Life Insurance – All the details

Everything you need to know about TAL Life Insurance.

Life Insurance Cover types

You can choose which Cover you’d like for your Life Insurance from:

  • Accident Cover;
  • Illness Cover; and
  • Adventure Sports Cover.
 
 Life Insurance What you're Covered for
Accident Cover You will be Covered in the event of your Accidental Death, subject to any Special Conditions specified in your Policy Schedule. For example, Cover would be provided for death as a result of accidental drowning, or as a result of a transport accident.
Illness Cover  You will be Covered in the event of death as a result of Illness, subject to any Special Conditions specified in your Policy Schedule. For example, Cover would be provided for death due to cancer, circulatory disease, heart disease, neurological disease or organ failure.  Illness Cover is intended to cover causes of death other than those as a result of Accidental Death.

Illness Cover also includes Terminal Illness Cover .  If you are diagnosed by a Medical Practitioner with a Terminal Illness with a life expectancy of less than 12 months, your Life Insurance Benefit Amount will be payable in full. 
Adventure Sports Cover  Adventure Sports Cover is an extension to Accident Cover.  In order to hold this Adventure Sports Cover, you must also hold Accident Cover.

You will be Covered in the event of death as a result of undertaking Adventure Sports, subject to any Special Conditions specified in your Policy Schedule. For example, you could opt to be Covered for activities including recreational aviation, hang-gliding, and/or scuba diving. 

 

 Life Insurance What you're not Covered for
Accident Cover If you select only Accident Cover, then no Cover is provided if you pass away from Illness, or as a result of undertaking Adventure Sports. For example, no Cover would be provided as a result of death due to suicide, cancer, heart attack or infectious disease or other non-accidental cause, or as a result of undertaking recreational aviation, motor racing or scuba diving or other Adventure Sports
Illness Cover  If you select only Illness Cover, then no Cover is provided if you pass away as a result of an Accident or as a result of participation in Adventure Sports. For example, no Cover would be provided for death as a result of accidental drowning, a transport accident or a skydiving accident.

If you select Illness Cover, you are not Covered in the event of suicide in the first 13 months following the Policy Commencement Date, or for any increases, within 13 months of the date of the increase in Cover.
Adventure Sports Cover Adventure Sports Cover is an extension to Accident Cover.  In order to hold this Adventure Sports Cover, you must also hold Accident Cover.
If you select only Adventure Sports Cover and Accident Cover, then no Cover is provided if you pass away from Illness. For example, no Cover would be provided as a result of death due to cancer, heart attack or infectious disease.

What’s included

Death Benefit
Depending on the Cover you choose, a lump sum payment will be paid to your Nominated Benefit Recipient or the Policy Owner if you pass away while you have Life Insurance Cover under a current TAL Lifetime Protection Policy.

Terminal Illness 
A lump sum payment of the Life Insurance Benefit Amount will be payable if you are diagnosed with a Terminal Illness while you are Covered by Illness Cover under TAL Lifetime Protection.  Your Life Insurance Cover will end upon payment.  Further Information can be found regarding this Cover in the glossary.  

Inflation Protection 
You can also choose whether you want your Cover to increase each year in line with the cost of living – this will mean that your premium will increase each year as the Cover is increased through a process called indexation.  If you have a Stepped Premium Policy, it will mean that there are two reasons your Policy will increase each year.

The default setting for all TAL Lifetime Protection Policies is for those Policies to have indexation applied to them but can be turned off on request. If you are Bundling TPD or Recovery Insurance with your Life Insurance, you will need to have Inflation Protection switched on or off for all insurances.

Indexation can be declined on any number of occasions or switched off permanently at any time, otherwise indexation continues on Life Insurance, and on TPD or Recovery Insurance Bundled with Life Insurance until Policy expiry. For TPD which is Standalone, indexation ends at the Policy Anniversary prior to your 65th birthday. For Recovery Insurance which is Standalone, indexation ends at the Policy Anniversary prior to your 70th birthday. 

Indexation applies to both Stepped and Level Premiums. For Level Premiums, the additional premium for the increased Cover is based on your age at the time of the increase – not at the time the Policy started. Indexation does not apply to Cover due to Life Insurance Buy Back Options, and Future Life Event increases.

The indexation rate is the CPI or 5%, whichever is the greater for Life Insurance, TPD and Recovery Insurance. For Income Protection, the indexation rate is 3% or CPI, whichever is the greater. The CPI rate is published each October and applies from the beginning of the following calendar year. Indexation applies to the Anniversary Statement issued for the next Policy Anniversary (i.e. after 1 January.) Indexation will cease on the anniversary prior to the Policy Expiry Date. Indexation continues through the maximum Cover allowable at the time of taking out the Policy. 

While you have an active Income Protection claim, and you are receiving payments from TAL, the Benefits are not indexed unless the Policy has the “increasing claims” optional extra. Indexation of these Benefit Amounts is the lower of CPI and 3%.

Indexation increases can be reversed on request. In this case only the most recently increased portion of the Cover is cancelled. The rest of the Cover (pre indexation) remains the same, and the premium relating to this Cover is the premium based on the recently calculated anniversary. 
Inflation Protection will not apply if Premiums are being waived under the Premium Relief Option.

Funeral Advancement 
Once a Death Certificate has been provided to us in respect of a Life Insured under the Policy, we’ll make an early payment of 10% of your Benefit Amount to a maximum of $25,000 to assist your estate with final expenses. Any payment made under the Funeral Advancement will reduce your Life Insurance Benefit Amount by a corresponding amount paid.  The balance of your Benefit Amount is payable on our acceptance of the claim. 

Future Life Events 
Future Life Events means you can increase your Life Insurance, TPD or Recovery Insurance Benefit Amount(s) without evidence of your health or pastimes when specific life events occur, for example, getting married or divorced, obtaining or increasing a mortgage or increasing your financial interest in a business. 

 

 

 Future Life Event Maximum allowable increase
 You or your spouse becoming a new parent through birth or adoption  25% of the Benefit Amount at Policy commencement, or $200,000, whichever is the lesser.
 Your marriage or divorce 
 Your dependent child starting secondary school
 Your completion of a post-graduate degree
 You becoming a full-time carer
 An increase in your financial interest in a business to which the Policy is related via a buy-sell, share purchase or succession agreement
 An increase in the loan liability of the business for which you are the primary guarantor
 An increase in your value to a business in which you are a key person
 Taking out or increasing a mortgage on your home  The amount of the mortgage being taken out, or the increased portion of an existing mortgage, to a maximum of $200,000.
 Your annual income increasing by $10,000 or more  Five times the annual salary increase, or $200,000, whichever is the lesser

 

 The following terms and conditions apply to Future Life Events:

  • You must be under the age of 55 at the time of the Future Life Event.
  • Applications for increasing Cover must be made within 30 days of a specified Future Life Event, or within 30 days of the Policy Anniversary following the Future Life Event. Increases are at our discretion based on evidence acceptable to us.
  • The amount of an increase cannot exceed the maximum Cover amounts and combined Cover limits specified. Find out limits for Life Insurance , Total Permanent Disability Insurance or Recovery Insurance . 
  • Future Life Events may be exercised only once in a 12 month period (designated by the last time the option was exercised). 
  • Cumulative increases from Future Life Events may not exceed $1,000,000 or the original Benefit Amount, whichever is the lesser. 
  • Future Life Events cannot be exercised where:
    - you have lodged or are eligible to lodge a claim under any  policy with TAL or any other insurer; or
    - a medical loading or medical Exclusion applies to you; or
    - Premiums are being waived under the Premium Relief Option; or
    - the Cover has resulted from applying for the Life Buy Back Option
  • In the first 6 months following the date of increase, the increased portion of the Benefit will only be paid in the event you suffer from a claimable event as a result of:
    - an Accident or an Accident as a result of Adventure Sports, depending on the Life Insurance Cover you have selected. If your Cover is for Illness only, then you are unable to claim the increased portion for any Illness occurring in the first 6 months;
    - an Accident or an Accidental Injury as a result of Sports, depending on the TPD Insurance Cover you have selected. If your Cover is for Illness only, then you are unable to claim the increased portion for any Illness occurring in the first 6 months; or
    - a Critical Injury as the result of an Accident under Recovery Insurance. If your Cover is for Critical Illness or Cancer, then you are unable to claim the increased portion for any diagnosed Event occurring within the first 6 months.

Cover Pause

At TAL we understand that not everything always goes as planned, that’s why we allow you to request to pause your Cover for up to three months in the event of financial hardship. During Cover Pause you will not have to pay premiums.

You need to be aware that no Cover will be provided while the Cover Pause is in effect – so if you request a Cover Pause, you will not be able to claim should your death or the Illness or Injury leading to your death occur or become apparent during the time your Cover is paused and you are not paying premiums.

At the end of the Cover Pause period, you can re-start Cover without needing to go through health and lifestyle assessment again.
Once your Cover is restarted by paying your premium, a qualifying period of three months will apply, so you’ll be eligible to claim three months after you re-start your Cover. You will not be eligible to claim should your death, or Illness or Injury leading to your death occur or become apparent during the qualifying period.

Stepped vs. Level Premiums

TAL Lifetime Protection offers the choice of Stepped or Level Premiums for all Cover types.  
Stepped Premiums means that the amount you pay in premiums increases each year as you get older.  

Stepped Premiums are re-calculated based on your age at each Policy Anniversary. This generally means your premium rate will start lower than the Level Premium structure, but will increase each year corresponding with increasing risks. 

Level Premiums means that the base cost of your Cover stays the same year on year, however as your Cover increases with Inflation Protection, the cost of that new Cover will be added to your premium.  

Level Premiums can give you more certainty on cost when planning ahead for the future and if you’re planning to keep your Cover for many years.  If keeping your costs stable is important to you, you also have the option of removing Inflation Protection.

When you select our Level Premium option, you should note that Level Premiums end at age 65 and will revert to the corresponding Stepped Premium for your age after age 65 until your Policy expiry.  

The options you can add

Premium Relief Option

This needs to be set up over the phone with one of our Insurance Specialists

If you are between 18 and 61 when applying, you can add Premium Relief to your Life Insurance, TPD and/or Recovery Insurance for an additional premium.  If you are covered under this option, we will waive your Life Insurance, TPD and/or Recovery Insurance (as applicable) premiums if you are unable to work for at least three consecutive months due to Illness or Accident.

This option expires on the Policy Anniversary prior to you turning 65.

To qualify for the Premium Relief Option you will need to be:

  • Totally unable to work in any occupation that you could be considered suitable for by training, education or experience;
  • Not earning an income; and
  • Following the advice of a Medical Practitioner

The amount waived will be the daily proportion of premiums due.

While premiums are being waived, Future Life Events are unable to be activated and your premiums and Cover will not increase with Inflation Protection.

Premium waivers under this option will cease on the earlier of:

  • Returning to work;
  • Generating Monthly Income; or
  • The Policy Anniversary prior to your 65th Birthday.

How claims work

How to make a claim

If you wish to make a claim under the Policy, you must contact us at the earliest possible opportunity. Once a claim has been lodged, we will begin the assessment process and identify any opportunities where further assistance can be provided.

Payments to your beneficiaries
You can nominate to whom we will pay your Life Insurance Benefit in the event of your death. Your nominee(s) are called Nominated Benefit Recipient(s).

Any selection of Nominated Benefit Recipient(s) is binding on us once we’ve received your nomination and send written confirmation of the nomination back to you. However, you can ask us to change or cancel a nomination at any time. If a nomination is made, details of the Nominated Benefit Recipient/s will be shown in your Policy Schedule. If a change or cancellation is made to a nomination, a new Policy Schedule will be issued as confirmation of the change.

If a Nominated Benefit Recipient passes away before you, the nomination of that Nominated Benefit Recipient becomes invalid. If there are other surviving Nominated Benefit Recipients then the benefits will be paid to them in accordance with the proportions in your nomination, but with those surviving proportions being scaled up to total 100%.
If there is no surviving Nominated Benefit Recipient, then the Life Insurance Benefit will be paid to your estate or to your legal personal representative, or a person we are permitted to pay under the Life Insurance Act 1995 (Cth).

The claim 
The event for which you are claiming must occur at a time while your Cover is current. Benefit payments will commence once we are satisfied you have met the terms and conditions of your Policy. 

To ensure we are able to assist you in an efficient manner, you must notify us in writing or by telephone, of any event that gives rise to a claim. This should be done as soon as reasonably possible otherwise claim payments may be reduced to the extent the ability to assess the claim has been prejudiced by the delay in being able to adequately assess the claim.

Claim requirements at your expense
You must provide us with any requirements we reasonably consider necessary to assess your claim. Upon notification, TAL will provide specific details of these claim requirements. 
Our obligation to pay a Benefit under the Policy is subject to the following information being provided to us:

  • notice of any claim or potential claim being provided to us as soon as reasonably possible;
  • the initial Medical Practitioner’s report;
  • a certified copy of your identification and proof of age;
  • the Policy Schedule;
  • all standard claim forms and other documentation or reports required by us to continue the initial and ongoing assessment, including but not limited to progress medical reports, records of your income and other personal financial documentation; and
  • such other information relating to the claim that we may reasonably request.

Claim requirements at TAL’s expense
If we arrange for you to be medically examined in connection with your claim:

  • the person who examines you will be an appropriate registered Medical Practitioner or other health practitioner chosen by us at our discretion;
  • you must use your best endeavours to attend the examination; and
  • we will pay the Medical Practitioner’s fees.

If we arrange for you to be medically examined and you fail to attend the examination and we incur a non-attendance fee, this fee must be paid by you.

We may also require you to:

  • attend interviews with a member of our staff or someone appointed by us as often as is reasonably required to fully consider your claim; and
  • attend and engage with occupational rehabilitation services by an appropriately qualified person selected by us.

If you are outside Australia and become Disabled, the entitlement to your claim may be suspended where we are unable to appraise the medical opinion or data relied upon by you. Consequently, you may have to return to Australia for the claim to be assessed, at no expense to us, before we are able to determine our liability for the claim.

We may cancel a Policy for a fraudulent claim
If you make a fraudulent claim under your Policy or another policy you have with us, we may cancel your Policy.

Claims assessment
Both the eligibility and extent of any claim payments relating to your Illness, Injury or Disablement will be based solely on the medical factors contributing to the Illness, Injury or Disablement. Under the terms of this Policy, we will exclude any claims made on the basis of additional impact due to economic, seasonal or any other non-medical factors.

Payment of claim
If you are judged not to be legally competent, we will pay any Benefits to whomever we are legally permitted to make payments.
We will not be liable to you for any loss you suffer (including consequential or special loss) caused by the fact that we are required by law to delay, block, freeze or refuse to process a transaction, where applicable.

Claims contact details
GPO Box 5380 Sydney NSW 2001 
Customer Service 1800 101 016 
www.tal.com.au
Email Retail.Claims@tal.com.au

General Information

The cost
The cost of your Policy depends on a range of factors, including your age and gender, the type and amount of Cover, the number of Cover types you hold, the length of time you’ve held Cover with us and whether or not you smoke.

We also take your occupation, health, income and personal pastimes into account. Once we know a little bit about you and the Cover you require, we can then determine the basic costs involved. 

When you take out a Policy you will receive welcome documentation and a Policy Schedule, you should read it carefully. The welcome documentation will show you the first premium payable and due date. The premium amount will also include any extra amounts charged to you when we accepted your application or re-issued you a Policy.

Eligibility
Australian citizens, permanent Australian residents, or New Zealand citizens residing permanently in Australia aged 18 to 74 are eligible to apply.  Level Premiums are available to applicants aged 59 or under.

Minimum and Maximum Cover
The minimum Cover amount you can apply for is $100,000.
The maximum Cover amount you can apply for is $1,500,000. 
Other limits may apply depending on your income and your age.  These limits will be detailed on your application.

Cover Start and End Dates
Once your application is accepted by us we guarantee to renew your Life Insurance Cover until the Policy Anniversary prior to  your 100th birthday as long as you have complied with the Duty of Disclosure and you have paid premiums when due. This guarantee applies regardless of any change in your personal circumstances.

Your Cover will end when the full Benefit Amount is paid, Cover is removed from your Policy, Cover is cancelled through non-payment of premiums or when Cover expires at age 99.  There may be other reasons Cover may end.

What you’re not covered for 
Some Exclusions apply to your Life Insurance regardless of the Cover you have selected. No payments will be made under Life Insurance if the event giving rise to the claim occurs while you are visiting a country for which the Australian Department of Foreign Affairs and Trade (DFAT) has issued a ‘Do Not Travel’ warning advice that is in force during the time of your stay in that country.

In addition, specific Special Conditions may apply to your Life Insurance depending on the Cover options that you have selected. Refer to your Policy Schedule for details of any additional Special Conditions that apply to your Policy. 

If you have selected Accident Cover only, no claim will be payable in the event of:

  • your death as a result of Illness;
  • your death as a result of suicide; or
  • your death as a result of undertaking Adventure Sports.

If you have selected Illness Cover only, no claim will be payable in the event of:

  • your Accidental Death;
  • your death as a result of undertaking Adventure Sports; or
  • your death as a result of suicide in the first 13 months of your Cover commencing and in the first 13 months following any increases in Cover, in respect of the increased amount.

If you have selected Accident Cover and Illness Cover, but not Adventure Sports Cover, no claim will be payable in the event of:

  • your death as a result of suicide in the first 13 months of your Cover commencing and in the first 13 months following any increases in Cover, in respect of the increased amount; or
  • your death as a result of undertaking Adventure Sports.

If you have selected Accident Cover and Adventure Sports Cover, but not Illness Cover, no claim will be payable in the event of:

  • your death as a result of Illness; or
  • your death as a result of suicide.

Loadings and Exclusions
When you apply for TAL Lifetime Protection, you will be asked a number of questions.  These questions relate to your Duty of Disclosure .

Your answers to the questions may mean that you have increased risk factors under the Policy.  In some cases we will be unable to provide you with all or some parts of the Cover for which you have applied.  In other cases, Cover may be subject to conditions such as a premium loading, or an Exclusion. A premium loading will mean that you pay a higher premium for the Cover, an Exclusion will mean that you will not be Covered if you suffer a specified excluded medical condition, or you are injured or die as a result of participating in an excluded pastime or activity.

Premium changes  
We can change the premium rates applying to all TAL Lifetime Protection Policies. If we do change them you will be advised of the change 30 days prior to it taking effect.
No one individual Policy can be singled out for an increase in premium rates because of an adverse change in your health or circumstances, once your Cover is in place.

 

Structuring the right Policy for you

With TAL Lifetime Protection you can have as much or as little flexibility as you want.  If you’re tailoring your own Cover, there are a number of choices you’ll need to make.

Standalone and Bundled Cover
Standalone 
You can keep your Insurances independent - purchase just one, two, three or all four Insurances independently and receive the full Benefit Amount on acceptance of your claim. (This is subject to any adjustments  and meeting eligibility criteria).

You will pay more for Standalone, but the advantage is if you make a claim your Life Insurance Cover Benefit Amount will not be drawn down unlike Bundled Covers.

TAL Lifetime Protection insurance plan

Bundled
This can only be set up over the phone.

To keep the cost down, you can Bundle TPD and Recovery Insurance with your Life Insurance.

Image displaying how TAL Lifetime Protection can be bundled together

If you make a claim on a Bundled Cover, your Life Insurance Cover Benefit Amount and the Benefit Amount of any other Cover in the Bundle will be drawn down by the amount of the claim payment.  Structuring your Policy in this way means that generally the cost of Cover will be reduced.  Once you have claimed and your Benefit Amount is reduced, your premiums will also reduce accordingly.

Your Bundled Insurance needs to have a lower Benefit Amount than your Life Insurance and any Inflation Protection must be consistently applied across all Covers. For example if you wish to turn Inflation Protection off for your Life Insurance, it must also be turned off for the Bundled Covers.  

If your Life Insurance has been reduced due to a TPD or Recovery Insurance claim, you can buy back the Life Cover to its original level if you have selected the Life Buy Back Option.

How Bundled Cover works at Claim
If you Bundle TPD or Recovery Insurance with Life Insurance Cover, the payout of one Cover will reduce the Benefit Amount of the Covers within the Bundle by a corresponding amount. 

Example: 

You take out $1,000,000 of Life Insurance and Bundle this with $500,000 TPD and $250,000 Recovery Insurance.  

Two years later, you are diagnosed with a Brain Tumour and make a claim on Recovery Insurance under Cancer Cover.

Policy before claim on Recovery Insurance Cancer Cover

 Image showing a bundled insurance policy

When your claim is approved and $250,000 has been paid to you, you are no longer Covered by Recovery Insurance and the Benefit Amount for the other Covers within the same Bundle reduces in line with the Benefit Amount paid. In this case:

  • your Life Insurance Cover amount reduces to $750,000, and
  • your TPD Cover  amount reduces to $250,000

Policy after payout of claim on Recovery Insurance Cancer Cover

Image displaying how a Claims scenario for a bundled product would work

Your premium will also reduce in line with the reduced Benefit Amounts. 

If you hold a Life Buy Back Option , you have the opportunity to buy back the $250,000 sum insured of Life Insurance Cover after 12 months from date of claim.

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