plan rules - riskinforiskinfo.com.au/.../files/2008/08/amp-death-tpd-plan-rules.pdf · amp flexible...
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Flexible Lifetime® – ProtectionA safety net for living
Keep this document it is part of your contract with AMP Issued by AMP Life Limited ABN 84 079 300 379
® Registered trade mark of AMP Life Limited
Plan RulesDeAth, totAL AND PeRMANeNt DIsABLeMeNt AND tRAuMA
DeAth, totAL AND PeRMANeNt DIsABLeMeNt (suPeRANNuAtIoN)
2007
2007I
INNOVA-
Winner of the Asset Innovation Awards Trauma Insurance Product of the Year Flexible Lifetime – Protection Trauma cover Standard
This document
Please read this document with the Certificate of Insurance. We suggest you keep them together and in a safe place.
THIS DOCUMENT IS IN TWO PARTS: •abriefintroductionthatcoversthepurposeoftheplan, whom we pay, and who is
insured. It starts on the next page
• therulesofyourplan. A table of contents for the rules starts on page 3.
If there is something you don’t understand, please contact your financial planner or us.
UNDERSTANDING DEFINED Throughout this document:
TERMS IN THIS DOCUMENT • AMPmeanstheAMPGroup(theAMPGroupismadeupofseveralentities,whichinclude
AMP Superannuation Limited and AMP Life Limited)
• you,yourandyourself;inrelationtoDeath,TotalandPermanentDisablement
(Superannuation)plans means the insured person;andmeanstheplan owner in
relation to Death, Total and Permanent Disablement, Trauma plans
• AMPLife,we,us,andourmeansAMPLifeLimited
• TheFundmeanstheAMPPersonalSuperannuationFund
• insured person(s)meanstheperson(s)insuredundertheplan. In relation to Death, Total
and Permanent Disablement (Superannuation)plans the insured person is a member of
the AMP Personal Superannuation Fund
• plan owner in relation to Death, Total and Permanent Disablement (Superannuation)
plans means AMP Superannuation Limited, and means the owner of the plan for Death,
Total and Permanent Disablement, Trauma plans
• non-superannuation plan means Death, Total and Permanent Disablement, Trauma plan
under Flexible Lifetime – Protection. Your Certificate of Insurance will show if you have
this plan
• superannuationplanmeansDeath,TotalandPermanentDisablement(Superannuation)
planunderFlexibleLifetime–Protection(Superannuation).Your Certificate of Insurance
will show if you have this plan.
In addition:
• rule39describesTraumadefinitionsusedthroughoutthisdocument,and
• rule40containsa‘Glossaryofdefinitions’ofothertechnicalwordsusedinthisdocument.
Each time a defined word is used, it appears in type like this. Also, we list the defined words
used on each page in a box at the bottom left-hand corner of the page.
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREdpERSON
• plAN
• plANOwNER
• TERMINAlIllNESS
THE DEFINITIONS ARE SET
OUTINRUlE40
AMP Flexible liFetiMe – Protection – PlAn rules – 1
introduction
PurPose For non-superannuation plans, this product provides you with a specified lump sum if you:
•haveselectedDeathcoverandtheinsured person dies or has less than 12 months to
live due to a terminal illness
•haveselected TotalandPermanentDisablement(TPD)cover,andtheinsured person
becomestotally and permanently disabled
•haveselectedTraumacoverandtheinsured person suffers one of the trauma
conditions we cover.
For superannuation plans, this product provides a specified lump sum if you:
•dieorhavelessthan12monthstoliveduetoaterminal illness
•haveselectedTotalandPermanentDisablement (TPD)cover,andbecome totally and
permanently disabled.
You may have additional options on your plan.
the cover the insured person has is shown on the Certificate of Insurance. that
information is updated each year in the Annual statement.
WHo We PAY For non-superannuation plans, we pay you.
For superannuation plans,wepayAMPSuperannuationLtdwhowillpaythebenefitin
accordancewiththeTrustDeedoftheFund.
INSUREDPERSON For non- superannuation plans more than one insured personcanbecoveredunderthe
plan.Forexample,youcanaskustoinsureyourspouse,child,orbusinesspartner,aswell
as yourself. You can do that at any time – even after we have issued the plan.
Youmayinsureachild(forChildren’sTraumacover)whenanadultisincludedasan
insured person under the plan.
Youcanalsobeaninsured person or you can own the planbutnotbeaninsured
person.
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• PlAN
• PlANOWNER
• TERMINAlIllNESS
• TOTAllYAND
PERMANENTlYDISABlED
• TRAUMACONDITIONS
THE DEFINITIONS ARE
SETOUTINRUlE40
2 – AMP Flexible liFetiMe – Protection – PlAn rules
cHAnGinG Your PlAn once the plan has started, you can apply to change it. For some changes, all you need to
doistellusbycallingusorinwriting.Forothers,youmayhavetosupplymoreinformation
for us to consider. You should contact your financial planner or us to discuss this.
tHe rules Therulesdescribingyourplan are set out on the following pages. When the plan starts,
these rules and the Certificate of Insurance we sent you with these Plan rules form the
contract and plan with us.
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• PlAN
THE DEFINITIONS ARE
SETOUTINRUlE40
AMP Flexible liFetiMe – Protection – PlAn rules – 3
Tableofcontents
What has to happen for us to pay
reasons why we pay a lump sum 1 7
Waiver of premium option 1.2 8
stand alone cover or linked cover 2 8
trauma cover – adults 3 9
Table1–TraumacoverPremier – 10
Table1.1–PremierPartialsPlusoption – 11
Table2–TraumacoverStandard – 11
cover for some trauma conditions is delayed 3.1 11
trauma conditions suffered in three month period 3.2 12
TotalandPermanentDisablement(TPD)cover 4 12
Terminalillnessbenefit–adults 5 12
Deathcover 6 13
FuneralBenefit 6.1 13
FinancialPlanningBenefit 6.2 13
This rule has been removed 6.3
BusinessSafeguardoption 6.4 14
Children’sTraumacover 7 15
Thetraumaconditionswecover 7.1 15
Table3–Children’sTraumacover – 15
Coverforsomeconditionsisdelayed 7.1.1 16
Traumaconditionssufferedinthreemonthperiod 7.1.2 16
Children’sTraumacoverchangestoDeathcover 7.1.3 16
DeathcoverprovidedunderChildren’sTraumacover 7.2 16
How much we pay
What we pay 8 17
When we pay 9 17
Howmuchwepay 10 17
Terminalillnesscover–$2,000,000limit 10.1 17
Changestotheamountofcover 10.2 17
Taxesorcharges 10.3 17
cover amounts may change after we pay 11 18
Children’sTraumacover 11.1 19
TraumaPremierwithBuybackoption 11.2 19
example – 19
TraumaPremierReinstatementoption 11.3 20
rule no. Page no.
4 – AMP Flexible liFetiMe – Protection – PlAn rules
Whenwewon’tpay
on purpose 12 22
Death–orterminalillness–byownhand 13 22
Children’sTraumacover 14 22
Increasingbenefitsautomatically
Indexationfeature 15 23
Increasesstopatacertainage 15.1 23
You can decline increases – 23
When the plan and cover start and end
Whentheplanandcoverstart 16 24
Whentheplanandcoverend 17 24
Whenwecanendtheplan 17.1 25
Refundofpremiums 18 25
Restartingtheplan – 25
Guaranteed continuation of cover
Weguaranteetocontinueyourplan 19 26
Keeping you informed
Wesendyouanannualstatement 20 26
changing your plan
You can change your plan 21 27
Automatic plan enhancements 21.1 27
Guaranteedfutureinsurability 21.2 28
rule no. Page no.
AMP Flexible liFetiMe – Protection – PlAn rules – 5
Premium – what you have to pay
Howmuchandwhen 22 30
Governmenttaxes,duties,andcharges 22.1 30
Premium guarantee 23 31
Premium rates and discounts not guaranteed 23.1 31
Keeping the premium the same – 31
Ifwereduceourpremiumrates 24 32
Planfee 25 32
Premiumfrequencyfee 26 32
Discounts 27 32
Whenyoudon’thavetopaypremiums
if we pay you 28 33
Waiver of premium 29 33
Waiverofpremiumoption–individuallife 29.1 34
Waiverofpremiumoption–nominatedlife 29.2 34
How to make a claim
Whattodo 30 35
Healthandotherinformation 30.1 35
Ageandidentity 30.2 35
Timelimits 31 36
Lateclaimsandresponses 32 36
rule no. Page no.
6 – AMP Flexible liFetiMe – Protection – PlAn rules
Miscellaneous
ownership and transfers 33 37
Governinglaw 34 37
Australian$ 35 37
Ourliabilityislimited 36 37
no share of profits 37 37
This rule has been removed 38 –
trauma definitions and descriptions
Descriptionsoftraumaconditions 39 38
Glossary of definitions
Glossaryofdefinitions 40 64
enquiries and complaints
Contactus – 69
TimelimitsonmakingcomplaintstotheSCT – 70
rule no. Page no.
AMP Flexible liFetiMe – Protection – PlAn rules – 7
non-suPerAnnuAtion PlAn
Therearethreetypesofcoveravailableinnon-superannuationplans.
the three types of cover are:
1. trauma cover – if the insured person suffers a trauma condition, and survives
aspecifiednumberofdays,wepayalumpsum–seerule3.Thereare2levelsof
cover, trauma cover standard and trauma cover Premier. Premier covers more trauma
conditions than standard.
if a child is covered as an insured personunderChildren’sTraumacover,wepaya
lump sum if they suffer a trauma condition or die – see rule 7.
2.TotalandPermanentDisablement(TPD)cover–iftheinsured personbecomestotally
and permanently disabled,wepayalumpsum–seerule4.
3.Deathcover–
•Terminalillnessbenefit–iftheinsured person has less than 12 months to live, we pay
theamountwewouldpayiftheyhaddied(upto$2,000,000).Upondeath,wepayany
remainingDeathcover,ifapplicable–seerules5and10.1.
•Death–iftheinsured person dies, we pay a lump sum.
suPerAnnuAtion PlAn
TherearetwotypesofcoveravailableinSuperannuationplans.
the two types of cover are:
1.TotalandPermanentDisablement(TPD)cover–ifyoubecometotally and
permanently disabled,wepayalumpsum–seerule4.Note,TPDcovercanonlybe
selectedifDeathcoverisalsoselected.
2.Deathcover–
• Terminalillnessbenefit–ifyouhavelessthan12monthstolive,wepaytheamount
wewouldpayifyouhaddied(upto$2,000,000).Upondeath,wepayanyremaining
Deathcover,ifapplicable–seerules5and10.1.
•Death–ifyoudie,wepayalumpsum.
the Certificate of Insurance shows the type, or types, of cover, which apply to the
insured person(s).
What has to happen for us to pay
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• PlAN
• TOTAllYAND
PERMANENTlYDISABlED
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40
1.
reAsons WHY We PAY A luMP suM
8 – AMP Flexible liFetiMe – Protection – PlAn rules
1.1 Thisrulehasbeenremoved
1.2
WAiVer oF PreMiuM oPtion under this option, we will waive premiums that fall due under your plan if the insured
person is totally disabledforaperiodofmorethan6months. We may waive some
or all of the premiums falling due under this option, depending on whether you have
selected “nominated life “ or “individual life “. see rule 29.
2.
STANDALONECOVERORLINKEDCOVER if an insured person is covered for more than one type of cover, all their cover is either
Stand alone or linked:
• Stand alone means that each type of cover is completely independent of all other types
of cover that apply to an insured person under this plan. if we pay under one type of
cover,itdoesn’taffecttheamountofanyothercoverforthat insured person. the only
timethisdoesn’tapplyisifwepayunderTerminalIllnessbenefit,whenwereducethe
amountoftheDeathcoverthatappliestothe insured personbytheamountwepay.
•linked means that each type of cover for an insured person is dependent on each
other type of cover. if we pay under one type of cover, the amount of each remaining
type of cover that applies to that insured personisreducedbytheamountwepay.See
rule 11.
note, if an insured personiscoveredforonlyonetypeofcover,it’streatedas Stand alone.
exAMPle
IndiraownsaFlexibleLifetime–Protectionplan under which she is an insured person.
she has:
•Traumacoverof$200,000,and
•Deathcoverof$300,000.
if she chooses Stand alone coverandwepayherbecauseshesuffersa trauma
condition,herTraumacoverwouldendbutherDeathcoverwouldcontinueunchanged.
instead if she chooses linkedcoverandwepayherbecauseshesuffersatrauma
condition,herTraumacoverwouldendandherDeathcoverwouldbereducedby
$200,000.Thatis,herDeathcoverwouldbereducedto$100,000.
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• lINKED
• MONTH
• PlAN
• PREMIUM
• STANDAlONE
• TOTAllYDISABlED
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
Your Certificate of Insurance shows whether the cover that applies to an insured
person is Stand alone or linked.
AMP Flexible liFetiMe – Protection – PlAn rules – 9
3.
TRAUMACOVER–ADULTS
AVAILABILITY Notavailabletosuperannuationplans.
We pay if an insured person suffers a trauma condition,andsurvivesfor14
days. note, the trauma condition for coma has a different survival period. see the
description for coma in rule 39.
Thedescriptionsinrules30,31and39setouttheotherrequirementsthatmustbemet
beforewepay.
Thenumberoftrauma conditions an insured person is covered for depends on if
you have selected:
•TraumacoverStandard,or
•TraumacoverPremier,or
•TraumacoverPremierwithPartialsPlusoption.
Tables1,1.1and2showwhichtrauma conditions are covered under each of the
covertypesabove.
For each insured person the Certificate of Insurance shows whether standard,
Premier, or Premier with Partials Plus option applies and when the cover starts and ends.
note, cover is delayed for three months for some trauma conditions.SeeTables1,
1.1 and 2.
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• MONTHS
• PlAN
• TRAUMACONDITIONS
THE DEFINITIONS ARE SET
OUTINRUlE40.
Your Certificate of Insurance shows whether trauma cover - adults applies to an
insured person.TheruleonChildren’sTraumacoverissetoutinrule7.
10 – AMP Flexible liFetiMe – Protection – PlAn rules
Trauma cover Premier covers the following trauma conditions for adults*
Coverfortheconditionsinthiscolumn
starts immediately
Coverfortheconditionsinthiscolumn
is delayed for three months. See rules
3.1 and 3.2
Alzheimer’sdiseaseandotherdementias Aortic surgery
Aplastic anaemia Benigntumourofthebrainorspinalcord
blindness cancer
cardiomyopathy coronary artery angioplasty– triple vessel
coma coronary artery surgery
encephalitis Heart attack– myocardial infarction
HIV/AIDS–medicallyacquired Heart attack– out of hospital cardiac arrest
HIV/AIDS–occupationallyacquired Heart valve surgery
intensive care open heart surgery
Kidney failure Pneumonectomy
liver failure severe rheumatoid arthritis
loss of hearing stroke
loss of independent living
loss of speech Partial benefit only:
Lossofuseoflimbsand/orsight Cancer(Partial)
lung failure Coronaryarteryangioplasty(Partial)
Major head trauma Parkinson’sdisease(Partial)
Major organ transplant
Motor neurone disease
Multiple sclerosis
Muscular dystrophy
Myelodysplasia
Myelofibrosis
Paralysis that is one of:
•diplegia
•hemiplegia
•paraplegia
•quadriplegia
•tetraplegia
Parkinson’sdisease
Peripheralbloodstemcellorbonemarrow transplant
Peripheral neuropathy
Primary pulmonary hypertension
Severeburns
systemic lupus erythematosus
systemic sclerosis
* From the plan anniversary following the insured person’s69thbirthday,theonly
trauma conditions coveredareLossofindependentlivingandLossofuseoflimbs
and/or sight.
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• PlAN
• TRAUMACONDITIONS
THE DEFINITIONS ARE SET
OUTINRUlE40.
Table1
AMP Flexible liFetiMe – Protection – PlAn rules – 11
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• CPI
• INSUREDPERSON
• MONTHS
• PlAN
• PlANANNIVERSARY
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
Table1.1
The Partials Plus option covers the following trauma conditions for adults
Coverfortheconditionsinthis
column starts immediately
Coverfortheconditionsinthiscolumnis
delayed for three months – see rules 3.1 and 3.2
Partialblindness Melanoma
Prostate cancer
Severeinflammatoryboweldisease
severe osteoporosis
Table2
Trauma cover Standard covers the following trauma conditions for adults*
Coverfortheconditionsinthis
column starts immediately
Coverfortheconditionsinthiscolumnis
delayed for three months – see rules 3.1 and 3.2
Kidney failure Aortic surgery
Major organ transplant cancer
Paralysis that is one of: coronary artery surgery
– diplegia Heart attack – myocardial infarction
– hemiplegia Heart attack – out of hospital cardiac arrest
– paraplegia Heart valve surgery
– quadriplegia stroke
– tetraplegia
Peripheralbloodstemcellorbone
marrow transplant
* From the plan anniversary following the insured person’s64thbirthday,theonlytrauma
conditions coveredareLossofindependentlivingandLossofuseoflimbsand/orsight.
Forustopaybecauseaninsured person suffers one of the trauma conditions listed in
therighthandcolumnofTable1,Table1.1orTable2,theinsured person must suffer
the trauma condition more than three months after the trauma cover for the insured
person starts or restarts. that date is shown on the Certificate of Insurance or in the
document in which we told you that we have restarted the trauma cover or plan.
Also, if we have increased the amount of the trauma cover for that insured person
becauseyouaskedusto,andwithinthreemonths after the increase that insured person
suffers one of the trauma conditionsintherighthandcolumnofTable1,Table1.1or
Table2,wepaytheamountthatappliedbeforetheincrease.Thatthreemonth period
starts on the date from which the increase applies.
these restrictions do not apply to regular CPI increases.
if your plan replaces a previous planissuedbyusoranotherinsurer,thethreemonth
delayexplainedpreviouslywon’tapplyifyouwereeligibletoclaimforthesamecondition
under the previous plan provided:
•thepreviousplan was in force at the time we issued your plan, and
•thepreviousplan was in place for at least three months.
We will require satisfactory evidence of these points at the time of any claim for this
to apply.
3.1
coVer For soMe trAuMA
CONDITIONSISDELAYED
12 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• DOCTOR
• HOMEDUTIES
• MONTH
• OWNOCCUPATION
• REGUlARREMUNERATIVE
WORK
• TERMINAlIllNESS
• TOTAllY&PERMANENTlY
DISABlED
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40
if an insured person suffers a trauma condition in the right hand column of the trauma
covertableswithinthreemonths after the trauma cover for that insured person starts,
orrestarts,we’llneverpayforthatcondition,eveniftheinsured person suffers it again
later.
We pay if:
•anillnessorinjurywhichcausesaninsured persontobecometotally and permanently
disabled happens while that insured personiscoveredbyTPDcover,and
•theysurviveforsixmonthsafterthedateonwhichtheystopperforming(orwould
havestoppedperforming)homeduties,regularremunerativework, or their own
occupationbecauseoftheirillnessorinjury.
However, if an insured person meetsthedefinitionofTPDbecauseofeitherLossofuseof
limbsand/orsightorLossofindependentlivingorLossofcognitivefunctioningunderthe
definition of totally and permanently disabled,theyonlyneedtosurvivefor14days.
For superannuation plans,wepayAMPSuperannuationLtdwhowillpaythebenefitto
youinaccordancewiththeTrustDeedoftheFund.
5.
TERMINALILLNESSBENEFIT–ADULTS
We pay if an insured person is diagnosed as having less than 12 months to live. For us
to pay, the insured person’s doctormusttellusinwritingthattheybelievetheinsured
person has less than 12 months to live. the doctor’sbeliefmustbebasedonclinical
findings and reports. We will only pay if we agree with the doctor. We may also require
you to give us information from medical advisers we choose.
3.2
TRAUMACONDITIONSSUFFEREDIN
THREEMONTHPERIOD
4.
TOTALANDPERMANENTDISABLEMENT
(TPD)COVER
Your Certificate of InsuranceshowswhetherTPDcoverappliestoaninsuredperson
ThiscoverisbuiltintoDeathcover.IftheDeathcoverappliestoan insured person,
that person is automatically covered for terminal illness. Your Certificate of
InsuranceshowswhetherDeathcoverappliestoaninsured person.
AMP Flexible liFetiMe – Protection – PlAn rules – 13
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• MONTH
• PlAN
• PlANOWNER
THE DEFINITIONS ARE SET
OUTINRUlE40.
6.
DEATHCOVER
We pay if the insured person dies.
6.1
FunerAl beneFit
AVAILABILITY Notapplicabletosuperannuationplans.
WHATHASTOHAPPENFORUSTOPAY Wewilladvanceyou,onyourrequest,partoftheDeathcoveramountontheproduction
of the insured person’s death certificate, while we are assessing the death claim.
Theadvancewillbemadetoeither:
•asurvivingplan owner, or
•ifthe plan owner is deceased, and on completion of an indemnity and discharge in a
formacceptabletous,toanypersonconsideredbyustobedependentontheinsured
person at the time of their death.
HOWMUCHWEPAY Wewilladvanceupto$10,000.TheDeathcoveramountontheplanwillbereduced
bytheamountoftheadvance.TheremainderoftheDeathcoverwillbepayableupon
acceptance of a death claim.
6.2
FinAnciAl PlAnninG beneFit
AVAILABILITY Notapplicabletosuperannuation plans.
WHATHASTOHAPPENFORUSTOPAY Wewillreimburseyouforthecostoffinancialplanningadviceafterabenefitpaymenton
this plan.
Thefinancialadvicemustcomefromasuitablyqualifiedpersonacceptabletous.
HOWMUCHWEPAY Wewillreimburseyouupto$1500,additionaltotheamountofthebenefitpaid.
WHENWEPAY Wewillreimburseyouafterthebenefithasbeenpaidandyouproduceevidenceofthis
expenseinaformacceptabletous.
HOWOFTENWEPAY Thisbenefitispayableonlyonceforeachinsured person on this planandmustbe
claimed within twelve monthsofthebenefitbeingpaid.
Your Certificate of InsuranceshowswhetherDeathcoverappliestoaninsured person.
14 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• PlAN
• TERMINAlIllNESS
THE DEFINITIONS ARE SET
OUTINRUlE40.
6.3 Thisrulehasbeenremoved
6.4
BUSINESSSAFEGUARDOPTION
AVAILABILITY Notapplicabletosuperannuationplans.
WHENYOUCANINCREASEYOUR YoumayapplytoincreasethelevelofDeathorTPDcover,orbothDeathandTPDcovers
DEATHORTPDCOVER withoutfurthermedicalevidence.
HoW MucH You cAn increAse You can apply to increase the cover under this option:
COVERBY •ifthisplanformspartofawrittenbuy/sell,sharepurchaseorbusinesscontinuation
agreement:bytheactualincreaseinthevalueofyourinterestinthebusinesssincethe
latter of last time the option was exercised and the commencement of the option, or
•iftheinsured personisakeypersontothebusiness,theactualincreaseinthevalue
of the insured persontothebusinesssincethelatterofthelasttimetheoptionwas
exercised and the commencement of the option.
WHENDOESTHEOPTIONEND? Theoptionwillceasewhenanyofthefollowingoccurs:
•youdon’texercisetheoptionforfiveyears.
•after10yearsfromthecommencementoftheoption
•theinsured personturns65
•theDeathorTPDcoverisfivetimestheoriginalamount
•theDeathcoverreaches$15,000,000ortheTPDcoverreaches$2,500,000
•theinsured personhasreceived,oriseligibletoreceive,abenefitunderthisoranother
life insurance plan.
ELIGIBILITYTOINCREASE Youcan’ttakeupthisoptionifatthetimeofyourrequestthe insured person has made
oriseligibletomakeaterminal illness,traumaorTPDclaimunderanyplan with us.
CONDITIONSOFINCREASE Wewillrequirefinancialevidenceoftheincreaseinthevalueofthebusinessfroman
independentqualifiedaccountant,businessvaluer,orotherappropriatepersonallofwhom
mustbeapprovedbyus.
AMP Flexible liFetiMe – Protection – PlAn rules – 15
7.
CHILDREN’STRAUMACOVER Notavailabletosuperannuationplans.
7.1
THETRAUMACONDITIONSWECOVER
We will pay if an insured person suffers a trauma condition,andsurvivesfor14days.
Thedescriptionsinrules30,31and39setouttheotherrequirementsthatmustbemet
beforewepay.
For some trauma conditions, cover is delayed for three months. For the others, cover
only applies to an insured personwhohasturned10.TheCertificate of Insurance
showswhenChildren’sTraumacoverstarts.Thecoverfortrauma conditions under
Children’sTraumacoverendsaftertheinsured personturns16andautomatically
convertstoDeathcover.SeeRule7.1.3.
Table3
Children’sTraumacovercoversthefollowingtraumaconditionsforchildren
Coverforthetraumaconditionsinthis
column starts immediately*
Coverforthetraumaconditionsinthis
column is delayed for three months.
See rules 7.1.1 and 7.1.2
Major head trauma Aplastic anaemia
Major organ transplant bacterial meningitis
Paralysis that is one of: cancer
•diplegia leukaemia
•hemiplegia Subacutesclerosingpanencephalitis
•paraplegia Viral encephalitis
•quadriplegia
•tetraplegia
Peripheralbloodstemcellorbonemarrow
transplant
Severeburns
*Ifthechildisunder10,coverisdelayeduntiltheyturn10.
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• MONTH
• PlAN
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
Your Certificate of Insurance shows whether it applies to an insured person.
this rule applies to insured personscoveredunderChildren’sTraumacover.SeeRule
3 for trauma conditions covered under trauma cover standard, trauma cover Premier
and trauma cover Premier with Partials Plus option.
16 – AMP Flexible liFetiMe – Protection – PlAn rules
7.1.1
coVer For soMe trAuMA For us to pay when an insured person suffers a trauma condition listed in the right hand
CONDITIONSISDELAYED columnofTable3,theinsured person must suffer the trauma condition more than
three monthsaftertheChildren’sTraumaCoverforthatinsured person starts or restarts.
that date is shown in the Certificate of Insurance or in the document in which we told
youthatwehaverestartedtheChildren’sTraumacoverortheplan.
Also,ifwehaveincreasedtheamountoftheChildren’sTraumacoverbecauseyouaskedus
to, and within three months after the increase the insured person suffers one of the trauma
conditionsintherighthandcolumnofTable3wepaytheamountthatappliedbeforethe
increase. the three month period starts on the date from which the increase applies.
these restrictions do not apply to regular CPI increases.
if your plan replaces a previous planissuedbyusoranotherinsurer,the3month delay
explainedpreviouslywon’tapplyifyouwereeligibletoclaimforthesameconditionunder
the previous plan provided:
•thepreviousplan was in force at the time we issued your plan, and
•thepreviousplan was in place for at least three months.
We will require satisfactory evidence of these points at the time of any claim for this to apply.
7.1.2
TRAUMACONDITIONSSUFFEREDIN if an insured person suffers:
THREEMONTHPERIOD •atrauma conditionlistedintherighthandcolumnofTable3onpage15withinthree
months after the cover for that insured person starts, or restarts,
•atrauma conditionlistedinthelefthandcolumnofTable3onpage15beforetheyturn
10,wewon’teverpayforthatcondition,eveniftheinsured person suffers it again later.
7.1.3
CHILDREN’STRAUMACOVER At the plan anniversaryonorbeforetheinsuredchild’s17thbirthday,theChildren’s
CHANGESTODEATHCOVER TraumacoveranditsbuiltinDeathcoverends.However,atthatdatetheamountofthe
Children’sTraumacoverautomaticallychangestoDeathcover(whichincludesbuilt-in
terminalillnessbenefit,GuaranteedfutureinsurabilityandFuneralbenefit).
7.2
DEATHCOVERPROVIDEDUNDER
CHILDREN’STRAUMACOVER
WepayifaninsuredchilddieswhilecoveredbyChildren’sTraumacover.Wewillpay
$10,000.
. Note,thisDeathcoverendsifwepaybecausetheinsured person suffers one of the
trauma conditionscoveredunderChildren’sTraumacover.
THESE WORDS AND PHRASES ARE DEFINED:
•CERTIFICATEOFINSURANCE
• CPI
• INSUREDPERSON
•MONTH
• PlAN
•PlANANNIVERSARY
•TRAUMACONDITION
THEDEFINITIONSARESETOUTINRUlE40
Deathcover(excludingtheTerminalIllnessbenefit,Guaranteedfutureinsurabilityand
Funeralbenefit)isbuiltintoChildren’sTraumacover.
AMP Flexible liFetiMe – Protection – PlAn rules – 17
THESE WORDS AND PHRASES ARE DEFINED:
• CPI
• HOMEDUTIES
• INSUREDPERSON
• MONTH
• OWNOCCUPATION
• PlAN
• REGUlARREMUNERATIVEWORK
• TERMINAlIllNESS
• TERMINAllYIll
• TRAUMACONDITIONS
THEDEFINITIONSARESETOUTINRUlE40.
8.
WHAt We PAY We pay a lump sum.
9.
WHen We PAY We will pay as soon as we have processed a claim which satisfies the rules of the plan.
10.
HoW MucH We PAY trauma cover – we pay the amount of the cover that applies on the date that the
requirements of the trauma condition was met.
TPDcover–wepaytheamountofcoverthatappliesonthedatesixmonths after the
insured personstoppedperforming(orwouldhavestoppedperforming)home duties,
regularremunerativework or their own occupation.
TerminalIllnessbenefit–wepaytheamountofDeathcoverthatappliesonthedatewe
agree with the terminal illnessdiagnosis.Seerule10.1.
Deathcover–wepaytheamountofcoverthatappliesonthedatelistedinthedeath
certificate(oronthedateofdeath).
Note,ifwehavealreadypaidyoubecauseofsomethingthathappenedtothatinsured
person,anyremainingcovermayhavebeenreduced.Seerule11.
10.1
terMinAl illness Ifwepaybecausetheinsured person is terminally ill, we will advance you up to
COVER–$2,000,000LIMIT $2,000,000ofanyDeathcoveramount.the most we will pay altogether under all AMP
plansbecauseaninsured person is terminally illis$2,000,000.Ifthe$2,000,000limit
applies,wereducetheDeathcoverthatappliestothatinsured personbytheamountwe
pay, and later when they die, we pay any remaining death cover.
10.2
cHAnGes to tHe AMount oF coVer After the plan starts, the amount of each cover for an insured person may change in any
of the following ways:
•itcanincreaseeachyearbyanyincreaseintheCPI. each year, we will show the new
amount in the Annual statement, or
•itcanchangewhenyouaskustochangeit.Ifithaschangedinthisway,wewillshow
the new amount in the document we send you to record the change, or
•itwillreduce–perhapstozero–foraninsured personifwepaybecausesomething
happens to that insured person. see rule 11.
10.3
tAxes or cHArGes We deduct any taxes or government charges from the amount we pay:
•whichthelawrequiresustodeduct,or
•whichhavetobepaidandwhichwedecidetodeduct.
How much we pay
18 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND PHRASES
ARE DEFINED:
• CERTIFICATEOFINSURANCE
• INSUREDPERSON
• lINKED
• STANDAlONE
• TRAUMACONDITION
THE DEFINITIONS ARE SET OUT
INRUlE40.
if cover is stand alone
Ifwepayabenefitforaninsured person and the cover that applies to them is Stand
alone:
•thecoverforwhichwepaidends,and
•ifwepaytheTerminalillnessbenefit,thedeathcoverforthat insured person also ends.
However,ifthe$2,000,000limitinrule10.1applies,thedeathcoverisonlyreducedby
the amount we pay; and
•theamountofanyothercoverthatcontinuesforthat insured person stays the
same – that is, these amounts are not reduced. note, if the insured person dies, all
cover for that insured person ends.
the Certificate of Insurance shows if cover is Stand alone.
if cover is linked
Ifwepayabenefitforan insured person and the cover that applies to them is linked:
•thecoverforwhichwepaidends,and
•wereducesome,orall,ofanyothercoverforthatinsured personbytheamountwe
paid, and
•some,orall,ofanyothercoverforthat insured person will end.
We explain the way covers are reduced in the example provided under rule 2 on page 8.
the Certificate of Insurance shows if cover is linked.
11.
coVer AMounts MAY cHAnGe
AFter We PAY
AMP Flexible liFetiMe – Protection – PlAn rules – 19
THESE WORDS AND
PHRASES ARE DEFINED:
• BUYBACK
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• lINKED
• PlANANNIVERSARY
• PREMIUM
• PREMIUMRATES
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
11.1
CHILDREN’STRAUMACOVER Ifwepaybecauseaninsured person suffers a trauma conditionunderChildren’s
trauma cover or dies, all cover for that insured person ends.
11.2
trAuMA PreMier WitH Your Certificate of Insurance shows if theBuybackoptionhasbeenselected.
buY bAcK oPtion theBuybackoptionisonlyavailableifyouchooseDeathcoverlinked with your trauma
cover Premier. if you select theBuybackoption,youwillbeabletorestoretheDeath
cover on the planbytheamountitwasreduceduponafullTraumacoverclaim.The
optiontorestoretheDeathcoverbecomesavailableoneyearafterwepaythefullTrauma
coverclaim,andisexercisablefor30days.
WewillbasethepremiumforthenewcoveronournormalDeathcoverpremium rates
and the insured person’s age at the time, taking into account the cover amount, and
any special conditions or premium loadings applying to your original cover. the Buyback
option will cease on the plan anniversary following the insured person’s64thbirthday.
TheindexationfeatureandGuaranteedfutureinsurabilityarenotavailableontherestored
Deathcover.
exAMPle
JennyownsaFlexibleLifetime–Protectionplan under which she is an insured person.
she has:
Deathcoverof$300,000linkedwithTraumacoverPremierof$200,000.Shehas
also selected the Buyback option. if she suffers a trauma condition, we will pay her
$200,000,andherDeathcoveramountwillreduceto$100,000.Oneyearafterwepay
theclaim,JennycanaskustorestoreherDeathcoveramountbackto$300,000.
20 – AMP Flexible liFetiMe – Protection – PlAn rules
11.3
trAuMA PreMier reinstAteMent oPtion Your Certificate of InsuranceshowsiftheTraumaReinstatementoptionhasbeen
selected.
TheTraumaReinstatementoptioncanonlybeselectedwhenyouchooseTraumacover
Premier.
ThisoptionallowsyoutochoosetorestorethefullTraumabenefitamountwehavepaid
after a full trauma claim, without having to provide additional evidence of health, details of
the insured person’s occupation or pastimes. the trauma reinstatement option does not
applytoanypartialtraumabenefitswepay.
ThisoptionbecomesavailableoneyearafterwepaythefullTraumacoverclaim,andis
exercisablefor30days,bycompletingtherelevantapplicationform.Wewillbasethe
premium for the Reinstated Trauma coveronourTraumacoverratesapplicableatthe
time and the insured person’s age at the time, taking into account the sum insured and
any special conditions or premium loadings applying to the original trauma cover.
the option to reinstate the cover will cease on the earlier of the following:
•thedateshownintheCertificate of Insurance, and
•13monthsafterthedateoftheoriginalfullTraumaclaim.
Youcan’texercisetheTraumareinstatementoptionifwehavepaidatraumaclaimforany
benefitthatisapartialbenefit(whetherunderPremiercoverorthePremierPartialsPlus
option).
if the Premier with Buyback option applies to your plan(seeRule11.2),youmustrestore
theDeathcoveronyourplan at the same time you restore your trauma cover otherwise
youlosetheoptionrestoretoyourDeathcoveratafuturedate.IfthePremierwithBuy
back option does not apply to your plan, you do not have the option to restore any
reducedorcancelledDeathcover.
reinstated trauma cover
TheIndexationfeatureandGuaranteedfutureinsurabilityarenotapplicableonthe
Reinstated Trauma cover.
We will not pay a claim for the Reinstated Trauma cover if:
•theinsured person was diagnosed or suffered symptoms leading to diagnosis of a
new trauma conditionthatbecameapparentoroccurredintheintervening13month
periodpriortothedateofreinstatementoftheTraumacover(andwereceiveyour
completed application form and first premium),or
•thenewtrauma condition is the same as the original trauma condition or is directly
or indirectly caused or related to the trauma condition for which the original trauma
cover was paid, or
•thenewtrauma condition is directly or indirectly related to the treatment used for the
original trauma condition, or
THESE WORDS AND
PHRASES ARE DEFINED:
• BUYBACK
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• PlAN
• PREMIUM
• REINSTATEDTRAUMA
COVER
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
AMP Flexible liFetiMe – Protection – PlAn rules – 21
•thetrauma condition is Kidney failure or a Heart condition* and the original trauma
cover payment was for systemic lupus erythematosus, or
•the trauma condition is a Heart condition* and the original trauma cover payment was
also for a Heart condition*, or
•thetrauma conditionisaStrokeorParalysis**(directlyorindirectlyresultingfroma
stroke)andtheoriginaltraumacoverpaymentwasforaHeartcondition*.
* Heart condition means any of the following definitions: aortic surgery, cardiomyopathy, coronary artery angioplasty – triple vessel, coronary artery surgery, heart attack – myocardial infarction, heart attack – outofhospitalcardiacarrest,heartvalvesurgery,majororgantransplant(heartonly),openheartsurgery,primary pulmonary hypertension.
** Paralysis means any one of diplegia, hemiplegia, paraplegia, quadriplegia or tetraplegia.
Wewon’tpayabenefitundertheReinstated trauma cover for a trauma condition for
whichwehavealreadypaidatraumabenefit.
Wewon’tpayabenefitundertheReinstated trauma cover for a trauma condition
unlessacceptableevidenceisprovidedthatthenew trauma condition is:
•independentof,andtotallyunrelatedtothepreviouslypaidtrauma condition, and
•totallyunrelatedtothetreatmentusedfortheoriginaltrauma condition for which we
paid.
Wewon’tpayabenefitundertheReinstated trauma cover for any conditions or
symptomsthatbecomeapparentorarediagnosedbeforethedateofreinstatementofthe
trauma cover.
exAMPle
MichaelownsaFlexibleLifetime–Protectionplanunderwhichheisaninsured person.
He has:
TraumacoverPremierof$400,000.HehasalsoselectedtheTraumaReinstatementoption.
if he suffers a trauma condition,wewillpayhim$400,000,andhisTraumacoverwill
cease. one year after we pay the claim, Michael can exercise the trauma reinstatement
option and have Reinstated Trauma coverof$400,000.
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• REINSTATEDTRAUMA
COVER
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
22 – AMP Flexible liFetiMe – Protection – PlAn rules
Whenwewon’tpay
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• CPI
• INSUREDPERSON
• PlAN
• TERMINAllYIll
• TOTAllYAND
PERMANENTlYDISABlED
• TOTAllYDISABlED
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
Rules12and13alsoapplytoanyclaimsunderChildren’sTraumacover.
12.
on PurPose Wewon’tpayiftheinsured person’s trauma condition or the insured person
becoming totally and permanently disabled or totally disabled was caused directly or
indirectlybyanintentionalordeliberateactbyyou,ortheinsured person.
13.
DEATH–ORTERMINALILLNESS– Wewon’tpayiftheinsured persondies(orbecomesterminally ill)bytheirownhand
BYOWNHAND withinoneyearand30daysofthedatetheDeathcoverstartsorrestarts(respectively).
that date is shown on the Certificate of Insurance or in the document in which we told
youthatwehaverestartedtheDeathcoverorplan.
Also,ifwehaveincreasedtheamountoftheDeathcoverforaninsured personbecause
youaskedusto,andwithinoneyearand30daysaftertheincrease,thatinsured person
dies–orbecomes terminally ill–bytheirownhand,wepaytheamountthatapplied
beforetheincrease.Thatoneyearand30dayperiodstartsonthedatefromwhichthe
increase applies. that date is shown in the document in which we told you that we have
increasedtheDeathcover.
if your plan replaces a previous planissuedbyus,oranotherinsurer,theoneyearand
30dayperiodwon’tapply.Ifyouwouldhavebeenentitledtoclaimundertheprevious
plan, provided:
•thepreviousplan was in force at the time AMP issued this plan, and
•thepreviousplanwasinplaceforatleastoneyearand30days.
Wewillrequiresatisfactoryevidenceoftheabovepointsatthetimeofanyclaimforthisto
apply.
Note,itdoesn’tmatterwhetherthe insured person was sane or insane when they
becameterminally ill or died.
this restriction does not apply to regular CPI increases.
14.
CHILDREN’STRAUMACOVER Wewon’tpayifan insured person’s trauma conditioniscauseddirectlyorindirectlyby
any congenital condition.
Wewon’tpayifaninsured person’s trauma condition or death is caused directly or
indirectlyby:
•alcoholordrugs,or
•anybodywhoisconnectedtotheinsured person, or to either of their parents, or to a
de facto spouse of either parent.
AMP Flexible liFetiMe – Protection – PlAn rules – 23
IncreasingbenefitsbytheCPI
15.
INDEXATIONFEATURE each year, on the plan anniversary, we will increase the amount of an insured person’s
coverbyanyincreaseintheCPIor5%,whicheverishigher,unlessweagreednottowhen
that cover started.
TheseincreaseswillbeclearlyidentifiedintheAnnualStatementwesendyoueachyear.
increasing an insured person’s cover makes the premium increase.
Ifyoudon’twantthisincrease,infullorinpartthenyouneedtotellus.
Note:wedon’tincreasethefollowing:
•the$10,000DeathcoverunderChildren’sTraumacover
•reinstated trauma cover issued as a result of exercising the trauma reinstatement
option(seeRule11.3)
•deathcoverissuedasaresultofexercisingtheBuybackoption(seeRule11.2).
15.1
cPi increAses stoP At A certAin AGe the last time we increase an insured person’scoverbyanyincreaseintheCPI is on the plan
anniversaryon,orbefore,theinsured personreachestheageshowninthetablebelow.
Type of cover Age limit
trauma cover – adults 75
TerminalIllnessbenefit 75
Deathcover 75
TPDcover 75
You can decline cPi increases
We make increases under the indexation feature automatically. However, you can ask us:
•toincreasetheamountofsomeorallofaninsured person’scoverbyonlysomeofthe
increaseavailableundertheindexationfeature,or
•nottoincreasetheamountofan insured person’s cover at all, or
•nottoincreasetheamountofan insured person’s cover ever again.
Ifyouwantustodoanyofthesethings,youneedtotellus,inwriting,beforeyoupay
the premium that falls due on the plan anniversary from which the increase under the
indexation feature is to apply.
Youcansubsequentlyaskustomakeincreasesundertheindexationfeaturetothatcover
for that insured person again.
We may agree to do this.
THESE WORDS AND
PHRASES ARE DEFINED:
• BUYBACK
• CPI
• INSUREDPERSON
• PlAN
• PlANANNIVERSARY
• REINSTATEDTRAUMA
COVER
THE DEFINITIONS ARE SET
OUTINRUlE40.
24 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• HOMEDUTIES
• INSUREDPERSON
• OWNOCCUPATION
• PlAN
• REGUlARREMUNERATIVE
WORK
• TOTAllYAND
PERMANENTlYDISABlED
• TRAUMACONDITIONS
THE DEFINITIONS ARE SET
OUTINRUlE40.
When the plan and cover start and end
16.
WHENTHEPLANANDCOVERSTART When we accept your application for insurance we will send you a Certificate of
Insurance showing you the details of your insurance and the date your plan commenced.
While most cover for an insured person starts on the date shown in the Certificate of
Insurance, cover for some trauma conditions is delayed. this is explained in rule 3.1 for
TraumacoverPremierandStandardandrule7.1.forChildren’sTraumacover.
the CertificateofInsurance shows the dates on which each type of cover for each
insured person starts.
17.
WHENTHEPLANANDCOVEREND each type of cover for an insured person ends on the first of the following dates:
•whenwepayyouforthatinsured person for that type of cover. this is explained in rule
11, or
•whenwereducetheamountofthattypeofcovertozeroforaninsured person
becausewepayyouunderanothertypeofcover.Thisisexplainedinrule11,or
•onthedateshownintheCertificate of Insurance for that insured person for that
type of cover, or
•ifyouchangeyourplan in a way that ends that type of cover for that insured person, or
•iftheinsured person dies, or
•whentheplan ends.
the insured person’s cover ends when the plan ends. the plan ends as soon as one of
the following happens:
•allcoverforthelastremaininginsured person ends, or
•youwritetousandaskustoendtheplan, or
•weendtheplan under rule 17.1.
note, if an insured personwhoiscoveredbyTPDcoverstopsperforminghome
duties, or regularremunerativework or their own occupation, the circumstances
in which we would pay under that type of cover are very narrow. this is explained in
the definition of totally and permanently disabledinrule40.
AMP Flexible liFetiMe – Protection – PlAn rules – 25
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• MONTHS
• PlAN
• PREMIUM
THE DEFINITIONS ARE SET
OUTINRUlE40.
17.1
WHENWECANENDTHEPLAN to keep the plan going, you must pay the premium on time. We can end the plan if you
don’tdothis.However,ifyoudon’tpayontime,youhaveanextra30daystopaybefore
we take steps to end the plan.Ifyouhaven’tpaidontime,wewillwriteandremindyou.
18.
REFUNDOFPREMIUMS if you end the plan during a period for which you have already paid the premium, we
refund the premium less the plan fee, stamp duty and government charges – for any
unused complete months.Wedon’trefundpremiums if the plan ends for any other
reason.
exAMPle
if you have paid a yearly premiumof$1,200,andyouendtheplan nine months later,
werefund$300.
For superannuation plans we will pay this refund into a similar complying superannuation
fundthatyounominate,ortoanaccountintheAMPEligibleRolloverFund(ERF)onyour
behalf.
restArtinG tHe PlAn if you end the plan, you can ask us to restart it. but you
must ask us in writing within 12 months of it ending.
if we end the planbecauseyoudon’tpayontime,you
can ask us to restart it. but you must ask us in writing
within 12 months after the due date of the premium you
didn’tpay.
to restart the plan, you must:
•payusonepremium, and
•giveusanyinformationwerequireaboutanyinsured
person.
We may then agree to restart the plan.
26 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• PlAN
• PlANANNIVERSARY
• PREMIUM
THE DEFINITIONS ARE SET
OUTINRUlE40.
Guaranteed continuation of cover
Keeping you informed
19.
We GuArAntee to continue Your PlAn if you pay your premium on time and the cover is still current, we guarantee:
•tokeepthecoverforeach insured person going on the same rules each year, and
•nottocancelit–oranypartofit.
20.
WESENDYOUANANNUALSTATEMENT each year, we will send you an Annual statement. it will set out:
•thenameofeach insured person, and
•thetypesofcoveryouhaveforeachinsured person, and
•theamountofcoverafteranyregularincreaseundertheindexationfeature,and
•thepremium you have to pay to keep the plan going.
WewillsendyoutheAnnualStatementjustbeforeyourplan anniversary.
this provides an opportunity for you to speak to your financial planner, or us, and
review and update your insurance needs.
AMP Flexible liFetiMe – Protection – PlAn rules – 27
THESE WORDS AND
PHRASES ARE DEFINED:
• BUYBACK
• INSUREDPERSON
• lINKED
• PlAN
• PREMIUM
• PREMIUMRATES
• SPECIAlRUlE
• STANDAlONE
THE DEFINITIONS ARE SET
OUTINRUlE40.
changing your plan
21.
You cAn cHAnGe Your PlAn You can change your plan in the following ways without needing to give us more details
aboutthe insured person’s health, occupation, or pastimes. this applies even if the
insured person’s health gets worse, or they change their occupation, or pastimes.
For example you can:
•changethelevelofcoverfromTraumacoverPremiertoTraumacoverStandard,or
•changean insured person’s type of cover from Stand alone to linked, or
•removetheBuyback option.
However:
•ifyoutransferatypeofcover,wemayrequireyoutotransferallofthattypeofcover
that applies to that insured person under this plan to the new plan. For linked cover,
we reduce the amount of any other remaining cover for that insured personbythe
amount you transferred, and
•the insured personmustbeunder70whenyoumakethechange,and
•thenewpremium, the new amount of cover, and the insured person’s age, must each
meetanynormalrequirementswehave(atthetimeyouchange)fortheplan or cover
which you change to.
Note,youcan’tmakeanyofthesechangesifaspecial rule applies to that insured person.
21.1
AutoMAtic PlAn enHAnceMents We review our insurance plans regularly. if we enhance our definitions or product features
without:
•changingthepremium rates or
•changingexistingpremium discounts, or
•chargingextrapremiums,
wewillautomaticallyprovideyouenhancementsforwhichyouareeligibleatnocharge.
Ifwemakeachangethatisnotanenhancementthesewon’tautomaticallyapplytoyour
plan.
Wewillwritetoyouandadviseyouofthechangesshouldautomaticenhancementsbe
made.
Note,youmaybeabletomakeotherchangestotheplan. For example, you can add
an insured person to this plan, or increase a type of cover. However, we will need
detailsabouttheinsured person’s health, occupation and pastimes. We suggest you
speaktoyourfinancialplanner,orus,aboutanychangesyouwouldliketomakeand
whatourrequirementswillbe.
28 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• CARER
• INSUREDPERSON
• MONTH
• PlAN
• PREMIUM
THE DEFINITIONS ARE SET
OUTINRUlE40.
21.2
GUARANTEEDFUTUREINSURABILITY You may increase an insured person’s Deathcoverand/orTPDcoverand/orTraumacover
without providing any evidence of health if:
•theinsured person marries, or
•the insured person divorces, or
•the insured person’s childisbornortheylegallyadoptachild,or
•theinsured person’s child starts school, or
•theinsured personisgrantedahousingloanbyafinancialinstitutiontobuytheirfirst
home, or
•theinsured person completes their first undergraduate degree at a recognised
Australian university, or
•theinsured personbecomesacarer for the first time.
You must apply for the increase within 12 months of the date the event occurs. You must
provideappropriateproofoftheevent,thatisacceptabletous,suchascertificationofthe
event or a statutory declaration. Premiumswillbebasedontheratesapplicableatthe
time of exercising this feature.
You can only increase the insurance cover amount once under this feature in any 12 month
period.Eachtime,youmayincreasetheinsurancecoveramountby25%oftheoriginal
suminsuredor$250,000,whicheveristhelesser.
ThemaximumtotalamountbywhichyoucanincreasetheDeathcoverunderthisfeature
over the life of the plan is the lesser of:
•theinitialamountofDeathcoverundertheplan(excludingincreasesunderthe
indexationfeatureandincreaseseffectedunderGuaranteedFutureInsurability),and
•$1,000,000.
ThemaximumtotalamountbywhichyoucanincreasetheTPDcoverand/orTraumacover
under this feature over the life of the plan is the lesser of:
•theinitialamountofTPDand/orTraumacoverundertheplan(excludingincreasesunder
theindexationfeatureandincreaseseffectedunderGuaranteedFutureInsurability),and
•$250,000.
ThemaximumamountyoucanincreaseTPDcovertounderthisfeatureis$2.5million.The
maximum amount you can increase trauma cover to under this feature is $2 million.
ThisfeatureisnotavailableforChildren’sTraumacover.
AMP Flexible liFetiMe – Protection – PlAn rules – 29
Youcan’texercisethisfeatureifatthetimeofyourrequest:
•theinsured personisolderthan55yearsofage,or
•the insured person’s plan has a premium loading or special terms, or
•theinsured person’s premiumsarebeingwaivedunderthewaiverofpremiumoption,or
•the insured personiseligibletomake,orhasmadeaterminal illness,TPDortrauma
claim under any plan that the insured person holds with AMP.
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• PlAN
• PREMIUM
• TERMINAlIllNESS
THE DEFINITIONS ARE SET
OUTINRUlE40.
30 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• PlAN
• PlANANNIVERSARY
• PREMIUM
• PREMIUMRATES
THE DEFINITIONS ARE SET
OUTINRUlE40.
Premium – what you have to pay
22.
HOWMUCHANDWHEN the amount of the premium when the plan starts, and when the premium falls due, are
bothshownintheCertificate of Insurance.
We recalculate the premiumeachyear.Atthattime,webaseitontheageofeach
insured person and the cover that applies to them. We use the premium rates, loadings,
discounts,andplanfees(andanygovernmentchargeslikestampduty)thatapplyatthat
time. We show you the recalculated premium in the Annual statement. We send this just
beforetheplan anniversary.
22.1
GOVERNMENTTAXES,DUTIES You have to pay us any government taxes, duties, or charges relating to the plan.
ANDCHARGES We will include these amounts in the amount of the premium when we tell you how
much the premium is.
if you change the plan, it is likely that the premium will change. After any change, we
will inform you of the change and the amount of the new premium in writing.
AMP Flexible liFetiMe – Protection – PlAn rules – 31
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• MONTHS
• PlAN
• PlANANNIVERSARY
• PREMIUM
• PREMIUMRATES
THE DEFINITIONS ARE SET
OUTINRUlE40.
23.
PreMiuM GuArAntee We guarantee not to increase the premiumbetweenplan anniversaries, unless:
•youchangeyourplan in a way which increases the premium, or
•thegovernmentintroducesanewtax,duty,orcharge,orchangesanexistingone.
23.1
PREMIUMRATESANDDISCOUNTS We can change premium rates and discounts, and withdraw discounts and loadings, in
NOTGUARANTEED thefuture,astheyaren’tguaranteed.However,ifwedothatforthisplan, the changes
willapplytoallFlexibleLifetime–Protectionplans that are similar to this one.
Additionally if we do that for an insured person, it will apply to all people we insure
underFlexibleLifetime–Protectionplans that are similar to this one, for example people:
•whoareinthesameAMPLifeinsuranceratingcategoryasthatpersonatthattime,or
•whohavesimilarcovertothatperson,or
•whoarepartofaspecialarrangementwehaveestablishedwiththeiremployer,
professional affiliation, or similar type of association.
However, if we have given you an individual discount on your premiums, we may remove
this discount at any time.
if we do anything which changes the premium for the plan or for an insured person, we
willtellyouaboutthechange,andtheamountofthenewpremium,beforeitapplies.
KeePinG tHe PreMiuM if you want to keep the premium the same for the next
tHe sAMe 12 months as it was for the last 12 months, you need to
askustodothis,inwriting,beforetheplan anniversary
from which you want the premium to stay the same.
You must also tell us what cover you want reduced or
cancelled, to keep the premium the same.
You need to ask us to do this each year that you want it
to happen.
note, we may not agree to do this in the future.
32 – AMP Flexible liFetiMe – Protection – PlAn rules
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• CPI
• INSUREDPlAN
• PlAN
• PlANANNIVERSARY
• PREMIUM
• PREMIUMRATES
THE DEFINITIONS ARE SET
OUTINRUlE40.
24.
IFWEREDUCEOURPREMIUMRATES if we reduce our premium rates, or we increase any discounts, we may keep your
premiumthesamebyincreasingtheamountofcoverundertheplan. if we do that, we
willtellyouinwritingbeforetheplan anniversary from which the change applies and
you agree to the change when you pay the next premium.
Ifyoudon’twantthechange,pleasetellusinwriting.
25.
PlAn Fee there is a plan fee for each insured person. that fee is included in your premium.
if there is more than one insured person under the plan, the plan fee is lower for the
second and following insured persons.
each year, we increase the planfeebyanyincreaseintheCPI. However, it stays the same
if the CPI is negative.
26.
PreMiuM FreQuencY Fee if you pay more often than yearly, we charge an extra fee. that fee is included in your
premium. it is a percentage of your premium. We can change the percentage we use to
calculate the increase at any plan anniversary.
27.
DISCOUNTS We have a range of discounts which may apply to you. the premium shown in the
Certificate of Insurance and Annual statement is the premium after any discounts have
beenapplied.
AMP Flexible liFetiMe – Protection – PlAn rules – 33
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• INSUREDPERSON
• PlAN
• PREMIUM
• TERMINAllYIll
• TOTAllYDISABlED
THE DEFINITIONS ARE SET
OUTINRUlE40.
Whenyoudon’thavetopaypremiums
28.
iF We PAY You You do not have to pay the premium for an insured person:
•ifwehavepaidbecausethat insured person is terminally ill, or
•ifyouhavetheWaiverofPremiumoption–seerule29.
29.
WAiVer oF PreMiuM
TherearetwotypesofWaiverofPremiumavailableunderthisplan. However, you can add
only one type to your plan.
ThetwotypesofWaiverofPremiumavailableare:
individual life
•youdon’thavetopaythepremium for one or more insured persons while they are
totally disabled. this is explained in rule 29.1, or
Nominatedlife(doesn’tapplytoSuperannuationplans)
•youdon’thavetopayanypremium under the plan while a particular insured person
is totally disabled. this is explained in rule 29.2.
the Certificate of Insurance shows whether you have the Waiver of Premium option.
34 – AMP Flexible liFetiMe – Protection – PlAn rules
29.1
WAiVer oF PreMiuM oPtion – if an insured personhasbeentotally disabled for at least six monthsbeforetheyturnage
INDIVIDUALLIFE 60,youdon’thavetopayanymorepremiums for that insured person and their cover
continues. in addition, the premium you paid during the six months while we determined
if the insured person was totally disabledwillberefundedtoyou.
For superannuation plans we will pay this refund into a similar complying superannuation
fundthatyounominate,oranaccountintheAMPEligibleRolloverFund(ERF)onyour
behalf.
You have to start paying the premium for that insured person again on the first of the
following dates:
•assoonasthat insured person stopsbeingtotally disabled, or
•thedateDeathcoverceasesfortheinsured person, or
•theplan anniversary on or after the insured person’s70thbirthday,or
•theterminationoftheplan.
Thistypeofoptionisavailableforoneormoreinsured persons covered under this plan.
if there is more than one insured person, we calculate the amount of the plan fee we
willwaivebydividingthetotalplanfeebythenumberofinsured persons.
29.2
WAiVer oF PreMiuM oPtion – Thisisnotavailableinsuperannuationplans.
NOMINATEDLIFE if you have selected this option only one “nominated” insured personiscoveredby
theWaiverofPremiumoption.Ifthatpersonhasbeentotally disabled for at least
six monthsbeforetheyturnage60,youdon’thavetopayanymorepremium under
this plan even if there are other insured persons on the plan and they are not totally
disabled. in addition, the premium you paid during the six months while we determined
if the insured person was totally disabledwillberefundedtoyou.
You have to start paying the premium on the plan again on the first of the following dates:
•assoonasthenominatedinsured personstopsbeingtotally disabled, or
•thedateDeathcoverceasesforthenominated insured person, or
•theplan anniversary on or after the nominated insured person’s70thbirthday,or
•theterminationoftheplan, or
•ifthatinsured person dies.THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• MONTH
• PlAN
• PlANANNIVERSARY
• PREMIUM
• TOTAllYDISABlED
THE DEFINITIONS ARE SET
OUTINRUlE40.
AMP Flexible liFetiMe – Protection – PlAn rules – 35
THESE WORDS AND
PHRASES ARE DEFINED:
• DOCTOR
• INSUREDPERSON
• PREMIUM
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
How to make a claim
30.
WHATTODO to make a claim you need to contact us. We will send you a claim form to fill in and return
tous.Youmustalsodoeachofthethingssetoutinrules30.1to30.3.
Wecanaskfortheinformationdescribedinthoserules:
•whileweareassessingtheclaim,and
•whileyouarenotpayingthepremiumbecausewearewaivingyourpremium. in that
case, we can ask for it as often as we need it.
30.1
HEALTHANDOTHERINFORMATION For you to give us that information, you must give us any documents and information
whichwereasonablyrequireabout:
•aninsured person’s health, and
•thecircumstancessurroundingtheirhealthproblems,and
•anythingelserelatedtotheclaim.
You must pay the costs of getting information from the insured person’s doctors and
advisers. However, we will pay the costs of getting information from advisers and medical
specialists we choose.
An insured person suffers a trauma condition if they meet the description shown in
rule 39. usually, we will ask an appropriate consultant medical specialist who specialises
inthediagnosis,rehabilitationortreatmentofthat trauma condition to confirm that
the insured person meets that description. For example, we usually ask a neurologist to
confirm that the insured personhassufferedastrokeasdescribedinrules3and39.
30.2
AGEANDIDENTITY You must prove the insured person’s age and identity.
36 – AMP Flexible liFetiMe – Protection – PlAn rules
31.
tiMe liMits You must tell us that you are going to make a claim. You must do that within the relevant
timeperiodshowninthetablebelow.
You must give us all information which we ask for within six months after you tell us in
writing that you are going to make a claim.
Type of claim How soon you must tell us that you are
going to claim
An insured person suffers a trauma
condition.
Within 12 months of the insured person
suffering the trauma condition.
An insured person is totally and
permanently disabled.
Within 12 months of the insured person
suffering the illness or injury which causes you
tomakeaclaimbecausetheyare totally and
permanently disabled.
An insured person is totally
disabled and you want to make a
claim under the Waiver of Premium
option.
Within 12 months of the insured person
beingtotally disabled.
An insured person is terminally ill. Notimelimit–butthesooneryoutellus,the
sooner we can pay.
An insured person dies. Notimelimit–butthesooneryoutellus,the
sooner we can pay.
32.
LATECLAIMSANDRESPONSES Ifyoudon’tmeetthesetimelimitsandwehavebeenprejudicedbythedelay,wewill
reduce the amount we pay to compensate us for the prejudice we have suffered.
THESE WORDS AND
PHRASES ARE DEFINED:
• INSUREDPERSON
• MONTH
• TERMINAllYIll
• TOTAllYAND
PERMANENTlYDISABlED
• TOTAllYDISABlED
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
However, we may extend those periods if you ask us.
AMP Flexible liFetiMe – Protection – PlAn rules – 37
Miscellaneous
33.
OWNERSHIPANDTRANSFERs You can transfer the ownership of the plan if it is a non-superannuation plan.
to transfer ownership:
•youmustcompletethetransferformonthelastpageoftheCertificate of Insurance
we sent you when the plan started and send it to us, and
•youmustsendusthat Certificate of Insurance, and
•weregisterthetransfer.
After the transfer, we will communicate only with the new plan owner.
34.
GoVerninG lAW this planisgovernedbytheLifeInsuranceAct1995,andtheInsuranceContractsAct
1984.
35.
AustrAliAn $ All amounts under this planmustbepaidinAustraliandollars.
36.
OURLIABILITYISLIMITED the assets of our no. 1 statutory Fund – or any other fund of which this plan forms part
at the time – are the only assets we will use to pay you under this plan.
37.
no sHAre oF ProFits this is a non-participating plan. that means it does not entitle you to share in any profits
of AMP life.
38. Thisrulehasbeenremoved
THESE WORDS AND
PHRASES ARE DEFINED:
• CERTIFICATEOF
INSURANCE
• PlAN
• PlANOWNER
THE DEFINITIONS ARE SET
OUTINRUlE40.
38 – AMP Flexible liFetiMe – Protection – PlAn rules
39.
DESCRIPTIONSOFTRAUMACONDITIONS
Alzheimer’sdiseaseandotherdementias
DESCRIPTION Wewillpayifaninsuredperson’sbrainfunctionfailssignificantlyandpermanently.The
failure must cause the insured person to:
•beunabletoperformanyoneoftheactivitiesofdailylivingwithoutassistancefrom
someone else, or
•requiredailycareonanongoingbasis.
Wewon’tpayifthedementiaisdirectlycausedbyalcoholordrugabuse.
GlossArY oF terMs
Activities of Daily Living – Seerule40forthedefinition.
Dementia – Progressivementaldeteriorationduetoorganicdiseaseofthebrain.
trauma definitions and descriptions
Tosatisfythesedefinitionsanddescriptionsyoumustsurvivefor14days.
claims Guiding statement
Medical diagnoses and investigation methods used in many of the trauma conditions that we cover are advancing at a rapid rate.
Someofthesenewdiagnosticmethod(s)mayprovetobetterdefineaparticulartrauma condition.Shouldyoubediagnosedwith
one of the trauma conditions,andthediagnosticmethod(s)usedisn’tspecifiedwithinthetraumadefinition,wemaytakethe
method(s)intoconsideration,whichmayassistyouintheassessmentofyourclaim.
THESE WORDS AND
PHRASES ARE DEFINED:
• TRAUMACONDITION
THE DEFINITIONS ARE SET
OUTINRUlE40.
AMP Flexible liFetiMe – Protection – PlAn rules – 39
Aortic surgery
DESCRIPTION Wewillpayifaninsuredpersonhassurgeryperformedtocorrectastructuralabnormality
ofthethoracicorabdominalaorta.Intheopinionofanappropriateconsultantmedical
specialist,thetreatmentmustberequiredonmedicalgroundsandmustbethemost
appropriatetreatment.Wewon’tpayforsurgeryperformedusingintraluminalor
laparoscopic techniques.
GlossArY oF terMs
Aorta – Themainarteryarisingfromtheheartwithbranchestoeverypartofthebody.
Intraluminal techniques – Thetreatmentofinternalabnormalitiesbymeansofacatheterinsertedthrougha
superficialbloodvesseltoapplycertaintechniques,andnotinvolvinganopensurgical
operation.
Catheter – Ahollowtube.
Aplastic anaemia
DESCRIPTION Wewillpayifaninsuredpersonhassevereaplasiaofbonemarrowasdefinedbyan
appropriate consultant medical specialist.
GlossArY oF terMs
Aplasia – Failureofthebonemarrowtoproducebloodcells.
Aplastic anaemia – Asevereformofanaemiacausedbyaplasiaofthebonemarrow.
bacterial meningitis
DESCRIPTION Wewillpayifaninsuredpersonsuffersbacterialmeningitiscausedbyaprovenorganism.
the meningitis must produce neurological deficit causing permanent and significant
functional impairment.
GlossArY oF terMs
Meningitis – Inflammationofthecoveringofthebrainandspinalcord.
Neurological deficit – Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultingindisorders
of function.
40 – AMP Flexible liFetiMe – Protection – PlAn rules
Benigntumourofthebrainorspinalcord
DESCRIPTION Wewillpayifaninsuredpersonhasanon-canceroustumourinthebrainorspinal
cordwhichishistologicallydescribedandwhichproducesneurologicaldeficitcausing
permanent and significant functional impairment or requires radical surgery for its removal.
Wedon’tcoveranyofthefollowing:
•cysts,granulomasandcerebralabscesses,or
•malformationsin,orof,thearteriesorveinsofthebrain,or
•haematomas,or
•tumoursinthepituitarygland.
GlossArY oF terMs
Benign tumour – An enlargement or swelling due to overgrowth of tissue which pushes aside normal tissue
butdoesn’tinvadeit.
Cerebral abscess – Alocalisedcollectionofpusoccurringinthebrain.
Cyst – Asacorcapsulecontainingliquidorsemi-solidsubstance.
Granuloma – Amassoftissueoccurringinreactiontothepresenceof,forexample,aforeignbodyor
bacterialinfection.
Haematoma – Amassproducedbyacoagulationofbloodinatissueorcavity.
Histologically described – A conclusion reached after a microscopic examination of cells.
Neurological deficit – Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultingindisorders
of function.
Pituitary gland – the master gland of the endocrine system which controls hormone production of other
endocrine glands.
blindness
DESCRIPTION Wewillpayifaninsuredpersonlosesthesightofbotheyestotheextentthatvisualacuity
is6/60orlessinbotheyes,ortotheextentthatthevisualfieldisreducedtotendegrees
orlessofarc.Thatlossmustbeirreversibleandunabletobecorrectedbyglassesorany
other means.
AMP Flexible liFetiMe – Protection – PlAn rules –41
cancer
DESCRIPTION Wewillpayifaninsuredpersonsuffersamalignanttumour,malignantsarcoma,Hodgkin’s
lymphoma,non-Hodgkin’slymphoma,malignantbonemarrowdisorderorleukaemiawith
theexceptionofchroniclymphocyticleukaemia,BinetstagesAandBorRaistages0,Iand
ii. We only pay for chronic lymphocytic leukaemia rai stages i or ii if the insured person
isdiagnosedundertheageof45.Thecancermustbeconfirmedbypathologytestsand
characterisedbytheuncontrolledspreadofmalignantcellsandtheinvasionofnormal
tissue.
Wewon’tpayforanyofthefollowing:
•skincancersotherthanmelanoma,or
•melanomawherethethicknessislessthan1.5mmandtheClarklevelofinvasionisLevel
1 or 2, or
•prostatictumourswhichareequivalenttoorlessthanTNMClassificationT1anda
Gleasonscoreoflessthan8(note,wewon’tconsidertheGleasonscoreforprostatic
tumourswhichareequivalenttoormorethanTNMClassificationT2),or
•tumourswhicharehistologicallydescribedaspre-malignantorshowingmalignant
changes of “carcinoma in situ” and not requiring radical surgery, or
•HIV/AIDSrelatedcancers.
GlossArY oF terMs
Binet/Rai stages – Classificationofchroniclymphocyticleukaemiawhichdescribesdiseaseprogression.
Bone marrow disorders – Lifeshorteningdisorderofbonemarrowelements.
Carcinoma in situ – Cancerconfinedtoitssiteoforiginandreadilycurable.
Chronic lymphocytic leukaemia – A form of leukaemia that is usually only life threatening in its advanced stages.
Clark Level – Aclassificationsystemdescribingthedepthofinvasionofamelanomapastthetoplayers
oftheskin.Theclassificationsarefrom1to5.
Gleason score – A grading method assigned to indicate how aggressive the tumour is.
Histologically described – A conclusion reached after a microscopic examination of cells.
Hodgkin’s lymphoma and
non-Hodgkin’s lymphoma – Sometimestreatablemalignantdiseasescausingenlargementofthelymphnodesandspleen.
Leukaemia – Amalignantdiseaseofthebonemarrow,wherethereisimpairmentofformationof
maturebloodcells.Thisimpairmentcanbemanifestedinbleedingandbruising,serious
infection and symptoms of anaemia such as tiredness and fatigue.
Malignant bone marrow disorders – Malignantdiseaseinthebonemarrowduetotumourspreadfromotherorgansordue
totumoursarisingfromtheblood-formingcellsresultinginlifethreateningeffectsonthe
maturebloodcells.
42 – AMP Flexible liFetiMe – Protection – PlAn rules
Melanoma – A malignant tumour of the skin, usually developing from a mole.
Sarcoma – Amalignanttumouroftissuessuchasbone,muscleorligament.
TNM classification – Aclassificationsystemdescribingtheextentoflocalinfiltrationandspreadtoglandsor
otherpartsofthebody.
Cancer(Partial)
DESCRIPTION We will pay if an insured person suffers carcinoma in situ of the vulva, vagina or fallopian
tubes,wherethetumourisclassifiedastumourinsitu(Tis)accordingtotheTNM
classification system.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
GlossArY oF terMs
Carcinoma in situ – Cancerconfinedtoitssiteoforiginandreadilycurable.
TNM classification – Aclassificationsystemdescribingtheextentoflocalinfiltrationandspreadtoglandsor
otherpartsofthebody.
cardiomyopathy
DESCRIPTION Wewillpayifaninsuredperson’sheartmusclefailstofunctionproperlyresultingin
permanent physical impairment to at least class 3 of the new York Heart Association
classification of cardiac impairment.
Wewon’tpayforcardiomyopathythatisdirectlycausedbyalcohol,orrelatedtodruguse
thatisnotprescribedbyadoctor.
GlossArY oF terMs
New York Heart Association
Classification of Cardiac Impairment – Afunctionalclassificationtoassesscardiovasculardisability.
Class 3 – Physicalimpairmentconstitutedbyamarkedlimitationofphysicalactivity.Theinsured
personwillbecomfortableatrest,butlesswhileengaginginordinaryactivity.
AMP Flexible liFetiMe – Protection – PlAn rules –43
coma
DESCRIPTION Wewillpayifaninsuredpersonisinastateofunconsciousnessanddoesn’treactto
externalstimuli.Thestateofunconsciousnessmustscore6orlessontheGlasgowComa
scale.
the state of unconsciousness must either:
•becontinuousforatleast4days,followedbynewfunctionalimpairmentproducing
neurologicalsignswhichlastatleastafurther14days.Thesignsmustbedemonstrated
clinicallyandbyacerebralCTscan,angiogram,MRI,PET,oranyotherreliableimaging
techniqueapprovedbyAMP,or
•becontinuousforatleast90days.
Inallcircumstances,wewon’tpayforanycomathatis:
•causedbytheinsuredperson’salcoholordrugabuse,or
•theresultoftheinsuredpersonsufferinganothertraumaconditionforwhichwepay.
GlossArY oF terMs
Glasgow Coma Scale – bedside assessment of levels of consciousness.
Coronaryarteryangioplasty(Partial)
DESCRIPTION We will pay if an insured person undergoes angioplasty involving less than 3 coronary
arteriesduringthesameprocedure(withorwithouttheinsertionofastent,lasertherapyor
atherectomy).Intheopinionofanappropriateconsultantmedicalspecialist,thetreatment
mustberequiredonmedicalgroundsandmustbethemostappropriatetreatment.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
GlossArY oF terMs
Angioplasty – Thetreatmentofaninternalabnormalitybytheinflationofaballooncatheterinserted
through a superficial artery and not involving an open surgical operation.
Coronary artery – Vesselconveyingbloodtotheheartmuscle.
44 – AMP Flexible liFetiMe – Protection – PlAn rules
coronary artery angioplasty – triple vessel
DESCRIPTION Wewillpayifaninsuredpersonundergoesangioplastyofthecoronaryarteries(with
orwithouttheinsertionofastent,lasertherapyoratherectomy)to3ormorecoronary
arterieswithinthesamesurgicalprocedure.Angiographicevidence,indicatingobstruction
of 3 or more coronary arteries, is required to confirm the need for this procedure. in the
opinionofanappropriateconsultantmedicalspecialist,thetreatmentmustberequiredon
medicalgroundsandmustbethemostappropriatetreatment.
GlossArY oF terMs
Angioplasty – Thetreatmentofaninternalabnormalitybytheinflationofaballooncatheterinserted
through a superficial artery and not involving an open surgical operation.
Coronary artery – Vesselconveyingbloodtotheheartmuscle.
coronary artery surgery
DESCRIPTION We will pay if an insured person has coronary artery disease and as a result has surgery
involvingbypassgraftstooneormorecoronaryarteries.Intheopinionofanappropriate
consultantmedicalspecialist,thetreatmentmustberequiredonmedicalgroundsandmust
bethemostappropriatetreatment.
Wedon’tpayunderthisparticulartraumaconditionforproceduressuchasangioplasty,
laser and intra-arterial techniques or other non-surgical procedures.
GlossArY oF terMs
Angioplasty – Thetreatmentofaninternalabnormalitybytheinflationofaballooncatheterinserted
throughasuperficialbloodvesselandnotinvolvinganopensurgicaloperation.
Coronary artery – Vesselconveyingbloodtotheheartmuscle.
Coronary artery disease – Significantnarrowingorblockageofthecoronaryarteries.
encephalitis
DESCRIPTION Wewillpayifaninsuredpersonisdiagnosedashavingencephalitisbyanappropriate
consultantmedicalspecialist.Theinsuredpersonmusthaveimpairedbrainfunctionwhich
causespermanentinabilitytoperformanyoneoftheactivitiesofdailylivingwithout
assistance from someone else.
Wewon’tpayforencephalitiscauseddirectlyorindirectlybyHIV/AIDS.
GlossArY oF terMs
Activities of Daily Living – Seerule40forthedefinition.
Encephalitis – Infectionofthebraincausinginflammation.
AMP Flexible liFetiMe – Protection – PlAn rules – 45
Heart attack – myocardial infarction
DescriPtion We will pay if part of an insured person’s heart muscle dies as a result of inadequate blood
supply to the relevant area. An appropriate consultant medical specialist must certify that a heart
attack has occurred and provide confirmatory evidence of this by the following test results:
•newelectrocardiographicchangesconsistentwithmyocardialinfarction,and
–abnormalbiomarkerssuchasacardiacenzymeriseabovetheupperlimitofnormal,or
– a rise of troponin i above 2.0 ng/ml or troponin t above 0.6 ng/ml.
Ifontheabovecriteria,aheartattackisconfirmed,buttheresultsarebelowthelimits
indicated,thefollowingwillbeconsideredasdiagnosticevidence:
•abnormalwallmotionasassessedbyechocardiography,or
•reductionofleftventricularejectionfractionto50%,orless
where either of the above is confirmed at least 6 weeks after the cardiac event.
Wewon’tpayforothercausesofseverenon-cardiacchestpain,heartfailureorangina.
GlossArY oF terMs
Abnormal wall motion – An area of dead heart muscle.
Cardiac enzymes – Damage to heart muscle can raise the level of these enzymes. this is shown in a blood test.
Echocardiography – the use of ultrasound to investigate the heart.
Electrocardiographic changes – A graph of electrical activity of the heart showing variation from the normal which is
consistent with a heart attack.
Myocardial infarction – Heart attack.
Heart attack – out of hospital cardiac arrest
DescriPtion We will pay if an insured person suffers a cardiac arrest which:
•isn’tassociatedwithanymedicalprocedure,and
•isdocumentedbyanelectrocardiogram,and
•occursoutsideahospital,and
•isduetoeithercardiacasystoleorventricularfibrillation.
GlossArY oF terMs
Cardiac arrest – Sudden,andoftenunexpected,stoppageofeffectiveheartaction.
Cardiac asystole – complete failure of contraction of the heart causing cardiac arrest.
Electrocardiogram – A graph of electrical activity of the heart.
Ventricular fibrillation – Heart abnormality with ineffective twitching of the heart chambers.
46 – AMP Flexible liFetiMe – Protection – PlAn rules
Heart valve surgery
DESCRIPTION We will pay if an insured person has surgery to correct, or replace, a cardiac valve. in the
opinionofanappropriateconsultantmedicalspecialist,thetreatmentmustberequiredon
medicalgroundsandmustbethemostappropriatetreatment.
Wewon’tpayforsurgeryperformedusingintraluminalorlaparoscopicprocedures.
GlossArY oF terMs
Intraluminal techniques – Thetreatmentofinternalabnormalitiesbymeansofacatheterinsertedthrougha
superficialbloodvesseltoapplycertaintechniques,andnotinvolvinganopensurgical
operation.
HIV/AIDS–medicallyacquired
DESCRIPTION We will pay if the insured person acquires HiV through accidental infection as a result of a
medicalprocedure.Wewillonlypayifwebelieveonthebalanceofprobabilitiesthatthe
infectionarosebecauseofoneofthemedicaleventslistedbelow.
Theeventmusthavebeenmedicallynecessaryanditwasperformedbyorunderthe
supervision of a medical doctor or a dentist, and:
•itmusthaveoccurredtotheinsuredpersonineitherAustraliaorNewZealand,and
•itmusthaveoccurredasaresultofanyoneofthefollowingprocedures:
–abloodtransfusion
–thetransfusionwithbloodproducts
– an organ transplant to the insured person
– assisted reproductive techniques.
before we will pay, we will require proof of the incident via a statement from a statutory
Health Authority that the infection was medically acquired.
Wewon’tpayiftheHIVinfectionisacquiredthroughanyothercauseincludingbutnot
limited to sexual activity, intravenous drug use except as a legitimate medical procedure, or
deliberateself-infection.
GlossArY oF terMs
HIV – the Human immunodeficiency Virus. As the name implies over time infection with HiV
causestheimmunesystemtobecomedeficient,whichcanleadtothedevelopmentof
illnesses such as cancers.
AMP Flexible liFetiMe – Protection – PlAn rules –47
HIV/AIDS–occupationallyacquired
DESCRIPTION WewillpayifaninsuredpersonbecomesinfectedwithHIVif:
•thevirusisacquiredasaresultofanaccidentoccurringduringthecourseoftheinsured
person’snormaloccupation,and
•thevirusisacquiredwhiletheinsuredpersonwascarryingouttheirnormaloccupational
duties, and
•seroconversiontotheHIVinfectionoccurswithin6monthsofthataccident.
Anyaccidentgivingrisetoapotentialclaimmustbereported:
•totherelevantauthorityoremployer,and
•touswithin14daysofitsoccurrence,and
•besupportedbyanegativeHIVantibodytesttakenaftertheaccident.
Wewillonlypayifweareableto:
•independentlytestallbloodsamplesused
•takefurthersamples
•obtainacopyofthereportmadetotherelevantinstitutionoremployer;and
•obtainallevidencerelatingtotheallegedsourceofinfection.
Wewon’tpayif:
•theHIVinfectionisacquiredthroughanyothercauseincludingbutnotlimitedtosexual
activity,recreationalintravenousdruguseordeliberateself-infection,or
•recommendedprecautionarymeasuresaren’ttakenbeforeorafterthepresumedcausal
event.
GlossArY oF terMs
HIV – the Human immunodeficiency Virus. As the name implies, over time infection with HiV
causestheimmunesystemtobecomedeficient,whichcanleadtothedevelopmentof
illnesses such as cancers.
Sero conversion – Thedocumentedchangefromtheabsencetothepresenceinthebloodofantibodies
totheHIV.Theseantibodiesusuallyappearinthebloodforthefirsttimewithin8to12
weeksofinfectionoccurringbutcanappearlater.
48 – AMP Flexible liFetiMe – Protection – PlAn rules
intensive care
DESCRIPTION We will pay if an insured person has an accident or illness which requires them to have
continuousmechanicalventilationbymeansoftrachealintubation.Thetrachealintubation
mustneedtocontinuefor10consecutivedays(24hoursperday)inanauthorised
intensivecareunitofanacutecarehospital.Wewon’tpaywheretheaccidentorillnessis
aresultofalcoholordrugusethatisn’tprescribedbyadoctor.
GlossArY oF terMs
Mechanical ventilation – Mechanically assisted movement of air into the lungs.
Tracheal intubation – Insertionofatubeintothetrachea.
Kidney failure
DESCRIPTION Wewillpayifaninsuredpersonsuffersirreversiblefailureofbothkidneyswhichrequires
either:
•continuingrenaldialysis,or
•transplantationofahumankidney.
in the opinion of an appropriate consultant medical specialist, the dialysis or transplant
mustberequiredonmedicalgroundsandmustbethemostappropriatetreatment.
Wewon’tpayintheeventoftemporaryrenaldialysisforacuteandreversiblekidney
failure.
GlossArY oF terMs
Kidney transplant – Transplantationofadonorkidneyintoanotherperson’sbody.
Renal dialysis – Theuseofdefinedfilteringtechniquestoremovewasteproductsnormallyexcretedbythe
kidney.
leukaemia
DESCRIPTION We will pay if an insured person is diagnosed with leukaemia.
GlossArY oF terMs
Leukaemia – Amalignantdiseaseofthebonemarrow,causingabnormalitiesintheblood,spleenand
lymph nodes.
liver failure
DESCRIPTION Wewillpayifaninsuredpersonsuffersirreversiblefailureoftheliverandasaresult
the only effective treatment option is to receive a liver transplant. in the opinion of an
appropriateconsultantmedicalspecialist,thetransplantmustberequiredonmedical
groundsandmustbethemostappropriatetreatment.
Wewon’tpayiftheliverfailureisdirectlycausedbyalcoholorrelatedtouseofother
drugsnotprescribedbyadoctor.
AMP Flexible liFetiMe – Protection – PlAn rules –49
loss of hearing
DESCRIPTION Wewillpayifaninsuredpersonsuffersatotalandpermanentlossofhearing,both
naturalandassistedfrombothears.Acochlearimplantmustbedeemednecessarybyan
appropriateconsultantmedicalspecialist.Thismustbecertifiedatleast3monthsafterthe
abilitytohearwasfirstlost.
loss of independent living
DESCRIPTION Wewillpayifaninsuredpersonsufferstotalandpermanentinabilitytoperformatleast2
of the activities of daily living without assistance from someone else.
Wewon’tpayforlossofindependentlivingcauseddirectlybyalcoholordrugabuse.
GlossArY oF terMs
Activities of Daily Living – Seerule40forthedefinition.
loss of speech
DESCRIPTION Wewillpayifaninsuredpersontotallylosestheabilitytospeakduetoorganicbrain
diseaseoraccidentalinjury.Thelossmustbeirreversible.Wewon’tpayforlossofspeech
which is due to any psychological cause.
Lossofuseoflimbsand/orsight
DESCRIPTION Wewillpayiftheinsuredperson,becauseofphysicalseveranceorpermanentnerve
damage, totally and permanently loses the:
•useofbothfeet,or
•useofbothhands,or
•useofonefootandonehand,or
•sightinbotheyes(totheextentof6/60orless),or
•anycombinationof2of:ahand,afootorsightinaneye(totheextentof6/60orless).
lung failure
DESCRIPTION Wewillpayifaninsuredpersonsuffersirreversiblefailureofbothlungsrequiring
continuous oxygen supply and with FeV1 test results of consistently less than one litre.
GlossArY oF terMs
FEV1 – Forced expiratory volume in one second.
50 – AMP Flexible liFetiMe – Protection – PlAn rules
Major head trauma
DESCRIPTION We will pay if an insured person suffers an accidental head injury which produces
neurological deficit causing significant functional impairment which, in the opinion of an
appropriateconsultantmedicalspecialist,islikelytobepermanent.
GlossArY oF terMs
Neurological deficit – Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultingindisorders
of function.
Functional impairment – Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultinginsome
disorder of function.
Major organ transplant
DESCRIPTION We will pay if an insured person requires a transplant from a human donor of one of the
following whole organs and is placed on a waiting list at an Australian hospital:
•kidney
•heart
•liver
•lung
•pancreas.
Intheopinionofanappropriateconsultantmedicalspecialist,thetransplantmustbe
requiredonmedicalgroundsandmustbethemostappropriatetreatment.
Wewon’tpayintheeventofadonationbytheinsuredpersonofanorganfortransplant.
AMP Flexible liFetiMe – Protection – PlAn rules – 51
Melanoma
DESCRIPTION We will pay if the insured person has a malignant melanoma where the thickness is less
than1.5mmandtheClarklevelofinvasionisLevel2.Themelanomamustbeconfirmed
bypathologytestsandcharacterisedbytheuncontrolledspreadofmalignantcellsandthe
invasionofnormaltissue.Wewon’tpayforamelanomawherethethicknessislessthan
1.5mmandtheClarklevelofinvasionisLevel1.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
GlossArY oF terMs
Clark Level – Aclassificationsystemdescribingthedepthofinvasionofamelanomapastthetoplayers
oftheskin.Theclassificationsarefrom1to5.
Melanoma – A malignant tumour of the skin, usually developing from a mole.
Motor neurone disease
DESCRIPTION We will pay if an insured person receives an unequivocal diagnosis of motor neurone
diseasebyanappropriateconsultantmedicalspecialist.
GlossArY oF terMs
Motor neurone disease – Disorderswithprogressivemuscleweaknessandwastingduetodestructionofnerves.
Multiple sclerosis
DESCRIPTION We will pay if an insured person receives an unequivocal diagnosis of advanced multiple
sclerosisbyanappropriateconsultantmedicalspecialist.Theremustbesignificant
neurologicaldeficitwhichcausespermanentinabilitytoperformanyoneoftheactivitiesof
daily living without assistance of someone else.
GlossArY oF terMs
Activities of Daily Living – Seerule40forthedefinition.
Multiple sclerosis – Adiseasewithabnormalnervoustissueinthebrainandspinalcordwhichinterfereswith
the normal function of the nerves.
Neurological deficit – Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultingindisorders
of function.
52 – AMP Flexible liFetiMe – Protection – PlAn rules
Muscular dystrophy
DESCRIPTION We will pay if the insured person receives an unequivocal diagnosis of muscular dystrophy
byanappropriateconsultantmedicalspecialist.
GlossArY oF terMs
Muscular dystrophy – An inherited disease which results in the muscles failing to function.
Myelodysplasia
DESCRIPTION Wewillpayiftheinsuredpersonisdiagnosedtohavemyelodysplasiabyanappropriate
consultant medical specialist. the condition must have progressed to the point that it is
permanentandtheseverityissuchthattheinsuredpersonrequiresabloodtransfusionat
leastmonthlyand/oradmissiontohospitalduetocomplicationsofthedisorderatleast4
times per year.
GlossArY oF terMs
Myelodysplasia – Abonemarrowdisorderleadingtosignificantimpairmentofnormalbloodformation
whichresultsinanaemia,reducedwhitebloodcellsandplatelets.
Myelofibrosis
DESCRIPTION Wewillpayiftheinsuredpersonisdiagnosedtohavemyelofibrosisbyanappropriate
consultant medical specialist. the condition must have progressed to the point that it is
permanentandtheseverityissuchthattheinsuredpersonrequiresabloodtransfusionat
least monthly.
GlossArY oF terMs
Myelofibrosis – Adisorderwhichcancausefibroustissuetoreplacethenormalbonemarrowandresultsin
anaemia,lowlevelsofwhitebloodcellsandplateletsandenlargementofthespleen.
open heart surgery
DESCRIPTION Wewillpayiftheinsuredpersonhasopenheartsurgeryrequiringdiversionoftheblood
through a heart-lung machine, in order to have surgery to correct any heart defect
including heart valve surgery. in the opinion of an appropriate consultant medical specialist,
thetreatmentmustberequiredonmedicalgroundsandmustbethemostappropriate
treatment.Wewon’tpayunderthisparticulartraumaconditionforproceduressuchas
valvotomyorcoronaryarteryangioplastywhichdon’trequireopenheartsurgery.
GlossArY oF terMs
Coronary artery angioplasty – Thetreatmentofaninternalabnormalitybytheinflationofaballooncatheterinserted
throughasuperficialbloodvesselandnotincludinganopensurgicaloperation.
Valvotomy – surgical widening of a narrowed heart valve.
AMP Flexible liFetiMe – Protection – PlAn rules – 53
Paralysis – diplegia
DESCRIPTION Wewillpayifaninsuredpersonsufferstotalandpermanentparalysisofbotharmsor
bothlegsduetoorganicdiseaseoraccidentalinjury.Wewon’tpayforpartialparalysis,for
temporary post-viral paralysis, or for paralysis due to psychological causes.
GlossArY oF terMs
Paralysis – Completelossoftheabilitytomovepartsofthebody.Itisasymptomofawidevarietyof
disorders.
Paralysis – hemiplegia
DESCRIPTION Wewillpayifaninsuredpersonsufferstotalandpermanentparalysisofboththearm
andthelegonthesamesideofthebodyduetoorganicdiseaseoraccidentalinjury.We
won’tpayforpartialparalysis,fortemporarypost-viralparalysis,orforparalysisdueto
psychological causes.
GlossArY oF terMs
Paralysis – Completelossoftheabilitytomovepartsofthebody.Itisasymptomofawidevarietyof
disorders.
Paralysis – paraplegia
DESCRIPTION Wewillpayifaninsuredpersonsufferstotalandpermanentparalysisofbothlegsdueto
organicdiseaseoraccidentalinjury.Wewon’tpayforpartialparalysis,fortemporarypost-
viral paralysis, or for paralysis due to psychological causes.
GlossArY oF terMs
Paralysis – Completelossoftheabilitytomovepartsofthebody.Itisasymptomofawidevarietyof
disorders.
Paralysis – quadriplegia
DESCRIPTION Wewillpayifaninsuredpersonsufferstotalandpermanentparalysisofbotharmsand
bothlegsduetoorganicdiseaseoraccidentalinjury.Wewon’tpayforpartialparalysis,for
temporary post-viral paralysis, or for paralysis due to psychological causes.
GlossArY oF terMs
Paralysis – Completelossoftheabilitytomovepartsofthebody.Itisasymptomofawidevarietyof
disorders.
54 – AMP Flexible liFetiMe – Protection – PlAn rules
Paralysis – tetraplegia
DESCRIPTION Wewillpayifaninsuredpersonsufferstotalandpermanentparalysisofbotharmsand
bothlegs,togetherwithlossofheadmovement,duetoorganicdiseaseoraccidental
injury.Wewon’tpayforpartialparalysis,fortemporarypost-viralparalysis,orforparalysis
due to psychological causes.
GlossArY oF terMs
Paralysis – Completelossoftheabilitytomovepartsofthebody.Itisasymptomofawidevarietyof
disorders.
Parkinson’sdisease
DESCRIPTION WewillpayifaninsuredpersonreceivesanunequivocaldiagnosisofadvancedParkinson’s
disease.Theremustbesignificantneurologicaldeficitwhichcausespermanentinabilityto
perform any one of the activities of daily living without assistance from someone else.
GlossArY oF terMs
Activities of daily living – Seerule40forthedefinition.
Neurological deficit – Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultingindisorders
of function.
Parkinson’s disease – Aprogressivediseaseofthebrainwithmusclestiffnessandtremors.
AMP Flexible liFetiMe – Protection – PlAn rules – 55
Parkinson’sdisease(Partial)
DESCRIPTION WewillpayiftheinsuredpersonreceivesanunequivocaldiagnosisofParkinson’sdisease
asconfirmedbyanappropriateconsultantmedicalspecialist.
Parkinson’sDiseasemeanstheunequivocaldiagnosisofidiopathicParkinson’sDiseasedue
todegenerationinthenigrostriatalareaofthemidbrainandcharacterisedclinically,byone
or more of the following symptoms:
•rigidity
•tremor
•akinesia.
other forms of Parkinsonism, whether related to medication, toxins or other
neurodegenerative conditions are specifically excluded.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
Akinesia – Absence,loss,orimpairmentofthepowerofvoluntarymovement.
Nigrostriatal system – Anareadeepwithinthebrain.
Parkinson’s disease – Aprogressivediseaseofthebrainwithmusclestiffnessandtremors.
56 – AMP Flexible liFetiMe – Protection – PlAn rules
Partialblindness
DESCRIPTION We will pay if the insured person:
•losesthesightinbotheyeswithirreversibleeyedamagetotheextentof6/24,or
•losesthesightinoneeyewherevisualacuityhasreducedto6/60orlessinthatoneeye,
andthelossisunabletobecorrectedbyglassesoranyothermeans.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
Peripheralbloodstemcellorbonemarrowtransplant
DESCRIPTION Wewillpayifaninsuredpersonreceivesabonemarrowtransplant,orperipheralblood
stem cell transplant for the treatment of lymphoma or leukaemia. in the opinion of an
appropriateconsultantmedicalspecialist,thetransplantmustberequiredonmedical
groundsandmustbethemostappropriatetreatment.
Wewon’tpayintheeventofadonationbytheinsuredpersonofanorganfortransplant.
AMP Flexible liFetiMe – Protection – PlAn rules – 57
Peripheral neuropathy
DESCRIPTION Wewillpayifaninsuredpersonisdiagnosedtohaveperipheralneuropathybyan
appropriate consultant medical specialist. the condition must have progressed to the point
thatitispermanentandresultsintheinsuredpersonnotbeingabletodoanyoneormore
ofthebelowactivitieswithoutassistancefromsomeoneelse:
•getinandoutofabed
•getonoroffachair/toilet
•movefromplacetoplacewithoutusingawheelchair.
Wewon’tpayiftheperipheralneuropathyisdirectlycausedbyalcoholorrelatedtouseof
otherdrugsnotprescribedbyadoctor.
Wewon’tpayifthisconditioniscontributedtoorcausedbyHIV/AIDSrelatedconditions.
GlossArY oF terMs
Peripheral neuropathy – Adiseaseofthenerveswhichaffectspeople’sabilitytousetheirarms,orhandsorlegsor
feet.
Pneumonectomy
DESCRIPTION We will pay if the insured person undergoes surgical removal of an entire lung. in the
opinion of an appropriate consultant medical specialist, the insured person must require
thetreatmentonmedicalgroundsanditmustbethemostappropriatetreatment.
58 – AMP Flexible liFetiMe – Protection – PlAn rules
Primary pulmonary hypertension
DESCRIPTION We will pay if an insured person suffers primary pulmonary hypertension associated with
therightventriclebeingenlargedandthis:
•isestablishedbycardiaccatheterisationand/orechocardiography,and
•resultsinpermanentphysicalimpairmenttoatleastClass3(markedlimitationofactivity
bysymptoms)oftheNewYorkHeartAssociationClassificationofCardiacImpairment.
Wedon’tpayforanyothercausesofpulmonaryhypertension.
GlossArY oF terMs
Cardiac catheterisation – Atubeinsertedintotheheartorcoronaryarteries.
Echocardiography – the use of ultrasound to investigate the heart.
New York Heart Association
Classification of Cardiac Impairment – Isafunctionalclassificationtoassesscardiovasculardisability.
Class 3 – Physicalimpairmentconstitutedbyamarkedlimitationofphysicalactivity.Theinsured
personwillbecomfortableatrest,butlesswhileengaginginordinaryactivity.
Primary pulmonary hypertension – A condition, cause unknown, associated with increased pressure in the heart-lung
circulation,andmanifestedbyanenlargedrightventricleoftheheart,asconfirmedby
chest x-ray, ecG, echocardiogram and cardiac catheter studies.
Right ventricle – Oneofthemajorlowerchambersoftheheart.
9%
18%
18%
18%
9%9%
1%
AMP Flexible liFetiMe – Protection – PlAn rules – 59
Prostate cancer
DESCRIPTION We will pay if an insured person is diagnosed as having a prostate tumour equivalent to
TNMClassificationT1andaGleasonscoreoflessthan8.Thetumourmustbeconfirmed
bypathologytestsandcharacterisedbytheuncontrolledspreadofmalignantcellsandthe
invasion of normal tissue.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
GlossArY oF terMs
Gleason score – A grading method assigned to indicate how aggressive the tumour is.
TNM classification – Aclassificationsystemdescribingtheextentoflocalinfiltrationandspreadtoglandsor
otherpartsofthebody.
Severeburns
DESCRIPTION Wewillpayifaninsuredpersonsuffersthirddegreeburnsto20%ormoreoftheirbody
surfaceareaasmeasuredbytheLundBrowderBodySurfaceChartshownonthispage.
Theburnscanbecausedbythermal,electricalorchemicalagents.
Thehead(includingtheneck)andeacharm(includingthehand)areseparatelyconsidered
tobe9%ofthetotalbodysurface.Thefront,backandlegs(includingfeet)areeach
separatelyconsideredtobe18%ofthetotalbodysurface,withtheremaining1%being
the perineal area.
Wewillalsopayiftheinsuredpersonsuffersthirddegreeburnstothewholeofboth
hands or the whole of the face where grafting is required.
lund browder body surface chart
60 – AMP Flexible liFetiMe – Protection – PlAn rules
Severeinflammatoryboweldisease
DESCRIPTION WewillpayifaninsuredpersonsuffersSevereinflammatoryboweldisease.Severe
inflammatoryboweldiseasemeansadiagnosisofCrohn’sdiseaseand/orulcerativecolitis
that has failed surgical and conventional medical intervention and requires indefinate
second-line therapy.
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
GlossArY oF terMs
Crohn’s disease – A chronic inflammatory disease, primarily involving the small and large intestine, which can
affect other parts of the digestive system.
Immunosuppressive – Capableofsuppressingtheimmuneresponse.
Ulcerative colitis – Aninflammatoryboweldiseasethatcausesinflammationandsores(ulcers)intheliningof
the large intestine.
AMP Flexible liFetiMe – Protection – PlAn rules – 61
severe osteoporosis
DESCRIPTION We will pay if an insured person suffers severe osteoporosis. severe osteoporosis means
theinsuredperson,beforetheageof50,suffersatleasttwovertebralbodyfracturesora
fractureoftheneckorfemur,duetoosteoporosisandhasbonemineraldensityreading
withaT-scoreoflessthan-2.5.Thismustbemeasuredinatleasttwositesbydualenergy
x-rayabsorptiometry(DEXA).
We will pay:
•$10,000,or
•10%ofthesuminsured(subjecttoamaximumof$25,000),
whichever is higher.
if we pay under this particular trauma condition, the cover for other trauma conditions the
insuredpersonhasonthisplancontinues,butthecontinuingamountofcoverisreduced
bywhatwepaidunderthiscondition.Yourpremiumisalsoreducedaccordingly.
We pay under this definition only once.
GlossArY oF terMs
Osteoporosis – Asofteningofthebonesthatgraduallyincreasesandmakesthemmorefragile.
T-score of less than -2.5 – 2.5standarddeviationsbelowtheyoungadultmeanforbonedensity.
Dual energy X-ray absorptiometry (DEXA) – Animagingtestthatmeasuresbonedensitybypassingx-rayswithtwodifferentenergy
levelsthroughthebone.
severe rheumatoid arthritis
DESCRIPTION Wewillpayifaninsuredpersonisdiagnosedashavingsevererheumatoidarthritis,byan
appropriate consultant medical specialist who recommends reconstructive surgery as part of
the most appropriate treatment, where response to conventional disease modifying therapy
hasfailedandtheconditionhasprogressedtothepointthattheinsuredpersoncan’t
perform any one of the activities of daily living without assistance from someone else.
Wewon’tpayforanyotherformofarthritis.
GlossArY oF terMs
Activities of daily living – Seerule40forthedefinition.
Severe rheumatoid arthritis – chronic active arthritis with no complete freedom from pain and moderate or marked
deformities with serious restrictions of movement and impairment of function.
62 – AMP Flexible liFetiMe – Protection – PlAn rules
stroke
DESCRIPTION Wewillpayifaninsuredpersonsuffersacerebrovascularepisodeproducingneurological
damagewhichlastsformorethan24hours.
Thedamagemustbeevidencedclinicallyby:
•cerebralCTscan,or
•anangiogram,or
•anMRIorPET,or
•otherreliableimagingtechniquesapprovedbyAMPLife.
Wewon’tpayfortransientischaemicattacks,reversibleischaemicneurologicaldeficit,
major head injuries or symptoms due to migraine or headache.
GlossArY oF terMs
Cerebrovascular episode – Aneventwherethebloodsupplytopartofthebrainisimpaired.
CT scan, angiogram, MRI or PET – Varietyoftestswhichprovideimagesofanorgansuchasthebrain.Thesetestsareusedto
defineabnormalitiessuchastumourordamagetoanorganfromimpairedbloodsupplyor
injury.
Neurological damage – Damagetothebrain,spinalcordornerveswherethenormalstructureandfunctionhas
beenaffectedresultinginsymptomssuchasimpairedvision,speechorparalysis.
Transient ischaemic attack – Aneventwherethereistemporaryinterruptionofthenormalbloodflowtothebrain,
resultingintemporaryabnormalitiesofbrainfunctionandleadingtosymptomssuchas
impairmentofbalance,vision,speechorco-ordinationwhicharen’tpermanent.Recovery
ofnormalfunctionoccurswithin24hours.
Reversible ischaemic neurological deficit – Abnormalityofneurologicalfunctionwhichlastsfor24hoursbutwhichisreversible.
Subacutesclerosingpanencephalitis
DESCRIPTION Wewillpayifaninsuredpersonsufferssubacutesclerosingpanencephalitis.
GlossArY oF terMs
Subacute sclerosing panencephalitis – Aprogressiveandfataldiseaseofthebrainsuspectedtobeofviralorigin.
AMP Flexible liFetiMe – Protection – PlAn rules – 63
systemic lupus erythematosus
DESCRIPTION WewillpayifaninsuredpersonsuffersSystemiclupuserythematosus(SLE)where
irreversibleorgandamagehasoccurredrequiringintravenousimmunosuppressiveor
cytotoxictherapy.Theorgandamageincludeslupusnephritis,cerebrallupus,cardiac
disease specially related to sle. An appropriate consultant medical specialist must confirm
the diagnosis of sle with pathological and other supporting evidence.
GlossArY oF terMs
Cerebral lupus – Achronicautoimmunediseasecharacterisedbyinflammationinthebrain.
Cytotoxic therapy – A process that kills cells.
Immunosuppressive – Capableofsuppressingtheimmuneresponse.
Lupus nephritis – A kidney disease that occurs with sle and often leads to renal failure.
Systemic lupus erythematosus – Achronicinflammatoryconditionaffectingtheinternalorgans,causedbyanautoimmune
disease.
systemic sclerosis
DESCRIPTION Wewillpayifaninsuredpersonisdiagnosedtohavesystemicsclerosisbyanappropriate
consultant medical specialist. the condition must have progressed to the point that the
insuredpersoncan’tperformanyoneoftheactivitiesofdailylivingwithoutassistance
from someone else.
GlossArY
Activitiesofdailyliving– Seerule40forthedefinition.
Systemicsclerosis– Aprogressiveskindisorderwhichischaracterisedbythickeningandtighteningoftheskin
affecting the face and hands. the disease also affects internal organs.
Viral encephalitis
DESCRIPTION Wewillpayifaninsuredpersonsuffersencephalitisduetodirectviralinvasionofthe
central nervous system. the encephalitis must produce neurological deficit causing
permanent and significant functional impairment.
GlossArY oF terMs
Encephalitis– Inflammationofthebrain.
Neurologicaldeficit– Abnormalitiesofthenervoussystemproducingcertainsymptomsandresultingindisorders
of function.
64 – AMP Flexible liFetiMe – Protection – PlAn rules
Glossary of definitions
40.
GLOSSARYOFDEFINITIONS
ACTIVITIESOFDAILYLIVING 1. Washing: the insured personcanwashthemselvesbysomemeans.
2.Dressing:the insured person can put clothing on or take clothing off.
3. Feeding: the insured person can get food from a plate into their mouth.
4.Continence:the insured personcancontrolboththeirbowelandtheirbladder
function.
5.Mobility:the insured person can:
a)getinandoutofabed
b)getonoroffachair/toiletand
c)movefromplacetoplacewithoutusingawheelchair.
buY bAcK see rule 11.2
cArer Theprimarycaregiver,whoprovidesassistancewithcommunication,mobilityorself-careto
adisabledoragedperson,formorethan6months.
certiFicAte oF insurAnce Certificate of Insurance is the certificate we send you when the plan starts.
the certificate sets out the details of who owns the plan, who is insured, the amount of
cover,andotherimportantinformationabouttheplan when it starts.
the certificate and the Plan rules in this document form your contract with AMP.
the information in the Certificate of Insurance canbeupdatedinthefollowingtwoways:
•first,intheAnnualStatementwesendyoueachyear,and
•second,ifyouaskustochangetheplan and we agree to it, we will send you a
MemorandumofAlteration recording the change.
We suggest that you keep each Annual statement and each Memorandumof
Alteration with the Certificate of Insurance.
AMP Flexible liFetiMe – Protection – PlAn rules – 65
cPi CPI means consumer Price index.
When we make a calculation using the increase in the CPI, we use the percentage increase
intheAustralianNationalAllGroupsConsumerPriceIndexpublishedbytheAustralian
BureauofStatistics.However,ifthatindexisabolishedorchanged,wemayuseanother
indexwhichwebelievefairlyandaccuratelyreflectschangesinthecostofliving.
When calculating the increase to the plan fee or the amount of cover, we use the annual
percentageincreasetotheindexfortheSeptemberquarterinthepreviouscalendaryear.
DOCTOR Doctor means a legally qualified medical practitioner registered to practise in Australia,
NewZealand,theUnitedKingdom,theUnitedStatesofAmerica,orCanada.
Thatpersonmaynotbe:
•you,yourbusinesspartner,oramemberofyourimmediatefamily,or
•theinsured person, the insured person’sbusinesspartner,oramemberofthe
insured person’s immediate family.
HOMEDUTIES An insured person is engaged in home dutiesiftheyaredoingatleast4ofthe
following duties related to running the family home:
•cleaningthefamilyhome
•shoppingforfoodandhouseholditems
•mealpreparation
•laundryservices
•caringforachildordependant(ifapplicable).
INSUREDPERSON
LINKED
linked cover means that each type of cover for an insured person is dependent on each
other type. if we pay under one type of cover, the amount of each remaining type of cover
that applies to an insured personisreducedbytheamountwepay.
MEMORANDUMOFALTERATION MemorandumofAlteration is a document we send you confirming a change to the plan.
MontH Month means calendar month.
oWn occuPAtion Your Own Occupation is the primary full-time occupation you have performed
immediatelypriortobecomingdisabled.ThisoptionisonlyavailabletoclassAoccupations
which include professional and white collar workers.
PlAn Plan means the rules in this document, the Certificate of Insurance, your Annual
statements and any documents we send you recording a change to your plan.
Insured person is explained under the heading ”Insured person” on page 1.
66 – AMP Flexible liFetiMe – Protection – PlAn rules
PlAn AnniVersArY the date of the plan anniversary for the plan appears in the Certificate of Insurance.
For most plans,itwillbethesamedateineachyearasthedateonwhichtheplan starts.
However,ifyouwantittobeadifferentdate,wemayagreetomakeitadifferentdate.
the plan anniversary is the date in each year on which we make any CPI increase to the
types of cover. When we recalculate the premium each year, the new amount applies for
one year from the plan anniversary.
PlAn oWner Plan owner is the person who owns the plan and whom we pay. We call that person
“you”. More than one person may own the plan. if it is a superannuation plan, it is owned
byAMPSuperannuationLimited.
PreMiuM the premiumistheamountpayableforyourplan, calculated from our premium rates.
it includes the plan fee, premium frequency fee, any discounts or loadings and any
government fees, duties or charges.
PreMiuM rAtes Premium ratesmeansthestandardrateswesetandusetocalculatethebasepremium.
Theydependonanumberoffactorsincluding:eachinsured person’s age, sex, health,
pastimes,smokinghabitsandoccupation.
reGulAr reMunerAtiVe WorK An insured person is engaged inregularremunerativework if they are doing work
inanyemployment,business,oroccupationforatleast10hoursperweek.Theymustbe
doing it for reward, or the hope of reward of any type.
REINSTATEDTRAUMACOVER see rule 11.3.
sPeciAl rule Special rule means any rule which we apply to a particular insured person and which
doesn’tnecessarilyapplytoallotherFlexibleLifetime–Protectionplans.
STANDALONE Stand alone cover means that each type of cover is completely independent of all other
types of cover that apply to an insured person under this plan. if we pay under one type
of cover, it does not affect the amount of any other cover for that insured person. the
onlytimethisdoesn’tapplyisifwepayunderTerminalIllnessbenefit,whenwereducethe
amountoftheDeathcoverthatappliestotheinsured personbytheamountwepay.
TERMINALLYILLANDTERMINALILLNESS An insured person is terminally ill if they are diagnosed as having less than 12 months
to live. Terminal illness has a corresponding meaning.
AMP Flexible liFetiMe – Protection – PlAn rules – 67
TOTALLYAND An insured personcanbetotally and permanently disabled if they:
PERMANENTLYDISABLED
•areunabletowork,or
•areunabletoperformspecifiedhome duties, or
•sufferlossofuseoflimbsand/orsight,or
•sufferlossoftheabilitytoperformtheactivities of daily living, or
•sufferlossofcognitivefunction,
andmeetthedefinitionsofanyoftheaboveasdescribedintheTPDtableonpage68.
TOTALLYDISABLED An insured person is totally disabledwhiletheyareunabletoengageinanyregular
remunerativeworkforwhichtheyarereasonablyfittedbytheireducation,trainingor
experience.Theymustbeunabletodothatbecausetheyhavesufferedanillnessorinjury.
TRAUMACONDITION the trauma conditions covered under trauma cover standard, trauma cover Premier and
the Partials Plus option are listed in rule 3.
the trauma conditions coveredunderChildren’sTraumacoverarelistedinRule7.1.
the full description of each trauma condition is set out in rule 39.
You, Your You and your and yourself in relation to superannuation plans means the insured
person; and means the plan ownerinrelationtoDeath,TotalandPermanent
Disablement,Traumaplans.
68 – AMP Flexible liFetiMe – Protection – PlAn rules
Definition of Totally and Permanently Disabled
Definition The insured person is totally and permanently disabled if they:
Part 1
Unabletowork
•sufferanillnessorinjury,and
•theillnessorinjurywhollypreventsthemfromengaginginregularremunerativework for at least 6months in a row, and
•sincetheybecameillorinjured,theyhavebeenundertheongoingcareandattentionofadoctor for that illness or injury, and
•inouropinion,theillnessorinjurymeansthattheyareunlikelytoeverworkinregular remunerative workforwhichtheyarereasonablyfittedbyeducation,trainingorexperience.
the insured personmustalsosurvive6months.
Uponadmittanceofyourclaim,wewillrefundanypremiumsfallingdueduringthis6month period, thathavebeenpaidfortheinsured person.
Part 2
Unabletowork–Own occupation(Part2isonlyapplicableto insured persons who have selected the own occupationoption)
•sufferanillnessorinjury,and
•theillnessorinjurywhollypreventsthemfromengagingintheirown occupation for at least 6months in a row, and
•sincetheybecameillorinjured,theyhavebeenundertheongoingcareandattentionofadoctor for that illness or injury, and
•inouropinion,theillnessorinjurymeansthattheyareunlikelytoeverworkintheirown occupation.
the insured personmustalsosurvive6months.
Uponadmittanceofyourclaim,wewillrefundanypremiumsfallingdueduringthis6month period, thathavebeenpaidforthe insured person.
Part 3
Home duties
•sufferanillnessorinjury,and
•theillnessorinjurywhollypreventsthemfromengagingin home dutiesforatleast6months in a row, and
•sincetheybecameillorinjured,theyhavebeenundertheongoingcareandattentionofadoctor for that illness or injury, and
•inouropinion,theillnessorinjurymeansthattheyareunlikelytoeverattendtohome duties.
the insured personmustalsosurvive6months.
Uponadmittanceofyourclaim,wewillrefundanypremiumsfallingdueduringthis6month period, thathavebeenpaidfortheinsured person.
Part4
Lossofuseoflimbsand/orsight
•sufferfromthetotalandirrecoverablelossof:
–theuseoftwolimbs,or
–thesightofbotheyes,or
–theuseofonelimbandthesightofoneeye
wherealimbmeansthewholehandbelowthewristorthewholefootbelowtheankle.
Thelossmustbeunabletoberemediedandtheinsured personmustsurvivefor14daysaftertheloss.
Part5
loss of independent living
•becometotallyandpermanentlyunabletoperformatleast2oftheactivities of daily living without assistance from someone else.
Wewillnotpayforlossofindependentlivingcauseddirectlybyalcoholordrugabuse.
the insured personmustsurvivefor14daysaftertheloss.
Part6
loss of cognitive functioning
•suffersignificantandpermanentcognitiveimpairmentwithalossofintellectualcapacity,and
•theyarerequiredtobeunderthecontinuouscareandsupervisionofsomeoneelse.
the insured personmustsurvivefor14daysaftertheloss.
AMP Flexible liFetiMe – Protection – PlAn rules – 69
enquiries and complaints
contAct us Ifyouneedanyadditionalinformationaboutyourplan, or if you have a concern or
complaint, then please contact your financial planner or contact AMP customer service on
131267.
if you want to write to us, our address is:
AMP life limited
POBox300
PARRAMATTANSW2124
OurCustomerServiceOfficersareavailabletoansweryourenquiriesandcomplaints.
Wewilltrytoresolveyourenquiryorcomplaintasquicklyaspossible.Tohelpusdothis,
pleasegiveusasmuchinformationaboutyourcomplaintaspossible.
Wehaveestablishedprocedurestodealwithanycomplaints.Ifyoumakeacomplaint,we
will:
•acknowledgeitsreceiptandensureanappropriatepersonproperlyconsidersthe
complaint; and
•respondtoyouassoonaswecan.
Ifyourcomplaintcannotberesolvedatfirstcontact,thenwewillkeepyouinformedofthe
progressandaimtogiveyouaresponsetoyourcomplaintwithin10workingdays.Ifthe
complaintisnotresolvedbythattime,thenwewillkeepyouadvisedatregularintervalsof
the status of your complaint.
Ifwecannotresolveyourcomplainttoyoursatisfactionwithin45days,thenyoumayhave
therighttolodgeacomplaintwiththeFinancialIndustryComplaintsService(FICS)(contact
detailslistedbelow).
Thisindustrysponsoredexternalservicewasestablishedtohelpclientswithcomplaints
they cannot resolve directly with their company. it is independent and impartial. Please try
toresolveyourcomplaintdirectlywithusbeforecontactingtheFICS.
Financial industry complaints service
Telephone:(03)86232000or1300780808
Fax:(03)96212291
email: [email protected]
or write to
POBox579,CollinsStreetWest
MelbourneVIC8007
Additionally,forFlexibleLifetime–Protection(Superannuation)members,ifwecannot
resolveyourcomplainttoyoursatisfactionwithin90days,thenyoumayhavetherightto
lodgeacomplaintwiththeSuperannuationComplaintsTribunal(SCT)(contactdetailslisted
below).
70 – AMP Flexible liFetiMe – Protection – PlAn rules
the sct reviews the decisions of superannuation trustees as they affect an individual
member.Itisindependentfromus.Evenso,pleasetrytoresolveyourcomplaintdirectly
withusbeforecontactingtheSCT.
SuperannuationComplaintsTribunal
Telephone:1300780808
or write to
LockedBag3060,
GPOMelbourneVIC3001
tiMe liMits on MAKinG if you contact the sct more than 12 months after our decision or response, then the sct
coMPlAints to tHe sct may decide not to deal with your complaint. However, this general rule does not apply to a
complaintaboutthedenialofatotalandpermanentdisablement(TPD)claim(seebelow).
Ifwedenyyourtotalandpermanentdisablement(TPD)claim,thenyoumaybeunableto
make a complaint to the sct:
•ifyoulodgeaTPDclaimwithusmorethan2yearsafteryoupermanentlystopworking,
or
•ifyoucomplaintotheSCTmorethan2yearsafterourfirst(original)decisiontodeny
yourTPDclaim.
You should contact the sct first to ensure that it can deal with your complaint.
AMP Flexible liFetiMe – Protection – PlAn rules – 71
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72 – AMP Flexible liFetiMe – Protection – PlAn rules
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Directory
AMP Life LimitedREGISTERED OFFICE
Level24
AMP Building
33 Alfred Street
SYDNEYNSW2000
Phone:0292575000
Fax:0292577886
AMP Customer Service CentrePHONE
131267
Monday to Friday
FAx
1300301267
ADDRESS
AMP Financial Services
Jessie Street Building
POBox300
PARRAMATTANSW2124
WEBSITE
www.amp.com.au
AMPLifeLimitedABN84079300379 33AlfredStreetSydneyNSW2000
90438311/07
advice
investments
banking
retirement income
superannuation
insurance
Contact your adviser or financial planner
telephone131267 web www.amp.com.au email [email protected]
If you have any enquiries or complaints please mention your plan number