Term Definition
All events cover means, in accordance with all other terms and conditions of the policy, cover for death or total and permanent disability arising from a sickness or injury regardless of the date the sickness or injury became apparent.
At work means you are actively performing all the essential duties of your regular occupation, are not absent from work because of sickness or injury, and are not in receipt of and/or entitled to claim income support benefits from any source including workers’ compensation benefits, statutory transport accident benefits and disability income benefits. Where you are on approved leave you must be capable of performing all the duties of your regular occupation had you not been on approved leave. If you do not meet these requirements, you are correspondingly described as not at work.
Benefit period means the maximum period of time for which a benefit will be payable.
Employed means being gainfully employed or self-employed for income or reward in any business, trade, profession, vocation, calling or employment on a permanent basis.
Essential duties means the duties of your regular occupation which could reasonably be considered primarily essential to producing your ‘salary’. The way you perform these duties will be taken into account when deciding what your essential duties are.
Injury means an accidental or intentional bodily injury suffered by you while you are insured for the relevant benefit under SSP.
Medical practitioner
means a person who is legally qualified and properly registered to practice medicine, other than:
•
you•
any of your business partners or associates•
your spouse (including legal spouse, de facto or same-sex partner), parent (including parent-in-law), or child.If practising other than in Australia, the medical practitioner must have qualifications acceptable to the Insurer.
Monthly earnings mean your earned income during a month in which you are ‘partially disabled’. New events
cover
means, in accordance with all other terms and conditions of the policy, cover for death and Total and Permanent Disablement arising from a ‘sickness’ which first becomes apparent or an ‘injury’ which first occurred on or after the commencement of Trustee Minimum Cover.
Partially disabled means that, because of ‘sickness’ or ‘injury’, you:
•
have been totally disabled for at least the qualifying period stated below: Waiting period–
30 days–
60 daysQualifying period to be partially disabled
–
14 consecutive days–
30 consecutive days•
would be ‘totally disabled’ except that you are performing, or are capable of performing, one or more of the ‘essential duties’ of your regular occupation, or are working in another occupation and•
have ‘monthly earnings’ which are less than your ‘pre-disability earnings’ because of your disabilityand
•
are following the advice of a ‘medical practitioner’ (acceptable to Suncorp Life).If you become a member of the Plan on or after 1 July 2014, you must also satisfy either the ‘temporary incapacity’ or ‘permanent incapacity’ conditions of release under the superannuation law (refer to page 10 of this Product Guide).
This additional requirement will also apply to a member who joined prior to 1 July 2014 but is provided with insurance cover for an Income Protection Benefit on or after that date. However, it does not apply to a member who is eligible for Income Protection benefit cover prior to 1 July 2014, even if we are not advised of their eligibility for it and/or membership until on or after that date.
Term Definition
Pre-disability earnings
means the total monthly value of the ‘salary’ received by you from your occupation at the time your total disability first occurs, averaged over the most recent 12 month period you were ‘at work’, or the actual period of work, if less.
Salary means, unless otherwise agreed in writing by Suncorp Life:
If you are ‘employed’, the fixed annual cash component of income paid to you by your employer in respect of your employment. For the avoidance of doubt, salary does not include the Superannuation Guarantee Charge payable in respect of you; or
If you are self-employed, that part of the income of your business due directly to your personal exertion, less that part of the expenses of the business (measured over the same period) reasonably apportionable to you, before income tax.
Sickness means a sickness or disease you suffer which becomes apparent while you are insured under SSP. Terminal illness means two medical practitioners certify that your life expectancy is, due to ‘sickness’ or ‘injury’, likely to
result in your death within 12 months of the date of certification, and:
•
at least one of the medical practitioners is a specialist in an area related to the ‘sickness’ or ‘injury’; and•
the period of certification for each of the certificates has not ended.Totally disabled means that, as a direct result of ‘sickness’ or ‘injury’, you are not capable of doing the ‘essential duties’ of your occupation and are:
•
not working in any occupation•
not earning income from any other source (other than purely investment income), that involves physical or intellectual exertion by you and•
being treated at least monthly (unless otherwise agreed by Suncorp Life) by a ‘medical practitioner’ and are following the advice and treatment recommendations of that person.If you become a member of the Plan on or after 1 July 2014, you must also satisfy either the ‘temporary incapacity’ or ‘permanent incapacity’ conditions of release under the superannuation law (refer to page 10 of this Product Guide).
This additional requirement will also apply to a member who joined prior to 1 July 2014 but is provided with insurance cover for an Income Protection Benefit on or after that date. However, it does not apply to a member who is eligible for Income Protection benefit cover prior to 1 July 2014, even if we are not advised of their eligibility for it and/or membership until on or after that date.
Totally and permanently disabled (TPD)
means either:
a. you are ‘employed’ for 15 hours or more per week at the time of the event giving rise to the claim, and you have been absent from employment through ‘sickness’ or ‘injury’ for six consecutive months and we are satisfied that you are incapacitated to such an extent that you are unlikely ever to be able to resume work or attend any gainful profession or occupation for which you are suited by reason of your education, training or experience or
b. you suffer the loss of both feet or both hands or both eyes; or any combination of two of, a hand, a foot or an eye; where ‘loss’ means the total and permanent loss of the use of the hand or foot from the wrist or ankle joint, or sight in the eye or
c. you are not ‘employed’ for 15 hours or more per week at the time of the event giving rise to the claim, and are constantly and permanently unable to perform two or more activities of daily living without the physical assistance of someone else. Definitions of activities of daily living are:
–
bathing and showering–
dressing and undressing–
eating and drinking–
maintaining of continence with a reasonable level of personal hygiene–
getting in and out of bed, a chair or wheelchair or moving from place to place by walking, wheelchair or walking aid.If you can perform the activity on your own by using special equipment, we will consider you able to perform that activity.
Term Definition
Totally and permanently disabled (TPD) (continued)
If you become a member on or after 1 July 2014 then, in addition to satisfying one of the above definitions a, b or c (whichever applies), the Insurer must have also determined that, after consideration of medical and any other evidence it is reasonably satisfied that your ill health (whether physical or mental) makes it unlikely that you will engage in gainful employment for which you’re reasonably suited by education, training or experience.
This additional requirement will also apply to a member who joined prior to 1 July 2014 but is provided with insurance cover for Total and Permanent Disablement on or after that date. However, it does not apply to a member who is eligible for Total and Permanent Disablement insurance cover prior to 1 July 2014, even if we are not advised of their eligibility for it and/or membership until on or after that date. Waiting period means the nominated number of consecutive days during which you have to remain ‘totally disabled’
or ‘partially disabled’ before receiving Income Protection benefits.
War includes, but is not limited to, declared or undeclared war and armed aggression by one or more countries resisted by any country, combination of countries or international organisations.
Non-participating policy
This policy is a non-participating policy. As a result you do not have any right to any surplus in the statutory fund.