Australian law requires compulsory superannuation contributions to be made by employers on behalf of each and every employee. As an aside to the investment of your superannuation contributions most superannuation companies also offer a degree of insurance coverage for certain events.
What does my superannuation policy cover? “It varies depending on your super choices”
Most superannuation policies offer to cover you for Total and Permanent Disability (TPD), Total Temporary Disability (TTD) and/or a Death Benefit.
How can I find out if I have insurance? “Your Super statement summary will show this”
You should look at the last statement you received from your superannuation fund. These statements are generally sent out at the end of each financial period as you need the information for taxation purposes. Information on the type of cover should be in this document. It should specify if you have TPD, and/or TTD and/or Death cover or alternatively just one or other form of coverage. It should also specify the amount of insurance you have for each of the potential claims. Alternatively, you can telephone your superannuation fund and ask them for the details.
What if I am not covered by insurance within my superannuation policy? “You may not have a claim”
If you did not have an insurance policy as a part of your superannuation policy at the time you suffer your injury, then you, or your family will not be able to make a claim via the superannuation policy. There may be circumstances tha you may be entited to other compensation so speak to a lawyer.
How do I know if I can claim? “It’s complicated speak to a lawyer”
Insurance terms in your superannuation policies can be confusing and complicated. A lawyer can help you with this. We can tell you what the terms of the policy mean and what you need to provide to the insurer to satisfy the terms and give yourself the best possible chance of applying sucessfully. Sometimes it is as easy as getting information from your treating doctor. At other times, we may need to send you for one or more independent medical examinations with a specialist doctor in the relevant field/s. When you come to see us, try to have your superannuation documents with you and also a copy of the definitions section from the policy or superannuation trust deed. This can save you time and money. Whether you can claim depends upon you firstly having insurance coverage within your superannuation policy, secondly, an assessment of the definition within the policy, and thirdly a detailed consideration of the medical evidence and your personal circumstances.
Total and Permanent Disability (TPD) Claims.
To make a TPD claim your injury or illness does not have to be work related. Whether your condition is caused by a car accident, workplace accident, public place accident or a medical condition, such as cancer, heart attack or mental illness (to name a few), you can make a claim. You don’t have to be unfit for all types of jobs. What is required is simply that you cannot return to a job for which you are “reasonably qualified by way of training or experience”.
Each policy has a slightly different wording and accordingly different requirements need to be met. It is necessary to consider the wording of the policy and to look closely at your employment and educational history before we can determine what evidence we will require before submitting your application.
Strict time limits apply to these claims and it is important that you contact us as soon as possible to protect your rights. The insurer will usually require independent medical examinations.
If you are covered in case of death, your superannuation benefit will usually be paid to your dependents in the form of a lump sum. In some situations, where you are diagnosed with a terminal illness, there may be the opportunity to access the lump sum before you pass away. Although you can nominate the person you want lump sum to go to in case of your death, the superannuation fund is not usually bound by this nomination and it can pay the lump sum to one or more of your dependants. Strict time limits can also apply to these claims, so it is important to seek advice as soon as possible.
If you have any questions or would like to discuss the changes to the worker’s compensation legislation and its impact on you or your family, please contact:
Gouldson Legal on (07) 3009 7000.
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