Before you enter into a contract of insurance with an insurer, you have a duty under the Insurance Contracts Act 1984
(Cth) to disclose to the insurer every matter that you know or could reasonably be expected to know, is relevant to the insurer’s decision whether to accept the risk of insurance and, if so, on what terms.
You have the same duty to disclose those matters to the insurer before you renew, extend, vary or reinstate a contract of insurance. Your duty, however, does not require disclosure of a matter that
• diminishes the risk to be undertaken by the insurer
• is of common knowledge
• that the insurer knows, or in the ordinary course of business, ought to know or
• we have waived.
Non-disclosure
If you do not disclose to the insurer every matter that you know or could reasonably be expected to know, that would be relevant to the insurer’s decision whether to accept the risk of the insurance and if so, on what terms, the insurer may avoid the contract, or avoid your cover within three years of entering into it, provided that the insurer would not have entered into that contract or accepted cover for you had full disclosure been made.
Where the insurer is entitled to avoid a contract of insurance, the insurer may elect not to avoid it but apply either of the following options:
• reduce the sum that you would have been insured for in accordance with a formula that takes into account the premium that would have been payable if you had disclosed all relevant matters to the insurer; or
• vary the contract in such a way as to place the insurer in a position that the insurer would have been had you disclosed all relevant matters or not made a misrepresentation.
Where your contract is in respect of death cover, the insurer may only apply the fi rst of the two options and the insurer must do so within three years of you entering into the contract or the insurer providing cover to you.
Declaration
I declare that:
• I understand my duty of disclosure and the eff ect of non-disclosure under the Insurance Contracts Act 1984.
• I have answered all questions in this application truthfully and correctly (to the best of my knowledge), and have disclosed everything I know that could aff ect OnePath Life’s decision to accept my application.
• I understand that insurance cover through LGsuper will be provided to me on the terms contained in LGsuper’s insurance policy as changed from time to time.
• I have read and understood LGsuper’s Insurance guide or LGsuper’s Defi ned Benefi t account guide or Defi ned Benefi ts
Fund guide (for members with a defi ned benefi t).
• I consent to the collection, use and disclosure of my personal information in accordance with the LGsuper Privacy
statement and the OnePath Life Privacy statement set out in LGsuper’s Insurance guide.
• I understand that the additional 2 units of cover will not become eff ective until my application is accepted in writing and provided my member account has adequate funds to meet the premium payable. I understand that increases.
• I understand that the information I provide in this application form, along with any other statements made or evidence provided in connection with this application, will be used by OnePath Life to assess whether to accept the application and issue the increased amount of insurance.
Signature Date
Now you have completed this form and signed the declaration, please send it to us by:
Post LGsuper Email (scanned copy) Fax 07 3244 4344
GPO Box 264 [email protected] Brisbane Qld 4001
Declaration
I declare that:
• I understand my duty of disclosure and the eff ect of non-disclosure under the Insurance Contracts Act 1984.
• I have answered all questions in this application truthfully and correctly (to the best of my knowledge), and have disclosed everything I know that could aff ect OnePath Life’s decision to accept my application.
• I understand that insurance cover through LGsuper will be provided to me on the terms contained in LGsuper’s insurance policy as changed from time to time.
• I have read and understood LGsuper’s Insurance guide or LGsuper’s Defi ned Benefi t account guide or Defi ned Benefi ts
Fund guide (for members with a defi ned benefi t).
• I consent to the collection, use and disclosure of my personal information in accordance with the LGsuper Privacy
statement and the OnePath Life Privacy statement set out in LGsuper’s Insurance guide.
• I understand that the additional 2 units of cover will not become eff ective until my application is accepted in writing and provided my member account has adequate funds to meet the premium payable. I understand that increases.
• I understand that the information I provide in this application form, along with any other statements made or evidence provided in connection with this application, will be used by OnePath Life to assess whether to accept the application and issue the increased amount of insurance.
Signature Date
Now you have completed this form and signed the declaration, please send it to us by:
Post LGsuper Email (scanned copy) Fax 07 3244 4344
GPO Box 264 [email protected] Brisbane Qld 4001
Benefi t withdrawal form
B01
Toll free 1800 444 396 Facsimile 07 3244 4344 [email protected]
The Queensland Local Government Superannuation Board ABN 94 085 088 484 AFS Licence No. 230511
GPO Box 264 Brisbane Qld 4001