Some of the features of your insurance in Equip are changing from 1 July 2016, many being improved and simplified. Here is a summary of the features that have been changed. The full details of insurance in Equip MyFuture can be found in the Insurance in your super – additional guide. The guides will be available on the website from 1 July 2016.
Claim waiting period for TPD claims
The waiting period before you can claim for a TPD benefit has been reduced to three months. Before you make a claim for a TPD benefit, you need to have been a permanent employee working 15 or more hours each week within the 6 months prior to the date of your disablement. You will need to show that, due to illness or injury, you are unable to do any work as a result of the injury or illness for 3 consecutive months before you make your claim.
Injuries or illnesses for TPD immediate assessment
A new feature enables you to obtain a TPD benefit if you are diagnosed with a defined medical condition. If you are unable to perform your usual job as a result of suffering one or more of these defined medical conditions, the insurer will waive the usual 3 month waiting period and will start the assessment of your claim once it receives your completed documentation. Some examples of illnesses and injuries that can be assessed immediately are blindness, loss of hearing, loss of speech, quadriplegia, major head trauma, multiple sclerosis, and Parkinson’s disease.
Change to part of the TPD definition from ADL to EWA
There are a number of ways you can satisfy the definition of total and permanent disablement and there has been a change to one of those ways. Instead of assessing your ability to perform Activities of Daily Living, the insurer will assess your ability to perform Everyday Working Activities (EWAs) to do with mobility, communication, vision, lifting, and manual dexterity, and you will need to have lost some capacity in these areas to the extent required to the satisfaction of the insurer.
If you are on leave from your employer, any death, TPD or SC cover you have with us will continue and premiums will be deducted. Your cover will continue whilst there are sufficient funds to cover your insurance premiums.
Any death, TPD or SC cover you have with us will continue if you are temporarily overseas for up to 3 years, provided that:
- you remain a member of Equip throughout the period;
- you have sufficient money in your account for premiums to be deducted; and
- a claim does not arise directly or indirectly from when you have been in a country listed as ‘do not travel’ on the Department of Foreign Affairs & Trade website (www.dfat.gov.au).
Death benefit while on Salary Continuance (SC) benefits
We have improved SC benefits in the event that if you die while you are receiving a SC benefit, the insurer will pay your dependants a lump sum equal to 3 months of your SC benefit.
Change to definition for partial disability (you have some capacity to earn an income) for SC benefits
The insurer will pay you a partial disability benefit if, directly before suffering a partial disability, you suffered total disability continuously for a period of at least 7 days out of 12 consecutive days.
Change to definition for an unsuccessful return to work
If you are suffering total disability and return to work during the 3 month waiting period and your return to work is not successful due to the Injury or Illness causing total disability, then the original waiting period will continue if the number of days you return to work for is no more than 10% of the waiting period.