Specified Injury Benefit

The specific injury benefit generally pays a number of monthly benefits in advcance, as a lump sum amount, if you suffer a particular injury or sickness as defined by the medical conditions set out in the Product Disclosure Statement (PDS). This benefit is paid regardless of whether or not you stay off work for the duration of the waiting period.

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The specified injury benefit may not be offered by every life insurance company.

How does the Specified Injury Benefit work?

This benefit helps you skip the required Waiting Period by advancing you the monthly benefit of a predetermined number of months.

However, if the specified injury or illness lasts longer than the advancement + the waiting period, then normal benefits would usually continue if you still meet the insurer’s definition or total or partial disablement.

Your specified injury benefit is generally offered either as a:

  • Built-in benefit on your Standard or Plus income protection policy, or
  • Optional extra benefit you can add to your policy for an additional fee.

You’ll generally be eligible for a specified injury benefit if:

  1. You selected this benefit option when applying for your income protection policy or your policy has it built-in,
  2. You suffer one of the injuries or illnesses as defined in your PDS, and
  3. Your policy has a waiting period of 3 months or less.

Including Trauma Conditions

Select insurers have started including specific trauma conditions into this policy option. Please consult your PDS for more information or ask one of our specialists.

How much will I receive?

The benefit amount you can receive will depend on your policy, injury and your monthly benefit.

Minor injuries

Minor injuries such as fractures may pay out 1 to 3 months’ worth of benefits up front.

More serious injuries

More serious injuries such as the loss of a limb or eye may pay out 12 to 24 months up front.

Paralysis

Paralysis may pay out up to 60 months of benefits up front.

When will the benefit begin?

Your eligibility to receive the benefit will generally begin from the date of the injury, regardless of your chosen waiting period. However, select life insurance companies may only offer the specified injury benefit option if you have a waiting period of fewer than 90 days.

How long will I receive the benefit for?

Each condition specified in the PDS will have a different benefit period. See the below table for more information.

Other times the benefit may end include:

  • The benefit period expiring
  • Your income protection cover expiring
  • Your death

What injuries are typically covered under a Specified Injury Benefit?

The table below is a general list of injuries and conditions covered and what each injury and condition’s benefit period is.

Injury/ConditionPayment Period
Paralysis60 months (unless a 2-year benefit period is selected, in which case claim payments will cease at the end of your benefit period.
Loss of both feet or both hands or sight in both eyes24 months (unless a 2-year benefit period is selected, in which case claim payments will cease at the end of your benefit period.
Loss of any two: A foot, a hand or sight in one eye24 months (unless a 2-year benefit period was chosen, in which case claim payments will cease at the end of the benefit period.
Loss of one leg or one arm18 months
Loss of one foot or one hand12 months
Loss of sight in one eye12 months
Loss of the thumb and index finger of one hand6 months
Fracture of thigh (femur)3 months
Fracture of pelvis3 months
Fracture of leg (below the knee and above the ankle – tibia and fibula)2 months
Fracture of knee cap (patella)2 months
Fracture of upper Arm (humorous)2 months
Fracture of shoulder bone (scapula)2 months
Fracture of jaw (maxilla and mandible)2 months
Fracture of forearm (Above the wrist – radius and ulna)1.5 months
Fracture of collarbone (clavicle)1.5 months
Fracture of heel (calcaneous)1 month

Definitions:

  • Loss generally means the total and permanent loss of, or use of, that particular body part.
  • Fracture generally means any bone fracture that requires the application of a plaster cast or immobilising device.

Please note that each life insurance company may differ on what injuries and conditions they cover and what benefit period is provided for each. Please consult the relevant PDS for exact information or contact one of our consultants.

Published: August 13, 2018
  • Benefits of Income Protection

    Benefits of income protection cover include payment of up to 75% of your salary, which you can start to receive when your waiting period ceases!

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