Below are the terms and conditions of your death and Total and Permanent Disability (TPD) and Salary Continuance (SC) insurance in Equip that were enhanced from 1 July 2016.
Change to part of the TPD definition from ADL to EWA
There are a number of ways you can satisfy the policy definition of total and permanent disablement. The definition of one of those ways has changed from Activities of Daily Living to Everyday Working Activities. EWA is defined as:
Mobility – you cannot do one of the following:
- walk more than 200m on a level surface without stopping due to breathlessness: or
- bend, kneel or squat to pick something up from the floor and straighten up again, nor get in and out of standard sedan car
Communicating – you cannot do one of the following:
- speak in your first language so that you are understood in a quiet room, nor can you hear (with or without a hearing aid or other aid) an instruction given in a normal voice in your first language in a quiet room; or
- understand a simple message in your first language, and relay that message to another person.
Vision – you cannot, with or without glasses or contact lenses, read ordinary newsprint and pass the standard eyesight test for a car license
Lifting – you cannot lift, carry or move objects weighing up to 5kg using your hands
Manual dexterity – you cannot use your hands or fingers to manipulate small objects with precision
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 total and permanent disablement benefit, you need to be a permanent employee working 15 or more hours each week within the 6 months prior to the date of your disablement and 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
If you are unable to perform your usual job as a result of suffering one or more defined medical conditions, the insurer will waive the usual 3 month waiting period and will start the assessment of your claim on receipt of your initial documentation. Some examples of illnesses and injuries that can be assessed immediately are quadriplegia, major head trauma, multiple sclerosis, Parkinson’s disease.
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 choose to work overseas for up to 3 years or are on leave from your employer provided that:
- you remain a member of Equip throughout the period;
- you have sufficient money in your account for premiums to be deducted; and
- the country you are visiting is not listed as ‘do not travel’ on the Department of Foreign Affairs & Trade website (www.dfat.gov.au).
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. Partial disability occurs where you have ceased to suffer total disability and you:
- have resumed partial employment; or
- are deemed capable of returning to partial employment duties; and
- as a result of the injury or illness that caused your total disability, you receive, or in the Insurer’s opinion you would receive, a post disability income that is less than your monthly income; and
- are under the continuous and regular care of a doctor undergoing appropriate treatment.
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 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.