South Australian Consolidated Regulations South Australian Consolidated Regulations (1) An application for
insurance under this Part, including an application to increase the level of
the applicant's insurance, must be in the approved form and must specify the
voluntary invalidity or death insurance that the applicant is applying for.
(1a) Despite
regulation 28(1), if the granting of an application for fixed insurance
cover by a member who has been a member of the scheme for 6 months or
more would result in the member having—
(a)
basic invalidity/death insurance consisting of—
(i)
1 unit of fixed insurance cover instead of
2 units of standard insurance cover; or
(ii)
in the case of a member who has made an election under
Schedule 3 clause 1(1) of the revoked regulations (within the
meaning of regulation 34)—1 unit of fixed insurance cover
instead of 1 unit of standard insurance cover; and
(b) an
increased level of insurance,
this regulation will apply to the application as if it were an application to
increase the level of the applicant's insurance.
(2) An applicant must
provide the Board with the following information as to the state of the
applicant's health:
(a)
information relating to medical advice, examination or treatment received by
the applicant;
(b)
information as to any other treatment received by the applicant for any
illness, condition or disability suffered by the applicant;
(c)
information as to any illness, condition or disability suffered by the
applicant or any symptoms suffered by the applicant that may indicate an
illness, condition or disability;
(d)
information as to any drugs or other substances (whether legal or illegal and
whether medicinal or not) taken by the applicant or to which the applicant has
been exposed,
and the Board may require an applicant to provide satisfactory evidence of the
state of the applicant's health.
(3) The cost of any
medical examination to which an applicant is required to submit for the
purposes of subregulation (2) is to be borne by the applicant.
(4) If it appears to
the Board—
(a) that
an applicant's state of health is such as to create a risk of invalidity or
premature death; or
(b) that
an applicant has in the past engaged in a prescribed activity that increases
the risk of invalidity or premature death; or
(c) that
an applicant is likely in the future to engage in an activity of a kind
referred to in paragraph (b),
the Board may grant the application on authorised conditions.
(5) A condition on
which an application has been granted (whether under the repealed Act or these
regulations) may be varied or removed by the Board if the Board considers it
appropriate to do so following consideration of medical evidence provided by
the applicant (but a condition may not be removed unless the Board is
satisfied that none of the circumstances specified in
subregulation (4)(a), (b) or (c) apply in relation to the applicant).
(6) Subject to
subregulation (7), if it appears to the Board that an applicant withheld
information required in relation to his or her application under this
regulation, the Board may withhold or reduce insurance benefits that the
applicant would otherwise have been entitled to.
(a) it
appears to the Board that an applicant withheld information required in
relation to his or her application under this regulation; and
(b) the
withheld information relates to an illness, condition or disability suffered
by the applicant that caused or is connected with the applicant's invalidity
or death,
the Board must withhold insurance benefits that the applicant or another
person would otherwise have been entitled to in respect of that invalidity or
death.
(8) In this
regulation—
"authorised condition", in relation to voluntary invalidity/death insurance or
voluntary death insurance in respect of a person, means—
(a) a
condition providing that insurance is not payable if the person's invalidity
or death is caused wholly or partly by—
(i)
a pre-existing illness, condition or disability; or
(ii)
an illness, condition or disability arising out of a
pre-existing illness, condition or disability; or
(iii)
a prescribed activity; or
(b) a
condition that insurance cover is to be provided only in respect of incapacity
or death arising from—
(i)
accidental causes; or
(ii)
an illness or condition that is not related to or
associated with a medical condition of a kind specified by the Board;
"prescribed activity" means the smoking, chewing or sucking of a
tobacco product or any other activity involving the consumption of a tobacco
product;
"tobacco product" means—
(a) a
cigarette; or
(b) a
cigar; or
(c)
cigarette or pipe tobacco; or
(d)
tobacco prepared for chewing or sucking; or
(e)
snuff.