Panel Key Person policies follow the standard retail life insurance exclusion framework. The most common limitations are a 13-month suicide exclusion, non-disclosure remedies under the Insurance Contracts Act, condition-specific exclusions for pre-existing illness, and Trauma definitions tied to precise PDS wording.
This is general advice only. Exclusion and limitation wording varies between insurers and product variants. Read the relevant PDS in full before applying.
Standard Life cover exclusions
All nine panel insurers (AIA, Zurich, TAL, OnePath, ClearView, NEOS, Encompass, Acenda, Futura) carry these standard Life cover restrictions in some form:
- Suicide within 13 months of policy commencement or reinstatement
- Non-disclosure or misrepresentation at application, with remedies under Insurance Contracts Act 1984 s20B (duty to take reasonable care not to make a misrepresentation) and s28A to s28D (proportionate remedies; rescission only on fraud)
- War, terrorism, or nuclear hazard in some product variants
- Hazardous activity exclusions for undisclosed high-risk pursuits
TPD exclusions and limitations
TPD adds further constraints:
- Pre-existing condition exclusions for conditions not disclosed at application
- Inside-super any-occupation only: own-occupation TPD inside super is not available on any panel insurer since 1 July 2014 (SIS Regulation 4.07D)
- Working-hours minimum of 20 to 30 hours per week for some occupation classes
- Age cessation typically at 65 for TPD (Life cover usually runs further)
- ClearView Class C and CC restriction: own-occupation TPD is not available for high-risk blue-collar occupations on ClearView ClearChoice (ClearView adviser guide, also Section "Own occupation TPD and Business Expense are not available" for Class C/CC blue-collar)
Critical Illness / Trauma exclusions
Trauma cover is the most exclusion-heavy on the panel:
- Definition compliance: the diagnosed condition must meet the precise PDS definition. Cancer in situ, mild heart attacks, and minor strokes often pay a partial benefit only
- Survival period: typically 14 days from diagnosis to first qualify (consistent across AIA, Zurich, TAL, OnePath, ClearView, NEOS, Encompass, Acenda, Futura)
- Qualifying period: 90 days from policy commencement for cancer and heart-related conditions on most insurers
- Inside super bar: Critical Illness inside super is generally not available for new cover post-1 July 2014 under the SIS Act s62 sole-purpose test
Income Protection and Business Expense Cover limitations
Business Expense Cover has product-specific limitations:
- Not available standalone on NEOS, Encompass, or Futura (only AIA, Zurich, TAL, OnePath, ClearView, and Acenda offer the product on our panel)
- ClearView excludes Class C and CC occupations from Business Expense Cover
- $60,000 per month cap on OnePath OneCare and ClearView ClearChoice; Acenda offers a Business Expenses Platinum Option with a higher cap
- 12-month benefit period is industry standard; some products offer 24 months
- Allowable expenses definitions vary: Zurich Business Expenses excludes the life insured's own remuneration and revenue-generating staff salaries
Standalone Income Protection has its own constraint: TAL Accelerated Protection does not allow IP where the policy owner is a company that is not a superannuation trustee (PDS). Business-purpose IP on TAL must therefore use the Business Expense Option add-on.
Key Person specific limitations
At the financial-underwriting layer:
- Maximum sums insured apply per cover type. AIA's Business Safeguard Forward Underwriting caps at $10 million with TPD-specific sub-caps. Acenda's Business Safeguard Option caps at $15 million for Life Cover, $5 million for TPD professional, $3 million for TPD other, and $2 million for Critical Illness
- Business-event proof required for forward-underwriting increases (audited accounts, accountant's valuation, share certificates, buy/sell deed)
- Future Increase Benefit caps of $200,000 per event on NEOS, Encompass, and Futura
Inside-super structural limits
Key Person cover inside an SMSF or retail super fund is restricted by the SIS Act 1993 s62 sole-purpose test. The cover must serve a member benefit (retirement, death, disability), not a business benefit. If the proceeds need to flow to the business, do not hold the policy inside super. Cross-reference: ITAA 1997 ss302-195 and 302-200 for tax on super death benefits to non-tax dependants.