Critical Illness Insurance

Protecting you if you become critically ill or injured.

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Critical Illness Insurance with TAL

Critical Illness Insurance (sometimes referred to as Trauma Insurance) gives you financial freedom by providing a lump sum payout if you become critically ill or injured and require extensive medical treatment to recover your health.

Key features & benefits

  • Critical Illness Benefit

    You can get a quote for cover up to $500,000. For cover up to a maximum benefit of $2 million please call us on 131 825 or speak to your Financial Adviser.

  • Built-in Paralysis Support Benefit

    Doubles your cover amount to a maximum of $2 million, offering support if you’re faced with the profound impact of permanent paralysis.

  • $10,000 of Critical Illness cover for children

    Providing some financial security if your child (aged 2-19 next birthday) suffers a Child’s Critical Illness Event, as defined by TAL.

  • Advancement Benefit (Premier policy only)

    An advanced payment of a portion of the Critical Illness Insurance Benefit Amount for specified injuries and illnesses, including some early stage cancers.

  • Inflation Protection Benefit

    Your benefit amount automatically increases on the Policy Anniversary by 5% or the indexation factor, whichever is higher, to keep pace with inflation.

Resources

 

What is Critical Illness Insurance and how does it work?

Critical Illness provides worldwide cover for a number of injuries and illnesses and may provide you with a lump sum payment. At TAL, Critical Illness Insurance is available as 'Standard' or Premier’. The type of Critical Illness Insurance and any applicable options is stated in your Policy Schedule.

Critical Illness Insurance can give you the comfort of knowing you can access medical treatment, pay for rehabilitation, and even cut back at work to concentrate on your recovery.

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What other benefits does Critical Illness Include:

Not all benefits, options and sum insured levels are available online.

Critical Illness Benefit

Critical Illness Benefit A benefit is payable if you suffer a Critical Illness Event. You must also meet the requirements as defined in the Critical Illness Event definition in Section 9.3 of the Product Disclosure Statement.

Critical Illness Benefit

Critical Illness Benefit

Critical Illness Benefit A benefit is payable if you suffer a Critical Illness Event. You must also meet the requirements as defined in the Critical Illness Event definition in Section 9.3 of the Product Disclosure Statement.

Paralysis Support Benefit

Paralysis Support Benefit

The Critical Illness Insurance Benefit Amount will be doubled (up to $2 million) if you become permanently paralysed. 

Death Buy-Back Benefit

Death Buy-Back Benefit (only available if Critical Illness Insurance is Attached or Linked to Life Insurance)

If 100% of the Critical Illness Insurance Benefit Amount is paid, you can repurchase Life Insurance in 12 months’ time, up to the Critical Illness Insurance Benefit Amount paid. The request must be made in writing within the specified timeframe.

Advancement Benefit

Advancement Benefit

Pays a portion of the Critical Illness Insurance Benefit Amount for Advancement Benefit Events. Payment of this benefit will reduce the Benefit Amount by the amount paid. 

Female Critical Illness Benefit

Female Critical Illness Benefit

Pays 20% of the Critical Illness Insurance Benefit Amount, up to $50,000, for conditions such as Pregnancy Complications and Congenital Abnormalities. Payment of this benefit will reduce the Benefit Amount by the amount paid. This benefit only applies if the Life Insured is a female.

Needlestick Benefit

Needlestick Benefit

Pays up to $1 million if you suffer Occupationally Acquired HIV or Occupationally Acquired Hepatitis B or C. This benefit only applies if your occupation class is AA+ as specified in the Policy Schedule.

Inflation Protection Benefit

Inflation Protection Benefit

Automatically increases the Benefit Amount on the Policy anniversary by the greater of 5% and the Inflation Factor to help keep pace with inflation. Increased cover affects your premium, so you have the option to remove this benefit.

Premium Freeze Benefit

Premium Freeze Benefit

Your premiums stay the same and the Benefit Amount will reduce at each Policy anniversary. This benefit can only be exercised if stepped premiums have been selected and you are at least 30 years of age.

Financial Planning Benefit

Financial Planning Benefit

Reimburses up to $5,000 on fees for professional financial planning advice incurred when we pay 100% of the Benefit Amount. Your financial plan must be prepared by a financial adviser within 12 months of the date we paid your claim and we must receive evidence of the financial plan. 

Long Distance Accommodation Benefit

Long Distance Accommodation Benefit

Reimburses up to $250 per day, up to 14 days, for accommodation costs of an Immediate Family Member when they are required to travel more than 100 km to be with you.

To be eligible, you must be Bed Confined more than 100 kilometres from your usual place of residence and the Terminal Illness Benefit, 100% of the TPD Insurance Benefit Amount or 100% of the Critical Illness Insurance Benefit Amount has been paid. 

What important details do I need to know?

What's not covered?

No payment will be made under Income Protection and any included or optional benefits (if applicable), if the claim arises:

  • directly or indirectly because of an intentional, self-inflicted act by the Life Insured;
  • because of normal and uncomplicated pregnancy, miscarriage or childbirth. Normal and uncomplicated pregnancy includes, but is not limited to morning sickness, backache, varicose veins, ankle swelling, bladder problems, multiple pregnancy, carpal tunnel syndrome, or participation in an IVF or similar program;
  • directly or indirectly because of War or an act of war, even if the disability manifests itself after the War or warlike activity;
  • directly or indirectly as a result of the Life Insured’s participation in a criminal act and/or for any period that they are incarcerated due to their participation in a criminal act; or
  • directly or indirectly as a result of a permanent or temporary banning, deregistration, disqualification or restriction being placed on the Life Insured from performing all or some of the duties of their Working Occupation.
Travel outside Australia

If Life Insured is outside Australia, the Totally Unable To Work Benefit and/or the Partially Unable to Work Benefit will be limited to three months of payments. Entitlement to further and/or ongoing benefits will be assessed once the Life Insured returns to Australia and has met the necessary claim requirements (refer to Section 3 of the PDS for details).

If we limit payment of the Totally Unable to Work Benefit and/or Partially unable to Work Benefit payment to three months and the Life Insured remains Totally Unable to Work or Partially Unable to Work, the Overseas Assistance Benefit may be available to assist the Life Insured to return to Australia.

This limitation will not apply during periods when the Life Insured is medically certified as unfit for air travel, or where air travel to Australia is not possible.

What's not covered
What's not covered?

No payment will be made under Income Protection and any included or optional benefits (if applicable), if the claim arises:

  • directly or indirectly because of an intentional, self-inflicted act by the Life Insured;
  • because of normal and uncomplicated pregnancy, miscarriage or childbirth. Normal and uncomplicated pregnancy includes, but is not limited to morning sickness, backache, varicose veins, ankle swelling, bladder problems, multiple pregnancy, carpal tunnel syndrome, or participation in an IVF or similar program;
  • directly or indirectly because of War or an act of war, even if the disability manifests itself after the War or warlike activity;
  • directly or indirectly as a result of the Life Insured’s participation in a criminal act and/or for any period that they are incarcerated due to their participation in a criminal act; or
  • directly or indirectly as a result of a permanent or temporary banning, deregistration, disqualification or restriction being placed on the Life Insured from performing all or some of the duties of their Working Occupation.
Travel outside Australia

If Life Insured is outside Australia, the Totally Unable To Work Benefit and/or the Partially Unable to Work Benefit will be limited to three months of payments. Entitlement to further and/or ongoing benefits will be assessed once the Life Insured returns to Australia and has met the necessary claim requirements (refer to Section 3 of the PDS for details).

If we limit payment of the Totally Unable to Work Benefit and/or Partially unable to Work Benefit payment to three months and the Life Insured remains Totally Unable to Work or Partially Unable to Work, the Overseas Assistance Benefit may be available to assist the Life Insured to return to Australia.

This limitation will not apply during periods when the Life Insured is medically certified as unfit for air travel, or where air travel to Australia is not possible.

Waiting Periods & Benefit Periods
Waiting Periods & Benefit Periods

A choice of Waiting Periods applies from the Date of Disablement before Benefits commence:

  • 4 weeks;
  • 8 weeks; or
  • 13 weeks

Occupational restrictions may apply when applying for new Income Protection cover or when you increase your Income Protection cover. Your benefit period options will depend on the income replacement option you choose:

IP Focus

  • 1 year
  • 2 years, or
  • 5 years
Conditions

All benefit payments under Income Protection are limited by the terms and conditions set out in Section 2.6, Section 3 and Section 9 of the PDS.

The benefit payable may be reduced or stopped as a result of the following:

  • If you are not working or earning to your full capability (refer to ‘How much is payable and what are the ongoing benefit payments?’ and ‘When will we adjust your benefit payments?’ in Section 2.6.1 for details).
  • If you are receiving other payments (refer to Section 2.6.5 of the PDS for details).
  • The Totally Unable to Work Benefit or Partially Unable to Work Benefit will stop after three months if you are overseas (refer to Section 2.6.4 of the PDS for details).

A claim resulting from or related to any of the following will be excluded (refer to Section 2.6.4 of the PDS for details):

  • Intentional self-inflicted act.
  • Normal and uncomplicated pregnancy.
  • War or act of war.
  • Deregistration, disqualification or restriction which prevents or restricts you from performing your occupation.
  • Participation in a criminal act and/or for any period that you are incarcerated due to your participation in criminal act.

A claim may not be paid or paid at a reduced amount, if a special condition applies. If applicable, the special condition will be shown in the Policy Schedule.

During your assessment
What is underwriting?

Underwriting is a term used to describe the process of assessing insurance risk prior to issuing a policy. It usually takes the form of questions about your occupation, medical history and activities you enjoy doing.

Underwriting is designed to ensure the premiums and cover terms for your insurance plan are appropriate for your own medical situation, lifestyle and occupation, and for the insurer to assess if insurance can be provided to you and if so on what terms.

Loadings & Exclusions

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 as a result of participating in an excluded pastime or activity.

What other insurance can I include in my TAL life insurance plan?

TAL Accelerated Protection has a range of Insurances you can include in your life insurance plan

Download the Product Disclosure Statement

Download the PDS

Everything you need to know about TAL Accelerated Protection

Download

Why choose TAL as your Recovery Insurance provider?

Australia's leading life insurer
TAL is a leading Life Insurance specialist
TAL Customers
Trusted by over 5 million customers
Commitment to Claims
$3.5 billion in claims paid in 2022/23 FY


How to apply

Apply for Critical Illness Insurance with TAL.

Are you eligible for Critical Illness Insurance?

To be eligible for TAL Critical Illness Insurance, you must be:

  • Between 18-60 years old next birthday (level premiums) OR
  • Between 18-62 years old next birthday (stepped premiums)
  • A citizen or permanent resident of Australia or a New Zealand citizen residing permanently in Australia.

You’ll be asked a few questions related to your job, health and lifestyle, so we can determine if you have increased risk factors we need to consider in relation to your policy.

Step by step

1. Use TAL’s Cover Builder to get a quote, and speak to one of our advisers to answer any questions you might have.

2. Review your quote and the Product Disclosure Statement very carefully to make sure it suits what you need.

3. Pay for your cover and make sure you know where all your documents are in case you ever need to make a claim.

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Critical Illness Insurance FAQs

How much cover can I apply for?

You can get a quote for up to $500,000 of Critical Illness Insurance cover online. Cover available for ages 19–62 (age next birthday). For cover up to a maximum benefit of $2 million please call us on 131 825 or speak to your Financial Adviser.

If you have existing Critical Illness cover via another insurer TAL will cover the difference of your existing cover up to a maximum of $2 million. 
 

What does Critical Illness Insurance cover?

Critical Illness Insurance provides financial peace of mind in the form of a Lump Sum Payment, if you suffer a specified serious event listed on the policy, for example, cancer or stroke of specified severity. For many specified serious events, this means the condition will be required to progress beyond a diagnosis. Your Critical Illness Insurance payout can be used for things like medical treatment, rehabilitation, to replace lost income if you cut back at work, and for any other means to support your recovery.

How is Critical Illness Insurance different to Income Protection Insurance?

Both Critical Illness Insurance and Income Protection Insurance can give you cover in the form of a payment, paid out if you experience a specified serious event and you’re out of action and unable to generate an income. With Critical Insurance policies, you’ll receive one lump sum payment (determined by your policy).

With Income Protection Insurance, you’re eligible to receive up to 70% of your income, paid on a monthly basis while you’re unable to work.

How much Critical Illness Insurance do I need?

The right amount of cover for you will depend on your age, lifestyle, family circumstances and financial situation. Because everyone is unique, the right amount of cover for you is a personal decision. You should factor in your financial situation and any other types of life or health insurance policies you have when considering your Critical Illness Insurance policy.

How does Critical Illness Insurance work in Australia?

You can buy Critical Illness Insurance as a stand-alone policy, or as a rider benefit within a life insurance policy. When applying, your health and lifestyle will be assessed to determine any increased risk factors that should be considered before the policy is issued. If you suffer a specified serious event, you can lodge a claim and once approved, you’ll receive a lump sum payment, with the freedom to spend it on anything you like to support your recovery.

How long does it take for Critical Illness Insurance cover to start?

A three month waiting period applies in certain circumstances. This means no payment or benefit will be made if a claim arises related to certain Critical Illness Events, if the condition occurred, was diagnosed or symptoms became apparent within three months after the policy began.

Can I get Critical Illness without a medical examination?

Generally, it’s not necessary to undergo a medical examination when applying for Critical Illness Insurance.

At TAL, we will ask you some questions about your medical history. You have a duty to tell the insurer anything you know that may be relevant to our decision about providing you with insurance.

This duty applies when you first apply for Critical Illness Insurance, and on an ongoing basis if you choose to extend, vary or reinstate your insurance policy.

How much does Critical Illness Insurance cost?

The cost of your Critical Illness Insurance policy will depend on your age, gender, lifestyle and medical history. For example, premiums for smokers are higher than for non-smokers. Costs can also vary according to the policy’s features. The premiums you need to pay for your first year will be outlined in your policy.

What are pre-existing conditions?

A pre-existing condition is any illness or ailment where you have experienced the signs or symptoms during the 6 months up to and including the day you took our Critical Illness Insurance. It is considered a pre-existing condition regardless of whether you were aware of or diagnosed with any condition or not during this period.

Are Critical Illness Insurance premiums tax deductible?

With Critical Illness Insurance, your policy premiums are not tax deductible. However, the Lump Sum Payment you receive as a critical illness insurance payout are generally not subject to tax, either. This means the full benefit amount payable is yours, tax-free.

How do I make a Critical Illness Insurance claim?

To make a critical illness insurance claim, contact us as early as possible. This gives us the opportunity to gather the evidence we require to assess your claim, as delays may impact the time it takes us to process your claim.

When we are notified that you wish to make a claim, we will provide the forms that need to be completed and explain in detail our requirements and what the next steps are.

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2024 © TAL Services Limited a Dai-ichi Life Group Company.

"TAL is Australia's leading life insurer" based on Inforce premiums for risk only life insurance policies, NMG Consulting (2023).

Any financial product advice is general in nature only and does not take into account any person’s objectives, financial situation or needs. Before acting on it, the appropriateness of the advice for any person should be considered, having regard to those factors. Persons deciding whether to acquire or continue to hold life insurance issued by TAL should consider the relevant Product Disclosure Statement (PDS). The Target Market Determination (TMD) for the product (where applicable) is also available. Life insurance issued by TAL Life Limited ABN 70 050 109 450 AFSL 237848.