I understand and agree to the following:
- Cover is only for eligible customers nominated by the selected group policyholder.
- Cover is subject to policy terms, conditions and exclusions and they can be found in the policy conditions.
- For application received from 1st - 15th of the month, coverage will start on 1st of the following month and for application received from 16th to end of the month, coverage will start on 15th of the following month.
- Income reserves the right to reject any application for this insurance.
- An acknowledgement of receipt of the application will be sent via email upon submission of this application. Confirmation of coverage will be emailed to you before the start of the coverage date upon acceptance
- I confirm that I understand and agree to the 'Personal data use statement'.
- I agree that if I or any #Relevant Person is found to be a +Prohibited Person:
- you are entitled not to accept this application; and
- if any policy is issued, you are entitled to end this policy, not pay any benefit or not allow any transaction, such as surrender and assignment, to be carried out under this policy. You will not refund any unutilised premium when this policy is ended
- I authorise, consent and agree to the following:
- Income Parties to collect from and/or disclose to the group policyholder, the personal data for all the relevant purposes listed above and in Income’s Privacy Policy including to respond to enquiries from the group policyholder for the purposes of this application and policy servicing matters, including confirmation of eligibility for the cover; and
- The group policyholder to disclose the personal data to Income Parties for all the relevant purposes listed above and in Income’s Privacy Policy.
Your decision in every respect of the above will be final. I will inform you immediately if there is any change in my or any Relevant Person's identity, status or identity documents.
#Relevant Person includes insured, trustee, settlor, beneficiary, assignee, nominee, payee, mortgagee, financier of this application/policy, and in relation to an entity, its director, partner, manager, person having executive authority, authorised signatory, shareholder or beneficial owner.
+Prohibited Person means a person or entity who is, or who is ^Related to a person or entity:
- subject to laws, regulations or sanctions administered by any inter-government, government, regulatory or law enforcement authorities of any country, which will prohibit or restrict you from providing insurance or carrying out any transaction under this policy, or
- who is involved in any terrorist or illegal activities or placed on sanctions listing or issued with freezing order.
^Related includes relationships such as parent, step-parent, child, step-child, adopted child, spouse, sibling, step-sibling, adopted sibling, parent-in-law, child-in-law, sibling-in-law, cousin, uncle, aunt, grandparents, niece, nephew, grandchild, employee, employer, associate, parent company, subsidiary and shareholder.
Information is correct as at 24 November 2023.