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Occupation Declaration – Insurance

  • (DD/MM/YYYY)


  • Eligibility Questions Please complete the questions below to determine if you qualify as a white collar or professional worker. If you do qualify, you will receive a higher Death & TPD insured benefit at no extra cost.

  • Are you able to carry out the identifiable duties of your current and normal occupation on a full-time basis without restriction due to illness or injury (even if you are not currently working on a full-time basis)? Full-time basis is considered to be at least 30 hours per week.
  • Are the duties of your occupation limited to professional, managerial, administrative, clerical, secretarial or similar 'white collar' tasks which do not involve manual work and are undertaken entirely (or at least 80%) within an office environment (excluding travel time from one office environment to another)?
  • If 'Yes' to questions a - b, you qualify as a white collar worker.

  • Are you earning in excess of $100,000 per annum?
  • Do you hold tertiary qualifications and are you a member of a professional institute or registered by a government body?

    OR

    Are you a member of your organisation's executive leadership team with more than 10 years experience in your industry?
  • If 'Yes' to all questions (a - d), you qualify as a professional worker.

    If you answered 'no' to all of the eligibility questions above, you will not be eligible to change your occupation rating and your existing level of insurance cover will remain unchanged.

    Declaration: By submitting this form I am making the following statements:
    • I declare that the answers to the questions in this application are true and correct.
    • I have read Nationwide Super's Product Disclosure Statement and Insurance Guide.
    • I have read and understood the Duty of Disclosure and I have not withheld any information that may affect the insurer's decision as to whether or not to accept my application for cover.
    • I have read the Privacy statement. I understand that Nationwide Super and it's insurer may undertake appropriate enquiry and investigation to verify the answers I have provided.
    • I understand that the increase in my insurance cover provided per unit will not commence until this declaration has been received and accepted by Nationwide Super.
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