Trauma Cover + Optional Extras
MetLife Protect Insurance Range
If you’re diagnosed with a serious medical condition, Trauma Cover can provide you the financial freedom to seek the best medical treatment possible, and assist you and your family whilst you’re on the road to recovery.
How it can help
Trauma Cover is designed to help if you suffer a serious medical condition such as cancer, heart attack or stroke. The money you receive can help you pay off debts, replace lost earnings and focus on a return to health. Please refer to the PDS for more details on the Trauma Conditions covered under the product.
Key Features and Benefits
What we mean by...
No-Claim Period
For any benefits where this applies, it is the period of time after cover commences before you will begin to be insured for those benefits.
Accidental Injury Cover
Means an amendment to cover where benefits will only be payable as a result of a Life Insured suffering a bodily Injury that is unexpected and unintended.
See the PDS for full details.
Trauma Cover Amount
The amount of cover that we agree to insure you for (which may increase over time, due to Indexation). The payment you receive at claim time is based upon your Trauma Cover Amount.
Trauma Categories
Each condition that is covered under Trauma Cover has been assigned to one of five groups, known as Trauma Categories.
The categories are:
- Cancer Conditions;
- Heart Conditions;
- Neurological Conditions;
- Vital Organ and Digestive System Disorders; and
- Disability Conditions and Accidental Incidents.
Related or Progressive Trauma Conditions
Means a condition that is symptomatic of, secondary to, or otherwise connected with another condition for which we have paid a benefit under Trauma Cover.
See the PDS for full details.
Extra Cost Options
What you need to know about Trauma Extra Cost Options and/or Extras Cover
- Adding Extra Cost Options and/or Extras Cover to your Trauma Cover will increase your premium.
- Extra Cost Options and/or Extras Covers expire at age 65.
- Eligibility criteria may apply. Please refer to the PDS for details.
Making a Claim
We’ll tell you what information we need
When we are contacted regarding a claim, we’ll identify and request all the information we need up-front, to make a decision. We’ll only ask for, and rely on, information and assessments that are relevant to your claim and will explain why we’re requesting them.
We assess your claim
We’ll review all of the information provided and make a decision on whether your claim can be paid. We pay every genuine claim we receive, quickly and with compassion and care.
We calculate the payment
If your claim is successful, we’ll calculate your benefit based on the severity of your medical condition and the cover you hold (including whether you have Trauma Cover Extra Cost Options and/or Extras Cover). We will also take into account previous Trauma Cover benefit payments and whether you have an Accidental Injury Cover definition applicable to your cover. You’ll receive benefit payments as a one-off lump sum.
Your cover continues if you have purchased the Trauma Cover Reinstatement Option
If we pay a claim under Trauma Cover and you have purchased the Trauma Cover Reinstatement Option, your cover will automatically continue. The payment of future claims will be in accordance with the following principles:
1. The Trauma Category Rule
Your Trauma Cover Amount is available to be paid a total of once, under each of the five Trauma Categories. Once we’ve paid 100% in total for a Trauma Category, your cover for conditions in that category ends.
2. Related or Progressive Trauma Conditions
In the case of Related or Progressive Trauma Conditions, subsequent benefit payments will be offset against previous Trauma Cover benefit payments. The maximum amount we will pay for Related or Progressive Trauma Conditions is 100% of your Trauma Cover Amount.
3. The application of the Accidental Injury Cover definition
Once we pay a benefit under Trauma Cover, we will apply a 12-month Accidental Injury Cover definition to your Trauma Cover (applicable to an amount of cover which equals the benefit payment made). After 12 months, the Accidental Injury Cover definition is removed and coverage is restored. Note that Accidental Injury Cover definition does not apply to Related or Progressive Trauma Conditions.
Please note that taking out Individual Extras may allow you to be paid a benefit outside of the above rules – see the PDS for more detail.
Claim example
Jack is diagnosed with stage 2 lung cancer at age 45. Based on his diagnosis, he is eligible for a Tier 2 benefit under Trauma Cover, in the Cancer Conditions category. He receives a $125,000 benefit, which is 50% of his $250,000 cover amount. His Trauma Cover Amount remains at $250,000.
Jack’s Trauma Cover will be available for future claims in accordance with the following:
The Trauma Category Rule
$125,000 remains available for further claims within the Cancer Conditions category.
Related or Progressive Trauma Conditions
If Jack suffers a Related or Progressive Trauma Condition, any future benefit payment will be offset by the $125,000 already received.
The application of the Accidental Injury Cover definition
For 12 months following a benefit payment, $125,000 of cover (the benefit amount paid) will only be payable if claims arise as a result of Accidental Injury. The other $125,000 is unaffected by this and provides coverage for all conditions.
After 12 months have passed since a benefit was paid, the Accidental Injury Cover definition is lifted and the full $250,000 is once again available for all conditions.
This page provides a summary only. For full details of the product including information on making a claim, please refer to the MetLife Protect and MetLife Protect Super Combined Product Disclosure Statement and Policy Terms (PDS).