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Income Protection Insurance More Information

Introducing Guardian Income Protection Insurance

With Guardian Income Protection Insurance there is a range of flexible insurance combinations to suit your needs.

There’s Income Protection Insurance – broadly, this insurance provides a monthly Income Benefit if, as a direct result of an Disability, Sickness or Injury your suffer a loss of income – which you can apply for on its own. In addition to the monthly Income Benefit, a premium waiver benefit and a recurrent disability benefit are provided under the Policy.

Plus there is a range of optional benefits that you can apply for with your Income Protection Insurance:

  • Rehabilitation benefits – pays an additional income benefit to assist with rehabilitation program costs, plus a benefit to help pay for return to work costs, such as special equipment to assist you to re-enter the workforce or workplace modification.
  • Homemaker Insurance – broadly, this insurance provides up to $1,000 per month for up to six months if the Homemaker is unable to perform Domestic Duties due to Sickness or Injury.
  • Final Expenses Insurance – up to $50,000 benefit paid upon death to help with final expenses.
  • Children’s Insurance – lump sum benefit is paid in the event of Accidental Death or Paralysis, Blindness, Deafness, Total and Permanent Loss of Use of Two Limbs, Encephalitis, Meningitis or Major Head Trauma of the Insured Child.

A full explanation of these benefits, and the terms and conditions applying, are set out in the PDS. With Income Protection Insurance, you are protected 24 hours a day, 7 days a week, worldwide provided you remain an Australian Resident.

Income Protection Insurance

1. What is Total & Permanent Disability Insurance?

Income Protection Insurance pays an Income Benefit if you are unable to work due to a Disabling Sickness or Injury for longer than your chosen Waiting Period. In addition you have the option of adding rehabilitation benefits which are designed to help you get back to work.

2. Income Protection Insurance eligibility

You can apply for Income Protection if you are working at least 20 hours per week in permanent paid employment for at least 12 months prior to the Policy Commencement Date, and, if you are self employed, you have been working in this capacity for at least 24 months prior to the Policy Commencement Date.

You must be an Australian Resident aged between 18 and 59.

3. Income Protection Insurance Benefit amount

The minimum and maximum Income Benefit amount that you can apply for at the Policy Commencement Date is shown on the following table:

Minimum monthly
Income Benefit amount
Maximum monthly
Income Benefit amount
$1,000 75% of your monthly
Pre-Tax Income up to a
maximum monthly
benefit of $10,000.

The Income Benefit payable will not exceed 75% of your average monthly Pre-Disability Income.

4. Income Protection Insurance benefit payment

We will pay the benefits explained below except in the circumstances explained in “Income Protection Insurance exclusions”.

Income Benefit

We will pay the Income Benefit as a monthly amount if you:

  • suffer a Disabling Sickness or Injury while covered under the Policy; and
  • remain continuously Disabled during the Waiting Period; and
  • are continuously Disabled after the end of the Waiting Period, and
  • solely as a result of the Disabling Sickness or Injury, your capacity to earn your Pre-Disability Income, from your Regular Occupation reduces by 20% or more.

Disabling Sickness or Injury means due to a Sickness or Injury occurring after the Acceptance Date, you are:

  • confirmed by a Medical Practitioner as being unable to perform the usual duties of your Regular Occupation necessary to produce income; and
  • you are under the regular care, and following the advice, of a Medical Practitioner in relation to your Sickness or Injury for which you are claiming; and
  • suffering a loss of income; and
  • you are not engaged in your Regular Occupation or any other gainful occupation.

Disabled / Disability has the same meaning as Disabling Sickness or Injury.

The Income Benefit is payable monthly in arrears during the Benefit Period, with the first payment occurring one month after the end of the Waiting Period.

Your Policy Schedule will show the Benefit Period and Waiting Period you have chosen.

Benefit Period

The Benefit Period is the maximum period of time that the Income Benefit will be paid for any one Disabling Sickness or Injury claim you make under your Income Protection Insurance. When you apply for cover, you can choose a 6 month, 1 year, 2 year or 5 year Benefit Period.

The Benefit Period starts at the end of the Waiting Period and continues until the earliest of:

  • the end of the Benefit Period shown on the Policy Schedule; or
  • the date you are no longer Disabled; or
  • the Policy Anniversary following your 65th birthday; or
  • the date your Policy ends.

Example: If you choose a 30 day Waiting Period, your first payment would be 60 days after you were first eligible to claim (the 30 day Waiting Period plus 30 days because claims are paid in arrears).

Income Benefit amount

The Income Benefit payable may be less than the Monthly Amount Insured shown on your Policy Schedule.

The Income Benefit payable will be calculated as the lesser of:

  • the Monthly Amount Insured; and
  • 75% of your Pre-Disability Income.

If you are receiving Other Payments, this amount may then be reduced so that the combined total of the monthly amount we pay, plus the Other Payments you receive, is no more than the lesser of:

  • the Monthly Amount Insured; and
  • 75% of your Pre-Disability Income.

If you make a claim we will require you to provide satisfactory financial evidence of your Pre-Disability Income.

We will continue to pay you the Income Benefit until:

  • the Disabling Sickness or Injury giving rise to the claim does not prevent you from earning your Pre-Disability Income from your Regular Occupation; or
  • the Benefit Period ends; or
  • the Policy ends; or
  • your death; or
  • you are no longer under the regular care of a Medical Practitioner with regard to treatment of the Disabling Sickness or Injury; or
  • you are no longer following the treatment recommended by a Medical Practitioner at such intervals and frequency as will lead to a cure, alleviation, or minimization of the condition causing the Disabling Sickness or Injury.
Recurrent disability benefit

If the Disabling Sickness or Injury recurs within six months of your last Income Benefit and you need to restart your claim, we will treat it as a continuation of your previous claim. In this circumstance the Waiting Period will be waived, but your claim is only payable for the balance, if any, of the Benefit Period. You must return to full time work for at least six consecutive months and perform all of the important Income Producing Duties of your Regular Occupation without restriction before becoming eligible to submit a new claim for the same or related cause. A new Waiting Period and Benefit Period will then apply.

Rehabilitation benefits (optional)

These benefits are intended to help you return to work, and are payable if you are receiving the Income Benefit. This option is only available if you have selected a 2 or 5 year Benefit Period. If you are covered for the Rehabilitation Benefit, it will be shown on your Policy Schedule. The rehabilitation benefits are payable as follows:

Rehabilitation Program: If you participate in a Rehabilitation Program, we will reimburse you up to an additional 50% of your Monthly Amount Insured each month you participate in the program, up to a maximum of 6 months.

Example: If your Monthly Amount Insured is $3,000 per month, we will reimburse you up to an extra $1,500 per month for up to 6 months.

Return to work costs: We will pay up to 6 times the Monthly Amount Insured toward expenses such as the cost of special equipment and workplace modifications designed to assist you to re-enter the workforce. This benefit does not cover health costs which are typically covered by Medicare or private health insurance.

Example: If your Monthly Amount Insured is $3,000 per month, we will reimburse you up to $18,000. The rehabilitation benefit expenses must be incurred whilst you are receiving the Income Benefit and, to receive any one of the rehabilitation benefits, you must have our written approval to meet the expenses of the Rehabilitation Program, or the rehabilitation expenses, before they are incurred.

Limit on benefits

You are only entitled to one Income Benefit payable at any one time under this cover, even if you suffer more than one Sickness or Injury giving rise to the claim.

At no time can your Income Benefit exceed 75% of your Pre-Disability Income.

If you are covered under more than one Guardian Income Protection Insurance Policy, we will apply these limits to the total of the benefits payable under all Guardian Income Protection Insurance Policies. Any reduction in the Income Benefit will be applied to the Insurance most recently commenced and we will refund the premiums paid referable to the amount by which the Income Benefit is reduced.

5. Income Protection Insurance premiums

Premiums are the cost of your Insurance. The premium you are required to pay when the Policy starts is shown on your Policy Schedule.

Your premium is calculated at each Policy Anniversary and is based on:

  • your age, gender and smoking status at that time;
  • the Monthly Amount Insured;
  • the Benefit Period;
  • the Waiting Period; and
  • various factors which may affect the premium rating such as the state of your health, family history, occupation and participation in hazardous activities.

For a premium estimate you should contact a Guardian Insurance Consultant on 1300 709 560.

Premium Waiver

You do not have to pay your premium for any period during which the Income Benefit is payable. If we receive your completed claim form within 30 days from the start of your Sickness or Injury and the Income Benefit is payable, we will also refund the portion of the premium you have paid in the Waiting Period.

6. Income Protection Insurance exclusions

We will not pay an Income Benefit in respect of a claim for a Disabling Sickness or Injury occurring directly or indirectly from:

  • a Mental Disorder or Illness; or
  • an intentional self inflicted act; or
  • attempted suicide; or
  • the consumption of drugs (unless it was under the direction of a Medical Practitioner and not in connection with treatment for drug addiction, substance abuse or dependence); or
  • the consumption of intoxicating liquor, including having a blood alcohol content over the prescribed legal limit whilst driving; or
  • normal pregnancy (including participation in an IVF or similar program, normal discomforts such as morning sickness, backache, varicose veins, ankle swelling or bladder problems), giving birth, miscarrying or having a pregnancy terminated; or
  • war (whether declared or not) or war-like activity, or taking part in a riot or civil commotion; or
  • engaging in any criminal activities or illegal acts.

We will not pay the Income Benefit where we have agreed a special term with you in respect of your cover that specifically excludes the event or condition leading to the claim. Any such special term will be agreed with you before your Policy is issued and will appear on your Policy Schedule.

7. Income Protection Insurance start and end

If your application for Income Protection Insurance is accepted by us, your cover starts on the Acceptance Date set out in the Policy Schedule. Your first premium is deducted from the Commencement Date, which is also set out in the Policy Schedule.

We guarantee to renew your Income Protection Insurance (provided you pay your premiums when due) until you attain age 65.

Your Income Protection Insurance ends when the first of the following occurs:

  • the Policy Anniversary following your 65th birthday; or
  • the date the Policy ends; or
  • your death; or
  • the date you cancel the Policy; or
  • the date we cancel the Policy; or
  • you are no longer an Australian Resident.

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