You must have a NSW Compensation Insurance Policy to receive any Workers Compensation Top-Up Cover under the Policy.
All benefits within the U-PLUS Insurance Workers Compensation Top-Up option are compulsory. Individual elements cannot be added or removed.
Death
A single payment equal to 16% of the compensation paid under section 25(1) (a), section 26 or section 27 of the Workers Compensation Act (“WCA”), whichever applies.
These sections of the WCA (NSW) refer to the situation where workers die leaving dependants (section 25(1)(a)), partial dependants (section 26) or no dependants (section 27).
Permanent Injury
Where the permanent impairment that has resulted from the same incident has been caused by only one Workers Compensation Injury, the benefit payable will be equal to 125% of the Total Compensation subject to a maximum of:
a) the permanent impairment of the Insured Person under section 66 of the WCA (NSW); and
b) the pain and suffering of the Insured Person resulting from the same permanent impairment under section 67 of the WCA (NSW).
Where the permanent impairment that has resulted from the same incident has been caused by more than one Workers Compensation Injury, the Benefit TOWER will pay to the Insured Person is equal to 81.25% (which is 65% of 125%) of the Total Compensation subject to a maximum of:
a) in the case of hearing loss the maximum payment is $3,000 for each of sections 66 and 67 of the WCA (NSW); and
b) in the case of back injury the maximum benefit is $6,000 for each of sections 66 and 67 of the WCA (NSW).
Where there is more than one permanent impairment arising out of the incident cause the Injury (or Injuries), 65% of 125% of the Total Compensation subject to:
a) in the case of any part of this benefit relating to hearing loss, that part of the benefit is capped to a maximum of $3,000 for each of sections 66 and 67; and
b) in the case of any part of this benefit relating to back injury, that part of the benefit is capped to a maximum of $6,000 for each of sections 66 and 67.
Non-WorkCover Pain and Suffering
This benefit applies to situations where an Injury results in a degree of permanent impairment assessed under the WCA (NSW) of greater than or equal to 5% but less than 10%.
A maximum benefit of $5000 applies, except in the case of hearing loss, where the benefit is subject to a maximum of $3,000. We will not pay you a Pain & Suffering Benefit payment if the Insured Person is entitled to compensation under section 67 of the WCA (NSW) for the same incident or injury.
Notes:
• The benefits provided by the various options above are explained Standard Benefits Table
• It is possible for NSW employers to select Workers Compensation Top-up cover on a standalone basis, but only if you already have insurance equivalent to option 2 (NSW Enhanced Cover) or option 4 (Other states Enhanced Cover) as described in the Cover Options Table, through a different arrangement. In this situation, the applicable premium rate will be $36.50 per Insured Person per month.
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