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New insurance design for CareSuper members

Changing with you as your insurance needs change.

Our new insurance design, effective 15 March 2010, differentiates the needs of young members from those who are more likely to have greater financial commitments and dependants.
The default death and total and permanent disablement (TPD) cover for members over 30 will double to 4 units, in recognition of the fact that most people* are underinsured and rarely get around to assessing their insurance needs, let alone actually implementing appropriate cover. 

However we believe that younger members should not have to pay for cover they don’t really need and so, we’ve set the default cover for members under the age of 30 at 1 unit of death cover and 4 units of TPD cover. Current members under 30 will keep their existing level of death cover.
All cover amounts in the Death and TPD scales remain the same Click here to see the scales. Income Protection scales and premiums are not changing..

The major changes are outlined below. Further information can be obtained by calling the CareSuperLine on 1300 360 149 or by downloading the 15 March 2010 Member Guide Product Disclosure Statement (PDS), available on this website from 15 March.

What are the important changes?

Before 15 March 2010	From 15 March 2010
All members:  2 units of death & TPD cover	Members aged under 30: 1 unit of death cover & 4 units of TPD cover (current members will retain existing death cover) Members aged 30 to 64: 4 units of death and TPD cover
1 Unit of death & TPD cost $1.50, split evenly – i.e. 75 cents for a death unit and 75 cents for TPD	Combined premium remains $1.50 for 1 unit of death & TPD However, death cover is now $0.83 per unit per week, and TPD cover is $0.67

New limits for extra cover

Subject to underwriting (ie. The completion of the health questionnaire in the PDS and any other requirements deemed necessary by the insurer) the new policy now allows for up to:

• $5 million death cover
• $3 million TPD
• $20,000 per month IP

Extra options for new members

Within 60 days of the date of the welcome letter, new members can enhance their cover in the following ways (without the need for underwriting):

Option 1 - Add income protection (rates are unchanged for IP)
Automatic acceptance limits – 12 units general scale; 17 units office; 24 units professional
and/or
Option 2 - Increase Death & TPD cover to up to 10 x salary (maximum of $1.55M)

Other changes

• TPD cover can now exceed Death cover at all ages except under new member package choice options
• The time before you can claim for TPD has reduced from 6 months to 3 months
• The fixed cover scales have changed. Click here to download the new scales.

New definitions

We’ve worked with the insurer, CommInsure, to improve terms for our members. To see the pre-15 March 2010 terms, check the 2009 Member Guide PDS.

Salary

Definition of salary for the calculation of insurance option 2:
1. Salary for permanent employees will be the gross annual salary (excluding bonuses, allowances etc.)
2. Salary for casuals/contractors will be annualised based on the total gross salary earned within the last 3 months immediately prior to application
3. Where a member has multiple employment arrangements the salaries (which may be either permanent or casual) will be combined to provide a total gross annual salary figure.

Terminal illness

The definition of terminal illness in order to gain an early release of the Death benefit is as follows:

A person suffers from an illness which:

(a) two medical practitioners, with at least one specialising in the person’s illness, certifies in writing will despite reasonable medical treatment lead to the person’s death within 12 months of the date of the certification; and

(b) the insurer is satisfied, on medical or other evidence, will despite reasonable medical treatment lead to the person’s death within 12 months of the date of the certification referred to in paragraph (a).
The illness from which the person suffers must occur, and the date of the certification referred to in paragraph (a) must take place, while the person is insured under this policy.

‘Total & Permanent Disablement’ means:

For employed or self-employed persons, an insured member is totally and permanently disabled if the insured member:
• Has suffered:
(i) The permanent loss of two or more limbs – a limb being the whole hand or foot, or
(ii) The complete and irrecoverable loss of sight in both eyes, or
(iii) The loss of one limb and the complete and irrecoverable loss of sight in one eye.
OR
• As a result of sickness or injury, has been absent from all employment for 3 consecutive months from the date of disablement, and the insurer is satisfied on the basis of medical and other evidence that the insured member is unlikely ever to be able to engage in any occupation, whether or not for reward.
OR
All of the following paragraphs (i), (ii), (iii) and (iv) apply to the person:
(i) the person was, on the date of disablement, aged 65 years or less
(ii) the person is absent from all work as a result of suffering cardiomyopathy, primary pulmonary hypertension, major head trauma, motor neurone disease, multiple sclerosis, muscular dystrophy, paraplegia, quadriplegia, hemiplegia, diplegia, tetraplegia, dementia and Alzheimer’s disease, Parkinson’s disease, blindness, loss of speech, loss of hearing, chronic lung disease or severe rheumatoid arthritis (each as defined in the Schedule of Medical Condition Definitions)
(iii) we consider, on the basis of medical and other evidence satisfactory to us, the person is unlikely ever to be able to engage in any occupation, whether or not for reward
(iv) the person is likely to be so disabled for life.

Where:
‘Occupation’ means:

• For a professional or manager, the person’s occupation based on the general area of expertise of the person
• For all other staff, either
• (a) an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience over the past 5 years where the member has remained in the same occupation (general area of expertise).

OR

• (b) an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience over the past 10 years where the member has changed occupation in the past 5 years.

‘Professional’ means a person who:

• Has a tertiary qualification or is eligible to belong to a professional body
• Earns a salary greater than $80,000 per annum, and
• Only works in an office environment and in a sedentary capacity.

‘Manager’ means a person who:

• Is part of the management of the employer
• Earns a salary greater than $80,000 per annum, and
• Only works in an office building and in a sedentary capacity.

OR

For persons unemployed for continuous period of 12 months before the onset of total disability leading to the permanent incapacity:

• The insured member has, in the opinion of the insurer, after consideration of medical and/or other evidence become permanently incapacitated to such an extent as to prevent him/her from engaging in any gainful occupation, or
• The insurer is satisfied that the insured member has become so disabled by bodily injury or illness that he/she will never be able to perform at least two of the following activities of daily living:
  
  
– Dressing – the ability to put on and take off clothing without assistance
– Bathing – the ability to wash or shower without assistance
– Toileting – the ability to use the toilet, including getting on and off without assistance
– Mobility – the ability to get in and out of bed and a chair without assistance
– Feeding – the ability to get food from a plate into the mouth without assistance

Where:
‘Assistance’ means the assistance of another person.

OR

For persons who perform full-time unpaid domestic duties, an insured member:

• has been unable to perform their unpaid domestic duties for 6 consecutive months and in the opinion of the insurer, after consideration of medical and/or other evidence, incapacitated to such an extent that it is unlikely that he or she will again be able to engage in their unpaid domestic duties, or in any other occupation for which they are reasonably suited by education, training or experience, and
• is so incapacitated that they are unable to leave their place of residence without the assistance of another person.

Where:
‘Assistance’ means the assistance of another person.

*Australian Institute of Superannuation Trustees Media Release, 3 June 2008.