If you’re diagnosed with a terminal illness you may be able to access your super and any death benefit you are insured for.

A Terminal Illness insurance benefit is the amount of money you’ll receive if you’ve been medically diagnosed with less than 24 months to live. You can choose to receive your benefit as a lump sum or a pension.

If you’re not insured through your super account, you can apply to have your account balance released due to suffering a terminal medical condition.

Here we explain the steps you need to take when making a Terminal Illness insurance claim.

You’ll need to meet the definition of a ‘terminal medical condition’ under the superannuation laws as outlined below.

You can apply for a payment if:

• a registered medical practitioner and a registered medical specialist have both certified, either jointly or separately, that you suffer from an illness, or have incurred an injury that’s likely to result in your death within a period (known as the certification period) and ends not more than 24 months after the date of the certification.

• the specialist is practising in the area related to your illness or injury

• the certification period hasn’t ended.

You don’t need a lawyer but if you choose to, it won’t guarantee a shorter assessment period, influence the outcome or the amount paid on a claim. You should also consider the cost involved in having your own lawyer.

When it comes to assessing claims, one of our responsibilities is to ensure our members’ interests are front of mind at all times. This means we’ll make sure any decisions are fair and comply with the conditions set out in the fund’s insurance policies, our trust deed and relevant laws.

1. Contact us – the best thing to do is give us a call on 1800 021 227 so we can talk you through the claims process, check if there is any insurance on the account and explain the documents and information you need to get started.
   
   
2. Complete the forms we send you – we’ll send you the forms you need to complete with a letter outlining the information you need to provide to us, e.g., statements from two of your attending medical practitioners, one of whom is your attending specialist.
   
   
3. Case management - You will be assigned a case manager to help you through the process. Your case manager will be in contact with you to provide you with an update, respond to your enquiries or request additional information.
4. Our Insurer will assess the claim for the insured component – if you have insurance through your super, the role of the insurer is to decide if the Terminal Illness benefit is payable.  Our Insurer will assess your claim with reference to the policy terms and conditions of the policy. Along the way, they may contact you if they need any further information.
   
   
5. We’ll review your claim – our role as the Trustee is to review your claim once all the relevant information is received. If insurance was held through your super account, we’ll also complete an independent review of the Insurer’s decision. We may ask for clarification or challenge the decision on your behalf if the claim is declined. You may receive a letter from us requesting further information.
   
   
6. Claim decision – when a decision is made, you’ll receive a letter letting you know the outcome of the claim and information about how to access your funds.
   
   
7. Payment – If your application is approved, any insurance proceeds will be paid into your super account. You’ll need to complete the withdrawal form and provide a copy of your bank statement along with certified proof of identity, to access your funds.
   
   Generally, it takes five business days to arrange a payment after receiving the above information.
   
   It’s possible your Terminal Illness benefit payment may result in financial or tax implications so you may also want to consider getting independent advice.

For your own piece of mind, we prioritise Terminal Illness claims. Hopefully all the necessary information requested by us is provided with your claim, but if not, we’ll help you by getting in touch with you as soon as possible.

You can help us shorten this time frame by including all relevant medical documents when you send us your application, and by responding to our requests for supporting information as soon as possible.

You are responsible for any costs associated with completing and providing the initial claim forms and any associated documents that we reasonably request for the assessment of your claim. If the Insurer directly requests information from a treating medical practitioner, they will pay this cost.

A TPD benefit is a payment you may be eligible to receive if you are injured or ill and permanently unable to work.

When it comes to insurance it’s important to understand that strict rules apply to insured TPD payments. To receive an insurance benefit payment you’ll need to satisfy the eligibility criteria and the TPD definition in the insurance policy.

There are two aspects to a TPD claim you need to know of. These are:

1. whether you meet the ‘permanent incapacity’ condition of release under superannuation law to access your super account balance

2. whether you have TPD insurance in your super account and if you meet the conditions that apply.

Your ability to meet certain definitions at the start of the policy (such as, ‘active employment’) could affect your eligibility to claim so it’s worth taking the time to read and understand the terms of your policy. These are set out in our Important conditions and the Insurance definitions section of the Insurance Guide.

These types of benefits and their tax treatments can be complicated depending on your circumstances so you might want to speak to your financial and/or tax adviser. To understand these types of payments ad their implications in more detail, you can visit ato.gov.au.

You don’t need a lawyer but if you choose to, it won’t guarantee a shorter assessment period, influence the outcome or the amount paid on a claim. You should also consider the cost involved in having your own lawyer.

When it comes to assessing claims, one of our responsibilities is to ensure our members’ interests are front of mind at all times. This means we’ll make sure any decisions are fair and comply with the conditions set out in the fund’s insurance policies, our trust deed and relevant laws.

1. Contact us – the best thing to do is give us a call on 1800 021 227 so we can talk you through the claims process, check if you have insurance and explain the documents and information you need to get started.
   
   
2. Complete the forms we send you – we’ll send you the forms you need to complete with a letter outlining the information you need to provide back to us, e.g., paperwork from your doctors describing the nature and extent of your disability or illness, a certified copy of your birth certificate, driver’s licence or passport plus any medical reports you have. Our Insurer will rely on the information you provide when making their assessment, so it’s important to include all relevant medical evidence in your application.
   
   
3. Case management - you will be assigned a case manager to help you through the process. Your case manager will be in contact with you to provide you with an update, respond to your enquiries or request additional information.
   
   
4. Our Insurer will assess the claim for the insured component – if you have insurance through your super, the role of the Insurer is to decide if the TPD benefit is payable. They will assess the claim with reference to the policy terms and conditions of the policy. Along the way, they may contact you if they need any further information or if you are required to attend an Independent Medical Examination.
   
   
5. We’ll review your claim – our role as the Trustee is to review your claim once all the relevant information is received. We’ll also complete an independent review of the Insurer’s decision. We may ask for clarification or challenge the decision on your behalf if the claim is declined. You may receive a letter from us requesting further information.
   
   
6. Claim decision – when a decision is made, you’ll receive a letter letting you know the outcome of the claim and information about how to access your funds.
   
   
7. Payment - If your application is approved, any insurance proceeds will be paid into your super account. You’ll need to complete the withdrawal form, provide a copy of your bank statement and certified proof of identity to access your funds.
   
   

   Generally, it will take five business days to arrange a payment after receiving the above information.

   It’s possible your TPD benefit payment may result in financial or tax implications so you may also want to consider getting independent advice.

The claims process will start once we’ve received all the relevant documents and information requested.

The time it takes for a TPD claim to be decided varies depending on the complexity. We’ll be in touch to provide you with updates and progress of the claim.

You can help us shorten this time frame by including all relevant medical documents when you send us your application, and by responding to our requests for supporting information as soon as possible.

You are responsible for any costs associated with completing and providing the initial claim forms and any associated documents that we reasonably request for the assessment of your claim. If the Insurer directly requests information from a treating medical practitioner, they will pay this cost.