Financial Adviser Guide

215 Pages·2012·1.29 MB·English

Adviser use only
Financial
Adviser Guide
MLC Insurance
MLC Insurance (Super)
Issue date: MLC Limited and MLC Nominees Pty Limited Trustee for The Universal Super
10 September 2012 ABN 90 000 000 402 ABN 93 002 814 959 Scheme ABN 44 928 361 101
AFSL 230694 AFSL 230702 RSE L0002998 R1056778 SFN 281440944
Issuer of MLC Insurance Issuer of MLC Insurance (Super)
Contents
At a glance, what is covered in this guide
1 Contact Summary 3 Underwriting
requirements tables
Contact MLC 11
Medical requirements 21
2 U nderwriting philosophy
What is the combined
and service
sum insured? 21
Underwriting philosophy Life Cover, Accidental Death,
statement 13 TPD and Critical Illness 21
Table A: Life Cover, Accidental Death,
Underwriting service 14
TPD and Critical Illness combined
Your underwriting team 14 sum insured 22
How do we help you? 14
Table B: Additional requirements for
How you can help your client 14 Critical Illness over $500,00 22
MLC Riskfirst applications 15
Income Protection 23
Legislation, FSC standards
Table C: Income Protection 23
and guidelines 16
Business Expenses 23
Privacy 17
Business Expenses with Income
Alternative terms and policy Protection 23
amendments 18
Key to type of medical evidence
Exclusions 18 required in addition to the personal
Why do we offer exclusions? 18 statement 24
Can exclusions be reviewed? 19 Glossary of requirements 25
If your client is in an accident, will
Financial requirements 26
their claim be considered? 19
Personal insurance: Life Cover,
Accidental Death, TPD and
Critical Illness 26
Multiple of earnings 27
Page 2 Financial Adviser Guide
Contents
(continued)
Business insurance: Life Cover, 5 Occupation
Accidental Death, TPD and
underwriting guide
Critical Illness 28
Occupation underwriting 95
Income Protection 30
Hard-to-classify
What is the maximum occupations 96
monthly benefit? 30
Change of occupation 96
When is financial evidence
More than one occupation 96
required? 30
Special occupation eligibility
Which type of evidence
categories 97
is required? 31
Apprentices 97
Business Expenses 32
Armed services 97
4 Occupation groups guide Bankruptcy, insolvency or
liquidation 97
How occupations are
Financial advisers 97
grouped 34
Homemakers - Total and
MLC can help you 34 Permanent Disability 97
Key to occupation groups 35 Leave from employment 98
Product codes 35 Newly self-employed 98
Life Cover and Critical Illness 35 Part-time workers 98
Income Protection, Business Total and Permanent Disability 98
Expenses and Total and Permanent Income Protection 98
Disability 36 Seasonal workers 99
Eligibility for ‘Own Occupation’ Professionals package 99
definition TPD 37 Eligibility 99
Occupation group Levels of cover 99
tables A - M 38 Professional sportspeople 101
Occupation group Working at heights 101
tables N - Z 74 Working at home 101
Working more than 60 hours
per week 101
Page 3 Financial Adviser Guide
Contents
(continued)
6 Pastimes table Joint and several liability 129
Business Safeguard 129
and guide
Income Protection 131
How pastimes are classified 103
Calculating the monthly benefit 131
Key to pastime classifications 104
Conditions for monthly benefits over
Pastime classification $30,000 131
tables A - Z 105 Income Protection Agreed Value
vs Indemnity benefit 132
7 Financial underwriting
Agreed Value cover 132
Financial requirements: why Agreed Value cover endorsed 132
financially underwrite? 124 Indemnity cover 132
Personal Insurance: Life Cover, Earnings 132
Accidental Death, TPD and Self-employed 132
Critical Illness 125 Employee 133
Other earnings 133
Employed/Self-employed
- Bonuses 133
applicants 125
- Commissions 133
Homemakers 126
- Depreciation 134
Unemployed, student and
- Donations 134
retired applicants 126
- Income distribution to spouse/
Business Insurance: Life, defacto/life partner 134
Accidental Death, TPD, - Non-cash personal benefits
Critical Illness and Business as earnings 135
Safeguard Option 127 Unearned income and assets 136
Purpose of Business 127 Business Expenses 137
Who can apply? 137
Ownership Protection (Buy/Sell)
insurance 127 Partnerships 137
Small businesses 137
Revenue Protection (Key person)
Sole traders 137
insurance 128
Expenses covered 138
Asset (Debt) Protection or loan
Expenses not covered 138
guarantee insurance 128
What is a Locum? 138
Page 4 Financial Adviser Guide
Contents
(continued)
8 Medical underwriting Underwriting medical
conditions 153
Medical requirements 140
Asthma 153
New business 140
Underwriting approach 153
Increases 141
Business Safeguard Option 141 Back/Neck pain or disorders 153
Arranging medical Underwriting approach 153
requirements 142 Blindness 154
MLC can arrange medical Causes of blindness 154
requirements 142 Underwriting approach 154
What is a PMAR? 142 Cardiovascular disease 155
You can arrange medical The heart 155
requirements 142 Common cardiac disorders 155
What is a RapidCheck? 142 - Hyperlipidaemia or raised
Does your client need to fast cholesterol 155
for a blood test? 142 - Coronary heart disease 156
- Hypertension 156
Underwriting questionnaires 144
Underwriting approach 157
Health pre-assessment 146
Diabetes 158
Health affects applications 146
Type 1 diabetes 158
Critical Illness Extra Benefits
Type 2 diabetes 158
Option - Partial Benefits 146
Gestational diabetes 158
Critical Illness - alternative terms
Underwriting approach 158
for special cardiovascular and
cancer risks 149 Family history 159
Critical conditions not covered 150 What family history is relevant? 159
Child Critical Illness 151 What is the risk? 159
Body mass index: height FSC Family History 159
and weight 151 Genetics 160
BMI ranges - what do they mean? 152 FAQs 160
Underwriting requirements 152
Page 5 Financial Adviser Guide
Contents
(continued)
Joint/Musculoskeletal 9 New business and policy
disorders 161 alterations
Underwriting approach
for disability cover 161 Application process 168
- Fracture 161 PDS and Application Form 169
- Arthritis 161 MLC Riskfirst 170
- Muscular or tendon injuries MLC Riskfirst - first class
and repetitive strain injuries 162 service for you 170
- Gout 162 170 Top 10 reasons why advisers
Mental health 162 choose Riskfirst 170
Some types of disorders 162 Travel and residency 172
- Anxiety 162 Must your client be a permanent
- Depression 162 resident of Australia? 172
- Bipolar disorder 162 Does your client plan to travel
- Postnatal depression 162 overseas? 172
Underwriting approach 163 Is your client an Australian citizen
FSC Mental Health Guidelines living and working overseas? 173
(Guidance Note No. 15) 163 General information for
Memorandum of Understanding 163 applications 174
Skin Lesions 164 Does your client read and
Basal cell carcinoma (BCC) 164 understand English? 174
Melanoma 164 Is your client having a break
Moles (benign naevus) 164 in employment? 174
Sebaceous cysts 164 Does your client have a disability
Squamous cell carcinoma (SCC) 164 claim pending? 174
Sunspots (solar keratosis) 164 Backdating applications 175
Underwriting approach 164 What if your client has a birthday
Sleep apnoea 165 before the policy completes? 175
Underwriting approach 165
Smoking 166
Underwriting approach 166
Page 6 Financial Adviser Guide
Contents
(continued)
Replacement business 176 Remuneration on Buy Back
Eligibility 176 benefits 192
Evidence requirements 176 Remuneration on rewritten
business 193
New business follow-up
procedures 177 Substitute business rules 193
Reinstating 178 Remuneration on substitute
Reinstating cancelled business 194
applications 178 Changing the level of cover, adding
Reinstating lapsed policies 178 extra cost options or altering
Continuation options for Group options which affect premiums 196
Insurance, MasterKey Business Remuneration for special cases 196
Super and MasterKey Wrap 179 Responsibility period 196
What are the terms Premium discount on
of eligibility? 179 commission 196
Group Insurance and MasterKey
10 Premium Information
Business Super (MKBS) 179
MasterKey Wrap 179 Premium rates 198
What cover options Minimum premium 198
are available? 179
How clients can pay
Requirements 180
premiums 199
Alterations to existing What payment options are
policies 181
available? 199
Financial advisers’
Which payment form
commission 192
is required? 199
Change of servicing adviser Direct debit system 200
or licensee 192
Credit card deductions 200
Remuneration rate 192 Cheque 200
Change of authorised
Bpay® facility 200
representative before completion 192
Eligible MLC Account
Clawback after change of deductions 201
authorised representative 192
Page 7 Financial Adviser Guide
Contents
(continued)
11 Claims procedures Structuring insurance
information between policies using
Connected Benefits 210
Claims process and contacts 203
Example 1: Structuring insurance
Claims procedures 205 inside and outside super 211
Claims philosophy 205 Example 2: Structuring insurance
Notification 205 inside and outside super (with an
Time limits on claims 206 external trustee) 211
Example 3: Structuring insurance
Submission of completed claim
for business and personal
forms/Proof of Loss 206
purposes 212
12 Product Information Fees and payment methods under
Connected Benefits 212
Policy structures 208
Setting up Connected Benefits 212
MLC Insurance (Super)
- insurance inside super 208 Sums insured, claims, cancellation
and options with Connected
Number of lives Insured 208
Benefits 213
Policy ownership 208
Rules unaffected by Connected
MLC Insurance - insurance
Benefits 213
outside super 208
Policy ownership 209 Nominating a beneficiary 214
Income Protection and Business Non-binding death benefit 214
Expenses third-party ownership 209 Non-lapsing binding
Ownership by a trust or death benefit 214
self-managed super fund 209 No nomination 214
Page 8 Financial Adviser Guide
Your financial
adviser guide
This is your guide to MLC insurance and
underwriting. It is designed to assist you
in writing MLC insurance by explaining our
underwriting philosophy, requirements and
practices, as well as our claims procedures and
product information.
The guide is comprehensive, but you may
need to discuss particular issues or
aspects of applications with one of MLC’s
Business Development Managers (BDMs)
or experienced underwriters.
The MLC Service teams are also there to help
you and we encourage you to call us about
any underwriting, new business, maintenance or
product enquiry you may have.
This guide is for adviser use only and is
not intended for general distribution.
It has been prepared by MLC Limited and
is intended as a reference and training
guide for advisers. The product information
contained in this guide should be read in
conjunction with the Product Disclosure
Statement (PDS) and the applicable
Policy Documents.
Page 9 Financial Adviser Guide
Contacts
summary
1
Page 10 Financial Adviser Guide