) by increments of 5% up to a maximum of two times your Default Cover.
See page 13 for more details.
7. DEFAULT COVER LEVELS OVER TIME
Age
Age
INSURANCE GUIDE 11
7. DEFAULT COVER LEVELS OVER TIME
NGS Plus/Select ($ cover per year)
NGS General ($ cover per year)
Income protection (IP) default cover (90 day Waiting Period and up to 5 year Benefit Payment Period)*
*Default cover is subject to a maximum of the higher of:
▪ up to 90% (including up to 10% super) of your Pre-Incapacity Income reducing to 70% of your Pre-Incapacity Income after age 65; and
▪ $41,000 per month.
Regardless of your Benefit Payment Period, your IP payment will always cease on your Cover Expiry Age.
Please note, your benefit amount may be reduced if:
▪ you are not Gainfully Employed and are not in receipt of any eligible income, as any claim for IP could be based on a reduced or nil income, as it is calculated on your Pre-Incapacity Income.
▪ you are receiving Other Disability Income from other sources while you are eligible for an IP payment.
Tax will be deducted from the amount before you receive your payment.
The following graph shows the Default Cover level for Income Protection and how this changes over time – please refer to cover tables from page 28 for specific Default Cover amounts and premiums.
Age
INSURANCE GUIDE 12
Income protection insurance claim examples
Example 1: Meet Sonia
Sonia recently celebrated her 44th birthday, and earns an annual income of $75,000 a year as Head of Music at a local primary school. Not long after her birthday, Sonia was involved in a serious car accident which stopped her from working for eight months.
Luckily, as a member of NGS Super, she was eligible for default NGS Plus Income Protection (IP) cover of $72,000 per annum, designed to provide up to 80% of her salary (plus 10% in super contributions) for up to $80,000 worth of income, if she became unable to work due to illness or injury.
Sonia called NGS Super to make a claim as soon as she discovered her injuries were severe enough that she wouldn’t be able to return to work for some time. Sonia’s maximum benefit will be at the rate of 90% of $80,000 which is $72,000 a year or $6,000 a month. However, as NGS income protection cover is subject to a maximum of 90% of your annual income, her cover provides an income at the rate of 90% of $75,000 which is $67,500 a year, or $5,625 a month, after expiry of the Waiting Period.
Once her default Waiting Period of 90 days completed, Sonia received $5,000 (80% of her monthly salary) monthly
benefit and the remaining benefit of $625.00 was paid into her superannuation account. This allowed her to continue meeting her mortgage payments and other living expenses until she could return to work.
Example 2: Meet Peter
Peter is age 30, earning $55,000 a year. He has NGS General default IP cover of $48,000, giving him salary cover of $53,333. While skiing with friends in Japan, he fractures his leg and can’t work for six months.
Peter’s maximum IP benefit will be at the rate of 90% of $53,333, which is $48,000 a year or $4,000 per month. His cover provides an income at the rate of 80% of $55,000, which is $44,000 a year, or $3,667 a month, after expiry of the Waiting Period. Since the maximum he is entitled to is $48,000 per year, the remaining benefit allows for super contributions of $4,000 a year or $333 a month.
Since Peter’s salary is higher than his IP cover, his IP benefit works out to be less than 90% of his annual salary. Had he successfully applied for additional IP insurance to cover 90% of his salary, he would have been eligible for the full benefit of 90% of his annual salary (80% income and 10% super).
Example 3: Meet Tom
Tom is age 50 and earns $102,000 working in the maths department (including a position of responsibility) at a local secondary school, with $72,000 of annual NGS Plus IP cover, which is designed to provide up to 80% of salary (plus 10% super contribution) up to a maximum salary of $80,000.
Due to his occupation and income level, Tom applies for NGS Select premium rates and is accepted as an NGS Select member. Tom however, decides to maintain his existing level of cover.
Tom is unable to work for ten months due to illness. 80% of Tom’s Pre-Incapacity salary is $81,600, or $6,800 per month. However, the maximum benefit Tom is entitled to is $72,000 of annual NGS Select IP cover a year or $6,000 a month. In Tom’s case, his cover is not enough to cover 80% of his Pre-Incapacity salary so he is not eligible for any super contribution benefit. This leaves Tom with an IP gap and, once his Waiting Period was complete, a maximum monthly gross taxable benefit of $6,000 ($72,000/12) and nil super. Had he successfully applied for additional IP insurance to cover 90% of his salary, he would have been eligible for the full benefit of 90% of his annual salary (80% income and 10% super).
New member example
Example: Meet Carol
Carol, aged 33, works in the principal’s office at a local girl’s secondary school which provides for a default category of NGS Plus. Given her default category and her age, Carol is entitled to receive (if she is in Active Employment and on the date her cover commenced receives an Employer Contribution for Carol from her employer related to a period within 120 days of joining her employer) automatic default NGS Plus Life/TI cover (totalling $570,000) and TPD cover (totalling $160,000) when she joined NGS Super, at a cost of $3.78 per week.
When Carol turns 34, the total value of her Life/TI and TPD will remain the same, based on her age, but her premium will increase to $4.03 per week. Later on in her membership when Carol turns 44, the total value of her Life/TI cover is now $510,000 and TPD is $130,000, based on her age, at a cost of $8.31 per week.
Carol also has the option to change to Fixed Cover if she wishes to maintain a particular cover level. In addition, Carol would also be eligible for Income Protection (IP) cover.
8. YOUR COVER IN PRACTICE
INSURANCE GUIDE 13
9. LIFE/TI AND TPD COVER
Your Options
New Member options Within 120 days from the date of you being eligible for Default Cover, you can apply to increase your Default Cover (subject to eligibility questions) by increments of 5% up to a maximum of two times your Default Cover. If you exercise this option, you will be allocated a Default Cover Multiple.
The maximum cover limits if you use the Default Cover Multiple approach is:
▪ Life cover – up to $1.14 million
▪ TPD cover – up to double the amount of the Default Cover.
In addition, Fixed Cover options are available subject to a maximum cover limit of:
▪ up to $1.14 million for Life cover and ▪ up to $400,000 for TPD cover.
All your Life/TI and TPD cover will be converted to Fixed Cover if you select this option.
Applying to increase cover
Applying for cover where:
▪ you are not eligible for Default Cover, or
▪ you require cover in addition to Default Cover, or
▪ where you have previously cancelled cover.
To take advantage of this special offer for additional cover, simply apply within 120 days of you being eligible for Default Cover. You can apply:
▪ through the TAL insurance portal button in Member Online if you joined NGS Super prior to 1 April 2020, or you received your confirmation of insurance letter, or
▪ by completing the Insurance New Member Option form.
Example:
A teacher who is aged 46, elects to obtain Default Cover within 120 days of the Welcome Letter. As their insurance category is NGS Plus, the Default Cover they would be eligible for:
▪ $480,000 Life, and
▪ $130,000 TPD.
When they make the election, on the same form (New Member options form) the member decides to increase their cover. The following outlines the effect on the level of cover under the options to increase cover:
▪ Life cover increased by 25% = $600,000 (which is 125% of $480,000) and▪ TPD cover increased by 100% = $260,000 (which is 200% of $130,000).
When the member turns 47, the value of their cover at that age will reduce based on their age:▪ Life Cover = $575,000 (125% of Default Cover level of $460,000) and▪ TPD cover = $240,000 (200% of Default Cover level of $120,000).
Alternatively, instead of using the increment of Default Cover Multiple approach, the member at age 46 could choose to apply for Fixed Cover at $600,000 Life cover and $260,000 TPD. Then when the member turns 47, the sum insured amount would not change, however, the cost of the cover would increase.
You can apply for cover if you are aged between 15 and 66 (for TPD) and 15 and 74 (for Life):
▪ through Member Online, or
▪ by completing the Insurance Increase Cover form.
All your Life/TI and TPD cover will be converted to Fixed Cover if you select this option.
INSURANCE GUIDE 14
10. INCOME PROTECTION COVER
Your Options
New Member Options You have the option to increase your IP cover within 120 days of becoming eligible for Default Cover:
Option 1 – subject to your income level supporting your requested cover level, if you are:
▪ an NGS Plus or NGS Select member with Default Cover, and
▪ you are aged 27 to 64,
you can apply for additional cover up to a maximum total insured cover of $86,000 per annum; or
Option 2 – subject to eligibility questions and your income level supporting your requested cover level, you can apply for cover up to a maximum total insured cover of $120,000 per annum. The increased amount together with your existing cover amount, cannot exceed the amount of $120,000 per annum (referred to as the Conditional Acceptance Limit).
Applying to increase cover
Applying for cover where:
▪ you are not eligible for Default Cover, or ▪ you require cover in addition to Default Cover, or
▪ where you have previously cancelled cover.
You can apply for cover if you are aged between 15 and 66:
▪ through Member Online, or
▪ by completing the Insurance Increase Cover form.
All your IP cover will be converted to Fixed Cover if you select this option.
You can apply for additional cover:
▪ through the TAL insurance portal button in Member Online, if you joined NGS Super prior to 1 April 2020, or you received your confirmation of insurance letter, or
▪ by completing the Insurance New Member Option form.
All your IP cover will be converted to Fixed Cover if you select this option.
INSURANCE GUIDE 15
11. LIFE/TI AND TPD FIXED COVER OPTION
Cover Fixed CoverAge-based Default Cover
Interim Accident Cover (when applying for Fixed Cover)^
Life/TI and TPD
Life/TI cover remains the same from year to year until you reach age 75. At this age, cover reduces to nil and premiums (which are payable weekly in arrears) will cease.
TPD cover remains the same until age 61, at which time a sliding scale applies (refer to below table for further details) until age 67, when the benefit becomes nil.
Premiums vary based on your age at your last birthday each year.
Health evidence may be needed before cover is provided.
The cost of cover is dependent on your age, and will likely change most years.
The value of your cover is also dependent on your age, and changes at certain ages as outlined in the Insurance cover tables and costs from page 28.
Cover continues until age 75 for Life/TI cover, and to age 67 for TPD cover. At these ages cover reduces to nil.
In some cases, you will also have a Default Cover Multiple and this will be advised to you on your Annual Member Benefit Statement.
This cover is provided for up to 120 days while TAL is assessing your request for cover.
The amount of accident cover is:
▪ the lesser of the amount of cover you’ve applied for; or
▪ $2,000,000 less any existing amount you are already insured for (conditions apply).
Terminal Illness cover is not included.
Life/TI only
Life/TI cover remains the same from year to year until you reach age 75. At this age, cover reduces to nil and premiums (which are payable weekly in arrears) will cease.
Premiums vary based on your age at your last birthday each year.
Health evidence may be needed before cover is provided.
TPD only TPD cover remains the same until age 61, at which time a sliding scale applies (refer to below table for further details) until age 67, when the benefit becomes nil and premiums (which are payable weekly in arrears) will cease.
Premiums vary based on your age at your last birthday each year.
Health evidence may be needed before cover is provided.
Insurance cover provided to eligible members is age based cover (where the sum insured changes automatically depending on your age) to Fixed Cover (where the sum insured will not change each birthday).
The table below shows the life/TI and disability (TPD) cover choices available.
If you have Fixed TPD cover then your TPD sum insured will be reduced from age 61 onwards, as shown in the following table:
Age last birthday Proportion of Fixed disability (TPD) cover that applies
60 full sum insured
61 80%
62 60%
63 40%
64 20%
65 20%
66 20%
67 Nil
If you apply for a change of insurance category, special conditions apply if you are on Fixed Cover or if you are in the NGS General category and your Default Cover Multiple is not 1.
Refer to the Insurance Change Insurance category form for details.
^ For more information, refer to page 17.
INSURANCE GUIDE 16
12. YOUR IP COVER IN DETAIL – MEMBER OPTIONS With our IP cover, you may be able to apply to change how long you have to wait before you start receiving payments, and how long you will receive benefits. In most instances (i.e. where you select a shorter Waiting Period or longer Benefit Payment Period option) you will need to provide Evidence Of Good Health before TAL will agree to provide it. Other conditions may also apply.
If you are not Gainfully Employed and you are not in receipt of any eligible income you may not be eligible for an IP benefit.
The table below shows the IP cover choices available
Feature
Amount of cover Your cover up to age 65 provides an income protection benefit of up to 90% (including up to 10% super contribution) of your Pre-Incapacity Income. For any benefit payable between age 65 and 67, the cover maximum reduces to 70% of your Pre-Incapacity Income (nil super contribution).
If you are eligible for Default Cover when you open your NGS Accumulation account, you receive default IPcover providing the following benefits:
Default Cover 90 day Waiting Period – up to 5 year Benefit Payment Period.
Length of Waiting Period options before payments commence
90 days 60 days 30 days
Benefit Payment Period optionsPlease see page 22 for details of how your cover expiry age affects your Benefit Payment Period.
Up to 2 years Up to 5 years Up to age 65 Up to age 67
The maximum monthly benefit you can receive (subject to application and acceptance) is: ▪ $41,000 per month for up to 2 years or up to 5 year Benefit Payment Period options; or ▪ $31,000 per month for up to age 65 and 67 Benefit Payment Period options.
Benefit Payment Period will end the earliest of the following days: (a) the day you are no longer Totally Disabled or Partially Disabled (as applicable).(b) the day your Benefit Payment Period ends;(c) the day you reach the cover expiry age (as applicable); and(d) the day you die.
New member options You have the option to increase your IP cover within 120 days of becoming eligible for Default Cover:Option 1 – subject to your income level supporting your requested cover level, if you are: ▪ an NGS Plus or NGS Select member with Default Cover, and ▪ you are aged 27 to 64,
you can apply for additional cover up to a maximum total insured cover of $86,000 per annum; orOption 2 – subject to eligibility questions and your income level supporting your requested cover level, you can apply for cover up to a maximum total insured cover of $120,000 per annum. The increased amount together with your existing cover amount, cannot exceed the amount of $120,000 per annum (referred to as the Conditional Acceptance Limit).
Interim Accident CoverThis cover is provided for up to 120 days while TAL is assessing your request for cover.
▪ The amount of accident cover is the lesser of: - the amount of cover you’ve applied for; or - $15,000 per month less any existing amount you are already insured for (conditions apply)
up to a maximum Benefit Payment Period of two years and has a 90 day Waiting Period.
Other Disability Income Offsets Your income protection benefit from NGS Super will be reduced by income from other sources including: ▪ paid sick leave ▪ amounts paid or payable under legislation such as workers’ compensation or motor accident compensation
▪ benefits you may receive or any other income, which in the insurer’s opinion, you could reasonably be expected to earn while you are Totally or Partially Disabled
▪ any benefits payable under other income protection insurance policies.
Payment of income protection benefits
The Waiting Period begins when a Medical Practitioner declares you are unable to carry out your usual work functions. Generally, the Benefit Payment Period begins after expiration of the Waiting Period and the Benefit is paid monthly in arrears. Please refer to page 45 for full definition of Waiting Period.
For all Benefit Payment Periods except for up to 2 years, your benefit amount will increase annually by the lower of 5% or CPI whilst you are receiving a benefit.
INSURANCE GUIDE 17
13. APPLYING FOR AND CHANGING COVER You can apply:
▪ for insurance cover (if you are not eligible to receive Default Cover)
▪ to increase your insurance cover ▪ to change your insurance category ▪ to take advantage of options available
to you as a new member within 120 days of your Welcome Letter or Cover Commencement Letter, whichever is relevant to your situation.
▪ to fix your insurance cover (see page 35) ▪ for additional cover due to a Life Event
(including a salary increase) ▪ to transfer cover from another provider.
You can also choose to:
▪ opt-in to receive Default Cover as a new member
▪ make an Election to Opt-in to Default Cover to keep your insurance cover even if your account becomes Inactive
▪ decrease or cancel your insurance cover ▪ decrease your Default Cover Multiple
of Default Cover ▪ make an Inactive Account Election
to Opt-in to insurance cover if your account has a low balance (under $6,000), or before it becomes Inactive.
The table below shows insurance forms that are available and their purpose
Form name Who should use this form Further information
Insurance New Member Options form
If you are a new member (and are eligible for Default Cover) applying within 120 days of the date of your
▪ Welcome Letter to opt-in to receive Default Cover and apply to increase cover, or
▪ Cover Commencement Letter to apply to increase cover.You can also:
▪ change your insurance category ▪ change from age-based cover to Fixed Cover.
Any change to your Income Protection cover will result in your cover being converted to Fixed Cover. You may choose to have Life and TPD converted to Fixed Cover.More details can be found on pages 13 and 14.
Insurance Change Insurance Category form
Members who are eligible to change the category of their insurance, which will result in reduced premiums.
The sum insured may change.More details can be found on page 8 under the heading Your default cover category.
Insurance Increase Cover form
If you do not have insurance (eg Personal division members) or if you have insurance and want to apply to:
▪ increase your sum insured amount, or ▪ reduce your Income Protection Waiting Period, or ▪ increase your Income Protection Benefit Payment Period.
Any change will result in your cover being Fixed Cover.More details can be found on pages 13 and 14.
Insurance Reduction or Cancellation form
If you have insurance and want to apply to:
▪ decrease your Default Cover Multiple ▪ decrease your sum insured amount (including cancel cover), or ▪ increase your Income Protection Waiting Period, or ▪ decrease your Income Protection Benefit Payment Period.
Any change (except cancel cover or decrease in your Default Cover Multiple) will result in your cover being Fixed Cover.
Insurance Change form (Fixed Cover)
If you have insurance and want to change your cover from age-based cover to Fixed Cover.
Premium costs can be found on pages 35-39.
Life Events Cover Options form
If you have insurance and would like to increase your sum insured amount due to a significant life event.
You must apply within 90 days of the life event occurring.Any change will result in your cover being Fixed Cover.More details including eligibility can be found on page 20.
Insurance Transfer form
If you have insurance cover outside of NGS Super and wish to transfer your external cover to NGS Super.
Any change will result in cover being converted to Fixed Cover. More details including eligibility can be found on page 19.
Opt-In Form (Inactive Account Election)
If you want to keep your insurance cover through NGS Super even if your account is (or becomes) Inactive.
If you opt-in to maintain your insurance cover, it will not be cancelled due to your account becoming Inactive.
Save time, apply onlineApplying to vary your insurance via the Member Online portal is quick and easy. Simply login via ngssuper.com.au/MOL and follow the prompts.
If you choose to decrease or cancel your insurance cover, you will only be eligible to go back to your original cover (which will be Fixed Cover) by applying for underwritten cover. Your application will be subject to Evidence of Good Health and there is no guarantee you will receive the cover again.
You can make these changes through Member Online, or if you prefer, you can also make changes using our forms which you will need to complete and return to us. Further details are provided below with reference to additional information within this Guide. Our forms are available on our website at ngssuper.com.au/forms
INSURANCE GUIDE 18
You can apply to increase your sum insured amount or choose to decrease your sum insured amount through Member Online at any time.
There are also offers where (with limited health evidence) you can increase your cover. If you are under age 60, you have the option to change your cover when a Life Event takes place or by completing an Insurance transfer (both these options are explained in further detail below).
Except in situations where you are reducing your cover, TAL may require additional information in relation to your health status to further assess your application. This may include a medical examination, but will depend on the level of cover or the type of change you’re applying for. You’ll need to provide all requested information so TAL can assess your application accurately. Your application may be declined if you don’t provide certain information, or if your request is unclear or not signed.
Once TAL has assessed your application, we’ll let you know the outcome and you will also be contacted if any special conditions, restrictions or exclusions will apply. Your insurance premiums will be adjusted accordingly.
Keep in mind that if you reduce or cancel your cover, you’ll need to provide TAL with updated information on your health if you decide to increase your NGS Super cover again in the future. Acceptance is not automatic.
Interim Accident coverIf you are an eligible NGS Accumulation account member, you may receive Interim Accident Cover during your application for cover. This is designed to provide you with some level of protection while TAL assesses your request.
A Benefit for Interim Accident Cover will not be payable if:
▪ death or Total and Permanent Disablement can reasonably be attributed to a Pre-Existing Condition;
▪ had the relevant underwriting process been completed and had TAL granted cover, a Benefit would not have been payable because:i. of any exclusions, loadings,
restrictions or additional conditions that TAL would have applied including but not limited to any current Limited Cover restrictions and exclusions; or
ii. you fail to comply with their disclosure obligations under the Insurance Contracts Act 1984 (Cth), as amended from time to time, when applying for cover.
Amount of accident cover
Life/TI and TPD
the lesser of:
▪ the amount of cover you’ve applied for; or
▪ $2,000,000 less any existing amount you are already insured for.
IP the lesser of:
▪ the amount of cover you’ve applied for; or
▪ $15,000 per month less any existing amount you are already insured for,
up to a maximum Benefit Payment Period of two years and with a Waiting Period of 90 days.
Interim Accident Cover commences as soon as TAL receives your fully completed application.
If you become entitled to make a claim for a benefit under your Interim Accident Cover, your application for cover will automatically be cancelled.
Can I still apply for cover once I turn 70?If you are age 70 or older when you start an NGS Accumulation account, you can only receive life cover if you apply and are accepted for it by TAL – in which case cover would apply through until age 75.
You can do this by applying:
▪ through Member Online, or ▪ by completing the Insurance increase
cover form.
13. APPLYING FOR AND CHANGING COVER (continued)
INSURANCE GUIDE 19
13. APPLYING FOR AND CHANGING COVER (continued)
14. CAN I TRANSFER OTHER INSURANCE COVER I HAVECan I transfer other insurance cover I have?If you are under age 602 you can apply to have your other life cover, TPD or IP insurance cover ‘transferred’ into your NGS Accumulation account.
Acceptance of your transfer request will depend on whether TAL accepts your application, and some limitations may apply. The amount of the total sum insured after the transfer of cover cannot exceed:
▪ $2 million for life and TPD cover; and ▪ $15,000 per month for IP.
For cover above these limits, you will need to apply and be accepted by TAL by completing an Application to increase cover.
Provided you meet the following conditions at the time your application was completed and received by TAL, your cover will generally be accepted where:
▪ you are in Active Employment ▪ you are not working in a Hazardous
Occupation ▪ you have not been diagnosed with, nor
are suffering from, any illness or injury that may cause permanent inability to work within the next 24 months
▪ you are not terminally ill with a life expectancy of less than 12 months
▪ in the last 10 years prior to the date of your application you have never received, nor are eligible to receive, any payment for an illness, injury or accident benefit from the following: - workers compensation - government benefits (such as sickness
benefit, invalidity pension) - motor accident scheme - superannuation fund - life insurance policies
▪ you have not within the last 12 months been absent from your usual occupation (employed or unemployed) for more than 10 consecutive days due to an injury or illness
▪ the amount you want to transfer isn’t more than the maximum level of cover permitted by NGS Super
▪ once the new cover transferred from another super fund has been confirmed in writing as accepted by TAL, you transfer the total available account balance (where applicable) of this fund into your NGS Accumulation account within 60 days
▪ you do not reinstate, transfer or take a continuation option for the insurance cover (in your former fund and/or insurer), from any former fund and/or insurer other than through NGS Super
▪ you provide evidence of your current cover which has not been issued more than 60 days previously.
To ensure there is no gap in your protection, any cover held in your former fund and/or insurer should only be cancelled once your new cover has been confirmed as accepted by TAL.
If TAL accepts your application, you’ll receive an amount of cover equivalent to the level of cover currently held with your former fund and/or insurer. Any special conditions such as exclusions or Limited Cover will continue to apply to the transferred cover.
If you are transferring death only, disability only or combined death and disability cover, transfer cover will apply in addition to any existing cover you may hold under your NGS Accumulation account.
If you are transferring IP cover, transfer cover will replace existing cover in your NGS Accumulation account. Where the waiting and benefit payment periods match your existing NGS Super cover, the transfer cover will be added (subject to your income level supporting requested cover level). The below outlines your waiting and benefit payment periods where there is no equivalent:
▪ there is no equivalent benefit period, the benefit period will be the next shorter benefit period available in NGS.
▪ there is no equivalent Waiting Period, the Waiting Period will be the next longer Waiting Period available in NGS.
If the waiting and Benefit Payment Periods match your existing NGS Super cover, the transfer cover will be added (subject to your income level supporting requested cover level).
All your cover will become Fixed Cover if you transfer cover into your NGS Accumulation account.
You can apply to do this through:
▪ Member Online, or ▪ by completing the Insurance Transfer form.
2 For ex-QIEC Super members up to and including 5 May 2024, under age 65.
It should be noted that acceptance of IP cover does not guarantee that any resulting benefit payment will be based on this amount, as this will be based on a range of factors at the time of any incapacity (such as eligibility, Pre-Incapacity Income and how much cover you have).
Please note that your transferred cover is subject to the NGS Super Insurance Terms and Conditions which may not match your previous policy.
To ensure there is no gap in your protection, any cover held in your former fund and/or insurer should only be cancelled once your new cover has been confirmed as accepted by TAL.
INSURANCE GUIDE 20
What is Life Event cover?Events like getting married, buying a house, or starting a family can have a huge impact on your everyday life. They can also affect the level of insurance cover you may need.
If you are under age 60 and not working in a Hazardous Occupation, you can make increases to your cover within 90 days of when any of the following events take place:
▪ you get married ▪ birth or adoption of a child ▪ you take out a mortgage for the
purchase of your first home ▪ your child’s first day at school;
primary or secondary ▪ divorce or separation of de facto partner ▪ death of a spouse/de facto partner ▪ you first become eligible for a
Centrelink carer’s allowance ▪ salary increase when employed by an
employer ▪ you attain the age of 30, 40 and 50 ▪ you have been a member of NGS Super
for 10 consecutive years (including continuous membership of QIEC Super immediately prior to 6 May 2019).
You can apply for a maximum of one Life Event increase every 12 months.
cover declined or been offered cover on alternative terms to those applied for (except where TAL is satisfied with the alternative terms).
The maximum Life Event cover limit is the lesser of:
▪ 25% of your existing cover level or $2,500 per month (for IP), and
▪ 25% of your existing cover level or $200,000 for Life and TPD cover.
The amount of the total sum insured after the increase of cover cannot exceed:
▪ $15,000 per month for IP; and ▪ $2 million for life and TPD cover.
Your change in cover will start on the date TAL confirms acceptance of your application.
15. WHAT IS LIFE EVENT COVER
To apply for an increase for a Life Event:
▪ you must not have had a cover increase in the previous 12 months as a result of a Life Event
▪ you are in Active Employment ▪ you have not been diagnosed with, nor
are suffering from, any illness or injury that may cause permanent inability to work within the next 24 months
▪ you are not terminally ill with a life expectancy of less than 12 months
▪ in the last 10 years prior to the date of your application you have never received, nor are eligible to receive, any payment for an illness, injury or accident benefit from the following: - workers compensation - government benefits (such as
sickness benefit, invalidity pension) - motor accident scheme - superannuation fund - life insurance policies
▪ you have not within the last 12 months been absent from your usual occupation (employed or unemployed) for more than 10 consecutive days due to injury or illness
▪ you have not had an application for death, total and permanent disablement or income protection
If you are under age 60 and not working in a Hazardous Occupation, you can make increases to your cover within 90 days of a Life Event. You can apply:
▪ through Member Online, or ▪ by completing the Life Events Cover
Options form.
All your cover will become Fixed Cover if you increase your cover as a result of a Life Event.
INSURANCE GUIDE 21
When does my cover cease?Your Life/ TI, TPD and IP cover will cease on the earliest of any of the following events:
▪ the date you turn 75 for any Life/TI cover, age 67 for TPD and IP cover3
▪ the date of your death ▪ any request to cancel your cover will
take effect from the later of the date - NGS receives your request; and - nominated by you in your request.
▪ the date you cease to have an NGS Accumulation account
▪ the date on which there are insufficient funds in your account to cover your next premium deduction
▪ the date you join any armed forces, other than the Australian Armed Forces Reserve
▪ the date the NGS Super insurance Policy with TAL terminates, unless that Policy is replaced immediately by a policy with another insurer providing equivalent cover
▪ The date your account becomes Inactive (i.e. your account has not received an eligible amount for a continuous period of 16 months) and you have not previously made an Inactive Account Election to Opt-in
▪ On 1 April 2020 where you had an account balance that was less than $6,000 on 1 November 2019 (or on the date of joining NGS Super, if later), and did not at any time between that date and 31 March 2020 have a balance of at least $6,000, and you did not previously make an Inactive Account Election to Opt-in.
16. WHEN DOES COVER CEASE
If I cancel my insurance cover or if my cover ends, can I get it back?
Reason your cover ceased Other things you should know
Applying for your cover to recommence
You chose to cancel your cover
You will only be eligible for insurance through NGS Super by applying for underwritten cover. Your application will be subject to Evidence Of Good Health and acceptance by TAL.
A new application for cover will be subject to the terms and conditions of insurance in NGS Super and any special terms that applied to your previous cover will not apply to new insurance.
You had insufficient funds in your account to pay your premium(s)
Cover will recommence when an Employer Contribution is received into your account within 6 months of your cover ceasing.
If an Employer Contribution is not received within 6 months of your cover ceasing, cover will not recommence automatically. You will only be eligible for insurance through NGS Super by applying for underwritten cover. Your application will be subject to Evidence Of Good Health and acceptance by TAL.
We will write to you to advise that cover will cease if you do not arrange for your account to have sufficient funds to pay your premium(s).
If your cover recommences within 6 months of ceasing, your cover will be subject to the same terms and conditions that applied to your cover prior to it ceasing.
Please refer to Scenario 1 and Scenario 2 (on page 22) on how your cover will be reinstated.
Your account was Inactive (i.e. your account had not received an eligible amount in a continuous period of 16 months) and we were required to cancel your cover by law.
You may within 60 days of the date your cover ceased be eligible for your cover to be reinstated if:
▪ you request reinstatement; and
▪ you have sufficient funds in your account to pay premiums.
If your cover is not reinstated, you will only be eligible for insurance through NGS Super by applying for underwritten cover. Your application will be subject to Evidence Of Good Health and acceptance by TAL.
If your account is inactive, we will write to you at intervals of 9 months, 12 months and 15 months advising you that your insurance cover will cease after 16 months when your account becomes Inactive. Your cover will cease unless you previously made an Inactive Account Election to Opt-in to cover.
Your account balance was less than $6,000 on 1 November 2019 (or on the date of joining NGS Super, if later) and it did not at any time between that date and 31 March 2020 reach at least $6,000 and we were required to cancel your cover by law.
Where you have an account balance which is less than $6,000 on 1 November 2019 (or on the date of joining NGS Super, if later) and it will not at any time between that date and 31 March 2020 reach at least $6,000, your cover will cease unless you previously made an Inactive Account Election to Opt-in to cover.
We will write to you again after your cover is cancelled and you will have the opportunity to have it reinstated within 60 days of the date cover ceased, on the same terms and conditions as before your cover was cancelled.
All other reasons provided under ‘When does my cover cease’ on this page.
You will only be eligible for insurance through NGS Super by applying for underwritten cover. Your application will be subject to Evidence Of Good Health and acceptance by TAL.
3 If you were an existing member of NGS Super at 1 June 2017 and at that date were aged 60 or above
- the maximum age at which any 5 year Income Protection benefit will expire is at age 65.
INSURANCE GUIDE 22
16. WHEN DOES COVER CEASE (continued)
Scenario 1: you remain with the same employer
If your cover has stopped due to insufficient funds in your NGS Accumulation account to cover the next premium deduction, your cover can be reinstated at your previous cover level provided the following conditions are met:
i. your employer’s super contribution is received by NGS Super within six months from the date that cover last ceased with NGS Super;
ii. you remained with the same employer throughout the period between the date the cover ceased and the date the cover recommenced; and
iii. you remained a member of NGS Accumulation account from the time the cover ended until the time the required Employer Contribution is received
If you are not in Active Employment on the ‘cover recommencement date’ you will receive Limited Cover until you return to Active Employment for 14 consecutive days.
Scenario 2: you join a new employer or re-join the same employer
If your cover has stopped due to insufficient funds in your NGS Accumulation account to cover the next premium deduction, your cover can be reinstated at your previous cover level provided the following conditions are met:
i. your employer’s super contribution is received by NGS Super within six months from the date that cover last ceased with NGS Super;
ii. the employer super contribution referred in (i) is received as a result of you joining a new employer or you re-joining the same employer; and
iii. you remained a member of NGS Accumulation account from the time the cover ended until the time the required Employer Contribution is received.
If you are not in Active Employment on the ‘cover recommencement date’ you will receive Limited Cover until you return to Active Employment for two consecutive months. However, if the beginning of the period your employer super contribution relates is more than 120 days after you commenced employment with the new employer or the same employer you will receive Limited Cover only for a two year period, after which you must be in Active Employment for at least 14 consecutive days for Limited Cover to cease.
If your cover recommences while you are receiving or are entitled to receive, or if you have received or are making a claim for benefits in relation to an illness or injury from any source including the following:
▪ benefits payable under a superannuation fund in respect of your permanent incapacity or Terminal Medical Condition, (both as defined in superannuation law)
▪ total and permanent disablement or terminal illness type benefits from any superannuation fund or insurance company
then you will only be entitled to Life only cover and IP cover, both of which will be Limited Cover until you are underwritten and accepted by TAL.
Any cover which recommences will continue to be subject to any loadings, exclusions or other special conditions that applied before your cover ceased.
How does my Cover Expiry Age affect the Benefit Payment Period for IP payments?Regardless of your Benefit Payment Period, your IP payments will always cease upon reaching your Cover Expiry Age.
Example: Meet JasonJason applied for and was accepted for an IP claim when he was aged 64 (at the end of his 90 day Waiting Period). Jason’s benefit period (5 years) commenced at the end of his 90 day Waiting Period. Although Jason has a five year Benefit Payment Period, his IP payments will only continue for 3 years (subject to Jason continuing to meet the definition of Totally Disabled) as his Cover Expiry Age was 67.
INSURANCE GUIDE 23
17. COVER FOR YOUR FLEXIBLE WORK PATTERNSCover while on unpaid leave
Your insurance cover in NGS Super will continue automatically in NGS Super while you are on leave without pay as long as:
▪ you have sufficient funds in your Accumulation account to cover your premiums; and
▪ on and from 1 July 2019, you have made an Inactive Account Election to Opt-in if your account becomes Inactive.
Your Pre-Incapacity Income during your period of unpaid leave will be determined based on Pre-Incapacity Income immediately prior to you commencing your unpaid leave if the period of leave is for unpaid employer approved leave. Otherwise, Pre-Incapacity Income will be calculated over the 12 months immediately prior to Total or Partial Incapacity.
Cover while you are on paid leave
If you are on paid leave and your employer is continuing to make superannuation contributions on your behalf, your insurance cover in NGS Super will continue automatically.
If you or your employer do not make contributions for a period of 16 months, your insurance may cease (see page 21). If you wish for your cover to continue, you will need to make an Inactive Account Election to Opt-in to keep your cover before your cover ceases. Please note, you will still need to have sufficient funds in your account to cover your premiums.
What happens if I move from Full-Time to Part-Time work
If you are employed on a permanent basis and you move from Full-Time work to Part-Time work, and the employer continues to make super contributions to NGS Super, there will be no change to your Life or TPD cover. You will continue to be covered for IP but your Pre-Incapacity Income will be based on your lower Part-Time Pre-Incapacity Income. Default and Fixed IP cover is subject to a maximum of 90% (reducing to 70% after age 65) of your Pre-Incapacity Income (see page 42 for dollar limits that apply).
What happens if I move from Full-Time or Part-Time work to casual work
If your employer continues to make super contributions to NGS Super, there will be no change to your Life or TPD cover. You will continue to be covered for IP but your Pre-Incapacity Income will be based on how much you earned in the 12 months prior to the date of Total or Partial Incapacity.
Have you made an Inactive Account Election to Opt-in?If you are on unpaid leave and there is a possibility that you and your employer may not make a contribution to your NGS Super account, it is important you make an Inactive Account Election to Opt-in. You can make an Inactive Account Election to Opt-in to maintain your insurance cover through the TAL insurance portal when you log in to Member Online.
INSURANCE GUIDE 24
NGS Super now offers three ways to lodge a claim: Tele Claim – over the phone, online via the member portal and paper by mail or email.
A key advantage of the Tele Claim method is that most of the information gathering is done verbally by the insurer. You can skip unnecessary questions based on your individual circumstances, which minimises the amount of follow-up questions that can arise from other methods. Upon request, a copy of the information provided in a Tele Claim conversation is provided to you to allow you the opportunity to make any corrections.
To start an insurance claim process, either call NGS Super on 1300 133 177 between 8:00am and 8:00pm, Monday to Friday to make a Tele Claim, paper application, or login to your account via ngssuper.com.au and navigate to the TAL insurance portal button in the insurance section.
Have you made an Inactive Account Election to Opt-in?
If you are on claim or are off work due to illness or disability, it is important that you make an Inactive Account Election to Opt-in as your Insurance cover will automatically cease if you are Inactive for 16 months or more (i.e. there is no Employer, Member, rollin or other eligible contribution to your NGS Super account).
How is disability for any IP benefit defined?To receive an IP benefit, you must have valid income protection cover in place and:
▪ be unable to perform at least one income-producing duty of your Own Occupation ▪ have been Totally Disabled for at least 14 out of the first 19 consecutive days of
your Waiting Period (no benefit will begin accruing until after the end of your Waiting Period )
▪ be Totally or Partially Disabled beyond the end of your Waiting Period or, if still working in your Own Occupation, have a reduced capacity (or be working in another occupation)
▪ be earning a monthly income that is less than your Pre-Incapacity Income ▪ be under the regular care of, and following the advice and treatment of, your
treating Medical Practitioner..
Tele-Claim over the phone
Online via member portal
Income Protection
Illness or Injury Claim Form
INCOME PROTECTION CLAIM FORM | PAGE 1 OF 6
Complete this form if you want to make an Income Protection claim for Illness or Injury.
y
y
This form is to be completed by or in the presence of the person who is making the claim.
Please answer all questions to the best of your ability to ensure that your claim is assessed as quickly as possible.
BEFORE YOU RETURN THIS FORM YOU WILL NEED TO COMPLETE THE FOLLOWING
Answer all questions fully
Sign and date the Information Authority
Sign and date the Privacy Disclosure
Certified copy of proof of age (copy of birth certificate, passport or driver’s licence) To find out who can certify documents, please go to https://www.comlaw.gov.au/Details/F2006C00248.
Provide a copy of your hospital discharge summary if applicable
Attach copies of reports received from specialists, other treating doctors and health professionals you may have
Provide any other information we have specifically requested
1. YOUR POLICY
Policy number/ Member number
2. PERSONAL DETAILS
Mr Mrs Miss Ms Other
Given name(s)
Surname
Date of birth DD / MM / YYYY
3. CONTACTING YOU
State Postcode
Street address
Suburb
Best contact phone number (Mobile phone preferred)
Email address
TAL Life Limited ABN 70 050 109 450 AFSL 237 848.
TALGRC007 05/17
Paper mail or email form
18. MAKING A CLAIM
Totally Disabled means because of illness or injury you:
▪ cease Gainful Employment; ▪ are unable to perform at least one
Income Producing Duty of your Own Occupation;
▪ are under the regular care of, and complying with the ongoing medical advice and treatment of your treating Medical Practitioner and any additional treatment (medical or otherwise) reasonably requested by the insurer, with the exception of any particular treatment that you decline or discontinue on reasonable grounds (including, without limitation, the reasonable advice of your own Medical Practitioner), and
▪ you are not working in any occupation, whether or not for reward.
Are there any reasons why my IP benefit may not be payable? You won’t receive any IP benefits for your Default Cover if your injury or illness is caused directly or indirectly by:
▪ self-inflicted injury or infection or attempted suicide
▪ Pregnancy or Childbirth or ▪ War.
Your IP benefits may also not be payable:
▪ if TAL finds that you were employed under a preferential employment practice and you were suffering a medical condition that was likely to cause your disablement within three years of your cover starting,
▪ your Other Disability Income offsets exceed your IP benefit, or
▪ at the time of your claim, your Pre-Disability Income is nil.
TAL insurance portal w
JANE,
INSURANCE GUIDE 25
18. MAKING A CLAIM (continued) What happens if I claim from overseas or go overseas whilst on claim?If you claim from outside Australia, TAL may require that you return to Australia, at your expense, for the purpose of assessment of your Terminal Illness, TPD or IP claim.
If TAL admits an IP claim whilst you are outside Australia TAL may provide benefits for up to a maximum of 12 months, when payments will cease unless you return to Australia at your expense. TAL may start to pay you again when you return to Australia if you are still entitled to claim.
If TAL is assessing your claim and you wish to leave Australia, you will need to get TAL’s approval prior to leaving.
What happens if my reason for claiming Life/TI or TPD is because of self-harm?For cover that is:
a) Limited Cover
b) Interim Accident Cover
c) Increased cover due to life events cover
d) Increased above Default Cover
e) cover that is applied for (except transferred cover);
no benefit shall be payable where a claim arises from any of the following:
▪ Life cover – suicide or as a result of a self-inflicted act within the first 13 months after the commencement, increase or recommencement of cover;
▪ Terminal Illness and TPD cover – an intentional self-inflicted act or intentional self-inflicted injury, or attempted suicide (irrespective of whether you were sane or not and whether intended or not at the time) within the first 13 months after the commencement, increase or recommencement of cover.
INSURANCE GUIDE 26
19. TERMINAL ILLNESS CLAIM If you would like more information about making a claim for a terminal medical condition benefit please contact NGS Super.Claiming for an insured Terminal Illness benefitAny member who wishes to claim an insured Terminal Illness benefit will be required to provide evidence that they have incurred an injury or illness that is likely to result in their death within a period that ends not more than 12 months after the date of certification.
If the Terminal Illness Benefit paid is less than your Life insurance cover the remaining balance is payable on your death as long as your death cover does not cease and premiums continue to be paid.
If you would like to access your NGS Accumulation account balance as a result of Terminal Medical Condition within a certification period of 24 months, please contact NGS Super. It is important that you leave sufficient funds in your account to pay for your insured Life/TI Cover premiums.
Access to your Superannuation moniesFrom 1 July 2015, the Government changed the certification period to access superannuation monies due to a Terminal Medical Condition. The certification period has extended from 12 months to 24 months. Under this amended rule, members who are suffering from a Terminal Medical Condition may be able to access their superannuation monies if their life expectancy has reduced to less than 24 months.
However, this extended certification period of 24 months only applies to the access to your superannuation monies and not to the payment of an insurance benefit.
INSURANCE GUIDE 27
20. BENEFITPAYMENTS Does a TPD payment impact my IP benefit?A TPD payment does not impact your entitlement to ongoing IP benefits.
How will a payment be made in the event of death?In the event of your death, your Accumulation account balance (including any paid insured benefit) will be paid into the NGS Super Cash and Term Deposits investment option until it is paid to your beneficiaries.
How will I receive any TI or TPD payment that I am entitled to?If you are entitled to receive a Terminal Illness or disability (TPD) payment to your Accumulation account, it will be paid into the NGS Super Cash and Term Deposits investment option. You then have the option to switch it into your choice of investment option(s). This will not affect the investment of your other super, which will stay invested in the investment option(s) you have already chosen.
What happens to my Life cover if I become eligible for a TPD benefit?If a TPD benefit is payable to you, any Life/TI cover you have will be reduced by the amount of the TPD benefit paid. If a TI benefit becomes payable, your Life and any applicable TPD cover will be reduced by the TI benefit amount.
When would I receive an IP benefit? You may receive a monthly income benefit (paid in arrears) if TAL considers you have met the Policy terms. Payments will begin accruing immediately after your Waiting Period and will continue up to your Benefit Payment Period, cover expiry age or until you are no longer Totally or Partially Incapacitated.
Income Protection premiums are waived for the period you are receiving IP benefits, for claims with a date of incapacity commencing from 1 June 2017 onwards.
If you are well enough to return to work part time, you may be eligible for a partial payment of your IP cover.
Where payments relate to recurrence of an existing claim condition more than 6 months later, a further Waiting Period would need to be re-served. Benefit periods are aggregated (i.e. for the purposes of determining maximum periods up to 2 year and up to 5 year payment limits) where there is recurrence of a related claim condition. A new period is applicable where a different incapacity claim is made.
All benefit payments you receive are included in your taxable income.
Will income from other sources impact my IP benefit?Your IP cover is designed to help replace up to 90% (including up to 10% super contribution) of the amount of Pre-Incapacity Income. So any monthly payment you receive will be based on your Pre-Incapacity Income, and whether you are receiving income from other sources. If you are receiving income from other sources while you are eligible for an IP payment, your benefit amount may be reduced.
Income from other sources includes:
▪ paid sick leave ▪ amounts paid or payable under
legislation such as workers’ compensation or motor accident compensation
▪ benefits you may receive or any other income, which in the insurer’s opinion, you could reasonably be expected to earn while you are Totally or Partially Disabled
▪ any benefits payable under other income protection insurance policies.
Any Life cover you have will be reduced by any amount of TPD or TI benefit payment that is made to you under this Policy.
INSURANCE GUIDE 28
How to use these tables1. As premiums are based on your insurance category, you will first need to identify
which insurance category is applicable to you:
▪ NGS Plus/Select, or ▪ NGS General.
2. Find the tables that are relevant to your insurance category:
NGS Plus/Select – Default Cover
Table 1 Life
Table 2 TPD
Table 3 IP (90 day Waiting Period; up to 5-year Benefit Payment Period)
NGS General – Default Cover
Table 4 Life
Table 5 TPD
Table 6 IP (90 day Waiting Period; up to 5-year Benefit Payment Period)
NGS Plus/Select – Fixed cover
Table 7 ▪ Life
▪ TPD
▪ IP (90 day Waiting Period; up to 5-year Benefit Payment Period)
NGS General – Fixed cover
Table 8 ▪ Life
▪ TPD
▪ IP (90 day Waiting Period; up to 5-year Benefit Payment Period)
Fixed cover IP (other Benefit Payment Periods and Waiting Periods)
Table 9 IP (30 day Waiting Period; all Benefit Payment Periods)
Table 10 IP (60 day Waiting Period; all Benefit Payment Periods)
Table 11 IP (90 day Waiting Period; all Benefit Payment Periods excluding 5 year)
3. Find the row in the appropriate table that relates to your age to review cover type (Life/terminal illness, TPD and IP), level and cost.
21. INSURANCE COVER TABLES AND COSTS
NGS Plus – where
▪ your employer has registered with NGS Super and is: - a school, a kindergarten, a P & C
Association, or other body which provides education as its primary function; or
- a credit union, bank or other employer in the finance sector, or
▪ your duties are limited to professional, managerial, teaching, administrative, clerical, secretarial or similar ‘white collar’ tasks which do not involve manual work and are undertaken entirely (or at least 80%) within an office environment or classroom (excluding workshops).
NGS Select – where
▪ your duties are limited to professional, managerial, teaching, administrative, clerical, secretarial or similar ‘white collar’ tasks which do not involve manual work and are undertaken entirely (or at least 80%) within an office environment or classroom (excluding workshops), and
▪ your earnings are $100,000 or more per annum.
NGS General – where you do not meet NGS Plus requirements.
You can apply to change your insurance category:
▪ through Member Online, or ▪ by completing the Insurance
Change Insurance Category form
which, if accepted by TAL, will result in a cheaper premium rate.
NGS Select premiums are ten percent less than NGS Plus.
INSURANCE GUIDE 29
NGS Plus – Default coverTable 1: Life/Terminal illness cover
The table below sets out the cost of age-based Default Cover for Life/TI, based on your age.
NGS Select premiums are ten percent less than the premiums outlined below.
Life/Terminal Illness cover
Age Last Birthday Sum insured Cost per week
15 $10,000 $0.03
16 $10,000 $0.04
17 $10,000 $0.04
18 $10,000 $0.04
19 $10,000 $0.04
20 $60,000 $0.27
21 $60,000 $0.25
22 $60,000 $0.24
23 $60,000 $0.22
24 $60,000 $0.21
25 $360,000 $1.18
26 $410,000 $1.40
27 $450,000 $1.62
28 $490,000 $1.87
29 $530,000 $2.15
30 $570,000 $2.45
31 $570,000 $2.60
32 $570,000 $2.80
33 $570,000 $2.98
34 $570,000 $3.26
35 $570,000 $3.60
36 $570,000 $4.00
37 $570,000 $4.42
38 $570,000 $4.93
39 $560,000 $5.43
40 $550,000 $5.97
41 $540,000 $6.21
42 $540,000 $6.71
43 $530,000 $7.02
44 $510,000 $7.23
Please note: all cover premiums are rounded to two decimal places (and in some cases a minimum of $0.01 applied) in this document for ease of understanding. This means that the premiums deducted from your account and shown on calculators may differ slightly from those shown here.
Life/Terminal Illness cover
Age Last Birthday Sum insured Cost per week
45 $490,000 $7.44
46 $480,000 $7.81
47 $460,000 $8.01
48 $440,000 $8.17
49 $420,000 $8.33
50 $390,000 $8.26
51 $370,000 $8.70
52 $340,000 $8.85
53 $280,000 $8.06
54 $250,000 $8.05
55 $220,000 $7.93
56 $180,000 $7.28
57 $150,000 $6.82
58 $120,000 $6.13
59 $80,000 $4.49
60 $50,000 $3.06
61 $10,000 $0.64
62 $10,000 $0.73
63 $10,000 $0.82
64 $10,000 $0.99
65 $10,000 $1.25
66 $10,000 $1.41
67 $10,000 $1.57
68 $10,000 $1.77
69 $10,000 $1.97
70 $10,000* $2.22
71 $10,000* $2.50
72 $10,000* $2.80
73 $10,000* $3.14
74 $10,000* $3.51
* Eligible Accumulation account members who join NGS Super will receive Default Cover if joining prior to age 70.
INSURANCE GUIDE 30
TPD cover
Age Last Birthday Sum insured Cost per week
15 $60,000 $0.01
16 $60,000 $0.01
17 $60,000 $0.01
18 $70,000 $0.03
19 $70,000 $0.04
20 $70,000 $0.05
21 $80,000 $0.07
22 $90,000 $0.09
23 $100,000 $0.11
24 $140,000 $0.17
25 $170,000 $0.22
26 $200,000 $0.28
27 $190,000 $0.30
28 $180,000 $0.31
29 $170,000 $0.32
30 $170,000 $0.35
31 $160,000 $0.36
32 $160,000 $0.40
33 $160,000 $0.44
34 $160,000 $0.49
35 $160,000 $0.56
36 $150,000 $0.59
37 $140,000 $0.62
38 $140,000 $0.70
39 $140,000 $0.81
40 $140,000 $0.92
TPD cover
Age Last Birthday Sum insured Cost per week
41 $140,000 $1.05
42 $130,000 $1.13
43 $130,000 $1.29
44 $130,000 $1.48
45 $130,000 $1.69
46 $130,000 $1.94
47 $120,000 $2.04
48 $120,000 $2.33
49 $120,000 $2.67
50 $110,000 $2.78
51 $110,000 $3.01
52 $100,000 $2.97
53 $100,000 $3.22
54 $90,000 $3.16
55 $80,000 $3.07
56 $70,000 $2.94
57 $60,000 $2.76
58 $60,000 $3.02
59 $50,000 $2.89
60 $40,000 $2.65
61 $30,000 $2.29
62 $20,000 $1.75
63 $20,000 $2.02
64 $10,000 $1.19
65 $10,000* $1.22
66 $10,000* $1.26
NGS Plus – Default cover (continued)Table 2: TPD cover
The table below sets out the cost of age-based Default Cover for TPD, based on your age.
NGS Select premiums are ten percent less than the premiums outlined below.
* Eligible Accumulation account members who join NGS Super will receive Default Cover if joining prior to age 65.
INSURANCE GUIDE 31
Age Last Birthday
Sum insured (per annum of benefit)
Salary covered (based on
where maximum IP benefit is
provided) up to Cost per
week
15 $10,000 $11,111 $0.19
16 $10,000 $11,111 $0.18
17 $10,000 $11,111 $0.19
18 $10,000 $11,111 $0.19
19 $10,000 $11,111 $0.19
20 $10,000 $11,111 $0.19
21 $10,000 $11,111 $0.19
22 $10,000 $11,111 $0.18
23 $48,000 $53,333 $0.85
24 $52,000 $57,777 $0.94
25 $56,000 $62,222 $1.06
26 $60,000 $66,666 $1.23
27 $72,000 $80,000 $1.63
28 $72,000 $80,000 $1.75
29 $72,000 $80,000 $1.84
30 $72,000 $80,000 $1.99
31 $72,000 $80,000 $2.16
32 $72,000 $80,000 $2.29
33 $72,000 $80,000 $2.51
34 $72,000 $80,000 $2.70
35 $72,000 $80,000 $3.08
36 $72,000 $80,000 $3.32
37 $72,000 $80,000 $3.60
38 $72,000 $80,000 $4.22
39 $72,000 $80,000 $4.50
40 $72,000 $80,000 $5.14
Age Last Birthday
Sum insured (per annum of benefit)
Salary covered (based on
where maximum IP benefit is
provided) up to Cost per
week
41 $72,000 $80,000 $5.47
42 $72,000 $80,000 $6.15
43 $72,000 $80,000 $7.01
44 $72,000 $80,000 $7.55
45 $72,000 $80,000 $8.32
46 $72,000 $80,000 $9.21
47 $72,000 $80,000 $10.04
48 $72,000 $80,000 $11.45
49 $72,000 $80,000 $12.36
50 $72,000 $80,000 $13.69
51 $72,000 $80,000 $15.55
52 $72,000 $80,000 $16.84
53 $72,000 $80,000 $18.46
54 $72,000 $80,000 $19.75
55 $72,000 $80,000 $21.85
56 $72,000 $80,000 $23.70
57 $72,000 $80,000 $25.64
58 $72,000 $80,000 $28.04
59 $72,000 $80,000 $30.49
60 $72,000 $80,000 $33.34
61 $72,000 $80,000 $36.46
62 $72,000 $80,000 $36.04
63 $72,000 $80,000 $30.30
64 $72,000 $80,000 $23.85
65 $36,000 $51,428 $7.63
66 $36,000 $51,428 $2.20
NGS Plus – Default cover (continued)Table 3: Income Protection (IP)
The Default Cover:
▪ is age based cover where the sum insured changes with your age, ▪ has an up to 5-year Benefit Payment Period, and ▪ has a 90 day Waiting Period.
The table below sets out the cost of Default Cover for IP, based on your age.
Annual benefits shown are divided by 12 and shown as a monthly IP benefit when using our calculators, on your benefit statements or when viewing insurance benefits through Member Online.
NGS Select premiums are ten percent less than the premiums outlined below.
INSURANCE GUIDE 32
Life/Terminal Illness cover
Age Last Birthday Sum insured Cost per week
15 $10,000 $0.04
16 $10,000 $0.05
17 $10,000 $0.05
18 $10,000 $0.06
19 $10,000 $0.06
20 $50,000 $0.30
21 $50,000 $0.29
22 $50,000 $0.27
23 $50,000 $0.25
24 $50,000 $0.23
25 $290,000 $1.28
26 $330,000 $1.52
27 $360,000 $1.75
28 $390,000 $2.01
29 $430,000 $2.35
30 $460,000 $2.66
31 $460,000 $2.83
32 $460,000 $3.05
33 $460,000 $3.25
34 $460,000 $3.56
35 $460,000 $3.92
36 $460,000 $4.36
37 $460,000 $4.82
38 $460,000 $5.37
39 $450,000 $5.89
40 $440,000 $6.45
41 $440,000 $6.83
42 $440,000 $7.38
43 $430,000 $7.69
44 $410,000 $7.85
Life/Terminal Illness cover
Age Last Birthday Sum insured Cost per week
45 $400,000 $8.20
46 $390,000 $8.56
47 $370,000 $8.69
48 $360,000 $9.02
49 $340,000 $9.11
50 $320,000 $9.15
51 $300,000 $9.52
52 $280,000 $9.84
53 $230,000 $8.94
54 $200,000 $8.70
55 $180,000 $8.76
56 $150,000 $8.19
57 $120,000 $7.37
58 $100,000 $6.89
59 $70,000 $5.30
60 $40,000 $3.30
61 $10,000 $0.87
62 $10,000 $0.98
63 $10,000 $1.10
64 $10,000 $1.34
65 $10,000 $1.69
66 $10,000 $1.90
67 $10,000 $2.12
68 $10,000 $2.38
69 $10,000 $2.67
70 $10,000* $3.00
71 $10,000* $3.37
72 $10,000* $3.79
73 $10,000* $4.24
74 $10,000* $4.73
NGS General – default coverTable 4: Life/Terminal illness cover
The table below sets out the cost of age-based Default Cover for Life/TI based on your age.
* Eligible Accumulation account members who join NGS Super will receive Default Cover if joining prior to age 70.
INSURANCE GUIDE 33
NGS General – default cover (continued)Table 5: TPD cover
The table below sets out the cost of age-based Default Cover for TPD based on your age.
TPD cover
Age Last Birthday Sum insured Cost per week
15 $50,000 $0.01
16 $50,000 $0.01
17 $50,000 $0.04
18 $60,000 $0.09
19 $60,000 $0.13
20 $60,000 $0.16
21 $70,000 $0.23
22 $80,000 $0.30
23 $80,000 $0.32
24 $120,000 $0.53
25 $140,000 $0.66
26 $160,000 $0.83
27 $160,000 $0.93
28 $150,000 $0.95
29 $140,000 $0.97
30 $140,000 $1.06
31 $130,000 $1.09
32 $130,000 $1.20
33 $130,000 $1.32
34 $130,000 $1.47
35 $130,000 $1.67
36 $120,000 $1.75
37 $120,000 $1.97
38 $120,000 $2.23
39 $120,000 $2.56
40 $120,000 $2.92
TPD cover
Age Last Birthday Sum insured Cost per week
41 $120,000 $3.32
42 $110,000 $3.54
43 $110,000 $4.04
44 $110,000 $4.62
45 $110,000 $5.30
46 $110,000 $6.07
47 $100,000 $6.29
48 $100,000 $7.17
49 $100,000 $8.22
50 $90,000 $8.41
51 $90,000 $9.12
52 $80,000 $8.79
53 $80,000 $9.54
54 $70,000 $9.10
55 $60,000 $8.52
56 $60,000 $9.33
57 $50,000 $8.52
58 $50,000 $9.32
59 $40,000 $8.55
60 $40,000 $9.82
61 $20,000 $5.65
62 $20,000 $6.48
63 $10,000 $3.73
64 $10,000 $4.41
65 $10,000* $4.53
66 $10,000* $4.65
* Eligible Accumulation account members who join NGS Super will receive Default Cover if joining prior to age 65.
INSURANCE GUIDE 34
NGS General – default cover (continued)Table 6: Income protection (IP)
The table below sets out the cost of Default Cover for IP.
The Default Cover:
▪ is age based cover where the sum insured changes with your age, ▪ has an up to 5-year Benefit Payment Period, and ▪ has a 90 day Waiting Period.
Annual benefits shown are divided by 12 and shown as a monthly IP benefit when using our calculators, on your benefit statements or when viewing insurance benefits through Member Online.
Age Last Birthday
Sum insured (per annum of benefit)
Salary covered (based on
where maximum IP benefit is
provided) up to Cost per
week
15 $10,000 $11,111 $0.35
16 $10,000 $11,111 $0.33
17 $10,000 $11,111 $0.35
18 $10,000 $11,111 $0.35
19 $10,000 $11,111 $0.35
20 $10,000 $11,111 $0.35
21 $10,000 $11,111 $0.35
22 $10,000 $11,111 $0.34
23 $12,000 $13,333 $0.39
24 $23,000 $25,555 $0.77
25 $34,000 $37,777 $1.19
26 $48,000 $53,333 $1.83
27 $48,000 $53,333 $2.01
28 $48,000 $53,333 $2.16
29 $48,000 $53,333 $2.28
30 $48,000 $53,333 $2.45
31 $48,000 $53,333 $2.66
32 $48,000 $53,333 $2.83
33 $48,000 $53,333 $3.09
34 $48,000 $53,333 $3.33
35 $48,000 $53,333 $3.80
36 $48,000 $53,333 $4.10
37 $48,000 $53,333 $4.44
38 $48,000 $53,333 $5.20
39 $48,000 $53,333 $5.55
40 $48,000 $53,333 $6.33
Age Last Birthday
Sum insured (per annum of benefit)
Salary covered (based on
where maximum IP benefit is
provided) up to Cost per
week
41 $48,000 $53,333 $6.75
42 $48,000 $53,333 $7.59
43 $48,000 $53,333 $8.64
44 $48,000 $53,333 $9.32
45 $48,000 $53,333 $10.26
46 $48,000 $53,333 $11.35
47 $48,000 $53,333 $12.38
48 $48,000 $53,333 $14.13
49 $48,000 $53,333 $15.25
50 $48,000 $53,333 $16.88
51 $48,000 $53,333 $19.18
52 $48,000 $53,333 $20.76
53 $48,000 $53,333 $22.77
54 $48,000 $53,333 $24.36
55 $48,000 $53,333 $26.95
56 $48,000 $53,333 $29.23
57 $48,000 $53,333 $31.62
58 $48,000 $53,333 $34.58
59 $48,000 $53,333 $37.61
60 $48,000 $53,333 $41.13
61 $48,000 $53,333 $44.97
62 $48,000 $53,333 $44.45
63 $48,000 $53,333 $37.37
64 $48,000 $53,333 $29.42
65 $24,000 $34,285 $9.41
66 $24,000 $34,285 $2.71
INSURANCE GUIDE 35
NGS Plus Cover
Annual rate per $1,000 sum insured cost per week
Age Last Birthday
Life/TI cover
TPD cover
IP cover
45 $0.790 $0.677 $6.010
46 $0.846 $0.775 $6.649
47 $0.905 $0.884 $7.249
48 $0.965 $1.008 $8.271
49 $1.032 $1.156 $8.928
50 $1.101 $1.313 $9.886
51 $1.222 $1.424 $11.229
52 $1.353 $1.544 $12.159
53 $1.497 $1.676 $13.332
54 $1.675 $1.828 $14.262
55 $1.874 $1.995 $15.784
56 $2.102 $2.185 $17.116
57 $2.365 $2.395 $18.515
58 $2.655 $2.620 $20.248
59 $2.916 $3.003 $22.023
60 $3.179 $3.450 $24.082
61 $3.348 $3.973 $26.334
62 $3.774 $4.556 $26.027
63 $4.245 $5.245 $21.883
64 $5.170 $6.191 $17.225
65^ $6.522 $6.365 $11.015
66^ $7.328 $6.540 $3.176
67 $8.182
68 $9.178
69 $10.269
70 $11.549
71 $12.996
72 $14.585
73 $16.340
74 $18.237
NGS Plus Cover
Annual rate per $1,000 sum insured cost per week
Age Last Birthday
Life/TI cover
TPD cover
IP cover
15 $0.166 $0.004 $0.994
16 $0.183 $0.004 $0.939
17 $0.198 $0.012 $0.994
18 $0.212 $0.022 $0.994
19 $0.224 $0.031 $0.994
20 $0.234 $0.037 $0.994
21 $0.220 $0.047 $0.994
22 $0.206 $0.052 $0.957
23 $0.193 $0.057 $0.918
24 $0.180 $0.062 $0.943
25 $0.170 $0.066 $0.983
26 $0.177 $0.073 $1.070
27 $0.187 $0.081 $1.176
28 $0.198 $0.089 $1.267
29 $0.211 $0.097 $1.332
30 $0.223 $0.107 $1.437
31 $0.237 $0.118 $1.559
32 $0.255 $0.129 $1.655
33 $0.272 $0.142 $1.811
34 $0.298 $0.159 $1.948
35 $0.329 $0.181 $2.224
36 $0.365 $0.205 $2.400
37 $0.404 $0.230 $2.601
38 $0.449 $0.261 $3.047
39 $0.504 $0.300 $3.249
40 $0.564 $0.342 $3.709
41 $0.598 $0.389 $3.953
42 $0.646 $0.452 $4.443
43 $0.689 $0.517 $5.062
44 $0.737 $0.590 $5.456
Fixed Cover – NGS Plus CoverTable 7: Life, TPD and IP cover
The table below sets out the annual cost per $1,000 sum insured of Fixed cover for:
▪ Life/TI ▪ TPD ▪ IP (up to 5-year Benefit Payment Period and 90 day Waiting Period)
based on your age.
NGS Select premiums are ten percent less than the premiums outlined below.
^ TPD cover from age 65 is based on reduced events/circumstances.
INSURANCE GUIDE 36
NGS General Cover
Annual rate per $1,000 sum insured cost per week
Age Last Birthday
Life/TI cover
TPD cover
IP cover
45 $1.066 $2.505 $11.118
46 $1.142 $2.867 $12.301
47 $1.222 $3.269 $13.411
48 $1.303 $3.728 $15.302
49 $1.393 $4.276 $16.516
50 $1.486 $4.857 $18.289
51 $1.650 $5.268 $20.773
52 $1.827 $5.712 $22.494
53 $2.021 $6.203 $24.664
54 $2.261 $6.762 $26.385
55 $2.530 $7.381 $29.200
56 $2.838 $8.083 $31.665
57 $3.193 $8.861 $34.252
58 $3.584 $9.695 $37.458
59 $3.936 $11.110 $40.742
60 $4.292 $12.766 $44.552
61 $4.520 $14.700 $48.717
62 $5.094 $16.858 $48.149
63 $5.731 $19.405 $40.483
64 $6.980 $22.908 $31.867
65^ $8.805 $23.552 $20.378
66^ $9.893 $24.196 $5.875
67 $11.046
68 $12.390
69 $13.863
70 $15.591
71 $17.545
72 $19.690
73 $22.059
74 $24.620
NGS General Cover
Annual rate per $1,000 sum insured cost per week
Age Last Birthday
Life/TI cover
TPD cover
IP cover
15 $0.224 $0.015 $1.839
16 $0.247 $0.015 $1.737
17 $0.267 $0.043 $1.839
18 $0.286 $0.081 $1.839
19 $0.302 $0.114 $1.839
20 $0.316 $0.136 $1.839
21 $0.297 $0.174 $1.839
22 $0.278 $0.194 $1.770
23 $0.260 $0.210 $1.698
24 $0.243 $0.228 $1.745
25 $0.230 $0.245 $1.819
26 $0.239 $0.270 $1.979
27 $0.253 $0.301 $2.175
28 $0.268 $0.329 $2.344
29 $0.285 $0.358 $2.465
30 $0.301 $0.395 $2.658
31 $0.320 $0.438 $2.884
32 $0.345 $0.478 $3.063
33 $0.367 $0.527 $3.351
34 $0.402 $0.589 $3.603
35 $0.444 $0.670 $4.115
36 $0.492 $0.758 $4.440
37 $0.545 $0.852 $4.813
38 $0.607 $0.965 $5.637
39 $0.680 $1.108 $6.010
40 $0.762 $1.264 $6.863
41 $0.808 $1.438 $7.313
42 $0.872 $1.673 $8.220
43 $0.930 $1.911 $9.365
44 $0.996 $2.184 $10.093
Fixed Cover – NGS General CoverTable 8: Life, TPD and IP cover
The table below sets out the annual cost per $1,000 sum insured of Fixed cover for:
▪ Life/TI ▪ TPD ▪ IP (up to 5-year Benefit Payment Period and 90 day Waiting Period)
based on your age.
^ TPD cover from age 65 is based on reduced events/circumstances.
INSURANCE GUIDE 37
Fixed CoverTable 9: Income Protection (IP) – 30 day Waiting PeriodThe table below sets out the annual cost per $1,000 of per annum benefit for each:
▪ Waiting Period (30 days), and ▪ Benefit Payment Period (two years, five years, to age 65
or to age 67).
Category Rate Loading*
NGS Select NGS Plus NGS General
Males 0.70 0.80 1.45
Females 0.85 1.00 1.85
*multiplied by the rates below to determine the premium rate for the particular category/gender.
41 $10.303 $16.420 $43.142 $44.430
42 $10.944 $17.489 $45.387 $46.889
43 $11.586 $18.665 $47.629 $49.238
44 $12.334 $19.841 $49.765 $51.696
45 $13.083 $21.231 $51.898 $54.042
46 $13.829 $22.620 $54.031 $56.389
47 $14.685 $24.009 $56.057 $58.735
48 $15.539 $25.611 $57.972 $60.974
49 $16.392 $27.213 $59.889 $63.210
50 $17.355 $28.925 $61.599 $65.350
51 $18.426 $30.852 $63.203 $67.275
52 $19.496 $32.885 $64.593 $69.198
53 $20.672 $35.025 $65.767 $71.016
54 $21.957 $37.273 $66.727 $72.618
55 $23.241 $39.841 $67.473 $74.006
56 $24.740 $42.517 $67.685 $75.180
57 $26.236 $45.406 $67.253 $76.033
58 $28.086 $48.853 $66.501 $76.831
59 $30.059 $52.549 $64.660 $76.985
60 $32.267 $57.441 $61.710 $76.377
61 $34.714 $62.787 $56.982 $74.665
62 $37.401 $63.085 $49.794 $71.620
63 $37.002 $53.429 $34.541 $60.698
64 $36.337 $42.500 $13.570 $46.988
65 $29.001 $29.001 N/A $34.289
66 $11.177 $11.177 N/A $13.191
Waiting Period 30 days
Annual cost per $1,000 of per annum benefit cost
Age Last Birthday
BPP 2 years
BPP 5 years
BPP to age 65
BPP to age 67
Waiting Period 30 days
Annual cost per $1,000 of per annum benefit cost
Age Last Birthday
BPP 2 years
BPP 5 years
BPP to age 65
BPP to age 67
15 $2.584 $3.777 $9.410 $9.410
16 $2.584 $3.777 $9.410 $9.476
17 $2.584 $3.777 $9.410 $9.476
18 $2.584 $3.777 $9.410 $9.476
19 $2.584 $3.777 $9.410 $9.476
20 $2.651 $3.645 $9.079 $9.145
21 $2.651 $3.711 $9.410 $9.476
22 $2.651 $3.777 $9.741 $9.807
23 $2.717 $3.843 $10.073 $10.139
24 $2.717 $3.910 $10.338 $10.470
25 $2.898 $4.140 $11.110 $11.248
26 $3.085 $4.449 $12.054 $12.125
27 $3.278 $4.767 $13.110 $13.258
28 $3.552 $5.174 $14.365 $14.518
29 $3.839 $5.678 $15.754 $15.913
30 $4.135 $6.203 $17.286 $17.534
31 $4.528 $6.750 $18.969 $19.225
32 $4.939 $7.407 $20.812 $21.165
33 $5.365 $8.183 $22.913 $23.277
34 $5.901 $8.993 $25.102 $25.571
35 $6.459 $9.929 $27.476 $28.055
36 $7.039 $10.906 $30.042 $30.736
37 $7.743 $11.920 $32.807 $33.622
38 $8.370 $13.078 $35.782 $36.619
39 $9.127 $14.387 $38.867 $39.833
40 $9.768 $15.350 $41.005 $42.186
INSURANCE GUIDE 38
Waiting Period 60 days
Annual cost per $1,000 of per annum benefit cost
Age Last Birthday
BPP 2 years
BPP 5 years
BPP to age 65
BPP to age 67
15 $1.259 $1.855 $4.970 $4.970
16 $1.259 $1.855 $4.970 $4.970
17 $1.259 $1.855 $4.970 $4.970
18 $1.259 $1.855 $4.970 $4.970
19 $1.259 $1.855 $4.970 $5.036
20 $1.259 $1.789 $4.771 $4.837
21 $1.259 $1.789 $4.970 $4.970
22 $1.259 $1.855 $5.103 $5.169
23 $1.325 $1.855 $5.235 $5.301
24 $1.325 $1.922 $5.434 $5.434
25 $1.380 $2.001 $5.796 $5.866
26 $1.507 $2.152 $6.386 $6.457
27 $1.565 $2.384 $7.002 $7.076
28 $1.699 $2.549 $7.645 $7.723
29 $1.839 $2.719 $8.317 $8.396
30 $1.984 $2.978 $9.015 $9.181
31 $2.137 $3.247 $9.827 $9.912
32 $2.293 $3.528 $10.670 $10.847
33 $2.545 $3.909 $11.638 $11.821
34 $2.717 $4.215 $12.645 $12.926
35 $2.988 $4.628 $13.786 $14.171
36 $3.272 $5.057 $15.071 $15.467
37 $3.565 $5.604 $16.505 $16.913
38 $3.871 $6.173 $18.100 $18.518
39 $4.295 $6.871 $19.755 $20.291
40 $4.615 $7.406 $21.039 $21.683
Fixed Cover (continued)Table 10: Income Protection (IP) – 60 day Waiting PeriodThe table below sets out the annual cost per $1,000 of per annum benefit for each:
▪ Waiting Period (60 days), and ▪ Benefit Payment Period (two years, five years, to age 65
or to age 67).
41 $4.936 $8.049 $22.430 $23.182
42 $5.257 $8.692 $23.926 $24.786
43 $5.685 $9.332 $25.530 $26.390
44 $6.113 $10.081 $27.134 $28.207
45 $6.649 $10.937 $28.736 $30.024
46 $7.183 $11.900 $30.447 $31.839
47 $7.717 $12.862 $32.155 $33.762
48 $8.252 $13.931 $33.862 $35.577
49 $8.892 $15.107 $35.570 $37.605
50 $9.535 $16.284 $37.066 $39.424
51 $10.285 $17.569 $38.565 $41.243
52 $11.032 $18.960 $39.956 $42.954
53 $11.890 $20.459 $41.130 $44.559
54 $12.746 $22.064 $42.200 $46.056
55 $13.602 $23.776 $42.841 $47.232
56 $14.564 $25.596 $43.267 $48.299
57 $15.528 $27.414 $43.049 $49.046
58 $16.679 $29.591 $42.613 $49.607
59 $17.948 $31.788 $41.196 $49.629
60 $19.229 $34.747 $39.003 $48.998
61 $20.522 $37.982 $35.587 $47.594
62 $21.935 $37.642 $30.381 $45.297
63 $21.702 $31.555 $20.301 $38.278
64 $21.311 $24.582 $6.924 $34.710
65 $16.133 $16.133 N/A $19.988
66 $5.411 $5.411 N/A $5.846
Waiting Period 60 days
Annual cost per $1,000 of per annum benefit cost
Age Last Birthday
BPP 2 years
BPP 5 years
BPP to age 65
BPP to age 67
Category Rate Loading*
NGS Select NGS Plus NGS General
Males 0.70 0.80 1.45
Females 0.85 1.00 1.85
*multiplied by the rates below to determine the premium rate for the particular category/gender.
INSURANCE GUIDE 39
Waiting Period 90 days
Annual cost per $1,000 of per annum benefit cost
Age Last birthday
BPP 2 years
BPP to age 65
BPP to age 67
15 $0.663 $3.048 $3.048
16 $0.663 $3.048 $3.048
17 $0.663 $3.048 $3.048
18 $0.663 $3.048 $3.048
19 $0.663 $3.048 $3.115
20 $0.663 $2.916 $2.916
21 $0.663 $2.982 $3.048
22 $0.663 $3.115 $3.115
23 $0.663 $3.181 $3.247
24 $0.663 $3.313 $3.313
25 $0.690 $3.520 $3.588
26 $0.789 $3.946 $4.018
27 $0.894 $4.320 $4.395
28 $0.926 $4.711 $4.789
29 $0.959 $5.118 $5.197
30 $1.075 $5.459 $5.541
31 $1.110 $5.895 $5.982
32 $1.235 $6.349 $6.437
33 $1.273 $6.819 $6.910
34 $1.405 $7.306 $7.493
35 $1.542 $8.002 $8.098
36 $1.586 $8.724 $8.923
37 $1.834 $9.476 $9.782
38 $1.988 $10.463 $10.776
39 $2.255 $11.596 $11.918
40 $2.362 $12.559 $12.881
Fixed Cover (continued)Table 11: Income Protection (IP) – 90 day Waiting PeriodThe table below sets out the annual cost per $1,000 of per annum benefit for each:
▪ Waiting Period (90 days), and ▪ Benefit Payment Period (two years, to age 65 or to age 67).
41 $2.684 $13.630 $14.059
42 $2.897 $14.807 $15.236
43 $3.218 $16.091 $16.627
44 $3.540 $17.374 $18.125
45 $3.861 $18.872 $19.623
46 $4.289 $20.369 $21.334
47 $4.716 $21.973 $23.044
48 $5.144 $23.467 $24.754
49 $5.678 $25.069 $26.569
50 $6.213 $26.568 $28.282
51 $6.856 $28.067 $29.995
52 $7.391 $29.457 $31.707
53 $8.033 $30.634 $33.205
54 $8.783 $31.597 $34.595
55 $9.424 $32.345 $35.771
56 $10.173 $32.772 $36.734
57 $10.923 $32.770 $37.374
58 $11.836 $32.282 $37.771
59 $12.650 $31.140 $37.735
60 $13.580 $29.334 $37.047
61 $14.518 $26.418 $35.695
62 $15.355 $22.155 $33.452
63 $15.191 $14.241 $27.572
64 $14.917 $4.062 $22.986
65 $10.690 N/A $14.302
66 $2.927 N/A $3.598
Waiting Period 90 days
Annual cost per $1,000 of per annum benefit cost
Age Last birthday
BPP 2 years
BPP to age 65
BPP to age 67
Category Rate Loading*
NGS Select NGS Plus NGS General
Males 0.70 0.80 1.45
Females 0.85 1.00 1.85
*multiplied by the rates below to determine the premium rate for the particular category/gender.
INSURANCE GUIDE 40
22. GLOSSARY: DEFINITIONS
INSURANCE GUIDE 41
Default Cover means the amount of insurance cover provided to you on a default basis under the agreement between NGS Super and TAL. Default Cover sum insured will vary based on your birthday and insurance category.
Default Cover Election to Opt-in means the application provided to NGS Super by you to Opt-In for Default Cover before you are at least 25 years of age and/or an account balance of at least $6,000.
Default Cover Multiple is the multiple that will be applied to your Default Cover to determine your insured benefit.
Employer means an entity that is contributing to NGS Super in respect of its employees who are NGS Accumulation account members.
Employer Contribution means
A. a superannuation guarantee contribution or;
B. a superannuation contribution made in or towards satisfaction of the employer’s obligation to make contributions for the employee; or
C. a superannuation contribution made in satisfaction of the employer’s binding obligation to make contributions for the employee under a legally enforceable contract between the employer and the employee; or
D. a salary sacrificed superannuation contribution under an effective salary salary sacrifice arrangement.
Evidence Of Good Health means a fully completed Personal Statement and other such medical, financial, employment, occupational and other information TAL may reasonably require to assess or underwrite your cover under the insurance Policies.
Ex-QIEC Super Member means a member of QIEC Super ABN 81 010 897 480 who became a Member of the Fund as a result of the NGS Super and QIEC Super merger on 6 May 2019 and does not include a Member of QIEC Super who:
▪ transferred to NGS Super from QIEC Super and who did not hold insurance cover in QIEC Super on 3 May 2019 including members who were under age 15 on 3 May 2019, or
GlossaryHere are definitions of some of the commonly used words and terms used throughout this guide. If there is any inconsistency between this guide and the Insurance Policy, the full terms and conditions contained in the relevant Policy will prevail to the extent of the inconsistency.
Active Employment means:
▪ you are employed to carry out identifiable duties
▪ you are actively performing or capable of performing those duties, and
▪ in TAL’s opinion, you are not restricted by illness or injury from carrying out those duties for at least 30 hours per week, or the duties of your usual occupation, even if you are then not working on a full time basis.
If you are on employer approved leave for reasons other than illness or injury, you will be considered to be in Active Employment if you satisfy the above at the date of determining Active Employment. If you do not meet these requirements, you will not be considered to be in Active Employment.
Benefit means money payable to you or your beneficiaries under the Policy (as applicable) for any of the following:
▪ Income Protection; ▪ Death; ▪ Terminal Illness; or ▪ Total and Permanent Disablement.
Date of Disablement means the later of:
A. the date you cease work due to Illness or Injury; or
B. the date the person suffers from the sickness or injury that is the principal cause of the person’s disablement.
The Date of Disablement must occur while you are covered under the Policy.
However, where you participate in a rehabilitation program and remain incapable of returning to employment within 12 months from the date your absence from employment began, the Date of Disablement will be the date that would have applied if you had not participated in the rehabilitation program.
In the event of any discrepancy, the terms and conditions of the Policy document will apply.
▪ whose insurance cover had not yet commenced pending an Employer Contribution, or
▪ who have cancelled their insurance cover on or after 6 May 2019, or
▪ whose insurance has been cancelled due to inactivity or insufficient funds and whose cover has not been reinstated.
First Employer Contribution means the first Employer Contribution received by the Fund after the date the Member becomes an Eligible Member.
Fixed Cover means an amount of cover that will not vary once set except in accordance with the table on page 15, unless you apply for and are granted a change to your level of cover.
Gainfully Employed means employed or self-employed for gain or reward in any business, trade, profession, vocation, calling, occupation or employment including a Member who has ceased temporarily to receive any gain or reward under a continuing arrangement for the Member to be Gainfully Employed.
Hazardous Occupation means an occupation that TAL determines to present particular underwriting difficulties. This includes, but is not limited to, occupations involving hazardous or very heavy manual work.
Inactive Account Election to Opt-in means the instruction provided to NGS Super by you to continue your cover if your account becomes Inactive.
Inactive means your account has not received an amount such as a contribution or rollover in a continuous period of 16 months.
Interim Accident Cover means cover that may apply for you while TAL is assessing an application which requires Evidence Of Good Health for cover subject to the terms of the Policy.
Limited Cover means you are only covered for life/terminal illness, Total and Permanent Disability (TPD) and/or income protection arising from an illness that first becomes apparent or an injury that first occurs on or after the date your cover last commenced, recommenced or increased under the Policy.
INSURANCE GUIDE 42
Maximum Cover Limit means:
▪ Life cover is unlimited ▪ TI cover is $5,000,000 ▪ TPD cover is $5,000,000 ▪ IP cover is $41,000 per month (for a
benefit period of up to two or up to five years) or $31,000 per month (for benefit period to age 65 or to age 67).
Medical Practitioner means unless we agree otherwise, a medical practitioner legally qualified and registered to practice in Australia but shall not include chiropractors, physiotherapists, psychologists or alternative health providers.
They cannot be your:
▪ spouse, partner in a de facto relationship;
▪ close family relative; ▪ business associate or partner; ▪ fellow security holder in the same
company/trust (other than a publicly listed entity); or
▪ employer or employee.
Member means you are the holder of an eligible NGS Accumulation account. You will not be eligible for automatic Default Cover where you are already an existing member of NGS Super. This includes if:
▪ you currently have an existing NGS Accumulation account (ie you are opening a second Accumulation account) or
▪ your Accumulation account is established due to a transfer of funds from an existing NGS Income account or NGS Transition to Retirement account (regardless of whether you will have an employer that will commence making contributions to NGS Accumulation account on your behalf).
However, this doesn’t prevent an income account holder from establishing an Accumulation account (ie where account is not being established with a transfer of NGS Income account or NGS Transition to Retirement account) and still be eligible for Default Cover, subject to acceptance rules.
Occupation means an occupation that you can perform, on a full or part time basis, based on the skills and knowledge you have acquired through education, training or experience.
Own Occupation means the normal occupation or work carried out by you before becoming incapacitated.
Partially Disabled means you:
A. are not Totally Disabled;B. have been Totally Disabled for at least
14 days out of the first 19 consecutive days of the Waiting Period;
C. are unable to work in your Own Occupation at full capacity immediately after being Totally Disabled because of the illness or injury that caused your Total Disability;
D. are working in your Own Occupation in a reduced capacity or working in another occupation;
E. earning a monthly income that is less than your Pre-Incapacity Income; and
F. are complying with the ongoing medical advice and treatment of your treating Medical Practitioner and any additional treatment (medical or otherwise) reasonably requested by the insurer, with the exception of any particular treatment that you decline or discontinue on reasonable grounds (including, without limitation, the reasonable advice of your own Medical Practitioner).
Permanently Incapacitated means TAL are reasonably satisfied that your ill-health (whether physical or mental) makes it unlikely that you will engage in gainful employment for which you are reasonably qualified by education, training or experience.
Personal Statement means an application form issued by TAL for the purpose of assessing you for cover under the Policy.
Pre-Existing Condition means a condition that directly or indirectly relates to an illness, injury or a symptom:
A. in respect of which you:i. were aware, or a reasonable person
in your position should have been aware;
ii. should have sought advice or treatment (conventional or alternative) from a Medical Practitioner or other allied health professional (in circumstances where a reasonable person in their position would have sought such advice or treatment); or
iii. have had a medical consultation or have been prescribed medication or therapy; and
B. which existed at any time in the five years immediately prior to the date your applicable cover commenced under the Policy.
Pre-Incapacity Income is calculated based on one of three employment statuses:
1. If you are employed on a permanent basis, Pre-Incapacity Income is the monthly value of your annual remuneration which applied immediately before you become incapacitated or immediately before commencing employer approved leave without pay if you become incapacitated during a period of employer approved leave without pay, earned from the employer you are employed with on a permanent basis and which is specified in your contract of employment or payslip issued by the employer to you. It includes any overtime, bonuses and shift allowances (averaged over the last three years), and packaged elements not received directly as taxable earnings.
2. If you are not employed on a permanent basis, Pre-Incapacity Income is the total monthly value of remuneration (including overtime, bonuses and shift allowances) you receive from all regular occupations, averaged over the most recent 12 months immediately before becoming incapacitated.
3. If you are self-employed, Pre-Incapacity Income is the total monthly amount earned in your business over the financial year as a direct result of your personal exertion or activities through your usual occupation (ie business earnings that would stop if you could not work due to illness or injury), less your share of business expenses (but before the deduction of income tax) for that business – or relevant proportion for part of a financial year.
INSURANCE GUIDE 43
If you are employed by, and the director of, an employer, Pre-Incapacity Income is the total of the following monthly amounts:
▪ any packaged elements not received directly by you as taxable earnings; and
▪ the amount by which income generated by the employer’s business directly due to your personal exertion or activities exceeds your share of necessarily incurred business expenses,
but excludes any director’s fees, bonuses, Employer Contributions (excluding salary sacrifice arrangements put into place by you), overtime, commission, investment income and profit distribution.
Pre-Incapacity Income does not include income you receive through investments or other forms of passive income, and also excludes any directors’ fees, compulsory employer superannuation entitlements, investment income and profit distributions.
Policy means the agreement between NGS Super and TAL to provide NGS Super members with insurance cover.
Pregnancy or Childbirth means normal and uncomplicated Pregnancy or Childbirth, multiple pregnancy, caesarean birth, threatened miscarriage, participation in in-vitro fertilisation or other medically assisted fertilisation techniques and normal discomforts of pregnancy such as morning sickness, backache, varicose veins, ankle swelling and bladder problems.
QIEC Super Member means a member of QIEC Super, other than an Ex-QIEC Super Member.
Terminal Illness means you are considered to be terminally ill (for the purpose of your eligibility to be paid an insured terminal illness benefit) when you suffer from an illness or injury which:
A. two Medical Practitioners have certified jointly or separately, that you suffer from a sickness or have incurred an injury that is likely to result in death within a period (the “Certification Period”) that ends not more than 12 months after the date of certification;
B. at least one of the Medical Practitioners is a specialist practising in an area related to the sickness or injury suffered by you;
C. for each of the certificates the Certification Period has not ended; and
D. TAL are satisfied, on medical or other evidence, that despite reasonable medical treatment, your sickness or injury is likely to result in the Insured Member’s death within the Certification Period.
The illness from which you suffer must occur, and the date of the certification referred to in paragraph (A), must take place while you are insured under this Policy.
Terminal Medical Condition means you are considered to be suffering from a Terminal Medical Condition (for the purpose of your eligibility to gain access to your super account balance – whether or not it includes any insured benefit) when you suffer from an illness or injury which:
A. two Medical Practitioners, at least one specialising in your illness, have certified in writing that despite reasonable medical treatment your illness or injury will lead to your death within 24 months of the date of the certification, and
B. the certification period has not ended.
It is important to note that there are circumstances where you may be eligible to access your Accumulation account balance because you have a Terminal Medical Condition, even though you may not be eligible for an insured Terminal Illness benefit.
Totally Disabled means because of illness or injury you:
A. cease Gainful Employment;B. are unable to perform at least one
Income Producing Duty of your Own Occupation;
C. are under the regular care of, and complying with the ongoing medical advice and treatment of the your treating Medical Practitioner and any additional treatment (medical or otherwise) reasonably requested by the insurer, with the exception of any particular treatment that you decline or discontinue on reasonable grounds (including, without limitation, the reasonable advice of your own Medical Practitioner), and
D. you are not working in any occupation, whether or not for reward.
Total and Permanent Disablement (TPD) means that, solely and directly as a result of an illness or injury:
A. you have, if you have life cover, survived the relevant illness or injury by at least three months;
B. you are regularly attending and under the ongoing and appropriate care of a Medical Practitioner;
C. you have undertaken any training, retraining or re-skilling program that it is reasonable for TAL to expect you to undertake (having regard to its cost and duration, your medical treatment or rehabilitation program and your capacity to recover); and
D. you have undertaken treatment (medical or otherwise) and rehabilitation recommended by your Medical Practitioner that TAL reasonably expects to affect whether or not you will satisfy: – if you are aged: ▪ less than 65 years, you must satisfy
any one of paragraphs (a), (b), (c), (d) or (e), or
▪ 65 and above (Total and Permanent Disablement cover ceases at age 67) you must satisfy any one of paragraphs (a), (b), or (e):
a. You are Permanently Incapacitated and suffer, as a result of illness or injury: ▪ blindness in both eyes; ▪ the total and permanent loss
of the use of two limbs; or ▪ the total and permanent loss
of the use of one limb and blindness in one eye;
where:
▪ blindness means the permanent loss of sight to the extent that visual acuity is 6/60 or less, or to the extent that the visual field is reduced to 20 degrees or less of arc; and
▪ limb means the whole hand below the wrist or whole foot below the ankle; or
b. You are Permanently Incapacitated and, as a result of illness or injury, totally unable to perform without the physical assistance of another person, any two of the following activities of daily living: ▪ dressing: the ability to put on and
take off clothing; ▪ toileting: the ability to use the
toilet, including getting on and off;
INSURANCE GUIDE 44
▪ mobility: the ability to get in and out of bed and a chair;
▪ bathing: the ability to wash or shower;
▪ feeding: the ability to get food from a plate into the mouth;
and in TAL’s opinion you are permanently and irreversibly unable to do so for life, on the basis of medical and/or other evidence satisfactory to TAL; or
c. You are Permanently Incapacitated and all of the following points apply: ▪ you were employed at any
time during the three months immediately before the Date of Disablement; and
▪ on the Date of Disablement, you are absent from all work as a result of suffering one of the conditions defined in the Policy’s Schedule of Medical Condition Definitions; and
▪ TAL considers, on the basis of medical and/or other satisfactory evidence, you will be unable ever to be able to engage in any Occupation for reward; and
▪ you are likely to be so disabled for life; or
d. You are Permanently Incapacitated and: ▪ you were employed at any
time during the three months immediately before your Date of Disablement; and
▪ as a result of illness or injury, you have been absent from all work for three consecutive months from the Date of Disablement, and TAL considers, on the basis of medical and/or other satisfactory evidence that you will be unable ever to engage in any Occupation for reward; or
e. You are Permanently Incapacitated and have become so disabled by injury or illness for a continuous period of at least 6 months, and that you will be permanently unable to perform (with aids or adaptations) at least four of the following activities of daily work: ▪ bending: the ability to bend, kneel or
squat to pick something up from the floor and straighten up again; and the ability to get into and out of a standard sedan car;
▪ communicating: the ability to: - clearly hear with or without a
hearing aid or alternative aid if required; and
- comprehend and express oneself by spoken or written language with clarity;
▪ vision (distance vision): the ability to read, with visual aids, to the extent that an ophthalmologist can certify that:
- visual acuity is equal to, or better than, 6/48 in both eyes; or
- constriction is greater than within 20 degrees of fixation in the eye with the better vision;
▪ walking: the ability to walk more than 200m on a level surface without stopping due to breathlessness, angina or severe pain elsewhere in the body;
▪ lifting: the ability to lift from the ground an object weighing 5kg, carry it a distance of 10 metres, and place the item down at bench height;
▪ manual dexterity: the ability, with reasonable precision and success, to: - use at least one hand, its thumb
and fingers, to manipulate small objects; or
- use a keyboard if you were required to use a keyboard in your previous job.
f. You are an Ex-QIEC member whose TPD cover commenced or recommenced prior to 1 July 2014 and you have continuously held TPD cover in QIEC Super from 1 July 2014 up to and including 5 May 2019 and in NGS Super from 6 May 2019 and: ▪ You are aged less than 65 at the Date
of Disablement; and ▪ You were employed and performing
your Usual Duties at any time during the three months immediately before the Date of Disablement; and
▪ As a result of illness or injury, have been absent from all work for three consecutive months from the Date of Disablement and TAL consider, on the basis of medical and/or other evidence satisfactory to TAL at the date it forms its opinion, you will be unlikely ever to engage in the occupation and perform the Usual Duties in which you were engaged immediately before the Date of Disablement, whether or not for reward.
Any claim must be supported by evidence to TAL’s satisfaction that you are undergoing appropriate treatment, or have been prescribed and are taking appropriate medication, as recommended by a relevant treating Medical Practitioner. Your permanent inability to perform the activities of daily work must have lasted for a continuous period of six months or more.
INSURANCE GUIDE 45
Total Incapacity means because of illness or injury the Insured Member:
a. ceases Gainful Employment;b. is unable to perform at least one
Income Producing Duty of their Own Occupation;
c. is under the regular care of, and complying with the ongoing medical advice and treatment of the Insured Member’s treating Medical Practitioner and any additional treatment (medical or otherwise) reasonably requested by Us, with the exception of any particular treatment that the Insured Member declines or discontinues on reasonable grounds (including, without limitation, the reasonable advice of their own Medical Practitioner), and
is not working in any occupation, whether or not for reward.
Usual Duties means if you are:
a. employed by an employer, the identifiable duties which you are performing for the employer;
b. self-employed, the identifiable duties which you are engaged in for self-employment;
c. unemployed, and i. engaged exclusively in domestic
duties – your domestic duties; or ii. not engaged exclusively in
domestic duties – the identifiable duties of the most recent occupation for which you were last employed or self-employed.
Waiting Period means the period starting on the date you are Totally Disabled and the duration of which is as determined in accordance with the terms and conditions of the Policy.
Waiting Period generally starts on the date a Medical Practitioner examines you and certifies you are Totally Disabled or Partially Disabled. You must be Totally Disabled for at least 14 out of the first 19 consecutive days of the Waiting Period to qualify for an Income Protection benefit. The Waiting Period is the minimum number of days that must elapse before any Income Protection benefit may become payable.
If you return to work at full capacity during the Waiting Period, the Waiting Period starts again unless the return to work happens once and it is for no more than five consecutive days. If this happens, the number of days you returned to work will be added to the Waiting Period.
War means any act of war (whether declared or not), revolution, invasion, rebellion or civil unrest.
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ngssuper.com.au1300 133 177
Issued by NGS Super Pty Limited ABN 46 003 491 487 AFSL No 233 154 the trustee of NGS Super ABN 73 549 180 515.
4341
(022
0)
How to contact usOnline at ngssuper.com.au/contact-us
Telephone 1300 133 177
For callers outside Australia +61 3 8687 1818
Fax (03) 9245 5827
Postal address GPO Box 4303 MELBOURNE VIC 3001
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