3. Marco conceptual
3.3. Marco teórico referente a la población de Estudio
If you are Totally Disabled for the selected qualifying period (3 days or 30 days) from when an Accidental Injury occurs, we will pay monthly in arrears 1/30 of your Insured Monthly Benefit for each complete day during your Waiting Period that you are Totally Disabled until the end of the selected Benefit Period (30, 60 or 90 days). Amounts payable under the Bed Confinement, Specified Injury or Crisis Recovery benefit will be deducted from the benefit amount.
Note: This benefit is not available with a 14 day Waiting Period. The 3 day qualifying period is not available for Occupation Category E or under the Superannuation Income Protection Plan.
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Claim Escalation benefit*
Under an Ordinary Income Protection Plan, if your claim is paid for more than 12 consecutive months, we will increase your claim payments by the higher of 3% and the CPI Increase. Under a Superannuation Income Protection Plan, we will increase your claim payments by the higher of 3% and the CPI Increase, up to a maximum of 5%. Under both Plans your claim payments will continue to increase each year while you remain disabled until the earliest to occur of, the end of your Benefit Period, the latest Policy Anniversary prior to your age 65. Other conditions apply.
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* Under the Superannuation Income Protection Plan, the monthly benefit payable cannot exceed 100% of your Pre-disablement Income.
NS Not available under the Superannuation Income Protection Plan.
52 Income Protection and Income Protection Accident Only Income Protection Income Protection with Advantage OptionalNS Income Protection with PLUS OptionalNS Income Protection Accident Only
Income Protection Lump Sum benefitSE
You can apply for, or we may offer you, a lump sum benefit of up to the lesser of $3,000,000 and 180 times your Insured Monthly Benefit if we are satisfied that your disablement meets the Total and Permanent Disablement (Own Occupation) definition. The lump sum payable depends on your age at time of claim and offsets may apply.
If we pay this benefit, no further Income Protection rider benefits will be payable and the Income Protection benefit will end.
Note: This benefit is only available for ‘To Age 65’ and ‘To Age 70’ Benefit Periods with Waiting Periods other than 1 or 2 years.
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—Carer’s Allowance benefitNS
If you are not earning any income because your nominated Child aged between 3 and 16 next birthday becomes totally dependent on you solely and directly due to Accidental Injury or Sickness, we will pay a benefit of 25% of the Insured Monthly Benefit (excluding any Retirement Optimiser) up to $2,000 per month for up to six months while the Child remains totally dependent on you for their essential everyday needs. The benefit is payable only once in a 12 month period per insured child. Up to 10 Children can be insured and a separate benefit will apply to each Child. The benefit will terminate on the Policy Anniversary before the Child turns 18. Different qualifying and waiting periods apply in the event of the Child’s Sickness and Accidental Injury.
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Retirement Optimiser
You can insure up to 5% of your average monthly Income so the superannuation account you nominate will continue to accumulate contributions while you are paid an Income Protection benefit. This means that, when we pay your monthly benefit for Total Disablement or Partial Disablement (or under the Day 1 Accident, Specified Injury or Crisis Recovery benefits, if applicable) we will also pay an additional amount into your nominated superannuation account. The additional amount we pay depends on whether your Income Protection benefit is on an Agreed Value or Indemnity basis and will be affected by reductions for partial disablement and any claim offsets. Benefit Indexation and Claim Escalation (if applicable) will also apply to the Retirement Optimiser benefit.
We will pay the Retirement Optimiser benefit as a non‑concessional contribution to your nominated superannuation fund on your behalf. You must provide us with the information we request to enable us to pay this benefit. We cannot pay the Retirement Optimiser benefit to you in cash.
Note: When the Retirement Optimiser is provided under a policy issued to the trustee of an approved superannuation fund or SMSF we will pay the entire Retirement Optimiser monthly benefit to the trustee to be credited into your superannuation account. We will not deduct or withhold tax from that payment. However, the trustee may deduct tax (including any applicable contributions tax) in respect of that payment.
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Business Expenses benefitNS
This benefit is designed to cover fixed business expenses during a period of disablement for self-employed practitioners, whether working alone, in partnership or as a working director (see pages 59 – 61).
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—NS Not available under the Superannuation Income Protection Plan.
SE Available with the Superannuation Income Protection Plan only under a linked Super Extras policy outside of superannuation, see page 70 for more information.
The benefits that apply to you will be shown on your Policy Schedule.
For a summary of the circumstances when a benefit may not be paid or where reductions in the sum insured or claim offsets may apply, see pages 75 – 79.