GROUP LIFE INSURANCE Supplementary Product Information Booklet
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GROUP LIFE INSURANCE
Supplementary Product Information Booklet
Issued: October 2021
This Group Life Insurance Supplementary We will ask questions we need to know the answers to. These
Product Information Booklet (‘SPIB’) supplements will be about your personal circumstances, such as your
information contained in the Group Life Insurance health and medical history, occupation, income, lifestyle,
Product Information Booklet (‘Group Life Insurance pastimes, and current and past insurance. The information you
give us in response to our questions is vital to our decision.
PIB’) issued July 2021.
If you do not meet your duty
This SPIB is issued by AIA Australia Limited (ABN 79 004
837 861 AFS Licence No. 230043), who is the insurer of If you do not meet your legal duty, this can have serious
the Group Life Insurance product. impacts on your insurance. There are different remedies that
may be available to us. These are set out in the Insurance
AIA Australia takes full responsibility for the entirety of this
Contracts Act 1984 (Cth). These are intended to put us in the
SPIB. This SPIB must be read together with the Group Life
position we would have been in if the duty had been met.
Insurance PIB issued July 2021.
Your cover could be avoided (treated as if it never existed), or
Section 1. INFORMATION ABOUT THIS its terms may be varied. This may also result in a claim being
declined or a benefit being reduced.
BOOKLET
Please note that there may be circumstances where we later
Clause 1.9 Duty of Disclosure will now be renamed investigate whether the information given to us was true. For
“Policy Owners Duty of Disclosure” example, we may do this when a claim is made.
Duty to Take Reasonable Care for Insured Members will Before we exercise any of these remedies, we will explain our
be added to the end of clause “1.9 Policy Owners Duty of reasons and what you can do if you disagree.
Disclosure” as follows:
We may apply these remedies separately to each type of cover
that we consider could form a separate policy.
1.9.1 Duty to take reasonable care for
Insured Members Guidance for answering our questions
Before you enter into a life insurance contract, you You are responsible for the information provided to us.
have a legal duty to take reasonable care not to make a When answering our questions, please:
misrepresentation to the insurer before the contract of • Think carefully about each question before you answer.
insurance is entered into. If you are unsure of the meaning of any question, please
A misrepresentation is a false answer, an answer that is ask us before you respond.
only partially true, or an answer which does not fairly reflect • Answer every question.
the truth. • Answer truthfully, accurately and completely. If you are
This duty applies to a new contract of insurance and also unsure about whether you should include information,
applies when extending or making changes to existing please include it.
insurance, and reinstating insurance. • Review your application carefully before it is submitted. If
someone else helped prepare your application (for example,
When you apply for life insurance, we conduct a process
your adviser), please check every answer (and if necessary,
called underwriting. It’s how we decide whether we can cover
make any corrections) before the application is submitted.
you, and if so, on what terms and at what cost.
aia.com.au PAGE 1Group Life Insurance | Supplementary Product Information Booklet
Changes before your cover starts
Before your cover starts, we may ask about any changes that
mean you would now answer our questions differently. As any
changes might require further assessment or investigation, it
could save time if you let us know about any changes when
they happen.
If you need help
It’s important that you understand this information and the
questions we ask. Ask us or a person you trust, such as your
adviser for help if you have difficulty understanding the
process of buying insurance or answering our questions.
If you’re having difficulty due to a disability, understanding
English or for any other reason, we’re here to help. If you
want, you can have a support person you trust with you.
Notifying the insurer
If, after the cover starts, you think you may not have met your
duty, please contact us immediately and we’ll let you know
whether it has any impact on the cover.
AIA Australia Limited (ABN 79 004 837 861 AFSL 230043) | 09/21 – GI6334 | PAGE 2GROUP LIFE INSURANCE PRODUCT INFORMATION BOOKLET July 2021 aia.com.au
Group Life Insurance Product Information Booklet |
About AIA Australia About AIA
AIA Australia is a leading life insurance specialist with over AIA Group Limited and its subsidiaries (collectively “AIA”
48 years’ experience and a commitment to help Australians or the “Group”) comprise the largest independent publicly
live healthier, longer, better lives. In 2014 the company listed pan-Asian life insurance group. It has a presence in
launched AIA Vitality, a world leading, science-based health 18 markets across the Asia-Pacific region – whollyowned
and wellbeing program, to the Australian market. In July branches and subsidiaries in Hong Kong SAR, Thailand,
2017, AIA and its partners launched AIA’s health insurance Singapore, Malaysia, Mainland China, South Korea, the
business, now known as AIA Health Insurance. Philippines, Australia, Indonesia, Taiwan (China), Vietnam,
New Zealand, Macau SAR, Brunei, Cambodia, Myanmar, and a
In 2021, CommInsure Life was integrated into AIA Australia.
49 per cent joint venture in India.
The lives of more than 3.8 million Australians are protected
and enhanced through AIA Australia’s unique value proposition The business that is now AIA was first established in
of life, health and wellbeing. Our vision is to embrace shared Shanghai a century ago in 1919. It is a market leader in
value in championing Australia and New Zealand to be the the Asia-Pacific region (ex-Japan) based on life insurance
healthiest and best protected nations in the world. premiums and holds leading positions across the majority
of its markets. It had total assets of US$326 billion as of
AIA Australia has been recognised with multiple awards,
31 December 2020.
including the Women in Finance Employer of the Year
Award (2018, 2019), Super Review’s Best Insurer of the AIA meets the long-term savings and protection needs of
Year (2018, 2019), iSelect Partner Awards Insurer of the individuals by offering a range of products and services
Year (2019), Insurance Asia International Life Insurer of including life insurance, accident and health insurance and
the Year (Australia, 2020), Shared Value Awards Corporate savings plans. The Group also provides employee benefits,
Organisation Leading Through Shared Value (2019) and credit life and pension services to corporate clients. Through
Shared Value Awards Organisation of the Year (2020). an extensive network of agents, partners and employees
across Asia-Pacific, AIA serves the holders of more than
Further information at aia.com.au.
38 million individual policies and over 16 million participating
members of group insurance schemes.
AIA Group Limited is listed on the Main Board of The Stock
Exchange of Hong Kong Limited under the stock code “1299”
with American Depositary Receipts (Level 1) traded on the
over-the-counter market (ticker symbol: “AAGIY”).
PAGE 2Group Life Insurance Product Information Booklet |
Partnering specialists Entrepreneurial culture
AIA Australia understands that the need of every client is Our aim is to set industry standards in both product and service
different. That’s why AIA Australia offers a flexible approach through our experienced and approachable team and by
to life insurance. We can combine different types of cover providing comprehensive, flexible group insurance solutions.
within a single policy, tailoring specific solutions to deliver
AIA Australia’s employees work as a team to deliver some of
the most effective level of protection for our clients’ needs.
the industry’s most innovative life insurance solutions, with
Our fresh and intelligent approach can add value, efficiency
the aim of providing a worry free future to our customers.
and a competitive advantage to our clients’ business.
We are passionately committed to providing an efficient and
• We are one of Australia’s largest group life insurers.
sensitive claims service that will help our customers when
• We provide solutions to some of Australia’s major financial they need it most.
institutions and corporate partners.
• We also offer retail insurance products through financial
advisers and a valued network of affinity partners. Experienced and proactive team
• We care for the health, insurance and rehabilitation needs Our Business Development Team brings with them years of
of more than 3.8 million Australians experience and insight in group insurance. We understand
• AIA Australia employs 2,325 staff across Australia. the specific needs of Australian group insurance clients
and have superannuation fund and employer owned policy
group insurance experience. The Business Development
Committed to the community Team is supported by some of the industry’s best group
claims, actuarial, underwriting, administration and account
The AIA Australia philosophy is simple – helping people when
management personnel from a myriad of backgrounds
they need it most. We want people to have adequate life
including superannuation, financial planning, consulting and
insurance. We pay the claims that should be paid. We have the
administration to name but a few. We also provide all the
knowledge and experience to engage in controlled risk taking
technical and communication support required by our clients.
rather than risk avoidance. We are constantly reviewing our
underwriting tools, such as non-medical limits, to minimise Our commitment to you is a long term one. We build
inconvenience to our clients and ultimately the lives insured. open and rewarding relationships through which we can
continuously improve our product offering, as well as the
We adopt a professional and positive approach to claims
way we work together, to create as much value as possible
assessment to ensure claims are paid promptly.
for you and your clients.
PAGE 3Group Life Insurance Product Information Booklet |
CONTENTS
About AIA Australia��������������������������������������������������������������������������������������� 2 5.2 Underwriting information access�����������������������������������14
About AIA������������������������������������������������������������������������������������������������������������ 2 5.3 Non-Standard terms��������������������������������������������������������������14
Partnering specialists����������������������������������������������������������������������������������� 3 5.4 Costs of underwriting������������������������������������������������������������14
Committed to the community������������������������������������������������������������������� 3 5.5 Interim Accidental Cover�����������������������������������������������������14
Entrepreneurial culture������������������������������������������������������������������������������� 3
6. Voluntary Cover and Life Stages Cover���������������������16
Experienced and proactive team������������������������������������������������������������ 3
6.1 Voluntary Cover������������������������������������������������������������������������16
1. Information about this booklet��������������������������������������� 5 6.2 Life Stages Cover��������������������������������������������������������������������16
1.1 Who issues the Product Information Booklet������������� 5
7. Benefit Details��������������������������������������������������������������������17
1.2 How to interpret AIA Australia’s Product
7.1 Death benefit�����������������������������������������������������������������������������17
Information Booklet����������������������������������������������������������������� 5
7.2 Terminal Illness benefit�������������������������������������������������������17
1.3 Implementing a Policy������������������������������������������������������������ 5
7.3 Total and Permanent Disablement (TPD) benefit�����17
1.4 Policy Owner������������������������������������������������������������������������������� 6
7.4 Accidental Top-up Death benefit – Optional�������������17
1.5 Assignment of Policy��������������������������������������������������������������� 6
1.6 Variations to the Policy���������������������������������������������������������� 6 8. Cover while on Leave Without Pay and
1.7 Termination of the Policy������������������������������������������������������ 6 Cover while overseas�������������������������������������������������������18
1.8 Currency���������������������������������������������������������������������������������������� 6 8.1 Cover while on Leave Without Pay���������������������������������18
1.9 Duty of Disclosure��������������������������������������������������������������������� 6 8.2 Cover while on paid leave���������������������������������������������������18
1.10 AIA Australia Privacy Statement��������������������������������������� 6 8.3 Cover while overseas������������������������������������������������������������18
1.11 Statutory Fund���������������������������������������������������������������������������� 8 9. When Cover ends and Policy Exclusions������������������19
1.12 Prohibition of certain transactions���������������������������������� 8 9.1 Extended Cover������������������������������������������������������������������������19
1.13 Any questions or concerns?������������������������������������������������� 8 9.2 Termination of Cover for an Insured Member�����������19
2. Product features at a glance������������������������������������������� 9 9.3 Reinstatement of Cover for superannuation
owned policies ������������������������������������������������������������������������19
2.1 What product features are available?����������������������������� 9
9.4 Continuation Option – Optional���������������������������������������20
3. Eligibility Conditions, Commencement of 9.5 Policy Exclusions���������������������������������������������������������������������20
Cover and Takeover Terms���������������������������������������������10
3.1 Who can obtain Cover?��������������������������������������������������������10 10. Claims������������������������������������������������������������������������������������21
3.2 TPD Cover availability�����������������������������������������������������������10 11. Profit Share and Multinational Pooling���������������������22
3.3 Commencement of Cover���������������������������������������������������10 11.1 Self Experience������������������������������������������������������������������������22
3.4 Takeover Terms (if applicable)�����������������������������������������11 11.2 Multinational Pooling������������������������������������������������������������22
4. Automatic Acceptance����������������������������������������������������12 12. Premiums�����������������������������������������������������������������������������23
4.1 Automatic Acceptance���������������������������������������������������������12 12.1 Calculation of Premium�������������������������������������������������������23
4.2 Who is eligible for Automatic Acceptance?���������������12 12.2 Guarantee of Premium���������������������������������������������������������23
4.3 Conditions for Automatic Acceptance��������������������������12 12.3 Variation of Premium Rates or terms
4.4 Variations in the Sum Insured������������������������������������������12 and conditions��������������������������������������������������������������������������23
4.5 Forward Underwriting Limit (FUL) and Cover over 12.4 Tax on Premiums���������������������������������������������������������������������24
the AAL�����������������������������������������������������������������������������������������13 12.5 Non-payment of Premiums������������������������������������������������24
4.6 Changes to the AAL���������������������������������������������������������������13
13. General Definitions�����������������������������������������������������������25
4.7 Automatic uplift to the new AAL�������������������������������������13
14. TPD Medical Definitions��������������������������������������������������30
5. Underwriting�����������������������������������������������������������������������14
5.1 When is underwriting required?��������������������������������������14
PAGE 4Group Life Insurance Product Information Booklet | Information about this booklet
1. INFORMATION ABOUT THIS BOOKLET
1.1 Who issues the Product 1.2 How to interpret AIA Australia’s
Information Booklet Product Information Booklet
This Product Information Booklet (“PIB”) is issued by Some words or expressions used in this PIB have a particular
AIA Australia Limited (ABN 79 004 837 861, AFSL 230043) meaning. These words are expressed in bold, capitalised and
(“AIA Australia”), which describes the main features of explained in Section 13 or Section 14 of this PIB.
AIA Australia’s Group Life insurance product.
The documents issued by us that make up your Policy are:
AIA Australia is located at 509 St Kilda Road, Melbourne,
1 This PIB;
3004, Australia.
2 The Policy Schedule issued and signed by us; and
This PIB and the corresponding Policy Schedule, when
3 Any riders or endorsements issued and signed by us.
issued together, form the Policy.
Whether the Policy is ordinary (non-superannuation) or
This PIB is only available to persons receiving the offer and
superannuation business will be set out under Policy Type in
making an application in Australia. It is not an offer, invitation
the Policy Schedule issued by us.
or recommendation by AIA Australia. Applications from
outside Australia will not be accepted. AIA Australia is also
not bound to accept any application.
1.3 Implementing a Policy
This PIB has been prepared with the intention of providing
In general, AIA Australia provides group insurance to
you with important information about AIA Australia’s
organisations such as employers, superannuation funds,
Group Life insurance product. Any financial product advice
associations or other Australian based institutions where there is
contained in this PIB is of a general nature only and has
commonality in the membership and where those organisations
been prepared without taking into account your objectives,
have 200 or more lives to be insured on a consistent basis.
financial situation or needs. Therefore, before making any
decision, you should consider the appropriateness of the In some cases, AIA Australia will provide Cover to
advice, having regard to your objectives, financial situation Australian organisations with less than 200 lives where
and needs. If you are deciding whether to acquire this Policy, those organisations, usually employers, operate and have
you should read this PIB before making your decision. Anyone offices in multiple countries.
making this PIB available to another person must provide After consultation with you, AIA Australia will provide
them with the entire electronic file or printout. We will also a quotation summary which should be considered in
provide a paper copy of the PIB on request without charge. conjunction with this document.
In this PIB and in the Policy Schedule (when issued) any In order to implement an AIA Australia group insurance
reference to: Policy, we require the following:
• “AIA Australia”, “we”, “us”, “our” or “the insurer” means 1 Acceptance by email from you of our terms and the time
AIA Australia Limited (ABN 79 004 837 861, AFSL 230043). and date you would like us to assume risk from (we will then
• “You”, “client” means any potential customer likely to confirm we are on risk by return email, issue an invoice and
become a person insured unless otherwise specified. a partially completed group insurance Proposal Form);and
• “Product Information Booklet” means the insurance plan 2 A fully completed group insurance Proposal Form; and
referred to in the PIB unless otherwise specified. 3 Payment of the required deposit premium.
Once all these are received, we will assist you in completely
installing the group insurance Policy and underwriting
members where necessary.
Cover for Eligible Persons does not commence until either
AIA Australia notifies you in writing that risk has been
accepted or by the issuance of a Policy.
PAGE 5Group Life Insurance Product Information Booklet | Information about this booklet
1.4 Policy Owner If you are an Insured Member (other than the Policy Owner),
any failure by you to tell us this information may be treated
All benefits payable under the Policy are paid to the as a failure by the Policy Owner to comply with this duty of
Policy Owner unless otherwise instructed in writing by disclosure.
the Policy Owner.
If you do not tell us something
1.5 Assignment of Policy We may apply the following rights separately to each type of
cover that we consider could form a separate policy.
The Policy can be assigned in accordance with the Life
If you do not tell us something that you know, or could
Insurance Act 1995 (Cth) with our prior written consent.
reasonably be expected to know, may affect our decision to
If we allow the assignment, the assignee will be recorded
provide the insurance and on what terms, this may be treated
as the new Policy Owner with all the rights, powers, duties,
as a failure by the person entering into the contract to tell us
obligations and privileges of the original Policy Owner.
something that he or she must tell us.
If you are the Policy Owner or Insured Member, and you
1.6 Variations to the Policy do not tell us anything you are required to, and we would
not have insured you if you had told us, we may avoid the
Once the Policy is issued by us, any changes or variations to
contract within three years of entering into it.
the Policy terms and conditions made after the Policy is first
issued, must be agreed and issued by us in the form of an If we choose not to avoid the contract, we may, at any time,
endorsement or rider. 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 us
1.7 Termination of the Policy everything you should have. However, if the contract has a
surrender value, or provides cover on death, we may only
1 The Policy Owner may terminate the Policy at any
exercise this right within 3 years of entering into the contract.
time by giving prior written notice. We shall refund any
premium for any period of unexpired risk and where If we choose not to avoid the contract or reduce the amount
applicable the Policy Owner must pay all outstanding you have been insured for, we may, at any time vary the
premiums up to the date the Policy is terminated. contract in a way that places us in the same position we
2 AIA Australia will give the Policy Owner 30 day’s written would have been in if you had told us everything you should
notice of its intention to terminate the Policy. have. However, this right does not apply if the contract has a
surrender value or provides cover on death.
If your failure to tell us is fraudulent, we may refuse to pay
1.8 Currency a claim and treat the contract as if it never existed. We may
All payments to or from us are to be made in Australian dollars. apply these rights separately to each type of cover that we
consider could form a separate policy.
1.9 Duty of Disclosure
If you are the Policy Owner, you have a duty to tell us
1.10 AIA Australia Privacy Statement
anything that you know, or could reasonably be expected to This section summarises key information about how
know, which may affect our decision to insure you and any AIA Australia handles personal information including
other Insured Member and on what terms. sensitive information. For further information, please review
the most up to date full version of the AIA Australia Group
You have this duty until we agree to insure you, and also Privacy Policy on AIA Australia’s website at www.aia.com.
before you extend, vary or reinstate the Policy. au, as updated from time to time (AIA Australia Privacy
You do not need to tell us anything that: Policy). AIA Australia is part of the AIA Australia Group. Our
customers’ include any potential or former customers and any
1 reduces our risk;
other individual referred to in the AIA Australia Privacy Policy
2 is common knowledge; on our website (together referred to as “our customers”). Our
3 we know or should know as an insurer; or customers’ privacy is important to us and AIA Australia is
4 we waive your duty to tell us about. bound by the privacy principles which apply to private sector
organisations under the Privacy Act, and other laws which
protect our customers’ privacy.
PAGE 6Group Life Insurance Product Information Booklet | Information about this booklet
AIA Australia Group consists of AIA Australia Limited, AIA and third parties, including the Insured Member, Policy
Financial Services Limited, CMLA Services, Jacques Martin Owner or beneficiaries of an insurance policy, our and
Pty Ltd, Jacques Martin Administration and Consulting Pty our Affiliates’ service providers and contractors, our
Ltd, AIA Group and their related bodies corporate and joint customers’ representatives or intermediaries (including
venture partners (together referred to as “AIA Australia”, without limitation, our customers’ financial advisers and the
“we”, “us” and “our”). Together, we provide the following Australian Financial Service Licensee they represent, the
notification and information about AIA Australia’s Privacy distributors of our customers’ insurance policies, the trustees
Policy and your rights. or administrators of our customers’ superannuation funds,
our customers’ employers, unions of current and former staff
Why we collect your personal information members of ours (including contractors) or anyone acting
on our customers’ behalf including any other representative
We collect, use and disclose personal and sensitive
or intermediary (“Representatives”), our customers’ bank or
information (“Personal Information”) for purposes set out
health providers, partners used in our activities or business
in our Privacy Policy, including to process our customers’
initiatives, reinsurers, insurance brokers and intermediaries,
applications, enquiries and requests in relation to insurance
our distributors and clients, regulatory and law enforcement
and other products, for underwriting and reinsurance
agencies, and other parties as described in our Privacy
purposes, to administer, assess and manage our customers’
Policy. Parties to whom we disclose Personal Information
insurance and other products, including claims, and to
may be located in Australia, South Africa, the US, the United
provide, manage and improve our products and services.
Kingdom, Europe, Asia and other countries including those
We may not be able to do these things without Personal
set out in our Privacy Policy.
Information. We may also collect, use and disclose Personal
Information to understand our customers’ needs, interests Where we provide Personal Information to a third party,
and behaviour, personalise our dealings with our customers, the third party may collect, use and disclose the Personal
to verify our customers’ identity, authority to act on behalf Information in accordance with their own privacy policy and
of a customer, maintain and update our records, manage procedures. These may be different to those of AIA Australia.
our relationship with our customers, comply with local and
foreign laws and regulatory requests, detect, manage and Other important information
deal with improper conduct and commercial risks, and for
By providing information to us or to Representatives,
reporting, research and marketing purposes. Where our
the trustees or administrators of superannuation funds,
customers agree or we are otherwise permitted by law, we
submitting or continuing with a form or claim, or otherwise
may also notify our customers of offers and other information
interacting or continuing a relationship with us, our
about products or services we think may interest them. If
customers confirm that they agree and consent to the
our customers do not wish to receive these direct marketing
collection, use (including holding and storage), disclosure
communications, they may indicate this where prompted or
and handling of Personal Information in the manner
by contacting us as set out in our Privacy Policy.
described in the most up to date version of our Privacy Policy
on our website and that our customers have been notified
How we collect, use and disclose your personal of the matters set out in this summary and the AIA Australia
information Privacy Policy before providing Personal Information to us.
We may collect Personal Information from various sources Our customers agree that we may not issue a separate notice
including forms our customers submit and our records about each time Personal Information is collected.
our customers’ use of our products and services and dealings Our customers must obtain and read the most up to date
with us, including any telephone, email and online interactions. version of the AIA Australia Privacy Policy from our website
We may also collect information from public sources, social at aia.com.au or by contacting us on 1800 333 613 to
media and from the parties described in our Privacy Policy. obtain a copy. Our customers have the right to access the
We are required or authorised to collect Personal Information Personal Information we hold about them, and can request
under various laws including the Life Insurance Act, Insurance the correction of Personal Information if it is inaccurate,
Contracts Act, Corporations Act and other laws set out in our incomplete or out of date. Requests for access or correction
Privacy Policy. Where our customers provide us with Personal can be directed to us using the details in the ‘Contact us’
Information about someone else they must have that party’s section below. Our Privacy Policy provides more detail
consent to provide their Personal Information to us in the about our collection, use (including handling and storage),
manner described in our Privacy Policy. disclosure of Personal Information and how our customers
We may collect Personal Information from, and exchange can access and correct Personal Information, make a privacy
Personal Information with, our related bodies corporate related complaint and how we will deal with that complaint,
including without limitation, joint venture entities (“Affiliates”) and our customers’ opt-out rights.
PAGE 7Group Life Insurance Product Information Booklet | Information about this booklet
For the avoidance of doubt, the Privacy Policy applicable to
the management and handling of Personal Information will
1.13 Any questions or concerns?
be the most current version published at aia.com.au, which If you should have any questions or concerns about your
shall supersede and replace all previous Privacy Policies Policy, please contact us directly on 1800 333 613 and we
and/or Privacy Statements and privacy summaries that our will promptly investigate your enquiry, referring it if necessary
customers may receive or access, including but not limited to to our Internal Disputes Resolution Committee (IDRC).
those contained in or referred to in any telephone recordings
Internal complaints are normally resolved within 45 days. In
and calls, websites and applications, underwriting and claim
special circumstances, we may take longer. If this is the case,
forms, Product Disclosure Statements and other insurance
we will advise you.
and disclosure statements and documentation.
If you are not satisfied with the response provided, you may
Contact us complain to the independent Australian Financial Complaints
Authority (AFCA)
If our customers have any questions or concerns about their
Personal Information, they can contact us as set out below: Details are as follows:
The Compliance Manager Australian Financial Complaints Authority (AFCA)
AIA Australia Limited PO Box 6111 GPO Box 3
Melbourne VIC 3004 MELBOURNE VIC 3001
Phone 1800 333 613 Telephone: 1800 931 678
Email: info@afca.org.au
Online: www.afca.org.au
1.11 Statutory Fund
The Policy will be written in the AIA Australia Statutory
Fund No. 1.
1.12 Prohibition of certain
transactions
Despite anything to the contrary, there is no cover under this
Policy and AIA Australia is not obliged to make any payments
or to provide any services or benefits in relation to this Policy if:
1 such cover, payments, services or benefits; or
2 cover, payments, services or benefits provided by a third
party in relation to or arising from the Policy (including
by a reinsurer of AIA Australia to AIA Australia);
would contravene any United Nations resolutions,
prohibitions or restrictions on trade or economic sanctions
or would contravene any laws, government policy, regulatory
guidance or regulator requests (including in relation to trade
or economic sanctions) in Australia, the European Union or
in any other jurisdiction applicable to the cover, payments,
services or benefits by AIA Australia or the third party.
PAGE 8Group Life Insurance Product Information Booklet | Product features at a glance
2. PRODUCT FEATURES AT A GLANCE
2.1 What product features are available?
Product Feature Description Page
Standard TPD Cover Available to all Insured Members, including Permanent Employees, Casuals and Fixed Term 10
Employees
Maximum Benefit limits Unlimited Death Cover (including Terminal Illness) and up to $5,000,000 of TPD Cover NA
(reducing to $3,000,000 after age 65) is available to all eligible Insured Members
Automatic Uplift to new AAL We may apply an increased AAL to some Insured Members including those who have 13
previously been restricted due to non-receipt of underwriting, had an exclusion applied, or a
loading applied when taking over an existing group insurance policy
Waiver of Underwriting Loadings Where a Policy has more than 100 Insured Members, we are able to waive underwriting 14
loadings for any formula driven, non-voluntary underwritten Cover
Interim Accidental Cover Interim Accidental Cover will be provided while an Insured Member is being underwritten 14
Life Stages Cover An Insured Member may apply to increase Cover without the usual requirement of providing 16
Evidence of Insurability when a specific life event occurs (e.g. marriage, divorce)
Cover while on leave without pay Cover will continue for a maximum period of up to 24 months while on approved leave 18
Cover while Overseas Cover is provided 24 hours a day, all year round while the Insured Member is working or 18
travelling overseas
Extended Cover Cover will continue for a maximum period of 60 days after the Insured Member ceases to 19
meet the Insured Member Eligibility criteria
Accidental Top Up benefit (optional) We will pay an additional benefit up to $1,000,000 if the Insured Member dies as a result of 17
an Accident within 90 days of the Accident
Continuation Option (optional) An Insured Member may be able to continue their Cover once their employment ceases 20
with the Employer
PAGE 9GroupLife Insurance ProductInformation Booklet | Eligibility Conditions, CommencementofCover, TakeoverTermsAND TRANSITIONTERMS
3. ELIGIBILITY CONDITIONS,
COMMENCEMENT OF COVER,
TAKEOVER TERMS AND
TRANSITION TERMS
3.1 Who can obtain Cover? Employment Status TPD Definition
Death or Death and Total and Permanent Disablement (“TPD”) Is Employed as a Permanent Employee, Casual Standard
Cover is available to all Eligible Persons under the Policy. An employee, or Fixed Term Employee in the previous or Own
Eligible Person is a person who satisfies the following: 16 months immediately prior to becoming total and Occupation*
permanently disabled.
1 The person meets the Insured Member Eligibility criteria
Is not Employed for 16 consecutive months or Alternative
as set out in the Policy Schedule;
more immediately prior to becoming totally and
2 The person is aged between the Minimum Benefit Entry permanently disabled.
Age and the Maximum Benefit Entry Age on the earlier of
* Own Occupation definition is only available to non-superannuation owned policies
the day he or she is first eligible for Cover or the date that where it is optional. Eligible members must meet the definitions of either Professional
he or she applies for Cover; and or Senior Management. If this definition applies it will be stated in the Policy Schedule.
3 The person is an Australian Resident or holder of a Visa.
The table below sets out the availability of Cover under
the Policy.
3.3 Commencement of Cover
Cover for an Eligible Person will commence as follows:
Death Cover TPD Cover 1 Where Cover is accepted under Automatic Acceptance
(Including provisions as described under clause 4.3 Conditions
Terminal Illness) for Automatic Acceptance, the later of the Policy
Minimum Benefit Entry Age 15 15 Commencement Date or the date the Eligible Person first
meets the Insured Member Eligibility criteria;
Maximum Benefit Entry Age 69 66
2 Where the Policy Owner is a superannuation fund,
Maximum Cover Expiry Age 70 70 subject to meeting the Automatic Acceptance provisions
as described under clause 4.3 Conditions for Automatic
Acceptance:
3.2 TPD Cover availability i) For members who Opt-in to Cover, the date the
Policy Owner receives the Eligible Person’s Opt-in
The type of TPD Cover available and the definition that will
within 120 days of their Welcome Letter;
apply in the event of a claim will depend on the Insured
Member’s employment status at the commencement of ii) For members who do not Opt-in to Cover:
the Waiting Period. The TPD definition which applies to a) the date the Eligible Person meets the PMIF
an Insured Member may differ to the TPD definition which Requirements provided a (SG) contribution is
applied to the Insured Member at the time cover commenced. received within 120 days prior to this date; or
There are three TPD definitions: Standard, Own Occupation
and Alternative.
PAGE 10GroupLife Insurance ProductInformation Booklet | EligibilityConditions, Commencementof Cover,TakeoverTermsANDTRANSITIONTERMS
b) the date the Policy Owner receives a (SG)
contribution in respect of the Eligible Person
3.5 Existing Insured Members
after first meeting the PMIF Requirements transition terms as at plan
iii) For PMIF Exempt Members, the date the Eligible
Person first meets the Insured Member Eligibility
Renewal Date
Criteria; An Insured Member with cover immediately prior to the
plan’s Effective Date of this Policy will have that cover (as
3 Where Cover is accepted under Takeover Terms, the date
applicable) continue under this Policy from the Participating
the Policy commences with AIA Australia; or
Employer’s Effective Date of this Policy subject to the
4 Where Evidence of Insurability or Voluntary Cover following conditions:
applies due to any of the circumstances as described
under clause 5.1 When is underwriting required?, the c) Each individual condition, exclusion, restriction or
date AIA Australia advises you in writing that Cover has loading which applied to the existing Insured Member’s
been accepted. cover under this Policy (each a “Pre-existing Term”) will
continue to apply under this Policy until such time as the
Pre-existing Term expires according to its terms;
3.4 Takeover Terms (if applicable) d) If the Insured Member had the Alternative Definition
under this Policy immediately prior to the Effective
Takeover Terms may be available if you had similar insurance
Date of this Policy as set out in the Policy Schedule
with another insurer before choosing to transfer the
and, has been Employed in the 16 months prior to the
insurance to AIA Australia.
Effective Date of this Policy, then subject to the terms
AIA Australia will apply Takeover Terms in accordance with of this Policy where total and permanent disablement is
the ‘FSC Group Insurance Takeover Terms’ as described in on or after the Effective Date of this Policy, the TPD –
FSC Guidance Note No. 11.00. If applicable, this will be stated Standard Definition or TPD – Own Occupation Definition
in the Policy Schedule. (if selected in the Policy Schedule) will apply to a total
Insured Members will be covered for benefits on and permanent disablement claim. Cover under the TPD –
underwriting terms no less favourable than those provided by Standard Definition or TPD – Own Occupation Definition
the previous insurer, including forward underwriting limits, (if selected in the Policy Schedule) will be restricted to
premium loadings, restrictions, exclusions and any limitations New Events Cover until the Insured Member is At Work
imposed on an Insured Member by the previous insurer. for 30 consecutive days at any time after the Effective
Date of this Policy. Full Cover will be provided where the
AIA Australia requires details of previous acceptance terms Insured member is At Work for 30 consecutive days after
for Insured Members who have Voluntary Cover and/or Cover the Effective Date of this Policy.
in excess of the previous insurer’s AAL within 90 days of the
takeover date, unless otherwise agreed in writing. New Events Cover means the Insured Member is only
covered for claims arising from an illness which became
AIA Australia reserves the right to request proof that a apparent or an injury which occurred on or after the Effective
person under a previous group insurance policy has been Date of this Policy and cannot be caused from an illness
satisfactorily underwritten for takeover of Cover to apply. or injury where the signs or symptoms existed prior to the
If underwriting exclusions or loadings do apply, these will Effective Date of this Policy.
be carried forward and applied above AIA Australia’s AAL or
the previous insurer’s AAL (as applicable) to form part of the
Takeover Terms.
If alternative Takeover Terms are agreed to by us, these will
be stated in the Policy Schedule.
In the event the Policy is terminated and transferred to
another bona fide Australian life insurer, AIA Australia will
comply with the FSC Group Insurance Takeover Terms, as
described in FSC Guidance Note No. 11.00.
PAGE 11Group Life Insurance Product Information Booklet | Automatic Acceptance
4. AUTOMATIC ACCEPTANCE
ii) The Eligible Person must be At Work on the Cover
4.1 Automatic Acceptance Commencement Date, otherwise New Events Cover
Where an Automatic Acceptance Limit (AAL) is applicable, applies until the Insured Member is At Work for
AIA Australia will provide an Insured Member Cover up 30 consecutive days, at which point full Cover will be
to the lesser of the specified AAL and the Sum Insured at provided; or
standard Premium Rates without having to provide Evidence 7 For a superannuation held policy:
of Insurability.
i) Where the Eligible Person is a PMIF Exempt Member
(other than an Opt-in member), they join the Policy
4.2 Who is eligible for Automatic on the date they first meet the Insured Member
Eligibility criteria and they must be At Work on the
Acceptance? Cover Commencement Date, otherwise New Events
Cover applies until the Insured Member is At Work
An Eligible Person who:
for 30 consecutive days, at which point full Cover will
1 meets the Insured Member Eligibility; be provided; or
2 is aged between the Minimum Benefit Entry Age and the ii) Where an Eligible Person does Opt-in or meets the
Maximum Benefit Entry Age; and PMIF Requirements, Cover is provided to an Insured
3 meets the PMIF Requirements or is a PMIF Exempt Member as New Events Cover from the Cover
Member where the Policy Owner is a superannuation fund Commencement Date until the Insured Member is
At Work for 30 consecutive days, at which point full
will be provided with Cover up to the AAL (if any). The Date
Cover will be provided.
of Cover commencement will be as described under clause
3.3 Commencement of Cover. AIA Australia reserves the right to change the Automatic
Acceptance conditions and/or AAL under the Policy at the
end of the Rate Guarantee Period, or upon lapse of conditions
4.3 Conditions for Automatic 2, 3, 4 or 5 above.
Acceptance Evidence of Insurability will be required for any person who
does not meet the Automatic Acceptance conditions.
Automatic Acceptance only applies to Eligible Persons who
satisfy the Insured Member Eligibility and is subject to the Cover will commence from the date we accept the Cover
following ongoing conditions: in writing.
1 The AAL shown in the Policy Schedule is for an amount
other than nil; 4.4 Variations in the Sum Insured
2 The Insured Member Eligibility ensures there is no
Subject to Automatic Acceptance conditions described
ability for a person to choose to have Cover which is not
above, the Sum Insured amount in respect of an Insured
consistent with the Benefit Design;
Member will automatically increase or decrease in line with
3 At least 75% of Eligible Persons who meet the Insured the Benefit Design. Any automatic increase in the Sum
Member Eligibility are Insured Members under the Policy; Insured will occur up to the higher of the AAL (if any) and the
4 The Sum Insured for each Insured Member is calculated Forward Underwriting Limit (FUL).
in accordance with the Benefit Design;
For plans of less than 50 lives, any automatic increases will
5 The Policy is the default superannuation fund of the be limited to a maximum increase of 30% in total within a
Employer (applicable to superannuation owned policies given 12 month period.
only); and
The premium will be adjusted to take into account the
6 For a non-superannuation owned policy:
variation in the Sum Insured in respect of an Insured Member.
i) The Eligible Person joins the Policy on the date they
first meet the Insured Member Eligibility; and
PAGE 12Group Life Insurance Product Information Booklet | Automatic Acceptance
4.5 Forward Underwriting Limit (FUL)
and Cover over the AAL
Evidence of Insurability will be required once the Sum
Insured for an Insured Member exceeds the AAL and/ or
where Automatic Acceptance conditions are not met. All
Insured Members accepted for Cover above the AAL may
receive a FUL in accordance with AIA Australia’s underwriting
rules. These rules may be altered from time to time.
4.6 Changes to the AAL
The AAL will apply for the duration of the Rate Guarantee
Period however, if the number of eligible Insured Members
reduces below 75% (unless we agree otherwise in writing)
under the Policy, we reserve the right to reduce the AAL,
after consultation with you.
When an AAL decreases, the lower AAL will apply to all Insured
Members after that date with the exception of existing Insured
Members whose Sum Insured is higher than the lower AAL,
in which case they will maintain their existing Sum Insured.
When an AAL increases, the higher AAL may apply to some
existing Insured Members above the previous lower AAL.
This includes members who have previously been restricted
due to non-receipt of underwriting, had an exclusion applied
or a loading applied. Any loading, limitation or exclusion that
previously applied to Cover above the lower AAL will also
apply to Cover above the new higher AAL. The higher AAL
does not apply to any Insured Members who have previously
been declined.
4.7 Automatic uplift to the new AAL
If stated in the Policy Schedule when taking over an existing
group insurance policy, if AIA Australia has offered an
AAL which is more competitive than the level under the
previous policy, AIA Australia may apply the new AAL to
some members. This includes members who have been
previously restricted due to non- receipt of underwriting, had
an exclusion applied or a loading applied. A member declined
under the previous policy will be restricted to the lower AAL
or FUL (as applicable).
Any loading, limitation or exclusion that previously applied
to Cover above the lower AAL will also apply to Cover above
the new higher AAL. We will advise you in writing if we agree
to do this. Any Insured Members who have been previously
underwritten above AIA Australia’s AAL, will continue to be
covered up to the level provided under the previous policy.
PAGE 13Group Life Insurance Product Information Booklet | Underwriting
5. UNDERWRITING
5.1 When is underwriting required? decisions, opinions and assistance with their life insurance
application. The AIA Australia client website is an ideal way
Evidence of Insurability is required in the following of submitting underwriting evidence and tracking the current
circumstances: status of an Insured Member’s life insurance application.
1 The proposed Sum Insured is in excess of the AAL;
2 The Sum Insured has automatically increased above the 5.3 Non-Standard terms
AAL or FUL in accordance with the Benefit Design;
Where a person is underwritten and standard acceptance
3 The Eligible Person is not eligible for an AAL due to not
terms are not offered by AIA Australia, alternate assessment
meeting Automatic Acceptance conditions;
terms will be offered wherever possible. If this is the case,
4 An AAL does not apply to that Policy; AIA Australia may:
5 The Insured Member is applying for Voluntary Cover
1 Apply a premium loading (e.g. + 50%) on the standard
(other than for Life Stages Cover);
rates*
6 The increase in an Insured Member’s Sum Insured in the
2 Apply an exclusion/s (e.g. spine, mental disorders, aviation)
previous 12 month period, exceeds 30%, in which case,
underwriting will be required (applicable to plans with 3 Apply a combination of premium loadings and exclusions.
less than 50 lives; If AIA Australia is unable to offer any acceptance terms for
7 The person is not eligible to reinstate Cover as a result of insurance Cover, AIA Australia will decline the application for
not meeting the reinstatement conditions as described Cover in writing.
under clause 9.3.1 Reinstatement of Cover due to * This loading will be recorded but not applied by AIA Australia unless an Insured
Member affects a Continuation Option, the Cover being applied for is Voluntary
Inactivity; or Cover, or if there are less than 100 members in the Policy.
8 When an Eligible Person Opts-in for Cover more than
120 days after receiving their Welcome Letter (for
Superannuation owned policies only). 5.4 Costs of underwriting
If Evidence of Insurability is required, an AIA Australia personal We will pay all reasonable costs for providing the information
health statement is required to be completed in addition to we require for underwriting of an Eligible Person. Any
any further underwriting evidence, the details of which may costs incurred outside Australia in connection with the
change from time to time and are available upon request. underwriting of an Eligible Person must be paid by the
Where a plan has more than 100 lives, AIA Australia Eligible Person. AIA Australia may reimburse these costs at
will waive underwriting loadings for any formula driven, our discretion.
underwritten Cover. Loadings may be applied for any element
of Voluntary Cover depending on the circumstances.
As a result of the underwriting process, AIA Australia will still
5.5 Interim Accidental Cover
record and advise of underwriting loadings for two reasons: Interim Accidental Cover will be provided while a person is
being underwritten, from the date we receive the application
1 If at some point in the future the Policy is terminated with for Cover, until the earlier of:
AIA Australia and transferred to another insurer that does
apply loadings, these loadings can be applied. 1 The date we either accept or reject the application
in writing;
2 Should a member exercise a Continuation Option, the
correct retail premium can be charged. 2 The date the person is cancelling or withdrawing the
application in writing;
3 90 days elapsing from the date we received the
5.2 Underwriting information access application; and
AIA Australia practices open communication with our 4 The Cover would have otherwise ceased under the Policy.
intermediary clients and our Insured Members. Any party A benefit will be paid in the event of Accidental Injury
related to the Policy is welcome to contact AIA Australia’s resulting in death and/or TPD.
underwriting staff for explanations on non-standard
PAGE 14Group Life Insurance Product Information Booklet | Underwriting
The maximum benefit we will pay the lesser of the Sum
Insured applied for and: $2,000,000 for Death Cover and
$1,500,000 for TPD Cover. Where an AAL or FUL applies, the
amount applied for is the excess of the relevant AAL or FUL.
The benefit will not be payable if, during the Interim
Accidental Cover period, death or disability is caused directly
or indirectly by:
1 Engaging in any sport or pastime that AIA Australia would
not normally cover at standard rates or terms; and
2 Other excluded events (as described under clause
9.5 Policy Exclusions).
PAGE 15Group Life Insurance Product Information Booklet | Voluntary Cover and Life Stages Cover
6. VOLUNTARY COVER AND
LIFE STAGES COVER
An Insured Member’s Sum Insured may vary either through 2 Relevant documentary proof of the event (e.g. Marriage
applying for Voluntary Cover or applying for Life Stages Cover. Certificate, Birth/Adoption Certificate, Mortgage
Documentation) must be provided for consideration to
AIA Australia within 60 days of the Life Stage event;
6.1 Voluntary Cover 3 The existing Cover for the Insured Member must have
Voluntary Cover is available if stated in the Policy Schedule. been accepted on standard terms, whether or not under
Automatic Acceptance provisions, and the Insured
A member can apply for Voluntary Cover, which will be Member not having previously been declined for life
subject to AIA Australia’s acceptance following the provision insurance Cover with AIA Australia or any other life
of Evidence of Insurability – the extent of which is at the insurance company;
discretion of AIA Australia. AIA Australia reserves the right to
4 The Insured Member must be under age 60 at the time of
offer modified acceptance terms or decline applications for
exercising this option;
such voluntary increases in Cover. The total of the TPD Sum
Insured amount held by the Insured Member cannot exceed 5 The Insured Member must not have made a claim or be
the Death Sum Insured amount. eligible to make a claim under this Policy, or any other
insurance policy on their life; and
6 The Insured Member can exercise a maximum of one
6.2 Life Stages Cover increase in their Sum Insured in any 12 month period
with a maximum of three increases in their Sum Insured
This applies if Voluntary Cover is stated in the Policy Schedule.
under this Policy.
Upon the occurrence of one of the Life Stage events listed
An Insured Member is required to be At Work at the time
below, Insured Members can apply to increase their Death
AIA Australia accepts the Life Stages Cover application.
and TPD Sum Insured without the usual requirement of
providing Evidence of Insurability: If they are not At Work at this time, New Events Cover
will apply to the increased portion of Cover for the first
1 Marriage;
12 months after AIA Australia has accepted the Life Stages
2 Birth or adoption of a child; Cover application.
3 Divorce;
At the end of the 12 month period the Insured Member is
4 Child attaining 12 years of age; required to be At Work for 30 consecutive days to receive
5 Insured Member attaining age 30; or full Cover.
6 Mortgage*.
* Effecting a mortgage on the purchase of a home or increasing an existing mortgage,
6.2.2 Exclusions on Life Stages Cover
for the purposes of building or renovation works, on the Insured Member’s principal 1 A suicide exclusion will apply to any Sum Insured
place of residence with a registered mortgage provider.
increase for the first 13 months from the date AIA Australia
Any increase in the Sum Insured is limited to the lesser of agrees to any increase in the Sum Insured; and
25% of the existing Sum Insured and $200,000. 2 In respect to TPD Cover, a self-inflicted injury exclusion
will apply to any Sum Insured increase for the first
6.2.1 Conditions for Life Stages Cover 13 months from the date AIA Australia agrees to any
The ability to exercise an increase in their Sum Insured under increase in the Sum Insured.
this clause is subject to the following:
1 The Life Stage event must have occurred while the
person is an Insured Member and be in relation to the
Insured Member;
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