Category: Exclusions
The headline exclusion across all 9 panel Life Cover products is the 13-month suicide clause; other exclusions are typically applied at underwriting for disclosed health conditions, hazardous pastimes, or sanctioned-country travel. There are very few blanket exclusions in panel retail Life cover beyond suicide in the first 13 months.
The panel is AIA, Zurich, TAL, OnePath, ClearView, NEOS, Encompass, Acenda, and Futura. Most causes of death (illness, accident, motor-vehicle accident, natural causes) are covered. The exclusions below are the ones that come up most often in claim disputes.
All 9 panel insurers exclude death by suicide or intentional self-inflicted act in the first 13 months from the policy start date. The clause resets for any later increase in sum insured, reinstatement after lapse, or buy-back amount. Industry-standard, not statutory.
| Insurer | Suicide-exclusion period | Replacement-policy waiver | |---|---|---| | AIA | 13 months | Yes, where the prior policy's full suicide-exclusion period has elapsed | | Zurich | 13 months | Yes, where the life insured had been continuously insured immediately before | | TAL | 13 months | Yes, standard waiver in PDS text | | OnePath | 13 months | 13-month clock attaches to each cover start, increase, reinstatement, or buy-back | | ClearView | 13 months | Yes, where the replaced policy had been in place for 13+ months | | NEOS | 13 months | Yes, where the replaced policy had been in place for 13+ months | | Encompass | 13 months | Yes, where continuous insurance for at least 13 months | | Acenda | 13 months | Yes, where the replaced policy meets the same continuous-insurance test | | Futura | 13 months | Yes, where the replaced policy had been in place for at least 13 months |
Where a new policy replaces an existing one and the prior insurer's 13-month period has already elapsed, panel insurers generally waive the new 13-month clock so cover is continuous from day one.
The PDS does not list condition-specific exclusions; those are documented on the Policy Schedule once underwriting is complete. Common types:
Underwriting decisions sit on the Policy Schedule and are unique to the applicant. Compare across multiple panel insurers because the same condition can attract different treatment between insurers.
Panel insurers must comply with the Autonomous Sanctions Act 2011 (Cth) and Australian sanctions regulations. Payments to or from sanctioned countries or persons are blocked. War and acts of war are commonly excluded; the precise wording varies by PDS. TAL's wording includes a sanctioned-country exclusion. Australian Government Department of Foreign Affairs and Trade 'Do Not Travel' destinations may also be excluded by some insurers.
The panel covers natural-cause death, accidental death, illness-related death (including cancer, heart disease, stroke), motor-vehicle accidents, and death during commercial passenger air travel. Some sources cite blanket mental-illness exclusions; this does not apply to panel Life Cover. (Mental-illness considerations on Income Protection are a separate topic and use different mechanics.)
If an applicant has breached the duty to take reasonable care not to make a misrepresentation (Insurance Contracts Act s20B, effective 5 October 2021 for consumer contracts), the insurer can apply the remedies in s28A-D. For non-fraudulent breach, the remedy must be proportionate; for fraudulent misrepresentation, the insurer can avoid the policy entirely (s28(2)). See the separate FAQ on the duty to take reasonable care for the full framework.
Life Insurance Code of Practice 2019 requires plain-English disclosure of all exclusions in the PDS. ASIC RG 274 sets sales-practice expectations. AFCA reviews disputed claim declinations under the binding external-dispute-resolution scheme. The full PDS for each panel product lists the exclusions in its own dedicated section; read the suicide clause and the duty-to-take-reasonable-care wording carefully at application.
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