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FAQs insuranceIn this section we have covered the most commonly asked questions about insurance. For more detailed information, we recommend you read the current Product Disclosure Statement.
what definitions will be used by AIG Life to assess my claim? what happens when I submit my application for extra cover? what if I work for an affirmative action employer or sheltered workshop?
what definitions will be used by AIG Life to assess my claim?Total and Permanent DisablementTotal and Permanent Disablement (TPD) means that you:
OR
Only one benefit is payable and the amount payable upon permanent disablement must not exceed the insured Death benefit. TPD additional cover while working less than 15 hours per weekIf you make a TPD claim and work less than 15 hours per week (averaged over 3 consecutive months prior to the claim), Health Super and AIG Life will make assessment of your claim against your additional cover (if any) based upon the following definition: The insured member, having been (for a period of 6 consecutive months after the commencement of the injury, sickness or disease) continuously and totally unable to perform at least 3 of the following activities of daily living, as certified by a registered medical practitioner appointed by the insurer, and provided such continued inability is irreversible, as certified by that registered medical practitioner. The activities of daily living are: bathing The ability to wash yourself either in the bath or shower or by sponge bath without the standby assistance of another person. dressing The ability to put on and take off all garments and medically necessary braces or artificial limbs usually worn, and to fasten and unfasten them, without the standby assistance of another person. eating The ability to feed oneself, once food has been prepared and made available, without the standby assistance of another person. toileting The ability to get to and from and on and off the toilet, without the standby assistance of another person and the ability to manage bowel and bladder functions through the use of protective undergarments or surgical appliances, if appropriate. transferring The ability to move in and out of a chair without the standby assistance of another person. please note: This definition is applied only to a claim against any additional cover where a member is working less than 15 hours per week (averaged over 3 consecutive months prior to the claim). A claim against any automatic cover is subject to the definition on page 24 (under ‘what is TPD’).
how do I make a claim?
Depending on your claim, you may be asked to provide further medical evidence or other information, i.e. an interview, financial information, etc., to assess your claim. Please note that additional information may be at the members expense. Any additional information required by AIG Life in respect to the claim will be passed onto the Trustee. Throughout the process, the Trustee will be kept informed in regard to the claims progress.
what happens when I submit my application for extra cover?When Health Super receives your completed insurance application form and the Confidential Personal Statement, we will forward it to AIG Life for assessment and approval. Depending on the information in your Confidential Personal Statement and the level of additional cover requested, AIG Life may ask you for extra information. This may include but is not limited to:
about loaded premiumsIf your application does not meet the standard underwriting conditions, AIG Life may apply premium loadings or exclusions. These will be notified to you.
how much cover is enough?There isn’t a hard and fast rule with this one. It really depends on you and your lifestyle. And if you’re like most people, there is a risk that you may not have enough insurance now and later on. The important thing is to think about the future. Just because you’re insurable now, doesn’t necessarily mean that you will be in the future. You may also have an existing policy with another provider. Look at both policies, and work out what you need. There might be a risk that insurance with Health Super may not provide you with the same benefits that you have available under your existing policy. Also, ensure that your insurance cover with Health Super is in place before you consider cancelling your existing policy. Think about getting advice. This is an important decision, and Health Super recommends that you get advice from an appropriately qualified adviser. They will thoroughly assess your needs so you choose the right amount of insurance appropriate to your needs. Health Super provides members with access to discounted financial planning services. For more information, click here.
what if I work for an affirmative action employer or a sheltered workshop?If you work for an affirmative action employer or a sheltered workshop, certain conditions apply. affirmative action employersFor example, if you work for an employer with affirmative action policies in relation to people with HIV/AIDS; and you contract HIV or AIDS before 1 July 2004; and make a death and disablement claim as a result of having HIV/AIDS, then you will not be covered for Death, TPD or Income Protection cover. These affirmative action employers include, but are not limited to, the following: AIDS Action Council of ACT, AIDS Council of Central Australia, AIDS Council of NSW, AIDS Council of Housing Action Group of Victoria, AIDS LINE Incorporated, Adelaide HIV/AIDS Counselling Team, Australia Federation of AIDS Organisations, Foley House Incorporated, National Association of People Living with HIV/AIDS, NSW Users and AIDS Association, Queensland AIDS Council, Queensland Aboriginal and Islander Health Forum, QUIVVA, Tasmanian AIDS Council, The Australian AIDS Fund Incorporated, Victorian AIDS Council/Gay Men's Health Centre and Western Australian AIDS Council. sheltered workshopIf you have a disability (either or both of a physical or intellectual nature); and work for a sheltered workshop or in an arrangement similar to a sheltered workshop, then you will not be covered for Income Protection at all. You should notify us immediately to opt out of Income Protection so we can stop deducting premiums. These employers include, but are not limited to, the following:
If you are unsure whether your organisation falls under either of these categories, please contact Health Super via our Superline on Freecall 1800 331 719.
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