aviva protectionfirst range product disclosure...

Aviva Protectionfirst Range

Product Disclosure StatementDate of issue 27 September 2004

To acquire the Aviva Protectionfirst products you must complete the application form contained in this Product Disclosure Statement

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Protection to suit you 1

How the Aviva Protectionfirst product range works:

Aviva Protection – Life 3

Aviva Protection – Recovery Money 8

Aviva Protection – Flexible Recovery Money 13

Aviva Protection – Stand Alone Recovery Money 16

Aviva Protection – Income Gold & Income Excell (Agreed Value & Indemnity) 18

Aviva Protection – Income Business Expenses 28

Additional Features – all products 31

Holding your policy in your superannuation fund 33

Charges 35

Premiums 35

Policy fees 36

Government taxes and charges 37

Taxation 38

Complaints 40

Other important information 41

Eligibility 41

About the Insurer 41

Cooling-off Period 41

Privacy statement 42

Medical Definitions 44

How do I get started? 48

Direct Debit Service Agreement 49

Application Form 53

Application for Binding Nominations – NUST 75

This Product Disclosure Statement (“PDS”) covers two separate financial products: life insurance and superannuation.

The life insurance product is called the Aviva Protectionfirst Range and is issued by Norwich Union Life Australia Limited(“NULAL”, “the Administrator”, “our”, “we”, or “us”) ABN 34 006 783 295 Australian Financial Services Licence Number(“AFSL number”) 241686. The superannuation product is called the Norwich Union Superannuation Trust (“NUST”) and is issued by NULIS Nominees (Australia) Limited (“NULIS” or “the Trustee”) ABN 80 008 515 633 AFSL number 236465.Both products are administered by NULAL.

NULAL and NULIS are part of the Aviva Australia group which is ultimately owned by Aviva plc (“Aviva”), the world’sseventh largest insurance and investment company.

The information given in this document is of a general nature only and has been prepared without takinginto account your individual investment objectives, financial situation or particular investment needs. This PDS is not a statement of advice.

Contents

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Protection to suit you

With Aviva Protectionfirst, you have peace of mind in knowing you andyour family will be financially secure, should unforeseen situations arise.

If you are unable to work because of injury or illness, Aviva Protection –

Income can pay you a percentage of your regular income. Our Life and Recovery Money policies pay alump sum benefit.

The following table provides an overviewof the products and benefits we offer.

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Aviva Protection – Life

B O B OC B B B B B O B B B B O N N N N

Aviva Protection – Recovery Money

B O B OC B B B B B O B N B B O OC O O B

Aviva Protection – Flexible Recovery Money

N N B OC B N B B B O B N N B O OC O O B

Aviva Protection – Stand AloneRecovery Money

N N B N B N B B B N B N N B N OC N O B

Policies providing a lump sum benefit

B = Benefit included in basic price O = Option at additional cost, benefit ceases at policy anniversary preceding age 65 OC = Option

at additional cost, definition changes to Loss of Independent Existence at policy anniversary preceding age 65 N = Not available

Strong historyAviva Protectionfirst is underwritten byNULAL, which is part of the Aviva plcgroup, one of the first insuranceorganisations in the world to protect personal wealth. NorwichUnion Society for the Insurance ofHouses, Stock and Merchandise fromFire was founded in 1797, at a time inthe United Kingdom when cities werebuilt largely of wood and the threat offire was uppermost in people’s minds.Over 200 years, the business hasgrown to be the world’s seventhlargest insurance group.

Financial strength By choosing Aviva Protectionfirst youbenefit from the financial strength and experience of Aviva plc. Aviva plc group has over $624 billionof assets under management and 30million customers worldwide as at 1July 2004 .

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Protection to suit you continued

Policies providing income replacement

Aviva Protection – Income Gold

O B B B B O B O B B O B B B B B B B B B N

Aviva Protection – Income Excell

O B N B N O B O B N N B B B N N N B N B N

Aviva Protection – Income Business Expenses

N B N B N N B N B N N B B N N N N B N B B

B = Benefit included in basic price O = Option at additional cost N = Not available

You can combine products to create your own personal package of cover.

Note: more detailed descriptions of the products’ benefits, risks, and charges are covered in the following sections.

Two reasons to protect your wealth with Aviva Protectionfirst

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Aviva Protection – Life provides death cover. You can choose to includeoptional disability cover, for an additional premium. If you die or (ifdisability cover is added) are disabled during the term of the policy, youor your beneficiaries will receive a pre-determined lump sum.

These policies are ‘guaranteedrenewable’. This means that providedyou pay the premiums you can renewyour cover each year until the policyexpiry date without having to providefurther medical evidence.

When you apply for the policy, youchoose the amount of the lump sumbenefit payable under the policy. Thislump sum benefit is called the ‘SumInsured’. If you choose to add disabilitycover to your policy, you can choose adifferent Sum Insured for your DeathBenefit and your Disability Benefit.

Your policy can be held in one of twoways. You can hold the policy yourself,or arrange for the trustee of acomplying superannuation fund to holdthe policy, with you as the life insured.

1. Ordinary policy

You hold the policy directly. You candetermine to whom the benefits arepaid, by completing the form on page65. Otherwise, benefits are paid to youor your estate.

2. Superannuation policy

Your policy may instead be held by thetrustee of a complying superannuationfund. Holding your policy through asuperannuation fund affects the taxtreatment of premiums and benefitpayments. You should discuss whetherthis structure is appropriate for youwith your financial adviser.

If you choose this structure, we canarrange for your policy to be heldthrough the Norwich UnionSuperannuation Trust (“NUST”), or you can instruct us to issue thepolicy to the trustee of anothercomplying superannuation fund ofyour choice.

For details in respect of holding yourpolicy through the NUST or anothercomplying superannuation fund, refer to page 33.

The benefitsPayment of benefitsIf you die, are diagnosed as beingterminally ill, or (if the disability cover isadded) are Totally and PermanentlyDisabled, the Sum Insured will be paidon the basis explained below. If thepolicy is held as an ordinary policy theSum Insured is paid to you, as directedby you in your application, or to yourestate. If the policy is held in acomplying superannuation fund, theSum Insured is paid to the trustee ofthe superannuation fund. The paymentof benefits is subject to the exclusionsexplained on page 7.

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B O B OC B B B B B O B B B B O

Aviva Protection – Life: a snapshot of what this cover includes


at additional cost, definition changes to Loss of Independent Existence at policy anniversary preceding age 65

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Death Benefit (standard)If you die the agreed Sum Insured willbe paid.

Terminal Illness Benefit(standard)Under this benefit where you arediagnosed as being terminally ill andlikely to die within twelve (12) months,the Sum Insured will be paid out earlywith the agreement of the policyowner as a Terminal Illness Benefit. A medical practitioner nominated by us will need to provide specifiedinformation about the nature of yourillness or injury.

The maximum amount payable underthe Terminal Illness Benefit, includingall other amounts payable by us, is$2,000,000 (or such other amount asadvised by us from time to time). If thedeath Sum Insured under the policy isgreater than $2,000,000, then theunpaid balance of the death SumInsured is payable on your death(provided the corresponding premiumshave been paid). If a Disability Benefitis attached, the amount of SumInsured provided by this benefit will bereduced by the amount paid.

If the cover is held through asuperannuation fund, the availability ofthe Terminal Illness Benefit is subject tothe superannuation legislationregarding the release of benefits ongrounds of permanent incapacity. Thisusually means a person has stoppedworking, and is unlikely to ever workagain. The taxation position may beless favourable than deferring paymentuntil it is payable as a death benefit(see page 39 for further information).

Disability Benefit (optional at additional cost)By taking this option, your policy isextended to include disability cover. If you become Totally and PermanentlyDisabled (as defined below), thedisability Sum Insured will be paid toyou as a lump sum.

Once a Disability Benefit is paid, thedeath cover ceases unless your deathSum Insured exceeds your DisabilityBenefit. Where it does, the excessdeath cover continues upon paymentof the corresponding premium.

Definition up to policyanniversary preceding age 65.

The definition of total and permanentDisability changes at the policypreceding age 65.

When you apply for your policy, youcan choose whether you want the ‘anyoccupation’ or ‘own occupation’ testof Total and Permanent Disability toapply. That choice affects the level ofyour premium, and you should discussit with your financial adviser.

The own occupation test is onlyavailable to certain occupations.

If you choose the ‘any occupation’ test, Total and Permanent Disabilitymeans either:

(a) you have suffered total andirrecoverable loss of the:- sight of both eyes, or- use of two limbs, or- sight of one eye and the use of

one whole hand, or one wholefoot, or

(b) you have been unable to performyour own occupation for a periodof at least three months due tobodily injury or illness and are sodisabled that you are unlikely toever be able to perform your ownoccupation or other occupation forwhich you are suited by education,training or experience.

If you choose the ‘own occupation’test, Total and Permanent Disabilitymeans either:

(a) you have suffered total andirrecoverable loss of the:- sight of both eyes, or- use of two limbs, or

- sight of one eye and the use of onewhole hand, or one whole foot, or

(b) you have been absent fromemployment through injury or illnessfor an uninterrupted period of threemonths and, have becomeincapacitated to such an extent as torender you unlikely ever to be ableto engage in your own occupation.

Your ‘own occupation’ for thispurpose is your occupation at thetime of proposing for this policy,unless you have been in yourcurrent occupation for a consecutiveperiod of at least 18 months at thetime of making a claim.

The above definition of Total andPermanent Disability applies until thepolicy anniversary preceding age 65.

Home duties

If your occupation immediately prior to the commencement of Total andPermanent Disablement can bedescribed as “Home Duties”, then“Total and Permanent Disablement”means that you have, for anuninterrupted period of three months,been under medical supervision withcomplete inability to perform themajority of normal domestic duties,and are unlikely ever to recover.

Occupations of specialised nature

For the purposes of the ownoccupation definition if youroccupation is classified as a SpecialistSurgeon, then part (b) of the definitionabove will be replaced by “you havebeen absent from employmentthrough injury or illness for anuninterrupted period of six monthsand, have become incapacitated tosuch an extent as to render youunlikely ever to be able to engage inyour own occupation”.

Aviva Protection – Life continued

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Definition after policy anniversarypreceding age 65

At the policy anniversary preceding your65th birthday the above definition ofTotal and Permanent Disability shallcease to apply. Instead Total andPermanent Disability shall mean Loss ofIndependent Existence as defined onpage 45. This definition shall applyirrespective of your occupation andwhether you have selected the ‘anyoccupation’ or ‘own occupation’ test.

Reduction of benefits forpayments under FlexibleRecovery Money policies

Where this policy is written inconjunction with an Aviva Protection –Flexible Recovery Money:

� The amount of the Death Benefitpayable on death or terminal illnessunder this policy will automaticallybe reduced by the amount ofbenefits actually paid under theFlexible Recovery Money policy.

� The amount of the Disability Benefitunder this policy will be reduced bythe amount by which the CriticalIllness Benefit paid under the FlexibleRecovery Money policy exceeds theDisability Sum Insured under theFlexible Recovery Money policy.

For example if you select the followingpolicies

� Life with $1,000,000 death SumInsured and $850,000 disabilitySum Insured

� Flexible Recovery Money with$250,000 critical illness SumInsured and $150,000 disabilitySum Insured

then after a claim under the FlexibleRecovery Money policy for $250,000the cover under the Life policy will be reduced to $750,000 death Sum Insured and $750,000 disability Sum Insured.

Any remaining benefit under the AvivaProtection – Life, if applicable, willcontinue upon payment of theappropriate premium.

The featuresAviva Protection – Life has variousstandard and optional features,described below. These features helpyou manage the cost of your premiumsand the level of cover over time.

Economiser (standard)The cost of your insurance cover willnormally change each year. WithEconomiser, however you can freezethe premium at any time after your30th birthday, enabling you to controlthe cost of your insurance.

1. At any time after your 30thbirthday you can request theoption to be applied.

2. Applying the Economiser means:

(a) Indexation (as defined on page 31) ceases; and

(b) except at policy anniversarieswhen benefits automaticallyreduce or cease for otherreasons, or premium loadingscease, the Sum Insured will beautomatically reduced ininverse proportion to theincrease in premium rates thatwould have occurred had thisreduction not been made.

This has the effect of ‘freezing’the premium, including inrelation to changes in thepremium scale, or crossingbelow size adjustment bands,as defined on page 35.

3. You may cancel the Economiser at any time by notice in writing.Indexation, if applicable, is thenreinstated.

Future Insurability (standard)When significant events happen in life,you can increase your death and/or

disability Sum Insured without havingto provide further medical evidence.

The death and/or disability SumInsured may be increased when:

� You marry.

� You have a child or legally adopt one.

� You take out a mortgage to buyyour first home.

� You receive an increase in annualsalary of at least 10%.

You must apply for this increase within30 days of the first renewal datefollowing the defined event. We willrequire proof of the defined event.

You may only increase your deathand/or disability Sum Insured onceunder this feature in any twelve (12)month period. You may increase yourSum Insured by 25% or $75,000 or 5times the salary increase (if applicable),whichever is lowest. The maximumtotal amount you can increase yourdeath and/or disability Sum Insuredunder this feature over the life of thepolicy is the lesser of:

� The amount of death and/ordisability Sum Insured under yourpolicy excluding CPI increases andincreases effected under thisfeature; and

� $1,000,000.

The feature cannot be exercised if atthe time of your request:

� You are older than 50 years of age

� You have previously been acceptedby us with special conditionsaffecting the premium rates

� The premiums are being waivedunder the Waiver of PremiumOption, or

� You are currently entitled to makea claim for a Terminal Illness orCritical Illness Benefit under apolicy you currently hold with us.

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Aviva Protection – Life continued

Any increase in the disability SumInsured as a result of exercising thisoption cannot result in the disabilitySum Insured exceeding the death SumInsured.

The option to increase the disabilitycover only applies where the initialdisability Sum Insured is $1,500,000 orless.

Disability Buy Back Option(optional at additional cost)

This option can be exercised twelve(12) months after the Disability Benefithas been paid. It enables purchase ofdeath cover from us, renewable to age90, at a time when you have almostcertainly become uninsurable. Thisoption provides disability sufferers witha second level of protection and peaceof mind.

For a period of thirty (30) days fromthe first anniversary of the payment ofthe Disability Benefit, we will accept aproposal provided:

(a) the Sum Insured does not exceedthe Disability Benefit paid; and

(b) premiums will be charged at theappropriate rate for the thenattained age based on the thencurrent published term insurancerates; and

(c) any original exclusions or specialconditions will be maintained.

The option does not apply afterpayment of a Terminal Illness Benefit.

This option ceases at the policyanniversary preceding age 65.

Waiver of Premium Option(optional at additional cost)This option provides for futurepremiums to be waived while you areTotally Disabled for an extended period.

If you are Totally Disabled for at leastthree continuous months then, whileTotal Disability continues, subsequent

premiums falling due are waived up to the policy anniversary prior to your65th birthday. Premiums for increases orpolicies effected as a result of BusinessProtection Option or the Buy-BackOption are not subject to this option.

For the purposes of the Waiver of Premium Option, you will beconsidered Totally Disabled if we aresatisfied that:

(a) you have suffered total andirrecoverable loss of the:

� sight of both eyes, or

� use of two limbs, or

� sight of one eye and use of onewhole hand, or one whole foot,or

(b) you have been unable to performyour own occupation (or otheroccupation for which you aresuited by education training orexperience) for a period of at leastthree (3) months due to bodilyinjury or illness.

Where you are wholly engaged in fulltime unpaid domestic duties at the dateof the event causing Total Disability,then the occupation for which you aresuited by education, training orexperience is be taken to include unpaiddomestic duties. In this case you mustbe disabled to such an extent that youare confined to your place of principalresidence unless assisted.

Business Protection Option(optional at additional cost)The Business Protection Optionprovides you with a right to apply foran annual increase in your death and(if applicable) disability Sum Insuredwithout having to supply furthermedical evidence. The BusinessProtection Option may be used for thefollowing purposes:

� Business succession planning

� Loan guarantor insurance

� Key person insurance

You will need to tell us in writing thepurpose for which you want theBusiness Protection Option and provideus with a valuation from a qualifiedaccountant or valuer of your businessor key person, or evidence of thecontractual guarantees, as the casemay be, together with any otherfinancial evidence that will satisfy usthat the value of your financial interestis at least equal to the increasedamount of cover. Any increase in theSum Insured is subject to our approval.

The death Sum Insured may beincreased subject to the followingmaximums:

� For business succession planningpurposes – three times the SumInsured when this option was firstpurchased or $10 million –whichever is less.

� For loan guarantor or key personpurposes – three times the SumInsured when this option was firstpurchased or $5 million –whichever is less.

You may increase the disability SumInsured to three times the Sum Insuredwhen this option was first purchasedor $2 million – whichever is less.However, the Sum Insured may not beincreased to an amount in excess ofyour death cover under the policy.

You can exercise the right to apply forthe increase within 30 days either sideof your policy’s renewal date up to thepolicy anniversary preceding your 65th birthday.

If the right to apply for an increase isnot exercised on three consecutivepolicy renewals from the later of:

� the date the option was purchased,or

� the date of any previous election toexercise the right for an increase,

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then the option will be automaticallycancelled, unless you can demonstratethat the financial evidence relating toyour business and the purposeidentified by you, in respect of thatperiod, did not support an increase inthe Sum Insured.

The maximum age at which the option can be purchased is age 60next birthday.

This feature is not available forsuperannuation policies.

Additional Features The following additional features areexplained on page 31:

Indexation of benefitUpgrade guarantee24 hour world wide coverInterim Accident Cover

Level of coverMinimumsThere is no minimum Sum Insuredrequirement. However minimumpremium and premium loadings doapply, refer to pages 35 and 36.

MaximumsDeath Sum Insured: There are no maximum limits in respect of death cover.

Disability Sum Insured: A maximumdisability Sum Insured of $2,500,000applies.

While there is no maximum death Sum Insured for policies effected undersuperannuation arrangements, youshould note that lump sum benefitsare subject to higher taxation ifReasonable Benefit Limits (RBL) areexceeded (see page 39).

ExclusionsThere are certain exclusions that apply to your policy. Exclusions arecircumstances in which we are notrequired to pay the benefits under the policy.

The Death Benefit is not payable ifyour death was caused by suicidewithin thirteen (13) months ofcommencement or reinstatement ofthe policy. If your death was caused bysuicide within 13 months of anincrease then the increase in the SumInsured is not payable.

Neither the Disability Benefit nor theWaiver of Premium Option will bepayable in the event of attemptedsuicide, self-inflicted illness or injury orparticipation in insurrection.

Where we agree to replace an existingpolicy from another insurer, thethirteen (13) month exclusion forsuicide will not apply where the SumInsured under the policy being replacedis greater than or equal to the SumInsured under this policy, and thepolicy being replaced has been in forcefor at least twelve (12) months.

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Aviva Protection – Recovery Money provides death cover, with part or allof the benefit payable early if you are diagnosed with one of the criticalillnesses covered by the policy. You may choose to include optionaldisability cover for an additional premium.

Aviva Protection – Recovery Money is a bundled death and critical illnesscontract with the option to purchasedisability cover.

One policy is issued covering all threeevents. Consequently there is onepolicy owner for all three components.

Being a bundled contract the pricingreflects the overlap of risks betweenthe three covers and the fact that aclaim for a critical illness or disabilitywill reduce the death cover SumInsured. The administration andestablishment costs are also shared.

This policy is ‘guaranteed renewable’.This means that provided you pay thepremiums you can renew your covereach year until the policy expiry datewithout having to provide furthermedical evidence.

When you apply for the policy, youchoose the amount of the lump sumbenefit payable under the policy. Thislump sum benefit is called the ‘SumInsured’. You can choose differentlevels of Sum Insured for the death,critical illness and disability parts of the policy.

The Critical Illness Benefit will only bepaid on correct diagnosis of any one of the listed critical illnesses. Paymentof Critical Illness Benefit is based upon the precise definitions shown in the‘Medical Definitions’ sectioncommencing on page 44.

Aviva Protection – Recovery Money: a snapshot of what this cover includes

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B O B OC B B B B B O B N B B O OC O O B


at additional cost, definition changes to Loss of Independent Existence at policy anniversary preceding age 65 N = Not available

DEATH DISABILITY CRITICALILLNESS

Overlapping Risk

One Policy Owner

Bundledpricing

advantages=

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The benefitsPayment of BenefitsIf you die, are diagnosed as beingterminally or critically ill, or (if disabilitycover is added) are Totally andPermanently Disabled, the Sum Insuredwill be paid to you, as directed by youin your application, or to your estate.The payment of benefits is subject tothe exclusions explained on page 12.

Payment of one type of benefitautomatically reduces the Sum Insured under the other types by a corresponding amount.

Death Benefit (standard)If you die the agreed Sum Insured willbe paid.

Terminal Illness Benefit(standard)Under this benefit where you arediagnosed as being terminally ill andlikely to die within 12 months, the SumInsured will be paid out early with youragreement. The Critical Illness Benefit,and if attached Disability Benefit, theamount of Sum Insured provided bythese benefits will be reduced by theamount paid. The basis on which theTerminal Illness Benefit is paid underthis policy is the same as under the Lifepolicies, and is explained on page 4.

Critical Illness Benefit(standard)Critical Illness definition before policy anniversarypreceding age 65

If you are correctly diagnosed with one of the following critical illnesses(as defined) at any time up to thepolicy anniversary preceding age 65,we will pay the critical illness SumInsured as a lump sum.

The critical illnesses covered are:

Aplastic AnaemiaBenign Intracranial TumourBlindnessCancerCardiomyopathyChronic Lung DiseaseComaCoronary Artery By-Pass SurgeryCoronary Artery DiseaseDeafnessDementiaEncephalitisHeart AttackHeart SurgeryLiver DiseaseLoss of Independent ExistenceLoss of SpeechMajor BurnsMajor Head TraumaMajor Organ TransplantMedically Acquired HIV InfectionMotor Neurone DiseaseMultiple SclerosisOccupationally Acquired HIV InfectionOpen Heart SurgeryOut of Hospital Cardiac ArrestParalysisParkinson’s DiseasePneumonectomyPrimary Pulmonary HypertensionRenal FailureStroke

The definitions of the critical illnessesare contained in the ‘MedicalDefinitions’ section of this document,commencing on page 44.

For Coronary Artery Disease andMultiple Sclerosis the amount payablemay be limited in the manner set outunder Medical Definitions commencingon page 44.

For Occupationally Acquired HIVInfection and Medically Acquired HIVInfection the Critical Illness Benefit maybe excluded where a Cure becomesavailable as set out under ‘MedicalDefinitions’ commencing on page 44.

Critical Illness definition afterpolicy anniversary precedingage 65

Conversion to Loss of IndependentExistence at age 65.

If you have been covered under theCritical Illness Benefit and there hasnot been a claim on the policy, thenthe Critical Illness Benefit will continuefrom the policy anniversary precedingage 65 until the expiry of the policy.However from the policy anniversarypreceding age 65, the abovedefinitions of critical illness shall ceaseto apply. Instead, the critical illnessSum Insured will be payable if you arecorrectly diagnosed as being subject toa Loss of Independent Existence (asdefined on page 45).

Disability Benefit (optional at additional cost)By taking this option, your policy isextended to include disability cover. If you become Totally and PermanentlyDisabled (as defined on page 4), thedisability Sum Insured will be paid toyou as a lump sum.

Once the Disability Benefit is paid, thedeath cover and critical illness coverboth cease, unless the Sum Insured ineither case exceeds the DisabilityBenefit. Where it does, the excessdeath and critical illness covercontinues upon payment ofcorresponding premiums.

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Aviva Protection – Recovery Money continued

Critical facts showing the risk of death andcritical illness for men and women aged 18-64.

27% Breast Cancer $8,509,700

13% Heart Attack $3,984,380

11% Stroke $3,643,925

2% Coronary

Artery Disease $552,365

10% Coronary Artery

Bypass Surgery $3,014,020

4% Other Illnesses $1,335,780

33% Other Cancer $10,655,396

2% stroke

11% cancer

3% heartattack

6% other

1% by-pass

2% death

75% healthy

Trauma & death: risks for females 18-64

3% stroke

10% cancer

9% heartattack

9% other

3% by-pass

5% death

61% healthy

Trauma & death: risks for males 18-64

The facts of life are that many of uswill suffer a major medical condition.

The following graph indicates thelikelihood of an 18-year-old femalesuffering one of the listed majormedical conditions which qualify for a critical illness benefit before shereaches 64.

The probability of death is slim at 2%.However cancer is a major concernwith a one-in-ten chance.

The following graph indicates thelikelihood of an 18-year-old malesuffering one of the listed majormedical conditions which qualify for a critical illness benefit before hereaches 64.

The probability of death is a concern at 5%. However risk of heart attack is higher at 9%. This represents analmost one-in-ten risk.

Source: Fabrizio, E. and Gratton, W. K. – Pricing Dread Disease Insurance: Transactions of the Institute of Actuaries of Australia1994, pages 292-468.

The Institute of Actuaries has consented to the statements attributable to them on this pagebeing included in this PDS in the form and context in which they are included.

Aviva’s claims experience

The above graph provides details of the critical illness claims paid, by NULAL between1 January 2001 and 31 December 2003 (based upon the medical definitions within the relevant NULAL policies).

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The featuresEach of the following features isprovided on the terms set out on pages 4 to 6:

Economiser (standard)

Future Insurability (standard)

Waiver of Premium Option (optionalat additional cost)

Business Protection Option (optionalat additional cost)

Disability Buy Back Option (optionalat additional cost)

Note that the Disability Buy BackOption is not available after a CriticalIllness Benefit or Terminal Illness Benefithas been paid under this policy.

Future insurability CriticalIllness (standard)When significant events happen in life,you can increase your critical illnessSum Insured without having to providefurther medical evidence.

The critical illness Sum Insured may beincreased when:

� You marry.

� You have a child or legally adoptone.

� You take out a mortgage to buyyour first home.

� You receive an increase in annualsalary of at least 10%

You must apply for this increase within30 days of the first renewal datefollowing the defined event. We willrequire proof of the defined event.

You may only increase your criticalillness Sum Insured once under thisfeature in any twelve (12) monthperiod. In any twelve (12) monthperiod you may increase your SumInsured by $25,000 or the original Sum Insured, whichever is lower. The maximum total amount you can

increase your critical illness SumInsured under this feature over the lifeof the policy is the lesser of:

� The amount of critical illness SumInsured under your policy excludingCPI increases and increases effectedunder this feature; and

� $1,000,000.

The feature cannot be exercised if atthe time of your request:

� You are older than 50 years of age

� You have previously been acceptedby us with special conditionsaffecting the premium rates

� The premiums are being waivedunder the Waiver of PremiumOption, or

� You are currently entitled to make aclaim for a Terminal Illness orCritical Illness Benefit under a policyyou currently hold with us.

This option is only available where theinitial critical illness Sum Insured is$1,000,000 or less.

In respect of Recovery Money andFlexible Recovery Money the criticalillness Sum Insured cannot exceed theamount of death Sum Insured.

Critical Illness Buy BackOption (optional atadditional cost)One year after a Critical Illness Benefithas been paid, you can purchase anAviva Protection – Life Policy (deathonly) without providing further medicalevidence.

This option can only be exercisedwithin a period of 30 days from thefirst anniversary of the payment of theCritical Illness Benefit. If your policyincludes this option, we will providedeath cover on the following basis:

(a) the death Sum Insured may not exceed the Critical IllnessBenefit paid;

(b) premiums will be charged at theappropriate rate for the thenattained age based on the thencurrent published term insurancerates;

(c) any original exclusions or specialconditions applicable under thispolicy will be maintained.

Where the Critical Illness Buy BackOption is exercised in conjunction with the Critical Illness ReinstatementOption (see below), Indexation (as defined on page 31) will not be available.


Critical Illness ReinstatementOption (optional atadditional cost)One year after a Critical Illness Benefithas been paid, you can reinstate 50%of the critical illness cover withoutproviding further medical evidence.This feature provides critical illnesssufferers with a second level ofprotection and peace of mind.

This option can only be exercisedwithin a period of 30 days from thefirst anniversary of the payment of theCritical Illness Benefit. If your policyincludes this option, we will reinstateyour critical illness cover on thefollowing basis:

(a) the critical illness Sum Insured maynot exceed 50% of the CriticalIllness Benefit paid;

(b) premiums will be charged at theappropriate rate for the thenattained age based on the thencurrent published term insurancerates;

(c) any original exclusions or specialconditions applicable under thispolicy will be maintained.

Indexation (as defined on page 31) will not be available.

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Aviva Protection – Recovery Money continued

This option cannot be exercised afterCritical Illness Benefits are paid forCoronary Artery Disease, or if Disabilityor Terminal Illness Benefits are paid.

We will pay a claim under thereinstated cover if you suffer from a Critical Illness and

� You have not claimed for the sameCritical Illness.

� You have not claimed for aCardiovascular Related Illness.

� It is not a condition that hasoccurred as a direct or indirectresult of the original Critical Illness event.

� It is not a Stroke (including Paralysisas a result of a CerebrovascularAccident) and the original claim wasfor a Cardiovascular Related Illness.

� The critical event occurs after thecover has been reinstated.

For the purpose of this sectionCardiovascular Related Illness are:

Coronary Artery By-Pass Surgery, Heart Attack, Heart Surgery,cardiomyopathy, Open Heart Surgery,Out of Hospital Cardiac Arrest, Primary Pulmonary Hypertension.


Additional features The following additional features areexplained on page 31:


Level of coverMinimumsA minimum critical illness Sum Insuredof $10,000 applies.

In addition minimum premium andpremium loadings do apply, refer topages 35 and 36.

MaximumsDeath Sum Insured: There are nomaximum limits in respect of deathcover.

Disability Sum Insured: A maximumdisability Sum Insured of $2,500,000applies.

Critical Illness Sum Insured: Themaximum level of critical illness cover is$1,500,000 in aggregate with us andunder any similar policy with any otherinsurer. Additional critical illness coverwill not be issued in excess of thisaggregate limit. The critical illness SumInsured cannot exceed the amount ofdeath Sum Insured.


The Death Benefit is not payable if yourdeath was caused by suicide withinthirteen (13) months of commencementor reinstatement of the policy. If yourdeath was caused by suicide withinthirteen (13) months of an increase thenthe increase is not payable.

No Critical Illness Benefit will bepayable in the event of self-inflictedillness or injury.

The Critical Illness Benefit will not be payable if it is shown that you donot have the condition which has been diagnosed.


No payment will be made for HeartAttack, Cardiomyopathy, Stroke,Benign Intracranial Tumour, Cancer,Heart Surgery, Open Heart Surgery,Coronary Artery By Pass Surgery orCoronary Artery Disease if thecondition is diagnosed, or symptoms

leading to diagnosis become reasonablyapparent, before or within threemonths of the commencement orreinstatement of the policy.

If any of the above conditions isdiagnosed or becomes apparent within three months of an increase in benefits, then the amount of theincrease will not be payable.

Payment will be made for any insured events that are independent of any conditions or symptomsoriginally diagnosed within the threemonth period.

Where this Recovery Money policy is toreplace an existing similar policy fromanother insurer, the three monthexclusion of payments will not applywhere the same medical conditions andprocedures have been covered under thepolicy to be replaced. This will only applyup to the lesser of the Sum Insuredunder the policy being replaced and theSum Insured under this policy. It will alsoonly apply where the life to be insured isthe same under both policies and wherethe policy being replaced has been inforce for at least three months.

In the event of a claim within the firstthree months of this policy, evidence of:

a) the conditions and procedurescovered under the replaced policy;

b) the currency of the replacementpolicy at the Commencement Dateof this policy ; and

c) cancellation of the replaced policyfrom the previous reinsurer,

must be provided by the Policyowner toenable the three month exclusion ofpayments to be waived.

Where we agree to replace an existingpolicy from another insurer, thethirteen (13) month exclusion forsuicide will not apply where the SumInsured under the policy being replacedis greater than or equal to the SumInsured under this policy, and thepolicy being replaced has been in forcefor at least twelve (12) months.

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Aviva Protection – Flexible Recovery Money provides a benefit if you arediagnosed with one of the critical illnesses covered by the policy. It is anancillary policy that can only be held in conjunction with an approvedAviva Protection – Life policy. The Flexible Recovery Money policy and theLife policy are linked. A benefit payable under one policy will reduce thebenefit provided under the other. You may choose to include optionaldisability cover for an additional premium.

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B OC B B B B O B B O OC O O B

Aviva Protection – Flexible Recovery Money: a snapshot of what this cover includes


at additional cost, definition changes to Loss of Independent Existence at policy anniversary preceding age 65

These policies are ‘guaranteedrenewable’. This means that, providedyou pay the premiums you can renewyour cover each year until the policyexpiry date without having to providefurther medical evidence.

When you apply for the policy youchoose the amount of the lump sumbenefit payable under the policy. Thislump sum benefit is called the ‘SumInsured’. You can choose differentlevels of Sum Insured for the criticalillness and disability parts of the policy.

The Critical Illness Benefit will only bepaid on correct diagnosis of any one ofthe listed critical illnesses. Payment ofCritical Illness Benefit is based uponthe precise definitions shown in the‘Medical Definitions’ sectioncommencing on page 44.

For benefits to be payable under thispolicy, an approved Aviva Protection –Life policy must have been in forcethroughout the period insured by thispolicy, with a death Sum Insured atleast equal to the greater of the criticalillness Sum Insured and the aggregateof the disability Sum Insured heldunder this and the associated Lifepolicy.

Aviva Protection – Flexible RecoveryMoney is a policy with the option topurchase disability cover. It is designedto be bundled with the AvivaProtection – Life policy.

The flexibility exists in the innovative waywe allow the critical illness cover to beowned by a different individual or entityfrom the death cover.

Two policies are issued, one for deathand optional disability cover, and onefor critical illness and optionaldisability cover. Each policy can have adifferent owner which can include asuperannuation fund (see page 33).However the policies are priced as ifthey are one combined policy resultingin significant pricing efficiencies.

As the policies are linked, the deathcover must be maintained for thecritical illness cover to remain in force.A claim for critical illness will reducethe death and disability Sum Insured.

DEATH DISABILITY CRITICALILLNESS

Overlapping Risk

Policy Owner 1

Bundledpricing

advantages=

Policy Owner 2

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The benefitsCritical Illness Benefit(standard)If a Death Benefit or Terminal IllnessBenefit is paid under the associatedAviva Protection – Life policy, theCritical Illness Benefit payable underthis policy will be reduced by acorresponding amount.

If a Critical Illness Benefit is paid underthis policy, the amount of DeathBenefit, Terminal Illness Benefit and, ifapplicable, Disability Benefit payableunder the Aviva Protection – Life policywill be reduced by a correspondingamount, as explained on page 5.

If a Disability Benefit is paid, theCritical Illness Benefit under this policywill be reduced by the aggregateamounts actually paid under this policyand the associated Aviva Protection –Life policy.

Critical illnesses definitionbefore policy anniversarypreceding age 65

If you are correctly diagnosed with one of the following critical illnesses (as defined) at any time up to policyanniversary preceding age 65, we willpay the Sum Insured as a lump sum.


Aplastic AnaemiaBenign Intracranial TumourBlindnessCancerCardiomyopathyChronic Lung DiseaseComaCoronary Artery By-Pass SurgeryCoronary Artery DiseaseDeafnessDementiaEncephalitisHeart AttackHeart SurgeryLiver DiseaseLoss of Independent ExistenceLoss of Speech

Major BurnsMajor Head TraumaMajor Organ TransplantMedically Acquired HIV InfectionMotor Neurone DiseaseMultiple SclerosisOccupationally Acquired HIV InfectionOpen Heart SurgeryOut of Hospital Cardiac ArrestParalysisParkinson’s DiseasePneumonectomyPrimary Pulmonary HypertensionRenal FailureStroke




Critical illnesses definition afterpolicy anniversary precedingage 65

Conversion to Loss of IndependentExistence at age 65.

If you have been covered under theCritical Illness Benefit and there hasnot been a claim on the policy, thenthe Critical Illness Benefit will continuefrom the policy anniversary precedingage 65 until the expiry of the policy.However from the policy anniversarypreceding age 65, the abovedefinitions of critical illness shall ceaseto apply. Instead, the critical illnessSum Insured will be payable if you arecorrectly diagnosed as being subject toa Loss of Independent Existence (asdefined on page 45).

Disability Benefit (optional atadditional cost)By taking this option your benefit isextended to include disability cover. If you become Totally and PermanentlyDisabled (as defined on page 4) thedisability Sum Insured will be paid toyou as a lump sum.

The featuresEach of the following features isprovided on the terms set out onpages 5 and 6.

Economiser (standard)

Waiver of Premium Option (optional at additional cost)

Disability Buy Back Option (optional at additional cost)

Each of the following features isprovided on the terms set out on page 11:

Future Insurability Critical Illness(standard)

Critical Illness Buy Back Option(optional at additional cost)

Critical Illness Reinstatement Option(optional at additional cost)

Additional features The following additional features areexplained on page 31:


Level of coverMinimumsA minimum critical illness Sum Insuredof $10,000 applies.


Aviva Protection – Flexible Recovery Money continued

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MaximumsDisability Sum Insured: A maximumDisability Benefit of $2,500,000applies, in aggregate between this andthe Aviva Protection – Life policy. Also,the aggregate of the disability coverheld under this policy and theassociated Aviva Protection – Life policycannot exceed the death Sum Insuredunder the Aviva Protection – Life policy.

Critical Illness Sum Insured: Themaximum level of critical illness cover is$1,500,000 in aggregate with us andunder any similar policy with any otherinsurer. Additional critical illness coverwill not be issued in excess of thisaggregate limit. Further, the criticalillness Sum Insured cannot exceed thedeath Sum Insured under the AvivaProtection – Life policy.


The Critical Illness Benefit will not bepayable in the event of self-inflictedillness or injury.

The Critical Illness Benefit will not bepayable if it is shown that you do nothave the condition which has beendiagnosed.


No payment will be made for HeartAttack, Cardiomyopathy, Stroke,Benign Intracranial Tumour, Cancer,Heart Surgery, Open Heart Surgery,Coronary Artery By Pass Surgery orCoronary Artery Disease if the condition is diagnosed, orsymptoms leading to diagnosis becomereasonably apparent, before or withinthree months of the commencement or

reinstatement of the policy.

If any of the above conditions isdiagnosed or becomes apparent withinthree months of an increase inbenefits, then the amount of theincrease will not be payable.

Payment will be made for any insuredevents that are independent of anyconditions or symptoms originallydiagnosed within the three monthperiod.

Where this Recovery Money policy is toreplace an existing similar policy fromanother insurer, the three monthexclusion of payments will not applywhere the same medical conditions andprocedures have been covered underthe policy to be replaced. This will onlyapply up to the lesser of the SumInsured under the policy being replacedand the Sum Insured under this policy. Itwill also only apply where the life to beinsured is the same under both policiesand where the policy being replaced hasbeen in force for at least three months.






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Aviva Protection – Stand Alone Recovery Money

Aviva Protection – Stand Alone Recovery Money provides a benefit if youare diagnosed with one of the critical illnesses covered by the policy. Unlike the Flexible Recovery Money policy which can only be held inconjunction with an approved Aviva Protection – Life policy, the StandAlone Recovery Money policy can be held separately.

Aviva Protection – Stand Alone Recovery Money: a snapshot of what this cover includes

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Aviva Protection – Stand Alone Recovery Money

B B B B B B B O O B

B = Benefit included in basic price O = Option at additional cost

To complete the range of solutions andoffer full flexibility, Aviva Protection –Stand Alone Recovery Money providescritical illness cover independent ofdeath and disability.

This is a more expensive way ofproviding critical illness cover becauseseveral risks are being covered in bothindividual contracts resulting in anoverlap in the pricing. The benefits of a bundled contract are not achieved.However it does mean that a claim forcritical illness will not affect the deathand disability cover which is being held separately.

Stand Alone Recovery Money alsomeans insurance can be providedwhere death and disability cover arealready in place with another provider.

These policies are ‘guaranteedrenewable’. This means that providedyou pay the premiums you can renewyour cover each year until the policyexpiry date without having to providefurther medical evidence.

When you apply for the policy, youselect the amount of the lump sumbenefit payable under the policy. This lump sum benefit is called the ‘Sum Insured’.

The Critical Illness Benefit will only bepaid on correct diagnosis of any one ofthe listed critical illnesses. Payment ofCritical Illness Benefit is based uponthe precise definitions shown in the

‘Medical Definitions’ sectioncommencing on page 44.

The benefitsCritical Illness Benefit(standard)If you are correctly diagnosed with one of the following critical illnesses (as defined) at any time up to policyanniversary preceding age 65, we willpay the Sum Insured as a lump sum.


Aplastic AnaemiaBenign Intracranial TumourBlindnessCancerCardiomyopathyChronic Lung DiseaseComaCoronary Artery By-Pass SurgeryCoronary Artery DiseaseDeafnessDementia

DEATH DISABILITY

Overlapping Risk

Policy Owner 1

CRITICALILLNESS

Standalone

pricing=

Policy Owner 2

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EncephalitisHeart AttackHeart SurgeryLiver DiseaseLoss of Independent ExistenceLoss of SpeechMajor BurnsMajor Head TraumaMajor Organ TransplantMedically Acquired HIV InfectionMotor Neurone DiseaseMultiple SclerosisOccupationally Acquired HIV InfectionOpen Heart SurgeryOut of Hospital Cardiac ArrestParalysisParkinson’s DiseasePneumonectomyPrimary Pulmonary HypertensionRenal FailureStroke




Death Benefit (standard)If you die within 14 days of thediagnosis of the critical illness, we will pay $5,000 to your estate.

The featuresThe Economiser feature is provided onthe terms as set out on page 5. TheFuture Insurability Critical Illness(standard) and Critical IllnessReinstatement Option (available at anadditional cost) on the terms set outon page 11.

The following additional features areexplained on page 31:


Level of coverMinimums/Maximums A minimum critical illness Sum Insuredof $10,000 applies.


The maximum Sum Insured is$1,500,000 in aggregate with us and under any similar policy with anyother insurer. Additional critical illnesscover will not be issued in excess ofthis aggregate limit.


The Critical Illness Benefit will not bepayable in the event of self-inflictedillness or injury.

It will also not be payable if it is shownthat you do not have the conditionwhich has been diagnosed.

We will only pay the Critical Illness Benefitif you live for at least fourteen dayswithout the aid of a life support system,after diagnosis of the Critical Illness.

No payment will be made for HeartAttack, Cardiomyopathy, Stroke,Benign Intracranial Tumour, Cancer,Heart Surgery, Open Heart Surgery,Coronary Artery By Pass Surgery orCoronary Artery Disease if thecondition is diagnosed, or symptomsleading to diagnosis becomereasonably apparent, before or withinthree months of the commencementor reinstatement of the policy.

If any of the above conditions isdiagnosed or becomes apparent withinthree months of an increase inbenefits, then the amount of theincrease will not be payable.

Payment will be made for any insuredevents that are independent of anyconditions or symptoms originallydiagnosed within the three monthperiod.

Where this Recovery Money policy is toreplace an existing similar policy fromanother insurer, the three monthexclusion of payments will not applywhere the same medical conditions andprocedures have been covered under thepolicy to be replaced. This will only applyup to the lesser of the Sum Insuredunder the policy being replaced and theSum Insured under this policy. It will alsoonly apply where the life to be insured isthe same under both policies and wherethe policy being replaced has been inforce for at least three months.






The Death Benefit is not payable if you commit suicide within thirteenmonths of the commencement orreinstatement of the policy.

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Aviva Protection – Income Gold, and Aviva Protection – Income Excell

Aviva Protection – Income Gold and Aviva Protection – Income Excellprovide income replacement while you are Totally Disabled or PartiallyDisabled and unable to work as a result of either sickness or injury.Payments are made until the end of the chosen benefit period.

The policies have the same basic structure, however Aviva Protection –Income Gold has several additional benefits and features.

Both policies offer you the choice ofagreed value or indemnity cover. Youhave the choice of an agreed monthlySum Insured (agreed value) or a SumInsured limited to the lesser of amonthly value nominated by you, and 75% of your average monthlyearnings for the 12 months precedingthe date of Total Disablement(indemnity). The maximum SumInsured is limited in the mannerdescribed on page 27. The premiumsfor agreed value and indemnity policiesare different and you should discusswith your financial adviser which is themost appropriate for you.

Insuring your greatest assetMany people consider their greatestasset to be their home, contents or insome cases an investment portfolio.The truth is these assets would simplynot exist if the individual did not havea consistent, reliable income.

As well as being necessary for survival,your ability to earn an income is in factyour greatest asset. Just like yourhouse and contents, you shouldconsider insuring this asset against theevent of illness or injury.

Aviva Protection – Income providesmonthly benefit payments to replace a significant portion of your income if you are ill or injured and unable to work.

Flexible solutionsThe Aviva Protectionfirst range ofincome protection solutions allows youto choose your own combination ofcover to meet your personal needs.You select the type of contract yourequire and the options you want atthe same time as having significantcontrol over the premium that you willpay.

By selecting certain options you canlimit the premium you pay, or you canmaximise the benefits you receive bypaying a higher premium.

It is important to discuss your optionswith your financial adviser to makesure you understand the implicationsof your decision.

Aviva Protection – Income Choose Aviva Protection –Income

Agreed ValuePolicy

IndemnityPolicy

Decision 2: Agreed Value Policy or Imdemnity Policy

Protection –Income Gold

Decision 1: Protection – Income Gold or Excell

Agreed ValuePolicy

IndemnityPolicy

Protection –Income Excell

Amount WaitingPeriod

BenefitPeriod

Decision 3: Benefit Amount, Waiting Period and Benefit Period


BenefitPeriod


BenefitPeriod


BenefitPeriod

The Aviva Income Protection decision tree

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Aviva Protection – Income Gold & Aviva Protection – Income Excell: a snapshot of what your cover includes


O B B B B O B O B B O B B B B B B B B B


O B N B N O B O B N N B B B N N N B N B

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The policies are ‘guaranteedrenewable’. This means that providedyou pay the premiums you can renewyour cover each year until the policyexpiry date without having to providefurther medical evidence.

When you apply for the policy, youmust choose the amount of incomereplacement payable on sickness orinjury. This is called the monthly SumInsured. In addition to selecting theSum Insured, you must also select aWaiting Period.

B = Benefit included in basic price O = Option at additional cost N = Not available

Monthly Sum Insured When you take out a policy, you nominate amonthly Sum Insured up to a maximum of75% of your Monthly Earnings (the definitionof Monthly Earnings is set out on page 26).You will be paid this benefit if you becomeTotally Disabled, subject to proof of MonthlyEarnings and the limited circumstances underwhich this may be adjusted, as set out in“Benefit Reductions” on pages 24. For theproportion payable on Partial Disability, referto page 21.

When you take out a policy, you nominate amonthly Sum Insured up to a maximum of75% of Monthly Earnings (the definition ofMonthly Earnings is set out on page 26). Ifyou are Totally Disabled, subject to the limitedcircumstances under which this may beadjusted, as set out in “Benefit Reductions”on pages 24, you will paid the lesser of thisamount and 75% of your Pre-DisabilityEarnings (see the definition of Pre-DisabilityEarnings on page 26). For the proportionpayable on Partial Disability, refer to page 21.

Agreed Value Indemnity

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Aviva Protection – Income Gold, and Aviva Protection – Income Excell continued

Waiting periodYou must choose a waiting periodwhen taking out your policy. TheWaiting Period is the period you mustwait before benefits become payable.

Your choice of waiting period dependson your choice of benefit period andthe type of premium (ie stepped orlevel). Your financial adviser will be ableto assist you with all these choices.

For stepped premiums if you choose atwo or five year benefit period, youhave the choice of waiting periods of14 days, 30 days, 60 days, 90 days,and 180 days.

If you choose a benefit period to age60, 65 or 70 years you also have thechoice of waiting periods of 365 and730 days. However if you choose a 365days or 730 days waiting period, theCritical Conditions Benefit, SpouseAccommodation Benefit, Nursing CareBenefit, Scheduled Injury Benefit,Emergency Travel Benefit, RehabilitationIncome Benefit are not available.

For level premiums you have the choiceof waiting periods of 14 days, 30 days,60 days and 90 days.

Generally speaking, the longer thewaiting period, the lower the insurancepremium.

The waiting period commences on thedate that you receive advice ofDisability from a medical practitioner. Incircumstances where it can besubstantiated that disability had begunearlier than the date of receiving advicefrom a medical practitioner, the date ofcommencement may be backdated byup to 7 days with medical certification.

If You return to full time gainfulemployment during the Waiting Periodfor five (5) consecutive days or less, the number of days that You weregainfully employed will be added tothe Waiting Period.

If You return to full time gainfulemployment during the Waiting Periodfor more than five (5) consecutive days,the Waiting Period begins again fromthe day after the last day You weregainfully employed.

Benefit periodThe Benefit Period is the maximumperiod of time for which the monthlybenefit is payable, whilst you areTotally or Partially Disabled due toinjury or sickness.

The Benefit Period commences at theend of the applicable waiting period. Itcontinues until the expiry of the BenefitPeriod selected or the policy anniversarypreceding the specified age (whichever occurs first), in accordance withthe following table.

Expiry at policy Benefit anniversaryPeriod: preceding age:

2 years for sickness and injury 65

5 years for sickness and injury 65

To age 60 years for sickness and injury 60



The benefit period to age 70 years isonly available to people in certainoccupational classes. Where thebenefit period is to age 70 years, theexpiry date of the policy is the policyanniversary preceding age 65 years.However, the insured is Totally orPartially Disabled at the policyanniversary preceding age 65 thenpayment of benefits will continue tothe policy anniversary preceding age70 years, or until the insured ceases tobe either Totally or Partially Disabled,whichever occurs first.

If the policy is an indemnity policy andyou are receiving benefits as a result ofPartial Disability then the claimpayment will continue for a maximumof two years.

The benefits andfeaturesKey terms used in this section aredefined on pages 25 to 27; please readthose definitions carefully.

Total Disability Benefit(standard)If, solely as a result of Injury orSickness, you are Totally Disabled whileyour policy is in force, we will pay yourmonthly Sum Insured. Payment willstart from the first day after theWaiting Period has elapsed andcontinue while you are Totally Disabledup to the cessation of the BenefitPeriod for any one Injury or Sickness.We will pay one-thirtieth of themonthly Sum Insured for each day ofTotal Disability.

Partial Disability Benefit(standard)If you are Partially Disabled, aproportion of the monthly Sum Insuredwill be paid to you.

For agreed value policies only

If you have an agreed value policy andyou are Partially Disabled for longerthan the Waiting Period, we will assessthe impact of Your Partial Disability onYour earning ability.

We will pay a proportion of theMonthly Benefit to the Policyowner, at the end of the Waiting Period, due to Your Partial Disability only if:

(i) solely because of Your PartialDisability You have been unable togenerate at least 80% of Your Pre-Disability Earnings for theduration of the Waiting Period; or

(ii) Your Partial Disability is due to Youhaving suffered a Deemed Disabilityand at the end of the applicablepayment period for DeemedDisability benefits You are stillPartially Disabled at the end of theWaiting Period.

If You satisfy one of the above criteria,the proportion we will pay will be:

A - B A

where A is Your Pre-Disability Earningsand B is Your Monthly Earnings for themonth in which Partial Disability isclaimed. If, during the first three (3)months of a continuous period ofPartial Disability Your Monthly Earningsare 20% or less of Your Pre-DisabilityEarnings, we will pay the full MonthlyBenefit during those months.

If You are capable of working on apartial basis but You are not working,then we will calculate MonthlyEarnings based on what You couldreasonably be expected to earn if Youwere working. We will base thiscalculation on medical advice (whichwill include the opinion of YourMedical Practitioner).

If You have suffered a DeemedDisability and at the end of theapplicable payment period you arePartially Disabled, the Waiting Periodwill be deemed to have commencedon the date that You suffered theDeemed Disability, as certified by aMedical Practitioner.

We will pay the Partial DisabilityBenefit monthly in arrears. The PartialDisability Benefit will stop at the end ofthe Benefit Period, or when You ceaseto be Partially Disabled or when YourMonthly Earnings equals Your Pre-Disability Earnings, whicheveroccurs first.

For indemnity policies only

If you have an indemnity policy andyou are Partially Disabled for longerthan the Waiting Period, we will assessthe impact of Your Partial Disability onYour earning ability.

We will pay a proportion of theMonthly Claim to the Policyowner, atthe end of the Waiting Period, due toYour Partial Disability only if:

(i) solely because of Your PartialDisability You have been unable togenerate at least 80% of Your Pre-Disability Earnings for theduration of the Waiting Period; or

(ii) Your Partial Disability is due to You having suffered a DeemedDisability and at the end of theapplicable payment period forDeemed Disability benefits You are still Partially Disabled at the end of the Waiting Period.

If you satisfy one of the above criteria,the proportion we will pay will be:

A - BA

where A is your Indexed Pre-DisabilityEarnings and B is your Monthly Earningsfor the month in which Partial Disabilityis claimed. If, during the first three (3)months of a continuous period ofPartial Disability your Monthly Earningsare 20% or less of Your Pre-DisabilityEarnings, we will pay the full MonthlyBenefit, during those months.

If You are capable of working on apartial basis but you are not working,then we will calculate Monthly Earningsbased on what you could reasonably beexpected to earn if you were working.We will base this calculation onmedical advice (which will include theopinion of your Medical Practitioner).

If you have suffered a DeemedDisability and at the end of theapplicable payment period you arePartially Disabled, the Waiting Periodwill be deemed to have commencedon the date that you suffered theDeemed Disability, as certified by aMedical Practitioner.

We will pay the Partial DisabilityBenefit monthly in arrears. The PartialDisability Benefit will stop at the end ofthe Benefit Period, or when you ceaseto be Partially Disabled or when yourMonthly Earnings, equal your Pre-Disability Earnings, whicheveroccurs first.

Page 21 of 76

The Partial Disability Benefit will berestricted to a maximum of two yearsin respect of any one claim, includingbenefits paid under the RecurrentClaim Benefit.

Waiver of Premium(standard)After you have been disabled forlonger than the Waiting Period, we willwaive all premiums payable under yourpolicy for the period you continue toreceive either the Partial or TotalDisability Benefit.

Recurrent Claim Benefit(standard)If your benefit period is to age 60, 65 or 70 and you suffer a Total orPartial Disability within 12 months afterthe end of a Disability claim from thesame or related causes, the WaitingPeriod will not be applied again and allperiods of Disability will be consideredpart of the same benefit period. For allother benefit periods this will applywhere the related disablement occurswithin 6 months.

Scheduled Injury Benefit(standard)If you sustain any of the followinginjuries, we will pay you a ScheduledInjury Benefit equal to your monthlySum Insured even if you are working.The Scheduled Injury Benefit is paidmonthly in advance commencing uponreceipt of the claim form verifying theinjury, and will stop on the earlier ofthe expiry of the Scheduled InjuryBenefit Payment Period, or the last day of the Benefit Period.

Total and PaymentPermanent periodLoss of: (months)

Use of your legs or your legs and arms due to paralysis 60

Both feet or both hands or sight in both eyes 24

Any combination of two of a hand, a foot and sight in one eye 24

One leg or one arm 18

One hand or one foot or sight in one eye 12

The thumb and index finger of same hand 6

Paymentperiod

Fracture of the: (months)

Thigh 3

Pelvis 3

Skull (except bones of face or nose) 2

Upper arm 2

Shoulder bone 2

Jaw 2

Leg (excluding ankle) 2

Knee cap 2

Forearm (above the wrist) 11/2

Collarbone 11/2

Scheduled Injury Benefits commenceupon receipt of the claim formverifying the Scheduled Injury. If youare Disabled at the end of the paymentperiod, you must wait until yourWaiting Period expires before Disabilitybenefits become payable.

Death Benefit (standard)If you die while you are receiving abenefit from your policy, the DeathBenefit will be paid to your estate.

The Death Benefit is six times themonthly Sum Insured subject to amaximum of $60,000 and is paid upon proof of death. This will be paidmonthly to your estate in six equalinstalments over a period of sixmonths. Payment of the Death Benefit means that no other benefitsare payable.

Page 22 of 76


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Critical Conditions Benefit(standard for Aviva Protection– Income Gold only)If you are first diagnosed as sufferingfrom one of the conditions listedbelow after you have purchased thepolicy, you will be paid the monthlySum Insured for six months, even ifyou are working, provided the criticalcondition is diagnosed by a medicalpractitioner and is supported byhistological and laboratory evidence asappropriate, depending on thecircumstances.

� Aplastic Anaemia� Benign Intracranial Tumour� Cancer� Cardiomyopathy� Chronic Lung Disease� Coma� Coronary Artery By-Pass Surgery� Deafness� Dementia� Encephalitis� Heart Attack� Heart Surgery� Liver Disease� Loss of Independent Existence� Loss of Speech� Major Burns� Major Head Trauma� Major Organ Transplant� Medically Acquired HIV Infection� Motor Neurone Disease� Multiple Sclerosis� Occupationally Acquired

HIV Infection� Open Heart Surgery� Out of Hospital Cardiac Arrest� Parkinson’s Disease� Pneumonectomy� Primary Pulmonary Hypertension� Renal Failure� Stroke

These critical conditions are defined inthe ‘Medical Definitions’ on page 44.

The Critical Conditions Benefit ispayable once for the same type ofcritical condition until the expiry dateof your policy. However it will only bepaid for another type of critical

condition if you recovered from yourprior critical condition, returned toemployment and have not beenreceiving any benefits from this policyfor at least six months. The benefit ispaid monthly in advance for a total ofsix months.

The waiting period begins upon thethe date of diagnosing of the criticalcondition if you are Disabled at theend of the Critical Conditions BenefitPeriod, you must wait until the WaitingPeriod expires before Disability Benefitsbecome payable.

The Critical Conditions Benefit will notbe paid:

(a) If Heart Attack, Stroke, BenignIntracranial Tumour, Cancer, HeartSurgery or Coronary Artery By-PassSurgery is diagnosed, or symptomsleading to the diagnosis becomereasonably apparent within threemonths of the inception, increaseor reinstatement of the policy. If this occurs within three monthsbefore an increase in benefits, the increase will not be payable.or

(b) If it is shown that you do not have the condition which has been diagnosed.

Emergency Travel Benefit(standard for Aviva Protection– Income Gold only)If, as a result of an Injury or Sickness,you require emergency transportationin an air, sea or land ambulance whileyou are outside Australia, we may, inour absolute discretion, refund thecosts of emergency transportationwithin the country where the Injury orSickness occurred.

If you become Totally Disabled whilstyou are outside Australia and remainso for more than 30 days, then ifDisability continues, and you choose toreturn to Australia, we will reimburseyou the cost of a single economyairfare by the most direct route on arecognised airline.

This benefit is limited to a maximumof three times the monthly SumInsured and is payable only once inany twelve (12) month period.Emergency Travel Benefits are notpayable on costs for which you areinsured or entitled to seekreimbursement from another source.

Nursing Care Benefit(standard for Aviva Protection– Income Gold only)During the Waiting Period if you areTotally Disabled and confined to bedand a doctor certifies that you requirethe continuing care of a registerednurse, other than an immediate familymember, for a period of at least threedays, we will pay an amount of one-thirtieth of the monthly SumInsured for each day of confinement.This will commence from the first dayof such care, until the end of theWaiting Period, when you are nolonger confined to bed, or you nolonger require the care of a registerednurse or for a maximum of 90 days,whichever first occurs.

Rehabilitation ExpensesBenefit (standard for AvivaProtection – Income Gold only)Should you need to undergo a formalrehabilitation course while you areTotally Disabled or require specialequipment to assist you to return towork or live at home, we will pay forsuch extraordinary expenses that youincur up to an amount equal to sixtimes the monthly Sum Insured.

Rehabilitation Income Benefit(standard for Aviva Protection– Income Gold only)When you are Totally Disabled and you choose to engage in rehabilitativeemployment we will increase the Total Disability Benefit by 50%. Thiswill be paid while rehabilitativeemployment continues for up to 12months for any one period of disability.

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Spouse AccommodationBenefit (standard for AvivaProtection – Income Gold only)If your spouse, partner or close relativeneeds accommodation more than 100km from your home, so that he or shecan be close to where you arehospitalised during a period of TotalDisability lasting more than three days,we will reimburse the cost of theaccommodation, less amounts that arereimbursed from another source, to amaximum of one-thirtieth of themonthly Sum Insured or $200.00 perday for a maximum of 30 days.

Unemployment Waiver(standard for Aviva Protection– Income Gold only)After this policy has been in force forsix months, if you involuntarily becomeunemployed and register withCentrelink or a recognised employmentagency we will waive premiums due or paid for the duration of yourunemployment up to a cumulativemaximum of twelve months during the life of the policy.

Increasing Claim Benefit(optional at additional cost)After you have been receiving a benefitfor 12 months, the amount of benefitwill be increased by the lesser of 10%p.a. or the increase in the ConsumerPrice Index (CPI).

Accident Benefit Option(optional at additional cost)If during the Waiting Period you becomeTotally Disabled due to Injury for at leastthree days, you will receive one-thirtiethof the monthly Sum Insured for each dayof Total Disability during the WaitingPeriod, up to a maximum of 90 days.

Guaranteed InsurabilityOption (optional atadditional cost)This option provides for an opportunityto increase your benefit up to 15%every three years without having toprovide further medical evidence.

Up to six option dates are available to age 50 next birthday.

Platinum Benefit (optional at additional cost for Aviva Protection – IncomeGold only)If you purchase the Platinum Benefitthen any Critical Condition Benefit or aNursing Care Benefit payable to youwill be increased by one third. If youdie when you are receiving a PlatinumBenefit, the Death Benefit isdetermined using this increasedmonthly benefit.

The following additional features areexplained on page 31:


Matters affectingpayment of benefitsUnemploymentIf you are unemployed, or on maternityor paternity leave, for more thantwelve (12) months immediately beforebecoming Totally Disabled, thenparagraph (a) in the definitions of “Total Disability” set out on page 26 is replaced by “you are unable toperform any occupation for which youare reasonably suited by education,training or experience.” If you are onsabbatical leave or study leave fromyour employer or long service leave this will not be considered asunemployment.

Maximum benefits payable offsetThe maximum Total Disability Benefitand Partial Disability Benefit payableunder the policy are reduced in certain circumstances.

For Agreed Value Policies Only

If you have an agreed value policy, themaximum amount payable under the

Total Disability Benefit and PartialDisability Benefit will be reduced if:

(i) you are eligible to receive benefitsfrom a disability insurance policy orsalary continuance policy from usor any other insurer which you hadnot disclosed when applying forthis policy, or a monthly benefit isreceived from a policy taken outafter this policy and you did notdisclose your entitlements toreceive benefits under this policy;or

(ii) the occupation class shown onyour policy schedule is not AAA,MP or LP and a workerscompensation payment or otherlegislated payment is received inrespect of loss of income and incalculating the payment therelevant tribunal or authority didnot or could not take into accountentitlements under this policy.

In these circumstances:

(i) your Total Disability Benefit may bereduced so that it, together withthe aggregate of those monies,does not exceed 75% of your Pre-Disability Earnings;

(ii) if a payment is a lump sum, it willbe converted to income on thebasis of 1% of the lump sum foreach month that a benefit is paidto you for a maximum of sevenyears, and the maximum benefitwill be calculated taking this figureinto account; and

(iii) your Partial Disability Benefit maybe reduced so that the total of yourMonthly Earnings and your monthlyPartial Disability Benefit (as limitedby this condition) is not greaterthan 100% of your Pre-DisabilityEarnings.

Your benefit will not be affected byany amounts you receive from:

(i) lump sum or income benefits underother insurance policies, except asdescribed above; or


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(ii) lump sum or income benefits underany retirement or superannuationfund (including government andstatutory funds), provided that ifthese policies or funds existed at thetime of the policy commencementdate or its reinstatement, all detailswere fully disclosed.

When your Total Disability Benefit orPartial Disability Benefit is reduced inaccordance with this condition, aproportionate refund of premiums paidwill be made. The refund will be:

A x B x C

where: “A” is the percentagereduction in the benefit; and “B” isyour average monthly premium overthe 12 months prior to Total Disability;and “C” is the lesser of the number ofmonths your policy was in force beforeyour claim started and 12.

For Indemnity Policies Only

If you have an indemnity policy, themaximum amount payable under theTotal Disability Benefit and PartialDisability Benefit will be reduced if:

(i) you are eligible to receive benefitsfrom a disability insurance policy or salary continuance policy fromus or any other insurer or througha superannuation fund; or

(ii) you are eligible to receive anyincome provided by or arranged byan employer, partnership orbusiness including sick leave; or

(iii) a workers compensation paymentor other legislated payment isreceived in respect of loss ofincome and in calculating thepayment the relevant tribunal orauthority did not or could not takeinto account entitlements underthis policy.

In these circumstances:

(i) your Total Disability Benefit may bereduced so that it, together withthe aggregate of those monies,

does not exceed 75% of Your Pre-Disability Earnings;

(ii) if a payment is a lump sum, it willbe converted to income on thebasis of 1% of the lump sum foreach month that a benefit is paidto you for a maximum of 7 years,and the maximum benefit will becalculated taking this figure intoaccount; and

(iii) your Partial Disability Benefit maybe reduced so that the total of yourMonthly Earnings and yourmonthly Partial Disability Benefit (as limited by this condition) is notgreater than 100% of your Pre-Disability Earnings.

Your benefit will not be affected byany amounts you receive from:

(i) lump sum or income benefits underother insurance policies, except asdescribed above; or

(ii) lump sum or income benefits underany retirement or superannuationfund (including government andstatutory funds), provided that ifthese policies or funds existed at thetime of the policy commencementdate or its reinstatement, all detailswere fully disclosed.

Concurrent benefitsOnly one of the Total Disability Benefit,Partial Disability Benefit, CriticalConditions Benefit, Nursing CareBenefit, Accident Benefit or ScheduledInjury Benefit is payable at any one time.

Payment of benefitsBenefits are payable to you monthly inarrears except for the Scheduled InjuryBenefit and the Critical ConditionsBenefit which are payable in advance.Benefits for periods of less than onemonth will be paid pro rata based on a30 day month.

Definitions The following defined terms are used above:

Benefit Period ends on the first tooccur of:

� the expiry of the Benefit Periodshown on your policy schedule;

� the date on which your Disability ceases;

� the Expiry Date as shown on yourpolicy schedule;

� the date of your death, or

� the termination of the policy.

Business Expenses are regular orcontinuing fixed expenses incurred by your business whether you areworking or not and which are not a payment of capital or of a capital,private or domestic nature, and couldnot reasonably be considered to give a private benefit to you, members ofyour family or any company, trust orother entity from which you or yourfamily derive a benefit. Your share ofthese payments will be that which isapportionable to you in line with theusual manner that the profits and/orlosses of your business are divided.

Deemed Disability means that whilstthe policy is in force you have sufferedone of the Scheduled Injuries see page22 (or a Critical Condition if your policyis Gold see page 23).

Disability or Disabled means TotalDisability or Partial Disability as thecontext requires.

Injury means an accidental bodilyinjury you suffer whilst your policy is in force.

Monthly Earnings is

(a) where you do not directly orindirectly own the business orprofessional practice from whichyou earn your regular income:

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the total monthly value of yourremuneration in respect of theperformance of your regularoccupation.

It includes:

salary, fees, commission, bonuses,regular overtime, and fringe benefits.

It will be determined by calculatingthe amount you could be expectedto receive if your total remunerationwas received as a salary or wage(before income tax is deducted);

(b) when you do directly or indirectlyown all or part of the business orprofessional practice from whichyou earn your regular income:

the income earned by your businessdirectly due to your personalexertion or activities less your shareof the necessarily incurred BusinessExpenses and costs for thatbusiness or professional practice,calculated on a monthly basis.

Partial Disability or PartiallyDisabled means that solely because ofSickness or Injury:

(i) you are not capable of doing atleast one of the duties of yourregular occupation; and

(ii) you are working in your regularoccupation on a partial basis, or youare working in another occupation,or you are capable of working inyour regular occupation on a partialbasis but you are not working; and

(iii) your Monthly Earnings are less thanyour Pre-Disability Earnings; and

(iv) you are following the advice of a Medical Practitioner.

If you were unemployed for more thantwelve (12) months immediately beforebecoming Disabled, then “your regularoccupation” in part (ii) will be replaced

by “an occupation for which you arereasonably suited by education,training or experience.”

Pre-Existing Condition is a sickness,disease or physical condition for whichsymptoms existed, that would cause areasonable person to seek diagnosis,care or treatment from a medicalpractitioner, before the commencementdate, date of reinstatement or the datean improvement is offered under theupgrade guarantee.

For any Pre-Existing Condition to becovered under the policy you must havetold us about it in your application.

Sickness means a sickness or diseaseyou suffer and which becomesapparent after the commencementdate, or which is disclosed in yourapplication.

For agreed value policies, thefollowing definitions apply:

Pre-Disability Earnings is the greater of:

(a) your Monthly Earnings for thetwelve (12) months immediatelyprior to the Commencement Date,and

(b) your Monthly Earnings for anyconsecutive twelve (12) months inthe three years immediately prior tothe date Disability commences.

When you are disabled, this figure willbe increased every twelve (12) monthsfollowing the date of commencementof Disability by the percentage changein the Consumer Price Index.

Total Disability or Totally Disabledmeans that solely because of injury orsickness:

(a) you are not capable of doing atleast one of the important incomeproducing duties of your regularoccupation, and

(b) you are not working in any gainfuloccupation, and

(c) you are following the advice of amedical practitioner.

For indemnity policies, thefollowing definitions apply:

Pre-Disability Earnings are calculatedas follows:

Where you do not directly or indirectlyown all or part of the business fromwhich you earn your regular income,your average Monthly Earnings overthe twelve months immediatelypreceding the date of Disability.

Where you do directly or indirectly ownall or part of the business from whichyou earn your regular income, youraverage Monthly Earnings based onthe financial evidence required fortaxation purposes for the tax year priorto the date of Disability.

Total Disability or Totally Disabledmeans that solely because of Injury orSickness:

(a) you are not capable of doing atleast one of the important incomeproducing duties of your regularoccupation; and

(b) you are not working in any gainfuloccupation; and


However if you have been receivingpayments under the Total DisabilityBenefit for two years (including as aresult of the Recurrent Claim Benefit)then part (a) of the above definition isreplaced by: “you are unable to workin any occupation for which you arereasonably suited by training,experience or education; and”.


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Making a claimNotice of claimWritten notice of a claim for a DisabilityBenefit must be given to us within 30days of you becoming disabled. We willthen send you the necessary claim form.

You and your doctor must completethe claim form and return it to uswithin 60 days of the beginning of aperiod of Disability for which benefitsare being claimed. You will beresponsible for any costs incurred incompleting the claim form.

No benefit will be payable in respect ofany period more than 60 days prior to usreceiving the claim form or any progressclaim form we may issue, unless yourDisability is such as to prevent you frominforming us within the 60 day period.

Level of coverMinimum Sum Insured$1,000 per month.

Maximum Sum Insured 75% of first $250,000 p.a. of grossincome after Business Expenses,

50% of next $100,000 p.a. of grossincome after Business Expenses, and

40% of gross income p.a. afterBusiness Expenses thereafter.

Subject to a maximum Sum Insured of$20,000 per month.

Termination of policyYour policy terminates on the earliestof: the Expiry Date shown on theschedule, or the death of the lifeinsured, or when we receive yourwritten request for cancellation, or ifany required premium or instalment isnot paid by the due date. Your policywill cease thirty 30 days after we giveyou notice of cancellation, if thepremium remains unpaid. Where thebenefit period to age 70 has been hasbeen chosen, the policy terminates at

the policy anniversary prior to age 65,but claim payments may continue pastthat date, as explained on page 20.

ExclusionsThere are certain exclusions that applyto your policy. Exclusions arecircumstances in which we are notrequired to pay the benefits under the policy.

The policy does not apply to or coverany Disability caused by:

(a) war, or an act of war; or

(b) intentional self injury, or attemptedsuicide; or

(c) pregnancy, childbirth or miscarriageunless Disability continues for morethan three months after the end of the pregnancy. When this occursthe date of Disability will be takenas being the date of the end of the pregnancy;

(d) your participation in a criminalactivity or your incarceration.

In addition, regardless of whether ornot there is a connection between yourDisability and your incarceration, benefitswill not be paid in relation to any periodduring which you are incarcerated.

Criminal activity means any activity givingrise to your conviction and incarceration.Incarceration means confinement in ajail of any description (including aprison farm or remand centre).

If your policy is an indemnity policy, a further exclusion applies. Benefits inrespect of any mental disorder will berestricted to a cumulative total of 2 years,excluding any period of confinement ina hospital or other health institution.Mental disorder includes, but is notlimited to, anxiety, depression, stress,fatigue, exhaustion, fibromyalgia,physical complication of psychiatricdisorders, drug or alcohol abuse,cognitive impairment, behaviouraldisorders, or complications of any of them.

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Aviva Protection – Income Business Expenses provides you with incomecover for your business expenses if you are disabled. If you are unable towork because of a sickness or injury you will receive a monthly benefit forup to one year after the waiting period for any one claim.

This policy can only be held in conjunction with an approved AvivaProtection Income Gold or Income Excell policy

This policy is ‘guaranteed renewable’.This means that, provided you pay thepremiums, you can renew your covereach year until the policy expiry datewithout having to provide furthermedical evidence.

When you apply for the policy, youchoose the amount of incomereplacement you require. This is calledthe monthly Sum Insured. In additionto selecting the monthly Sum Insured,you must also select a Waiting Period.

Monthly BenefitWhen you take out a policy, younominate a monthly Sum Insured,which may be up to 100% of yourBusiness Expenses listed in yourapplication.

Waiting PeriodYou must choose a Waiting Periodwhen taking out the policy. TheWaiting Period is the period you mustwait before benefits become payable.You can choose a Waiting Period of 14 or 30 days.

The benefits and featuresKey terms used in this section aredefined on pages 29 and 30; pleaseread those definitions carefully.

Total Disability BenefitIf you are Totally Disabled, we will payyou a monthly Total Disability Benefitequal to the Business Expenses listed inyour application that are actuallyincurred for that month, up to theMaximum Monthly Benefit. If youmake a claim you need to provide

evidence of your Business Expensesincurred for that month.

Partial Disability BenefitIf you are Partially Disabled, a monthlyPartial Disability Benefit will be paid to you if gross business income (that is, the income of the businessbefore expenses and tax) falls below Business Expenses as a result of your Partial Disability.

The Partial Disability Benefit is thedifference between the monthly grossbusiness income (or what you couldreasonably, be expected, as agreedbetween you and us, to contribute tothe monthly gross business income)and your monthly Business Expenses,up to the Maximum Monthly Benefit.

It is paid monthly in arrears and will stopat the end of the benefit period or whenyou cease to be Partially Disabled orwhen your monthly gross business

Aviva Protection – Income Business Expenses – A snapshot of what yourcover includes


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income equals or exceeds your monthlyBusiness Expenses, whichever first occurs.

Payment of the Total Disability Benefitand the Partial Disability Benefit will bemonthly in arrears. The benefits will onlybe payable if gross business income hasexceeded Business Expenses for theprevious 12 months, and it would bereasonable to assume that would havecontinued to be the case if you had notsuffered a disability.

If the Total Disability Benefit or PartialDisability Benefit payable under thispolicy, together with any benefitpayable under any other disabilitypolicy deemed to be business expensesinsurance, exceeds in any month theeligible Business Expenses which areincurred during that month, then theBenefit will be reduced by the excess.

Death Benefit If you die while you are receiving anybenefit under policy, the Death Benefitwill be paid.

The death benefit is twelve (12) timesthe monthly Sum Insured, less anyamounts already paid in respect of thecurrent claim, up to a maximum of$60,000, and is paid upon proof ofdeath. This will be paid as a lump sumto the policy owner. Payment of theDeath Benefit means that no otherbenefits are payable.

Extension of benefit periodIf Total Disability Benefits have beenpaid for a period of twelve (12) months,the benefit period may be extended ifthe total amount paid is less thantwelve (12) times the monthly SumInsured. The period of extension will be:

� for six (6) months; or

� until Total Disability ceases; or

� until the total amount paid equals 12times the monthly Sum Insured; or

� until the Expiry Date as shown onyour policy;

whichever occurs first.

Waiver of PremiumAfter you have been disabled forlonger than the Waiting Period we will waive all premiums payable underyour policy for the period you continueto receive either the Partial or TotalDisability Benefit.

Recurrent Claim BenefitThe Recurrent Claim Benefit isdescribed on page 21.

The following additional features are explained on page 31:


DefinitionsThe following defined terms are used above:

Benefit Period ends on the earlier of:

� the expiry of the Benefit Periodshown on your policy;

� the date on which your disabilityceases;

� the Expiry Date as shown on yourpolicy;

� the date of your death; or

� the termination of the policy.

Business Expenses consist of thefollowing expenses: rent, regularinterest instalment payment onbusiness mortgage or loan, electricity,gas, water, heat, laundry, telephone,cleaning, business property rates andtaxes, non-income producingemployees’ salaries and costs directlyrelated to salaries, (e.g. superannuationand other such fixed expenses whichare normal in the operation of yourprofession, business or occupation).They do not include salary, fees,drawing account or any otherremuneration for you or yourreplacement or members of yourfamily or person who is not your

employee or the salaries of employeeswho generate income for yourbusiness or the cost of goods orequipment used in your profession,business, or occupation, depreciationof real estate or payments of principalon business mortgages or loans.

Maximum Monthly Benefit payableunder the policy is the lesser of:

(i) the monthly Sum Insured, and

(ii) one twelfth part of the BusinessExpenses actually incurred by youin the operation of your profession,business or occupation during thetwelve months immediatelypreceding your Total Disability and which continue during thatTotal Disability.

Partial Disability or PartiallyDisabled means that solely because ofSickness or Injury:

(a) You are not capable of doing atleast one of the duties of Yourregular occupation; and

(b) You are working in Your regularoccupation on a partial basis, orYou are working in anotheroccupation, or You are capable ofworking in Your own occupation ona partial basis but You are notworking; and

(c) your gross business income or yourshare of the gross business incomeis less than your Business Expensesbecause of the sickness or injurywhich caused your Total Disability;and

(d) You are following the advice of aMedical Practitioner.

Pre-Existing Condition is a sickness,disease or physical condition for whichsymptoms existed, that would cause areasonable person to seek diagnosis,care or treatment from a medicalpractitioner, before the date the policycommenced, the date of reinstatementor the date an improvement is offeredunder the upgrade guarantee.

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Aviva Protection – Income Business Expenses continued

For any Pre-Existing Condition to becovered under the policy you must havetold us about it in your application.

Total Disability or Totally Disabledmeans that solely because of injury or sickness:

(a) you are not capable of doing atleast one of the important incomeproducing duties of your regularoccupation, and

(b) you are not working in any gainfuloccupation, and


Level of cover Minimum sum insured$1000 per month

Maximum sum insuredUp to 100% of the eligible BusinessExpenses

Termination of policyYour policy will automaticallyterminate on the earliest of the ExpiryDate as shown on the policy schedule,the death of the life insured, when wereceive your written request forcancellation, or when you cease to beresponsible for any expenses incurredby any business for a period of at leastsix months, or if any required premiumor instalment is not paid by the duedate. Your policy will cease thirty 30 daysafter we give you notice of cancellation,if the premium remains unpaid.

We may also cancel your policy if youcease to have an Aviva Protection –Income Gold or Income Excell policy with us.


This policy does not apply to or coverany disability caused by:

(a) war, or an act of war; or

(b) intentional self injury, or attemptedsuicide; or

(c) pregnancy, childbirth or miscarriageunless Disability continues for morethan three months after the end ofthe pregnancy. When this occursthe date of Disability will be takenas being the date of the end of thepregnancy;

(d) your participation in a criminalactivity or your incarceration.

In addition, regardless of whether or notthere is a connection between yourdisability and your incarceration, benefitswill not be paid in relation to any periodduring which you are incarcerated.

Criminal activity means any activitygiving rise to your conviction andincarceration. Incarceration meansconfinement in a jail of any description (including a prison farm or remand centre).

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Aviva Protection – Flexible RecoveryMoney

Aviva Protection – Stand AloneRecovery Money



Aviva Protection – Income BusinessExpenses

Indexation BenefitEach policy automatically providesincreases in the benefits by the greaterof the percentage increase in the CPI or3%, without further medical evidence.

The increases are applied on eachpolicy anniversary. You have the rightto refuse an increase in any year. Youmay cancel the Indexation Benefit atany time.

Unless specified below there are norestrictions upon the amount of coverthat may be indexed.

The maximum initial death Sum Insuredthat can be indexed is $3,000,000.

The maximum initial critical illness Sum Insured that can be indexed is$1,000,000.

Where the Business Protection Optionhas been selected the IndexationBenefit is not available.

Upgrade GuaranteeShould we improve the benefits underthe policy, where such improvementsresult in no increase in premium rates,we will automatically add these benefitimprovements to the policy.

The benefit improvements will notapply to claims:

(a) where the illness was diagnosed orinvestigated; or

(b) where the injury occurred

prior to the effective date of theimprovement.

Should a situation arise where apolicyholder is disadvantaged in anyway as a result of an improvement,then the previous benefit wording will prevail.

24 hour world-widecoverEach policy provides 24 hourworldwide cover.

Interim Accident Cover Interim Accident Insurance coverprovides cover against:

“Accidental Death” – for AvivaProtection – Life and Aviva Protection –Recovery Money applications.

“Accidental Critical Injury” – for AvivaProtection – Recovery Money, AvivaProtection – Flexible Recovery Moneyand Aviva Protection – Stand AloneRecovery Money applications and AvivaProtection – Life with Disability benefitapplications.

“Accidental Total Disability” – for AvivaProtection – Income applications

What types of accidents are covered?A benefit will only be available if theaccident causing your death, criticalinjury or disability occurs after thecommencement of the interim coverand prior to the termination date.

The death, critical injury or totaldisability must be caused solely anddirectly by violent accidental externaland visible means, independently ofother causes, and satisfy the conditionsset out below.

Commencement of coverInterim Accident Cover commences atthe later of the date of receipt of acompleted proposal by us; and thereceipt of the first or deposit premium.In circumstances where our practice isthat a deposit premium is not required,a completed and valid Periodical DebitAuthority or Credit Card authority isrequired. Interim Accident Cover is notprovided if payment authorities are nothonoured.

Termination of coverInterim Accident Cover ceases at thefirst to occur of:

� 90 days elapsing aftercommencement of the Interimcover

� the application is accepted by our underwriters and a policydocument is issued

� you are notified that ourunderwriters have declined yourapplication

� the application is withdrawn

� 21 days elapsing after you areoffered cover on loaded or variedterms, if you haven’t acceptedthose terms in writing.

Additional features – all products

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Additional features – all products continued

Conditions of cover1. General conditions

No benefit is payable if:

� the policy applied for is to replaceinsurance cover or anotherapplication on your life; or

� the death, critical injury or totaldisability arises from suicide,attempted suicide or otherintentional self-inflicted injury; or

� either you or the proposer hasfailed to comply with the Duty ofDisclosure as set out on theApplication Form.

We will pay only one Interim AccidentBenefit and the benefit will be reducedby any Interim Accident Benefits or similar payable under any otherinsurance proposals to other companies.If the client has proposed for bothIncome and Business Expenses cover,only one Interim Accident Benefit is payable.

2. Conditions specific to Accidental Death

Death must occur within 90 days ofthe accident.

The benefit payable is the lower of$1,000,000 and the proposed deathSum Insured.

3. Conditions specific to Accidental Critical Injury

“Accidental Critical Injury” means yousuffer one of the following criticalinjuries, for the first time, as a result ofand within 90 days of an Accident:

Blindness, Coma, Deafness, MajorBurns, Major Head Trauma, Paralysisand total and irrecoverable loss of theuse of two limbs, as defined on pages44 to 47.

The benefit payable is the lower of$500,000 and the proposed disabilitySum Insured or critical illness SumInsured, as appropriate. The Buy BackOptions do not apply to AccidentalCritical Injury.

4. Conditions specific to Accidental Total Disability

“Total Disability” has the samemeaning as in the relevant policydocument. No benefit is payable:

� if the Total Disability arises from anact of war, or

� in respect of any Pre-existingcondition, or

� if the occupation or pastimes of theperson to be insured would not beaccepted for cover by us under ournormal underwriting guidelines.

The benefit payable is the lower of$5,000 per month and the proposeddisability Sum Insured. The benefit ispayable each month that you remaincontinuously Totally Disabled after theend of the applied for waiting period,up to a maximum of 12 months.

The total monthly benefit will notexceed 75% of Pre-Disability Earningsfor Income Gold or Excell and the LifeInsured’s actual Business Expenses for Income Business Expenses, taking into account all other disability benefits payable.

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Holding your policy in your superannuation fund

In consultation with your financialadviser you may decide to hold yourAviva Protection – Life policy as part ofyour superannuation arrangements.

If you hold your policy through asuperannuation fund, the policy will beowned by the Trustee of thesuperannuation fund and you will bethe life insured. Benefits will be paid tothe Trustee.

The Trustee will determine how thebenefits may be paid to you inaccordance with the relevant TrustDeed and superannuation law. If anypart of the superannuation benefit isrequired to be preserved, then it mustbe held in a superannuation fund untilyou reach the preservation age orsatisfy a condition of release (asdefined on page 34).

For superannuation policies, the deathbenefits may, at the discretion of theTrustee and with the consent of thebeneficiary, be payable as a pension.

We can arrange for your policy to be held by the NUST which is acomplying fund under theSuperannuation Industry (Supervision)Act 1993 (“SIS”).

To apply for membership of the NUST you will need to complete the application form contained onpage 63.

Alternatively, you can arrange for yourpolicy to be held through anothercomplying superannuation fund ofwhich you are a member. To do so, youand the Trustee of the fund will needto complete the application on page 64.

We do not provide insurance cover fornon-complying superannuation funds.If your fund ceases to be a complyingfund at any time, you must notify usimmediately, and we may cancel thepolicy. However, we will offer to cover the life insured under a non-superannuation policy owned by youor any alternative party you nominate.

Nomination of beneficiariesBinding Nominations

You can direct the Trustee of yoursuperannuation fund as to how yourbenefits are to be distributed on yourdeath. If you hold your policy in theNUST, you can make a Binding Death Nomination. You may specifydependants and/or your estate as beneficiaries and nominate theappropriate proportion of your benefitspayable to each. If you wish to make aBinding Death Nomination, youcomplete the form on pages 73 to 76.

Non Binding Nominations

If you do not make a Binding DeathNomination, the Trustee of yoursuperannuation fund must consider all known dependants and your legalpersonal representative whendetermining the distribution of death benefits.

A non-binding nomination will guidethe Trustee as to your wishes, but willnot be binding on it. The Trustee hasabsolute discretion to determine whowill receive the death benefits.

Dependants will include a spouse,including de facto spouse, children orany person maintained by the memberas his/her child, or a person withwhom a member shares an‘interdependency relationship’ and anyother person substantially financiallydependent on the member at time ofdeath.

Two persons have an interdependencyrelationship if: (a) they have a close personal

relationship; and(b) they live together; and(c) one or each of them provides the

other with financial support; and(d) one or each of them provides the

other with domestic support andpersonal care.

(If they have a close personalrelationship but either or both of themsuffer from a physical, intellectual orpsychiatric disability such that thedisability is the reason they cannotsatisfy the other requirements above,they still have an interdependencyrelationship).

If you hold your policy through NUST,you may elect to make a non—bindingnomination by completing the form onpage 63.

Superannuation-owned life insuranceUsing a superannuation fund to own a life insurance policy can provide atax deduction or spouse rebate for thepremiums in the right circumstances.However it is unlikely that criticalillness cover can be owned by thesuperannuation fund and theownership of this disability coverneeds to be considered carefully basedon individual circumstances.

The flexibility of the Aviva range ofsolutions provides three alternativeways of structuring the estate plan.

Continuation featureIf your Aviva Protection – Life policy hasbeen set up under a superannuationfund it will usually expire by the policyanniversary before your 70th birthday.If you wish to continue your cover, youhave 3 months to apply for a deathcover under a new non-superannuationAviva Protection – Life policy for thesame Sum Insured without having toprovide further medical evidence.

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Conditions of releaseBenefits accruing in a superannuationfund cannot normally be paid out toyou until:

� You leave employment after age60; or

� You permanently retire from theworkforce on or after yourpreservation age as shown in thetable below:

Date of birth on Preservationor between age

Before 1 July 1960 55

1 July 1960 and30 June 1961 56

1 July 1961 and 30 June 1962 57

1 July 1962 and 30 June 1963 58

1 July 1963 and 30 June 1964 59

On or after 1 July 1964 60

A benefit may be paid before this if youdie, suffer permanent incapacity, suffersevere financial hardship (as determinedby law), or on compassionate grounds(determined by the relevantGovernment authority).

Please note that not all claims forDisability Benefits will necessarily meetthe definition of permanent incapacityunder superannuation law. Where thisis the case the monies will be held inthe fund until you satisfy anothercondition of release.

The preservation rules are unlikely toaffect you if your superannuationbenefits consist only of death cover.

Tax File NumbersWhere your policy is held in the NUST,the trustee is required to request you toprovide your Tax File Number (“TFN”).

If you do not provide the trustee withyour Tax File Number:

� the trustee is required to deducttax at the highest marginal rate,plus the medicare levy on both thepre-1 July 1983 component andthe post-30 June 1983 componentof any ETPs paid.

� it may be more difficult to find yoursuperannuation benefits if youchange address without notifyingyour fund or to amalgamate anymultiple superannuation accounts.

� the superannuation ‘surcharge’may apply to your superannuationcontributions, even if your‘Adjusted Taxable Income’ is below$99,710 (see ‘SuperannuationContribution Tax (surcharge)’ on page 38).

The basic concept used to determinewhat is paid for insurance is thematching of the cost to the risk.Equitably priced insurance isdependent on grouping togetherpeople with similar characteristics; age,sex, health, occupation and otherfactors, (such as amount of coverrequired and how long the benefitswill be paid for).

That is why applications for insurancecontain such a variety of questions andwhy insurers seek the most completeinformation on your medical history,occupation and pastimes – so that youpay the most equitable premium.

Aviva’s Protectionfirst range gives youaccess to a wide range of featuresincluded in the standard price, togetherwith many options that are available foran additional cost. Your financialadviser can provide exact costs forcover for your individual needs.

In these uncertain times it is prudent tospend a small amount of currentincome to help protect future wealth.In taking out Aviva Protectionfirst youhelp ensure your financial security,should the worst happen.

Premiums and charges PremiumsWe will determine your premiumaccording to a scale of rates thatapplies to all clients with policies basedon that scale. Your premiums will bebased upon the type and level of coveryou choose along with various factorssuch as your age, gender, health,lifestyle, occupation and whether ornot you are or have been a smoker.

For more details about premiums or toobtain a quotation for insurance,please contact your financial adviser.

Application for the Aviva Protectionfirstrange can only be made after youreceive a premium quotation from youradviser, a copy of which must

accompany your application form. Wewill not accept an application that doesnot have the quotation attached to it.

The quotation is subject to underwritingreview and risk assessment before issueof a policy. Consequently, we may issueto you a revised premium quotation andrequest you to submit an amendedproposal for your application.

Where premium payments are receivedmore frequently than annually, aloading of 5% of premium and policyfee for half yearly payments, and 8%of premium and policy fee for all otherpayments, is applied.

The premium scale is also adjusted byreference to the selected Sum Insured.A loading is applied where the SumInsured is less than the amount set outbelow.

Page 35 of 76

Charges

PremiumProduct type Sum insured loading

Life Protection Death less than $250,000 20%Death $250,000 to $499,999 10%

Recovery Money Death less than $250,000 20%Death $250,000 to $499,999 10%

Stand Alone Recovery Money Critical Illness less than $250,000 20%Critical Illness $250,000 to $499,999 10%

Flexible Recovery Money No loading applies

Income Protection Monthly Benefit less than $1,500 5%

Life, Recovery Money, FlexibleRecovery Money and Stand AloneRecovery Money policies only:

Two options are available:

Stepped PremiumsIf you choose stepped premiums, yourpremium will be recalculated eachpolicy anniversary based on your ageand/or any increase in the Sum Insuredas a result of indexation increases

Level PremiumsIf you choose level premiums, your premium is calculated at thecommencement of the policy. Yourlevel premium may change if there isan alteration to your Sum Insured andwill automatically change to a steppedpremium at the policy anniversarypreceding a certain age, which isnominated by you. The choices are anyof the 55th, 60th or 65th birthday.

Note: The minimum term for the levelpremium option is five years.

Income policies only:

Two options are available:

Stepped PremiumsIf you choose stepped premiums, yourpremium will be recalculated eachpolicy anniversary based on your ageand/or any increase in the Sum Insuredas a result of indexation increases

Level PremiumsIf you choose level premiums, your premium is calculated at thecommencement of the policy and maychange if there is an alteration to yourSum Insured.

Minimum PremiumsThe following minimum premiumrequirements apply:

Life, Recovery Money, FlexibleRecovery Money and Stand AloneRecovery Money policies only:

Stepped premium $200 plus policy fee.The minimum premium does not applyif the death Sum Insured (whereapplicable) is $200,000 or greater

Level Premium $500 plus policy fee.The minimum premium does not applyif the death Sum Insured (whereapplicable) is $300,000 or greater

Income policies only:

Minimum premium requirements donot apply for Income policies.

Policy feeAn annual policy fee applies to thepolicies, with the current fee applyinguntil 31/03/2005. The policy fee can beperiodically amended, but never at arate greater than the rate of increase inthe Consumer Price Index (“CPI”) sinceany previous amendment in the policyfee for equivalent policies.

The policy fees are:

Life $89.60

Recovery Money $89.60

Flexible Recovery Money $0.00

Stand Alone Recovery Money $89.60

Income (all policies) $89.60

Review of ratesWe may change the scale of rates but only if we do so for all clients with policies and premiums based on that scale.

If there are any changes to the non-government charges and fees detailedabove, you will be given three (3)months advance warning.

We do not provide a premium rateguarantee.

Page 36 of 76

Charges continued

Stamp duty rates

For Aviva Protection – Life and AvivaProtection Recovery Money the StateGovernment Stamp Duty rates arecurrently payable by us out of the premium and no separate fee is charged.

In respect of all other policies we willadd the amount of these duties set outbelow to the premium payable.

% of State premium

ACT 10%

Victoria 10%

South Australia 11%

Western Australia 10%

New South Wales 5%

Queensland 7.5%

Tasmania 8%

Northern Territory 10%

Government taxes and chargesWe reserve the right to charge anygovernment tax, licence fee, stampduty or impost relating to your policyat any time during the life of the policy.We may also increase the premiumrates as a result of changes to or theintroduction of Government taxes and charges.

Goods and Services TaxGoods and Services Tax (“GST”) is notpayable on the premiums on yourpolicy.

Termination for non-paymentIf you have not made payment within30 days from the due date or from thedate of notice to pay, (whichever islater), your cover will cease with effectfrom when the premium was due andno benefits will be payable.

Surrender valuePremiums paid are used to cover the risks and expenses incurred inmanaging the policy and consequentlythe policies do not have a surrender orcash value.

Statutory FundThe premiums for your AvivaProtectionfirst policy will form part ofNULAL’s Number 1 Statutory Fund andinsurance claims will be paid from thatfund.

Page 37 of 76

Charges continued

Taxation –superannuationThe following information is of ageneral nature only. For more detailson your tax situation, please consultyour financial adviser.

Tax deductions forcontributionsAll employer contributions are fully taxdeductible up to limits set by theGovernment. These limits are set out inthe following table:

Maximum deductible

Age contributions*

Under 35 years $13,934

35 to 49 years $38,702

50 years & over $95,980

If you are self-employed or substantiallyself-employed, you may be able to

claim a tax deduction in respect ofsome or all of your contributions.

You should consult your financialadviser to determine your eligibility.

If your policy is held in the NUST, at theend of the financial year, NULAL (asadministrator of the NUST) will ask youto complete a form (section 82AATNotice) indicating the amount youintend to claim as a personal taxdeduction. The trustee of the NUST will acknowledge receipt of this Noticein writing, in order for you to claim a tax deduction.

Rebate for contributionsmade in relation to a spouseA rebate is available where both thetaxpayer and the spouse are Australianresidents and the assessable income ofthe spouse is less than $13,800 in thefinancial year in which contributionsare made.

Tax on contributionsAll employer contributions or

contributions which are being claimedas a tax deduction by the contributor,less cost of insurance and certainother charges, are taxed at 15% as income of the superannuationfund. Where the policy is held in the NUST, the trustee will deductappropriate amounts from themembers’ accounts. This will be nil for contributions used wholly for thepayment of term insurance premiums.

SuperannuationContributions Tax (surcharge)This tax applies to your ‘surchargeablecontributions’ if your ‘Adjusted TaxableIncome’ (‘ATI’) exceeds $99,710*. As a general rule, ATI equals taxableincome plus surchargeablecontributions plus reportable fringebenefits. Surchargeable contributionsare generally employer contributions,deductible personal contributions anda portion of a rolled over employer ETP(Golden handshake).

The portion of an employer ETP usedto calculate your adjusted taxable

Page 38 of 76

Taxation

*These amounts apply to the 2004/2005 financial year and are indexed annually by Average Weekly Ordinary Time Earnings

Cover type Tax treatment of premiums Tax treatment of benefits

Death Benefits Generally not deductible Generally not taxable

Total & Permanent Disablement (TPD) Generally not deductible Generally not taxable

Critical Illness Benefit Generally not deductible Generally not taxable

Income Protection Benefit Generally deductible Generally treated as assessable income

This section contains general information about significant tax implicationsrelating to non-superannuation and superannuation Aviva Protectionfirst products.

The following taxation summary is a general statement only, and individualcircumstances may be quite different. The following tax interpretation reflects ourcurrent understanding of the tax laws as at the issue date of this document.

Taxation – non-superannuation

We do not deduct tax from your income protection benefit payments, it is yourresponsibility to declare this as assessable income.

income will vary depending on the formin which you take your benefit and thedate on which you take your benefit.

The maximum tax rate of 12.5% ispayable where ATI is $121,075* ormore. Between $99,710* and$121,075*, the 12.5% is phased in.

The Tax Office calculates the surcharge.

The ‘surcharge’ tax is complicated andyou should consult your financialadviser for more details about how itaffects your situation.

If your policy is held in the NUST andthe trustee receives an assessment inrespect of contributions to pay terminsurance premiums, the trustee willapply any tax against any other benefitaccounts you have in the NUST, first. If sufficient funds are not available, we may seek reimbursement directlyfrom you, so that premiums maycontinue to be paid by the trusteefrom contributions received.

When the policy is owned by asuperannuation fund other than theNUST, it is the responsibility of the fundto ensure all requirements relating tocontribution tax and surcharge arecomplied with.

Taxation of Death andDisability BenefitsDeath BenefitsConcessional taxation may apply onDeath Benefits paid to dependants.

See ‘dependent’ on page 33, butchildren over age 18 are notautomatically ‘dependents’ for taxconcession on death benefit payments.

All Death Benefit payments made on or after 1 July 1994 are subject tothe Reasonable Benefits Limits (RBL). Death Benefits are tested against yourpension RBL. The pension RBL for2004/2005 is $1,238,440. Someindividuals may have a higherTransitional RBL.

Death Benefits paid as a pensionreceive concessional tax treatment.

Disability BenefitsIf the trustee of the superannuationfund in which your policy is held is able to release your Disability Benefitbecause you fulfil the permanentincapacity requirements ofsuperannuation legislation, yourbenefit may also qualify forconcessional treatment as ‘InvalidityBenefits’. A ‘Post-June 1994 InvalidityComponent’ may be calculated. Thiscomponent is tax-free. It can be rolledover but will not be counted againstyour RBL.

The remainder of the Disability Benefitis treated as an ordinary eligibletermination payment and is taxedaccordingly, dependent upon thevarious eligible termination paymentcomponents.

If the trustee is unable to release theDisability Benefit received from aparticular policy, the moneys will beheld in the fund until you retire afteryour preservation age, or leave anyparticular employment after age 60. At the time of payment, the benefitwill be treated as an ordinary eligibletermination payment and will be taxedaccordingly dependent upon variouseligible termination paymentcomponents.

The taxation position detailed is ageneral statement only and individualcircumstances may be quite different.The above tax interpretation reflectsour current understanding of the taxlaws as at the date of this document.You should consult your financialand/or taxation advisers, in respect ofyour specific circumstances.

Page 39 of 76

*These amounts apply to the 2004/2005 financial year and are indexed annually by Average Weekly Ordinary Time Earnings

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This section provides information about the dispute resolution system coveringcomplaints and how the system may be accessed.

Complaints

Client concerns – non-superannuationComplaints should first be attempted tobe resolved through us. We have set upformal internal procedures for dealingwith complaints within 45 days. OurClient Support Team freecall phonenumber is 1800 037 022. We may beable to solve the problem over thephone, but if not, we will ask you to putit in writing.

If you are not satisfied with theoutcome of any complaint, or thecomplaint is not resolved within 90 days, you may contact the FinancialIndustry Complaints Service (“TheService”). The Service is totallyindependent of us and provides free,expert and impartial advice. Inquiriescan often be answered on the phonebut complaints will need to be in writing.

The Service will investigate anycomplaint within its terms of referenceand may help you resolve the problem.

The Financial Industry ComplaintsService can be contacted in Melbourneon 03 9629 7050 or on toll free 1300 780 808. Their postal address is:

PO Box 579Collins Street WestMelbourne Victoria 8007.

Fax: 03 9621 2291

Website: www.fics.asn.au

Client concerns –superannuationComplaints in relation to superannuationpolicies should first be attempted to beresolved through the relevantsuperannuation fund. For policies held inthe NUST, the trustee has set up formalinternal procedures for dealing withcomplaints within 90 days. Our ClientSupport Team phone number is 1800037 022. We may be able to solve theproblem over the phone, but if not, wewill ask you to put it in writing.

If you are not satisfied with theoutcome of any complaint, you maylodge a complaint in writing to theSuperannuation Complaints Tribunal(“SCT”). The SCT is an independentbody set up by the CommonwealthGovernment to help resolve complaintsabout decisions in relation to members(as opposed to decisions related to themanagement of the fund as a whole).

The SCT can also help you put thecomplaint in writing if required. Acomplaint can only be dealt with bythe SCT after it has been dealt with byour internal process. The SCT is locatedin Melbourne and its contact details are:

Locked Bag 3060GPO Melbourne Victoria 3001Telephone: 1300 884 114

Fax: 03 8663 5588

Website: www.sct.gov.au

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Eligibility Non-superannuation – are you eligible?

Cover type

Death Benefit 11 70 90

Disability Benefit(TPD) 17 60 90*

Critical Illness Benefit 17 60 90*

Income Protection Benefit 20 60 65

* Disability and Critical Illness Benefitdefinitions will automatically convert to theLoss of Independent Existence definition (asdefined on page 45) at the policy anniversaryprior to your 65th birthday.

i f you select the Stand Alone RecoveryMoney policy the Critical Illness Benefitceases at the policy anniversarypreceding your 65th birthday.

Superannuation – are you eligible?

Cover type

Death Benefit 18 65 70

Disability Benefit (TPD) 18 60 70*

* The Disability definition will automaticallyconvert to the Loss of Independent Existencedefinition (as defined on page 45) at the policy anniversary prior to your 65th birthday.

Contributions to a superannuationfund can be received for any memberunder the age of 65. For a memberfrom age 65 to less than 70 a

superannuation fund can only acceptmandated employer contributions,personal contributions, spousecontributions and voluntary employercontribution where you have workedat least 40 hours in any period of 30consecutive days in a financial year.Once this condition has been met, you can contribute for the rest of that financial year.

Information on your policyIf we approve your application, we will send you a confirmation of coveras required by law, copy of the policydocument and the policy schedule.These are important documents –please read them carefully and storethem with this PDS in a convenientplace. Your insurance cover is noteffective until we issue the policy.

About the InsurerNorwich Union Life Australia Limited –Insurer

Norwich Union Life Australia Limited(“NULAL”) is the issuer of the policiesoffered in this PDS.

NULAL is proud to be part of the AvivaAustralia group, which is part of theworldwide investment and insurancegroup, Aviva plc.

Aviva plc was formed in May 2000following the merger of UK companiesNorwich Union plc and CGU plc.

With offices in 30 countries, Aviva plcmanages assets in excess of $624 billion(as at 1 July 2004) and is the world’sseventh largest insurance group andthe biggest in the United Kingdom.

The Aviva Australia group is made upof two specialist companies, Norwich

Union Life Australia Limited andNavigator Australia Limited, ABN 45006 302 784, AFSL number 236466.The funds management companyPortfolio Partners Limited ABN 85 066081114, AFSL number 234483, whichoperates independently in Australia ispart of Aviva plc. Together theymanage or administer more than $17.3 billion for over 300,000customers (as at 1 April 2004).

By choosing Aviva Australia, you canbenefit from the global strength andsecurity of Aviva plc while still enjoyinga partnership with a local financialorganisation.

Postal Address:

GPO Box 2567W Melbourne Vic 3001Telephone: (03) 9829 8989

Facsimile: (03) 9820 1534

Cooling-off periodYou have 14 days from the earlier of:

� when you receive confirmation ofyour policy from us, or

� the end of the 5th day after the dayon which your policy was issued

to check that the policy meets yourneeds. This is known as the cooling-off period. Within this time you maycancel the policy (or, in the case ofsuperannuation policies, ask the trusteeof your fund to do so) without payingany charges if you notify us in writingor electronically that you wish to returnthe policy.

Note that if you cancel your policymore than 14 days after the relevantdate you may not receive a refund ofany premium you have paid.

Page 41 of 76

Other important information

This section covers important information with regards to eligibility ages for coverunder superannuation and non-superannuation Aviva Protectionfirst products. Thissection also includes details about the Insurer and Administrator, and covers yourrights under Privacy legislation.

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General PrivacyStatement – Use and DisclosurePrivacy rules covering all personalinformation held by organisationsregulate, among other matters, theway organisations collect, use, disclose,keep secure and give people access topersonal information.

In this statement ‘we’ and ‘us’ meansany or all of Norwich Union LifeAustralia Limited and each of itsrelated companies within the AvivaAustralia group.

A privacy policy describing how wemanage your personal information canbe obtained through our website,avivagroup.com.au, or by writingdirectly to us at GPO Box 2567W,Melbourne, Victoria, 3001 (Attention:Privacy Officer).

Purpose and use ofpersonal informationBy entering into and maintaining yourrelationship with us, you consent toany personal information we collectabout you being used and disclosed inthe manner set out below.

The main reason we collect yourpersonal information is to enable us toprovide to you the financial productsand services which you have asked usto provide. This also includes usingyour information:

� for our internal operations(including accounting, riskmanagement, record keeping,archiving, systems developmentand testing, staff training andcompliance monitoring);

� to help us develop, establish andadminister arrangements withother organisations in relation tothe administration and use of theproducts and services which you

have asked us to provide;

� to help us develop, identify andinform you of enhancements to theproducts and services which youhave asked us to provide (but noton the basis of any health or othersensitive information we may holdabout you);

� for research in relation to financialproducts and services;

� where relevant, to enable yourfinancial adviser and their staff toprovide you with advice andongoing service. The term ‘financialadviser’ means your currentfinancial adviser (or any otherfinancial adviser that you select), orwhere your financial advisertransfers his or her client register toanother adviser, that other adviser;

� if your employer makessuperannuation contributions onyour behalf into a product weprovide to you, to give youremployer any necessary details oftheir total contributions on yourbehalf for superannuationguarantee, taxation and fringebenefit reporting purposes; and

� in order to ensure that we complywith legislative and regulatoryrequirements, or for preventing orinvestigating crime or fraud.

We may also use and disclose yourpersonal information for the followingadditional purposes:

� to help us develop, identify andinform you of other financialproducts and services that mayinterest you (but not on the basisof any health or other sensitiveinformation we may hold about you);

� to help us develop, establish andadminister arrangements withother organisations in relation tothe promotion, administration and

use of such other products andservices;

� for marketing of financial productsand services.

If you do not wish to consent to yourpersonal information being used forthese additional purposes you can callour Client Support Team on 1800 037022 (toll free) or write to us at GPOBox 2567W Melbourne, Victoria 3001.

We may disclose your personalinformation to other members of theAviva plc Group. We may also discloseyour personal information to otherfinancial institutions and to any personwho carries out functions for us or toother organisations with whom wemay have arrangements for promotingor marketing our respective financialproducts and services including thefollowing (who will be bound byappropriate confidentiality obligations):

� your bank or other financialinstitution, for any direct debits orcredits;

� if you are a member of asuperannuation product, otherentities for the purpose of rolloveror transfer of benefits;

� entities we use for printing and/ormailing your regular statementsand reports, newsletters and othercorrespondence;

� other entities we may use foroutsourcing the administration ofthe financial products and/orservices we provide to you;

� auditors, consultants, legal oraccounting firms, reinsurers andfinancial services industry bodiesand regulators;

� debt collection agencies;

� private investigators in the event ofa claim;

Privacy statement

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� where relevant, your executor,administrator, trustee, guardian or attorney;

� third parties for the purpose offollowing up outstandinginformation in relation to yourapplication; and

� other parties to whom we areauthorised or required by law todisclose personal information.

If you do not provide personalinformation we request, or do notconsent to its use and disclosure asdescribed above, this may affect ourability to provide to you the financialproducts and services you have askedus to provide.

Access to your personalinformation You may request access to your personalinformation that we, or an outsourcedservice provider, hold in relation toyour investment with us by completinga Customer Personal InformationRequest form. The form can beobtained by writing directly to us atGPO Box 2567W, Melbourne, Victoria,3001 (Attention: Privacy Officer).

Where it is established that personalinformation we hold about you is notaccurate, complete or up-to-date, wewill take all steps necessary to correct it.

You may be charged a fee for obtainingaccess to your personal information.

Personal informationabout third partiesIf you supply us with informationabout another person, you agree toshow them a copy of this statementand to tell the person that:

� we are holding personalinformation about that person;

� personal information collectedabout that person will be used forthe primary purpose set out in thisstatement and without thatpersonal information, this purposecannot be fulfilled;

� personal information collectedabout that person will usually bedisclosed to third partyorganisations described in thisstatement; and

� the person has the right to accessand correct personal informationwe hold about him or her.

We have always treated your personalinformation with care, and have beencareful to put in place adequateprotection against inappropriate andauthorised use. This now has force oflaw and you have the right to complainto the Privacy Commissioner if youbelieve your privacy has beenbreached.

Insurance ReferenceAssociation AustraliaCertain details of insurance businessundertaken and claims received areprovided to the Insurance ReferenceAssociation Australia for the purposesof maintaining a central referencebureau for use by insurers.

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This section covers the precise medical definitions in relation to Critical Illnesscover under the Recovery Money products.

Medical Definitions

Aplastic AnaemiaMeans bone marrow failure whichresults in anaemia, neutropenia andthrombocytopenia requiring as aminimum one of the followingtreatments:

(a) marrow stimulating agents

(b) bone marrow transplantation

(c) blood product transfusions

(d) immunosuppressive agents

Benign IntracranialTumourMeans a non cancerous tumour on thebrain giving rise to symptoms ofincreased intracranial pressure such aspapilloedema, mental symptomsseizures and sensory impairment asconfirmed by a consultant Neurologist.The tumour must result in permanentneurological deficit causing at least25% impairment of whole personfunction as defined by the latestedition of the Guide to the Evaluationof Permanent Impairment, AmericanMedical Association.

The presence of the underlying tumourmust be confirmed by imaging studiessuch as CT Scan or MRI (MagneticResonance Imaging). Cysts,granulomas, cholesteatomas,malfunctions in or of the arteries orveins of the brain, haematomas andtumours in the pituitary gland or spineare not covered.

BlindnessMeans the complete and irrecoverableloss of sight of both eyes from any cause.

If the extent of sight loss is such thatcorrection measures can achieveneither Visual acuity of 6/60 or greaterin at least one eye, nor a field of visionof 10 degrees of arc or greater in atleast one eye, then this will beaccepted as Blindness.

CancerMeans the presence of a malignanttumour, including leukaemia,malignant lymphoma and otherhaemopoietic malignancies.

The tumour must be confirmed byhistological examination and must:

� Require major interventionisttherapy including radiotherapy,chemotherapy, biological responsemodifiers or any other majortreatment, or

� Be totally incurable

The following cancers are specificallyexcluded

� Tumours treated only byendoscopic procedures.

� Carcinoma in situ. PapillaryCarcinoma in situ of the breast iscovered under the Policy. DuctalCarcinoma in situ of the breast iscovered if it results in the removalof the entire breast. The proceduremust be performed specifically toarrest the spread of malignancy,and be considered appropriate andnecessary treatment.

� Prostatic cancers which arehistologically described as TNMClassification T1 (a) or T1 (b) or areof another equivalent or lesserclassification.

� Duke’s A Stage Colerectal Cancer.� All skin cancers other than

malignant melanoma of greaterthan Clark Level 2 depth orinvasion equal to or greater than1.5mm thickness.

CardiomyopathyMeans a condition of impairedventricular function resulting inpermanent physical impairment to thedegree of at least Class 3 on New YorkHeart Association Classification ofcardiac impairment.

Chronic Lung Disease Means end stage lung diseaserequiring permanent supplementaryoxygen, with FEV1 test results ofconsistently less than one litre.

ComaMeans total failure of cerebral functioncharacterised by total unarousableunresponsiveness to all external stimuli,persisting continuously with the use ofa life support system for a period of atleast ninety six (96) hours.

Coronary Artery By-Pass SurgeryMeans the actual undergoing ofcoronary artery by-pass surgeryconsidered necessary by a cardiologistto treat coronary artery disease, butnot including angioplasty, other intraarterial, or laser procedures.

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Coronary ArteryDisease Means the actual undergoing for thefirst time of Coronary ArteryAngioplasty to correct a narrowing orblockage of three or more coronaryarteries within the same procedure.

Angiographic evidence, indicating atleast 50% obstruction of 3 or morecoronary arteries is required to confirmthe need for this procedure.

A partial benefit is payable under thiscondition if the procedure is to treatone or two coronary arteries. Thepartial benefit is limited to ten (10)percent of the Sum Insured as statedon the Policy Schedule or $25,000whichever is the lesser. A partialbenefit is only payable if the SumInsured is $100,000 or more.

Partial benefits can only be paid onceunder this condition and the remainingSum Insured for death, critical illness ordisability benefits will be reduced bythe amount paid.

DeafnessMeans the total, irreversible andirreparable loss of hearing – bothnatural and assisted, in both ears as aresult of disease, illness or injury asmeasured by audiogram.

DementiaMeans a significant loss of brainfunction causing a permanent defect(e.g. Alzheimer’s Disease), as diagnosedby a consultant Neurologist. There mustbe deterioration and loss of intellectualcapacity on standard testing criteria anda need for continual care eitherprofessionally or as an in-patient.Alcohol and drug abuse are excluded ascauses of the dementia condition.

EncephalitisMeans severe inflammation of thebrain resulting in permanentneurological deficit causing at least25% impairment of whole personfunction, as defined by the latestedition of the Guide to the Evaluationof Permanent Impairment, AmericanMedical Association, as certified by aconsultant neurologist. Encephalitis asa result of HIV infection is excluded.

Heart AttackMeans death of a portion of heartmuscle as a result of inadequate bloodsupply to a relevant area. The basis fordiagnosis shall include either:

(a) New electrocardiographic changesassociated with the myocardialinfarction; and elevation of cardiacenzymes or cardiac biochemicalmarkers (such as troponin) consistentwith myocardial infarction; or

(b) Elevation of cardiac biochemicalmarkers ( such as troponin)consistent with myocardialinfarction; and a reduction in LeftVentricular Ejection Fraction below50% where measured at least 6weeks after the cardiac event.

Lesser acute coronary syndromesincluding unstable angina and acutecoronary insufficiency are excluded aspart of this definition.

If the above tests are inconclusive wewill consider other appropriate andmedically recognised tests.

Heart SurgeryMeans the actual undergoing of openheart surgery to replace or correctcardiac valves as a consequence ofheart valve defects, or to correct anynarrowing, dissection or aneurysm ofthe thoracic or abdominal aorta.

Liver DiseaseMeans chronic liver failure, togetherwith permanent jaundice, ascites orhepatic encephalopathy.

Liver damage secondary to alcoholusage or intravenous drug use isexcluded.

Loss of IndependentExistenceMeans a condition as a result of adisease, illness or injury whereby youare totally and irreversibly unable toperform at least two of the followingfive “Activities of Daily Living”:

(a) bathing and showering;

(b) dressing and undressing;

(c) eating and drinking;

(d) using a toilet to maintain personalhygiene; and

(e) moving from place to place bywalking, wheelchair or withassistance of a walking aid.

Loss of SpeechTotal and permanent loss of the abilityto produce intelligible speech, as aresult of permanent damage to thelarynx or its nerve supply or the speechcentres of the brain, whether causedby injury, tumour or sickness. The lossmust be certified as being total andpermanent by an appropriate medicalspecialist not less than three (3)months after the ability to speak wasfirst lost.

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Major BurnsMeans tissue injury caused by thermal,electrical or chemical agents causingthird degree burns to:

� 20% or more of the Body SurfaceArea as measured by the “rule of9” of the Lund and Browder BodySurface Chart; or

� the whole of both hands, requiringsurgical debridement and/orgrafting; or

� the whole of the face, requiringsurgical debridement and/orgrafting.

Major Head TraumaMeans a cerebral injury resulting inpermanent neurological deficit,causing at least 25% impairment ofwhole person function as defined bythe latest edition of the Guide to theEvaluation of Permanent Impairment,American Medical Association, ascertified by a consultant Neurologist

Major Organ TransplantMeans the human to human organtransplant, as a result of injury ordisease from a donor to you, of one ormore of the following complete organs:

� kidney� heart� lung� liver� pancreas, or� the transplantation of bone marrow.

The transplantation of all other organs or parts of organs or any other tissue transplant is excluded from this definition.

Medically Acquired HIV InfectionMeans accidental infection withHuman Immunodeficiency Virus (HIV)where the virus was acquired inAustralia by you from one of thefollowing necessary events conductedby a recognised and registered medicalpractitioner:

� A blood transfusion;� Transfusion with blood products;� Organ transplant to the life

insured;� Assisted reproductive techniques;� A medical procedure or operation

performed by a medicalpractitioner

Any event that potentially may give rise to a claim must be reported to Us in writing within thirty (30) days of the event. This advice will require asupporting negative HIV Test performedon material taken after the event date.Blood product will need to be madeavailable for independent testing.

ExclusionNo payment will be made where aCure has become available prior to theevent causing the infection or whereyou have elected not to take anyVaccine available prior to the accident.

“Cure” means any AustralianGovernment approved treatmentwhich renders HIV inactive and non-infectious.

“Vaccine” means any antigenicpreparation approved by the AustralianGovernment and recommended by agovernment authority for prophylacticuse to produce immunity to theHuman Immunodeficiency Virus.

Motor Neurone DiseaseMeans an unequivocal diagnosis ofmotor neurone disease by a consultantNeurologist, with the Insured notnecessarily confined to a wheelchair.

Multiple SclerosisMeans a disease characterised bydemyelination of nervous tissue. Anunequivocal diagnosis has to be madeby a consulting physician confirmingmore than one episode of well definedneurological deficit with persistingneurological abnormalities and with atleast a 25% impairment of wholeperson function as defined by the latestedition of the Guide to the Evaluationof Permanent Impairment, AmericanMedical Association. The diagnosis willbe based on confirmatory neurologicalinvestigations eg: lumbar puncture,evoked visual responses, evokedauditory responses and MRI (MagneticResonance Imaging) evidence of lesionsof the central nervous system.

A partial benefit payable is payableunder this condition based uponunequivocal diagnosis confirming morethan one episode of well definedneurological deficit with persistingneurological abnormalities and with atleast a 10% impairment of wholeperson function as defined by the latestedition of the Guide to the Evaluationof Permanent Impairment, AmericanMedical Association. The partial benefitis limited to ten (10) percent of theSum Insured as stated on the PolicySchedule or $25,000 whichever is thelesser. A partial benefit is only payable ifthe Sum Insured is $100,000 or more.

Partial benefits can only be paid onceunder this condition and the remainingSum Insured for death, critical illness ordisability benefits will be reduced bythe amount paid.

Medical definitions continued

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OccupationallyAcquired HIV InfectionMeans Human Immunodeficiency Virus contracted where the virus wasacquired due to an accident occurringwhilst engaging in your normaloccupation and the seroconversion tothe HIV infection being demonstratedby testing within six (6) months of theaccident. HIV infection acquired in anyother manner is excluded.

Any accident that potentially may giverise to a claim must be reported to us in writing within thirty (30) days of theaccident. This advice will require asupporting negative HIV Test performedon material taken after the accidentdate. Blood product will need to bemade available for independent testing.

ExclusionNo payment will be made where aCure has become available prior to the accident causing the infection or where you have elected not to take any Vaccine available prior to the accident.

“Cure” means any AustralianGovernment approved treatmentwhich renders HIV inactive and non-infectious.

“Vaccine” means any antigenicpreparation approved by theAustralian Government andrecommended by a governmentauthority for prophylactic use in youroccupation to produce immunity tothe Human Immunodeficiency Virus.

Open Heart SurgeryMeans the undergoing of athoracotomy for treatment of cardiacdefect(s), cardiac aneurysm or benigncardiac tumour(s).

Out of Hospital Cardiac ArrestMeans cardiac arrest which is notassociated with any medical procedureand is documented by anelectrocardiogram, occurs out ofhospital and is due to:

(a) Cardiac asystole; or

(b) Ventricular fibrillation with orwithout ventricular tachycardia.

ParalysisMeans the total and permanent loss of function of 2 or more limbs due to spinal cord injury or disease or brain injury or disease. This includesbut is not limited to diplegia,hemiplegia, paraplegia, quadriplegiaand tetraplegia.

Parkinson’s DiseaseMeans unequivocal diagnosis ofParkinson’s Disease where the disease:

(a) prognosis indicates progressive and permanent impairment of you to dress, feed and bathewithout assistance;

(b) cannot be controlled withmedication.

PneumonectomyMeans the excision of an entire lungwhen deemed medically necessary byan appropriate specialist.

Primary PulmonaryHypertensionMeans primary pulmonary hypertensionassociated with right ventricularenlargement established by cardiaccatheterisation resulting in significantpermanent physical impairment to thedegree of at least Class 3 of the NewYork Heart Association Classification ofcardiac impairment.

Secondary Pulmonary Hypertension dueto chronic lung disease is excluded.

Renal FailureMeans end stage renal failurepresenting as chronic irreversible failureof both kidneys to function, requiringpermanent regular renal dialysis.

StrokeMeans any cerebrovascular accident orincident producing neurologicalsequelae. Evidence of infarction ofbrain tissue, intracranial and/orsubarachnoid haemorrhage orembolisation from an extracranialsource is required. Transient ischaemicattacks, reversible ischaemicneurological deficit, cerebral symptomsdue to migraine and any intracranialbleeding caused by a trauma are each excluded.

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1. Your financial adviserYour financial adviser will help you workout what your needs are, so you candecide if any of the products in the AvivaProtectionfirst range are right for you.

Your adviser will help you choosebetween the different productfeatures, and help you to combineAviva Protectionfirst policies with eachother and with your other insurancearrangements.

Your adviser will explain theinformation in this PDS to you.

2. How to applyTo apply for any of the policiesdescribed in this PDS, you mustcomplete and sign the application form,after you have obtained a quotationfrom your adviser.

Your adviser must explain to you what information you are required toprovide to us. It is important that youprovide this information carefully andaccurately. You should refer to thedescription of your Duty of Disclosureon the Application Form and note thatit extends beyond the date ofsubmitting your proposal to us.

How do I get started?

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This document sets out the terms on which You will make payments by Direct Debit to Us.

Direct Debit Service Agreement

1. Definitions andinterpretation

1.1 Definitions‘BECS’ means the Bulk ElectronicClearing System as managed by theAustralian Payments ClearingAssociation Limited.

‘Business Day’ means a day which Weare ordinarily open for business.

‘Direct Debit’ means a debit made fromYour nominated bank account to Us inaccordance with instructions containedin a Direct Debit Request.

‘Direct Debit Request’ means a requestcompleted by You and addressed to Usauthorising debits from Yournominated bank account to Us.

‘We’ ‘Us’ or ‘Our’ means NorwichUnion Life Australia Limited ABN 34 006 783 295;

‘You’ means the customer whocompletes the Direct Debit Request inOur favour.

‘Your Financial Institution’ means thefinancial institution holding Youraccount nominated in the Direct Debit Request.

1.2 InterpretationIn this document, unless the contraryintention appears:

(a) the singular includes the plural andvice versa and one gender includesthe other genders;

(b) a promise or agreement by two ormore persons binds each personindividually and all of them jointly;

(c) a reference to a party includes that party’s successors andpermitted assigns;

(d) a reference to a document oragreement includes anamendment, supplement to,replacement or novation of, thatdocument or agreement;

(e) a reference to a thing includes apart of that thing;

(f) a reference to a person includes anindividual, a corporation, agovernment body and any otherentity that the law recognises; and

(g) if a word or phrase is definedanother grammatical form of the word or phrase has acorresponding meaning.

2. The arrangement (a) This document and the Direct Debit

Request contain the terms underwhich periodic debits to Us will bemade directly from Your nominatedbank account, as specified in YourDirect Debit Request.

(b) The amount of the debit to Us willequal the amount that We decide ispayable to Us by You, or anotheramount that we both may agree,and that We notify to YourFinancial Institution.

3. When will debits bemade?

(a) Debits by Your Financial Institutionto Us under the instructions in theDirect Debit Request will be madeon 4th day of each month.

(b) If the day on which any debits aredue falls at a weekend or on apublic holiday, then the debit willbe made on the next Business Day.

4. QueriesIf You have any queries about theDirect Debit Request, including thedate on which the debits will beprocessed, Your queries must bedirected to Us, not to Your Financial Institution.

5. Available fundsYou must ensure that there is alwaysenough money, in cleared funds, inYour account to meet the requireddebit on the due date for the debit to occur.

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Direct Debit Service Agreement continued

6. What happens if funds are notavailable?

(a) If there is not enough money incleared funds in Your account tomeet any required debit, YourFinancial Institution will not pay Us.If this happens We will not chargeYou a dishonour fee, although YourFinancial Institution may do so. IfYou have any queries about feeswhich Your Financial Institutionmay charge You, You shouldcontact Your Financial Institution.

(b) If any debit requested by You is notmade, You remain obliged to payany amount owing to Us until Wereceive Your payment. Cancellationof Your Direct Debit Request doesnot affect any of Our accrued rights.

7. Alterations(a) If We want to make any changes to

the terms of the Direct Debitarrangement, We will provide Youwith at least 14 days written noticeof those changes.

(b) If You want to make any changesto Your details contained on YourDirect Debit Request You may do so by sending Us a new DirectDebit Request.

(c) In order to process Your changedDirect Debit Request, We mustreceive Your request at least 7Business Days prior to the nextscheduled debit.

8. Stopping debits(a) You may stop a payment to be

made to Us pursuant to the DirectDebit Request by contacting Us,preferably in writing and requestingthat the debit be stopped. Werequire 7 Business Days notice fromthe time that We receivenotification from You to take actionon this type of request.

(b) We will confirm to You that thedebit has been stopped.

(c) You may defer or cancel a DirectDebit Request by contacting Uspreferably in writing, at least 7Business Days prior to the nextscheduled debit.

9. Availability ofaccounts

(a) Payment by direct debiting throughthe BECS is not available on allaccounts. Before completing theDirect Debit Request, You mustcheck with Your FinancialInstitution and confirm that it willbe possible for Direct Debits to bemade to Us through the accountthat You wish to select.

(b) It is Your responsibility to ensurethat You advise Us if Yournominated bank account is to betransferred or closed.

10. Complaints(a) If You have any complaint about

the way Your Direct Debit has beenadministered by Us, You shouldcontact:

ProtectionClient Support TeamGPO Box 2567W Melbourne Vic 3001 orFreecall 1800 037 022

and provide full details of thecomplaint.

(b) The complaint will be reviewed andWe will endeavour to forward aresponse to You within 3 businessdays.

(c) If any complaint referred to Uscannot be resolved in a mannersatisfactory to You, You shouldcontact Your Financial Institutionwho will then deal with the matter in the manner set out in the BECS rules.

11. TerminationWe may terminate this arrangement bygiving You 14 days notice in writing.

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12. PrivacyWe will not disclose any informationabout Your details contained in theDirect Debit Request except:

(a) to You;

(b) as required by any law, court orregulatory authority;

(c) to any person nominated by You inwriting; and

(d) to the financial institution holdingOur accounts.

By completion of the application form(attached to this brochure), youconsent to any personal information wemay collect about you in the normalcourse of our business being used asoutlined in our privacy policy. Ourpolicy, which is designed to protectyour interests and is consistent with thePrivacy Act, can be obtained throughour website, avivagroup.com.au or bywriting directly to us.

13. Assignment(a) You must get Our written consent

before You can assign or deal with any of Your rights under this agreement.

(b) We may assign any of Our rightsunder this document without Your consent.

14. Applicable LawThis agreement is governed by thelaws of Victoria.

15. Notices(a) Notices to Us should include Your

policy number and must be sent to:

ProtectionClient Support TeamGPO Box 2567W Melbourne Vic 3001 orFreecall 1800 037 022

(b) We will send notices to You at thelast known address that You haveprovided to Us.

(c) Notices may be left at or sent bypre-paid airmail post, hand deliveryto that address, and will be treatedas given to the recipient either:

1. on the day of delivery; or

2. three Business Days after thedate of posting by pre-paid post,provided that if the time ofdelivery or receipt is on a non-Business Day or after 5 PM on aBusiness Day, delivery or receiptwill be considered to haveoccurred on the next Business Day.

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Application for Aviva Protectionfirstversion 3.0

IMPORTANT INFORMATIONBefore you sign this application form, be aware that your adviser is obliged to have provided youwith the Aviva Protectionfirst Product Disclosure Statement (“PDS”) containing a summary of theimportant information in relation to this product along with a premium quote. This information willhelp you to understand the product and to decide whether it is appropriate to your needs.Date of issue: 27 September 2004 Please complete in blue or black ink, using BLOCK letters.

YOUR DUTY OF DISCLOSUREBefore you enter into a Contract of Life Insurance with an insurer youhave a duty, under the Insurance Contracts Act 1984, to disclose to theinsurer every matter that you know, or could reasonably be expected toknow, is relevant to the insurer’s decision whether to accept the risk ofthe insurance and, if so, on what terms.

Your duty, however, does not require the disclosure of a matter:■ that diminishes the risk to be undertaken by the insurer;■ that is of common knowledge;■ that your insurer knows or, in the ordinary course of business ought

to know;■ as to which your duty is waived by the insurer.

Non-disclosureIf you fail to comply with your Duty of Disclosure and the insurer wouldnot have entered into the Contract on any terms if the failure had notoccurred, the insurer may void the Contract within three years ofentering into it. If your non-disclosure is fraudulent, the insurer mayvoid the Contract at any time.

An insurer who is entitled to void a Contract of Life Insurance may,within 3 years of entering into it, elect not to avoid it but to reduce thesum that you have been insured for in accordance with a formula thattakes into account the premium that would have been payable if youhad disclosed all relevant matters to the insurer.

FOR ADVISER COMPLETION:

New Business Application Replace Existing Policy Upgrade to current series Alteration to Existing Policy

Existing Policy number(s) to be altered/replaced

Adviser Name Adviser Number

Section 1 Life to be Insured detailsOccupational rating of insured (Please tick)

AAA MP LP AA A B Other

Mr Mrs Miss Ms Dr Other

Title

SurnameMaiden name(if applicable)

Given name/s

Home Address(not PO Box)

Suburb State Postcode

Telephone (home) – (mobile) –

(work) –

State register (if different from state of residence) Date of birth / / Age next birthday

Place of birth

Sex Male Female Proof of age Attached To follow Already submitted

What is your marital status?

Do you smoke or have you smoked within the last 12 months?

Yes If yes, please state form and daily quantity

No Reason/s for quitting (if applicable)

Date of cessation(if applicable) / /

(Complete Postal address only if insured is also the proposer of this application and postal address is different from home address)

Postal address


Page 53 of 76

Aviva Protection – Life Options Frequency premium

Ordinary Waiver of premium (must meet minimum premium levels)

Superannuation (NUST owned) Business protection option

Superannuation (issued to another Disability buy back optioncomplying superannuation fund)

Death benefitLink to own occupation definition

Disability benefit (if required) (AAA, MP, LP & AA lives only)$

$

$

Aviva Protection – IncomeChoose one Gold Choose one Indemnity

Excell Agreed Value

Monthly benefit

Waiting period 14 days 30 days60 days 90 days180 days (stepped premium only)

365 days (available only for stepped premiumwith benefit periods to age 60, 65 or 70)

730 days (available only for stepped premiumwith benefit periods to age 60, 65 or 70)

$ Options

Platinum benefit (Gold only)

Increasing claim benefit

Accident benefit option

Guaranteed insurability option

Frequency premium

$

Benefit period for 2 years for 5 yearsto age 60 to age 65to age 70 (available only for AAA, MP, LP & AA lives only)

Premium Stepped

Level

Premium Stepped

Level


Monthly benefit $

Waiting period 14 days

30 days

Frequency premium

$

Premium Stepped Level (not available for Executive policy) Age at which premiums convert to stepped 55 60 65

Section 2 Cover details (Please attach a copy of the Aviva quotation)

Aviva Protection – Recovery Money Note: Only one contract type in this section may be selected.

Recovery Money Flexible Recovery Money Stand Alone Recovery Money

Death Benefit

Critical Illness Benefit

Disability Benefit

Link to own occupation definition (AAA, MP, LP & AA lives only)

Options Frequency premium

Waiver of premium* Critical illness buy back* (must meet minimum premium levels)

Business protection option** Disability buy back*

Critical Illness Reinstatement Option

Occupational loading of x standard rates on

disability benefit (refer occupation rating guide)

* These benefits are not available where the Stand Alone Recovery Money contract has been selected.** This benefit is not available for Flexible Recovery Money or Stand Alone Recovery Money contracts.

Premium Stepped Level (not available for Executive policy) Age at which premiums convert to stepped 55 60 65

$

$ N/A$$

$$$

$ N/A$ N/A$

Page 54 of 76

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Section 3 Policyowner details (Ordinary business only) To be completed in all cases except where the insured is the sole proposer.Provision is made below for two different policyowners. If there are more than two policyowners please attach the following information for the extraproposers. For third party ownership of Aviva Protection – Income policies the insured must own at least 50% of business in which they work.

Policyowner A Mr Mrs Miss Ms Dr Other

TitleSurname orCompany nameMaiden name(if applicable)

Given name/s

Postal address



(work) –

Date of birth / / (proposer) State register (if different from State of residence)

Which policy does the ownership pertain to: Life Cover Recovery Money Income Protection

Business Expenses Flexible Recovery Money Stand Alone Recovery Money

Please indicate the relationship of the Proposer to the Life Insured

Policyowner B Mr Mrs Miss Ms Dr Other

TitleSurname orCompany nameMaiden name(if applicable)

Given name/s

Postal address



(work) –

Date of birth / / (proposer) State register (if different from State of residence)

Which policy does the ownership pertain to: Life Cover Recovery Money Income Protection

Business Expenses Flexible Recovery Money Stand Alone Recovery Money

Please indicate the relationship of the Proposer to the Life Insured

PERSONAL STATEMENT INFORMATION – MUST BE COMPLETED

Section 4 Residency questions

How long have you lived in Australia? years months or all of life

Are you permanently residing in Australia? Yes No

Do you have any intention of travelling or living overseas? Yes No (If yes, please complete the following)

Date of departure / / Duration of stay

Destination

Purpose of stay Holiday Business Residing Other – Please specify

Section 7 Existing insurance details

(a) Have you ever had an application on your life declined, postponed, accepted with a loading or otherwise than as submitted? Yes No

If yes, provide name of company, alteration, date and reason, if known

(b) Are you, upon disablement, entitled to a pension or other benefit from a superannuation plan or your employer? Yes No

If yes, provide full details

(c) Are you in receipt of or have you made a claim for disablement insurance, workers compensation, social security or veteran’s affairs, sickness or invalid benefits? If yes, please give details below: Yes No

(d) Do you have, or have you recently applied for, or are applying for any life, disability and/or trauma insurance with any company, including Aviva, or from government employment?

Yes, please complete table below. No, go to section 8

** Your application to replace a policy will be considered on the understanding that you will cancel your prior policy(ies). Failure to do so mayrender invalid a claim on your Aviva Protection policy.

If this application is to replace a current NULAL policy, the policy to be replaced will cease and a new policy will commence.

Company Type of policy Date policy Insured Policy number To be replaced by(eg. Death/TPD Inc. Prot.) commenced amount (if known) this application?**

Date Company/Source Period of disability Cause of claim

Section 6 LifestyleYes No

Alcohol(a) Do you consume alcohol?

(b) If no, have you ever consumed alcohol?

Drugs(c) Have you ever used or injected yourself with

any drug not prescribed by a medical attendant?

HIV

(d) Are you suffering from Acquired Immune DeficiencySyndrome (“AIDS”) or are you carrying the HIV virus or antibodies to that virus?

(e) Are you suffering from unintentional weight loss,persistent night sweats, persistent fever, diarrhoea orswollen glands?

(f) Have you EVER engaged in male to male sexualactivity involving anal intercourse?

(If you have answered ‘YES’ to any of the above 3 questions, additional information will be requested by us to assess your application)

If Yes, please give details

Form anddaily quantity

Form, dailyquantity & date ceased

If Yes, please detail type of drug, frequency of use and when last used

Section 5 Height and weight details

What is your height? cm OR feet/inches

What is your weight? kg OR pounds

Page 56 of 76

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Section 8 Sports and pastimesDo you or do you intend to engage in any of the following sports and pastimes? Yes No

• Aviation other than as a fare-paying passenger• Body contact sports• Football• Hang-gliding, etc

• Motor sports• Parachuting or sky diving• Recreations involving heights• Underground activity

• Scuba/Skin diving• Water sports• Mountain climbing/abseiling/caving• Other (eg boxing, competitive riding etc)

If ‘Yes’ to any of these activities, please complete the questionnaire below. (If ‘no’, go to section 9.)

(i) Motor sports

Vehicle type and make Engine capacity cc

Type of circuits raced on (eg road, off road) Number of events per year

Maximum speeds reached kms per hour Are you a professional or Amateur

Have you ever suffered any injuries as a result of this sport /pastime? Yes No If “Yes”, please specify type of injury, when it occurred and degree of recovery.

(ii) Football /Soccer/Aussie rules, etcType Professional/Amateur Times per year

(iii) Mountain climbing/abseiling/cavingType Location Times per year

(iv) Scuba/skin divingAverage depth Maximum depth Professional/Amateur Dives per year

metres metres

Do you dive in caves or potholes? Yes No Do you dive alone? Yes No

Diving qualifications

(v) Aviation1. Do you hold a Civil Aviation Authority Licence? Yes No

2. Do you intend to change the scope of your present licence? Yes No3. Do you ever use other than recognised Civil Aviation Authority

landing areas? Yes No4. Do you intend to engage in any form of aviation other than the

categories below, eg ballooning, paragliding etc? Yes No5. Have you ever had an accident or been charged with violating

Civil Aviation Regulations? Yes No

Please complete the following schedule

Last 12 months Future annual averageIndicate number of hours flown as follows Crew Passenger Crew Passenger

Aero club/flying school

Agricultural

Charter

Commercial airline

Helicopter

Private

Ultralight aircraft

If “Yes”, state type and period held

Please elaborate on all “Yes” answers in Additional information below, ie type of sport, time spent training and participation, numberof times per annum, receipt of fees or payments, any injuries sustained, etc.

Additional information or details relating to activities above to which a “Yes” answer applies

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Sedentary/Administration

Light Manual Work

Heavy Manual Work

Heights >5 metres, any underground or offshore work

Other (please specify)

Total 100

Section 9 Occupation

(a) What is your present principal (i) occupation (ii) Industry (b) (i) Name and street address of place of employment


(ii) To the best of your knowledge is your place of employment insolvent or under/contemplating voluntary administration? Yes No

(iii) If self employed, has your company had a net operating loss in the last two years Yes No If ‘yes’, please provide last two yearstrading accounts for all entities.

(c) What are your duties (Please give full details including % of manual work involved)

Type of Work % of Time Specific duties you perform

(d) How long have you been in your current occupation? Years Months

(e) What qualifications do you have?

Type Source

(f) Are you thinking of changing your occupation? Yes No

If yes, please advise details

Do you require Income Protection Cover? Yes No If ‘yes’, complete (g) to (p) following. If ‘no‘, go to section 10.

(g) How many hours do you work in your principal occupation? Hours per week

(h) Do you work at your place of residence? Yes No If ‘yes’, how many hours per week

(i) Do you have any other occupation? Yes No

If yes, please specify type, hours worked per week, and full name and address of place of employment

Type

Address


(j) Have you ever been bankrupt? Yes No If ‘yes’, please provide details

(k) Please give details of your previous occupation/s over the last 5 years

(l) Are you self-employed or do you own any of the business in which you are employed? Yes No If ‘no’, go to section 10

(m) Do you operate as: Sole Trader Partnership Company Trust

(n) Please state what percentage interest/shareholding you have in the business

(o) For how long have you been self-employed in this current business?

(p) How many employees (excluding yourself) do you have?

%

From To Occupation Employer name

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Section 10 Income (all cases)

What was your annual income from personal exertion over the last two years from your principal occupation?

(a) Last 12 months

(b) 12 months prior to (a)

Income includes salary, fees, commission, bonuses, regular overtime and fringe benefits earned directly due to your personal exertion.Deduct any business expenses incurred in earning that monthly income, but not tax.

(c) Do you receive more than $15,000 p.a. unearned income (e.g. from investments)? Yes No

If yes, how much? $

$

$

Section 11 Doctor’s details(a) Please give full name and address of your usual medical attendant

Doctor

Address


Telephone – Fax –

(b) When did you last attend him/her? / /

(c) For what reason did you attend him/her, and what was the result?

(d) For how long have you been his/her patient? years months

(e) If less than 12 months also give previous medical attendant(f) If you have no usual medical attendant, please state date and reason why you last consulted any doctor, as well as the name and address of

that doctor.

Complete section 12-14 if you are not required to undergo a medical examination as part of this application.

If you are undergoing a medical exam, it is not compulsory to complete sections 12-14, and you may proceed to section 15. However,should you not complete sections 12-14 and a medical examination reveals past personal or family medical issues we may need toobtain further medical information. To expedite assessment of your application it is desirable to complete section 12-14 where youhave received any medical treatment or advice or where a family history of medical problems is known.

Section 12 Family history

Has any parent, brother or sister living or deceased, had any of the following: Yes No

If adopted, please complete only if family history is known.

• Diabetes• High blood pressure• Bowel cancer• Kidney trouble• Huntington’s chorea

• Heart trouble• Breast cancer• Other cancer• Haemophilia• Any other hereditary disorder

Family member Condition Age at diagnosis

If “yes”, please complete the following schedule of family history

Section 13 Medical historyHave you EVER had or been told you had, or received medical advice or treatment for any of the following?If you answer “Yes” to any of the underlined conditions below, please complete the Supplementary Health statement on page 61.If however, you answer “Yes” to the conditions which are not underlined please give further details in the Additional information sectionat the bottom of this page.If you are able to provide medical reports regarding any ‘Yes’ answers, please include them to expedite assessment of the application.

Yes No(a) High blood pressure, chest pain, high cholesterol, stroke,

rheumatic fever or any heart or vascular complaint

(b) Mental disorder, such as anxiety, depression,nervous condition or stress

(c) Strained back, sciatica, whiplash, spondylitis or any other form of back or spinal trouble

(d) Arthritis, rheumatism, gout, tendonitis, repetitive straininjury or any disorder of the joints or muscles

(e) Asthma, bronchitis, tuberculosis, pleurisy or otherlung complaint

(f) Neurological or nervous disorder such as epilepsy, fits, paralysis, migraine, persistent headaches, dizziness or neuritis

(g) Indigestion, ulcer, hiatus hernia, bowel disorder,colitis or passing of blood from the bowel

(h) Hepatitis, cirrhosis or any liver or gall bladder disease

(i) Diabetes, sugar in urine, thyroid trouble or pancreatic disease

(j) Kidney or bladder disorder such as kidney stones,nephritis, cystitis or passing of blood in the urine

(k) Cancer, cyst or tumour of any kind

(l) Skin conditions, defect in hearing or sight, varicose veins, haemorrhoids or rupture (hernia)

(m) Blood disorder, such as anaemia, haemophilia or leukaemia or received a blood transfusion ortreatment with human blood products?

Yes No(n) Has your weight varied by more than 5kg in the last

12 months?

(o) Have you within the last three years undergone any blood tests including HIV?

(p) Do you take, or have you ever taken drugs, tablets or any medications on a regular basis?

(q) Have you required medical treatment for any illness or injury not mentioned above?

(r) Do you contemplate seeking any medical advice, investigation or treatment (including surgery) for any current health problem(s)?

Females only

(s) Have you ever had any gynaecological condition or any complications with pregnancy or childbirth?

(t) Have you ever had a pap smear?If yes, please state date and result

(u) Are you currently pregnant?

If yes, date due / /

(v) Have you ever had or been advised to have a mammogram for any reason?

If yes, please state date and result

Question Illness, injury Date Time Degree of Full details of treatment Full name and address of number or tests commenced off work recovery including date of last symptoms doctor or hospitals consulted

Additional information (refer to instructions at top of page)

Page 60 of 76

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Section 14 Health Questionnaires

Supplementary Health StatementIf you need to complete this Supplementary Health Statement for more than two underlined conditions under Section 13, please complete andattach a separate form titled “Additional Supplementary Health Statement”.If the purpose of the Supplementary Health Statement is joint related, ie.13(d) please indicate the side of the body affected ie. left hand/right hand.

1. What is the nature of your condition?2. Please give details of:

(a) Date of first symptoms / /

(b) Frequency of symptoms

(c) Severity of symptoms

(d) Date of last symptoms / /

3. Give details of treatment including surgery, physiotherapy and medication:

(a) Previously received

(b) Now being received

4. Is any change to your treatment contemplated, including surgery? Yes No

5. Have you completely recovered? Yes No

6. Do you have any disability as a result of the illness? Yes No

7. Time off work as a result of this condition? Days8. Please include any additional information you feel may assist us.

9. Please provide the full name and address of the doctor who treated you for this condition.Doctor or

Clinic name

Address


1. What is the nature of your condition?2. Please give details of:

(a) Date of first symptoms / /

(b) Frequency of symptoms

(c) Severity of symptoms

(d) Date of last symptoms / /

3. Give details of treatment including surgery, physiotherapy and medication:

(a) Previously received

(b) Now being received

4. Is any change to your treatment contemplated, including surgery? Yes No

5. Have you completely recovered? Yes No

6. Do you have any disability as a result of the illness? Yes No

7. Time off work as a result of this condition? Days8. Please include any additional information you feel may assist us.

9. Please provide the full name and address of the doctor who treated you for this condition.Doctor or

Clinic name

Address


(a)

(b)

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Section 15 Business Expenses Cover Questionnaire (only to be completed if a Business Expenses Policy is required)

Note: The following expenses cannot be included: Personal salary of the insured, remuneration to members of the insured’s family, repayment of mortgage principal, costs of goods or merchandise, costs of implements of the insured’s trade or profession, salaries of employees who wouldcontinue to produce income after the insured’s disablement.

Name of business

Date business was started / / Number of full-time employees

What percentage of business income is derived by your personal exertion? %

What type of business? Sole proprietor Company Partnership Other

Are business expenses shared with others? Yes No

If yes, please give details below.

Please provide a brief explanation of what downturn would occur to the business if the Life to be Insured were to become disabled.

Details of all employees (if family members, relationship to insured)

Name of employee (relationship, if relevant) Occupation % of income generating duties Hours worked per week

Name of all such persons Occupation % Share of expenses % Interest in business

Please list the full annual expenses of the business.Premises

Rent, or mortgage interest

Business insurance premiums (fire, liability, etc)

Property rates

Services

Telephone Water

Electricity Laundry

Gas Cleaning

Equipment

Lease costs on equipment and motor vehicles

Registration and Insurance for motor vehicles

Maintenance $

$

$

$$

$$

$$

$

$

$

Salaries

Payroll tax

Professional

Accounting and auditing

Dues to professional bodies

Other

Please state details

Total annual

Monthly equivalent $

$

$

$

$

$

$

Salaries and related costs for employees who donot generate any business income

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Section 16 Superannuation NUST To be completed for Aviva Protection – Life policies owned by the Norwich Union Superannuation Trust (“NUST”) only (the applicant for this policyis the Trustee of the NUST)

Part A: ContributionsPlease identify who is contributing:

Personal contributions only* (member or spouse) % Member % Spouse (must equal 100%)

Employer† only (including salary sacrifice)

Part personal and part employer† contributions % Spouse % Personal % Employer (must equal 100%)

* If personal contributions, are you eligible to claim tax deduction? Yes No† Please complete the following only if the insured’s employer is contributing to the Aviva Protection – Life policy.Note that the applicant for this policy is the Trustee of the NUST.

Employer details:

Full name of employer (co.name)

Contact name

Postal address


Telephone (home) – Fax –

Part B: Nomination of dependants: (A dependant is a spouse, child, person in an interdependency relationship. Please refer to page 33 of the PDSfor details on who can be a financial dependant)I nominate the following as my dependant(s) to receive benefits on my death. I acknowledge that the Trustee is not bound by thisnomination but will take it into account when paying out the death benefit (see page 33). If I require the Trustees to be bound by mynomination I will complete the form contained on pages 73 to 76.

Person 1

Name % of benefit

Relationship to member Date of birth / /

Address


Telephone (home) –

Person 2

Name % of benefit

Relationship to member Date of birth / /

Address


Telephone (home) –

Note: You can revoke or change the nomination at any time prior to ceasing to be a member of the fund.

Part C: Declarations and acknowledgements to NULIS Nominees (Australia) Limited, Trustee of the NUST.(a) I hereby apply to become a member of the Norwich Union Superannuation Trust(b) I am eligible to make superannuation contributions, or I am eligible to receive contributions made on my behalf (see page 41)(c) I will be bound by the Trust Deed governing the Trust as it may be varied from time to time(d) I will make a full disclosure in writing of any superannuation benefits which are to be transferred to the Trust to enable the Trustee to

effectively administer all benefits secured on my behalf under the Trust(e) I will advise the Trustee in writing if the contribution information provided above changes(f) I am aware that in the event of a claim under a Aviva Protection – Flexible Recovery Money policy written in conjunction with this policy the

amount of death and, if applicable, disability cover payable under this policy will be reduced by the amount of benefit actually paid underthe Aviva Protection – Flexible Recovery Money contract.

Member’s signature Date / /X

SuperannuationIndividual Tax File Number Notification via Fund Trustee or Employer

This form may only be used to pass on your tax file number to yoursuperannuation fund.

(Please print neatly in block letters with a black or blue pen only).

Fund name

Fund address

Fund telephone number

( )Employer name (if applicable)

Telephone number

( )Your surname/Family name

Given names

Date of birth / / Sex Male Female

Membership no/Policy no(if known)

My Tax File Number

Signature

Date / /The Trustee is authorised to collect Tax File Numbers under theSuperannuation Industry (Supervision) Act 1993. You do not have to provideyour Tax File Number. Choosing not to provide it is not an offence, howeverif you do not provide your Tax File Number:■ you may pay more tax on your benefits than you have to (you can claim

this back at the end of the financial year in your income tax return);■ it may be more difficult to locate or consolidate your superannuation

benefits in the future when paying you any benefits you are entitled to; and■ you may become liable to pay the superannuation ‘surcharge’ on contributions

made by your employer on your behalf, or by you (in some cases the‘surcharge’ can be reclaimed through the Australian Taxation Office).

These consequences may change in the future.

If you provide your Tax File Number, the Trustee must safeguard it and only useit for lawful purposes, which currently include the following and may change inthe future:■ calculating the tax on any benefit you may be entitled to;■ finding, identifying and consolidating your superannuation benefits where

other information is insufficient;■ providing information to the Commissioner of Taxation; and■ in the future, providing it to another fund trustee or retirement saving

account provider to whom your benefit is to be transferred (unless youinstruct the Trustee in writing not to).

9898928930

509 ST KILDA ROADMELBOURNE 3004

NORWICH UNION SUPERANNUATION TRUST

NOTE FOR PRINTER

This is a fold outperforated flap attachedto page 63 and not a separate page.

The back of this flapshould be printed green.

NOTE FOR PRINTER

This is a the back of thefold out perforated flapattached to page 63 andnot a separate page.

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Section 17 Superannuation – issued to another complying superannuation fundPlease complete the following if the Aviva Protection – Life policy is to be owned by another complying fund (ie not the Norwich Union Superannuation Trust)

DeclarationTo be signed by two directors or company secretary and one director in the case of a Trustee Company, or by at least two of the individual Trustees.1. I am one of the Trustees or an officer of the Trustee Company.2. That our Fund is a complying superannuation fund and is operated in accordance with the requirements of the Superannuation Industry

(Supervision) Act 1993 and Regulations. If your Fund is non complying, see page 33.3. I undertake to promptly inform Norwich Union Life Australia Limited (“NULAL”) if the Fund ceases to be a complying superannuation fund or if

the Life Insured ceases to be a member of the Fund.4. The Trustee is authorised by the Fund’s Deed to enter into insurance contracts providing life or disability cover.5. There is nothing in the Fund’s Deed which conflicts with the provision of any of the benefits selected for this insurance policy.6. I undertake to promptly inform NULAL if there is a change of Trustee of the Fund.7. I am aware that in the event of a claim under a Aviva Protection – Flexible Recovery Money policy written in conjunction with this policy the

amount of death and, if applicable, disability cover payable under this policy will be reduced by the amount of benefit actually paid under theAviva Protection – Flexible Recovery Money contract.

Name of Superannuation fund

APRA Regulated Fund

SuperannuationFund Number (SFN)

OR

ATO Regulated Fund

Australian BusinessNumber (ABN)

Postal address


Telephone –

Trustee DetailsUse this section if the Trustee is a companyI am a sole Director and the sole Secretary of this company Yes No EXECUTED for and on behalf of

PTY LIMITED

Date

SignedDirector

Title Surname Given name(s)

SignedDirector/Secretary


OR Individual Trustee

Names (If more than 3 individuals, please attach further names. Note only two individual Trustees required to sign.)

First Individual Trustee


Signature Date

Second Individual Trustee


Signature Date

Third Individual Trustee


Signature Date / /

/ /

/ /

/ / Please affix company seal here if requiredby the Company’s Constitution

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Section 18 Beneficiary Nomination Form/Third Party Interests (Life and Recovery Money policies only)Ordinary business only

I, (the policy owner)nominate the undermentioned persons to receive any proceeds that may become payable under this policy as a result of the death or theoccurrence of an insured event affecting the life insured.

Title Mr Mrs Miss Ms Dr Other

Person 1 Date of birth / /

Address

State Postcode

Contact Phone no



Address

State Postcode

Contact Phone no



Address

State Postcode

Contact Phone no Total (Must equal 100%)

% of Death % of TPD and/orbenefit Critical Illness

benefit

% %

% %

% %

% %

NotesPayment of benefits will be made on the basis of the latest nomination received by NULAL. If there is no nomination, or the nomination has beenrevoked, benefits will be paid to the policy owner (or their estate). The policy owner may vary the nomination at any time.If a nominated person pre-deceases the Life Insured and no replacement nomination has been received by NULAL, then that person’s nominatedaccount will be paid to the policyowner (or the policyowner’s estate).Persons nominated should seek advice from their taxation adviser regarding the potential taxation implication of any benefit received. Uncertaintiesabout Capital Gains Tax implications exist for TPD and Critical Illness benefits if the recipient is other than the Life Insured or spouse or certaindefined relatives.

Policyowner A signature Date / /

Policyowner B signature Date / /(If applicable)

X

Xs

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Norwich Union Life Australia LimitedABN 34 006 783 295 AFSL number 241686

Head office and Registered Office509 St Kilda Road Melbourne Victoria 3004 GPO Box 2567W Melbourne Victoria 3001

Telephone client support freecall on 1800 037 022 Fax 03 9820 1534avivagroup.com.au

Section 19

Section 20 Premium ReceiptDeposit premium receiptReceived from

Name

Address

State Postcode

Total amount $ , .

For Norwich Union Life Australia Limited by

Norwich Union Life Australia Limited shall be on risk when the following conditions have been met.Conditions1. Payment of the first premium is received in full.2. Norwich Union Life Australia Limited notifies the Policyowner that the Application is accepted.3. If after signing the Application, but before the Policy is issued, the proposed Insured suffers any illness or injury or is refused life or disability insurance by another

Insurer, Norwich Union Life Australia Limited is to be notified whereupon it will then confirm to the Policyowner the terms on which it will consider the risk.4. This receipt is not valid unless signed by an Adviser, Broker or Employee of Norwich Union Life Australia Limited and unless the remittance, if made by cheque, is

honoured on the first presentation. This receipt is to be issued only if payment is made at the time of signing the Proposal, otherwise it must not be detached.If you are not contacted regarding the proposed Insurance within 30 days, please notify Norwich Union Life Australia Limited at its Head Office, 509 St Kilda Road, Melbourne 3004, giving the name of the Adviser, Broker or Employee, date and amount paid.

Authority to release medical information

Norwich Union Life Australia Limited (“NULAL”) is considering my application for insurance and I hereby authorise any medicalpractioner, hospital, clinic or other person (including any life insurance company or underwriter) to disclose to NULAL or any thirdparty engaged by NULAL full details of my health and medical history. A photocopy of this Authority should be accepted as mypersonal authority.

Insureds full name Date of birth

/ /Address

State Postcode

Signature Date / /Xs

Authority to release medical information

Norwich Union Life Australia Limited (“NULAL”) is considering my application for insurance and I hereby authorise any medicalpractioner, hospital, clinic or other person (including any life insurance company or underwriter) to disclose to NULAL or any thirdparty engaged by NULAL full details of my health and medical history. A photocopy of this Authority should be accepted as mypersonal authority.

Insureds full name Date of birth

/ /Address

State Postcode

Signature Date / /Xs

of 76










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Section 21 Payment Authorities Method of paymentMethod Direct Debit Credit Card Cheque

Initial

Ongoing*

* Not available for monthly payments

Both initial and ongoing fields must be complete.

Credit card premium payment authority

Credit card type Master Card Visa Bankcard Policy number

Card number Expiry date /

Card holder’s name

Signature Date / /X

s

Direct debit request Policy number

Surname First Name/s

I/We request you, until further notice, to debit to my/our account at the financial institution identified below, any amounts which Norwich Union LifeAustralia Limited ABN 34 006 783 295 AFSL number 241686 (User ID No 000110) may debit or charge me/us through the Direct Debit RequestSystem. This request will remain in force in accordance with the terms described in the service agreement provided to you.

Details of accounted to be debited

Name of Financial Institution

Branch Address

Account Name

Account Number BSB Number –

Please note: 1. Direct debiting is not available on the full range of accounts. If in doubt, please refer to your financial institution.2. A fee may be charged for this service.

Signature of customer Date / /

Name

Address

Suburb Postcode

X

s

Payment details Yearly Half-yearly Quarterly Monthly

DDR DDR DDR DDR

Credit Card Credit Card Credit Card Credit Card

Cheque Cheque Cheque

Office use only – deposit premium receiptIf no money submitted with proposal please indicate by writing “NIL” in space provided

Policy 1 Policy 2 Policy 3 Policy 4

Policy number

Amount banked $ , . $ , . $ , . $ , .

Date received / /

Payment method CDR number

Received by (Aviva officer’s initials)

of 76










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Section 22 Declaration I/We acknowledge that I/We have received, read and had explained to me a current Aviva Protectionfirst Product DisclosureStatement.

I/We acknowledge that a Financial Services Guide and a Statement of Advice was provided to me/us by my/our adviser.

Declaration and agreementI/We, the person(s) proposed for the Insurance, declare that the statements concerning myself contained in this Application and inany Personal Statement subsequently signed by me are true and I/we hereby agree that any medical practitioner who has been, orwho may hereafter be, consulted by me shall be and is authorised and directed by me to divulge at any time to Norwich Union LifeAustralia Limited, or to any legal tribunal, any information he may have acquired with regard to myself, and I expressly waive allprofessional confidence and provisions of law as to privilege or otherwise forbidding disclosure of such information.

I/We, the Policyowner, declare that all the answers to the questions and statements concerning the life to be insured, or myself,made in this form and any attachments are true and complete and details have been provided of all circumstances which mightaffect the risk of any insurance on the Life to be Insured.

I/We have read the duty of disclosure and the statement on non-disclosure set out on the front of this Application and I/Weunderstand the contents. I/We understand that the information contained in this Application is relied upon by Norwich Union LifeAustralia Limited in assessing the risk and the insurance.

I/We have read and understood the section on page 42 of the brochure titled ‘Privacy Statement’ and consent to the use, collectionand disclosure of my personal information for all the purposes and uses described within that section.

I/We understand that if, after signing this Application and before the policy is issued, the Life to be Insured suffers any illness orinjury or is refused life or disability insurance by another insurer, the duty of disclosure extends to notification to Norwich Union LifeAustralia Limited whereupon it will confirm to the Policyowner the terms upon which this application will be considered.

I/we hereby warrant receipt of the Aviva Protectionfirst Product Disclosure Statement from which this applicationwas taken, and expressly confirm that I/we have received a premium quotation in respect of the insurance product thatI/we am applying for.

Life to be Insured to sign and date: Policyowner (if Ordinary business only and different from Life to be insured) to sign and date

Date / / Date / /

Norwich Union Life Australia Limited ABN 34 006 783 295 AFSL number 241686

NULIS Nominees (Australia) Limited ABN 80 008 515 633 AFSL number 236465

XX

Section 22 Adviser detailsTo be completed by adviser

Company / Business name

Personal name

Telephone – Email

Fax –

Distribution fee format required (must be completed) Note: if transferring cover from an existing NULAL policy the format mustremain the same.

No Upfront Percentage of (complete where distributionUpFront Renewal Level Level standard basis fee is being reduced)

Aviva Protection – Life %

Aviva Protection – Recovery Money %

Aviva Protection – Income %

Aviva Protection – Income Business Expenses %

Distribution fee split

Agency Initial distribution Production Agency Renewal distributionnumber fee split split number fee split (Upfront only)

% % %

% % %

% % %

Must = 100% Must = 100% Must = 100%

Adviser/Broker field underwriting report If “No”, please provide full details (if insufficient space provide separate summary)

1. Has the application been fully completed and the declarations signed in your presence? Yes No

2. Have the authorities on pages 67 to 69 been completed? Yes No

3. Is the first premium attached to the application? Yes No4. Have all the relevant sections and declarations been completed

in full and signed? Yes No5. Do you give permission for us to contact your client

direct to clarify any particular matter relevant to this application? Yes No

6. Have all standard medical requirements been arranged? Yes No7. Are you utilising a paramedical service for the required

medical information? Yes No8. If a HIV/MBA blood test is required, have you provided the client

with the relevant brochure information? Yes No9. Is a copy of the quotation attached (mandatory) or else

this application cannot be processed? Yes No10. Have all adviser details including commission format,

been completed? Yes No

Adviser notes (special comments)

Page 72 of 76

Beneficiaries for Death BenefitsPlease complete the details required for your nominated beneficiaries, and select from the following list to indicate their current relationship to you:

■ Spouse (includes de facto spouse)■ Child■ Interdependent Relationship■ Other person financially dependent on you■ Legal Personal Representative

Important: “Spouse” does not include a same sex partner or former partner. “Child” includes an adopted child, step child or an ex-nuptial child. “Interdependency relationship” as defined on page 33.

Full Name of Beneficiary

1.

Relationship to Member*

Address

State Postcode

Date of Birth

/ /

This nomination is in respect of the following product:


Aviva Protection – Executive Life

(Please tick ✓ )

Note: For Aviva Protection – Flexible Recovery Money clients, (including Executive versions), please nominate the associatedAviva Protection – Life. For an existing policy or plan, please show the policy number or plan and member number.

Member/Policy Number

Title Surname

Given Names

Address

State Postcode

Date of birth / / Sex: Male Female

Type of Application

New Amending Revoking (Please tick ✓ )

Norwich Union Superannuation TrustApplication for Binding Nomination(Please print neatly in BLOCK LETTERS with a black or blue pen only).

This form is only to be completed if you wish to apply for a nomination that is binding on the Trustees of the NorwichUnion Superannuation Trust.

Page 73 of 76

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2.


Address

State Postcode

Date of Birth

/ /


3.


Address

State Postcode

Date of Birth

/ /


4.


Address

State Postcode

Date of Birth

/ /


5.


Address

State Postcode

Date of Birth

/ /

*If you are nominating a person who is financially dependent on you, state “financial dependant” or, if your legal personal representative, state“legal personal representative” when completing the details under ”Relationship to Member”.

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Death Benefit AllocationPlease specify your required benefit allocation, and ensure the total allocation adds up to 100%. Please also specify for each beneficiary, the % of their benefit which is to be paid as a lump sum or as an allocated pension, and ensure this adds up to 100%. If you have nominated yourlegal personal representative, the benefit must be paid as a lump sum.

Total Allocation Amount as Amount asBeneficiary (Name in full) (%) Lump Sum (%) Pension (%)

Supplementary Instruction to Trustee (optional)

If, at the time of my death, the lump sum benefit from my personalised strategy exceeds the Pension RBL, please:

Apply the table as specified

Adjust lump sum benefits to the Pension RBL and provide the excess amounts as pensions for the nominated beneficiaries.

100%

100%

100%

100%

100%

100%

100%—100%50%Mary Smith

100%20%80%50%Example: John Smith

DeclarationI am a member or have applied to become a member of the Norwich Union Superannuation Trust. This Binding Nomination and benefit allocationapplies only to the NULAL policy/interest to which this application form relates.

I understand that if this nomination is valid at the time of my death, the Trustee must pay the benefit as directed, regardless of any change in mypersonal circumstances or that of my beneficiary (except where they cease to be eligible to receive the benefits).I understand that this form will become invalid and have no effect:■ on the expiry of 3 years after the date of the signature;■ on the termination of the policy/interest to which this nomination relates;■ on my ceasing to be a member of the Norwich Union Superannuation Trust;■ in any circumstances stated in this form;■ in such other circumstances as are stated in the notes attached to this form.I understand that I should review this nomination regularly, or as my circumstances change (eg. new marriage, birth of a child).

By completing this form, you consent to any personal and sensitive information we may collect about you in the course of our business being used anddisclosed as outlined in our Privacy Policy. Our Policy, which is designed to protect your interests and is consistent with the requirements of the Privacy Act,can be obtained through our website, avivagroup.com.au, or by writing directly to us, at GPO Box 2567W, Melbourne Victoria (Attention: Privacy Officer).

DO NOT SIGN UNLESS YOU HAVE TWO ADULT WITNESSES PRESENT

Your signature

Date / /

Please print your full name

Two adult witnesses must sign and date this form at the same time as you have signed – but neither must be nominated as a beneficiary.

By witnessing this binding nomination I declare that I am over the age of eighteen years and witnessed the signing of this document by the investorwhose signature appears above.

Witness 1

Signature

Date / / This date must be the same as above.

Print name

Print address

Witness 2

Signature

Date / / This date must be the same as above.

Print name

Print address

Please return this form to:

Norwich Union Life Australia LtdGPO Box 2567WMelbourne VIC 3001

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AV

010B

10/

04

509 St Kilda Road Melbourne Victoria 3004 GPO Box 2567W Melbourne Victoria 3001

Telephone Client Support freecall on 1800 037 022 Fax 03 9820 1534

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