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Superannuation Disability Insurance Claims

How Super can help if you become ill or injured

If you suffer injury or become unwell and are unable to continue in your usual occupation, you may be able to access insurance benefits attached to your superannuation fund. These benefits are typically known as Total Permanent Disability benefits (TPD), Total Temporary Disability benefits (TTD) or Income Protection benefits (IP). You may also be able to access the balance of your super on the basis of permanent incapacity.

Every super fund is different, and every member has a different level of cover, depending on when you joined the fund, your age and the level of insurance you have taken out. You may also be able to bring more than one claim if you have additional super funds. It is important that you check with the fund to see what cover you had as at the date of your injury or on the last date you worked.

We understand that superannuation benefits can often make a significant financial difference in difficult times. It is for this reason that we strive to obtain the best results possible for all of our clients.

Superannuation Claims

Disability Benefits – TPD or TTD

The most common form of insurance benefit attached to your super fund is called Total and Permanent Disability (TPD)insurance. This insurance becomes available to you if you become unwell or injured and cannot work in your usual occupation.

It is important that you check with the fund to see what cover you had as at the date of your injury, or on your last day of work. If you have not been at work for a while and your employer has not made contributions to your fund, your current super statements may show that you do not have cover now. This doesn’t mean that you didn’t have cover when you were injured and cannot make a claim. We often find that, by aking the right questions of the super fund, we can identify that our clients had cover that they were not aware of. We also often discover that clients have more than one super fund against which they can claim. The amounts being claimed are often significant and can have a positive impact for our clients and their families.

Super funds also have specific rules and definitions that need to be met in order to successfully bring a TPD claim. That is why it is important to receive correct advice when lodging a TPD claim.

Death or Terminal Illness Benefits

If you are working and discover that you have a terminal illness, you may be able to access either terminal illness insurance or alternatively claim your death benefit insurance prior to passing away. Whilst this can be a very difficult time, it is important to understand what your options are to ensure that you maximise the benefit for yourself and your family. In these circumstances, we work closely with our wills and probate department to ensure you receive the correct advice so that an informed decision can be made.

Income Protection/Salary Continuance Insurance

if you are unable to work due to injury or illness, you may be able to claim income protection or salary continuance payments. These benefits are a weekly payment made to you. Every fund provides a different level of cover. The more common policies provide cover for up to 2 years. Some, however, provide cover up to age 65.

Most funds have a waiting period, which also varies, but is usually about 2 months. It is for this reason that it is important to see your GP and report your injury or illness as soon as it occurs so that any waiting period can commence immediately.

If you have an accepted income protection or salary continuance claim, it is important that you are aware that there are ongoing reporting requirements to the fund. It iis usually also a requirement that you continue to receive ongoing medical care.

If you are in receipt of Centrelink benefits, Workcover weekly payments or TAC loss of earnings benefits, we recommend that you seek legal advice prior to commencing an income protection claim, as any weekly benefits will need to be offset against your income protection claim. We regularly assess whether an income protection claim will result in a net benefit for our clients to ensure that the claim is worth pursuing.

Accessing your Superannuation early

In some cases, we have clients who cannot work due to illness or injury and who do not hold TPD or income protection insurance. Due to difficult financial circumstances, they could benefit from accessing the balance of their super fund to make ends meet.

The most effective way to access the balance of your fund if you have sustained an injury or illness is by way of a permanent incapacity claim. Because you are accessing the balance of your super fund, permanent incapacity claims are less onerous to prove and more readily accepted by the super funds.

It is important to obtain legal advice and ensure that accessing the balance of your fund  will not negatively impact other entitlements you may be receiving.

What to do if your insurance claim is rejected

If your TPD claim is rejected, you can dispute the decision but strict time limits apply. If you want to know more about your eligibility to an entitlement under your superannuation’s insurance policy, you may simply submit a preliminary enquiry online to us, and we will give you an initial free assessment.

Our role from that point on is to step in and act on behalf of our clients, preparing submissions to the superannuation funds to point out any incorrect application or interpreation of their policy, so that our clients' total permanent disability claims are approved.

What if my TPD insurance claim is rejected?

Total and Permanent Disability (TPD) insurance claims under Superannuation policies are often rejected in the first instance, but an experienced lawyer can assist in examining the policy to ensure the Super fund has applied their policy correctly.

Helpful links

Australian Financial Complaints Authority

Find a Financial Counsellor

ATO Held Super

Ryan Carlisle Thomas Superannuation TPD guide

Superannuation TPD Insurance FAQs

What Happens Once My Claim Is Lodged?+

When your super fund receives your TPD claim and its supporting documentation, they are required to assess it, act in good faith, give your claim real and genuine consideration and apply sound reason.

How Long Does A Superannuation Disability Claim Take?+

Unfortunately, there is no set time frame in which super funds are required to make their decision. 

To assist in making a decision, super funds are able to request that you be assessed by an independent medical examiner and, in some cases, may request additional information from your employer, GP, other medical specialists, Centrelink and/or the Australian Taxation Office.

Click here to submit information online so we can investigate your eligibility to make a claim. Once you have completed and submitted our online questionnaire, we will contact you within two business days to discuss your claim further.

Or call 1300 366 441 or find us at an office near you for free initial advice on Superannuation Disability Insurance matters.

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