Comcover Statement of Cover 2015-16
Table of Contents
Chapter 1 – Preamble
1.The Comcover Fund
2.Introduction
3.About Comcover
4.Conditions of Cover
Chapter 2 – Statement of Cover
5.The Statement of Cover
6.Defined terms
Chapter 3 – Liability
7.General Liability and Professional Indemnity
8.Directors’ and Officers’ Liability
Chapter 4 – Property
9.Property
10.Property in Transit
11.Fraud
12.Business Interruption
Chapter 5 – Motor Vehicle
13.Motor Vehicle
Chapter 6 – Personal Accident and Travel
14.Personal Accident
15.Travel Outside of Country - Baggage and Personal Effects
16.Travel Outside of Country - Medical Expenses and Medical Emergencies
17.Expatriate
18.Personal Effects and Travel inside Country
Chapter 7 – General Exclusions
19.General Exclusions – what we do not cover
Chapter 1 – Preamble
1.The Comcover Fund
(1)In this Statement of Cover certain words have defined meanings. When words appear in bold they have the meaning given to them in section 6 (under Chapter 2).[1]
(2)TheDepartmentof Finance, through Comcover, managesthe Commonwealth’s self-insurance arrangements.Comcover is part of the Risk, Insurance and Special Claims Branch in the Department of Finance. The Parliamentary Secretary to the Minister for Finance has portfolio responsibility for Comcover.
(3)TheComcover Fundwasestablished in1998 to provide acost-effective approach to managing theCommonwealth’sinsurable risks. Comcover isaninternal governmentmechanismthathelpsprotectthe Commonwealth Budget while atthesame time ensuringCommonwealthentities have acomprehensive programme of financial protection.
(4)All corporate Commonwealth entitiesand non-corporate Commonwealth entities operating within theGeneral GovernmentSector (Fund Members) are required to participatein theComcoverFund, unless they have been exempted by theMinister forFinance.Entities not classified within theGeneral GovernmentSectorare not coveredby this Statementof Cover.
(5)TheComcoverFund providesFund Members withcoverfor all normallyinsurable risks,with theexceptionof workers’ compensation, whichisthe responsibilityof Comcare.
(6)TheComcoverFundisa financialmechanismby which annual premiumscollected fromFund Members arepooled tomeetthecostof the Commonwealth’sinsurable losses. Although the risk isretained within theCommonwealth, theComcover Fund spreadsthe risk acrossthe Fund Members, minimisinganyadverse impactona singleentityor on the Commonwealth Budget.
(7)Thecalculationoftheannual premiumpool to keepreservesintheComcover Fund isbased onthe actuariallyassessed riskof lossesassociated withFund Members’operations, assetsand liabilities. Premiumsare allocated to Fund Membersaccording to theirproportionof the assessed risks acrosstheFund. These Premiums, aswellasexcesses, provide price signalsto eachFund Member andemphasise the focusonriskmanagement.
(8)The Comcover Fund also supports the Government’s aim of achieving greater transparency and accountability in the management of the Commonwealth Government’s risks.
(9)The Public Governance, Performance and Accountability Act 2013(PGPA Act) requires that accountable authorities of Commonwealth entities establish and maintain appropriate systems of risk oversight and management and of internal control for the entity.[2] Non-corporate Commonwealth entities must also comply with the Commonwealth Risk Management Policy.
(10)Comcover is committed to working in partnership with Fund Members to help them develop a risk management culture within their organisation. As part of this, Comcover provides Fund Members with access to a wide range of risk management support, including risk management training and networking opportunities, support to Boards, Executives and Senior Managers, professional risk management expertise and entity-specific advice.
(11)Comcover’s mechanism for dispute resolution is available on Comcover’s websiteat
2.Introduction
(1)TheStatementofCoverisaninternal policyarrangement for themanagementof lossesaffectingCommonwealthentitieswithin theGeneral GovernmentSector. TheStatementofCover is not intended to,and doesnot,give rise toanylegallyenforceable rightson thepartofFund Members orindividualsagainst Comcover.
(2)TheStatementofCoverdoesnotconstitute a contractofinsuranceor othertype of legally bindingcontractoragreement.
(3)TheStatementofCover is provided toexplain thetermsunderwhich losses incurred bya Fund Memberwill be fundedout ofthe ComcoverFund.
3.About Comcover
(1)TheRisk,InsuranceandSpecialClaimsBranch(Comcover)ispartofBusiness, ProcurementandAssetManagementwithintheDepartmentofFinance. The ParliamentarySecretarytotheFinanceMinister(theMinister)hasportfolio responsibilityforComcover.
4.Conditions of Cover
(1)Dutyof disclosure
(a)You have a dutyof disclosure in respectofyourriskexposures, which meansthat:
(i)before acceptingcover,you musttell Comcovereverymatter youknow, or could reasonably be expected to know,is relevantto Comcover'sdecisionto offer cover; and
(ii)at all timeswhilethisStatementof Cover applies, you must give Comcoverwritten notice, assoonaspossible, of everything that youare awareof in the ordinarycourseof businessthat isrelevanttoyourriskexposures.
(b)youdo not haveto disclose a matter:
(i)that diminishestherisk;or
(ii)thatwe knowor intheordinarycourse ofourbusinessought to know.
(2)Comcoverlooksto the support and cooperationof ourFund Members in the provisionof services.Itisexpected thatFund Memberswill:
(a)ensure that your staff are aware of statutory requirements and their responsibilities under relevant legislation, regulations and instructions.
(b)exercise reasonable careat all timesto protectagainstlosses;
(c)do everything thatisreasonably practicableto minimise the extentof aloss;
(d)do everything thatisreasonably practicableto investigate thecircumstances where itappearstheillegal or deliberate actions ofany person mayhave caused or contributed to aloss, and if appropriate:
(i)identifythe perpetrators;
(ii)prosecute or assistin theprosecutionof any perpetrators; and
(iii)assistusto seekfull recoveryof thelossfromany perpetratorsto the maximumextentpossible.
(e)comply with thetermsoftheComcover Statementof Cover and allapplicable lawandpolicies;
(f)participateinarrangementsthatare partof theComcoverservices;
(g)participateineducationactivitiesprovided byComcover;
(h)complete the annual Comcover benchmarking program within Comcover’s required timeframes;
(i)complete theannual renewal questionnaire within Comcover’srequired timeframes;
(j)ensureyourAssets Scheduleiskeptup-to-date and includesaccurate replacementvalues;
(k)supportComcover inundertakingclaimsmanagement responsibilitiesby providinginformationrequested promptlyand comprehensively;
(l)disclose allmattersrelating to a possible or actual claimpromptlyand comprehensively; and
(m)conductregularriskassessmentsand implement riskmanagementsolutions for all exposures.
(3)Claims
Whena claimismade against you, or aneventoccursthat maygive rise toa claim, you must:
(a)provide written details, including detailsof anyother insurance which coverstheclaim, toComcoverassoonaspracticable; and
(b)not admitliabilityfor, or settle, any claimor incur anycostsin connectionwith aclaimwithout the prior writtenconsentofComcover.
(4)Excess
(a)When aclaimismade against you, or aneventoccursthat maygive rise to aclaim, youmustpaytheexcesspromptly, asand wheninstructed byComcover.[3]
(b)Ifdifferentexcessesapplyto a claim underdifferentcovers,youmust pay thehigher orhighestexcess.
(c)Where more thanoneclaim arisesout of thesame actor omissionor a seriesof related actsoromissions, all of thoseclaimswill together be oneclaim for the purposesof determining theexcess.
(d)Wheremore thanoneclaim resultingfromanycombination ofevents or a seriesof related eventswhich occur duringany120hour period,all of those claimswill togetherbe treated asone claimfor the purposesof determining theexcess.
(5)Subrogation
(a)If Comcover acceptsa claim under thisStatementof Cover, Comcover will have yourrightsof recovery to the extentof theclaim payment made by Comcoverto you or onyourbehalftoanyother party.
(b)Youmust allow andassistComcoverto claimindemnityorcontribution inyourname fromany partyagainstwhomyoumayhave such rights.
(c)Youmust giveusall theassistancewemayreasonably require forthe prosecutionandsettlementof recoveryactions.
(d)Ifanamount isrecoveredthenComcover will be entitled to deductfrom that amountanyadministrative or legalcostsincurred or paid by Comcover infunding therecoveryaction.
(e)Whereyouhavepaid anexcessin relationto that claim, you will be entitled to a refund of that excessin theproportionthatthe net amount recovered (lessexpenses)bearsto theclaim paymentmade by Comcover.
(6)Claimsco-operationand settlement
(a)Comcover isresponsiblefor the defence and settlementofclaims.You must giveusall the assistance wemayreasonablyrequire for the defence and settlementofclaimsand recoveryactions.
(b)If you want to contestaclaim, whichwe believeshould be settled,you mayelectto doso butourliabilityfor theclaim willnot exceed the amountfor which,butforyourelection, theclaimcould have been settled togetherwith costsand expenseswemustpayyou up tothe date of yourelection.
(c)In the event that you,or adirector or officerof yours,isparty to a claim which iscoveredonlyinpartunderthispolicy, you(or yourself andyourdirector and officer)andComcoverwill use their bestefforts to agree upona fairandproper allocationofloss, and feesand expenses including defence costswhich should be insuredunderthispolicyand which relate solelyto whatiscovered under thispolicy.
(d)In the event thatanagreementcannot be reached,Senior Counsel (to be mutuallyagreed betweenus)will determine, asanindependentexpert but not anarbitrator, afairand proper allocation. Until the Senior Counsel hasmadehisorher determination,Comcovermay,inits discretion, paysuchlossandfeesandexpensesincluding defence costs asitconsidersappropriate.
(7)Comcover Services
You must not enterinto anyseparatecontract, arrangementor understanding withanysupplierofComcover Services in relationto the managementof a claimorprotectionofyournormallyinsurable risks without the expressapprovalofComcover.
(8)OtherInsurance
You mustadviseusassoonaspracticable if any riskthatwe coverisalso covered foryoubyanyother insurance policy.
Chapter 2 –Statement of Cover
5.The Statement of Cover
(1)ThisStatementof Coverhaseffectfrom1 July2015.
(2)TheStatementofCover may be terminated, or amended atany timeby notice:
(a)givenin writing to eachFund Memberbyus; and
(b)postedon ourwebsite.
(3)AllcoverprovidedunderthisStatementof Cover issubject toyounotbeing preventedfrommaintainingsuchcover byanylawor policy thatappliestoyou, includingbutnotlimited toenablinglegislation,internalpolicies,Accountable AuthorityInstructionsand LegalServicesDirections.
(4)Thetermsand conditionsshownonyour Scheduleof Cover takeprecedenceover anyof thegeneral termsand conditionsintheStatementof Coverto the extentof anyinconsistency.
(5)Theexcessshownagainsteachsectiononyour Schedule of Cover appliesto all individualclaimsfor thatsection.
6.Defined terms
Assets Schedulemeansthe schedule of assets, theirlocationsand valuesas declared bytheFundMemberandagreed byComcover.
bookdebtsmeans:
(a)the difference betweenoutstandingdebit balancesand the total amounts actually received;
(b)costsincurred in tracingand establishingdebit balancesincludingcollection expenses in excessofyournormal collectionexpenses; or
(c)interestchargesonanyloanyoutake outto off-setimpairedcollectionofyourbookdebts.
claimmeans:
(a)any demand byathird partyagainstaFundMember for compensation;or
(b)a request by youfor indemnityinaccordance withyour Schedule of Coverand this Statementof Cover.
Comcoverincludes service providerscontracted by Comcoverto assistin deliveringservicestoFund Members.
defence costsmeansreasonable legalcostsandotherexpensesincurred in defendingclaims withtheprior writtenconsentofComcover.
excessmeanstheamountthatyoumustcontributetowards thecostof anyloss.
expatriatemeansa personoutside hisor herhomecountryand whohasbeen noted onthe ScheduleofExpatriatesprovided toComcoverby theFundMember.
FundandComcoverFundmeantheFundestablishedbytheCommonwealthand managedbyComcoverasaBranchofthe DepartmentofFinancefor thepurposesof protectingFundMembersfromdefined losses.
Fund Membermeanstheorganisationnamed onyour Schedule ofCoverand all subsidiaries.[4]
indemnity periodmeansthe period beginningwiththe occurrence ofthe damage, lossor unauthorised use,interference or lossofaccessand ending not laterthanthe period specifiedinyourScheduleof Cover.
lossmeansall damages, legal costsawardedagainsta Fund Member(orif applicable anofficer)andsettlementsnegotiated with the prior writtenconsentof Comcover.
medical expensesmeansexpensesincurred andpaid to alegallyqualified health professional,hospital orambulanceservice for treatment, includingthe costsof medical suppliesand legallyprescribedmedicinesand drugs.
motorvehiclemeans:
(a)anymechanicallypropelled land-use vehicle, itsstandardtoolsandall accessories, and anythingordinarilytowed by thevehicle; or
(b)asubstitutemotorvehicle.
periodofcovermeansthe period duringwhich you are covered byComcover, as shownonyour ScheduleofCover.
personaleffectsincludestoolsoftrade andfield equipment butexcludesmoney.
propertymeans,all real orpersonal propertyincluding:
(a)money;
(b)electronicdata and records;
(c)structural improvements onorinland; and
(d)landscapingand gardens;
whichisyours, orisinyourcare, custodyorcontrol orisyourresponsibility,but excluding:
(i)land;
(ii)watercraftmore than15metres inlength;
(iii)aircraft;
(iv)rocketsandsatellites;
(v)livestock, animals, birds, and fish;
(vi)standingtimber;and
(vii)growingcropsand pastures,
(unlessnoted onyourAssets Schedule).
(e)Land doesnot include structural improvementsonorin theland.
ScheduleofCovermeans the termsand conditions ofcoverissued to theFund Memberwhich include detailsofthe type ofcover,maximumlimitsofcover, applicableexcesses, and special endorsementsor otherconditions.
Scheduleof Expatriatesmeansthelist notified toComcoverof expatriatesnominatedbytheFund Memberasrequiringcover.
substitute motorvehicle meansa vehicle thatyou have authorisedto be hired, borrowed or used for official purposesbecauseyourusualmotorvehicle isbeing repaired,servicedor hasbrokendown.
travellermeansapersonapproved byyou,includinganyapproved accompanying persons,ontravel outside hisorherhome country, or hisorher countryof assignment (including travel to outlying Australianterritoriesand islands)forup toonehundred andeighty(180) consecutive days.
we,usand/or ourmeansComcover.
you/yourmeansthe Fund Member.
voluntaryworkermeansa person who consentstoundertake dutiesunderyourdirectionor atyourrequestand receivesnilor nominal reward.
wrongfulactmeans:
(a)anerror,eitherbyomissionorcommission;
(b)amisstatementormisleadingstatement;or
(c)neglectorbreachof dutyorbreachoftrustbya directororofficerintheir capacityasa directororofficer.
Chapter 3 – Liability
7.General Liability and Professional Indemnity
(1)If youare legallyliable topaycompensationfor:
(a)injuryor illnessordeath;
(b)falsearrestor imprisonment, wrongful detention,maliciousprosecutionand humiliation;
(c)wrongful entryoreviction;
(d)assault and battery thatyou did not commitor direct— exceptto protect natural personsor property;
(e)libel,slanderor defamation;
(f)infringementofcopyright, title orslogan, passingoff or breach of intellectual property rights(includingmoral rights);
(g)unfaircompetition, piracy, misappropriationof ideasunder an impliedcontract; or
(h)breachof confidence, invasionof privacyorother similar misuse or disclosure of information,
(i)property whichisdamaged, lostor whichcannot beused,
(j)alosscaused by theexecutionor breach ofyourduty that arisesfromyouroperations or business,
and
(k)the claim for losswasmade againstyouduringyourperiod of cover, and reported toComcoverduring that period of coveror assoonasreasonably practicable,
then
(l)wewill indemnify youforall damagesor judgments, anddefence costs.
(2)Totheextentthatitislawfultodo so,directors,officers,employees,membersof committeesand advisorycouncilsappointedbyyou,voluntaryworkers and travellers,are also covered, whilstacting ingood faithinfulfilment oftheir dutiesandresponsibilitiesto you.[5]
(3)Exclusions
Wewill not payfor:
(a)legal costsinanyaction you bring (includingacrossclaim, counter claim,set- offor similar action) withoutthe prior writtenconsentofComcover;
(b)anyliabilityarisingout of liquidated damagesclausesorsimilar penalty clausesin contractsexceptto theextentthat liability would have attached in the absence of suchclauses;
(c)anyliabilityarisingout ofyourbreach of contractunlessliability would have arisenin theabsence of that breach;
(d)property damage arisingout of the use of a registeredmotorvehicle or a motorvehicle whichshould be registeredunderapplicable legislation;
(e)anyfeesorexpensesincludingdefence costs incurred byyou without the priorwrittenconsentofComcover;
(f)lossor any partoflossthat representscompensation, reimbursementor return of fees, duties, tariffs, taxes, leviesorchargesoranyother amounts incorrectlycollectedor received byyou; or
(g)anyclaim for or inany wayconnected withunderpaymentof employee entitlements.[6]
8.Directors’ and Officers’ Liability
(1)If youare legallyliable topayfor the consequencesof awrongfulactof a director or officer:
(a)ofyourorganisation; or
(b)whilethe director or officer heldanoutside directorshipappointedbyorrepresentingyou,
or
(2)if a director orofficer islegallyliableto payfortheconsequencesof awrongfulact:
(a)asadirector orofficerof yourorganisation;or
(b)while the director or officer held anoutside directorshipappointedbyorrepresentingyou,
and
(3)theclaimforlosswasmade againstyou, the director orofficer:
(a)duringyourperiod ofcover; and
(b)reported toComcoverduring that period ofcover orassoonasreasonably practicable;
(c)evenifthedirector orofficer had ceased beingadirector orofficer, duringor before that period ofcover,[7]
then
(4)wewill indemnify:
(a)you for yourownliabilityfor employment practices;
(b)you for yourliability to the director orofficerif he orsheisindemnified byyou;
(c)the directororofficer if he or she isnot indemnified by you;
(d)youforanylossanddefence costs up tothemaximum amount, provided thatsuch indemnityisnot prevented byanylawof theCommonwealth,including but not limited to, the PublicGovernance, Performance and Accountability Act 2013, theJudiciary Act1903, or theCorporations Act2001(whicheveris appropriate) (includingany Regulations, Orders, Legal ServicesDirectionsor Accountable AuthorityInstructions orpoliciesmadeorissued underthem), to the extent, ifany, theyapply toyou, the director orofficer;
(e)thespouse, de facto spouse or domesticpartnerof a director orofficerfor financial loss incurreddue to awrongfulactof a directoror officer, provided that:
(i)theclaimismade againstthe spouse, de factospouse or domestic partner only becauseheorsheisthe spouse, de facto spouseor domesticpartnerof the directororofficer; and
(ii)thelossrelatesto propertyeither jointlyheld by the director or officerandhisorherspouse, de facto spouse or domesticpartner or transferred by thedirectororofficerto hisorher spouse, de facto spouse or domesticpartner for legitimate purposes.
(5)If youreporttousfactsthat might give rise toaclaimagainstyou or adirector or officerassoonasreasonably practicableafter becomingawareof these factswe will indemnify you, the directoror officerfor anyclaimthat arisesfromthose facts.
(6)Notwithstanding GeneralExclusion19 inrespectofpollutants,we will pay defence costsincurred byadirector orofficer indefendingalossinconnectionwiththe actual oralleged discharge, dispersal, release or escape of any pollutant.
(7)Exclusions
(a)We will not payfor any claimmade againsta director orofficer forinjuryor illnessofany personorlossof,damage toor destructionof any physical property, including theofuse of itprovided,however, emotional distress claimsresultingfromemployment practicesthatare made byadirector or officerinyourorganisationagainst you oryourotherdirectorsorofficersare not excluded.[8]
(b)We will not payfor any claimmade againsta director orofficer thatarises fromthatdirector orofficer’s:
(i)improperuse of insideinformationto gainapersonal advantage or todeliberatelycause detriment toyouor another person;
(ii)wilfulbreach of theirdutytoyourorganisation;
(iii)breachof professional duty;
(iv)libel,slanderor defamation;
(v)medical malpractice;
(vi)conductother thanin good faith;
(vii)liabilityarisingout ofyourbreach ofcontractunlessliability would have arisenintheabsence of that breach; or
(viii)claimagainstyouor yourotherdirectorsorofficersunlesstheclaimisasaresultof employmentpractices.
(c)We will not payfor any claimmade againsta director orofficer thatarises from:
(i)anyclaimmade byyouagainsta director orofficerinyourorganisation;
(ii)losswhichistreated asaredundancy paymentorisinany way connected with redundancy;
(iii)anyfeesorexpensesincluding defence costs incurred by youwithout the prior writtenconsentofComcover; or
(iv)anyclaimfor or inany wayconnected withunderpaymentof employee entitlements.[9]
Chapter 4 – Property
9.Property
(1)If yourpropertyislost, destroyed or damaged asaresultof aneventthat occurred duringyourperiod of coverthenwe will payeither:
(a)the replacementvalue of thepropertylost, destroyed ordamaged; or[10]
(b)the indemnityvalueshouldyouchoose not to rebuild orreplace theproperty,[11]
and
(c)for reasonable architects’,surveyors’, engineers’, legal and otherfeesandclerks of works’salariesfor estimates, plans, specifications, quantities, tendersand supervision necessarilyincurred followingloss, destructionor damage excludingfeesandsalariesfor preparinganyclaim;
(d)for the reasonable costsincurredin theremoval, storage and disposal of debris, detritusorwreckage orindecontamination;
(e)for the reasonable costsincurredin demolition, dismantling,shoringup, propping, underpinningand othertemporary repairs; or
(f)anyextracostsnecessaryto comply with therequirementsof anycompetent authority providedyouhad not received notice of such requirementsbefore the loss, destructionor damage occurred,
up tothemaximumamountdeclared for that property inyourAssetsSchedule, where applicable. TheamountsspecifiedinyourAssetsSchedule at thetime oflossare the limitsthatComcoverwill pay.You areresponsible toensure thevaluesrecordedin yourAssetsSchedule are correctandinclude allowance for the additional costsspecifiedinsub-clause (1)above.
(2)Wewill also pay:
(a)for the reasonable costsincurredinextinguishingfiresator inthe vicinityofyourpropertywhich threatento involve yourproperty;
(b)for the cost of replacement locks and/or keys and/or combinations where a burglary or theft, or attempted burglary or theft, gives you grounds to believe that the keys may have been duplicated and also the cost of opening safes and/or strongrooms as a result of the theft of keys and/or combinations; and
(c)if youarethetenantandaspartofyourlease responsible for breakageof glass, the reasonablecoststhatyouare responsible for toreplace theglassand also anyincidental costs, includingsign writingand temporary protection.
(3)Exclusion
We will not pay for loss, destruction or damage:
(a)caused by wear and tear,rust, latent defect, gradualdeterioration, moths, vermin, disease, dampnessordrynessof atmosphere, extremesorchangesof temperature (otherthanfreezing), orfaulty workmanship, faultymaterial, faultyconstructionor faulty design[12];
(b)caused byunexplained inventory shortages, disappearancesresultingfrom clerical oraccountingerrors,shortage insupplyordeliveryofitemsto or from yourorganisation;
(c)to registered motorvehicles[13];
(d)caused by theactionof the seaincluding tidal waveorhigh waterunlesssuch loss, destructionor damage iscaused byorarisesout of anearthquakeor seismological disturbance[14];
(e)resultingfromanymisrepresentationsmade in connectionwithbenefitsor liabilitiesunder Commonwealth legislation;or
(f)topropertyundergoingconstruction, erection, alterationor additionwhenthe value of the workunderwayexceeds$5,000,000 unlessspecifically notedon yourAssetsSchedule.
10.Property in Transit
(1)We will payfor lossestoyourproperty:
(a)whilsttheproperty isintransit between a place orplaces; and
(b)whilst beingloaded and unloaded; and
(c)whilst temporarily beingstored atanyinterimplace between theinitial pointof dispatch and thedestination,
up toa maximumamountdeclared inyour Schedule of Cover.
(2)We will not payfor:
(a)ordinaryleakage, ordinarylossin weight or volumeorwearand tear of the propertyinsured;
(b)expensecaused by delay;
(c)expense arisingfrominsolvencyorfinancial defaultof the owners,managers, chartersoroperatorsof anyvessel;
(d)loss, destruction, damageor expense arisingfromunseaworthinessof a vessel or craft, or unfitnessof avessel,craft,conveyance, container, orlift vanfor the safecarriage of theproperty insured where theFund Memberisawareof the unseaworthinessorunfitnessatthetime theproperty isloaded therein;
(e)loss, destruction, damageor expense arisingfrominherent vice of thepropertyinsured; or