Macquarie Life Active

Our severity based approach to paying claims removes the ‘all or nothing’ effect that can see a client’s claim swing from 100% to zero because their condition has just fallen short of the policy definition. Under Active, staging of benefit payments and lower thresholds for when conditions are covered means that clients may not receive the full benefit for a Health Event, but are much more likely to receive something where traditional policies would pay nothing, including some medical conditions not generally covered by traditional trauma insurance policies.

Health Events are grouped into five categories depending on their severity and each category pays a different percentage of the cover amount, as shown in the table below.

As benefits are claimed your initial amount of cover reduces. As a result, a feature called Claim Protector is also built into Active policies, protecting 25% of the cover so there will be an amount left for future Health Event claims - right through to at least age 65, giving you peace of mind that there is some ongoing cover for future financial support should you suffer multiple Health Events.

There is also the flexibility to include additional death cover to ensure there is a source of financial support for your dependants if you are no longer around, regardless of the number of health event claims made over the lifetime of the policy.

Macquarie Life Active is a revolutionary life insurance product that is unique in the Australian market and has won Best Life Insurance Product of the Year¹ , and Best Value for Money²  in 2010.

Macquarie Life Active is a all-in-one insurance package that provides lump sum cover not only for death and terminal illness but also for a broad range of Health Events (from accidents and injuries to long-term illnesses and very serious conditions like heart attack, stroke, cancer, digestive conditions, severe depression, back disorders and many others).

Clients also have the option to add Income Cover, Child Cover or Additional death cover if required, at an additional premium.

Unlike traditional trauma and total and permanent disability  insurances, Macquarie Life Active pays claims based on the seriousness of the health event. The more serious the event, the larger the benefit payable. Our severity based approach to paying claims removes the ‘all or nothing’ effect that can see a client’s claim swing from 100 per cent to zero, because their condition has just fallen short of the policy definition. Under Macquarie Life Active, staging of benefit payments and lower thresholds for when conditions are covered means that clients may not receive the full benefit for a Health Event, but are much more likely to receive something where traditional policies would pay nothing, including some medical conditions not generally covered by traditional trauma and total and permanent disability insurances.

By providing an integrated product and severity based benefits, premiums under Macquarie Life Active can be approximately 20 to 30 per cent lower than standard bundled life, TPD and trauma policies.^*

Active Cover provides breadth of cover for conditions such as heart attack, stroke, cancer, digestive conditions, severe depression and many others.

Active includes cover for many conditions which have typically not been covered to date, removing the gaps that can mean some clients miss out on receiving a claim, despite suffering a significant health event.

It also introduces lower thresholds for many conditions, meaning clients can start claiming at earlier stages.

Even if a client were to suffer a medical condition that is not specifically listed, the condition can be assessed under Activities of Daily Living which measures a person’s ability to perform simple day to day tasks that are crucial to quality of life: self-care; communication; physical activity; sensory function; hand functions; and advanced functions.

All conditions are based on objective criteria, increasing the transparency and clarity of the cover provided.

Macquarie Life Active pays claims based on the seriousness of the health event.

It makes more sense to pay a larger benefit for more serious conditions and a lower benefit for conditions that have less impact on physical health and financial position.

Macquarie Life Active splits Health Events into five categories, plus death and terminal illness, and pays a percentage of the benefit, as shown in the table below.

Macquarie Life Active allows for multiple claims to be made over the lifetime of the policy. This can be for both related health events as a condition deteriorates over time and for unrelated medical conditions. Each claim will reduce the amount of cover available for subsequent claims. The Remaining Amount of Cover is the initial amount of cover minus any prior claim.

For subsequent Health Event claims, Active cover will pay an amount which is calculated based on the reduced amount of cover

• the difference in benefit severity for a deterioration of a condition for which a claim has already been paid (see Progressive Conditions on page 7 of the PDS)
• the difference in benefit severity for unrelated conditions that occur within the 12 month Limited Claim Period (see Limited Claim Period on page 8 of the PDS); or
•  the benefit payable under the policy (subject to remaining amount of cover) for unrelated conditions that occur outside the Limited Claim Period (see Subsequent claims under the policy on page 7 of the PDS)

The Claim Protector feature is an important part of Macquarie Life Active. It applies up to age 65 and means that your remaining amount of cover for Health Events will not drop below 25 per cent of the initial amount of cover you applied for.

It does not apply to terminal illness or death, so your death and terminal illness cover under the policy may reduce to nil unless you have additional death cover. It will not apply for the first 14 days following the occurrence of a health event for which a claim is paid.

Example
Michael took out a Macquarie Life Active policy for $1 million cover. He has made a series of claims which has resulted in the Remaining Amount of Cover for the policy being reduced to nil. 14 days following the last claim, the Claim Protector applies, and the Maximum Amount Payable for benefit categories A to E is increased as shown below.

Benefit categories A to C are increased to $250,000 based on 25 per cent of the Initial Amount of Cover. Benefit category D is increased to $200,000 based on 20 per cent of the Initial Amount of Cover, and benefit category E is increased to $50,000 based on 5 per cent of the initial amount of cover.

The table and graph are from page 12 of 68 of the Macquarie Life reference document

Premiums under Macquarie Life Active can be approximately 20 to  30 per cent lower than standard bundled life, TPD and trauma contracts.^*

• the lower pricing is through more efficient use of premiums:
  streamlining lump sum cover for medical conditions into a single benefit
• staged benefit payments mean full benefit payments are not being made for conditions that have a relatively minor impact on the client.

Macquarie Life Active includes the following built-in features:

• claim protector – Even if you have received claim benefits that total your initial amount of cover, up to the age of 65, 25 per cent of that cover is still available for future health events claims
• financial planning benefit – Macquarie Life will reimburse up to $1,000 when a qualified financial adviser is used to prepare a financial plan following a claim payment for benefit categories AA, A or B
• funeral assistance benefit – An advance payment of up to $15,000 of the death benefit can be made to assist with funeral costs
• indexation increases – Macquarie Life will increase your cover each year by the indexation rate, to be in line with inflation
• future increases – You can apply to increase your Initial Amount of Cover without the need for additional medical tests following certain life events, for example, getting married or taking out a mortgage.

The conditions covered under the Macquarie Life Active policy for Health Events are summarised below. If you suffer a medical condition that is not listed your claim may still be assessed under the category for the inability to perform activities of daily living.

The categories of which the health events fall under are outlined in the Macquarie Life Active Reference Document.

The table is taken from page 7 of 68 of the Macquarie Life reference document

 Benefits are not payable under Active Cover if any of the following apply:

Death and terminal illness (benefit category AA)

• if terminal illness or death occurs directly or indirectly by an intentional self inflicted act within 13 months of cover commencement.  

Health Events (benefit categories A to E)

• if the Health Event is caused directly or indirectly by an intentional self inflicted act at any time;
• if the Health Event has a specified exclusion (see Health Events section starting on page 40 of the PDS); or
• if the Health Event occurs within 90 days of cover commencement and the Health Event has a 90 day exclusion specified (see Health Events section starting on page 40 of the PDS).

Child Cover
Where the Child Cover Condition (or where the condition involves surgery or a procedure, the disease or condition for which the surgery or procedure is undertaken):

• is a congenital condition;
• is caused by the intentional act or intentional omission of the policy owner or the insured child’s parent, guardian or a person acting in a regular de facto role as a parent; or
• occurs within 90 days of cover commencement and the Child Cover Condition has a 90 day exclusion specified (see Child Cover section on page 12 of the PDS).

Income Cover

• if the disability is caused directly or indirectly by:
  • an intentional self inflicted act at any time;
  • normal or uncomplicated pregnancy or childbirth;
  • war or an act of war;
  • intentional criminal activity; or
  • elective surgery that occurs within six months of cover commencement;
• for claims payable under the Health Events benefit, if the Health Event occurs within 90 days of cover commencement and the Health Event has a 90 day exclusion specified (see Health Events section on page 40);
• any period while the insured person is in jail;
• any period beyond three months while the insured person is outside of Australia. Upon return to Australia, benefits can continue if otherwise payable; or
• if the insured person unreasonably refuses to undergo recommended medical treatment including rehabilitation to treat their disability.

Macquarie Life Active is available only to a trustee of a self managed superannuation fund, or a member of the insurance only division of the Macquarie Superannuation Plan.

Macquarie Life does not allow some parts of the Macquarie Life Active cover to be held within superannuation. If you choose to hold part of your Macquarie Life Active cover within superannuation, two policies will be issued:

• a superannuation policy which will be owned by the trustee of a superannuation fund; and
• a separate non-superannuation policy which will provide the cover that cannot be issued under a superannuation policy.

If a benefit is payable under the superannuation policy the benefit will be paid to the trustee of the superannuation fund. The release of the benefit from the superannuation fund will then be subject to the governing rules of the superannuation fund and related taxation laws current at the time of payment.

If your application is accepted a policy schedule will be sent to you. If more information is required to assess your application, we will be in contact with you.

Prior to each anniversary of your policy a letter will be sent from Macquarie Life outlining any changes to the following year including the amount of cover and the premium. Each year an indexation increase to your cover will be offered so it keeps pace with the cost of living.

Please notify Macquarie Life if you have a change of address, contact details, or banking or credit card details (relevant to the premium payment).

Please contact Macquarie Life on 1800 208 130.

If your circumstances change and you wish to change your level of cover, you are able to reduce cover by request and may apply to us for an increase. Additional documentation may be required

Requests to reduce your cover must be made in writing and requests to increase cover may be subject to additional underwriting.

There may be tax deductions that apply to the premiums you pay under Macquarie Life Active.

Macquarie Life recommends you speak to your tax adviser regarding the tax consequences of insurance cover and policy ownership. Please also refer to the tax section of the Macquarie Life Active PDS and Reference Document for further information.

Your premium can be paid either monthly or yearly in advance.

You will receive a six per cent discount if you pay your premiums yearly.

Premium payments can be made by:

• credit card
• direct debit from an Australian bank account
• Macquarie Cash Management Account

Please contact Macquarie Life on 1800 208 130 or email us at insuranceclaims@macquarie.com if you think you are eligible to make a claim or are unsure and would like some assistance.

It is important that you notify Macquarie Life as soon as possible after any event that may lead to a claim. Macquarie Life will send you claims forms and explain in detail what the next steps are

Macquarie Life understands that at the time of a claim it is not only financial support that is needed and so for severe claims, up to three free counseling sessions may be available for the claimant and/or their immediate family.

Macquarie Life Active is designed for multiple claims so your premiums continue to be charged after a Health Event claim is paid

You do not have to pay premiums for Income Cover while on claim and receiving monthly payments.

Depending on how much cover you apply for, you may be asked to undergo a medical examination and/or blood tests. This ensures that we are offering you the best priced premium. The tests required may vary depending on your age, occupation, and the amount of cover you apply for.

Macquarie Life will cover the costs associated with any tests required, and they will usually be organised through Macquarie Life’s nominated pathology provider who can arrange to have the tests at your workplace or home or at medical centre across Australia.

You can receive an indicative, obligation free quote by 

• contacting one of our Insurance Specialists on 1800 245 555.

They will be able to explain the features of Macquarie Life Active, the different levels of cover, and provide you with an indicative quote.

The premium you pay for Macquarie Life Active is based on a number of different factors including whether you smoke, your age, gender, health, occupation, pastimes and your state of residence. It is also based on the type and how much cover is taken out.

You can receive an indicative, obligation free quote by contacting one of our Insurance Specialists on 1800 507 750.

The tables below demonstrate the indicative cost of Active cover for all age groups and genders. The table demonstrates the premium cost difference when additional death cover is added. The table is based on NSW clients, working in clerical occupations with no hazardous pursuits. For a personal quote please contact us on 1800 181 875

Macquarie Life Active - Monthly Premium Table

The above tables have been prepared by Macquarie Life Limited ABN 56 003 963 773 as an estimate and is not based on personal information you have provided to us. To provide an indicative quote personal information such as state of residence, involvement in hazardous activities and employment must be provided. This list is by no means exhaustive.

It is provided as an indication of the cost of insurance, using Macquarie Life's standard premium rates, and does not represent a quote for any particular person. These rates are based on NSW clerical occupation premiums. Applications for insurance will be subject to underwriting procedures and additional premium loadings may apply. Macquarie Life Limited can reject applications for insurance cover, apply additional premium loadings or apply specific exclusions..

Applications for insurance cover will only be accepted on an application form attached to the current PDS or via an electronic application available through Macquarie's online insurance platform. It is advisable to read the PDS before completing an application form.