Frequently asked questions

Does Simple Life have a no claim period?

If you have Critical Illness Cover* there’s a 90 day no claim period from your cover start date. This means you can't claim for a critical illness or related event, including for symptoms of an illness which occurs in this time.

For example, if you have a stroke three weeks after you bought Critical Illness cover, you won't be paid the benefit because the event occurred within the 90 day no claim period.

* Critical illness cover conditions are:

  • Cancer
  • Coronary artery disease requiring bypass surgery
  • Heart attack
  • Stroke

Critical illness conditions have specific meanings and a benefit is only payable if you meet the precise meaning of the definition set out in the Simple Life Product Disclosure Statement and the Simple Life Medical Definitions Reference Guide.

Will my Simple Life policy cover me when I’m travelling overseas?

Yes, your Simple Life policy will cover you when you travel overseas.

If you intend to live outside Australia for more than 12 months in a row, you need to call 13 3982. If you live outside of Australia for more than 12 months in a row, you'll no longer be a permanent Australian resident and you won't have access to benefits for any claim event that occurs after this date.

Does Simple Life have any specific exclusions I need to know about?

Depending on the type cover you have, there are a few exclusions you need to know about.

Life Cover
Life Cover death or terminal illness benefit won't be paid when death or terminal illness results directly or indirectly from any of the following:

  • A pre-existing condition
  • Suicide, attempted suicide or self-inflicted injury, whether you're sane or not
  • As a result of war, whether it has been declared or not
  • Participation in an illegal activity
  • Working in hazardous conditions
  • If you've been living outside of Australia for more than 12 months in a row

Critical Illness Cover*
Critical Illness benefit won't be paid when your critical illness results directly or indirectly from any of the following:

  • A pre-existing condition 
  • Suicide, attempted suicide or self-inflicted injury, whether you're sane or not
  • As a result of war, whether it has been declared or not
  • Participation in an illegal activity
  • Working in hazardous conditions 
  • If you pass away within 30 days of being diagnosed with or suffering a critical illness
  • If you've been living outside of Australia for more than 12 months in a row

*Critical illness cover conditions are:

  • Cancer
  • Coronary artery disease requiring bypass surgery
  • Heart attack
  • Stroke

Critical illness conditions have specific meanings and a benefit is only payable if you meet the precise meaning of the definition set out in the Simple Life Product Disclosure Statement and the Simple Life Medical Definitions Reference Guide.

Total and Permanent Disability Cover (TPD)
TPD benefit won't be paid when your permanent disablement results directly or indirectly from any of the following:

  • A pre-existing condition 
  • Suicide, attempted suicide or self-inflicted injury, whether you're sane or not
  • As a result of war, whether it has been declared or not
  • Participation in an illegal activity
  • Working in hazardous conditions
  • If you've been living outside of Australia for more than 12 months in a row

You should also read about Simple Life’s no claim period.

You say hazardous working conditions aren’t covered by Simple Life – what does this mean for me?

With a Simple Life policy, you won't be able to make a claim if your claim is caused from working in hazardous working conditions.

Hazardous working conditions include:

  • Working above heights of 15 metres outside a building or in a building that’s under construction. For example, this may affect tree loppers, window cleaners and construction workers.
  • Working below the surface of the ground, either outside a building or in a building that’s under construction, or below the surface of water. For example, this may affect miners, construction workers and divers.
  • Work that requires the handling or transport of explosives or firearms. For example, this may affect police officers, armed security guards and on-site construction workers.
  • Working offshore. For example, this may affect people who work on offshore oil rigs, in the gas industry and commercial fishers.

What’s a pre-existing condition?

Simple Life won't cover you for any pre-existing conditions. In simple terms, a pre-existing condition means you aren't covered for any claim that’s caused directly or indirectly by any illness, injury, medical condition and/or symptoms that occurred in the five years before your cover start date.

Further explanation of what we mean by a pre-existing condition can be found in the Simple Life Product Disclosure Statement (PDS). To help give you some understanding of the pre-existing condition exclusion, here are five hypothetical examples we've put together for illustrative purposes:

Example 1:
October 2011: David’s doctor discovers he has a melanoma. David has it removed.
November 2013: David’s Simple Life application is accepted.
September 2014: David’s doctor diagnoses him with secondary cancer, which is related to the original melanoma
Potential outcome: David’s Simple Life claim would be declined due to the policy’s 5 year pre-existing condition exclusion
Reason: David’s secondary cancer was a result of the original melanoma, which was discovered within the 5 years before his Simple Life cover start date.

Example 2:
January 2011: Jane has a heart attack
December 2013: Jane’s application for Simple Life is accepted.
November 2016: Jane is diagnosed with liver cancer.
Potential outcome: Jane’s claim would be considered as part of the standard claims assessment process.
Reason: Jane’s liver cancer was first diagnosed after her Simple Life cover start date and isn't related to her heart attack.

Example 3:
February 2003: Steve has a serious skiing accident and breaks his pelvis, but makes a full recovery by 2005, which means he no longer has symptoms of the injury, requires medication or treatment for it.
January 2014: Steve’s application for Simple Life is accepted.
November 2017: Steve has a serious car accident and breaks his pelvis.
Potential outcome: Steve’s claim would be considered as part of the standard claims assessment process.
Reason: Steve’s broken pelvis in 2017 is unrelated to the injuries he sustained in the skiing accident in 2003.

Example 4:
February 2013: Katie gets a cold.
January 2014: Katie’s application for Simple Life is accepted.
November 2015: Katie has a stroke
Potential outcome: Katie’s claim would be considered as part of the standard claims assessment process.
Reason: Katie’s stroke is unrelated to the cold she had in the year before her Simple Life cover start date.

Example 5:
June 2013: Sean begins getting severe headaches, but he doesn't seek medical advice.
November 2013: Sean’s application for Simple Life is accepted.
January 2014: Sean is diagnosed with a brain tumour and is told he has fewer than 12 months to live. Doctors say his headaches were a symptom of the tumour.
Potential outcome: Sean’s claim would be declined, due to the policy’s 5 year pre-existing condition exclusion. Under Simple Life’s pre-existing condition exclusion, a terminal illness benefit won't be paid for an illness, injury, medical condition or related symptom for which a reasonable person in their circumstances should have been aware of, or would have sought medical help for.

If you have a pre-existing condition and want cover for that condition, you should consider whether Simple Life cover is appropriate for you and, if necessary, explore alternative insurance arrangements. If it applies to you, you might like to speak to a financial planner.

Important information:  Please note these are examples only of the possible application of the Simple Life pre-existing condition exclusion to certain basic hypothetical scenarios. The examples are of a general nature only and don't take into account individual circumstances. Any claim under a Simple Life policy will need to be considered and assessed on an individual basis having regard to the particular facts of the claim, including the supporting medical and other evidence obtained during the claims assessment process.

Will Simple Life cover me for any pre-existing conditions?

Simple Life won't cover you for a pre-existing condition. This means a benefit won't be paid if your death, terminal illness, permanent disablement, critical illness or disablement is caused directly or indirectly by an illness, injury, medical condition or related symptom:

a) of which you first became aware; or
b) for which you sought or intended to seek medical help; or
c) for which a reasonable person in your circumstances should have been aware or would have sought medical help

at any time during the five years before your cover start date.

Medical help means medical consultation, treatment, care or services which includes tests, other diagnostic measures or referral to a specialist.

For example, if in the five years prior to taking out the cover you had symptoms or are seeing a doctor about a heart condition, stroke or cancer, you may not be covered under the policy for any claim events related to those conditions. You may however be able to claim for insured events unrelated to those conditions.

You can find out more about Simple Life’s pre-existing condition exclusion on page 13 of the Simple Life Product Disclosure Statement (PDS).

You can also read some hypothetical examples of pre-existing conditions.

How do I cancel my Simple Life policy?

You can cancel your policy at any time. Your policy and its cover will end on the day your cancellation request is processed.

Call 13 3982 (between 8am and 8pm, Sydney time, Monday - Friday) if you'd like to cancel your policy.

Simple Life policies have no cash or surrender value.