Cover and Premium Suspension Due to Hardship: Terms & Conditions

Introduction

This document describes the terms and conditions that apply when a Special Application for Cover and Premium Suspension Due to Hardship is made. These terms, along with the terms of cover described in the applicable PDS and Policy Document will apply if your Special Application is accepted by TAL .

Please read this document carefully and consider seeking financial advice, before making a Special Application for Cover and Premium Suspension Due to Hardship.

How it works

If the eligibility criteria are met you may apply to temporarily suspend cover and premiums for an initial period of up to three (3) months (Cover and Premium Suspension)

This means that:

  • no evidence of the Life Insured’s health, occupation, income, or pastimes, or any other Underwriting information, will be required following the Cover and Premium Suspension ending;
  • no premium is payable, and no premiums are due during the Cover and Premium Suspension period. Your premium may vary on recommencement; and
  • in addition to the terms of the PDS and Policy Document and any special conditions already applicable to the Plan or Policy(ies), the following terms apply in respect of a Plan or Policy that has been suspended:

For Life (Term) insurance:

No benefit will be payable for any claim which arises directly or indirectly from any condition or event which occurred or was diagnosed, or the signs or symptoms leading to the diagnosis first became apparent to the Life Insured or would have become apparent to a reasonable person in the Life Insured’s position during the Cover and Premium Suspension period.

Note: If cover is suspended under the Cover and Premium Suspension Due to Hardship  offer, and the Life Insured subsequently passes away as a result of COVID-19 prior to 30 September 2020, we will pay the lesser of the death cover sum insured for the Life Insured prior to the decrease, and $750,000 across all policies providing death cover that are issued by TAL and Asteron in respect of the Life Insured.

For Critical Illness (Trauma/Recovery) insurance:

No benefit will be payable for claims which arise from any condition that occurred or was diagnosed, or for which signs or symptoms leading to diagnosis first became apparent to the Life Insured or would have become apparent to a reasonable person in the Life Insured’s position during the Cover and Premium Suspension period and for three months following the Cover and Premium Suspension end date.

The above exclusion does not apply to the extent that the Critical Illness (Trauma/Recovery) event arises from an Accidental Injury that occurs during the three months following the reinstatement of your suspended cover under the Cover and Premium Suspension Due to Hardship offer. ‘Accidental Injury’ means an injury caused wholly by violent, accidental, external and visible means.

For Income Protection & TPD insurance:

No benefit will be payable for claims which arise from any condition that occurred or was diagnosed, or for which signs or symptoms leading to diagnosis first became apparent to the Life Insured or would have become apparent to a reasonable person in the Life Insured’s position during the Cover and Premium Suspension period and for three months following the Cover and Premium Suspension end date.

The above exclusion does not apply to the extent that the Life Insured’s disablement arises from an Accidental Injury that occurs during the three months following the reinstatement of your suspended cover under the Cover and Premium Suspension Due to Hardship offer. ‘Accidental Injury’ means an injury caused wholly by violent, accidental, external and visible means.

This offer is not available for benefits paid by annual rollover from a superannuation fund, including Linked, Superlinked and Split benefits.

If we accept your Special Application for a Cover and Premium Suspension, the suspension will last for a period of three (3) months, or the dates we specify in our acceptance letter provided to you.

Your cover will recommence on the same terms that applied prior to the Cover and Premium Suspension, subject to any change in premium and the terms of the special condition. A change in your premium may occur on recommencement of your policy in the following circumstances (including but not limited to):

  • your policy anniversary occurring during the suspension period;
  • your benefit is indexed (if applicable); and/or
  • the premium rates for  the product  being altered by us.

Upon the Cover and Premium Suspension ending, collection of the new premium and any overdue premiums will automatically recommence according to the payment instructions you have provided. If your payment details are no longer valid, we will contact you to request updated payment information. If you wish to cancel your policy, please contact us to advise.

Unless you notify us that you wish to end your Cover and Premium Suspension early, it will apply for three (3) months. Please contact us if you continue to require a Cover and Premium Suspension for a longer period.

No refunds are provided under the Cover and Premium Suspension for any period of cover for which premiums have already been paid. If your application is accepted, the Cover and Premium Suspension will apply from the date to which premiums have been paid.

Eligibility Criteria

To make a Special Application for Cover and Premium Suspension Due to Hardship:

  • Your policy must have been in force for a minimum period of 6 months, and be in force at the time of making the Special Application. 
  • You must not be otherwise eligible to suspend your cover under the terms and conditions of your policy, such as by exercising an existing cover pause benefit.
  • You must be experiencing financial hardship as a result of:
    - involuntary unemployment,
    - the requirement to take leave without pay, or 
    significant disruption to the operation of your own business and/or you are otherwise eligible to receive government hardship benefits.
  • If you are applying for a suspension of Income Protection and/or Total and Permanent Disability cover, you must not have been declared bankrupt or your business placed into insolvency or liquidation.

We reserve the right to require evidence to support your Special Application for Cover and Premium Suspension Due to Hardship.

Important Information

During the period of Cover and Premium Suspension, premiums will not be payable and no claim will be paid for any event that occurs, or condition for which signs or symptoms became apparent or were diagnosed, while your cover is suspended (except where cover for the Life Insured includes a death benefit and death is caused by COVID-19. Where this occurs we will pay the lesser of  $750,000 and the sum insured across all policies for the same life insured with TAL and Asteron). In some cases, no claim will be paid for certain events that occur, or condition for which signs or symptoms became apparent or are diagnosed, for three (3) months after a period of Cover and Premium Suspension ends.

For this reason, before making a Special Application for Cover and Premium Suspension due to financial hardship it is important to consider alternatives that may be available to address your circumstances and which do not result in suspension of your cover. For example, you may wish to consider altering your sum insured, options or cover(s) under your policy, changing the way your policy is structured or the way your premiums are paid, and contacting us to discuss other financial hardship measures we may be able to offer, before applying to suspend your cover.

This information is general advice only, which means that it does not take into account your individual needs, objectives or financial situation. Before making any decision about your policy, you should consider whether the advice is appropriate for you, taking into account your individual needs, objectives or financial situation, and read the relevant Product Disclosure Statement, Policy Document or contractual document. TAL recommends that you consult your financial adviser before making any changes to your cover(s) or policy or submitting a Special Application for a Cover and Premium Suspension Due to Hardship.

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