Westpac Future Cover policy document Issued by Westpac Life Insurance Services Limited (‘Westpac Life’) ABN 31 003 149 157 Effective date: 9 July 2008 Your future is our future 5199_WFS145.indd 1 5199_WFS145.indd 1 17/7/08 3:43:28 PM 17/7/08 3:43:28 PM
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Westpac Future Cover policy document · Future Cover policy in place at any one time. If another Westpac Future Cover policy is already in place when this policy commences, we will
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Westpac Future Cover
policydocument
Issued by Westpac Life Insurance Services Limited (‘Westpac Life’)ABN 31 003 149 157
AThings toread firstKeep this bookletsafe – it’s yourcontract with us
Who is insured andwho do we pay?
1.1 You should keep this policy document and your policy schedule in a safe place. You will need these documents if you make a claim. You may also want to check something.
1.2 Your insurance contract comprises:
■ this policy document;
■ your policy schedule;
■ your application or acceptance forms (as applicable); and
■ any other document provided in connection with this insurance, which we tell you forms part of your contract.
1.3 This policy and the policy schedule are evidence of your policy contract with us and set out details of the insurance we provide you. We recommend you read them carefully. If there is something that you don’t understand, please call us on 131 817.
2 In this policy document:
■ the person whose life is insured is called the ‘insured person’. There may only be one insured person; and
■ the person who owns the policy and is paid the benefit is called the ‘policyowner’. We refer to this person as ‘you’ or ‘your’;
■ At the Commencement Date of this policy both the policyowner and the insured person are the same person.
You have a cooling-off period to decidewhether you want to keep this policy
3.1 Cover under this policy starts on the ‘Commencement Date’ shown in the policy schedule.
3.2 Each year we review the premium that you pay. We do this on the anniversary of the Commencement Date. We call this anniversary the ‘Review Date’.
4.1 You have 14 days starting from the earlier of:
■ the date you receive your policy document and policy schedule; or
■ the end of the 5th business day after the day on which we issue the policy to you,
to decide whether to keep or cancel your policy and receive a refund – this is known as the cooling-off period.
4.2 If you want to cancel it within this 14-day cooling-off period, you may write to us at Westpac Life Insurance Services Limited, GPO Box 524, Sydney NSW 2001 or call 131 817.
4.3 If you decide to cancel your policy within the cooling-off period, we will cancel your policy once we have received your request and will refund any premiums you have paid (except any amounts of tax or duties which we are unable to recover). Please note that you cannot exercise your right of cooling-off if you have made a claim under the policy.
We relied on whatyou told us – yourduty of disclosure
What your duty ofdisclosure requires
5.1 This policy is based on the fact that you:
■ provided the information we requested in the application honestly, completely and accurately; and
■ read and understood the material in the Product Disclosure Statement. This is very important. For your convenience, we repeat some of that information below.
Please read it again.
5.2 Before we decided to issue this policy, we needed to know exactly what risk we were insuring and how likely it would be that you would make a claim. You must be completely honest in telling us what we need to know to decide:
■ whether to give insurance;
■ how much to charge for it; and
■ whether any special conditions should apply.
5.3 For these reasons, you should have answered all the questions that we asked honestly, completely and accurately. In addition, you should have told us about anything else you know, or a reasonable person in the circumstances could be expected to know, that was relevant to our decision whether to insure you and, if so, on what terms. If your health, occupation or pastimes have changed between the time you provided the information (or request for reinstatement) that we required, and the time we sent this policy (or reinstate your policy) to you, you must tell us. If you have not already told us, you must do so now.
What happens if you do not follow theseinstructions?
This policy isnot a savings orinvestment policy
Changing to a newpolicy may not be inyour best interests
Where we put yourmoney
5.4 If you do not follow these instructions, we may be able to cancel the policy or any of its benefits or reduce the amount we pay on any claim you make under it. If you act fraudulently, we may be able to cancel the policy or any of its benefits and not have to pay benefits. So, if you think that you may not have followed the instructions, please tell us now.
6 This is not a savings or investment policy. It has no surrender or cash value:
■ you are not entitled to any payment if you end the policy; and
■ you are not entitled to share in any profit or surplus.
7 If you are not satisfied with this policy, please speak to us. We may be able to change the policy to satisfy you. If you change to a new policy, we may need to reassess the health of the insured person. Also, you may lose some benefits that you have under this policy.
8 We pay your premiums into a statutory fund called the Westpac Life Insurance Services Limited Statutory Fund Number 1, and benefits under your policy are paid out from that fund. The Life Insurance Act 1995 contains rules designed to protect the money in the fund.
BWhat thispolicy isabout 9.1 This is a term life policy. Under this
policy, we will pay you a lump sum benefit if the insured person dies. The policy schedule shows the type of benefit that applies to your policy. If the benefit shown in the schedule is:
■ an ‘Accidental Death Benefit’, only death of the insured person caused by an Accident is covered; or
■ a ‘Full Death Benefit’, death from any cause is covered (‘Death Benefit’). We will also pay a lump sum benefit if the insured person suffers a terminal illness. We call this a ‘Terminal Illness Benefit’. You cannot receive both a Death Benefit and a Terminal Illness Benefit in respect of the insured person under this policy.
9.2 You can only have one Westpac Future Cover policy in place at any one time. If another Westpac Future Cover policy is already in place when this policy commences, we will void this policy/ies from inception. We will refund all premiums if we void your policy (except any amounts of tax or duties which we are unable to recover), and it will be as if the policy never existed.
10 This benefit applies if your policy schedule indicates the Full Death Benefit applies.
11 If the insured person dies before this policy ends we will pay you a Death Benefit. The Death Benefit stops from the Review Date immediately after the insured person turns age 80.
12 The amount we will pay is:
■ the Death Benefit shown in the policy schedule we send you or the latest notice that we have provided to you, whichever is later; plus
■ any increase to the benefit applied as a result of the automatic annual increase (see clause 37.1).
13.1 We will not pay a benefit if the insured person dies as a result of suicide or intentional self inflicted injury (whether sane or insane at the time) within 13 months of:
■ the Commencement Date; or
■ if cover lapses, the date that cover recommences.
13.2 We will not pay a Death Benefit if we have already paid a Terminal Illness Benefit in respect of the insured person.
14 After we pay a Death Benefit, this policy ends.
15 This benefit applies if your schedule indicates the Full Death Benefit applies.
16 If an insured person suffers a terminal illness before this policy ends, we will pay you a Terminal Illness Benefit. The Terminal Illness Benefit stops from the Review Date immediately after the insured person turns age 80. The insured person suffers a terminal illness if, in our opinion, they suffer an illness or injury and as a result of this they are not expected to live more than 12 months from the date of the claim.
17 We will require the insured person’s treating registered medical practitioner to confirm that the insured person has less than twelve months to live. You must pay for this report. We must be satisfied with the clinical findings and the report of this doctor. We may require confirmation of the diagnosis by a registered medical practitioner of our choice and ask for any other medical reports we require. We will pay for these (see clause 27 for more details).
■ the Death Benefit shown in the policy schedule we send you or the latest notice that we have provided to you, whichever is later; plus
■ any increase in the benefit applied as a result of the automatic annual increase (see clause 37.1).
19 If you become entitled to a Terminal Illness Benefit and the insured person dies before we have paid the Terminal Illness Benefit, we will pay a Death Benefit instead (see clause 9.1).
20 After we pay a Terminal Illness Benefit, this policy ends.
21 This benefit applies if your policy schedule states the Accidental Death Benefit applies.
22.1 We will pay you an Accidental Death Benefit if the insured person sustains a Bodily Injury (means physical damage to the body sustained as a result of an external traumatic occurrence) caused by an Accident (means a single event that results in Bodily Injury that is unexpected. This does not include an event that results from sickness or disease) anywhere in the world before this policy ends which, without any other contributing cause, results in the death of that person within 12 months of the occurrence of the Accident.
22.2 The Accidental Death Benefit stops from the Review Date immediately after the insured person turns age 80.
23 The amount we will pay is:
(a) if the insured person was age 70 or less at the most recent Review Date before their death: ■ the Accidental Death Benefit
shown in the schedule; plus■ any increase to the benefit as a
result of the automatic annual increase (see clause 37.1); or
(b) half the amount calculated under paragraph (a) if the insured person was over 70 years but aged 80 or less at the most recent Review Date before their death.
No benefit is payable on or after the Review Date after the insured person turns age 80.
24 We will not pay a benefit if the death of the insured person resulting directly or indirectly from, or is in any way relating to:
■ the insured person’s suicide or intentional self inflicted injury (whether sane or insane at the time);
■ committing or attempting to commit a criminal offence;
■ an Accident caused by the insured person while under the influence of alcohol, non-prescribed drugs or drugs taken in excess of prescribed amounts;
■ the insured person driving a motor vehicle whilst having a percentage of alcohol in their breath or blood in excess of that permitted by law or while having an illegal substance in their system;
■ a medical condition or disease known to the insured that pre-exists the Accident;
■ engaging in aviation except as a fare-paying passenger on a scheduled airline service;
■ active participation in any riot, strike, civil commotion, coup, revolution or active participation in any military, naval or air force action (except where the insured person dies on war service); or
■ engaging in any of the following pursuits: boxing, caving, motor racing, mountain climbing, outdoor rock climbing, potholing, rodeo, or scuba diving to a depth of over 40 metres.
25 After we pay the Accidental Death Benefit, this policy ends.
26.1 To make a claim for a Death Benefit or Accidental Death Benefit, we must be told within 6 months after the insured person’s death occurs by the policyowner, your representative or your estate. We will send the person who notifies us the claim forms they need. They must complete the forms and return them to us. They must provide to us a certified copy of the death certificate and if necessary, a certified copy of the autopsy report. We will not pay for the cost of obtaining these documents.
26.2 To make a claim for a Terminal Illness Benefit, you must tell us within 6 months after the illness or injury begins. We will send you the claim forms you need. You must get a registered medical practitioner to fill in the claim forms for you and return them to us. We will not pay for the cost of getting a registered medical practitioner to fill in these forms.
26.3 No benefit will be paid until the policy and such other completed documents that we may require have been delivered to us at our office in Sydney.
27 At any time after we receive the claim forms, we may ask for more information. In the case of a claim for a Terminal Illness Benefit, we may also choose a registered medical practitioner to examine the insured person. You or the insured person must give us the information we need and the insured person must allow himself or herself to be medically examined at any reasonable time we request. We will pay the reasonable costs of getting this information or having any medical examination that we ask for.
28 We can ask you or the insured person for proof of the insured person’s age before we pay a benefit. This information must be given to us. If, when you applied for insurance:
■ the insured person’s age was lower than you told us it was, we will refund any premium you have paid above what you should have paid plus interest; or
■ the insured person’s age was higher than you told us it was, we will reduce your benefit to what it would have been if the premium you paid us was based on the true age.
29 We will deduct from any benefit paid under the policy any tax, duties or levies we are required by law to deduct.
30 The monthly premium you have to pay is shown in the policy schedule we send you or the latest notice that we have provided to you, whichever is later. This includes the policy fee (see clause 31).
31 We charge an annual policy fee which equates to $6.50 per month or $5.85 per month for partner’s policies. The policy fee is not subject to automatic annual increase or continuity discounts.
32 We calculate your premium when your policy begins and at each Review Date. Your premium may change on your Review Date, as it depends on:
■ the insured person’s age and gender (premiums for the Full Death Benefit usually increase with age);
■ the amount of the Full Death Benefit or the Accidental Death Benefit (as applicable);
■ any increases as a result of the automatic annual increase (see clause 37.1);
■ the insured person’s smoker or non-smoker classification;
■ the relevant scale of premium rates (which may include a loading) and continuity discounts at the Review Date; and
33.1 We can change the premium rates and policy fee. However, we can only do this by changing the premium rates and policy fees of all policyowners who have this version of this policy. We will write and tell you if we do this. We usually give you 3 months notice before changing the premium rates and policy fees.
33.2 We may change your premium rates immediately if:
■ a war or invasion occurs which involves Australia, whether war is declared or not; or
■ a change occurs to any tax or duty we must pay in relation to your policy.
We will write and tell you if we do this.
34.1 You can only pay monthly unless we allow you to pay on some other basis.
34.2 You must pay by a monthly direct debit authority with a bank, building society or credit union, or by a charge to a credit card acceptable to us, or by any other method that we accept.
What happens ifyou don’t pay yourpremiums whenthey are due
Tax
35 We will write and tell you if your premiums are overdue. We will give you the time specified in the notice to pay this amount. If we don’t receive your payment within 28 days of that time, we will cancel your policy. We will not pay any benefits if your policy is cancelled. We may let you reinstate the policy within a certain time if you pay all of the outstanding premiums. We may also ask you for more information about the insured person’s health, occupation or pastimes before we do so. If any of these have changed, we may not let you reinstate the policy.
36 We may require you to pay any taxes, duties or levies which relate to the policy. If the level of tax, duties or levies is varied or if additional tax, duties or levies are imposed, we may require you to pay this additional amount. We may cancel the policy in accordance with clause 35 if these amounts are not paid.
HAutomaticannualincreaseIncreasing thebenefit by theautomatic annualincrease
You can decidenot to have theautomatic annualincreases
37.1 We will increase the amount of your insured benefit by the automatic annual increase on each Review Date of this policy. The automatic annual increase is 3%.
37.2 We will do this unless you write and tell us not to.
38 You can tell us in writing within 30 days of the Review Date not to increase the amount of your insured benefit either for the particular year or for the remaining time of your policy. If for 2 years in a row you tell us not to apply the automatic annual increase, you lose your automatic right to increase your benefit in this way again. However, if you ask us to, we may restart the automatic annual increase, but we may ask you for more information about the insured person’s health, occupation or pastimes before we do so. If any of these have changed, we may refuse to restart the automatic annual increase.
39 We will send notices to the last address that you gave to us. If you move, you need to tell us your new address. We say that you receive a notice on the date that you would have received it in the ordinary course of the mail.
40 This policy is governed by the laws of New South Wales.
41 All dollar amounts are referred to in Australian currency. All claims will be paid in Australian dollars.
42 We may agree with you to change the terms of this policy, such as by adding new types of benefits, altering the amount of cover or the terms on which it is provided. The new arrangements will be agreed at the time and we will send you a written confirmation of the change. Any notice or endorsement we send you forms part of your policy.
43 If you die or suffer a terminal illness within 13 months of an increase to the benefit level (other than an automatic annual increase), we will only pay the benefit applicable before the increase applied.
44 If you have an enquiry or complaint, please call our Customer Relations Centre on 131 817 or address it in writing to:
Westpac Future Cover Customer Relations Centre, Westpac Life Insurance Services Limited, GPO Box 524, Sydney NSW 2001.
Where you have a complaint, we will endeavour to deal with it as soon as possible and within 45 days. If we do not deal with your complaint to your satisfaction or within 45 days, you may raise the matter directly with the Financial Ombudsman Service (FOS), a free independent body, GPO Box 3, Melbourne VIC 3001. Telephone: 1300 780 808. For more information see www.fos.org.au
JEnding thispolicy 45 This policy ends on the date that is
earliest of the following:
■ we pay a benefit for the insured person;
■ the insured person dies and no benefit is payable under this policy;
■ the benefits for the insured person end;
■ you ask us to cancel the policy;
■ we lapse or cancel the policy because you haven’t paid your premium (see clause 35);
■ we cancel or void the policy as a result of an innocent or fraudulent non-disclosure and/or misrepresentation made by you prior to our acceptance of risk or during the making of a claim; or
■ the Review Date immediately after the insured person reaches age 80.
KMemorandum of transfer –changingthe policyownership 46 A Memorandum of Transfer
form is to be used only when the ownership of this policy is to change. Please note the following:
■ under the Life Insurance Act, 1995, as amended, an assignment (transfer) is not valid until it is registered with Westpac Life Insurance Services Limited;
■ if the assignment is to a Bank, please advise which Branch is concerned. If notices under this policy are to continue to be sent to you, please show this;
■ the assignment may be liable to Stamp Duty under the legislation in your State or Territory. If applicable, the policy should be submitted to the appropriate Stamp Duty Authority for stamping before submission to us for registration of the assignment.