Significant Event Notice – 4 July 2022
Changes to Insurance Definitions
Diversa Trustees Limited, as Trustee of the Grosvenor Pirie Master Superannuation Fund Series-2, is writing to provide you with important information about your member account in Simple Choice Super.
This information is particularly pertinent to those members who hold Death & TPD insurance cover through their Simple Choice Super account.
From 7 March 2022, a new Group Life (Death and Total and Permanent Disablement) Insurance Policy has applied to Simple Choice Super members. The Policy is issued by AIA Australia Limited ABN 79 004 837 861 AFSL 230043 (the Insurer) to the Trustee.
For members, the new Policy results in one change, being a new definition of Total and Permanent Disablement – Limited, and within this new definition, two new sub-definitions, of Mental Illness and Permanent Incapacity.
All other terms and conditions of the Insurance Policy remain unchanged.
All Insured Members of Simple Choice Super with Death & TPD cover under the Policy that was in place immediately prior to 7 March 2022 will have that cover continue under the new Policy subject to any individual conditions, exclusions or restrictions which applied to an Insured Member continuing to apply until such time as they expire according to their terms.
Replacement Definition: Total and Permanent Disablement – Limited Definition
The following table highlights the differences between the definition that applied until 6 March 2022, and the new definition that has applied since 7 March 2022.
| ORIGINAL DEFINITION – Applicable to 6 March 2022 | NEW DEFINITION – Applicable from 7 March 2022 |
The Limited Definition applies to a member who is: | |
Not in Gainful Employment during the 3 months immediately prior to the Incident Date; or | Not in Gainful Employment for 16 consecutive months or more immediately prior to becoming totally and permanently disabled; or |
Working on average less than 20 hours per week during the 3 months immediately prior to the Incident Date; or | – |
Working in a hazardous or uninsurable occupation classified as “Individual Consideration” or “N/A” for Death only or Death & TPD cover in accordance with the Insurer’s Occupational Guide during the 3 months immediately prior to the Incident Date; or | Working in a hazardous or uninsurable occupation classified as “Individual Consideration” or “N/A” for Death only or Death & TPD cover in accordance with the Insurer’s Occupational Guide during the 3 months immediately prior to the Incident Date; or |
On Leave Without Pay, however: | On Leave Without Pay, however: |
— you have not applied for an extension of leave beyond your agreed ‘return to work’ date; or | — you have not applied for an extension of leave beyond your agreed ‘return to work’ date; or |
— the Insurer does not approve the extension application beyond your agreed ‘return to work’ date; or | — the Insurer does not approve the extension application beyond your agreed ‘return to work’ date; or |
— the period of leave is more than 24 months, | — the period of leave is more than 24 months, |
and your TPD Incident Date occurs after the period of approved Leave Without Pay (as outlined in clause 4.4). | and your TPD Incident Date occurs after the period of approved Leave Without Pay (as outlined in clause 4.4). |
Total and Permanent Disablement (TPD) means that the Insured Member | |
(a) Having been for a period of 6 consecutive months after the commencement of the injury, sickness or disease, continuously and totally unable to perform at least 2 of the following activities of daily living, as certified by a Medical Practitioner appointed by the Company, and provided such continued inability is irreversible as certified by that Medical Practitioner. The activities of daily living are: | (a) Having been for a period of 6 consecutive months after the commencement of the injury, sickness or disease, continuously and totally unable to perform at least 2 of the following activities of daily working, as certified by a Medical Practitioner appointed by the Company, and provided such continued inability is irreversible as certified by that Medical Practitioner. |
(i) Bathing: the ability to wash oneself either in the bath or shower or by sponge bath, without the physical assistance of another person. | (i) Mobility: the ability to: — Bend, kneel or squat to pick something up from the floor and straighten up again, and get into and out of a standard sedan; or— Walk more than two hundred (200) metres at a normal pace on a level surface without stopping due to breathlessness as a result of a medical condition; |
(ii) Dressing: the ability to put on or take off all garments and medically necessary braces or artificial limbs usually worn, and to fasten and unfasten them, without the physical assistance of another person. | (ii) Seeing: the ability to read ordinary newsprint and pass the standard eye test for a car licence (even with glasses or contact lenses) and your vision is better than legal blindness. Legal blindness is as certified by an ophthalmologist; |
(iii) Eating: the ability to feed oneself once food has been prepared and made available, without the physical assistance of another person. | (iii) Lifting: the ability to lift with their hands (from bench height) and carry a five (5) kg weight a distance of ten (10) metres and place the item back down at bench height; |
(iv) Toileting: the ability to get to and from and on and off the toilet, without the physical assistance of another person and the ability to manage bowel and bladder functions through the use of protective undergarments or surgical appliances, if | (iv) Communicating: the ability to speak in their first language with sufficient clarity such that they can hold a conversation in a quiet room\by understanding a simple message and relaying that message to another person; |
(v) Transferring: the ability to move in and out of a chair, without the physical assistance of another person, | (v) Manual dexterity: the ability to use — at least one hand to pick up or manipulate small objects precisely with their hand or fingers (such as picking up a coin from desk height, using cutlery, tying shoelaces or fastening buttons); or — a pen, pencil or keyboard to write a short note that can be understood by another person in their first language |
| Where the Insured Member is unable to perform one or more of the above activities when cover commenced, that activity will not be taken into consideration by AIA Australia as part of the TPD assessment. | |
| * Aids and adaptations refers to equipment or fixtures which assists the Insured Member to carry out the activities. | |
AND | OR |
(b) After consideration of all the medical evidence and such other evidence as the Company may require, has become, in the Company’s opinion, incapacitated to such an extent as to render him or her unlikely ever to be able to engage in his or her own occupation and any occupation for which he or she is reasonably suited by education, training and experience. | (b) The Insured Member is deemed to be totally and permanently disabled if, in the opinion of AIA Australia, he or she has a Mental Illness that: |
| — the Insured Member’s treating psychiatrist, psychologist or Medical Practitioner believes the condition won’t improve; and | |
| — has been assessed by a psychiatrist appointed by AIA Australia as having an impairment of 19% or more on the Psychiatric Impairment Rating Scale and in their opinion the condition is permanent. | |
| And with respect to (a) and (b) above the Insured Member has a Permanent Incapacity. |
2. The new Total and Permanent Disablement
– Limited Definition includes two new terms, which are also defined.
2.1 New Definition – Mental Illness
The following new definition applies from 7 March 2022:
Mental Illness
Means the Insured Member(‘s) has been diagnosed by a psychiatrist under the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association (or a similar diagnostic tool determined by the Royal Australian and New Zealand College of Psychiatrists Board).
2.2 New Definition – Permanent Incapacity
The following new definition applies from 7 March 2022:
Permanent Incapacity
Means in our opinion the Insured Member has become incapacitated due to ill-health (whether physical or mental) and as a result of this ill-health is unlikely he or she will ever engage in or work for reward in any occupation for which he or she is reasonably qualified by education, training or experience.
Simple Choice Super is a superannuation product within Grosvenor Pirie Master Superannuation Fund ABN 32 367 272 075; RSE Registration R1001204 (the Fund). Diversa Trustees Limited ABN 49 006 421 638, AFSL 235153 RSE Licence L0000635 (Trustee) is the Trustee of the Fund and the product issuer. This information is intended to provide you with general information only and does not take into account your personal objectives, financial situation or needs. Before making any financial decisions about Simple Choice Super, it is important that you read the Product Disclosure Statement (PDS) relevant to your membership and consider your particular circumstances and whether the particular financial product is right for you. The PDS for your product is available at https://simplechoicesuper.com.au/. You should consult a financial adviser if you require personal advice.
