Superannuation insurance claims

As a member of your superannuation fund, there are a number of benefits associated with that membership such as insurance policies. These can include TPD insurance, income protection insurance, death benefits and more, which you can access if you're unable to work for any reason, such as injury or illness.

Making an insurance claim on your superannuation won’t affect your retirement savings. If you make a successful claim, the benefit you receive will be paid from a separate insurance policy that your super fund opened on your behalf as part of your membership.

This means that it does not affect or reduce your superannuation fund balance.

Your superannuation insurance is there to provide financial support in situations where you're unable to work, such as if you are ill or injured. 

Superannuation insurance benefits may include a monthly income payment or a lump sum insurance payout. How much you can claim will depend on the type of claim you make and the details of your unique situation.

For example, a lump sum Total and Permanent Disability (TPD) benefit payment could be worth thousands of dollars. Alternatively, an income protection benefit of up to 75% of your gross wage could be paid to you in regular installments.

The exact amount of your benefit should be in your annual super member benefit statements. Our experienced superannuation insurance lawyers can also help you uncover this number.

You can lodge a superannuation insurance claim as soon as you are unable to work due to illness, injury or any other medical reason such as psychological injuries. This does not have to be work related. 

The exact process of making a superannuation insurance claim will depend on which benefits you are eligible for, such as:

• Total and Permanent Disability (TPD) benefits
• Income protection benefits
• Terminal illness and death benefits

Our expert superannuation lawyers generally go through six key steps when helping clients with making a claim, including:

1. Our team will listen to you and gather information needed to understand the details of your case. 
   
2. We investigate your entitlements and confirm all the benefits with your super fund or insurer in preperation for making your claim.
3. We’ll work with you to map out the best approach making a successful claim to obtain your full entitlements. That includes identifying any potential hazards such as policy fine print. When you’ve instructed us to do so, we'll contact the super fund to make your claim and request any claim forms and other requirements.
4. We obtain any necessary evidence, including claim forms by you, the employer, treating doctors and other sources of relevant information like the tax office, Medicare or Centrelink. It may be necessary for you to see your treating health care providers or an independent specialist.
5. We submit your claim on your behalf once we have all the supportive documents, including submissions in support of the claim. We require a prompt decision or else interest will be payable.
6. Your case is resolved and your benefits will be paid to you as quickly as possible. While most of our claims are paid out in the first instance, some are declined. Declined claims can often be successfully challenged through the fund’s complaints officer or through external dispute resolution. We advise you every step of the way to ensure you are informed of your rights and feel supported in challenging the claim rejection.

If you're still unsure whether you're eligible to make a superannuation insurance claim, use our free claim check tool to find out. You can also get in touch with one of our superannuation lawyers who will be able to advise you on your eligibility and what claims you may be able to make.

Yes, if you are a member of more than one super fund you may be entitled to make more than one claim. Juggling numerous claims simultaneously can be a challenge so seeking legal advice is always recommended.

Yes, absolutely.

If you lodge a complaint about your super fund or insurer’s decision, they will begin a formal review process. During this process, you can submit additional evidence to support your claim.

You can also make an appeal to the Australian Financial Complaints Authority (AFCA). You may also be able to pursue your claim through a court. 

We highly recommend seeking legal advice from a superannuation lawyer to increase your chances of overturning the decision.

If your insurer has rejected your superannuation claim, not paid your benefits in full or you’re having any kind of trouble with your insurer, please get in touch with our superannuation lawyers. We can help you navigate the dispute process, liaise with your insurer on your behalf or help you lodge a formal complaint.

Yes, most insurance policies require a claim be notified as soon as possible after the date you cease work. While it’s best to lodge a claim as soon as possible, there are legal protections that may allow claims to be successful years after ceasing work.

Remember, the sooner your claim is lodged, the sooner your fund or insurer can assess it and come to a decision that, if successful, will help relieve some of your financial burdens.

Time limits also apply for appealing a rejected claim (which the trustee/insurer may not warn you about), so it's important to seek advice about your rights as soon as possible. 

While every superannuation insurance claim is different, it’s our mission to help you get your entitlements as soon as possible. How long a claim will depend on the nature and complexity of your case, but there are some general guides for different types of claims. 

For example, The Life Insurance Code of Practice requires an insurer to decide on a TPD claim within six to twelve months depending on its complexity. This can be shorter for income protection claims, and some claims might be assessed sooner if they are fairly straightforward.

If the insurer fails to accept a claim in a reasonable time you can make a claim for interest. Our team of superannuation lawyers will be able to advise you on timeframes once we understand the details of your case.

Our superannuation lawyers represent clients on 'no win, no fee'* basis for superannuation insurance claims. This means that you don't pay our legal fees if we don't win your claim.