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					aoN master trust


Insurance update
Changes will apply from the date we receive your completed form.
If you have any questions, please call us on 1300 880 588 or email contactaon@pillar.com.au.
For more information go to our website aonmastertrust.com.au.                                                                                  AIA Australia Limited
                                                                                                                                              (ABN 79 004 837 861
                                                                                                                                                       AFSL 230043)
                                                                                                                                                    is the insurer for
                                                                                                                                                   Aon Master Trust




Your detaIls
Please select the appropriate option below.

        Personal Super member – you are an individual member

        Corporate Super member                                       Employer name
        – you are a member of an employer-sponsored plan

Member number (if known)



Title                           Given names


Surname


Date of birth                                                        Sex (M or F)                 Telephone


Mobile                                                               Email


Postal address


Suburb                                                                                                         State               Postcode



You can apply to increase your insurance cover at any time by completing and returning a Death TPD and income protection short form. If you require
more than $1,000,000 in death and TPD cover or more than $8,000 in income protection cover, complete and return a Personal statement and
declaration of health form.



Your optIoNs

opt out of minimum death and total and permanent disablement (tpd) cover (corporate super members only)
        I wish to opt out of the minimum level of death and TPD cover.

If you opt out of minimum cover:

º   you will revert to the cover selected by your employer if any (see your Product Disclosure Statement)
º   your cover will not be indexed
º   you will need to provide health evidence satisfactory to the insurer if you apply for an increase in cover in the future.




INsuraNce update                                                                                                                date Issued: 4 November 2009




Aon Master Trust ABN 68 964 712 340 Trustee: Aon Superannuation Pty Limited ABN 83 057 982 822, AFSL 237465
Send your completed form to: Aon Master Trust, PO Box 1949, Wollongong NSW 2500                                                                Page 1 of 3
Fix or reduce death and/or tpd cover
I wish to fix my death and/or TPD cover at its current amount or reduce my death and/or TPD cover to the new amount shown below:

      Death cover $                                                   (complete amount)

      TPD cover      $                                                (complete amount)

If you fix or reduce your cover:

º   premiums will be recalculated each year based on your age and occupation
º   you will need to provide health evidence satisfactory to the insurer if you apply for an increase in cover in the future.


change tpd definition (personal super members only)
I wish to change the TPD definition that will apply to me in the event of a TPD claim to (please select the appropriate option below):

      Standard definitions for TPD

      ‘Own occupation’ TPD definition – available only to selected occupations and increases TPD premium by 50%

      ‘Home duties’ TPD definition – where wholly engaged in full-time unpaid domestic duties in your own residence

For information on TPD definitions, please read the section Total and permanent disablement (TPD) insurance in your Product Disclosure Statement. The
full definitions, a list of eligible ‘own occupations’ and premium rates can be found in the factsheet Personal Super insurance scales, rates & definitions
available at aonmastertrust.com.au or by calling us on 1300 880 588.


change benefit/waiting period for income protection cover
I wish to (please select the appropriate option below):

      Change my maximum benefit period to                           up to 2 years         up to 5 years           to age 65

      Change my waiting period to                                   30 days               60 days                 90 days

If you are applying for:

º   a longer benefit period, or
º   a shorter waiting period
you will need to provide health evidence and this change will be subject to the insurer’s approval.


update occupation record
Current occupation

Exact nature of duties




º   If your occupation at date of claim is determined to be higher risk than the current occupation shown above, additional premiums will be deducted
    from any benefit paid.
º   If an updated occupation record places you in a new occupation class, that new class will apply from the date we receive and process your
    completed form.

cancel insurance cover
I wish to cancel my (please select the appropriate option below):

      Death cover

      Total and permanent disablement (TPD) cover

      Income protection cover

º   If you cancel insurance cover and wish to re-apply for cover in the future, you will need to provide health evidence satisfactory to the insurer.
º   If you cancel your death cover, the maximum TPD cover you can have is $100,000 and your premium rate will increase by 20%.

INsuraNce update                                                                                                                   date Issued: 4 November 2009




Aon Master Trust ABN 68 964 712 340 Trustee: Aon Superannuation Pty Limited ABN 83 057 982 822, AFSL 237465
Send your completed form to: Aon Master Trust, PO Box 1949, Wollongong NSW 2500                                                                   Page 2 of 3
declaratIoN aNd authorIsatIoN

duty of disclosure
Before you enter into a contract of life insurance with an insurer, you have a duty under the Insurance Contracts Act 1984 to disclose to the insurer
every matter that you know, or could reasonably be expected to know, that is relevant to the insurer’s decision whether to accept the risk of insurance,
and if so, and on what terms. You have the same duty to disclose those matters to the insurer before you renew, extend, transfer, vary or reinstate a
contract of insurance.


Non-disclosure and misrepresentation
If you fail to comply with your duty of disclosure and the insurer would not have entered into a contract on any terms if the failure had not occurred,
the insurer may avoid the contract within three years of entering into it. If your non-disclosure is fraudulent, the insurer may avoid the contract at
any time. An insurer who is entitled to avoid a contract of life insurance may, within three years of entering into it, elect not to avoid it but to reduce
the sum that you have been insured for in accordance with a formula that takes into account the premium that would have been payable if you had
disclosed all relevant matters to the insurer.


privacy
By completion of this form you consent to any personal information, including information that may be of a sensitive nature we or AIA Australia may
collect about you in the normal course of our and AIA Australia’s business, being used as outlined in our and AIA Australia’s respective Privacy Policies.
These policies are designed to protect your interests and are consistent with the requirements of the Privacy Act. A copy of our privacy policy can be
obtained from the Aon Master Trust by calling 1300 880 588 or visiting aonmastertrust.com.au. A copy of the privacy policy of AIA Australia can be
obtained by visiting aia.com.au.


General declarations
º   As a member of the Aon Master Trust I understand that I will be bound by the trust deed (as amended from time to time) and the rules thereunder.
º   I confirm that I received a copy of the Product Disclosure Statement (PDS) when I joined the Aon Master Trust. I acknowledge that some terms and
    conditions (as set out in that PDS) may have changed over time.
º   I declare that I have read the Privacy Statement set out above and I consent to the collection, use and disclosure of my personal and sensitive
    information in the manner described in that Privacy Statement.
º   I have read the Duty of Disclosure notice and understand what is meant by that notice.
º   I agree to be bound by the provisions of the relevant policy document between the insurer and the Aon Master Trust governing the terms of life insurance.


Signature                                                                           Date




INsuraNce update                                                                                                                    date Issued: 4 November 2009




Aon Master Trust ABN 68 964 712 340 Trustee: Aon Superannuation Pty Limited ABN 83 057 982 822, AFSL 237465
Send your completed form to: Aon Master Trust, PO Box 1949, Wollongong NSW 2500                                                                    Page 3 of 3

				
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Description: Insurance update