Australia Life Insurance Code of Practice (CALI Life Code) 5.66-5.67: Trauma and critical illness claims assessed under the better of the policy and the Code's current medical definitions

What does 5.66-5.67 require?

For cancer, heart attack and stroke cover listed in the Code's medical definitions section, a claim is assessed against both the policy's own definition for the full benefit and the Code definition current at the insured event, and the claimant gets the better outcome. This applies to trauma or critical illness cover up to $2 million on policies or group schemes that commenced from 1 July 2017 onward, but not to cover reinstated after a claim, severity-based benefits, or trauma benefits bundled with income protection or TPD.