Individual Personal Accident and Sickness Insurance

Version ACH-IPA-AU-20211004-TMD

This Target Market Determination is designed to provide customers, distributors and Agile Underwriting Services staff with appropriate information to understand who this product has been designed for and our approach to determining that the product is likely to be consistent with the objectives, financial situations and needs of the customer and the distribution conditions.

In this document the terms “we”, “us” or “our” refer to Agile Underwriting Services Pty Ltd (ABN 48 607 908 243, AFSL 483374) on behalf of Certain Underwriters at Lloyd’s.

Name of Product/Product category

Agile Individual Personal Accident and Sickness

Agile Individual Personal Accident and Sickness provides insurance for Accidental Death, Disability, Injury and Sickness.

This Target Market Determination (TMD) sets out the target market for:
Agile Individual PA Wording v4.7C

This is set out in the Appendix to this Statement.

Distribution of this product

This product is issued by Agile Underwriting Services Pty Ltd (ABN 48 607 908 243, AFSL 483374 on behalf of Certain Underwriters at Lloyd’s and designed to be distributed via:

  • Insurance Brokers and their representatives that hold an Australian Financial Services Licence.

Only Insurance Brokers and their representatives are authorised to distribute this product as they understand the market this product has been designed for.

Agile Underwriting Services Pty Ltd will make risk-based decisions to determine its acceptance criteria about insurance cover that can be offered to you. Some of the key acceptance criteria relating to this target market determination may include:

  • Age of insured person
  • Occupation of insured person
  • Activities undertaken during the scope of cover
  • Previous claims experience for this type of risk
  • Location
  • The benefit and/or sum insured limits

Reviewing this document

We will review this TMD within one year from the effective date this TMD was prepared to ensure it remains appropriate and in compliance with the objectives, financial situations and needs of the customer.

Furthermore, we will also review this TMD if any event or circumstances (called ‘review triggers’) occur that would reasonably suggest that the determination is no longer appropriate, such as:

  • We make a material change to the cover provided by the product,
  • A change in our acceptance criteria that impacts on the suitability of the product for the target market,
  • A material changes to the distribution of the product,
  • The discovery of a relevant and material deficiency in the product’s disclosure documentation,
  • Systemic complaints and claims issues which indicate that the product is no longer suitable for the described target market,
  • Material and relevant reductions in our key product suitability metrics such as:
    • Customer satisfaction,
    • Product acceptance,
    • Financial performance,
    • Benefits to customers,
    • Product value and affordability.

We will review this TMD within 10 business days of the occurrence of any review trigger.

Reporting

We record all complaints received about this product on a weekly basis (Complaints Reporting Period). Our distributors of this product are required to provide to us written details of any complaints about the product they have received during the Complaints Reporting Period within 10 business days of the end of the period.

Our distributors and their representatives are also required to report to us if they become aware of significant dealing in this product which is not consistent with this TMD within 10 business days of becoming aware of such dealing.

If the complaints are systemic and indicate that this product is no longer suitable for the described target market, we will review and update the TMD within the timeframe indicated above.

Record keeping

We will maintain records of the reasonable steps they have taken to ensure that this product is sold in a manner consistent with this TMD.

We will also prepare and maintain complete and accurate records of our decisions, and the reasons for those decisions, in relation to:

  • All target market determinations for this product,
  • Identifying and tracking review triggers,
  • Setting review periods, and
  • Any other matters documented in this TMD

Appendix - Suitability

This Agile Individual Personal Accident and Sickness Insurance has been designed for individuals who want to be covered against loss of income if they are unable to work either on a temporary basis due to injury or sickness or on a permanent basis due to injury or accidental death.

✓  This product is suitable for X   This product is NOT suitable for
  • Individuals
  • Groups
  • Persons over 75 years of age

The Agile Individual Personal Accident and Sickness Insurance is subject to the acceptance criteria. A summary of the key benefits and policy exclusions is detailed below. To review the complete schedule of benefits and exclusions please refer to the PDS:

Key Benefits and Exclusions
Provides financial security and peace of mind in the event of an accident resulting in injury or due to illness, subject to the policy terms, conditions and exclusions.

✓  What is insured X   What is NOT insured
  • Death and Capital Benefits
  • Temporary Total Disablement
  • Temporary Partial Disablement
  • Broken Bones
  • Various additional benefits – if specifically noted on the policy schedule
  • An insured person who has attained the age seventy-five (75) years inclusive, unless we have agreed to extend the insurance by prior notice and agreement.
  • An insured person engaging in air travel except as a passenger in any registered and licensed aircraft that carries passengers.
  • An insured person being under the influence of intoxicating liquor and having a blood alcohol content over the prescribed legal limit whilst driving, or being under the influence of any other drug unless it was prescribed by a doctor or specialist and taken in accordance with the doctor or specialist advice.
  • An insured person who has committed a criminal or illegal act.
  • An insured person engaging in or taking part in naval, military or air force service or operations.
  • An insured person engaging in or taking part in or training for professional sports of any kind.
  • An insured person racing and/or time trials of any form, other than on foot.
  • Any deliberate self-inflicted harm or Injury, caused or committed by the insured person, including suicide or attempted suicide, reckless misconduct or any criminal or illegal act.
  • Any form of war or terrorism
  • Events attributable wholly or partly to childbirth or pregnancy or the complications of these.
  • Any pre-existing condition.
  • An insured person playing or training for any code of football with a registered club or the insured person being a registered player.

*These items are only insured if selected and shown on the Policy Schedule and/or Product Disclosure Statement for an insured amount

**This product is not suitable for persons seeking coverage of losses arising from the policy exclusions listed and above.