FAQs - Virgin Income Protection

About our cover
  • Q. What is Income Protection Insurance?

    A. Income Protection insurance helps replace some of your income if you're unable to work due to sickness or injury. The money can be used to replace part of your lost income and help you to support you and your family to cover everyday expenses. The money could also assist with your recovery and see you back to full capacity.

    To find out more about your Virgin Income Protection policy call us on 1300 814 990, or read the Product Disclosure Statement (PDS).

  • Q. How does it work?

    A. You can use the payments to help you to pay your mortgage and cover your bills ‐ you really have the freedom to use your payments however you choose to.

    Bonus benefits are paid for some common injuries, such as broken bones, and illnesses such as a heart attack. If you're Out of Action for longer than 28 days, your payout is backdated to the day of your sickness or injury when a Bonus Cover Event is payable. This will help lift the financial burden so you can focus on getting back to full recovery.

    To keep your premiums as affordable as possible, some exclusions apply. These include mental illnesses or disorders, alcohol-related illness or injuries, or injuries caused by an intentional self-inflicted act or an act of war.

    We encourage you to carefully read the Virgin Income Protection Product Disclosure Statement (PDS) and your policy documents to find out more, information about restrictions and exclusions so that you know what you will not be covered for.

  • Q. When does cover start and end?

    A. The official start (commencement) date will be listed in your policy.

    Your cover will continue as long as you pay your premiums, until the anniversary of your plan following your 75th birthday. However, after the anniversary of your plan following your 65th birthday, your cover is limited to a maximum of $3,000.

  • Q. How do I receive information about my policy?

    A. The Policy Schedule, correspondence and notices about your policy were sent to the email address you gave to us unless you asked to receive this information in the post. You can nominate at any time to receive your policy correspondence by post instead of email. Just give us a call on 1300 814 990 or email expert@virginlifeinsurance.com.au

    You should save or print a copy of any information or documents that we email to you, and keep these in a safe place so that you can always refer back to them. Some documents, such as your Policy Schedule, may be required in the event of a claim.

    If you ever lose or misplace these documents and need another copy, just give us a call or email expert@virginlifeinsurance.com.au so a replacement can be organised.

  • Q. What is my waiting period and how does it work?

    A. The waiting period is the amount of time that has to pass before your benefit payments start to accrue. This period must be a consecutive number of days that you've been medically certified as unable to work by a medical practitioner. 

    Your waiting period will be specified on your policy schedule.

    An example of how a waiting period works is shown below:

    • Date of claim and the date a medical practitioner first certifies you are Out of Action: 01/04/16
    • Waiting Period: 60 days
    • Waiting period expires: 30/05/16
    • First payment due: 31/06/16 for the period 01/06/16 – 30/06/16

    Important : Please note that this is an example only and your actual waiting period will be specified on your policy schedule and payments will only be released upon assessment and admission of your claim.

  • Q. What happens if I return to work, only to find that I need more time to recover?

    A. You can resume receiving payouts (providing we agree that you're still unable to work and have not exceeded the payout period) without undergoing a new waiting period, if you resume your claim within six months of returning to work.

  • Q. Do I have to pay premiums while I'm unable to work?

    A. No. If you're eligible to receive a payout, you won't pay premiums until you're either able to go back to work, or the Benefit Period has been reached.

    Once your claim payouts start we'll even refund any premiums you paid during the waiting period.

  • Q. What happens if I left information out when I applied?

    A. At Virgin Money we never like to refuse a claim, however if it turns out you didn't reveal something important to us, we may have to do just that. That's not something we want to do, especially when you and your family are under stress. So it's best to be upfront and open with us from the start.

    You must give us the information we request when you apply for an Income Protection policy, and answer all of our questions honestly and completely. That's because if you make a claim, we'll need to check your medical, employment and financial records. If it turns out you didn't reveal something important, we may have to refuse your claim.

  • Q. What happens if I can't pay my premiums?

    A. It's very important that you let us know immediately if you can't pay a premium so we can help you work out an alternative arrangement. Your cover will cease if your premiums are more than 30 days overdue and you will lose access to your Income Protection benefits.

  • Q. Will my premiums go up?

    A. We work hard to give everyone great value insurance, but unfortunately the cost of providing income protection insurance does rise as you get older. For this reason, your premiums will increase over time. But you can be confident that we keep increases to a minimum, and that we'll give you at least 30 days' notice of any changes. And of course your premiums will also go up if you increase the cover amount.

About our claims process
  • Q. How do I make a claim?

    A. If you get ill or injured and can’t work for a while, we understand how stressful this can be so it's very important that you advise us of the claim as soon as you can. We'll do everything we can to make sure things run as smooth as possible.

    Please call us on 1300 814 990 and we will send out any forms which need to be completed and let you know of any other claim requirements.

    You will be given a dedicated Claims Manager whose details will be on the accompanying cover letter that we'll send in the event of a claim. He or she will personally oversee your case and help you work through the details of your claim.

  • Q. When would my payouts start?

    A. We pay income protection payouts one month in arrears, after the waiting period has finished. So, if your waiting period is 28 days, and you become eligible to claim on 1st September, you'll see out this waiting period, and receive your payment at the end of October, as claims are paid at the end of the first claimable month. After this, you'll receive your payout at the end of each month, until your benefit period runs out or you're able to return to work. 

    Please note that some common injuries, such as broken bones, and illnesses or a heart attack benefit from our Bonus Cover accrue faster - starting from day one of your Sickness or Injury.

  • Q. When is a benefit not payable?

    A. We encourage you to carefully read the Virgin Income Protection Product Disclosure Statement (PDS) and your policy documents to find out more information about exclusions.

  • Q. If I make an income protection claim, how much will I get?

    A. Your monthly payout will be the lesser of:

    • The cover you have applied, and been accepted for less any adjustments that may be applicable;
    • 85% of your pre-claim monthly income;
    • $10,000 for the Tailored Option; and
    • $3,000 after you turn 65 years of age.

    Lower limits apply to other claim options such as Involuntary Unemployment. Generally, we calculate monthly income as a before-tax average over the last 12 months before you became sick or injured. If you're self-employed, we'll calculate this value after deducting any business expenses. If you receive other income while you're not working - for example, a payout from another income protection policy, workers' compensation or social security - and this, combined with payments from the Income Protection adds up to more than 85% of your pre-claim monthly income, we'll reduce your Income Protection payouts.

    Remember Income Protection (less optional Kids' Injury Cover and Permanent Disability) premiums for income earners are usually tax-deductible and benefits are tax assessable. This taxation information is based on present laws and their current interpretation and is a general statement only.

    We encourage you to carefully read your policy documents and the Virgin Income Protection Product Disclosure Statement (PDS) to find out more, information about cover limits.

  • Q. How long would I get payouts for?

    A. Payouts will continue until the benefit period you've chosen runs out, or you're able to return to work.

    Your policy schedule will detail the Benefit Period for your policy.

Jargon unplugged

Benefit Period is the amount of time you can receive payment when you're unable to work due to sickness or injury. These payments will continue as required up to the end of your chosen Benefit Period.

Bonus Cover applies to some common Sicknesses and Injuries. If your Sickness or Injury qualifies for Bonus Cover, then the Benefit will accrue from the start of the Waiting Period and will be payable after 28 days, for the specified Bonus Cover Period, provided you are continuously Out of Action for this time. If the Sickness or Injury does not qualify for Bonus Cover, then the Benefit will accrue from the end of the Waiting Period.

Dangerous Occupation or Pastime means engaging in work or a lifestyle activity that involves explosives, weapons, heights above 20m, depths below 30m or speeds above 130km per hour, other than as a fare-paying passenger on a commercial airline.

Sickness means an illness or disease that first manifests or is first suffered by the Life Insured after the Commencement Date.

Injury means an accidental bodily injury suffered by the Life Insured after the Commencement Date.

Involuntary Unemployment/ Involuntarily Unemployed /Involuntarily Redundant/Involuntary Redundancy means the Life Insured is entirely without gainful employment and is actively seeking work and:

  • For a Life Insured who was a permanent employee working a minimum of 30 hours per week, the Life Insured has been made involuntarily redundant or has been involuntarily dismissed from employment through no fault nor choice of his or her own but solely because an employer has unexpectedly terminated the Life Insured’s employment; or
  • For a Life Insured who is Self-Employed, the business or the Life Insured is placed into insolvency administration, except where this is due to personal debts.

Out of Action
The definition depends on whether you're working or not working at the time of your claim:

  If you're working
Out of Action means
If you're not working
Out of Action means
Age 18-64

Solely as a result of Sickness or Injury as diagnosed by a Medical Practitioner and on his/her advice and in Our opinion:

  • Unable to attend or engage in his/her Usual Occupation or
  • Not working in or performing any occupation, whether income generating or not; and
  • Under the regular care of and following the advice of a Medical Practitioner, including recommended courses of treatment

Solely as a result of Sickness or Injury as diagnosed by a Medical Practitioner and on his/her advice and in Our opinion:

  • Unable to perform 2 or more of the following without the assistance of another person or using special equipment;
    • Cooking meals
    • Cleaning the home
    • Shopping for food
    • Providing care for children and/or dependent adults
    • Driving a car
  • Not working in or performing any occupation, whether income generating or not; and
  • Under the regular care of and following the advice of a Medical Practitioner, including recommended courses of treatment
Age 65-75

Solely as a result of Sickness or Injury as diagnosed by a Medical Practitioner and on his/her advice and in Our opinion:

  • Unable to perform 2 or more of the following without the assistance of another person or using special equipment;
    • Bathing – the ability to shower and bathe;
    • Dressing – the ability to put on and take off clothing;
    • Toileting – the ability to get on and off and use the toilet;
    • Mobility – the ability to get in and out of bed and a chair; and
    • Feeding – the ability to get food from a plate into the mouth.
  • Not working in or performing any occupation, whether income generating or not; and
  • Under the regular care of and following the advice of a Medical Practitioner, including recommended courses of treatment.

Pre Existing Medical Condition - means any:

  • Sickness, injury, or medical condition, or any symptoms of a sickness, injury or medical condition, of which, during the five years prior to the Cover Commencement Date, reinstatement or any increase in Cover you apply for, the Life Insured was aware, or of which a reasonable person could have been expected to be aware.
  • Stroke, bleeding from an arterial aneurysm or heart attack related claim, if any of the following was apparent in the five years prior to the Cover Commencement Date, reinstatement or any increase in Cover you apply for:
  • Body Mass Index of 40 or higher,
  • Systolic blood pressure having exceeded 160mmHg and diastolic blood pressure having exceeded 100mmHg,
  • Total blood cholesterol having exceeded 7.0 mmol/L, or
  • Being a diabetic with any one of the following: proteinuria, kidney disease, retinopathy, neuropathy or admittance to hospital for treatment of diabetes.
  • Malignant cancer diagnosed prior to the Cover Commencement Date, reinstatement or any increase in Cover you apply for which subsequently recurs or spreads.

Usual Occupation means:

  • The paid occupation in which the Life Insured was engaged for 20 or more hours a week immediately prior to being Out of Action, for which regular remuneration was received; or
  • The occupation in which the Life Insured was engaged for 30 or more hours a week immediately prior to being Involuntarily Unemployed and for which regular remuneration was received; or
  • Any occupation for which the Life Insured is suited by reason of his or her education, training and/or experience.

Waiting Period is the time you need to be continuously 'Out of Action' or redundant before benefits start to accrue. Benefits are then paid monthly in arrears while you're getting medical care or looking for new employment. You don't have to pay any premiums while you are receiving benefits.

Working means engaged in a Usual Occupation for 20 or more hours per week immediately before being ‘Out of Action’ or for 30 or more hours per week immediately before being made Involuntarily Unemployed.