INSURANCE IN YOUR SUPER

Money when
it matters most
26 May 2018
Contents Page
Why you need cover 5

Income Protection cover 8

Death and TPD cover 16

Terminal illness benefit 24

Nominate your beneficiaries 26

Useful things you should know 28

Words and terms used 32

Forms 34

The information in this document forms part of the following

Product Disclosure Statement (PDS) dated 26 May 2018 for
the Public Sector Division of AustralianSuper.
Issued by AustralianSuper Pty Ltd
ABN 94 006 457 987 AFSL 233788
Trustee of AustralianSuper ABN 65 714 394 898
AustralianSuper MySuper Authorisation
65 714 394 898 856
26/50 Lonsdale St, Melbourne VIC 3000
We use our size and scale to provide
the best possible insurance cover for
our members.
With insurance through your super
you can protect your income and
prepare for the future. We’ve paid
over $2.6 billion in insurance claims
in the past ten years.
You can have peace of mind
knowing we’ve got you covered
when you need it most.
What’s in this guide

You’ll find the things you need to know

to help you make the best decisions about
your insurance.

About this guide

This guide contains important information about your The information in this guide is only a summary of the
insurance cover through AustralianSuper. main features of the insurance policy terms. You can
It provides general information only. It doesn’t take ask for a copy of the actual insurance policy documents
into account your financial situation or specific needs. if you require complete details of the policy terms
Please read this guide carefully because it is important and conditions. Copies of the policy documents are
that you fully understand the terms and conditions available from AustralianSuper on request.
before you apply for or change your insurance cover.
It provides details of the terms and conditions you need
to satisfy when applying for or changing your insurance
cover for Death, Total & Permanent Disablement or
Income Protection.

4
Why you need cover

Build a secure future for you and your family.

Having the right insurance gives you peace
of mind that you’ll have an income when you
need it.

5
Here you’ll find:
Money when it Do you need cover Benefits of cover Your cover
matters and how much? through super choices

Money when it matters Do you need cover and

Most people need insurance and being able to earn a
future income is their biggest asset. So just like your car
or home you should protect it. If you were injured or ill
and couldn’t work – would you be able to pay your bills?
For how long could you manage without an income?
Very few of us could say that we don’t need any cover
at all – and most of us need more cover than we think.
We provide members with:
› Cover 24 hours a day, seven days a week
(not just when you’re at work)
› Income Protection cover
› Death and Total & Permanent Disablement
(TPD) cover (which includes cover for
terminal illness).
how much?
When making this decision think about now and
the future:
› The day-to-day expenses that your salary covers
(such as bills, food, transport).
› All your debts – mortgages, credit cards, personal loans.
› How much income you and your family need to live
comfortably.
› The future costs of your children’s care and education
or for anyone you support financially.
We’ve built our insurance for everyday Australians
We recognise how important it is to have insurance
cover. That’s why we work hard to keep costs down
and provide affordable cover for our members. When
they join, most members are provided with more than
the minimum level of cover that’s required by legislation.
It can be increased, reduced or cancelled anytime.

Our insurance calculator can help you work out how much cover
you need and what it will cost. Visit australiansuper.com/calculators

6
Benefits of cover through super
›› W e work with our Insurer to negotiate discounted ›› Y
 ou can decrease, increase or cancel your cover
bulk insurance rates for members. anytime so it meets your needs. Usually if you’re
›› We run only to benefit members, so you only pay increasing your cover you’ll need to provide some
for what it costs to provide your insurance. health information.
›› Your insurance costs (also called premiums) are
deducted from your super account each month
not your take home pay. So payments are hassle free.

Your cover choices

You can choose the types of cover you need

Income Protection cover

If you were injured or became ill, how many weeks or months could you manage
$ without an income to pay for day-to-day expenses? Income Protection may give
you a monthly income for a period of time to help you get back on your feet.
We offer benefit payment periods up to two years, up to five years or up to age 65.

Total & Permanent Disablement (TPD) cover

TPD cover may provide you with a lump sum payout if you become totally and
permanently disabled and can no longer work.
It can provide you and your dependants with money to live on. It can help you pay
for medical expenses and aids, modifications to your home, or extra support you
might need.

Death cover
What are your ongoing financial obligations? This cover is designed to provide
your dependants with money to live on or to repay your debts and final expenses.
If you die, Death cover may provide a lump sum payout to:
› your dependants or nominated beneficiaries (for example, your children or partner), or
› your legal personal representative (executor of your estate).

Terminal illness benefit

You’re also covered for terminal illness if you have Death or TPD cover.
If you’re suffering from a terminal medical condition, you may be able to claim your
Death or TPD cover amount, whichever is more.
It can help ease some of the stress and trauma for you and your family during this
difficult period.

In the 2017 financial year, we paid $463 million in insurance claims to our members and their families.

Stay up-to-date with your insurance

We review our insurance yearly to ensure that the cost
and amount of cover provided to members is the best
possible value, now and in the future.
As part of this review the cost of your insurance cover
may change (increase or decrease), and there could
also be changes to our terms and conditions.
If the cost of your cover increases, or if we make any
changes to the terms and conditions that negatively
impact your cover, we’ll let you know 30 days in advance.
To stay up-to-date with your insurance cover and
related policies, you can download our most recent
guide at australiansuper.com/InsuranceGuide

AustralianSuper insurance is provided by TAL Life Limited (the Insurer) ABN 70 050 109 450 AFSL 237848.

7
Income Protection cover

Feel confident knowing you’ve insured your

income if you become disabled or ill and are
temporarily unable to work.

8
Here you’ll find:
Waiting and benefit
Income Changing your The cost of payment periods Claiming a benefit
Protection cover cover cover and work ratings payment

Income Protection cover Age-based Income Protection cover amounts

Income Protection
Income Protection is available from age 15 until you turn Age
cover a month ($)
70. You can apply for cover up to the maximum limit of 15–24 0
$30,000 a month or 85% of your salary, whichever is 25 1,900
lower. A maximum of 75% of your salary is paid to you 26 2,000
and up to 10% is paid into your AustralianSuper account.
27 2,200
Your benefit can be payable for up to two years, 28 2,300
up to five years, or up to age 65. 29 2,400
Basic cover 30 2,500
When most members join us, they receive a basic level 31 2,600
of age-based Income Protection cover. It’s provided 32 2,700
automatically from ages 25 to 69, and no health 33 2,800
information is required. If you don’t get automatic 34 2,900
Income Protection cover when you join, you can apply. 35 3,000
Here are some things you should know: 36 3,000
›› Your basic Income Protection cover is based on 37 3,000
your age. The amount of cover and the cost of it 38 3,100
will change as you get older (see page 12 for the 39 3,100
cost of cover). 40 3,100
›› Basic Income Protection cover starts automatically 41 3,100
when you turn 25. If you’re under 25 you can apply 42 3,100
for fixed cover earlier. 43 3,100
›› If you’re age 25 or older and don’t have Income 44 3,100
Protection cover, you can apply for age-based or 45 3,100
fixed cover (see page 10 for details). 46 3,100
›› If you’re over age 65 and you want to increase your 47 3,000
Income Protection, you’ll need to apply by completing 48 3,000
the Change your insurance form in this guide or go to 49 3,000
australiansuper.com/forms 50 3,000
›› Your benefit payment period can provide payments 51 3,000
for up to two years. You can apply for a longer period 52 2,900
of up to five years or up to age 65 (see page 13 53 2,900
for details).
54 2,900
›› Income Protection with benefit payment periods of 55 2,800
up to five years or up to age 65 will stop at age 65. 56 2,800
›› You can choose a waiting period of 30 or 60 days. 57 2,800
If you don’t choose, your waiting period will be 58 2,800
60 days (see page 13 for details). 59 2,700
›› If you increase or decrease your level of cover, 60 2,700
your amount of cover will be fixed. 61–63 2,600
›› Your cover may be limited cover (see page 31 64 2,500
for details). 65–66 2,400
67 2,300
68–69 2,200

If you’re under 25 when you join

Basic Income Protection starts when you turn 25. If you want cover earlier you can apply for fixed cover.
You choose a total amount of fixed cover which will stay the same unless you change it. Age-based cover
won’t start automatically if you’ve fixed or cancelled your cover.

9
 Income Protection cover designs
Our insurance is flexible and you can change
your cover to suit your needs. The different
Income Protection cover designs you can apply
for are age-based or fixed cover.
Age-based cover
The amount of cover you get is based
on your age. This means the amount of
cover you get and the cost of it changes
as you get older.
Fixed cover
The amount of cover you have stays the
same unless you change it and generally
the cost of it increases as you get older.
See page 12 for the cost of Income Protection
cover.
When cover starts
If you’re eligible, your cover starts on the latest
of these dates:
›› the day you joined your employer, or
›› the beginning of the period of your first employer
super contribution, or
›› 120 days before we receive your first employer
super contribution.
If you’re not in active employment on the date your
cover starts with us, your cover may be limited (see
page 31 for details).
Do you have more than one income protection
arrangement?
You may already have income protection with another
super fund or through private cover you’ve arranged.
Or you may have cover through an enterprise
agreement which your employer may pay for. If so,
this means that your Income Protection with us may
be in addition to cover you already have.
Having Income Protection cover with us may let
you extend the period of time that you can receive
payments (see page 14 for details).
If you already have Income Protection elsewhere,
you should think about whether you need both.
Consider their features, who pays for them (you or
your employer) and how (costs deducted through
your super or your take home pay).
*Salary is your annual (before-tax) salary, excluding employer super contributions. If you receive
a benefit payment it will be no more than 85% of your salary, even if your insured amount is higher.
10
Changing your Income
Protection cover
You can change your Income Protection cover or apply
for it anytime.
Apply for more or new cover
If you want a different amount of cover than your
basic cover provides, you can apply for fixed cover.
This means your cover amount stays the same as you
get older.
If you don’t have Income Protection cover you can
apply for either age-based or fixed cover anytime.
Your application will be assessed by our Insurer and
you’ll need to provide detailed health information.
The maximum amount of cover you can apply for is:
Type of cover Maximum amount of cover available
Up to $30,000 a month or 85% of your
Income Protection
salary* (whichever is lower)
Apply by completing the Change your insurance form
in this guide or at australiansuper.com/forms
Increase your cover when you join offer
If you’re eligible for basic cover when you join
AustralianSuper, you can apply once, within 120 days
of the date on your offer letter, to increase your total
amount of cover up to a set limit, without the usual
health checks. Or by answering a few questions, you
can apply for even more cover.
Total cover you can Total cover you can
Type of cover apply for with no apply for with a few
health checks health questions
Up to $10,000 Up to $20,000
a month or 85% a month or 85%
Income Protection
of your salary* of your salary*
(whichever is lower) (whichever is lower)
Requirements
You must apply within 120 days of the date on your
offer letter and complete the form we send you.
You can apply for more cover without providing
detailed health information as long as you’re under 65
and you’ve never previously applied to:
›› change your Income Protection work rating, or
›› change your Income Protection benefit payment
period or waiting period, or
›› transfer your cover, or
›› change your cover amount or insurance design
(including your Death and TPD cover).
Any additional cover will be limited cover for at least
two years (see page 31 for details).
You can still apply for cover even if you don’t meet
the requirements or want higher amounts of cover.
You’ll need to provide detailed health information
and your application will be assessed by the Insurer.
Complete the Change your insurance form in this
guide or at australiansuper.com/forms
Increase your cover when your life changes
You can apply to increase your Income Protection
cover once every 12 months and you’ll only need to
answer a few health questions. You must already have
insurance with us and apply within 60 days of one of
these life events occurring:
›› you get married
›› you get divorced
›› you have a child or adopt a child
›› you start a de facto relationship
›› you end a de facto relationship
›› you take out a mortgage to purchase or build
your main home in Australia
›› your spouse or de facto dies
›› you first become eligible for a Centrelink
carer’s allowance.
To apply for more cover due to a life event complete
the Application for Life Event insurance cover form in
this guide or at australiansuper.com/forms
Each increase in cover:
›› will have the same exclusions and other special
conditions that apply to the rest of your cover
›› will be limited cover for at least two years from the
date the cover increased (see page 31 for details)
›› can’t cause your total cover to exceed $20,000 a
month or 85% of your salary. To apply for cover above
these amounts complete the Change your insurance
form in this guide or at australiansuper.com/forms
Increase your cover when your salary increases
If you already have insurance with us, you can apply
to increase your Income Protection cover when your
salary increases. You’ll only need to answer a few health
questions, so long as:
›› you haven’t applied to increase your Income
Protection cover due to an increase in salary in the
past 12 months, and
›› you apply to increase cover within 30 days of the
effective date or notification date of a salary/income
increase, whichever is later, and
›› your employer confirms your salary/income
increase, and
›› the level of your total cover is no greater than
$20,000 a month or 85% of your salary.
To apply for more cover, complete the Application to
increase Income Protection cover after a salary increase
form in this guide or at australiansuper.com/forms
Any amount above 75% of your salary before you were injured or ill (pre-disability income)
will be paid into your AustralianSuper account.
Any increase in cover is based on your existing Income
Protection work rating. Limited cover may apply to the
additional cover amount (see page 31 for details).
The following table shows the maximum increase
possible in one salary review year.
Income Protection work rating Maximum increase
Standard $1,000
Low Risk $1,500
Professional $2,000
Reduce or cancel your cover
You can reduce or cancel part or all of your cover
anytime, but check your cover details first. If you do
cancel your cover and decide to apply for cover in the
future, you’ll need to provide detailed health information
and your application will be assessed by the Insurer.
Complete the Change your insurance or Cancel your
insurance form at australiansuper.com/forms
Interim accident cover
When you apply for insurance for a life event
or you provide detailed health information you
may receive interim accident cover. With interim
accident cover, you’re insured during the time that
your application for cover is being assessed by
the Insurer.
If you have an accident (during the interim
accident period) and you become disabled within
120 days of your application you’ll receive a benefit
payment. The interim accident benefit is payable
only once. If it’s paid, your insurance application
will be cancelled.
The interim accident cover period will start on
the date that we receive your application for
insurance. It will end at the earliest of:
1. t he application being withdrawn, accepted
or rejected, or
2. the policy terminating, or
3. t he Insurer cancelling your interim accident
cover in the event of fraud, or
4. 120 days passing since AustralianSuper
received your application for insurance.
The amount you’d be paid in this situation is the
amount you have applied for or $15,000 a month,
less any cover you already have – whichever is
lower. This will generally be paid in addition to the
cover amount you already have.
Accident means bodily injury caused solely and
directly by accidental, external and visible means,
independent of any other cause.
11
The cost of Income Protection cover
How much you’ll pay for Income Protection cover depends on your age, Income Protection work rating, waiting
period, benefit payment period and amount of cover.
Weekly cost (in dollars) for $100 a month of Income Protection
You can use the costs below to calculate the total cost of your Income Protection cover (age-based or fixed cover).
Standard work rating Low Risk work rating Professional work rating
Benefit payment period Benefit payment period Benefit payment period
Up to two Up to five Up to age 65 Up to two Up to five Up to age 65 Up to two Up to five
Age Up to age 65
years years years years years years
Waiting period (days) Waiting period (days) Waiting period (days)
30 60 30 60 30 60 30 60 30 60 30 60 30 60 30 60 30 60
15 0.026 0.015 0.039 0.027 0.089 0.063 0.014 0.008 0.023 0.017 0.054 0.038 0.012 0.007 0.020 0.014 0.045 0.032
16 0.026 0.015 0.039 0.027 0.089 0.063 0.014 0.008 0.023 0.017 0.054 0.038 0.012 0.007 0.020 0.014 0.045 0.032
17 0.026 0.015 0.039 0.027 0.089 0.063 0.014 0.008 0.023 0.017 0.054 0.038 0.012 0.007 0.020 0.014 0.045 0.032
18 0.026 0.015 0.039 0.027 0.089 0.063 0.014 0.008 0.023 0.017 0.054 0.038 0.012 0.007 0.020 0.014 0.045 0.032
19 0.026 0.015 0.039 0.027 0.089 0.063 0.014 0.008 0.023 0.017 0.054 0.038 0.012 0.007 0.020 0.014 0.045 0.032
20 0.026 0.015 0.039 0.027 0.089 0.063 0.014 0.008 0.023 0.017 0.054 0.038 0.012 0.007 0.020 0.014 0.045 0.032
21 0.030 0.017 0.045 0.032 0.104 0.073 0.016 0.009 0.027 0.019 0.063 0.044 0.014 0.008 0.023 0.016 0.053 0.037
22 0.036 0.020 0.054 0.038 0.124 0.086 0.019 0.010 0.033 0.023 0.075 0.053 0.017 0.009 0.027 0.019 0.062 0.043
23 0.040 0.022 0.060 0.042 0.138 0.097 0.020 0.011 0.036 0.025 0.083 0.058 0.019 0.010 0.031 0.021 0.069 0.048
24 0.043 0.025 0.064 0.045 0.147 0.103 0.021 0.013 0.039 0.027 0.088 0.062 0.019 0.011 0.033 0.023 0.074 0.052
25 0.049 0.027 0.073 0.051 0.166 0.117 0.024 0.014 0.043 0.031 0.100 0.071 0.022 0.012 0.037 0.025 0.083 0.059
26 0.055 0.030 0.081 0.057 0.189 0.133 0.027 0.015 0.049 0.035 0.114 0.080 0.024 0.014 0.041 0.028 0.095 0.066
27 0.058 0.033 0.088 0.062 0.208 0.146 0.029 0.017 0.054 0.038 0.125 0.088 0.026 0.015 0.044 0.032 0.104 0.074
28 0.064 0.036 0.098 0.068 0.233 0.163 0.032 0.018 0.059 0.041 0.140 0.098 0.029 0.016 0.049 0.035 0.117 0.082
29 0.065 0.039 0.101 0.071 0.242 0.169 0.033 0.020 0.061 0.043 0.145 0.102 0.030 0.018 0.051 0.036 0.121 0.085
30 0.078 0.044 0.121 0.085 0.294 0.206 0.039 0.022 0.073 0.052 0.177 0.124 0.035 0.020 0.061 0.043 0.147 0.103
31 0.086 0.048 0.134 0.094 0.325 0.227 0.043 0.024 0.08 0.057 0.196 0.137 0.039 0.022 0.067 0.047 0.163 0.114
32 0.095 0.053 0.151 0.105 0.367 0.257 0.048 0.027 0.091 0.063 0.221 0.155 0.043 0.024 0.076 0.053 0.184 0.128
33 0.104 0.058 0.165 0.116 0.404 0.283 0.053 0.029 0.099 0.069 0.243 0.171 0.047 0.026 0.083 0.058 0.202 0.142
34 0.112 0.063 0.180 0.126 0.441 0.309 0.056 0.032 0.108 0.076 0.265 0.185 0.051 0.028 0.091 0.063 0.221 0.155
35 0.121 0.068 0.195 0.137 0.478 0.335 0.060 0.034 0.117 0.082 0.287 0.201 0.055 0.031 0.098 0.068 0.239 0.167
36 0.130 0.073 0.211 0.147 0.515 0.360 0.065 0.037 0.126 0.088 0.309 0.217 0.058 0.033 0.105 0.074 0.258 0.180
37 0.139 0.078 0.227 0.160 0.557 0.389 0.070 0.039 0.137 0.096 0.334 0.234 0.063 0.035 0.114 0.080 0.279 0.195
38 0.149 0.084 0.246 0.173 0.597 0.418 0.075 0.042 0.147 0.103 0.359 0.252 0.067 0.038 0.123 0.086 0.299 0.209
39 0.159 0.090 0.264 0.185 0.637 0.446 0.080 0.045 0.159 0.112 0.382 0.268 0.072 0.041 0.133 0.093 0.319 0.223
40 0.171 0.097 0.287 0.201 0.687 0.481 0.086 0.049 0.173 0.121 0.413 0.289 0.078 0.044 0.144 0.101 0.344 0.241
41 0.183 0.103 0.308 0.216 0.731 0.512 0.092 0.052 0.185 0.129 0.439 0.307 0.083 0.046 0.155 0.108 0.365 0.256
42 0.197 0.111 0.334 0.234 0.783 0.548 0.099 0.056 0.201 0.141 0.471 0.329 0.089 0.050 0.167 0.117 0.392 0.275
43 0.209 0.119 0.358 0.251 0.828 0.580 0.105 0.060 0.215 0.151 0.498 0.348 0.094 0.054 0.179 0.125 0.415 0.291
44 0.225 0.127 0.387 0.271 0.883 0.618 0.113 0.064 0.233 0.163 0.531 0.372 0.101 0.057 0.194 0.136 0.442 0.309
45 0.241 0.136 0.416 0.292 0.935 0.655 0.121 0.068 0.249 0.175 0.561 0.393 0.109 0.061 0.208 0.146 0.467 0.327
46 0.258 0.146 0.448 0.314 0.988 0.692 0.130 0.073 0.269 0.188 0.593 0.415 0.116 0.066 0.224 0.157 0.495 0.346
47 0.277 0.156 0.483 0.339 1.043 0.731 0.138 0.078 0.291 0.203 0.626 0.438 0.125 0.070 0.242 0.169 0.522 0.365
48 0.295 0.166 0.519 0.363 1.094 0.765 0.148 0.083 0.312 0.218 0.657 0.460 0.132 0.075 0.260 0.182 0.547 0.383
49 0.315 0.178 0.560 0.393 1.149 0.805 0.159 0.089 0.337 0.236 0.689 0.483 0.142 0.080 0.280 0.197 0.575 0.403
50 0.337 0.190 0.602 0.421 1.199 0.839 0.169 0.095 0.361 0.253 0.720 0.504 0.152 0.086 0.301 0.211 0.600 0.420
51 0.359 0.203 0.646 0.453 1.246 0.873 0.180 0.102 0.388 0.272 0.747 0.523 0.162 0.091 0.323 0.226 0.623 0.437
52 0.386 0.217 0.697 0.487 1.294 0.906 0.193 0.109 0.418 0.293 0.777 0.544 0.173 0.098 0.348 0.244 0.647 0.454
53 0.411 0.232 0.747 0.523 1.333 0.933 0.205 0.116 0.448 0.315 0.800 0.560 0.185 0.104 0.374 0.262 0.666 0.466
54 0.439 0.248 0.804 0.563 1.367 0.957 0.220 0.124 0.483 0.338 0.821 0.575 0.198 0.112 0.402 0.282 0.684 0.479
55 0.468 0.265 0.865 0.605 1.393 0.975 0.235 0.133 0.519 0.363 0.836 0.585 0.211 0.119 0.433 0.303 0.697 0.487
56 0.500 0.282 0.928 0.651 1.406 0.984 0.250 0.141 0.558 0.391 0.844 0.591 0.225 0.127 0.464 0.325 0.703 0.493
57 0.533 0.301 0.996 0.697 1.405 0.983 0.267 0.151 0.598 0.419 0.843 0.591 0.240 0.135 0.498 0.348 0.703 0.492
58 0.568 0.321 1.069 0.748 1.388 0.973 0.284 0.161 0.642 0.449 0.834 0.583 0.256 0.144 0.535 0.375 0.695 0.486
59 0.606 0.342 1.149 0.804 1.353 0.947 0.304 0.171 0.689 0.483 0.812 0.568 0.273 0.154 0.575 0.402 0.677 0.474
60 0.646 0.365 1.238 0.866 1.289 0.903 0.323 0.183 0.743 0.520 0.774 0.542 0.290 0.164 0.619 0.434 0.645 0.452
61 0.687 0.389 1.195 0.837 1.195 0.837 0.345 0.195 0.717 0.502 0.717 0.502 0.310 0.175 0.598 0.419 0.598 0.419
62 0.733 0.414 1.047 0.733 1.047 0.733 0.367 0.207 0.628 0.440 0.628 0.440 0.330 0.186 0.524 0.366 0.524 0.366
63 0.780 0.441 0.887 0.621 0.887 0.621 0.390 0.221 0.533 0.373 0.533 0.373 0.352 0.198 0.444 0.311 0.444 0.311
64 0.831 0.470 0.645 0.317 0.645 0.317 0.416 0.235 0.387 0.191 0.387 0.191 0.374 0.212 0.323 0.159 0.323 0.159
65 0.884 0.500 n/a n/a n/a n/a 0.443 0.250 n/a n/a n/a n/a 0.398 0.225 n/a n/a n/a n/a
66 0.941 0.532 n/a n/a n/a n/a 0.471 0.266 n/a n/a n/a n/a 0.424 0.239 n/a n/a n/a n/a
67 1.000 0.566 n/a n/a n/a n/a 0.501 0.283 n/a n/a n/a n/a 0.451 0.255 n/a n/a n/a n/a
68 1.010 0.572 n/a n/a n/a n/a 0.547 0.286 n/a n/a n/a n/a 0.457 0.257 n/a n/a n/a n/a
69 0.683 0.372 n/a n/a n/a n/a 0.410 0.186 n/a n/a n/a n/a 0.342 0.167 n/a n/a n/a n/a
Total weekly costs are rounded to the nearest cent.

12
How to work out your weekly
Income Protection cover cost:
1. Divide the amount of cover you have, or wish to apply
for, by 100.
2. Then multiply by the cost of cover based on your age,
Income Protection work rating, waiting period and
benefit payment period.
Example:
Sam is aged 30. He wants to apply for $3,500 a
month of Income Protection based on a benefit
payment period of up to two years, a 60 day
waiting period and a Standard work rating.
The cost of his cover is $1.54 a week.
3,500
x 0.044 = $1.54 a week
100
Waiting period
Your waiting period starts on either the date you
stopped working because of an illness or injury, or the
date a medical practitioner certifies you as unable to
work due to illness or injury, whichever date is later.
You must be totally disabled for the first 14 days of
your waiting period to qualify for a benefit payment.
No benefits are paid for the waiting period.
You can choose a waiting period of 30 or 60 days.
If you don’t choose it will be 60 days. You can change
it to 30 days but it will cost more.
Benefit payment period
Up to two years
If you receive basic Income Protection cover when
you join or apply for it later, it’ll be based on a benefit
payment period of up to two years. This means
benefits may be paid a maximum of two years. Income
Protection with a two year benefit payment period is
available until you turn 70.
Up to five years or up to age 65
Depending on your occupation you can apply to
change your maximum benefit payment period to up
to five years or up to age 65. With a benefit payment
period of up to five years or up to age 65 your Income
Protection cover will end when you turn 65.
You can change your benefit payment period to up
to two years anytime. This will mean your cover will
end when you turn 70. If you do change to a two year
benefit payment period at age 63 or 64, you’ll need to
provide detailed health information to the Insurer.
After you’ve received payments for one year, your
payment may increase each year with the consumer
price index (up to a maximum of 5% a year) as
costs increase.
There are some occupations where you can’t have a
benefit payment period of up to five years or up to
age 65. These occupations are listed at
australiansuper.com/occupations
Changing your benefit payment period
Complete the Change your insurance form at the back
of this guide or go to australiansuper.com/forms
What’s your Income Protection
work rating?
The type of work you do determines your Income
Protection work rating – Standard, Low Risk or
Professional. This makes a difference to how much you
pay for your Income Protection.
Your work rating will be Standard, unless you apply
to change it. If you spend at least 80% of your time in
an office environment and don’t do any manual work,
you may be eligible for a Low Risk or Professional work
rating, which means your Income Protection cover will
cost less.
Changing your work rating
To check your work rating, log into your account and go
to My insurance.
›› To apply for a Low Risk or Professional rating
complete the Change your work rating form in this
guide or at australiansuper.com/forms
›› If your application is accepted, the cost of your cover
will reduce from the date your application is accepted.
Use our Work Rating Wizard at
australiansuper.com/calculators to check
which work rating may apply to you.
13
Claiming an Income Protection benefit payment
An Income Protection benefit is payable if you’re totally
or partially disabled after the waiting period has ended.
No benefits are paid for the waiting period.
You can be insured for up to 85% of your salary. The
maximum payment you can receive is the lowest of:
›› your level of cover, or
›› 85% of your pre-disability income (the salary you
earned before you were ill or injured), or
›› $30,000 a month.
Any amount above 75% of your pre-disability income
will be paid to your AustralianSuper account.
If you’re totally or partially disabled and a benefit is
paid, you don’t pay Income Protection premiums from
the end of the waiting period while Income Protection
payments are being made.
How much will you get paid each month?
You’ll receive a letter with each payment showing
how much your payment is and any tax that’s been
deducted. You’ll either get a full or partial payment.
Full payment
You get paid the full amount of your Income Protection
benefit, less tax, if you’re totally disabled, not working
and don’t receive income from other sources (see page
14 for details).
Partial payment
You get paid part of your Income Protection benefit,
less tax, if you’re partially disabled, able to work part
time or receive other income from other sources.
Your payment is based on your reduced income.
See page 33 for definitions of total disability, partial
disability and pre-disability income.
When does payment stop?
Your benefit payments are paid monthly, in arrears,
from the end of the waiting period until one of the
following happens:
›› you’re no longer totally disabled or partially disabled
›› you reach the end of your benefit payment period
›› you reach the maximum payment period where you’re
totally or partially disabled and you’re outside of
Australia. The maximum payment period will depend
on your circumstances
›› if you’re receiving a partial disability benefit and
your total income exceeds 85% of your pre-disability
income for three months in a row
›› you reach age 65 or 70, depending on your maximum
benefit payment period, or
›› you die.
Call us on 1300 667 387 to make a claim or find out more at australiansuper.com/InsuranceClaim
14
Income from other sources
Your monthly Income Protection benefit payments will
be reduced by the amount of income you receive from
any one of these sources:
1. Any income or commutation of income (lump sum
payments) you receive or are entitled to receive as a
result of your illness or injury including:
›› sick leave payments
›› amounts payable under legislation such as workers’
compensation, social security benefits (other than
Centrelink and Department of Veterans’ Affairs
payments) or motor accident compensation, and
›› benefits payable under other Income Protection
insurance policies.
2. Employer super contributions.
3. Income earned from working while disabled.
4. Any income that, in the opinion of the Insurer,
you could reasonably be expected to earn in your
occupation while disabled.
Sick leave benefits will reduce your Income Protection
benefit. But you can make a claim for an Income
Protection benefit before your sick leave is used up.
Extended waiting period
Do you have two Income Protection insurance policies?
If you do, it generally doesn’t mean you get paid twice
as much if you make a claim. But with AustralianSuper
you can extend your waiting period while you’re
receiving benefit payments from another policy.
This means you may get payments from us after
payments from your other insurance provider stop.
If you want to extend your waiting period:
›› you must tell us that you’re claiming on another
income protection policy before the end of the
30 or 60 day waiting period of your cover with
AustralianSuper, and
›› you must continue to be disabled in order to
receive payment.
If you make a claim on another Income Protection
policy, payments from us will start on the later of:
›› at the end of your chosen waiting period, or
›› on the date you last received payment from the other
policy, provided you continue to be totally or partially
disabled (see page 33 for definitions), or
›› on an earlier day that you choose after the date
of your selected waiting period.
Call us on 1300 667 387 to extend the start of your
Income Protection payments.
Recurring disability
If you become totally or partially disabled again from
the same or a related sickness or injury within six
months of the period for which you were eligible to
receive an Income Protection benefit, the disability will
be treated as a continuation of the original claim and
a new waiting period will not apply, provided you have
active cover.
After six months, the waiting period will apply.
The subsequent period(s) of disability will be added
to the initial period to determine if the maximum of
your chosen benefit payment period is reached.
Returning to work during the waiting period
After you’ve completed the initial 14 day period (where
you’ve been totally disabled), you can return to work at
full capacity for up to five days in a row without your
waiting period starting again. The number of days you
returned to work will be added to the end of your
waiting period.
Rehabilitation service
If you become disabled, the best outcome is that
you recover and are able to earn your full income for
the rest of your career. That’s why we may ask you
to take part in our Insurer’s rehabilitation service if
you become disabled.
This may include training, retraining or re-skilling to
help you return to work. The Insurer will pay the cost of
this service direct to the service provider. If you refuse
to take part in the rehabilitation service, or delay your
participation in it, your payments may be reduced.
Income Protection cover exclusion
You won’t be paid an insurance benefit if an illness or
injury is directly or indirectly caused by:
›› intentional self-inflicted act or suicide attempt,
whether sane at that time or not
›› your service in the armed forces of any country, other
than service in the Australian Armed Forces Reserve
›› normal pregnancy or childbirth or assisted fertilisation
techniques, or
›› war. War includes any act of war (whether declared
or not), revolution, invasion, rebellion or civil unrest.
The maximum time the Insurer will pay a benefit for
a disability resulting from the same or related condition
is your chosen benefit payment period – up to two
years, up to five years, or up to age 65.
Income Protection and tax
A few things you should know about Income Protection
and tax:
›› Our Income Protection insurance is a benefit provided
through the AustralianSuper Fund and your premiums
are deducted from your super account. So, you can’t
claim a personal tax deduction for the premiums.
›› Tax deductions are generally available for your
personal super contributions, including any additional
contributions you make to your AustralianSuper
account to cover the premiums paid for insurance
(contribution caps apply).
›› Benefit payments under Income Protection
insurance that are paid directly to you are paid as
taxable income and attract Pay As You Go (PAYG)
withholding tax, the same as salary and wages. PAYG
withholding tax will be deducted from the benefit
payment before it’s paid, and forwarded to the
Australian Taxation Office.
›› If you receive Income Protection insurance benefits
you’ll be asked to provide your Tax File Number (TFN)
to AustralianSuper. If you don’t provide your TFN,
tax will be deducted at the highest PAYG withholding
tax rate.
›› The portion of your Income Protection benefit that’s
paid as super will be paid into your AustralianSuper
account and will count towards your before-tax
contribution cap.
These statements about taxation are based on
interpretation of current Australian tax law, which may
change anytime. You should consult a professional
taxation adviser for a full explanation and advice on
your individual circumstances.
15
Death and TPD cover

Life is full of uncertainties. Death and TPD

insurance can provide financial security for your
family if you die or your future if you become
totally and permanently disabled and can never
work again.

16
Here you’ll find:
Cover when Changing your How our different The cost of Claiming a
you join us cover cover designs work cover TPD benefit

Cover when you join us Age-based Death and TPD cover amounts
Death cover TPD cover
Age
You can have Death cover from age 15 up until you ($) ($)
turn 70. TPD cover is available from age 15 to 65. 15–19 0 0
Basic cover 20 50,000 25,000
When most members join us, they automatically receive 21 51,000 28,000
a basic level of age-based Death and Total & Permanent 22 66,000 33,000
Disablement (TPD) cover, and no health information is 23 82,000 38,000
required. This automatic cover is designed to provide 24 100,000 44,000
you with a basic level of financial protection for death 25 116,000 48,000
and permanent disablement. Here are some things you 26 132,000 52,000
should know: 27 147,000 56,000
›› Your basic cover is based on your age. The amount of 28 161,000 58,000
cover and the cost of it will change as you get older 29 175,000 61,000
(see page 21 for the cost of cover).
30 178,000 61,000
›› Basic Death and TPD cover starts automatically once 31 182,000 60,000
you turn 20 years old. 32 183,000 59,000
›› If you don’t get Death and TPD insurance 33 183,000 57,000
automatically when you join you can still apply for 34 183,000 56,000
cover (see page 18 for details). 35 180,000 53,000
›› You can apply to top up your basic cover with extra 36 178,000 51,000
(fixed) cover or you can apply for a total amount of 37 174,000 49,000
fixed cover.
38 171,000 47,000
›› Your cover may be limited cover (see page 31 39 166,000 45,000
for details). 40 160,000 43,000
When cover starts 41 154,000 40,000
If you’re eligible, your cover starts on the latest of 42 146,000 37,000
these dates: 43 140,000 34,000
›› the day you joined your employer, or 44 131,000 32,000
›› the beginning of the period of your first employer 45 124,000 29,000
super contribution, or 46 115,000 27,000
›› 120 days before we receive your first employer 47 107,000 23,000
super contribution. 48 98,000 21,000
If you’re not in active employment on the date your 49 90,000 19,000
cover starts with us, your cover may be limited (see 50 80,000 17,000
page 31 for details). 51 72,000 15,000
52 63,000 13,000
53 54,000 11,000
If you’re under 20 when you join
54 46,000 10,000
Basic age-based Death and TPD cover starts
when you turn 20. If you want cover earlier, you 55 37,000 9,000
can apply for: 56 30,000 7,000
›› An extra amount of fixed Death and/or TPD 57 22,000 6,000
cover on top of your basic cover. This means 58 15,000 6,000
when you turn 20, your basic age-based cover 59 9,000 6,000
will start and your extra cover will continue. 60–64 9,000 5,000
›› Fixed Death and/or TPD cover. You choose a 65–69 9,000 0*
total amount of fixed cover which will stay the * If you were born on or after 1 January 1953, your TPD cover will end
same unless you change it. Age-based cover when you turn 65. If you were born before 1 January 1953 and had TPD
won’t start automatically if you’ve fixed or cover before 28 October 2017, your TPD cover will continue until you
cancelled your cover. turn 70 or you cancel it.

17
Changing your Death and TPD cover
You can change your Death and TPD cover or apply for it anytime.

Death and TPD cover designs

Age-based cover Age-based + extra (fixed) cover Fixed cover

The level of cover you get is based
on your age. This means the
amount of cover you get and the
cost of it changes as you
get older.
You can get age-based Death and The amount of cover you have
TPD cover and top up by applying stays the same unless you change
for extra (fixed) cover. it and generally the cost of it
Your age-based cover will increases as you get older.
continue to change as you
get older, but your extra cover
amount will stay the same, unless
you change it.

See page 21 for the cost of Death and TPD cover.

Apply for more or new cover Requirements

If you have basic Death and/or TPD cover, you can
apply for more cover in two ways:
1. Top up your basic cover with extra (fixed) cover.
2. Apply for a total amount of fixed cover.
If you don’t have Death or TPD cover you can apply
anytime. You can choose age-based, age-based + extra,
or fixed cover. Your application will be assessed by
our Insurer and you’ll need to provide detailed health
information. The maximum amount of cover you can
apply for is:
Type of cover Maximum amount of cover available
Death No maximum
TPD $3 million
* Salary is your annual (before-tax) salary, excluding employer contributions.
Apply by completing the Change your insurance form in
this guide or at australiansuper.com/forms
Increase your cover when you join offer
If you’re eligible for basic cover when you join
AustralianSuper, you can apply once, within 120 days
of the date on your offer letter, to increase your total
amount of cover up to a set limit, without the usual
health checks. Or by answering a few questions, you
can apply for even more cover.
You must apply within 120 days of the date on your
offer letter and complete the Set up your account form
we send you. You can apply for more cover without
providing detailed health information as long as you’ve
never previously applied to:
›› change your Income Protection work rating, or
›› change your Income Protection benefit payment
period or waiting period, or
›› transfer your cover, or
›› change your cover amount or insurance design
(including your Income Protection cover).
Any additional cover will be limited cover for at least
two years (see page 31 for details).
You can still apply for cover even if you don’t meet
the requirements or want higher amounts of cover.
You’ll need to provide detailed health information
and your application will be assessed by the Insurer.
Complete the Change your insurance form in this guide
or at australiansuper.com/forms

Cover you can

Cover you can apply for with
Type of cover apply for without
a few health questions
health checks

Up to $1 million (cover above

Death and/or $600,000 will be capped at
Up to $600,000
TPD the lower of $1 million or
10 times your salary*)

* Salary is your annual (before-tax) salary, excluding employer contributions.

18
Increase your cover when your life changes
You can apply to increase your Death and TPD cover
up to certain limits once a year by answering just a
few health questions. You must already have insurance
with us and apply within 60 days of one of these life
events occurring:
›› you get married
›› you get divorced
›› you have a child or adopt a child
›› you start a de facto relationship
›› you end a de facto relationship
›› you take out a mortgage to purchase or build your
main home in Australia
›› your spouse or de facto dies
›› you first become eligible for a Centrelink
carer’s allowance.
To apply for more cover due to a life event complete
the Application for Life Event insurance cover form
in this guide or at australiansuper.com/forms
Each increase in cover:
› will have the same exclusions and other special
conditions that apply to the rest of your cover
› will be limited cover for at least two years from the
date the cover increased (see page 31 for details)
› can’t be higher than $500,000
› can’t cause the total of your cover to exceed $1 million
or ten times your salary (if your total cover exceeds
$600,000). To apply for cover above these amounts
complete the Change your insurance form in this guide
or at australiansuper.com/forms
Reduce or cancel your cover
You can reduce or cancel part or all of your cover
anytime. If you do cancel your cover and decide to
apply for cover in the future, you’ll need to provide
detailed health information and your application will
be assessed by the Insurer. Complete the Change
your insurance or Cancel your insurance form at
australiansuper.com/forms
Interim accident cover
When you apply for insurance for a life event
or you provide detailed health information you
may receive interim accident cover. With interim
accident cover, you’re insured during the time that
your application for cover is being assessed by
the Insurer.
If you have an accident (during the interim
accident period) you’ll be paid a benefit if you
die, or become totally and permanently disabled,
within 120 days of your application. The interim
accident benefit is payable once. If it’s paid, your
application for insurance will be cancelled.
The interim accident cover period will start on
the date that we receives your application for
insurance. It will end at the earliest of:
1. the application being withdrawn, accepted
or rejected, or
2. the policy is terminating, or
3. the Insurer cancelling your interim accident
cover in the event of fraud, or
4. 120 days passing since AustralianSuper
received your application for insurance.
The amount you’d be paid in this situation is the
amount you have applied for or $1 million, less
any cover you already have – whichever is lower.
This will generally be paid in addition to the cover
amount you already have.
Accident means bodily injury caused solely and
directly by accidental, external and visible means,
independent of any other cause.
19
 How our different cover designs work
Tom’s 30 when he joins AustralianSuper. These examples show what his Death cover looked like when he first
joined at 30, and how it may change by the time he’s 40, based on his choice of cover.
Basic age-based cover
K
250
Death cover ($)

Tom joins Death cover amount

AustralianSuper 200
if Tom stays on age-
and is automatically 150 based cover:
provided with a 100 At aged 30: $178,000
basic level of Age-based
age-based cover. 50 cover At aged 40: $160,000

10 20 30 40 50 60 70 Age (years)
Basic age-based cover + extra (fixed) cover
K Death cover amount if
250 Extra Tom stays with basic
Death cover ($)

Tom wants the cover:

200 $50,000 age-based cover, plus
basic age-based the extra $50,000
cover amount of 150 fixed amount:
$178,000 but would 100
like to add $50,000 At aged 30: $228,000
Age-based
of extra cover. 50 cover ($178,000 + $50,000)
At aged 40: $210,000
10 20 30 40 50 60 70 Age (years) ($160,000 + $50,000)
Fixed cover
K
250 Fixed cover
Death cover ($)

200 Death cover amount if

Tom wants to fix Tom keeps fixed cover:
150
his Death cover
100 At aged 30: $178,000
at $178,000.
Age-based At aged 40: $178,000
50 cover
10 20 30 40 50 60 70 Age (years)

20
The cost of Death and TPD cover
How much you’ll pay for Death and TPD cover depends on your age.

Weekly cost (in dollars) for $10,000 of Death and

TPD cover Example:
Use the costs below to calculate the total cost of your Sally is 38 and wants $800,000 of Death cover
cover (age-based, age-based + extra or fixed cover). and $800,000 of TPD cover.
Age Death TPD To work out the weekly cost of Sally’s Death cover:
15 0.067 0.050 800,000
16 0.066 0.050 x 0.119 = $9.52 a week
10,000
17 0.066 0.050
18 0.066 0.050
To work out the weekly cost of Sally’s TPD cover:
19 0.067 0.050
20 0.067 0.050 800,000
x 0.113 = $9.04 a week
21 0.067 0.051 10,000
22 0.069 0.051
23 0.069 0.051
24 0.071 0.051
25 0.072 0.047
Multiple of age-based cover
26 0.073 0.048
27 0.075 0.048
On 28 October 2017 we made some changes to
28 0.078 0.049
our insurance and some members have a multiple
29 0.081 0.050
of age-based Death or TPD cover.
30 0.084 0.051 If you have a multiple, your cover amount follows
31 0.087 0.055 the age-based curve at a level lower or higher than
32 0.091 0.061 basic cover (depending on your multiple). To check
33 0.095 0.067 whether you have a multiple of cover you can log
34 0.100 0.074 into your online account at australiansuper.com
35 0.104 0.082 You can apply to change your cover anytime
36 0.110 0.093 to make sure your insurance suits your needs.
37 0.116 0.102 For example, remove your multiple, apply for
38 0.119 0.113 more cover or change to fixed cover. Use the
39 0.126 0.126 Change your insurance form in this guide or at
40 0.134 0.139 australiansuper.com/forms
41 0.146 0.155
42 0.156 0.173
43 0.166 0.192
44 0.184 0.213
45 0.200 0.237
46 0.217 0.263
47 0.235 0.291
48 0.256 0.318
49 0.280 0.350
50 0.307 0.386
51 0.337 0.430
52 0.370 0.482
53 0.408 0.520
54 0.452 0.603
55 0.501 0.709
56 0.557 0.811
57 0.622 0.915
58 0.694 0.998
59 0.779 1.151
60 0.875 1.210
61 0.961 1.465
62 1.003 1.848
63 1.046 2.120
64 1.087 2.499
65 1.130 2.824*
66 1.172 3.192*
67 1.214 3.606*
68 1.256 4.077*
69 1.298 4.606*
* If you were born on or after 1 January 1953, your TPD cover will end
when you turn 65. Costs shown for TPD cover after age 65 only apply
if you were born before 1 January 1953 and already had TPD cover before
28 October 2017.

21
What your Death and
TPD insurance covers
Death insurance provides a lump sum to your
dependants or legal personal representative if you die
(see page 27 for details). A Death benefit may also be
prepaid if you’re terminally ill.
TPD insurance provides a lump sum to you if you
become totally and permanently disabled. A TPD
benefit may also be paid if you’re terminally ill.
See page 25 for more details on terminal illness benefit.
Claiming a TPD benefit
If you have TPD cover, you can make a TPD claim if
something happens and you:
›› won’t work again in any occupation, or
›› can’t do everyday working activities.
Our Insurer will decide if you’re eligible.
You won’t work again in any occupation
This applies if, immediately before you became totally
and permanently disabled because of your illness or
injury, you were:
›› working (including being self-employed), or
›› unemployed for less than six months in a row.
You’ll be considered totally and permanently disabled if:
›› solely because of your illness or injury you haven’t
been able to work in any job for at least three months
in a row since you became ill or injured, and
›› you’re getting treated by and following the advice of
a medical practitioner* for your illness or injury, and
›› at the end of the three months in a row, your injury or
illness means that you’re incapable of ever working in
any job that you’re suited to based on your previous
education, training or experience, or any job that
you may reasonably become suited to with further
education, training or experience.
This will be decided by considering things such as:
›› what re-skilling, training or voluntary work you’ve
done already
›› any retraining or reskilling you reasonably could be
expected to do, and
›› any rehabilitation you’ve done already or any
rehabilitation you reasonably could be expected to do.
The decision will be based on all relevant information
available from the time you become ill or injured, and
information up to the date that the Insurer makes a
decision about your claim.
You can’t do everyday working activities
This applies if, immediately before you became totally
and permanently disabled because of your injury or
illness, you’ve been unemployed for at least six months
in a row.
Call us on 1300 667 387 to make a Death or TPD claim or find out more
at australiansuper.com/InsuranceClaim
22
You’ll be considered totally and permanently disabled
if solely because you become ill or injured after your
cover starts:
›› you’ll never be able to do at least two of five everyday
working activities, without physical help from
another person, even with the use of medication and
appropriate aids. You must have been unable to do
the everyday working activities for at least six months
in a row since you became ill or injured, and
›› you’re getting treated by and following the advice of
a medical practitioner* for your illness or injury, and
›› because you’re ill or injured and you’re unable to
work in any job that you’re suited to based on your
education, training or experience.
*F
 or mental health conditions the treating practitioner must be a
registered psychiatrist.
The everyday working activities include:
1. Mobility – you can’t do one of these:
›› Walk more than 200 metres on a level surface
without stopping because of breathlessness or
severe discomfort.
›› Bend, kneel or squat to pick something up from the
floor and straighten up again, or get in and out of a
standard sedan car.
2. Communicating – you can’t do one of these:
›› Speak in your first language so that you’re understood
in a quiet room, or 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.
›› Understand a simple message in your first language
and pass on that message to another person.
3. Vision
Even if you’re wearing glasses or contact lenses, you
can’t read ordinary newsprint and pass the standard
eyesight test for a car licence.
4. Lifting
You can’t lift, carry or move objects weighing up to 5kg
with at least one hand.
5. Manual dexterity
You can’t use your hands or fingers to handle small
objects with precision (such as picking up a coin,
fastening shoelaces or buttons, using cutlery, or using
a pen or keyboard to write a short note).
Death and TPD cover exclusion
An exclusion will apply if more than six months after
you start work with your AustralianSuper employer you:
›› join AustralianSuper, or
›› increase your cover without providing detailed
health information.
 nder the exclusion, you or your beneficiaries won’t
U
be paid a benefit if, within 12 months of your basic or
increased cover starting:
›› your death is caused by suicide, or
›› you become terminally ill or totally and permanently
disabled as a result of harming yourself (or attempting
to harm yourself) on purpose (including attempted
suicide), whether or not you’re sane at the time.
23
Terminal illness benefit

If you have Death or TPD cover with us, you may

receive a benefit for terminal illness. This can help
reduce some of the stress and hardship that you
and your family are going through at an already
difficult time. You may also be able to access your
super account balance.

24
Here you’ll find:
What gets paid
Claiming a terminal if you have a Do you have Income
illness benefit terminal illness? Protection cover?

$
$ SUPER

Claiming a terminal Do you have Income

illness benefit Protection cover?
You’ll be able to apply for a terminal illness benefit You may choose to continue working even if you’ve
payment if your Death or TPD cover is current and: claimed your terminal illness benefit. But if the medical
›› two of your treating doctors (one must specialise condition that your terminal illness benefit was paid for
in your condition) believe that despite medical causes you to stop work within 24 months you may be
treatment for your condition, your life expectancy able to also claim an Income Protection benefit payment
is less than 24 months from the date of their written if you have cover. This applies even if your account was
certification, and closed when you claimed your terminal illness benefit.
›› it’s been less than 24 months since the medical The waiting period for your Income Protection benefit
certificates were provided. may still apply, be reduced or waived. The time between
your written certification and the date you stopped work
will count towards your waiting period.
What gets paid if you have Call us on 1300 667 387 for more information or to
check if you can make a claim.
a terminal illness?
If you’re eligible for a payment it will be made up of:
›› the greater of your Death or TPD cover, plus
›› the early release of your super account balance.
The Insurer will assess your eligibility to claim terminal
illness benefit and make the decision on your claim.
AustralianSuper will assess your eligibility for an early
release of your super.
If you have a terminal illness and don’t have insurance,
you can still apply for the early release of your super if
you’re eligible.

25
Nominate your beneficiaries

Deciding who will receive your super and

insurance money if the worst happens is an
important decision for you.

26
Here you’ll find:
Decide what
What’s paid if happens to Who can be
you die? your money nominated?
What’s paid if you die?
If you die, the amount payable to your dependants,
nominated beneficiaries, or legal personal
representatives (executor of your estate) is made up of:
›› your super account balance. This may include super
contributions made by your employer or by you, and
any amounts rolled over from other super funds (less
any appropriate charges and taxes), and
›› any insurance amount which may be payable, the
amount of which depends on your level of insurance
cover with us and your age at the time of your death.
Decide what happens
to your money
You have two options when deciding what happens
to your money.
Non-binding nomination
A non-binding nomination isn’t legally binding.
We (AustralianSuper) are legally responsible for
deciding who to make payments to after your death
and must follow the laws about this. We’ll consider all
nominated beneficiaries, but we’re not bound by the
nominations if we decide we have an obligation under
our Trust Deed and current legislation to pay someone
else. To make a non-binding nomination log into your
account at australiansuper.com You can change your
nominations anytime.
Binding nomination
With binding nominations, you provide formal written
direction to AustralianSuper to tell us who you want
your account balance and death benefit paid to. As
long as it’s valid, your nomination is legally binding
and we must follow it. This means that we must pay
the people nominated, as long as they qualify as a
beneficiary – see list opposite.
A correctly completed binding nomination comes into
effect from the date we accept it and expires three
years from the date you sign the form. The expiry date
of your binding nomination is shown on your member
statement and we’ll also send you a reminder before
your nomination expires.
You can set up or change your binding nomination
anytime. You’ll need to complete a valid Making,
changing or cancelling a binding death nomination
form available at australiansuper.com/forms
Claims for a Death, terminal illness or TPD benefit can be lodged by calling us on 1300 667 387.
Find out more at australiansuper.com/InsuranceClaim
Our
responsibility
Who can be nominated?
You can nominate these people as beneficiaries:
›› a spouse (including de facto and same-sex)
›› children of any age (including adopted and
step-children)
›› interdependants (someone who lives with you and
shares a close personal relationship where one or
both of you provide for the financial and domestic
support and personal care of the other)
›› other financial dependants (such as someone who
relies on you financially)
›› your legal personal representative (who will be the
executor of your estate).
Special conditions for children
Children aged between 18 and 25, who are financially
dependent on you, may choose to receive your benefit
as regular income payments until they reach 25 (unless
your account runs out earlier). The remaining account
balance will be paid out to them when they turn 25. If
your child is permanently disabled, they may continue
to receive regular payments until the money runs out,
regardless of their age. Beneficiaries should consider
seeking financial advice before making a decision.
What if my nomination is invalid?
If your binding nomination is invalid we’ll consider
your wishes but use our discretion when paying
out your account balance. Examples of an invalid
nomination include:
›› your nomination was made more than three years ago
›› your form was not correctly signed and witnessed
›› any of the people nominated dies before you do
›› the individuals nominated no longer qualify as your
dependants at the time of your death.
Our responsibility
When one of our members dies, we have a responsibility
to pay out the member’s account balance to the person
or people entitled to it. We decide who to pay by
following legislative guidelines and the AustralianSuper
Trust Deed. We must decide who receives a payment
within strict legal guidelines even if the decision is an
unpopular one.
27
Useful things you should know

There’s a few more important things

that we need to tell you about our
insurance and how it works.

28
 Here you’ll find:
When does your Cover while
cover stop? on leave
When does your cover stop?
Insurance for Death, TPD or Income Protection will stop
as a result of the earliest event below:
›› You reach age 65 (for TPD cover and Income
Protection cover with a benefit payment period up
to five years or up to age 65) or age 70 (for Death
and Income Protection cover with a benefit payment
period of up to two years).
›› Your AustralianSuper membership ends.
›› Income Protection cover will stop 13 months from
the date we receive your last super contribution from
your employer.
›› Death and TPD cover will stop when your account
balance* falls below $10,000 on or after 13 months
since your last employer super contribution is
received.
›› The conclusion of the day on which, if you’re a
member of the Australian Armed Forces Reserve,
you’re called to active duty (applies to Death and TPD
cover only).
›› The date we receive your written request to cancel
your insurance cover.
›› The date an insured Death, TPD or terminal illness
benefit becomes payable from the Insurer. If a TPD
insurance benefit is paid to you, and the amount of
the payment is less than your Death cover – then
your TPD cover may end, and your Death cover will
continue, but it will be reduced by the amount of your
TPD payment. Any Income Protection cover you hold
will also stop, other than Income Protection cover for
the same condition for which a terminal illness benefit
was paid.
›› The end of the day in which you don’t have enough
money in your account to pay the insurance
premiums.
›› The date the insurance policy is terminated or
cancelled for any reason.
›› The date you transfer your cover into another fund.
If for any reason no insurance benefit is payable, then
any benefit paid to you will consist solely of your
account balance.
* Your account balance excludes any estimated earnings accrued since the start of the financial year.
Transferring Worldwide Limited
cover cover cover
Continued cover period
For most members if we don’t receive an employer super
contribution for 13 months, Income Protection cover will
stop. Death and TPD cover stops if we don’t receive an
employer super contribution for 13 months and your
account balance* is below $10,000.
While your account balance* is above $10,000 your
Death and TPD cover will continue and premiums will be
deducted from your account.
During the 13 month period, premiums will continue
to be deducted from your account and your cover will
stop if there isn’t enough money in your account to pay
the premiums.
When 12 months have passed since your last employer
super contribution was made, we’ll write to you and ask
if you want to continue your Income Protection cover, as
long as your account balance* is more than $1,000. We’ll
write to you and ask if you want to continue your Death
and/or TPD cover if your balance* is below $10,000
(and is more than $1,000).
Extension of Death, TPD and/or
Income Protection cover
If we write to you and offer the option of extending your
Death, TPD and/or Income Protection cover, you can
take up the option as long as:
›› you do so within the required time frame, and
›› no other benefit is payable.
If you don’t take up this option you won’t be able
to restart your cover until you receive an employer
super contribution.
If you extend your Income Protection cover your existing
Income Protection work rating will apply.
If your cover starts again
If your insurance cover stops (and if the policy permits),
your Death, TPD and/or Income Protection cover may
restart when we receive new super contributions from
your employer. You’ll get the basic cover for your age at
the time – even if it’s higher or lower than the cover you
had before.
If you receive basic Income Protection cover, it will be
on a Standard Income Protection work rating, a benefit
payment period of up to two years and a 60 day
waiting period. Any type of cover that’s previously been
cancelled won’t start again. You can reduce or cancel
your cover anytime.
If you have any questions, call us 1300 300 273.
29
 Cover while on leave
Your insurance cover will continue unchanged while
you’re on parental leave or leave without pay. Cover
will be maintained and premiums will continue to
be deducted until cover ends based on the rules
regarding when Death, TPD and Income Protection
cover stops. You don’t need to notify AustralianSuper
of this leave.
Transferring cover
From another AustralianSuper account
Already have insurance with us? If you do, you may be
eligible to transfer any insurance you have between our
divisions. You must transfer the whole amount of your
existing cover. Your cover will have the same conditions
and exclusions that applied previously and it may be
limited cover (see page 31 for details).
From another insurer or fund
You can apply to transfer any existing Death, TPD
or Income Protection cover from your individual
insurance or employer sponsored super arrangement
to AustralianSuper.
The maximum amount of cover that can be transferred
is $2 million for Death and TPD cover and $20,000 a
month for Income Protection. Your total cover after
transfer can’t exceed the maximum levels.
What happens when you transfer your cover?
The transferred Death and TPD cover will be added
to your existing cover. You’ll have an amount of fixed
cover for Death and/or TPD to replace the level of
cover you have with your other fund, rounded up
to the next $1,000.
For Income Protection the higher of your existing
cover or transferred cover applies (rounded to the
nearest $100).
You can also apply to have your Income Protection
cover matched to your work rating for either Low
Risk or Professional by answering the work questions
included in the Insurance transfer form.
For Income Protection:
›› The waiting period will be 60 days, unless 30 days
applied under your previous policy or you’ve applied
for 30 days.
›› If your AustralianSuper insurance cover has the same
benefit payment period as your cover with the other
insurer or fund, it will remain unchanged. If not, an
up to two year benefit payment period will be
applied. To apply for a longer benefit payment
period by use the Change your insurance form at
australiansuper.com/forms You’ll need to provide
detailed health information to the Insurer.
Your transferred cover with AustralianSuper can only
start once you’re eligible and you’ve:
›› received written confirmation that your transfer
request has been accepted by AustralianSuper, and
›› cancelled your previous cover.
30
If you become disabled while you’re on employer-
approved unpaid leave and you’re eligible for
an Income Protection payment, payments will
commence when you’re due to return to work as
agreed with your employer or at the end of the
waiting period, whichever is later.
If you transfer your cover from another fund and you
get more cover because AustralianSuper rounds up
your amount of cover, the additional cover will be
limited cover (see page 31 for details).
To transfer your existing cover to AustralianSuper,
complete the Insurance transfer form in this guide
or at australiansuper.com/forms
Maximum cover
The maximum cover available refers to the maximum
cover you can have with AustralianSuper. Your total
Income Protection cover can’t exceed $30,000 a
month or 85% of your salary (whichever is lower),
and your total TPD cover can’t exceed $3 million.
There’s no maximum for Death cover.
Worldwide cover
With your insurance you’re covered for travel overseas.
›› You’re not required to let us know before you go
›› The Insurer may ask you to return to Australia for an
assessment if you make a claim overseas
›› If you’re overseas when you’re receiving Income
Protection payments, the time that you receive
payments may be restricted to a maximum of six
months or the end of your benefit payment period,
whichever happens first.
If you have any questions, call us on 1300 667 387.
Investment of insured benefits
From the date we receive the insured benefit from the
Insurer and until it’s paid to you or your beneficiaries,
the insured component of the benefit is invested in
a low risk investment option. The account balance
component of any benefit remains invested in the
options you’ve chosen.
Limited cover
What does limited cover mean?
Limited cover means that you won’t be covered for any illnesses or injuries that you already had before you
got your cover. You’ll be covered for an illness that becomes apparent or an injury that occurs, on or after the
date that your cover starts, restarts or increases.

When your cover will be limited cover How long limited cover will last

›› Y ou’re not in active employment
on the date your basic cover starts, restarts or increases.
›› You’ve been unable to work
because you’re ill or injured, for ten days in a row in the
12 months before your basic cover starts or restarts.
Your basic cover and any automatic increases will be
limited cover. Full cover will start once you’ve been in
active employment for two months in a row.
See page 33 for an explanation of active employment.

›› Y our basic cover starts (or restarts) more than Limited cover will last for at least two years.
six months after starting employment with your At the end of two years, you must be in active employment
AustralianSuper employer for full cover to start. If you’re not, then limited cover will
›› You get more cover without providing detailed continue until you have been in active employment for two
health information months in a row.
Limited cover will start from the date your cover See page 33 for an explanation of active employment.
increases and will only apply to any additional cover
you get because you :
-- join AustralianSuper and apply for cover without
health checks or you only have to answer a few
health questions (see pages 10 and 18)
-- increase your cover using AustralianSuper’s Life
Events cover (see pages 11 and 19)
-- change your cover between age-based cover and
fixed cover, and this causes your cover to increase
-- transfer your cover from another fund or
AustralianSuper division, and you get more cover
because AustralianSuper rounds up your amount
of cover.

›› Y
 ou’re being paid income support payments
On the date your cover starts, you’re getting or are
entitled to get, income support payments from any
source. Examples of income support payments are
workers’ compensation, statutory transport accident
payments and disability insurance payments.
Limited cover will apply to your basic cover and any extra
cover you get without health checks.
Limited cover will continue for at least two years from the
day that your income support payments stop.
At the end of two years, you must be in active employment
for full cover to start. If you’re not, then limited cover will
continue until you have been in active employment for
two months in a row (see page 33 for an explanation of
active employment).

›› Y
 ou transfer cover from another fund that is already Limited cover will continue at AustralianSuper for the rest
limited cover of the limited cover period you had at the previous fund.
This cover will still be limited cover.

›› T
 PD or terminal illness payment
If you’ve ever been paid, or are entitled to be paid,
a TPD or terminal illness payment from us, another super
fund or insurance policy.
Limited cover will apply to your basic cover and any extra
cover you get without health checks, and it will be limited
cover for the life of your membership.

›› Y
 ou apply for more Income Protection cover after a Your increased cover will be limited cover. Full cover will
salary increase and you’re not in active employment start once you have been in active employment for two
months in a row.

31
Words and terms used

32
 Here you’ll find:
Words and
terms
AaBbCc
Accident
Means bodily injury caused solely and directly by
accidental, external and visible means, independent of
any other cause.
Active employment
Active employment means:
›› you’re employed or self-employed, and
›› illness or injury is not restricting you from doing the
normal duties of your job full-time (at least 30 hours a
week), even if you’re not working full-time. The Insurer
makes this assessment.
Employer super contributions
These are super contributions that your employer pays
into your account. They include:
›› Superannuation Guarantee contributions
›› additional employer contributions, and
›› salary sacrifice contributions.
Income producing duty
An income producing duty is a duty that is part of your
usual occupation, which generates 20% or more of your
pre-disability income. You won’t be considered unable
to perform an income producing duty if you refuse
to accept:
›› any reasonable omission, modification or substitution
of that duty, or
›› the use of any appropriate assistive aids that would
enable you to perform that duty.
Partial disability
To receive a partial disability benefit you must be unable
to perform at least one income producing duty, but:
›› you’re able to perform at least one other income
producing duty of your usual occupation, or
›› you’ve returned to work in your own occupation, or
›› you’re working in another occupation.
You must also meet each of the following requirements:
›› you’ve been totally disabled for the first 14 days of
your waiting period
›› you’re earning, or only capable of earning, a monthly
income that is less than your pre-disability income,
and
›› you’re under the regular care of, and following the
advice and treatment of, a medical practitioner*.
* For mental health conditions the treating practitioner must be a registered psychiatrist.
Premium
A premium is the sum of money paid periodically,
to purchase and maintain insurance cover in
AustralianSuper.
Pre-disability income
Business owners
If you own all or part of a business in which you perform
your regular occupation, your pre-disability income is
the total amount earned by that business as a direct
result of your personal exertion, less your share of
business expenses, but before income tax is deducted
for the same period.
Employees
If you’re employed on a permanent or casual basis or
work as a contractor, pre-disability income means
monthly salary immediately before date of disablement
(before-tax and excluding super contributions of 10%
or less) earned by you from all regular occupations,
including:
a. fringe benefits that you receive from your employer
through salary sacrifice, and will benefit from for at
least six months after the date that the salary, which
you sacrificed for the fringe benefit, would have been
paid by your employer,
b. performance related annual bonuses and
commissions, (averaged over the previous three
years or the period that you’ve been receiving these
payments, whichever is shorter), and
c. overtime payments and shift allowances (averaged
over the previous 12 months or period of employment,
whichever is shorter).
Total disability
To receive a total disability benefit you must:
›› be totally unable to perform all income producing
duties of your usual occupation
›› be under the regular care of, and following the advice
and treatment of, a medical practitioner*, and
›› not be working in any occupation (paid or unpaid).
33
Forms
 Forms
This handy booklet contains all the forms you need to
manage your insurance with AustralianSuper.

I want to… What form to use

Apply for insurance or change my cover, such as:

•• increase, reduce or cancel my insurance
•• change my Income Protection waiting period and Change your insurance
benefit payment period
•• switch my age-based cover to fixed cover

Increase my cover after one of the following life events:

•• the birth/adoption of a child
•• marriage or divorce
•• start or end of a de facto relationship
Application for Life Event insurance cover
•• new mortgage or construction of my home in
Australia
•• death of a spouse/de facto
•• becoming eligible for carer’s allowance from Centrelink

Transfer insurance cover from outside of AustralianSuper Insurance transfer

Let you know what type of work I do Change my work rating

Application to increase Income Protection cover

Increase my cover after a salary increase
after a salary increase

Please read the Privacy Collection Statement on the next page to see how AustralianSuper uses your personal information.

australiansuper.com 1300 300 273

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 InsGd PSD 05/18 ISS5
 Privacy Collection Statement
Please read this Privacy Collection Statement to see how AustralianSuper uses your personal information.
AustralianSuper Pty Ltd (ABN 94 006 457 987) of 26/50 Lonsdale Street, Melbourne, Victoria, collects your personal
information (PI) to run your super account (including insurance), improve our products and services and keep you
informed. If we can’t collect your PI we may not be able to do these tasks. PI is collected from you but sometimes
from third parties like your employer. We will only share your PI where necessary to perform our activities with our
administrator, service providers, as required by law or court/tribunal order, or with your permission. Your PI may be
accessed overseas by some of our service providers. A list of countries can be found at the URLs below. Our Privacy
Policy details how to access and change your PI, as well as the privacy complaints process. For complete details on the
above go to australiansuper.com/CollectionStatement and australiansuper.com/privacy or call us on 1300 300 273.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com
 Change your insurance

When you join AustralianSuper you receive basic age-based cover for Death, Total & Permanent Disablement (TPD) and Income
Protection. Age limits and conditions apply. Our insurance options allow you to apply for, adjust or switch your cover to suit your
needs. You can choose from the following cover options:

Cover available
Cover options
Death and TPD Income Protection
Age-based cover Both the amount of cover you get and the cost of it changes as you
get older. ✔ ✔

Age-based cover You can add an extra amount of cover on top of your age-based cover.
+ extra (fixed) The extra amount is provided as fixed cover and will stay the same as ✔ n/a
cover you get older (unless you change it) but the cost will change.

Fixed cover You can apply for a total amount of fixed cover. This means your total
amount of cover stays the same as you get older (unless you change it) ✔ ✔
but the cost will change.

Use this form to apply for new cover or to increase, reduce, change or cancel your cover. AustralianSuper will only make changes
to each type of cover you change on this form.
Before you change your cover, you should check your latest statement or log into your
Use our Insurance calculator at
account to understand what type and how much cover you have. You should also australiansuper.com/calculators
read the Insurance in your super guide for your division. It contains all of the terms and to work out the right level of cover
conditions about insurance, including how much you can apply for, your eligibility for for you.
cover, cost of cover, when cover starts and stops, and any limitations or exclusions.

Duty of Disclosure
Your duty of disclosure to the insurer
Before you enter into a life insurance contract, you have a duty to tell the insurer anything that you know, or could reasonably be
expected to know, may affect its decision to insure you and on what terms.
You have this duty until the insurer agrees to insure you.
You have the same duty before you extend, vary or reinstate your insurance cover.
You do not need to tell the insurer anything that:
•• reduces the risk it insures you for, or
•• is common knowledge, or
•• the insurer knows or should know as an insurer, or
•• the insurer waives your duty to tell it about.

If you do not tell the insurer something

In exercising the following rights, the insurer may consider whether different types of cover can constitute separate contracts of life
insurance. If they do, the insurer may apply the following rights separately to each type of cover.
If you do not tell the insurer anything you are required to, and the insurer would not have insured you if you had told the insurer, the
insurer may avoid the contract to provide you with that insurance within three years of entering into it.
If the insurer chooses not to avoid the contract, the insurer may, at any time, reduce the amount you have been insured for. This
would be worked out using a formula that takes into account the premium that would have been payable if you had told the insurer
everything you should have. However, if the contract provides cover on death, the insurer may only exercise this right within three
years of entering into the contract.
If the insurer chooses not to avoid the contract or reduce the amount you have been insured for, the insurer may, at any time vary
the contract in a way that places the insurer in the same position it would have been in if you had told the insurer everything you
should have. However, this right does not apply if the contract provides cover on death.
If your failure to tell the insurer is fraudulent, the insurer may have the right to refuse to pay a claim and treat the contract as if it
never existed.
Our duty of disclosure
The Trustee has a similar duty to tell the insurer anything that it knows that may affect the insurer’s decision to provide you with
insurance, and if the Trustee fails to do so the consequences are comparable.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 1 of 10
 Change your insurance

Please complete in pen using CAPITAL letters and print 7 to mark boxes where applicable. Read the Privacy Collection
Statement at the front of this booklet to see how AustralianSuper uses your personal information.

1. YOUR PERSONAL DETAILS

Last name Mr Mrs Miss Ms Dr

First name

Date of birth Your member number Gender

D D M M Y Y Y Y M F
Street address

Suburb State Postcode

Postal address (if different)

Suburb State Postcode

Telephone (business hours) (after hours) Mobile

To process your application, TAL Life Limited ABN 70 050 109 450 AFSL 237848 (the Insurer) may send you specific health
questionnaires to complete. To receive them by email please provide your address below:
Email

Provide your salary if you want to apply for more cover or change your work rating*.
Annual (before-tax) salary, excluding employer super contributions $ , , .
0 0
Provide your occupation if you want to apply to change your work rating*.
Job title/occupation 

Average number of hours you work in your main occupation hours a week
* If you’re a Public Sector Division member, your work rating only applies to Income Protection.

2. DEATH AND TPD COVER

Complete this section to:
•• apply for age-based cover
•• top up age-based cover with extra (fixed) cover, or change your extra (fixed) cover amount
•• apply for or change your fixed cover (includes switching your age-based cover to fixed cover), or
•• remove multiples of cover (see the Insurance in your super guide for your division for details about multiples and how much
cover you’ll get).
You can apply for an unlimited amount of Death cover and up to $3 million of TPD cover. Print (✗) to confirm what you want to do.
If you want to cancel any part of your cover (or all of it), go to Section 5.

Cover options Type of cover Cover in $1,000 amounts

Age-based Death
Age-based cover Your cover amount will be based on your age.
Age-based TPD

$ , , 0 0 0 The amount you write here will be added

Extra Death
Extra (fixed) cover to your age-based cover, or replace your
Extra TPD $ , , 0 0 0 existing extra cover.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 2 of 10
 2. DEATH AND TPD COVER (CONTINUED)

Cover options Type of cover Cover in $1,000 amounts

Fixed Death $ , , 0 0 0 The amount you write here will replace your
Fixed cover
existing cover (including age-based cover).
Fixed TPD $ , , 0 0 0

If your multiple is greater than 1.0 your age-based cover will reduce to the basic
Remove my Death
cover amount and any extra (fixed) cover you have will stay the same. If it is less
multiple
TPD than 1.0 your total cover amount (and any extra cover you have) will be fixed.

If you’re applying for or increasing your Death or TPD cover, complete the Health Questions in Section 6. You don’t need to
complete Section 6 if you’re only switching your age-based cover to fixed cover.

3. INCOME PROTECTION COVER

Complete this section to apply for or change your Income Protection cover (includes switching your age-based cover to fixed cover).
The maximum amount of Income Protection you can apply for will be the lower of 85% of your monthly salary* (up to 75% can be
paid to you and up to 10% to your super), or $30,000 a month.
* Salary is your annual (before-tax) salary, excluding employer super contributions.

Here’s an example to help you work out the maximum amount of Income Protection cover you can apply for.
Ben earns $78,000 a year (before-tax), excluding employer super contributions. The maximum cover amount he
can apply for is:
$78,000 x 0.85 = $5,525 a month Ben can apply for cover up to $5,600 a month.
12 (months) (rounded up to the nearest $100)

Print (✗) below to confirm what you want to do. If you want to cancel your cover, go to Section 5.

Cover options Type of cover Cover in $100 amounts

Age-based cover  ge-based

A Your cover amount will be based on your age.
Income Protection

Fixed cover Fixed Income The amount you write here will replace your
$ , 0 0 a month existing cover (including age-based cover).
Protection

If you’re applying for or increasing your Income Protection cover, complete the Health Questions in Section 6.
You don’t need to complete Section 6 if you’re only switching your age-based cover to fixed cover.
Complete this section to select or change your waiting period and/or benefit payment period (go to Section 4 if you
don’t want to make a change). Print (✗) below to confirm what you want to do.
The cost of your cover will depend on the waiting period and benefit payment period you choose (as well as your
work rating). For more information and the different costs, read the Insurance in your super guide for your division at
australiansuper.com/InsuranceGuide

Waiting period This is the minimum time you must wait before you’ll start receiving an Income
30 days
Protection benefit payment (as long as you’re eligible). Payments are made one
month in arrears. If you’re applying for Income Protection cover your waiting period 60 days
will be 60 days. You can change your waiting period to 30 days. A shorter waiting
period will cost more.
Your new waiting period is effective from the date we accept your application plus the number of days
of your current waiting period. For example if you change your waiting period from 60 days to 30 days
and then you claim within 30 days of making the change, you’ll need to complete a 60 day waiting period.

Benefit payment If you’re applying for Income Protection cover your benefit payment period is up to
Up to two years
period two years. This means benefits may be paid for a maximum of two years if you’re
temporarily unable to work due to illness or injury. You can apply for a benefit Up to five years†
payment period of up to five years† or up to age 65†.  A longer benefit payment period
will cost more. Up to age 65†
† There are some occupations where you can’t have a benefit period of up to five years or up to age 65.
These occupations are listed at australiansuper.com/occupations

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 3 of 10
 3. INCOME PROTECTION COVER (CONTINUED)
Please complete the Health Questions in Section 6 if you’re:
•• applying for a benefit payment period of up to five years or up to age 65, or
•• aged 63 or 64 and reducing your benefit payment period to two years (which means you’re extending your cover to age 70).
You don’t need to complete Section 6 if you’re only changing your waiting period.

4. YOUR WORK RATING

You could pay less if your work is rated as Low Risk or Professional. Complete this section to apply to change your work rating*.  
For more information on work ratings download the Insurance in your super guide for your division at
australiansuper.com/InsuranceGuide
1. Are the usual activities of your job ‘white collar’? Yes No
This means:
•• you spend more than 80% of your job doing clerical or administrative activities in an office-based environment, or
•• you’re a professional using your university qualification in a job that has no unusual work hazards
(some examples of unusual work hazards include: working underground, working underwater,
working at heights or working in the air).
2. Are you earning $100,000 or more a year from your job? Yes No

3. Do you have a university qualification? Yes No

4. Do you have a management role in your company? Yes No

* If you’re a Public Sector Division member, your work rating only applies to Income Protection.

5. CANCEL YOUR COVER

Complete this section to cancel all or part of your cover. Put an (✗) next to each type of cover you wish to cancel.
When you cancel your cover you won’t be insured for that cover from the date your cancellation is accepted. So, you (or your
beneficiaries) won’t be able to make an insurance claim for that type of cover, in the event of illness, injury or death. If you
decide to apply for cover in the future, you’ll need to supply detailed health information as part of your application.
I want to cancel ALL of my cover. Death TPD Income Protection

I only want to cancel my extra cover. Extra Death Extra TPD

Go to Section 9 if you’re only completing Sections 1 and 5.

6. HEALTH QUESTIONS
1. Has an application for life, disability, trauma, accident or illness insurance on your life ever been declined,
deferred or accepted with a loading, exclusion or special terms? If Yes please provide details below. Yes No

Insurance company name Date Terms offered and reason

2. Are you claiming or have you ever claimed a benefit from any source (e.g. Total & Permanent Disablement benefit from any
Superannuation Fund, Workers’ Compensation, Disability pension, Veterans’ Affairs or any other insurance policy providing
accident or illness benefits)?
If Yes please provide details below. Yes No
Benefit type/source/reason for claim

Claim date Claim amount Date claim finalised

$

Benefit type/source/reason for claim

Claim date Claim amount Date claim finalised

$

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 4 of 10
 6. HEALTH QUESTIONS (CONTINUED)

Height (cm) (ft/in) Weight (kg) (st/lb)

3. What’s your height and current weight? OR OR

4. Are you currently off work due to injury or illness, or restricted from being capable of performing your
full and normal duties on a full-time basis (for at least 30 hours a week), even if your actual employment
is on a part-time or casual basis? Yes No

5. Have you in the last year had medication prescribed by a medical practitioner that is intended to be used
for three months or longer (excluding contraceptives and treatment for hay fever, hair loss and acne)? Yes No

6. Have you been unable to work because of injury or illness (excluding pregnancy) for more than two
consecutive weeks in the last three years? Yes No

7. Have you ever had or received medical advice or treatment (including surgery) for any of the
following conditions:
a) Chest pain, high blood pressure, raised cholesterol or any heart/circulatory disorder? Yes No

b) Stroke, paralysis, epilepsy, multiple sclerosis or any blood or neurological condition? Yes No

c) Diabetes, hepatitis, or any condition of the thyroid, liver, kidneys, prostate or urinary bladder? Yes No

d) Asthma, sleep apnoea, respiratory or any other lung condition (other than the common cold)? Yes No

e) Any injury, disease or disorder of the back, neck, knee, shoulder or other joint, bone, muscle,
tendon or ligament condition, including arthritis or gout? Yes No

f) Depression, anxiety, chronic tiredness or fatigue, panic attacks, post-traumatic stress, or any
other behavioural, mental or nervous condition? Yes No

g) Cancer, tumour, melanoma, sun spot, mole or malignant growth of any kind? Yes No

h) Drug dependence or abuse (either prescribed or non-prescribed), or alcohol dependence or abuse? Yes No

i) Hernia, gall bladder, bowel or stomach condition (other than constipation, upset stomach, diarrhoea,
or gastro where these were short, isolated episodes from which you have made a full recovery)? Yes No

j) Any condition of the eyes causing visual impairment (partial or complete loss of sight that can’t be
corrected by glasses, contact lenses or laser eye surgery) or impaired hearing or tinnitus? Yes No

8. Have you been infected with the Human Immunodeficiency Virus (HIV) or tested positive for
Acquired Immune Deficiency Syndrome (AIDS)? Yes No

9. Apart from any condition already disclosed, do you plan to seek or are you awaiting medical advice,
investigation or treatment for any other current health condition or symptoms? Yes No

7. NEXT STEPS

If you answer Yes to any of the following questions, you’ll also need to complete PART TWO of this form.

•• Will your total Death or TPD cover exceed $800,000 if this application is accepted?* Yes No

•• Will your total Income Protection cover exceed $10,000 a month if this application is accepted? Yes No

•• Are you applying for an Income Protection benefit payment period of up to five years or up to age 65? Yes No

•• Have you answered Yes to any of the questions in Section 6 (Q1 to Q9)? Yes No

If you answer No to all of the above questions, please read, then sign and date the Declaration in Section 14.

* The Insurer may require medical evidence based on your age, amount of cover or health history. This may involve a medical exam or test which the Insurer will pay for.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 5 of 10
 PART TWO: DETAILED HEALTH STATEMENT

8. ACTIVITIES AND PASTIME DETAILS

Do you currently, or do you intend to engage in any hazardous pastime and/or sporting activity such
as aviation (other than as a fare paying passenger on a commercial airline), football, scuba diving,
motor sports, trail bike riding or rock climbing? Yes No
If Yes, provide further details below:
What are the activities you engage in?

At what level do you participate?

Recreational only (non-competition) Recreational with competition Semi-professional/professional

Number of times you participate on average in these activities a year (for example
hours flown, number of drives, events)

Do you receive any income from participating in these activities? Yes No

Maximum depth or speed reached (if applicable)

9. PERSONAL HEALTH DETAILS

1. Have you smoked in the last 12 months? Yes No

If Yes, please indicate type (for example cigarettes or cigars) and average amount smoked in one of the following boxes.
Substance smoked A day A week A year

2. In the last five years have you smoked any substance other than tobacco? Yes No

If Yes, please indicate substances smoked, frequency of use, date first smoked and when last smoked.
Substance smoked Frequency Date first smoked Date last smoked

D D M M Y Y Y Y D D M M Y Y Y Y

D D M M Y Y Y Y D D M M Y Y Y Y

D D M M Y Y Y Y D D M M Y Y Y Y

D D M M Y Y Y Y D D M M Y Y Y Y

3. Do you drink alcohol? Yes No

If Yes, please provide the average number of standard drinks you consume (one standard drink is:
a nip of spirits, a glass (150ml) of wine, a pot (285ml) of beer).
A day A week A year

4. In the last five years have you engaged in any activity reasonably expected to having an increased
risk of exposure to the HIV/AIDS virus (this includes unprotected anal sex, sex with a sex worker or
sex with someone you know, or suspect to be HIV positive)? Yes No
If Yes, we will contact you to complete a confidential questionnaire.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 6 of 10
 10. FAMILY HISTORY

Has any of your immediate family (mother, father, brother or sister) been diagnosed with any of the following conditions before
the age of 60: Heart disease (e.g. angina or heart attack), stroke, cardiomyopathy, cancer, diabetes, mental illness, Alzheimer’s
disease, multiple sclerosis, muscular dystrophy, Parkinson’s disease, polycystic kidney disease, Huntington’s disease or any
other inherited blood or neurological disorder?

Unknown No – go to Section 11 Yes – complete the following table

Approximate Age at death
Relationship to member Condition (e.g. Type 2 diabetes, breast cancer)
age of onset (if applicable)

11. DOCTOR DETAILS

1. What’s the name and address of the last doctor or medical centre you visited?
Full name of doctor or medical centre

Street address and suburb State Postcode

Telephone Facsimile

2. a) What was the date of your last consultation?

Within the last month 7 - 12 months ago

1 - 3 months ago 12 months to 2 years ago

4 - 6 months ago Over 2 years ago

b) What was the reason for your consultation? (Please specify a reason for the consultation)

c) What was the result/outcome from your last consultation?

Referral to specialist/health professional Ongoing treatment (for example ventolin inhaler)

Tests conducted – results pending Routine tests conducted – results all clear/normal

Not fully recovered yet All clear/normal/full recovery – no tests or prescribed

treatment required (other than contraceptive and
cold/flu medication)

3. Is the doctor/medical centre mentioned above your usual doctor/medical centre? Yes No

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 7 of 10
 12. GENERAL HEALTH QUESTIONNAIRE
If you have answered Yes to questions 4 to 9 in Section 6, please complete the table below.
Please ensure you write the question number in the box above each column.

Question number Question number Question number

1. Name of condition
2. Date symptoms first started D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y
3. Date symptoms ceased D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y

(if ongoing please state) Yes No Yes No Yes No

4. How often do/did you have symptoms?
Please choose one of the following
daily, weekly, monthly, quarterly,
half-yearly, yearly, one-off, other.
5. Severity of condition
Please choose from one of the following
mild, moderate, severe, never had
symptoms, symptoms ceased.
6. Did you take medication or have you had
any other treatment (ie physiotherapy
or an operation) for this condition? Yes No Yes No Yes No

If Yes, name the treatment/condition:

7. Are you still on treatment,
including medication? Yes No Yes No Yes No
8. Have you ever been off work
due to this condition? Yes No Yes No Yes No
Details (if there is insufficient space
please attach an additional sheet)

If Yes, please state the total time off work?
Date from: D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y
Date to: D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y
9. Have you had any residual, ongoing effects
or restrictions as a result of this condition? Yes No Yes No Yes No

If Yes, please provide details and dates:

Date from: D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y
Date to: D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y
10. Is your treating doctor different from
your usual doctor? Yes No Yes No Yes No

If Yes, please provide doctor’s details: Full name of doctor Full name of doctor Full name of doctor

Address (street/state/postcode) Address (street/state/postcode) Address (street/state/postcode)

Phone and fax number Phone and fax number Phone and fax number

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 8 of 10
 13. SPECIFIC HEALTH QUESTIONNAIRE
Please complete relevant questionnaire below if you have answered Yes to either Question 7d) or 7e) in Section 6.
A. A
 sthma and bronchitis or any other lung B. Joint/musculoskeletal questionnaire
complaint questionnaire

a) Name of condition If applying for Death only cover complete Questions a) and b) only.
If applying for TPD or Income Protection cover, complete all
questions.
a) Nature of complaint (doctor’s diagnosis), eg sciatica, back
pain, broken bone
b) Have you been diagnosed within
the last 12 months? Yes No
b) Location of complaint, eg lower back, right knee, sciatic nerve
c) Frequency of symptoms in the last five years
Daily

c) When did symptoms first begin? D D M M Y Y
Weekly
d) Cause of condition, eg lifting, car accident, fall in workplace,
Occasionally unknown

One-off episode
e) Was an x-ray or scan taken?
None – childhood only
No Go to Question f
d) Severity of symptoms in the last five years:
Yes Complete below
Nil symptoms – childhood only
Date of tests taken D D M M Y Y
Mild ie exercise-induced only, seasonal Details of results of tests taken
(related to hay fever allergy, colds or flu)

Moderate (ie all year round, specific triggers) f) Is the nature of the condition
Severe (ie constant, reduced lung capacity, degenerative or a disc problem? Yes No
restriction of lifestyle or work duties) g) Are you still undergoing treatment
or experiencing symptoms? Yes No
e) Have you required over the last five years:
If No, complete below:

Daily preventative inhalers, such as ventolin Yes No Date symptoms ceased D D M M Y Y
Occasional use of a nebuliser or oral steroid
Date treatment ceased D D M M Y Y
medication eg prednisolone Yes No
h) Have you ever been off work as a result of this
Hospitalisation/emergency treatment Yes No complaint or been unable to perform your
normal day-to-day activities? Yes No
f) Maximum number of consecutive days off If Yes, please indicate period/s off work:
work/school you have had over the last two Date from Date to
years due to this condition?
D D M M Y Y D D M M Y Y
Number of days
i) Do you have any residual, ongoing effects
g) Is your treating doctor different from your or restrictions as a result of this condition? Yes No
usual doctor? Yes No If Yes, please provide dates and details
If Yes, please complete details below:
Full name of doctor j) Is your treating doctor different from
your usual doctor? Yes No
If Yes, complete below:
Full name of doctor

Street address
Street address

Suburb State Postcode

Suburb State Postcode


Phone number
Phone number
Fax number Fax number

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 9 of 10
 14. DECLARATION
This section must be completed in all circumstances.
I have read the Duty of Disclosure at the start of this form and I
am aware of the consequences of non-disclosure. I understand
that the Duty of Disclosure continues after I have completed this
statement until my application for cover has been accepted in
writing by AustralianSuper and the Insurer.
I authorise:
•• The Insurer to provide any information included in my
insurance application (and any medical reports and
statements made in connection with my application) to other
entities involved in providing or administering the insurance
(for example reinsurers, medical consultants, legal advisers).
•• The Insurer and any person appointed by the Insurer to
obtain information on my medical claims and financial
history from the Insurance Reference Association and any
other body holding information on me.
•• Any hospital, doctor or other person who has treated or
examined me to give to the Insurer any information on my
illness or injury, medical history, consultation, prescription or
treatment or copies of all hospital or medical reports.
A photocopy of this authorisation is as valid as the original.
I declare that:
•• The answers to all the questions and the declarations on this
form are true and correct (including those not in my own
handwriting).
•• I have not withheld any information which may affect any
decision to provide insurance.
•• I understand that I may need to provide further medical
authorities if requested.
•• I have read and understood the Product Disclosure
Statement for my division.
•• I have read and understood the Insurance in your super guide
for my division at australiansuper.com/InsuranceGuide
Sign here:
Date
Print full name
Please return this completed form to:
AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com
•• If I’m a Public Sector Division member I understand that the
work rating will only apply to my Income Protection cover.
•• I have read the Privacy Collection Statement and I agree with
how AustralianSuper will use my personal information.
A summary of AustralianSuper’s Privacy Collection Statement
is at the at the front of this booklet. Our Privacy Collection
Statement and Privacy Policy may change from time to time.
The latest versions will be available online at australiansuper.
com/CollectionStatement and australiansuper.com/privacy
For information on the Insurer’s privacy and information-
handling practices, read their Privacy Policy Statement at
tal.com.au or call 1300 209 088 for a copy.
I acknowledge that:
•• The answers I have provided, together with any special
conditions, will form the basis of the contract of insurance,
and that cover will only be provided on the terms and
conditions set out in the contract of insurance with the
Insurer and as agreed between AustralianSuper and the
Insurer from time to time.
•• If I fix any of my cover, I understand that my cover amount
won’t change (TPD cover reduces gradually from age 61
to zero at age 65, unless you’re a Public Sector Division
member) but the cost will increase with age.
•• If I have chosen to cancel any of my cover, I’ll no longer be
insured for that cover, and if I decide to apply for cover in the
future I’ll need to supply detailed health information as part
of my application.
•• Any change in cover will start from the later of the date it is
accepted by the Insurer (as long as my employer is paying
contributions) or, I have received confirmation that my cover
has started or restarted, and hasn’t stopped (depending
on the plan I belong to). Please refer to the Insurance in
your super guide for my division at australiansuper.com/
InsuranceGuide for details.
D D M M 2 0 Y Y
1267.7 0518 ISS5 page 10 of 10
 Application for Life Event insurance cover

Please complete in pen using CAPITAL letters. Print 7 to mark boxes where applicable. Read the Privacy Collection
Statement at the front of this booklet to see how AustralianSuper uses your personal information.
Only use this form if you’re currently insured for Death, Total & Permanent Disablement (TPD) Your application won’t be accepted if:
or Income Protection cover and wish to apply for cover after one of the following Life Events:
•• the application and relevant
•• birth/adoption of a child attachments are received by
•• marriage or divorce AustralianSuper more than 60
•• start or end of a de facto relationship days after the Life Event
•• new mortgage on purchase or construction of your primary residence in Australia
•• death of a spouse/de facto •• you’ve successfully applied for
you first become eligible for a Centrelink carer’s allowance (only available to Public Sector new or increased cover for a Life
••
Division members). Event in the last 12 months (as at
the date of the more recent Life
You must attach a certified photocopy of the relevant document(s) outlined in Section 5. Event).
The maximum amount of Death and TPD cover you can apply for with each Life Event is
$500,000 (for each cover). Also your increased cover can’t cause your total cover to exceed Cover under this application won’t
the following maximum cover amounts: start until you receive written
confirmation that your Life Event
Type of cover Maximum cover available cover application has been accepted.
Death and/or TPD $1 million (cover above $600,000 will be capped at $1 million or Any additional cover you receive will
10 times your salary*, whichever is lower) be limited cover for at least two years.
Income Protection Up to $20,000 a month or 85% of your salary*, whichever is lower If you’re not eligible to apply for or
increase cover using this form, you
* Salary is your annual (before-tax) salary, excluding employer super contributions. can still apply to increase your cover
For more information on Life Event cover read the Insurance in your super guide for your by using the Change your insurance
division at australiansuper.com/InsuranceGuide form in this booklet.

1. YOUR PERSONAL DETAILS

Last name Mr Ms Mrs Miss Dr

First name

Date of birth Your member number Gender

D D M M Y Y Y Y M F
Other/previous names

Street address

Suburb State Postcode

Postal address (if different)

Suburb State Postcode

Telephone (business hours)† (after hours)† Mobile†

Email

Provide your salary to apply for more cover.

Annual (before-tax) salary, excluding employer super contributions $ , , . 0 0

Job title/occupation
† While processing your application, we or the Insurer may contact you by telephone to clarify any answers you have provided.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 1 of 4
 2. LIFE EVENT

1. F
 or what Life Event are you applying for increased cover?
Print (✗) below to confirm which Life Event applies.
Type of Life Event

Birth of a child Start or end of a de facto relationship

Adoption of a child New mortgage on purchase or construction of your primary residence in Australia

Marriage Death of a spouse/de facto

Divorce First become eligible for a Centrelink carer’s allowance*

2. When did this Life Event occur?

Date of Life Event

D D M M Y Y Y Y

* Only available to Public Sector Division members.

3. ADDITIONAL COVER REQUIRED

You can use this form to apply for more cover as long as you already have existing cover with us.
Check your latest statement or log into your account at australiansuper.com/login to understand what type and how much cover
you have.

3.1 Death and TPD cover

Complete this section to apply for or increase your Death and/or TPD cover. Additional Death and TPD cover will be added as a
fixed amount on top of your existing cover.

Type of cover Additional cover in $1,000 amounts

Death $ , 0 0 0 The amount you write here will be added to any existing
cover you have.
TPD* $ , 0 0 0

* The amount of fixed TPD cover will reduce gradually from age 61 to zero at age 65, unless you’re a Public Sector Division member.

3.2 Income Protection cover

Complete this section to apply for or increase your Income Protection cover. When you increase your Income Protection cover,
your total cover will be fixed (even if you currently have age-based cover).

Type of cover Additional cover in $100 amounts

The amount you write here will be added to any existing
Income Protection $ , 0 0 a month cover you have and all of your cover will be fixed.

Select your preferred waiting period (go to Section 4 if you don’t want to change your waiting period) 30 days 60 days
If you change your waiting period from 60 days to 30 days and then submit a claim within 30 days of making this change, you’ll need to complete a 60 day waiting
period. A 30 day waiting period will cost more.

If you don’t have Income Protection cover and you’re applying for it you’ll receive a benefit payment period of up to two years.
If you already have Income Protection cover and you want to change your benefit payment period you’ll need to complete the
Change your insurance form in this booklet.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 2 of 4
 4. A FEW HEALTH QUESTIONS
All questions must be completed in this section.
1. Are you:
•• unemployed
•• employed and off work because you are ill, injured or have had an accident
•• unable to do all the duties of your usual occupation (without any limitation) full-time
(at least 30 hours a week), even if you are working full-time, part-time or casually, or
•• in your usual occupation but your duties have changed or been modified in the last 12 months,
because of an illness, accident or injury? Yes No
2. Have you:
•• in the last 12 months, been away from work for more than 10 working days in a row because
you were ill or injured, or
•• been advised by, or discussed with your medical practitioner that because of an illness or injury
you’ll need to take at least 10 working days in a row off work (regardless if diagnosed) in the
next 12 months? Yes No
3. Have you been diagnosed with an illness or injury that reduces your life expectancy to less
than 12 months? Yes No
4. Have you ever been declined Death, TPD or Income Protection cover, or been excluded from
insurance cover for a specific medical condition or injury? Yes No
5. Have you ever made or satisfied the requirements to make a claim for an injury or illness either in
Australia or overseas through:
•• AustralianSuper or another super fund
•• Workers’ Compensation
•• an illness benefit or invalid pension
•• an insurance Policy that provides Terminal illness, TPD cover, or Income Protection (including accident
or illness cover), or
•• a common law settlement? Yes No
Your answers to the questions above will determine if you are eligible for additional cover.

5. ATTACHMENTS
The table below lists the documents you need to attach to this application.

Type of Life Event Certified copy of document required

Birth of a child Birth certificate

Adoption of a child
Marriage
Divorce
Start of a de facto
relationship
End of a de facto relationship Completed Providing proof of your de facto relationship form available from
New mortgage for purchase
or construction of your
primary residence in
Australia
Death of a spouse/de facto
First become eligible for a
Centrelink carer’s allowance*
Order effecting an adoption or an entry in a public official record of the adoption of a child
Australian marriage certificate or equivalent overseas marriage certificate recognised in Australia
Divorce Decree Absolute
Written co-habitation or personal or domestic relationship agreement, or completed
Providing proof of your de facto relationship form available from australiansuper.com/forms
australiansuper.com/forms
All of the following (if applicable):
•• Any loan documents including loan application and credit contract
•• Stamped front page of the contract of sale, and
•• Statutory declaration by the applicant declaring that the property described is/will be the
applicant’s principal place of residence
Death certificate and a completed Providing proof of your de facto relationship form available from
australiansuper.com/forms
Letter from Centrelink confirming the date you become eligible for a carer’s allowance

All copies must be certified. A certified copy is a copy of an original document that has been certified by any of the following
acceptable persons: legal practitioner, Justice of the Peace, magistrate, notary public, police officer, dentist, veterinary practitioner,
pharmacist, accountant, Member of Parliament, minister of religion, and medical practitioner.
A certified copy must be noted as follows: ‘I certify that I have sighted the original document and this is a true copy of it.’
This certification must have the certifier’s full name, title, registration number (where applicable) and be signed and dated.

* Only available to Public Sector Division members.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 3 of 4
 6. DUTY OF DISCLOSURE
Your duty of disclosure to the insurer
Before you enter into a life insurance contract, you have a duty to tell
the insurer anything that you know, or could reasonably be expected
to know, may affect its decision to insure you and on what terms.
You have this duty until the insurer agrees to insure you.
You have the same duty before you extend, vary or reinstate your
insurance cover.
You do not need to tell the insurer anything that:
•• reduces the risk it insures you for, or
•• is common knowledge, or
•• the insurer knows or should know as an insurer, or
•• the insurer waives your duty to tell it about.
If you do not tell the insurer something
In exercising the following rights, the insurer may consider whether
different types of cover can constitute separate contracts of life
insurance. If they do, the insurer may apply the following rights
separately to each type of cover.
If you do not tell the insurer anything you are required to, and the
insurer would not have insured you if you had told the insurer, the
insurer may avoid the contract to provide you with that insurance
within three years of entering into it.
7. DECLARATION
This section must be completed in all circumstances.
•• I have read the Duty of Disclosure (in Section 6 of this form) and
I am aware of the consequences of non-disclosure.
•• I understand that the Duty of Disclosure continues after I have
completed this statement until my application for cover has been
accepted in writing by AustralianSuper and the Insurer.
•• I understand that information contained in the Product
Disclosure Statement should be read in conjunction with all
reference material.
I authorise:
•• The Insurer to provide any information included in my insurance
application (and any medical reports and statements made in
connection with my application) to other entities involved in
providing or administering the insurance (for example reinsurers,
medical consultants, legal advisers).
•• The Insurer and any person appointed by the Insurer to obtain
information on my medical claims and financial history from the
Insurance Reference Association and any other body holding
information on me.
•• Any hospital, doctor or other person who has treated or
examined me to give to the Insurer any information on my illness
or injury, medical history, consultation, prescription or treatment
or copies of all hospital or medical reports.
A photocopy of this authorisation is as valid as the original.
I declare that:
•• I have read and understood the Product Disclosure Statement
for my division.
Sign here:
Date
Print full name
Please return this completed form to:
AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com
If the insurer chooses not to avoid the contract, the insurer may, at
any time, reduce the amount you have been insured for. This would
be worked out using a formula that takes into account the premium
that would have been payable if you had told the insurer everything
you should have. However, if the contract provides cover on death,
the insurer may only exercise this right within three years of entering
into the contract.
If the insurer chooses not to avoid the contract or reduce the amount
you have been insured for, the insurer may, at any time vary the
contract in a way that places the insurer in the same position it
would have been in if you had told the insurer everything you should
have. However, this right does not apply if the contract provides
cover on death.
If your failure to tell the insurer is fraudulent, the insurer may have
the right to refuse to pay a claim and treat the contract as if it
never existed.
Our duty of disclosure
The Trustee has a similar duty to tell the insurer anything that it
knows that may affect the insurer’s decision to provide you with
insurance, and if the Trustee fails to do so the consequences are
comparable.
•• I have read and understood the Insurance in your super guide
for my division at australiansuper.com/InsuranceGuide
•• The answers to all the questions and the declarations on this form
are true and correct (including those not in my own handwriting).
•• I have not withheld any information which may affect any
decision to provide insurance.
•• I understand that I may need to provide further medical
authorities if requested.
•• I have read the Privacy Collection Statement and I agree with
how AustralianSuper will use my personal information.
A summary of AustralianSuper’s Privacy Collection Statement is
at the front of this booklet. Our Privacy Collection Statement and
Privacy Policy may change from time to time. The latest versions
will be available online at australiansuper.com/CollectionStatement
and australiansuper.com/privacy
For information on the Insurer’s privacy and information-handling
practices, read their Privacy Policy Statement at tal.com.au or call
1300 209 088 for a copy.
I acknowledge that:
•• Insurance cover will only be provided on the terms and
conditions set out in the contract of insurance with the Insurer
and as agreed between AustralianSuper and the Insurer from
time to time.
•• The answers I have provided, together with any special
conditions, will form the basis of the contract of insurance.
•• Any change in cover I make using this form will only start from
the date this form is accepted by the Insurer.
D D M M 2 0 Y Y
1267.7 0518 ISS5 page 4 of 4
 Insurance transfer

Please complete in pen using CAPITAL letters. Print 7 to mark boxes where applicable. Read the Privacy Collection
Statement at the front of this booklet to see how AustralianSuper uses your personal information.
If you’re an AustralianSuper member you Protection cover you can transfer is $20,000 a month.
can apply to transfer additional Death, Also, after it’s transferred, your total cover can’t exceed the Stay covered while
Total & Permanent Disablement (TPD) following maximum cover amounts:  assess your
we
and/or Income Protection insurance cover application.
you have outside of AustralianSuper. Maximum total cover amounts Don’t cancel any cover you
Type of cover
(after transfer) have with your old fund or
You need to complete all sections
Death Unlimited insurer until you’ve received
of this form and will need to provide
evidence of your current cover by TPD $3 million written confirmation that
your transfer request
attaching one of the following: Income Protection Up to $30,000 a month or 85% of has been accepted by
your last member statement (within your salary*,  whichever is lower. AustralianSuper and that
45 days of it being issued) * Salary is your annual (before-tax) salary, excluding employer your cover has started.
Please refer to the
a current print-out of your online super contributions.
member account Insurance in your super
Your transfer request is subject to the Insurer (TAL Life guide for your division at
a statement from the insurer of Limited) accepting your application and some limitations australiansuper.com/
your individual policy apply (see Section 6 of this form). Any additional cover InsuranceGuide
The maximum amount of Death you receive as a result of the transfer will be limited cover If you’re not sure, please
and TPD cover you can transfer is for at least two years. Please refer to the Insurance in give us a call before you
$2 million (for each type of cover), your super guide for your division australiansuper.com/ cancel your cover.
and the maximum amount of Income InsuranceGuide for more information on limited cover.

1. YOUR PERSONAL DETAILS

Last name Mr Ms Mrs Miss Dr

First name

Date of birth Your member number Gender

D D M M Y Y Y Y M F
Street address

Suburb State Postcode

Telephone (business hours) (after hours) Mobile

Provide your salary to apply for more cover or transfer insurance.
Annual (before-tax) salary, excluding employer super contributions $ , , . 0 0
Provide your occupation if you want to apply to change your work rating*.

Job title/occupation
* If you’re a Public Sector Division member, your work rating only applies to Income Protection.

2. PERSONAL STATEMENT AND CONFIRMATION OF REQUIREMENTS

1. Please confirm (by marking (7) in the box below) that the following statements are true and correct:
a) For Death and TPD cover – I will cancel all insurance cover with my former insurer within 60 days of receiving confirmation
from AustralianSuper of my successful transfer application (even if I’m not transferring all types and amounts of cover).
b)  For Income Protection cover – I will cancel the amount of cover I’m transferring with my former insurer within 60 days of
receiving confirmation from AustralianSuper that my transfer application has been successful (even if I’m not transferring
all of my cover).
c) I won’t transfer the level of cover I’ve requested on this form under my former insurer to any other fund other
than AustralianSuper.
d) I won’t continue, reinstate or start the level of cover I’ve requested on this form with my former insurer.
I confirm that all four statements are true and correct and agree to abide by these requirements. Yes No

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 1 of 4
 2. PERSONAL STATEMENT AND CONFIRMATION OF REQUIREMENTS (CONTINUED)
2. Are you:
•• unemployed
•• employed and off work because you are ill, injured or have had an accident
•• unable to do all the duties of your usual occupation (without any limitation) full-time
(at least 30 hours a week), even if you are working full-time, part-time or casually, or
•• in your usual occupation but your duties have changed or been modified in the last 12 months,
because of an illness, accident or injury? Yes No
3. Have you:
•• in the last 12 months, been away from work for more than 10 working days in a row because you
were ill or injured, or
•• been advised by, or discussed with your medical practitioner that because of an illness or injury you’ll
need to take at least 10 working days in a row off work (regardless if diagnosed) in the next 12 months? Yes No

4. Have you been diagnosed with an illness or injury that reduces your life expectancy to less than 12 months? Yes No
5. Have you ever been declined Death, TPD or Income Protection cover, or been excluded from insurance
cover for a specific medical condition or injury? Yes No
6. Have you ever made or satisfied the requirements to make a claim for an injury or illness either in
Australia or overseas through:
•• AustralianSuper or another super fund
•• Workers’ Compensation
•• an illness benefit or invalid pension
•• an insurance Policy that provides Terminal illness, TPD cover, or Income Protection (including accident
or illness cover), or
•• a common law settlement Yes No
Your answers to the questions above will determine if you are eligible to transfer your cover.
7. Is your cover under the former insurer subject to any premium loadings and/or exclusions, including but
not limited to pre-existing condition exclusions, or restrictions in regards to medical or other conditions? Yes No
If YES, please provide details of the premium loading, exclusion or restriction, including a copy of the advice
you received from the former insurer advising you of the acceptance of your cover subject to these additional terms.

3. ABOUT THE INSURANCE I AM TRANSFERRING

When you transfer insurance, your additional Death and/or TPD cover will be applied as a fixed amount on top of your existing
cover. Fixed TPD cover will reduce gradually from age 61 to zero at age 65, unless you’re a Public Sector Division member.
If your Income Protection cover is higher elsewhere we’ll match your cover amount, and your total cover will be fixed.
Check the Insurance in your super guide for your division at australiansuper.com/InsuranceGuide
Name of former fund/individual insurer Former fund member/individual policy number

USI (Unique Superannuation Identifier)

I confirm that my under my former insurer, this is the level and type of cover that I have (in dollars), and want to transfer:

Death cover $ , , Date cover started D D M M Y Y Y Y

TPD cover $ , , Date cover started D D M M Y Y Y Y

Income Protection cover $ , a month Date cover started D D M M Y Y Y Y

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 2 of 4
 3. ABOUT THE INSURANCE I AM TRANSFERRING (CONTINUED)

Income Protection waiting period under former insurer (such as 30 days, 60 days, 90 days, 180 days)
If you’re transferring Income Protection cover with a 30 or 60 day waiting period, you’ll keep your waiting period.
If you’re transferring Income Protection cover with a waiting period greater than 60 days, you’ll be given a 60 day waiting period. You can choose a 30 day waiting
period below. A shorter waiting period will cost more.

Choose your preferred waiting period 30 days 60 days

Income Protection benefit payment period under former insurer (such as two years, five years, to age 65)
If your AustralianSuper insurance cover has the same benefit payment period as your cover with the other insurer or fund, it will remain unchanged. If not, an up to two
year benefit payment period will be applied. You can apply for a benefit payment period of up to five years or up to age 65. For more information read the Insurance in
your super guide for your division at australiansuper.com/InsuranceGuide

I have attached an up-to-date statement (within 45 days of it being issued) from my former fund Yes No
I understand that my cover above, once accepted, will be subject to the terms and conditions of AustralianSuper’s insurance
arrangements and my Death, TPD or Income Protection cover will be set up as explained in Section 6 of this form.

4. WORK RATING
You could pay less if your work is rated as Low Risk or Professional. Complete this section to apply to change your work rating.
For more information on work ratings read the Insurance in your super guide.
1. Are the usual activities of your job ‘white collar’? Yes No
This means:
•• you spend more than 80% of your job doing clerical or administrative activities in an office-based environment, or
•• you’re a professional using your university qualification in a job that has no unusual work hazards
(some examples of unusual work hazards include: working underground, working underwater,
working at heights or working in the air).
2. Are you earning $100,000 or more a year from your job? Yes No
3. Do you have a university qualification? Yes No
4. Do you have a management role in your company? Yes No
If accepted we’ll confirm your new work rating in writing and the cost of your cover will be reduced (for Public Sector Division
members only the cost of your Income Protection cover will change). If your application for a Low Risk or Professional work rating
isn’t successful – the cost of your cover will be based on your existing work rating with AustralianSuper, or a Standard work rating
if you don’t already have cover with us.

5. DUTY OF DISCLOSURE
Your duty of disclosure to the insurer
Before you enter into a life insurance contract, you have a duty
to tell the insurer anything that you know, or could reasonably
be expected to know, may affect its decision to insure you and
on what terms.
You have this duty until the insurer agrees to insure you.
You have the same duty before you extend, vary or reinstate
your insurance cover.
You do not need to tell the insurer anything that:
•• reduces the risk it insures you for, or
•• is common knowledge, or
•• the insurer knows or should know as an insurer, or
•• the insurer waives your duty to tell it about.
If you do not tell the insurer something
In exercising the following rights, the insurer may consider
whether different types of cover can constitute separate
contracts of life insurance. If they do, the insurer may apply the
following rights separately to each type of cover.
If you do not tell the insurer anything you are required to, and
the insurer would not have insured you if you had told the
insurer, the insurer may avoid the contract to provide you with
that insurance within three years of entering into it.
If the insurer chooses not to avoid the contract, the insurer may,
at any time, reduce the amount you have been insured for. This
would be worked out using a formula that takes into account
the premium that would have been payable if you had told the
insurer everything you should have. However, if the contract
provides cover on death, the insurer may only exercise this right
within three years of entering into the contract.
If the insurer chooses not to avoid the contract or reduce the
amount you have been insured for, the insurer may, at any
time vary the contract in a way that places the insurer in the
same position it would have been in if you had told the insurer
everything you should have. However, this right does not apply
if the contract provides cover on death.
If your failure to tell the insurer is fraudulent, the insurer may
have the right to refuse to pay a claim and treat the contract as
if it never existed.
Our duty of disclosure
The Trustee has a similar duty to tell the insurer anything that it
knows that may affect the insurer’s decision to provide you with
insurance, and if the Trustee fails to do so the consequences are
comparable.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 3 of 4
 6. DECLARATION
I acknowledge that:
•• If I do not fully complete, sign and date this application, I won’t
be eligible to transfer my existing cover to AustralianSuper.
•• If the Insurer accepts my application, I’ll receive:
a)  Death and TPD cover equal to the amount of my existing
cover under my former insurer in addition to any cover
that I currently have. Additional cover is allocated as fixed
cover (rounded up to the next $1,000). Fixed TPD cover
reduces gradually from age 61 to zero at age 65 (unless
I’m a Public Sector Division member).
b) The greater amount of my existing Income Protection cover
under my former insurer or any Income Protection cover that
I currently have. My total Income Protection cover will be
fixed (rounded up to the next $100 a month).
•• If the Insurer accepts my application, any individual conditions
(other than premium loadings), exclusions or restrictions that
applied to my transferred cover will continue to apply.
•• The maximum cover that can be transferred is $2 million for
Death and TPD, and $20,000 a month for Income Protection
(subject to AustralianSuper’s maximum cover limits).
•• My transferred cover with AustralianSuper can only start once
my cover has started and I’ve:
– received written confirmation that my transfer request has
been accepted by AustralianSuper, and
– cancelled my previous cover (claims will not be paid if
cover has not been cancelled). Please refer to the
Insurance in your super guide for your division at
australiansuper.com/InsuranceGuide for more details.
•• AustralianSuper and the Insurer may undertake appropriate
enquiry and investigation to verify the answers I have provided.
•• AustralianSuper and the Insurer may investigate whether any
restrictions that may have applied within the terms of the policy
document were applicable to the type and/or level of cover stated
on the up-to-date statement from the former insurer.
•• I agree to provide AustralianSuper or the Insurer with access to
the health evidence or other information I provided to my former
insurer in my application for cover and any non-disclosure to a
former insurer may be acted upon by AustralianSuper or
their Insurer.
Sign here
Date
Print full name
Please return this completed form to:
AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com
•• The total of my transferred cover and existing cover with
AustralianSuper doesn’t exceed $3 million for TPD and $30,000
a month for Income Protection (there’s no maximum for
Death cover).
•• Should it become apparent to AustralianSuper or the Insurer that I
have not undertaken the requirements that I confirmed in Section
2 of this form, then any insured benefit that may be payable from
AustralianSuper may be reduced by the insured amount paid or
payable from my former insurer; an associated section or division
of the former insurer; or other fund; or any policy issued under
any option that I exercised, as a consequence of my failure to
abide by these conditions. But this reduction in benefit will be
limited to the extent that my benefit from AustralianSuper is no
less than I would have been eligible to receive under the terms
of the policy between AustralianSuper and the Insurer had I not
applied for a transfer of cover.
•• If I’m a Public Sector Division member I understand that the work
rating will only apply to my Income Protection cover.
I declare that:
•• I have read and understood the Product Disclosure Statement for
my division.
•• I have read and understood the Insurance in your super guide for
my division at australiansuper.com/InsuranceGuide
•• The answers to all the questions and the declarations on this
form are true and correct (including those not in my own
handwriting).
•• I have not withheld any information which may affect any
decision to provide insurance.
•• I understand that I may need to provide further medical
authorities if requested.
•• I have read the Privacy Collection Statement and I agree with
how AustralianSuper will use my personal information.
A summary of AustralianSuper’s Privacy Collection Statement is
at the front of this booklet. Our Privacy Collection Statement and
Privacy Policy may change from time to time. The latest versions
will be available online at australiansuper.com/CollectionStatement
and australiansuper.com/privacy
For information on the Insurer’s privacy and information-handling
practices, read their Privacy Policy Statement at tal.com.au or call
1300 209 088 for a copy.
D D M M 2 0 Y Y
1267.7 0518 ISS5 page 4 of 4
 Change your work rating

Please complete in pen using CAPITAL letters and print 7 to mark boxes where applicable. Read the Privacy Collection
Statement at the front of this booklet to see how AustralianSuper uses your personal information.
You could pay less for your cover if your work is rated as Low Risk or Professional. To apply for a Low Risk or
Professional work rating*, you must complete all parts of this form. See the Insurance in your super guide for your division
at australiansuper.com/InsuranceGuide for more details.
* If you’re a Public Sector Division member, your work rating only applies to Income Protection

1. YOUR PERSONAL DETAILS

Last name Mr Ms Mrs Miss Dr

First name

Date of birth Your member number Gender

D D M M Y Y Y Y M F
Street address

Suburb State Postcode

Postal address (if different)

Suburb State Postcode

Telephone (business hours) (after hours) Mobile

Email

Provide your salary and occupation to apply to change your work rating*.
Annual (before-tax) salary, excluding employer super contributions $ , , . 0 0

Job title/occupation
* If you’re a Public Sector Division member, your work rating only applies to Income Protection.

2. ELIGIBILITY FOR LOW RISK OR PROFESSIONAL WORK RATING

1. Are the usual activities of your job ‘white collar’? Yes No

This means:
•• you spend more than 80% of your job doing clerical or administrative activities in an office-based
environment, or
•• you’re a professional using your university qualification in a job that has no unusual work hazards
(some examples of unusual work hazards include: working underground, working underwater,
working at heights or working in the air).
2. Are you earning $100,000 or more a year from your job? Yes No

3. Do you have a university qualification? Yes No

4. Do you have a management role in your company? Yes No

Please note:
•• Eligibility for a Low Risk or Professional work rating is subject to acceptance by TAL Life Limited ABN 70 050 109 450 AFSL 237848 (the Insurer).
•• If accepted, we’ll confirm your new work rating in writing and the cost of your cover will be reduced.
•• For Public Sector Division members only the cost of your Income Protection cover will change.
•• If your application is not successful, there’ll be no change to your work rating or the cost of your cover.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 1 of 2
 3. DUTY OF DISCLOSURE
Your duty of disclosure to the insurer
Before you enter into a life insurance contract, you have a duty
to tell the insurer anything that you know, or could reasonably
be expected to know, may affect its decision to insure you and
on what terms.
You have this duty until the insurer agrees to insure you.
You have the same duty before you extend, vary or reinstate
your insurance cover.
You do not need to tell the insurer anything that:
•• reduces the risk it insures you for, or
•• is common knowledge, or
the insurer knows or should know as an insurer, or
••
•• the insurer waives your duty to tell it about.
If you do not tell the insurer something
In exercising the following rights, the insurer may consider
whether different types of cover can constitute separate
contracts of life insurance. If they do, the insurer may apply the
following rights separately to each type of cover.
If you do not tell the insurer anything you are required to, and
the insurer would not have insured you if you had told the
insurer, the insurer may avoid the contract to provide you with
that insurance within three years of entering into it.
4. DECLARATION
I declare that:
•• All answers provided by me on this form are true and
correct.
•• If I’m a Public Sector Division member I understand that the
work rating will only apply to my Income Protection cover.
•• I have read and understand the Duty of Disclosure
(in Section 3) and I am aware of the consequences of
non-disclosure. I understand that the Duty of Disclosure
continues after I have completed this statement until my
application for cover has been accepted in writing by
AustralianSuper and the Insurer.
•• I have read and understood the Insurance in your
super guide for my division at australiansuper.com/
InsuranceGuide
•• I have not withheld any information that may affect the
Insurer’s decision as to whether to accept my application
to change my work rating.
•• I am currently employed and am able to carry out all of the
identifiable duties of my employment without restriction due
to injury or illness, on a full-time basis.
Sign here:
Print full name
Please return this completed form to:
AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com
If the insurer chooses not to avoid the contract, the insurer
may, at any time, reduce the amount you have been insured
for. This would be worked out using a formula that takes into
account the premium that would have been payable if you
had told the insurer everything you should have. However,
if the contract provides cover on death, the insurer may only
exercise this right within three years of entering into the
contract.
If the insurer chooses not to avoid the contract or reduce
the amount you have been insured for, the insurer may, at
any time vary the contract in a way that places the insurer in
the same position it would have been in if you had told the
insurer everything you should have. However, this right does
not apply if the contract provides cover on death.
If your failure to tell the insurer is fraudulent, the insurer may
have the right to refuse to pay a claim and treat the contract
as if it never existed.
Our duty of disclosure
The Trustee has a similar duty to tell the insurer anything that
it knows that may affect the insurer’s decision to provide
you with insurance, and if the Trustee fails to do so the
consequences are comparable.
•• I have read the Privacy Collection Statement and I agree
with how AustralianSuper will use my personal information.
A summary of AustralianSuper’s Privacy Collection Statement
is at the front of this booklet. Our Privacy Collection Statement
and Privacy Policy may change from time to time. The latest
versions will be available online at australiansuper.com/
CollectionStatement and australiansuper.com/privacy
For information on the Insurer’s privacy and information
handling practices, read their Privacy Policy Statement at
tal.com.au or call 1300 209 088 for a copy.
I acknowledge that:
•• If I don’t complete this application correctly, or I don’t sign
and date this form, my work rating won’t change.
•• Insurance cover will only be provided on the terms
and conditions set out in the contract of insurance
with AustralianSuper’s Insurer and as agreed between
AustralianSuper and its Insurer from time to time.
•• Any change in cost of cover will only start from the date
this form is accepted by the Insurer.
Date
D D M M 2 0 Y Y
1267.7 0518 ISS5 page 2 of 2
 Increase your Income Protection cover
after a salary increase
Please complete in pen using CAPITAL letters and print 7 to mark boxes where applicable. Read the Privacy Collection
Statement at the front of this booklet to see how AustralianSuper uses your personal information.

Only use this form if you’re currently insured for Income
Protection and wish to increase your cover as a result of a pay
increase. You must attach either:
•• the Employer confirmation of salary increase form (page 5
of this form), or
•• copies of your previous and new pay slips with details of
your new salary and effective date, or
•• a copy of the letter advising you of your salary increase, or
a notice from your employer or union announcing the pay
increase.
When you increase your Income Protection cover, you’ll get a
fixed amount of cover (even if you currently have age-based
cover). The increase will be based on your existing work rating.
Limited cover may apply.
The table below shows the maximum increase possible in any
one salary review year. For example, if you have a Low Risk work
rating and $2,000 of Income Protection cover a month, you can
apply to increase to a maximum of $3,500 of cover a month.
Work rating Maximum increase
Standard $1,000

Your application won’t be accepted if: Low Risk $1,500

•• this form and relevant attachments are received more than
30 days after the effective date or notification of your salary
increase, or
•• you’ve successfully applied for increased Income Protection
cover as a result of a salary increase in the last 12 months.
Professional $2,000
Also, your increased cover can’t cause the total of your Income
Protection cover to exceed the lower of $20,000 a month or
85% of your salary*.
*Salary is your annual (before-tax) salary, excluding employer super contributions.

1. YOUR PERSONAL DETAILS

Last name Mr Ms Mrs Miss Dr

First name

Date of birth Your member number Gender

D D M M Y Y Y Y M F
Street address

Suburb State Postcode

Postal address (if different)

Suburb State Postcode

Telephone (business hours) (after hours) Mobile

Email

Job title/occupation

Average number of hours you work in your main occupation hours a week

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 1 of 6
 2. NEW INCOME PROTECTION COVER
The cover you apply for must be an increase on the existing amount of cover you have. The maximum monthly benefit you can
apply for can’t be higher than 85% of your monthly salary* (up to 75% can be paid to you and up to 10% to your super) or $20,000
a month, whichever is lower. See page 1 of this form for cover limits when applying for an increase.

How do I work out my maximum Income Protection cover amount?

Here’s an example to help you.
Ben earns $78,000 a year (before-tax), excluding employer super contributions.
The maximum cover amount he can apply for is:
$78,000 x 0.85 = $5,525 a month
12 (months)
Ben can apply for cover up to $5,600 a month (rounded up to the nearest $100).

Annual (before-tax) salary, excluding employer super contributions $ , , a year

You must provide your salary* to apply for more cover.

Write the total amount of Income Protection cover you want (in $100 amounts) $ , 0 0 a month

Your Income Protection waiting period and benefit payment period won’t change. If you want to change them complete the
Change your insurance form in this booklet.
*Salary is your annual (before-tax) salary, excluding employer super contributions.

3. A FEW HEALTH QUESTIONS

All questions must be completed in this section.

1. Are you:
•• unemployed
•• employed and off work because you are ill, injured or have had an accident
•• unable to do all the duties of your usual occupation (without any limitation) full-time
(at least 30 hours a week), even if you are working full-time, part-time or casually, or
•• in your usual occupation but your duties have changed or been modified in the last 12 months,
because of an illness, accident or injury? Yes No

2. Have you:
•• in the last 12 months, been away from work for more than 10 working days in a row because
you were ill or injured, or
•• been advised by, or discussed with your medical practitioner that because of an illness or injury
you’ll need to take at least 10 working days in a row off work (regardless if diagnosed) in the
next 12 months? Yes No

3. Have you been diagnosed with an illness or injury that reduces your life expectancy to less
than 12 months? Yes No

4. Have you ever been declined Death, Total & Permanent Disablement (TPD) or Income Protection
cover, or been excluded from insurance cover for a specific medical condition or injury? Yes No

5. Have you ever made or satisfied the requirements to make a claim for an injury or illness either in
Australia or overseas through:
•• AustralianSuper or another super fund
•• Workers’ Compensation
•• an illness benefit or invalid pension
•• an insurance Policy that provides Terminal illness, TPD cover, or Income Protection
(including accident or illness cover), or
•• a common law settlement? Yes No

Your answers to the questions above will determine if you are eligible for more cover.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 2 of 6
 4. DUTY OF DISCLOSURE
Your duty of disclosure to the insurer
Before you enter into a life insurance contract, you have a duty
to tell the insurer anything that you know, or could reasonably
be expected to know, may affect its decision to insure you and
on what terms.
You have this duty until the insurer agrees to insure you.
You have the same duty before you extend, vary or reinstate
your insurance cover.
You do not need to tell the insurer anything that:
•• reduces the risk it insures you for, or
•• is common knowledge, or
•• the insurer knows or should know as an insurer, or
•• the insurer waives your duty to tell it about.
If you do not tell the insurer something
In exercising the following rights, the insurer may consider
whether different types of cover can constitute separate
contracts of life insurance. If they do, the insurer may apply
the following rights separately to each type of cover.
If you do not tell the insurer anything you are required to, and
the insurer would not have insured you if you had told the
5. DECLARATION
This section must be completed in all circumstances.
I have read the Duty of Disclosure (in Section 4 of this form)
and I am aware of the consequences of non-disclosure. I
understand that the Duty of Disclosure continues after I have
completed this statement until my application for cover has
been accepted in writing by AustralianSuper and the Insurer.
I authorise:
•• The Insurer to provide any information included in my
insurance application (and any medical reports and
statements made in connection with my application) to other
entities involved in providing or administering the insurance
(for example reinsurers, medical consultants, legal advisers).
•• Any employer to divulge to AustralianSuper or the Insurer
any or all information concerning a salary increase.
Photocopies are as valid as the original.
•• AustralianSuper or the Insurer to contact the employer to
obtain confirmation of information provided on this form
and to obtain copies from my employer and/or union of any
relevant documents.
A photocopy of this authorisation is as valid as the original.
I declare that:
•• I am currently employed and am able to carry out all of the
identifiable duties of my employment, without restriction due
to injury or illness, on a full time basis.
•• The answers to all the questions and the declarations on this
form are true and correct (including those not in my own
handwriting).
Sign here:
Date
Print full name
Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898
insurer, the insurer may avoid the contract to provide you with
that insurance within three years of entering into it.
If the insurer chooses not to avoid the contract, the insurer may,
at any time, reduce the amount you have been insured for. This
would be worked out using a formula that takes into account
the premium that would have been payable if you had told the
insurer everything you should have. However, if the contract
provides cover on death, the insurer may only exercise this right
within three years of entering into the contract.
If the insurer chooses not to avoid the contract or reduce the
amount you have been insured for, the insurer may, at any
time vary the contract in a way that places the insurer in the
same position it would have been in if you had told the insurer
everything you should have. However, this right does not apply
if the contract provides cover on death.
If your failure to tell the insurer is fraudulent, the insurer may
have the right to refuse to pay a claim and treat the contract as
if it never existed.
Our duty of disclosure
The Trustee has a similar duty to tell the insurer anything that it
knows that may affect the insurer’s decision to provide you with
insurance, and if the Trustee fails to do so the consequences are
comparable.
•• I have not withheld any information which may affect any
decision to provide insurance.
•• I understand that I may need to provide further medical
authorities if requested.
•• I have read and understood the Product Disclosure
Statement for my division.
•• I have read and understood the Insurance in your super guide
for my division at australiansuper.com/InsuranceGuide
•• I have read the Privacy Collection Statement and I agree with
how AustralianSuper will use my personal information.
A summary of AustralianSuper’s Privacy Collection Statement
is at the front of this booklet. Our Privacy Collection Statement
and Privacy Policy may change from time to time. The latest
versions will be available online at australiansuper.com/
CollectionStatement and australiansuper.com/privacy
For information on the Insurer’s privacy and information-
handling practices, read their Privacy Policy Statement at
tal.com.au
I acknowledge that:
•• Insurance cover will only be provided on the terms and
conditions set out in the contract of insurance with the
Insurer and as agreed between AustralianSuper and the
Insurer from time to time.
•• The answers I have provided, together with any special
conditions, will form the basis of the contract of insurance.
•• Any change in cover I make using this form will only start
from the date this form is accepted by the Insurer.
D D M M 2 0 Y Y
1267.7 0518 ISS5 page 3 of 6
 This page has been left blank intentionally.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 4 of 6
 Employer confirmation of salary increase

Please complete in pen using CAPITAL letters. Read the Privacy Collection Statement at the front of this booklet to see
how AustralianSuper uses your personal information.
As an AustralianSuper member, your employee has the opportunity to increase their Income Protection cover with AustralianSuper
within 30 days of the effective date or notification of their salary increase by completing a few health questions.
Please provide confirmation of their salary increase by completing and returning this form to your employee or AustralianSuper as
soon as you can, to help your employee take advantage of this offer.

1. MEMBER’S DETAILS
Last name Mr Ms Mrs Miss Dr

First name

Date of birth Gender

D D M M Y Y Y Y M F

2. EMPLOYER’S DETAILS
Employer trading name Employer ABN

Employer’s business name (if different)

Address

Suburb State Postcode

Telephone (business hours) Telephone (after hours) Mobile


Email

Name of person completing this form

Position of person completing this form Employer number

3. SALARY DETAILS
Member’s previous salary* Member’s new salary*
* Salary is annual (before-tax) salary,
$ , , a year $ , , a year excluding employer super contributions.
Effective date of new salary: Notification date of new salary:
D D M M Y Y Y Y D D M M Y Y Y Y

4. EMPLOYER’S DECLARATION
I declare that:
•• all answers provided by me on this form, including those not in my own hand-writing, are true and correct
•• the member (named in Section 1) is currently employed by the employer noted above and is currently carrying out all the
identifiable duties of their employment without restriction due to injury or illness
•• I have read the Privacy Collection Statement and I understand how AustralianSuper will use the personal information provided
on this form.
A summary of AustralianSuper’s Privacy Collection Statement is at the at the front of this booklet. Our Privacy Collection
Statement and Privacy Policy may change from time to time. The latest versions will be available online at australiansuper.com/
CollectionStatement and australiansuper.com/privacy
Sign here:
Date

D D M M 2 0 Y Y

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898 1267.7 0518 ISS5 page 5 of 6
 This page has been left blank intentionally.

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
Telephone 1300 300 273 Web australiansuper.com 1267.7 0518 ISS5 page 6 of 6
Choose the cover that’s
right for you.

We have insurance options

to help you protect your
tomorrow.
Find out more.
Call
1300 300 273
8am–8pm AEST/AEDT weekdays

Visit
australiansuper.com

Mail
GPO Box 1901
Melbourne VIC 3001

This guide was issued in May 2018 by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788, Trustee of AustralianSuper ABN 65 714 394 898.
This document is of a general nature and does not take into account your personal objectives, situation or needs. Before making a decision about
AustralianSuper, consider your financial requirements and read our Product Disclosure Statement, available at australiansuper.com/pds or by calling
1300 300 273. For information about the methodology used by Chant West, see chantwest.com SuperRatings does not issue, sell, guarantee or underwrite
this product. Go to superratings.com.au for details of its ratings criteria. More information about our awards is available at australiansuper.com/ratings
1267.7 05/18 ISS5