ness super · why having insurance in superannuation is important 3 1.1 what types of cover does...

NESS SuperEmployed Division Insurance Guide

Issued 1 April 2020 by NESS Super Pty Ltd ABN 28 003 156 812 RSE Licence No L0000161 as trustee of the NESS Super ABN 72 229 227 691 RSE Registration No R1000115 AFSL No 238945 MySuper Authorisation 72 229 227 691 044

1 April 2020

NESS Super - Employed Division Insurance Guide

1. Why having insurance in superannuation is important 3

1.1 What Types of Cover does NESS provide 5

2. Death, terminal illness and TPD insurance 6

2.1 What insurance you receive when you join 7a. When cover commences 7b. Offer to increase cover when first joining 8c. Do you have insurance already? 8

2.2 How you can change your cover 8a. Converting from units of cover to fixed cover 9b. Converting from fixed cover to units of cover 10

2.3 When cover stops and how you can get cover again 10

2.4 How to make a claim 11

Other important things to know 13

Words and Terms Used 14

3. Income protection insurance for employed members 18

3.1 What insurance you receive when you join 19a. When cover commences 19b. Do you have insurance already? 19

3.2 Can I make alterations to my cover? 19

3.3 When cover stops and how you can get cover again 20

3.4 How to make a claim 20

3.5 How to make a complaint 20

Other important things to know 21

Words and Terms Used 22

Contents

3www.nesssuper.com.au | 1800 022 067

1. Why having insurance in superannuation is important

http://www.nesssuper.com.au/

4 NESS Super - Employed Division Insurance Guide

When most people buy a house or a car they will take out insurance to protect that asset. But what would happen if an illness or injury prevented you from earning a future income. How would you be able to pay your bills or, if you have purchased a house, pay your mortgage? It may be possible to get by for some time with sick leave, savings, workers compensation (if you have a workplace accident), or the help of family and friends, but reliance on these in the long-term is difficult.

We hope you never have to make a claim, but we provide insurance at NESS Super to provide you with peace of mind and income if you need it.

A common misconception is that workers compensation will provide income if you have a workplace injury or illness. However, what happens if the injury or illness happens away from work.

The insurance we offer at NESS Super provides you with cover 24 hours a day, 7 days a week, irrespective of whether you are at work.

Do you know how much cover you need?Depending on your circumstances, the Default Death, Terminal Illness (TI) Total & Permanent Disablement (TPD) and Income Protection (IP) cover may or may not be the right amount of cover for you. In working out the level of insurance you need you may want to think about what you need now and into the future to cover:

• your current living expenses that your salary now pays for (such as bills, food, transport, insurance, education expenses);• your debts – mortgages, car loans, credit card• future costs that you may see coming (school education for your children and those who you support financially).As a guide, we recommend using the Government’s Moneysmart Life Insurance Calculator to work out what you need.

https://www.moneysmart.gov.au/tools-and-resources/calculators-and-apps/life-insurance-calculator

If you find the automatic insurance that we provide is not enough, you have the option of changing your cover to an amount that suits your circumstances. See How you can change your cover to find out how to get the cover you need.

1. Why having insurance in superannuation is important

https://www.moneysmart.gov.au/tools-and-resources/calculators-and-apps/life-insurance-calculator


1.1 What Types of Cover does NESS provideThe table below summaries what types of insurance we provide for you and what options you have to change your cover.

Type of Insurance Description Default Cover Options

Sect

ion

2 –

Deat

h, T

I and

TPD

Insu

ranc

e

Death (Insured by Hannover Re of Australasia Ltd).

Death cover helps ease financial stress by paying a lump sum benefit to your beneficiaries if you die. Note: It’s an important decision that you can make now of who will receive your benefit if you die. Refer to page 13 to see what options you have to nominate beneficiaries.

2 units of age-based cover. Additional cover:If under 35 units fixed cover, ORIf 35 or older, additional units or fixed cover up to a to a maximum of $5,000,000.

Terminal Illness(Insured by Hannover Re of Australasia Ltd).

Terminal Illness cover provides you with a lump sum benefit if two Insurer approved medical practitioners certify that it is highly likely that you will die within 24 months.

Same as death. 2 units of age-based cover.

Additional cover:If under 35 units fixed cover, ORIf 35 or older, additional units or fixed cover up to a to a maximum of $3,000,000.

TPD(Insured by Hannover Re of Australasia Ltd).

TPD cover can provide you with a lump sum benefit if you are totally and permanently disabled and no longer can work. A lump sum can help cover your future cost of living and also help to pay for immediate medical expenses you may face.

2 units of age-based cover.

Additional cover:If under 35 units fixed cover, ORIf 35 or older, additional units or fixed cover up to a to a maximum of $3,000,000.

Sect

ion

3 –

Inco

me

Prot

ectio

n In

sura

nce Income Protection

(Insured by Chubb Insurance Australia Limited)

Income Protection can provide cover if you are injured or become ill and are unable to work for a period of time.

Up to 75% of your income payable to you plus up to 10% payable as a contribution to NESS Super for up to 2 years (104 weeks) or until you turn 65. Waiting period is 30 days.

Options to:Increase Benefit Period to 5 years (260 weeks). Increase Waiting Period to 60 or 90 days.

Important – Default Cover is subject to Government legislation requirements known as Putting Members Interests First (collectively known as ‘PMIF Requirements’). This means that if you join NESS Super on or after 1 April 2020 to commence Default Cover you need to EITHER:

1. Opt-in to receive Default Insurance within 60 days of joining NESS Super; OR

2. Meet BOTH the requirements of the legislation being you are 25 years of age AND your NESS Super account balance exceeds $6,000.

In Sections 2 – Death, TI and TPD Insurance and 3 – Income Protection Insurance we will provide you information on:

1 What insurance you receive when you join

2 How you can change your cover

3 When cover stops and how you can get cover again

4 How to make a claim

It is important that you read each section independently of each other, as the insurances covered in each section are covered by separate group insurance policies that have been negotiated by the Trustee with two separate insurers.



2. Death, terminal illness and TPD insurance

(Insurance Provided by Hannover Re of Australasia Ltd)


2.1 What insurance you receive when you join

Death CoverWhen you join NESS Super, you will receive Default Death Cover of 2 units based on your age (subject to meeting the PMIF requirements and other eligibility conditions). The value of cover, and the premium you pay, changes based on how old you are. To find out the age-based Death and TPD cover amounts and costs (refer to page 16).

You can apply to:

• Increase your cover with either taking out additional fixed cover or, from the age of 35, taking out additional units of cover

• Convert all your cover to a fixed amount (refer to conditions on page 8)

The maximum limit of death cover you can apply for is capped at $5,000,000.

TI CoverIf you have Death cover with us and you have a medical terminal medical condition, you may be eligible to receive a terminal illness benefit and be able to access your super account balance before you pass away. Note: If you have applied for Death Cover exceeding $3,000,000 you will only receive $3,000,000 prior to your death.

Example of how Default Death Cover changes over time.

The graph below gives you a quick idea as to what Default Death cover looks like at different ages.

Default Death Cover

$-

$50,000

$100,000

$150,000

$200,000

15 20 25 30 35 40 45 50 55 60 65 70

Defa

ult

Deat

h Co

ver

Age Last BirthdayNew Death Cover

TPD CoverWhen you join NESS Super, you will receive Default TPD Cover of 2 units based on your age (subject to subject to meeting the PMIF requirements and other eligibility conditions)). The value of cover, and the premium you pay, changes based on how old you are. To find out the age-based Death and TPD cover amounts and costs (refer to pages 16).

You can apply to:

• Increase your cover with either taking out additional fixed cover or, from the age of 35, taking out additional units of cover

• Convert all your cover to a fixed amount. (refer to conditions on page 8)

The maximum limit of TPD cover you can apply for is capped at $3,000,000.

Example of how Default TPD Cover changes over time.

The graph below gives you a quick idea as to what Default TPD cover looks like at different ages.

Default TPD Cover

$-15 20 25 30 35 40 45 50 55 60 65

Defa

ult

TPD

Cove

r

Age Last BirthdayNew TPD Cover

$50,000

$100,000

$150,000

$200,000

a. When cover commencesWhen joining NESS Super, members must met the PMIF eligibility requirements, NESS Super must also receive an Employer Contribution within 180 days of you becoming First Eligible to join the Fund. Default Cover then commences when a member meets one of the following requirements:

• If you are a PMIF exception member ( this is where your insurance premium is PAID by your Participating Employer) then cover will commence from the first day to which that employer contribution applies, if you are not At Work on the date that cover commences then ALL cover is Limited Cover until you have been At Work for 30 consecutive days, or

• If you have Opted In, from the date that NESS Super receives the opt in request, or

• The later of the date and you are both 25 years old and have a balance of at least $6,000

Where you as a member have either opted in or are 25 years old and have a balance of $6,000 then ALL cover is Limited Cover until you have been At Work for 30 consecutive days.

Where you Do Not meet these requirements or if you have previously been paid a TPD or TI benefit from any source or are aware of any condition or symptom that may entitle you to apply for a TPD or TI benefit from any source you will not be eligible for Default Cover and all cover is Voluntary Cover and is subject to underwriting.

Generally, most members will fit into the scenario of being At Work, meeting PMIF requirements and in receipt of employer contributions, however it’s important that you know circumstances where receiving Default cover may not always be as straight-forward.



b. Offer to increase cover when first joining If you are employed by a Participating Employer and have met the conditions outlined in a. When cover commences and are not subject to any of the exceptions listed above you may request to increase your Insured Cover without underwriting by up to 2 units of Death Cover and/or 2 units of TPD cover, subject to you:

• applying to us within 180 days of the date you were First Eligible to join the Fund, or

• applying to us within 30 days of the date you receive the Insurance confirmation letter from NESS Super and your Default Cover has commenced outlined in a. When cover commences, and

• an Employer Contribution has been received, and• you are At Work, • If you have Death cover only, the increase will apply only to death

cover, and• You must not have previously requested to increase Insured Cover

under this offer.

Otherwise the increase in Insured Cover under this clause will not be provided.

Where you had converted your Default Cover to fixed cover prior to the request to increase Insured Cover under this offer, the equivalent amount will be provided as fixed cover.

The increase in Insured Cover commences on the latter of the date that NESS Super received the request to increase Insured Cover and the date Default Cover had commenced as outlined in a. When cover commences and provided that your account balance is sufficient to pay the Premium. Otherwise the increase in Insured Cover will be deemed not to have come into force under this clause.

No cooling off period applies to an increase in insurance under this offer.

If you are not employed by a Participating Employer, or you were employed by a Participating Employer but did not satisfy the conditions as outlined in a. When cover commences, or who previously opted-out or cancelled all Default Cover, you will not able to take advantage of this offer.

c. Do you have insurance already?If you have super elsewhere, have arranged private cover, or are entitled to insurance through an enterprise agreement through your employer, you may already have insurance.

If you do have cover, you should consider whether you need both.

When weighing up your insurance think about things like:

• How are your insurance premiums being paid? (eg. through super or your take home pay);

• Who is paying for your insurance? (you or your employer)

Transferring cover

You can transfer cover from other insurance policies you may have at any time, but you may find that the time you join NESS Super is a great time to do this. This is especially the case if you find that the insurance we provide is very competitive, and want to transfer across to NESS Super the insurance that you have elsewhere

You can transfer your cover if your Death, TI or TPD cover was insured under:

(a) A group life insurance cover with another Australia life insurer, or(b) An individual retail life insurance policy with another Australian life

insurer provided you were underwritten and accepted for cover within the previous 5 years.

Your existing cover must not be subject to any exclusions, premium loadings, limitations, special terms, limited cover, conditions or restrictions in regard to medical or other conditions

In addition you must:

1. be less than 65 years of age on the date you apply to transfer your cover;

2. not be working in an Excluded Occupation3. confirm your existing cover being transferred will cease on cover

commencing with us. (No claim will be considered if you retain any form of your previous cover elsewhere);

4. not continue the cover, after acceptance of the transfer by NESS Super, under any other insurance arrangement, reinstate cover or effect a continuation option with any fund, and

5. the Eligible Person providing a copy of your most recent Benefit Statement or Policy Renewal Statement dated within the previous 31 days as evidence of your current cover and insured benefit previously held. This includes a copy of the advice you received from the insurer or fund advising you of acceptance of your insurance and if on standard terms or subject to additional terms, and

6. you must satisfactorily complete a Transfer of Cover Application Form, including being able to answer ‘no’ to the agreed health questions and it must be received by NESS Super within 31 days of being signed and dated.

Please note, the total amount of cover held with the Fund after acceptance of the transfer of cover will be capped at $1,500,000.

Where all of the above requirements have been met, cover will commence from the latter of the date we accept the Transfer of Insurance Application Form and your account balance being sufficient to pay Premium. If your account balance is not sufficient to pay Premium within 31 days of the date we accept the Transfer of Insurance Application Form then the transfer of cover will not be considered to have started and a new Transfer of Insurance Application Form is required to be completed.

2.2 How you can change your coverYou can change your cover at any time. This includes:

(a) Applying for more or new cover – subject to maximum limits;(b) Opting out of or reducing your cover;(c) Changing to fixed cover, or unitised cover, or a mixture (subject to

limits on frequency).

Applying for more or new cover – Life events

We understand that personal circumstances change, and you may find that the level of insurance that you had thought was enough does not provide for your current situation. With NESS Super’s Death and TPD cover, you can increase the level of cover you have by unit for each type of cover you hold, when certain ‘Life events’ happen, namely:

(a) You get married;(b) You get divorced;(c) You or your partner gives birth to or adopts a child;(d) Your purchase a house in Australia that has a mortgage of more

than $100,000; or(e) You take out a new business loan for more than $100,000.

If you hold both Death and TPD Insurance, you can increase your cover for both insurances by one unit. If you hold only Death insurance, you can only increase your cover for Death insurance by one unit. If you have fixed cover insurance, you can increase your cover to the equivalent value of one unit based on your age.

2. Death, terminal illness and TPD insurance (cont)


Please note that your application is subject to you meeting the following conditions:

(a) You have cover with NESS Super when the Life Event occurred, and (b) You are less than 60 years of age when you applied for more cover

as a result of a Life Event, (c) You have not been declined for cover, or have any exclusions,

premium loadings, limitations, special terms, limited cover, conditions or restrictions applying to your cover, and

(d) You have not previously been paid a total and permanent disablement or terminal illness benefit from any source and is not aware of any condition or symptom you have that may entitle you to apply for a total and permanent disablement or terminal illness benefit from any source, and

You can only:

(a) Increase your cover once for any Life Event in any 12 month period, (b) Increase your cover once for each Life Event, and(c) Increase your cover for a total maximum of 4 Life Events.

In addition, you must provide NESS Super with sufficient proof that the Life Event occurred, within 90 days of the event occurring.

You will not be able to receive Life Event cover if it would result in you obtaining an amount greater than the maximum limits of $5,000,000 for Death and $3,000,000 for TPD.

Your must be At Work on the date the Life Event occurred and At Work on the date you signed the application, provided that the application is received by NESS Super within 31 days of the date you signed your application. If this requirement is not met, you will need to complete and submit a new application form.

Limited Cover will apply to the increased portion of cover for the first 24 months after your application has been accepted. Immediately prior to the end of the 24-month period the you must be At Work for 30 consecutive days to receive full cover. The additional cover you received will not be paid if your Death or TPD was a result of suicide or a self-inflicted injury that occurred within the first 13 months from the date your cover increased.

Cover will commence on the date that the insurer notifies the NESS Super in writing that they have agreed to accept cover.

Applying for more or new cover - Underwriting

Apart from the situations mentioned above, when you want to increase the level of your cover you will be required to be underwritten. If underwriting is required you will need to provide our insurer, Hannover Re of Australasia Limited all information that they regard as being necessary for underwriting purposes. This will typically commence with you completing a Personal Statement for our insurer, and dependent on your answers may result in further questions being asked concerning your application.

After reviewing any information that is received in respect of your application, our Insurer may either:

(a) Accept the cover, or(b) Offer cover subject to whatever exclusions, premium loadings,

limitations, special terms, limited cover, conditions or restrictions, as we consider appropriate, or

(c) Refuse to provide the cover.

Interim Accident Cover

If you apply for Death and TPD Cover and require underwriting, you are provided with Interim Accident Cover from the date that the Insurer receives your underwriting application. This means that if you die as a result of an injury or suffer a total and permanent disablement as a result of an injury a benefit will be paid to the lesser of $1,500,000 or the amount of cover applied for, less any cover you have under the Policy.

Interim Accident Cover will not be payable where:

(a) You die directly or indirectly as the result of suicide or attempted suicide, or

(b) if your total and permanent disablement is the result of an intentional self-inflicted injury or attempted suicide.

Interim Accident Cover will cease at the earliest of:

(a) Your application for underwriting is withdrawn, accepted or rejected;(b) 90 days after we received your application for insurance;(c) Your Death and TPD cover with NESS Super ceasing; or(d) the policy between NESS Super and our insurer ceasing.

Opting out of or reducing your cover

You may opt out of all cover, reduce your units of cover, or reduce your fixed cover by writing to NESS Super at any time. This variation will apply from the date we receive your request and premiums will stop being deducted applicable to the amount of cover you have cancelled or reduced. Before you cancel your cover, please bear in mind the following:

(a) You (or your beneficiaries) won’t be able to make an insurance claim if something happens after you have cancelled your cover. Claims may still be paid for something that happened prior to you cancelling your insurance.

(b) You might not be able to get cover if you change your mind. This is because Any subsequent request to increase cover will be subject to Underwriting.

If you are opting out or reducing your cover because you have obtained or are in the process of obtaining insurance elsewhere, you should make sure that your other insurer has confirmed that your cover has started before you cancel your insurance with NESS Super.

You should think about whether you need financial advice to help you work out whether cancelling or reducing your insurance is right for you.

Changing to fixed cover, or unitised cover, or a mixture (subject to limits on frequency).

a. Converting from units of cover to fixed coverYou can choose to convert units of Death and TPD Insurance that you currently have with NESS Super to fixed cover, without underwriting, once every 5 years by writing to the Fund.

You cannot make changes to your cover after either your 60th birthday or where a TPD or TI claim has been accepted by the insurer and you remain insured for residual death cover.

The premium rates that apply to fixed cover are shown on page 17 of this Guide.

The amount of fixed cover after the conversion will be rounded up to the next $1,000.

Any exclusions, premium loadings, limitations, special terms, limited cover, conditions or restrictions that applied to your units of cover, will continue to apply under fixed cover.



Any TPD cover held as fixed cover will automatically reduce from the Insured Person’s 61st birthday as set out in the table below:

Age Last BirthdayTPD Tapering Factor (as a % of the Insured Cover for TPD)

Up to 60 100%

61 80%

62 75%

63 67%

64 50%

b. Converting from fixed cover to units of coverIf you elect to convert your fixed cover back to units of cover at a later stage you will receive the same type of cover and corresponding amount of units of cover (rounded up to the next highest number of units) but subject to a maximum of 2 units of cover. Any amount of cover they held above the value of 2 units will be cancelled.

If you have fixed cover you are not permitted to convert your fixed cover to units of cover prior to your 34th birthday.

You also cannot make changes to your cover after either your 60th birthday or where a TPD or TI claim has been accepted by us and they remain insured for residual death cover.

Please note that any increase in cover resulting from this conversion is subject to you being At Work on the date fixed cover was converted to units of cover. If you were not At Work on this date, Limited Cover will apply to any increase until they are At Work for 30 consecutive days.

Worldwide Cover

With your insurance you’re covered even when you travel or reside overseas (for up to 5 years). We do not require you to notify us before you go. Subject to the following:

(a) You remain a member of NESS Super, and(b) You remain an Australian Resident, and(c) The residence Overseas is temporary in nature, and(d) Premium continues to be paid.

If you make a claim while you are overseas the Insurer may request that you return to Australia for an assessment.

Cover while on leave

Your insurance cover will continue unchanged while you’re on employer approved leave. This means that you will keep your Death and TPD cover and premiums will continue to be deducted from your superannuation account until your cover ends based on the rules as to when Death and TPD cover ceases. You do not need to notify NESS Super of your leave.

2.3 When cover stops and how you can get cover again

When does your cover stop?

Your cover will stop at the earliest of:

(a) You reaching 70 years of age for Death cover;(b) Your reaching 65 for TPD cover;

(c) You join the armed forces of any country, except the Australian Defence Force Reserves while performing duties within Australia;

(d) As a member of the Australian Defence Force Reserves, you depart Australia as a result of being posted Overseas;

(e) Your account balance is insufficient to meet your next premium which falls due;

(f) You die;(g) You are paid a benefit under your TPD or TI cover, except where

there is a residual Death cover amount; (h) You cease to be a member of NESS Super;(i) You have been inactive for 16 months, and have not nominated to

maintain your cover;(j) You are no longer a PMIF Exception Member and you:

(i) are under 25 years of age and

(ii) since 1 November 2019, your account balance never reached $6,000; or

(iii) have not made an election to the Fund to continue your cover

(k) You are Overseas for a period exceeding 5 years; (l) You are the perpetrator of a fraudulent claim under this

insurance policy;(m) You request your cover to be cancelled;(n) Cover ceases for all members under the policy;

(o) You cease to be a member of the Fund or are transferred out as a Lost Member; or

(p) You cease to be an Australian Resident or leave Australia permanently.

Keeping your cover

If you want to keep your cover, it is important that you make sure that money continues to go into your super account. If your NESS Super account does not receive contributions or a rollover for 16 months you may lose your cover. We’ll write to you if we haven’t seen contributions or a rollover for 9, 12 and 15 months. The letter(s) we send you will include the date that we last had a contribution or rollover paid into your account, and when your insurance will end if you do not do anything. It will also provide you with an option to maintain your cover, but be mindful that if your NESS Super account does not receive any contributions or rollovers you account balance will reduce and your insurance will cease if your balance is insufficient to meet your next premium.

How can you get cover again

Where your account balance is insufficient to meet your next premium your Death and TPD Cover will be reinstated to the previous level of cover where an Employer Contribution is received within 180 days of cover ceasing. If an Employer Contribution is received more than 180 days after your cover ceased, your cover will be reinstated at the default level of Death and TPD Cover for your age.

Any restrictions, conditions, exclusions or premium loadings that were imposed on your cover immediately before the date cover involuntarily ceased, will continue to apply to the cover from the date the cover recommences, and

Any Limited Cover terms which applied prior to reinstatement will continue to apply for the intended period of Limited Cover during which cover has been provided, and

If you are not At Work on the date your cover is reinstated, your reinstated cover will be Limited Cover until you are again At Work for 30 consecutive days, at which time full cover will commence, and



If Limited Cover terms applied prior to your cover ceasing and you are not At Work on the date your cover is reinstated, Limited Cover will continue to apply to the later of:

(i) The end of the intended period of Limited Cover during which cover has been provided, and

(ii) you are again At Work for 30 consecutive days, at which full cover will commence.

Your cover will not be reinstated and all cover will be subject to underwriting where:

(a) Your cover ceased for any reason other than your account balance being insufficient to meet your next premium;

(b) You cancelled your cover, or requested it not be reinstated, by writing to NESS Super. or

(c) You have previously been paid a TPD or TI benefit from any source, or are aware of any condition or symptom you have that may entitle you to apply for a TPD or TI benefit from any source.

2.4 How to make a claimMaking a claim for insurance can often feel daunting, but you should be reassured that NESS Super lives by its motto that we are big enough to matter, small enough to care. You should take confidence that we are required to pursue on behalf any claim that has a reasonable prospect of success.

When you are ready to make a claim follow these steps

1. Contact us by phone on 1800 022 067 between 8.30 am and 6.00 pm Sydney time (weekdays). Even if you are not sure if you should apply, please call us as we are here to help you.

2. When you call one of our member services officers will provide you with an overview of the claim process and will pass you through to our Administrator.

3. Our Administrator will send you some claim forms to complete. They will work with you to make sure we receive all the information required to process your application. They will also report back to NESS Super management the progress of collecting this information on a fortnightly basis so that we can make sure that your claim is being dealt with efficiently.

4. When your information has been sent back, the Insurer will review your application. Depending on what you are claiming, they may ask for further information and possibly a medical report.

5, Once the Insurer makes a decision on your claim we will let you know in writing and confirm any amount payable.

If your claim isn’t approved, NESS Super will require the Insurer to provide reasons as to why they have declined the claim so that we can review the decision. You’ll be contacted with the outcome of our review and we will give reasons for the decision.

Claiming a TPD Benefit Payment

If on the date of disablement you are

(a) gainfully employed as a Permanent Employee, Contractor, or self-employed, and

(b) have worked for an average of at least 15 hours per week within the 6 months prior to the Date of Disablement,

the Insurer will pay you a TPD benefit if you satisfy one of the definitions listed below in Part 1, Part 2 or Part 3.

If you do not satisfy (a) and (b) on the date of disablement the Insurer will pay the Total and Permanent Disablement benefit if the you satisfy one of the definitions listed below in Part 2, Part 3 or Part 4.

Part 1 - Unlikely to Return to Work

You are unable to do any work as a result of Injury or Illness for 3 consecutive months and in the Insurer’s opinion at the end of that 3 months you continue to be so disabled as the result of your ill-health (whether physical or mental) that you are unlikely to resume your previous occupation at any time in the future and will be unlikely ever at any time in the future to engage in Gainful Employment for which you are reasonably suited by education, training or experience.

Part 2 - Loss of Use Of

You suffer the total, permanent and irrecoverable Loss Of Use Of:

(a) The use of 2 limbs, or(b) The sight of both eyes, or(c) The use of 1 limb and sight of 1 eye, and(d) In the Insurer’s opinion, you must be disabled to such an extent as

a result of your illness or injury that you are unlikely to resume your previous occupation at any time in the future and will be unlikely to engage in any Gainful Employment for which you are reasonably suited by education, training or experience at any time in the future.

Part 3 – Everyday Work Activities

You suffer an Injury or Illness, that in the Insurer’s opinion:

(a) Totally and irreversibly prevents you from performing 2 of the Everyday Work Activities without assistance from another adult for at least 3 consecutive months, and

(b) Since you became ill or injured, have been under the regular care and attention of a Doctor for that Injury or Illness, and

(c) You are unlikely to ever again be able to perform at least 2 of the Everyday Work Activities without assistance from another adult, and

(d) You must be disabled to such an extent as a result of that Injury or Illness that in the Insurer’s opinion you are unlikely ever at any time in the future to engage in any Gainful Employment for which you are reasonably suited by education, training or experience.

Everyday Work Activities are defined as:

(a) Mobility - you cannot do 1 of the following:(i) Walk more than 200 metres on a level surface without stopping

due to breathlessness, or

(ii) Bend, kneel or squat to pick something up from the floor and straighten up again, nor get in and out of a motor vehicle, and



(b) Communication - you cannot do 1 of the following:(i) Speak in your first language so that they 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 their first language in a quiet room, or

(ii) Understand a simple message in your first language, and relay that message to another person, and

(c) Vision - you cannot, with or without glasses or contact lenses, read ordinary newsprint and pass the standard eyesight test for a car license, and

(d) Lifting - you cannot lift, carry or move objects weighing up to 5 kilograms using their hands, and

(e) Manual Dexterity – you cannot use your hands or fingers to manipulate small objects with precision (such as picking up a coin or fastening shoelaces or buttons, using cutlery, or using a pen or keyboard to write a short note).

Part 4 - Home Duties

You suffer an Illness or Injury, that in the Insurer’s opinion:

(a) Totally and irreversibly prevents you from performing Home Duties on a full time basis without assistance from another adult person for at least 3 consecutive months, and

(b) Since you became ill or injured, have been under the regular care and attention of a Doctor for that Injury or Illness, and

(c) You are unlikely to ever again be able to perform Home Duties on a full time basis without assistance from another adult person, and

(d) You must be disabled to such an extent as a result of that Injury or Illness that in the Insurer’s opinion you are unlikely ever at any time in the future to engage in any Gainful Employment for which you are reasonably suited by education, training or experience.

Home Duties are defined as all duties related to running the family home and may include:

(a) Cleaning - the ability to clean the family home such as using a vacuum cleaner, sweeping with a broom, using a mop, cleaning dishes (automatic or manually),

(b) Cooking - the ability to cook the family meals such as preparing fresh or frozen food, using an oven, stove or microwave oven),

(c) Washing - the ability to do the family laundry such as loading and unloading a washing machine and hanging out clothes or using a dryer, folding clothes and ironing,

(d) Shopping - the ability to shop for food and household items such as attending shops or using the phone or internet to purchase food or household items for the family),

(e) Carer - the ability to take care of dependent children less than 16 years of age or in full time secondary education such as supervising, lifting, transporting, feeding and bathing, or providing full time care for an invalid members of the Insured Person’s immediate family.

What gets paid if your are totally and permanently disabled?

If you’re eligible for a payment your entitled to:

(a) Your TPD cover (on the date confirmed by the Insurer), plus(b) The early release of your NESS Super account balance.

The Insurer will assess your eligibility to receive a TPD benefit and make the decision on your claim. As mentioned above, if your claim is declined NESS Super will conduct a review of this decision and give you reasons.

NESS Super will assess your eligibility for the release of your TPD benefit and an early release of your NESS Super account balance.

Claiming a TI Benefit Payment

Where you have been diagnosed with a Terminal Illness, the Insurer will pay a Terminal Illness benefit if in its opinion:

(a) The Date of Certification of the Terminal Illness is on or after the date your cover commenced under The Policy. No Terminal Illness benefit will be considered where the Date of Certification is prior to this date, and

(b) A Terminal Illness benefit for you will be the lesser of your Death Cover or $3,000,000. If a Terminal Illness benefit is admitted, all cover will cease other than any residual death benefit balance. Provided you remain an Insured Person and NESS Super continues to receive Premium for your Death Cover, the Insurer will pay the residual death benefit balance on your death, and

(c) You must supply, at your own expense, supporting medical evidence from two Doctors, at least one of the registered Doctors must be a specialist practising in the field to which the Terminal Illness relates. The Insurer will require this information in a form of their choosing and reserves the right to ask for any additional information that they feel is appropriate. Where they ask for additional information, they will incur the cost of obtaining this information, and

(d) If the policy between ourselves and Hannover Re of Australasia Limited has terminated the you will only be eligible for a Terminal Illness benefit where:(i) The Date of Certification is prior to the date that The Policy

terminated, and

(ii) You are not eligible for a terminal illness, total and permanent disablement or death claim under a new replacement policy.

From the date a Terminal Illness claim has been lodged, you will no longer be eligible for any increase in cover under The Policy without the Insurer’s prior approval.

Where a Terminal Illness benefit is paid it will be considered as an advance payment of your death benefit.



Other important things to know

Nominate your beneficiariesYou can advise the Trustee of the person who you would like to receive your death benefit. You can make a Preferred Beneficiaries Nomination which tells the Trustee your wishes but leaves the Trustee with discretion regarding beneficiaries, or make a Binding Death Benefit Nomination, which requires the Trustee to follow your wishes when a benefit is paid on death (conditions apply).

What’s paid if you die?

If you die, the amount payable to your dependants, nominated beneficiaries or legal personal representatives is made up of:

• Your super account balance; and• Any Death Cover insurance amount which may be payable.

You can decide what happens to your money

You have two options when deciding what happens you money.

Preferred (Non-Binding) Beneficiaries Nomination

On joining NESS Super, you complete the Preferred Beneficiaries section of the Application for Membership Form. This is an indication of your preferences only, and is not legally binding on the Trustee to follow in the event of your death.

Binding Death Benefit Nomination

You can complete a Binding Death Benefit Nomination form to nominate one or more persons to whom the Trustee must pay your benefit to and in what proportion. A binding death benefit nomination will be invalid if:

• it is not made using the NESS Super Binding Death Benefit Nomination Form,

• the Binding Death Benefit Nomination Form has not been properly completed in accordance with the relevant legal requirements (for example, the nominated proportions do not equal 100% or the form has not been signed or witnessed correctly),

• at the time of your death one or more of the persons nominated has died or is not your dependant or legal personal representative; or

• you remarry or divorce after making the nomination, or • you were legally incapable of making the nomination. • A binding death benefit nomination will cease to have effect if: • three years have passed from the date you signed the Binding Death

Benefit Nomination Form or last reconfirmed that nomination, • you revoked the nomination, • the Trustee is prevented from making the payment by legislation, or • you are prevented from making a nomination by a Court Order.

Who can I nominate?

When making a nomination of preferred beneficiaries or a binding death benefit nomination, you have the choice of nominating one or more of your dependants and your legal personal representative (your estate).

Your dependants include:

• your spouse (including de-facto or same sex partners),• your children including step children, adopted children and children

of same sex partners,• any other person who the Trustee considers is wholly or partially

financially dependent on you, and • any other person with whom you have an interdependency

relationship. This occurs where you have a close relationship with another person (whether or not related by family) and

– you live together, – you, the other person or both of you provide the other with

financial support, and – you, the other person or both of you provide the other with

domestic support and personal care.

It will also occur where you have a close personal relationship with the other person but, due to a disability, the other criteria of interdependency cannot be met.

What does Limited Cover mean?Limited cover means cover is only provided for an Illness that first became apparent, or an Injury that first occurs, on or after the date cover commences or is reinstated for you under The Policy.

For avoidance of doubt, where Limited Cover applies to Insured Cover you are not covered for a pre-existing Injury, Illness, condition or related symptom that you were aware of, or a reasonable person in their position should be aware of, or for which they had a medical consultation, on or prior to the date Insured Cover commences or recommences.

ExclusionsNo benefits will be payable if your claim arises directly or indirectly from the following:

(a) As a result of War or act of war, or you were participating in Militant Activities,

(b) You have been in a country listed on the Department of Foreign Affairs and Trade website (www.dfat.gov.au) as subject to a ‘do not travel’ warning at the time you entered the country, or

(c) Any additional exclusion that came into effect for an Insured Person as part of Underwriting

(d) Where cover has been provided on a Limited Cover basis, your death or Total and Permanent Disablement is not the result of a pre-existing Injury or Illness or condition or related symptom.

In addition to (a), (b), (c) and (d) above, any additional Death or TPD Cover will also not be payable where a claim is directly or indirectly the result of:

(e) Suicide, attempted suicide or intentional self-inflicted harm, within 13 months from the date your additional cover was accepted, if the claim is for death, or

(f) Intentional self-inflicted harm or attempted suicide, within 13 months from the date your additional was accepted, if the claim is for Total and Permanent Disablement.



Words and Terms Used

At Work means that a person:

(a) Is not restricted by Illness or Injury from being capable of actively performing all of their full and normal duties of their usual occupation for their employer on a full-time basis (for at least thirty 30 hours per week) even though actual employment may be on a full-time, part-time, casual or contract basis, or

(b) If on employer approved leave, except leave caused by an Illness or Injury, could otherwise be able to attend work and perform their normal duties without restriction due to Illness or Injury, or

(c) If a person is performing Home Duties on a full time basis, is actively performing all the functions of their normal Home Duties on a full time basis, and

(d) Is not in receipt of, or is not eligible to receive, any income support benefits from any source including but not limited to workers’ compensation benefits, statutory transport accident benefits and disability income benefits.

Australian Residentmeans an Australian citizen or a person who is the holder of an Australian permanent visa within the meaning of the Migration Act 1958, Subsection 30(1), or resides in Australia on a Temporary Work (Skilled) visa, who is legally permitted to reside in and be gainfully employed in Australia. It also includes a New Zealand citizen who is residing and working in Australia.

Contractormeans a person who is working on a fixed term contract for the employer with a duration of at least 12 months that requires the person to perform identifiable duties for a regular number of hours each week.

Date of Certification means the latter of the dates 2 Doctors, approved by us acting reasonably and in good faith, have certified (the date of diagnosis), jointly or separately, that the Insured Person suffers a Terminal Illness. At least 1 of the Doctors must be a specialist practicing in the field to which the Terminal Illness relates. Each of the certificates must be supported by test results and the certification period must not have ended.

Date of DisablementMeans, where applicable, the earlier of the date:

(a) The 3 consecutive months absence from work that results in Total and Permanent Disablement began under Part 1 of clause 4.2 (Total and permanent disablement). However, if the Insured Person undertakes a formalised graded return to work which fails within 12 months, we will take the Date of Disablement as being the date on which the person first ceased work, or

(b) The Insured Person suffers the Loss of Use Of the sight in both eyes, or the Loss of Use Of both limbs, or the Loss of Use of both the sight in 1 eye and 1 limb, or

(c) The Insured Person suffers the Loss of Use Of the sight of another eye or the Loss of Use Of another limb, having already suffered the Loss of Use Of the sight of an eye or the Loss of Use Of a limb, or

(d) The 3 consecutive month’s inability to perform at least 2 of the Everyday Work Activities that results in Total and Permanent Disablement began, or

(e) The 3 consecutive month’s inability to perform Home Duties on a full time basis that results in Total and Permanent Disablement began.

Default Covermeans for a member who joins the Fund prior to their 65th birthday, 2 units of death cover and 2 units of Total and Permanent Disablement cover, and

for member who joins the Fund after their 65th birthday, 2 units of death cover.

Doctor means a registered medical practitioner who is legally qualified and properly registered to practice in Australia or New Zealand or as otherwise agreed by us. That person may not be the Insured Person, the Insured Person’s business partner, a member of the Insured Person’s immediate family or their employer.

Eligible Person means someone that:

(a) Is a member of the Fund, and(b) Is an Australian Resident, and(c) Is aged between the Minimum Entry Age and the Maximum Entry

Age, and (d) Is not employed in an Excluded Occupation, or who does not perform

any duties of an Excluded Occupation, or(e) We expressly agree in writing is an Eligible Person.

We will provide a refund of Premium if, in our opinion, the Premium was paid to us in error by the Fund for a person who did not meet the requirements to be an Eligible Person.

Employer Contributionmeans the mandatory Superannuation Guarantee contribution amount remitted to the Fund by an employer on behalf of an employee that is to be credited to the member’s superannuation account in respect of a period of employment.

Excluded Occupationmeans:

(a) Aviation worker such as a pilot, air traffic controller or aerial photographer,

(b) Emergency services worker such as a fireman, police officer, ambulance officer or paramedic, except as a volunteer,

(c) Entertainer working professionally such as an actor, dancer, musician or performer,

(d) Forestry worker such as a tree feller or sawmill worker,(e) Horse racing industry worker such as a jockey, trainer or strapper,(f) Mining worker such as a miner, mineral explorer earth driller or

explosives handler,(g) Offshore worker such as a fisherman, oil rig worker or diver,(h) Security worker such as a security guard, doormen, bouncer or

crowd controller,(i) Sex worker,(j) Sports person working professionally or semi-professionally,(k) Underground or underwater worker.

First Eligiblemeans a person is first eligible to join the Fund on the later of:

(a) The first time they commence employment with a Participating Employer at which time a Fund membership number is first allocated to them, or



(b) When their employer becomes a Participating Employer but only where the employer selects the Fund to be the current default superannuation fund for the purpose of Superannuation Guarantee Contributions for their employees at which time a Fund membership number is first allocated to them.

Should an employee of a Participating Employer first become eligible to receive a Superannuation Guarantee Contribution at a date later than (a) or (b), then this date will become the date they were first eligible to join the Fund.

Fundmeans NESS Super.

Gainful Employmentmeans employed or self-employed for gain or reward in any business, trade, profession, vocation, calling, occupation or employment at the time we assess the claim and includes part-time occupations, an occupation which may be perceived by the person to be of lower status than the person’s previous occupation or an occupation in which the person does not earn as much income as they did in their previous occupation and taking into account any reasonable retraining they have undertaken or have a capacity to undertake in the future at the time of final assessment of their claim.

Illnessmeans a sickness, disease or disorder.

Injurymeans bodily injury caused by violent, external and visible means.

Interim Accident Covermeans only where a claim is solely as a result of Injury for cover that comes into force under section 3 that results in the death, or where applicable Total and Permanent Disablement, of an Eligible Person or Insured Person.

Limited Covermeans cover is only provided for an Illness that first became apparent, or an Injury that first occurs, on or after the date cover commences or is reinstated for an Insured Person under The Policy.

For avoidance of doubt, where Limited Cover applies to Insured Cover they are not covered for a pre-existing Injury, Illness, condition or related symptom that the Insured Person was aware of, or a reasonable person in their position should be aware of, or for which they had a medical consultation, on or prior to the date Insured Cover commences or recommences.

An Insured Person may apply to remove the Limited Cover restriction subject to clause 2.6 (Underwriting). Any change in the cover terms is subject to our approval and will commence from the date that we advise in writing.

Loss Of Use Of means:

(a) The permanent loss of sight, whether aided or unaided due to Injury or Illness to the extent that the visual acuity is 6/60 or less in both eyes, or to the extent that visual field is reduced to 20 degrees or less of arc, as certified by an ophthalmologist, or

(b) The loss of the use of a leg from at or above the ankle, or an arm from at or above the wrist, which is permanent.

Militant Activities means actively participating or contributing to, an act of terrorism, war or war-like operation or civil commotion.

Minimum Member Detailsmeans:

(a) Name, and(b) Date of birth, and(c) Address, and(d) Date employment commencement.

On-timemeans an Employer Contribution that is received by the Fund within 180 days of the date in respect of which the Employer Contribution relates.

Overseasmeans anywhere other than the Commonwealth of Australia and its Territories, or New Zealand.

Participating Employermeans an employer who makes or agrees to make superannuation guarantee (SG) contribution payments to the Fund on behalf of an employee who is a member of the Fund.

For avoidance of doubt, a Participating Employer includes:

(a) An employer who has selected the Fund to be the current default superannuation fund for the purpose of SG contributions for their employees, and

(b) An employer who has selected a different fund to be their default superannuation fund but directs SG contributions for an Eligible Person to the Fund under Choice of Fund legislation.

A self-employed person is not a Participating Employer.

Partner means a legal spouse or a person living with an Insured Person as their spouse on a bona-fide domestic basis, they may be the same gender as the Insured Person.

Permanent Employee means an employee who is employed on a permanent basis under an ongoing contract that:

(a) Requires the employee to perform identifiable duties for a regular number of hours each week, and

(b) Provides the employee with paid annual leave, sick leave, leave loading and long service leave.

PMIF Exception Membermeans any Insured Person to whom the Policy Owner is permitted to provide Insured Cover despite them not having reached age 25 and/or their account balance never having reached $6,000, including an Insured Person:

(a) whose Employer Contribution includes an additional amount to pay Premiums due, or

(b) to whom the dangerous occupation exception applies as per 68AAF of the Superannuation Industry Supervision Act 1993.

Terminal Illnessmeans a disease or condition as the result of an Injury or Illness that is highly likely to result in the death of the Insured Person within 24 months of the Date of Certification.

Warmeans an act of war, whether declared or not, armed aggression by a country or organisation resisted by any country or organisation, or civil disturbance.



Unitised Cover Scale and Default Amount of Death and TPD CoverThe table below shows the cover you will receive and the weekly premiums.

Cover per unit Default Cover Weekly cost ($) for default cover (per week)

Annual cost ($) for default cover

Age Last Birthday Death TPD

Default Units Death TPD Death TPD Death TPD

15 $5,000 $5,000 2 $10,000 $10,000 0.128 0.042 $6.66 $2.18 16 $5,000 $5,000 2 $10,000 $10,000 0.128 0.042 $6.66 $2.18 17 $5,000 $5,000 2 $10,000 $10,000 0.128 0.042 $6.66 $2.18 18 $5,000 $5,000 2 $10,000 $10,000 0.128 0.042 $6.66 $2.18 19 $5,000 $5,000 2 $10,000 $10,000 0.128 0.042 $6.66 $2.18 20 $25,000 $25,000 2 $50,000 $50,000 0.594 0.248 $30.89 $12.90 21 $25,000 $25,000 2 $50,000 $50,000 0.594 0.248 $30.89 $12.90 22 $25,000 $25,000 2 $50,000 $50,000 0.594 0.248 $30.89 $12.90 23 $25,000 $25,000 2 $50,000 $50,000 0.594 0.248 $30.89 $12.90 24 $25,000 $25,000 2 $50,000 $50,000 0.594 0.248 $30.89 $12.90 25 $35,000 $35,000 2 $70,000 $70,000 1.506 1.076 $78.31 $55.95 26 $50,000 $50,000 2 $100,000 $100,000 1.506 1.076 $78.31 $55.95 27 $65,000 $65,000 2 $130,000 $130,000 1.506 1.076 $78.31 $55.95 28 $72,500 $72,500 2 $145,000 $145,000 1.506 1.076 $78.31 $55.95 29 $75,000 $75,000 2 $150,000 $150,000 1.506 1.076 $78.31 $55.95 30 $77,500 $77,500 2 $155,000 $155,000 1.506 1.076 $78.31 $55.95 31 $80,000 $80,000 2 $160,000 $160,000 1.506 1.076 $78.31 $55.95 32 $82,500 $82,500 2 $165,000 $165,000 1.506 1.076 $78.31 $55.95 33 $85,000 $85,000 2 $170,000 $170,000 1.506 1.076 $78.31 $55.95 34 $87,500 $87,500 2 $175,000 $175,000 1.506 1.076 $78.31 $55.95 35 $87,500 $87,500 2 $175,000 $175,000 1.506 1.076 $78.31 $55.95 36 $87,500 $87,500 2 $175,000 $175,000 1.506 1.076 $78.31 $55.95 37 $87,500 $80,000 2 $175,000 $160,000 1.506 1.076 $78.31 $55.95 38 $87,500 $72,500 2 $175,000 $145,000 1.506 1.076 $78.31 $55.95 39 $85,000 $65,000 2 $170,000 $130,000 1.506 1.076 $78.31 $55.95 40 $82,500 $60,000 2 $165,000 $120,000 2.582 1.93 $134.26 $100.36 41 $80,000 $55,000 2 $160,000 $110,000 2.582 1.93 $134.26 $100.36 42 $75,000 $52,500 2 $150,000 $105,000 2.582 1.93 $134.26 $100.36 43 $70,000 $50,000 2 $140,000 $100,000 2.582 1.93 $134.26 $100.36 44 $65,000 $47,500 2 $130,000 $95,000 2.582 1.93 $134.26 $100.36 45 $60,000 $45,000 2 $120,000 $90,000 2.582 1.93 $134.26 $100.36 46 $57,500 $42,000 2 $115,000 $84,000 2.582 1.93 $134.26 $100.36 47 $55,000 $39,000 2 $110,000 $78,000 2.582 1.93 $134.26 $100.36 48 $52,500 $36,000 2 $105,000 $72,000 2.582 1.93 $134.26 $100.36 49 $50,000 $33,000 2 $100,000 $66,000 2.582 1.93 $134.26 $100.36 50 $48,000 $30,000 2 $96,000 $60,000 2.078 2.434 $108.06 $126.57 51 $46,000 $28,000 2 $92,000 $56,000 2.078 2.434 $108.06 $126.57 52 $44,000 $26,500 2 $88,000 $53,000 2.078 2.434 $108.06 $126.57 53 $42,000 $25,000 2 $84,000 $50,000 2.078 2.434 $108.06 $126.57 54 $40,000 $23,500 2 $80,000 $47,000 2.078 2.434 $108.06 $126.57 55 $37,000 $21,000 2 $74,000 $42,000 2.078 2.434 $108.06 $126.57 56 $34,000 $20,000 2 $68,000 $40,000 2.078 2.434 $108.06 $126.57 57 $32,000 $17,000 2 $64,000 $34,000 2.078 2.434 $108.06 $126.57 58 $30,000 $15,000 2 $60,000 $30,000 2.078 2.434 $108.06 $126.57 59 $27,000 $12,000 2 $54,000 $24,000 2.078 2.434 $108.06 $126.57 60 $24,000 $10,000 2 $48,000 $20,000 1.978 2.534 $102.86 $131.77 61 $22,000 $7,500 2 $44,000 $15,000 1.978 2.534 $102.86 $131.77 62 $21,000 $5,000 2 $42,000 $10,000 1.978 2.534 $102.86 $131.77 63 $20,000 $4,000 2 $40,000 $8,000 1.978 2.534 $102.86 $131.77 64 $19,000 $2,500 2 $38,000 $5,000 1.978 2.534 $102.86 $131.77 65 $18,000 - 2 $36,000 - 4.51 - $234.52 - 66 $15,000 - 2 $30,000 - 4.51 - $234.52 - 67 $12,000 - 2 $24,000 - 4.51 - $234.52 - 68 $10,000 - 2 $20,000 - 4.51 - $234.52 - 69 $7,500 - 2 $15,000 - 4.51 - $234.52 -



Premium Rates for Fixed CoverThe weekly cost for fixed cover is calculated by dividing the amount of fixed cover by $1,000 and multiplying it by the premium rate and dividing it by 52.

Example:To calculate the weekly cost for a 30 year old requiring $200,000 of fixed Death cover and $100,000 of TPD cover:

Death Cover cost:

$200,000 / $1,000 * $0.44 / 52 = $1.69 per week

TPD cost:

$100,000 / $1,000 * $0.31/ 52 = $0.60 per week.

Total cost: $2.29 per week


Death & TPD Cover

15 0.63 0.22 0.85

16 0.63 0.22 0.85

17 0.63 0.22 0.85

18 0.63 0.22 0.85

19 0.63 0.22 0.85

20 0.63 0.22 0.85

21 0.59 0.24 0.83

22 0.56 0.24 0.80

23 0.53 0.25 0.78

24 0.51 0.25 0.76

25 0.48 0.25 0.73

26 0.45 0.25 0.70

27 0.44 0.27 0.71

28 0.44 0.28 0.72

29 0.44 0.28 0.72

30 0.44 0.31 0.75

31 0.44 0.33 0.77

32 0.46 0.35 0.81

33 0.48 0.37 0.85

34 0.50 0.40 0.90

35 0.51 0.43 0.94

36 0.53 0.46 0.99

37 0.57 0.51 1.08

38 0.62 0.56 1.18

39 0.67 0.60 1.27

40 0.71 0.70 1.41

41 0.78 0.80 1.58

42 0.85 0.92 1.77

43 0.93 1.06 1.99

44 1.02 1.23 2.25

45 1.11 1.41 2.52


Death & TPD Cover

46 1.22 1.64 2.86

47 1.33 1.89 3.22

48 1.45 2.17 3.62

49 1.59 2.51 4.10

50 1.71 2.84 4.55

51 1.87 3.26 5.13

52 2.02 3.72 5.74

53 2.19 4.24 6.43

54 2.38 4.73 7.11

55 2.58 5.27 7.85

56 2.81 5.91 8.72

57 3.09 6.66 9.75

58 3.38 7.53 10.91

59 3.72 8.49 12.21

60 4.04 9.47 13.51

61 4.36 10.54 14.90

62 4.71 11.70 16.41

63 5.07 12.87 17.94

64 5.45 14.37 19.82

65 5.86 - -

66 6.39 - -

67 6.97 - -

68 7.52 - -

69 8.12 - -



3. Income protection insurance for Employed members(Insurance Provided by Chubb Insurance Australia Ltd (Chubb))


3.1 What insurance you receive when you joinThe default income protection cover, offered by Chubb, insures you for an amount equivalent to up to 85% of your pre-disability income (up to 75% of your income payable to you plus up to a 10% payable as a contribution to your NESS Super account) for up to 2 years (104 weeks), or until you turn 65 (whichever occurs first), with a 30-day waiting period.

The default product provides cover for both Total Disablement (you are unable to work) and Partial Disablement (you are only able to return to partial employment duties) where you suffer a Sickness or Injury.

• If you suffer from Total Disablement, you will be paid a weekly benefit of up to 75% of your average weekly income (calculated using your income over the last 12 months from your employer who pays into NESS Super on your behalf), plus up to 10% of your average weekly income payable as a contribution to your NESS Super account.

• If you suffer from a Partial Disablement, you will be paid the difference between what you earned from your partial duties and the weekly benefit amount described above for Total Disablement.

Maximum Benefit: $25,000 per month (always subject to a maximum of 75% of your income)

Default Maximum Benefit Period: up to but not exceeding 2 years (104 weeks) (after the waiting period), or until you turn 65 (whichever occurs first)

Default Waiting Period: 30 consecutive days

These benefits are paid fortnightly. If you are receiving income from other sources (e.g. Workers’ Compensation benefits), the other income will be deducted from the benefit paid to you.

Other benefits include:

• Certain serious medical conditions including dementia; motor neuron disease; multiple sclerosis; primary pulmonary hypertension; permanent paralysis; Parkinson’s disease; stroke; total blindness; total deafness; total loss of limb will benefit from a nil waiting period.

• Members with more than 2 years’ continuous cover, without an approved claim, under the NESS Super Income Protection insurance provided by Chubb will have a 7-day reduction in their chosen waiting period.

a. When cover commences (Cover is subject to the government legislation PMIF requirements)

To be eligible for the Income Protection cover you must have your employer Superannuation Guarantee (SG) contributions paid to your NESS Super account, as this is how premiums are deducted to cover the income you wish to have insured. If your SG contributions are being paid to another fund you will not qualify for Income Protection cover.

(i) Existing members of NESS Super as at 30 November 2019

If you are an existing member of NESS Super as at 30 November 2019, who has not opted out of the cover, cover shall commence for you on 30 November 2019, provided

you are Actively At Work on that date and the applicable premiums are being made by NESS Super to Chubb.

If you are not Actively at Work on 30 November 2019, cover shall commence when you recommence employment and are Actively At Work, provided an employer superannuation contribution payment is made by an Admitted Employer after you recommence employment by the quarterly deadlines outlined in the Superannuation Guarantee Legislation.

For those members where the payment was not received by the first quarterly deadline, cover shall commence from the first date that the first employer superannuation contribution payment made by an Admitted Employer represents, but shall be limited to New Events only.

(ii) Members of NESS Super who join after 30 November 2019, but prior to 1 April 2020.

If you join NESS Super after 30 November 2019, cover will commence from the first date that the first employer superannuation contribution payment made by an Admitted Employer represents, provided that this payment is made by the first quarterly deadline outlined in the Superannuation Guarantee Legislation and

1. you have instructed your employer to have NESS Super as your superannuation fund for receiving Superannuation Guarantee payments on the commencement of new employment and you are Actively at Work; or

2. the Admitted Employer has nominated NESS Super as the default superannuation fund for the purpose of complying with the Superannuation Guarantee Legislation for receiving Superannuation Guarantee payments on the commencement of new employment and you are Actively at Work.

Where all the above conditions are not met, cover shall commence from the first date that the first employer superannuation contribution payment made by an Admitted Employer represents but shall be limited to New Events only.

(iii) Members of NESS Super who join from 1 April 2020.

If you join NESS Super from 1 April 2020, you will be subject to the same commencement terms as (ii) above, with the additional requirement that you must have opted-in within 60 days of joining NESS Super to have this insurance or alternatively reached the age of 25 years and have a balance exceeding $6,000 in your NESS Super account, before cover can commence.

b. Do you have insurance already?If you have super elsewhere, have arranged private cover, or are entitled to insurance through an enterprise agreement that your employer adheres to, then you may already have income protection insurance.

If you do have cover, you should consider whether you need both.

When weighing up your insurance think about things like:

• How are your insurance premiums being paid (e.g. through super or your take home pay);

• Who is paying for your insurance (you or your employer)

3.2 Can I make alterations to my cover?You can apply to increase the length of cover up to 5 years (260 weeks) or increase your waiting period to either 60 or 90 days. Different premiums apply for these different options.

Alterations in cover are also subject to the following:

1. Where an Insured Member has elected to reduce their Waiting Period under this policy, the alteration will not apply for any:

(a) Pre-Existing Sickness which occurred prior to the date of the alteration in cover; or

(b) Injury which occurred prior to the date of the alteration in cover.

Alteration in Cover 1. (a) & (b) won’t apply where, as at the date the Insured Member elected to reduce their Waiting Period, the Insured Member has had two (2) years of Continuous Cover and has been Actively at Work during the final two (2) months of that two (2) year period.



2. Where an Insured Member has elected to increase their Benefit Period under this Policy, the alteration will not apply for any;

(a) Pre-Existing Sickness which occurred prior to the date of the alteration in cover; or

(b) Injury which occurred prior to the date of the alteration in cover.

Alteration in Cover 2. (a) won’t apply where, as at the date the Insured Member elected to reduce their Waiting Period, the Insured Member has had two (2) years of Continuous Cover and has been Actively at Work during the final two (2) months of that two (2) year period, from the date they elected to increase their Benefit Period.

3.3 When cover stops and how you can get cover again

Cover will cease at the earliest of when:

• you elect in writing to no longer have this cover;• you reach the age of 65;• you are no longer employed by an Admitted Employer;• you are employed as a casual employee with an Admitted Employer

and the amount of time that has passed without you completing a day at work with the Admitted Employer is greater than ninety (90) consecutive days;

• you cease to be a member of NESS Super; • all cover for every NESS Super member under the Chubb policy

ceases; • you join the armed forces of any country other than the Australia

Defence Force Reserves, • you reside overseas; • you cease to be an Australian resident or leave Australia

permanently; • you retire permanently from the workforce; • you are the subject of a fraudulent claim under the Income

Protection policy; • premiums on your behalf cease to be paid to Chubb; or• you die.

You will also not be eligible for the Income Protection cover if employer SG contributions are not being paid to your NESS Super account. See the ‘When cover commences’ section for further details.

If you are a member of NESS Super who is eligible for cover but have opted out of cover, cover may commence from the date when your written request to take up cover is received by NESS Super, provided an employer superannuation contribution payment is made by an Admitted Employer after this request by the first quarterly deadline outlined in the Superannuation Guarantee Legislation after the request.

For those members where the payment was not received by the first quarterly deadline, cover shall commence from the first date that the first employer superannuation contribution payment made by an Admitted Employer represents, but shall be limited to New Events only.

3.4 How to make a claimChubb have appointed n2n Claims Solutions Pty Ltd (n2n Claims), a third party, to manage claims on their behalf.

Making a claim for insurance can often feel daunting, but you should be reassured that NESS Super lives by its motto that we are big enough to matter, small enough to care. You should take confidence that we are required to pursue on behalf any claim that has a reasonable prospect of success.

When you are ready to make a claim follow these steps

1. Contact us by phone on 1800 022 067 between 8.30 am and 6.00 pm Sydney time (weekdays). Even if you are not sure if you should apply, please call us as we are here to help you.

2. When you call, one of our member services officers will take your call and will pass you through to n2n Claims.

3. n2n Claims take your details, provide you with an overview of the claim process and will send you a claim form to complete. The claim form consist of 3 parts:(i) First part for you to complete; &(ii) Second for treating doctor to complete; &(iii) Third for your employer.

They will work with you to make sure all the information required to process your application is received as efficiently as possible.

4. When your information has been sent back, n2n Claims will review your application. Depending on what you are claiming, they may ask for further information and possibly a medical report.

5, Once the n2n Claims makes a decision on your claim, they will let you know in writing and confirm any amount payable.

If your claim isn’t approved, NESS Super will require the n2n Claims to provide reasons as to why they have declined the claim so that we can review the decision. You’ll be contacted with the outcome of our review and we will give reasons for the decision.

3.5 How to make a complaintIf you are dissatisfied with any aspect of your relationship with Chubb including Chubb’s products or services and wish to make a complaint, please contact Chubb at:

The Complaints OfficerChubb Insurance Australia LimitedGPO Box 4065Sydney NSW 2001O 1800 815 675E [email protected]

The members of our complaint handling team are trained to handle complaints fairly and efficiently.

Please provide us with your claim or policy number (if applicable) and as much information as you can about the reason for your complaint.

3. Income protection insurance for employed members (cont)


Other important things to know

Premium ratesEmployed Members Benefit Design

The default IP cover is based on income with both levels of cover and premiums based on the Super Guarantee (SG) contributions made by members.

• Weekly Benefits: up to 75% of your pre-disability income plus up to 10% of pre-disability income paid to the member’s NESS Super account

• Maximum Benefit: $25,000 per month

• Maximum Benefit Period: up to but not exceeding 2 years (104 weeks) (after the waiting period), and prior to the member turning 65.

• Waiting Period: 30 consecutive days

Income Protection for 2 years (104 weeks) Premium deducted

Default with 30 Day Waiting Period 1.76% of SG contributions

Member electing a 60 Day Waiting Period 1.584% of SG contributions


From 30 November 2019, members may elect to increase their Maximum Benefit Period to 5 years (260 weeks)

Income Protection for 5 years (260 weeks) Premium deducted






ExclusionsLimitations and exclusions apply under the policy, including that no benefit will be payable when a claim arises directly or indirectly as a result of:

1. actively participating in militant activities (actively participating or contributing to, an act of terrorism, war or war-like operation or civil commotion);

2. service in the armed forces with the exception of the Australian Defence Force Reservists;

3. self-inflicted harm or attempted suicide, regardless of whether the person was sane or insane at the time;

4. normal and uncomplicated pregnancy or childbirth. For the purposes of this exclusion multiple pregnancy, threatened or actual miscarriage, participation in an IVF or similar programme, discomfort commonly associated with pregnancy such as morning sickness, backache, varicose veins, ankle swelling or bladder problems are not considered abnormal or complications of pregnancy;

5. Any Pre-Existing Sickness; 6. Any Injury that occurs prior to your Continuous Cover commencing;7. Any act which results in you being charged by the police. Should you

subsequently be found not guilty of the act in question, this exclusion will not apply. This does not include traffic infringements other than those related to driving under the influence of alcohol or drugs;

8. you being a self-employed member of NESS Super;9. engaging in any of the following occupations, activities or duties:

(a) piloting or being a crew member of any aircraft; or engaging in any aerial activity except as a passenger in a properly licensed aircraft;

(b) professional entertainer such as actor, dancer, musician and stage performer;

(c) fireman, police, ambulance officer, paramedic or other emergency service worker;

(d) professional and semi-professional sport person who earns more than 15% of their Income in monetary reward from participation in such an activity.

Words and Terms Used(a) Actively at Work means when an Insured Member

(i) is in Chubb’s opinion capable of actively performing all of the duties and hours of their usual occupation without restriction, for their Admitted Employer(s); or

(ii) if on Admitted Employer(s) approved leave (except leave caused by any Sickness or Injury) would be able to attend work and perform their normal duties and hours without restriction due to Sickness or Injury; and

(iii) For the avoidance of doubt, an Insured Member who has a permanent impairment or permanent disablement prior to being an Insured Member will not ever be considered Actively at Work for that condition.

(b) Admitted Employer(s) means an employer who makes employer superannuation contributions to NESS Super on behalf of an Insured Member.

(c) Continuous Cover means an unbroken period of time that an Insured Member has been covered under an Income Protection policy provided by Chubb subject to the following: • If an Insured Member ceases cover, their continuous cover

period ends on that date. If an Insured Member recommences cover under an income protection policy provided by Chubb, their new continuous cover period commences on the date their cover recommences.

• If an Insured Member has a claim approved under the ‘Loyalty Program Benefit’ available under the policy, the continuous cover period ends on the cessation of the claim and will recommence at zero (0) years from the later date of either the cessation of that claim or the Insured Member returns to work with an Admitted Employer.

(d) Income means the average weekly income before personal deductions and income tax, and including all overtime and all allowances actually paid to the Insured Member which was earned from personal exertion from their usual employment, from which they are a member of NESS Super, for the number of weeks so engaged during the fifty-two (52) weeks period immediately preceding Injury or Sickness resulting in payment of the benefit covered by the Chubb policy. Any investment income, income received from deferred compensation plans, disability income policies or retirement plans or income not derived from vocational activities, are excluded.

(e) Injury means bodily injury caused by violent, external and visible means which occurs whilst Continuous Cover is in force.

(f) Insured Member(s) means a member of NESS Super for whom cover has commenced under the terms of the policy, who has not opted-out, is Actively At Work, employed by an Admitted Employer and for whom the applicable premiums have been paid by NESS Super to Chubb.

(g) New Events means an Injury that first occurs or a Sickness that first becomes apparent on or after the date that NESS Super receives the superannuation contribution paid on behalf of the employee.

(h) Partial Disablement means where an Insured Member has ceased to suffer Total Disablement and:(i) has resumed employment or is capable of returning to partial

employment duties; and(ii) as a result of the Injury or Sickness that caused their Total

Disablement the Insured Member receives, or would in Chubb’s opinion receive, a Post-Disability Income that is less than the Insured Member’s Income; and

(iii) is under the continuous and regular care of a medical practitioner undergoing appropriate treatment and care.

(i) Post-Disability Income means any income (other than a benefit under the Chubb policy for the same claim) that a person may derive after the commencement of the Waiting Period during a week for which the amount of the benefit that applies to them under the policy is being assessed.However, if the Insured Member is in Chubb’s opinion suffering Partial Disablement but has not received such income it is the reasonable estimate Chubb make of what that person would have been capable of earning, having regard to the extent of their disability.

3. Income protection insurance for employed members (cont)


(j) Pre-Existing Sickness means any sickness that an Insured Member has had treatment or advice for or is aware of the condition prior date the Insured Member became covered under the policy and has not ceased all treatment or advice with the agreement of a medical practitioner prior to the date of commencement, recommencement or alteration of their cover under the Policy.However, such condition will be covered provided:

(i) an Insured Member has, with the agreement of a medical practitioner, ceased all treatment or advice for at least six (6) consecutive months during Continuous Cover; or

(ii) An Insured Member has had two (2) years of Continuous Cover under the policy prior to the time of their disablement and had been Actively At Work during the final two (2) months of these two (2) years.

(k) Sickness means a state of being ill including a degenerative condition (any condition that has gradually developed over time affecting your musculoskeletal system (muscles,bones, ligaments and joints, including vertebral discs and cartilage) resulting in a Total Disablement or Partial Disablement, which is first contracted or which the Insured Member first becomes aware of while Continuous Cover is in force and which continues for a period of not less than the Waiting Period and excludes any Pre-Existing Sickness and any Injury.

(l) Superannuation Guarantee Legislation means the Superannuation Guarantee (Administration) Act 1992 and associated Regulations.

(m) Total Disablement means an Insured Member who is medically certified as totally disabled by a medical practitioner due to the Injury or Sickness and is;(i) unable to perform at least one income producing duty of his or

her Admitted Employer occupation; and(ii) not otherwise working or engaged in business activity; and(iii) under the regular care of a medical practitioner and undergoing

appropriate treatment and care.

Where an income producing duty is a duty of the Insured Member’s occupation immediately before he or she became disabled which generates 20% or more of the Insured Member’s Income

(n) Waiting Period means the continuous period elected by the Insured Member which premiums are being paid, before a benefit is payable. The Waiting Period commences on the first day of disablement, as certified by a medical practitioner. If an Insured Member returns to work during the Waiting Period and this return to work proves unsuccessful due to the Injury or Sickness causing the disablement, then the original Waiting Period will continue if the number of days the Insured Member returns to work for is no more than 10% of the Waiting Period.


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Further information about NESS SuperWe are here to help you.It’s important that you tell us if you change address so that you continue to get all the information issued by NESS Super.

You can do this via Member Access or you can contact us using any of the ways set out above.

More informationIf you have any questions or would like more information about NESS Super you can contact us by:

Free call 1800 022 067

Post NESS Super Administration Locked Bag 20 Parramatta NSW 2124

Web www.nesssuper.com.au

Email [email protected]

http://www.nesssuper.com.au

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