Berrill and Watson Lawyers are experts in superannuation and insurance advice and claims. The types of insurance that are usually available in your superannuation are total and permanent disability (TPD), income protection, terminal illness and death insurance. The benefits available in superannuation can be large six figures lump sums and/or monthly income benefits. If you have more than one super fund, you may have more than one claim.
TPD benefits are usually lump sums paid if you can’t do your normal job because of an injury or illness and you won’t be able to return to the work that you have the skills or experience to do. Sometimes you will also have to prove you are unable to be retrained into a different job.
Unlike Workers Compensation, your injury or illness does not have to be work related and you can use all your injuries or illnesses for a TPD claim.
So if you have been diagnosed with MS, cancer, diabetes, a mental illness or a back injury or any other health problems, you can use all of them for TPD claim.
You may be entitled to an insurance lump sum plus your superannuation account balance.
Terminal illness insurance benefits are usually lump sums paid if you have been diagnosed with an illness that is likely to lead to your death within 12 months or maybe up to 24 months. It is often the same amount as death cover.
You must be diagnosed by two doctors- one must be your treating specialist. If you have no insurance cover, you can still claim your account balance on grounds of a terminal illness.
if you die while covered under a super fund for death insurance, your dependents or next-of-kin can claim a death insurance benefit in addition to any superannuation account balance.
The benefits are paid to your surviving spouse, de facto (including same-sex), children, financial dependents, inter-dependents or to your estate. Who gets paid what depends on the trustee’s discretion or any binding nomination.
Income protection, or temporary disability benefits, are usually monthly payments of up to 75% of your salary paid if you are off work for a period of time and can’t do your normal job. You might also be paid contributions to your superannuation fund.
The waiting period can be 30, 60 or 90 days and the benefits can be paid for two years, five years or may be all the way up to age 65 or longer.
To win a claim, you have to show you can’t do your usual job for now. You don’t have to prove you will never work again.
Income protection policies can also pay partial disability benefits if you can work part-time but can’t do all your work duties. A partial disability benefit will usually top up your salary.
You might also have TPD, income protection, terminal illness or death insurance outside your super fund. It could be:
If you suffer a heart attack, cancer, MS, stroke, loss of use of limbs or sight of an eye etc, you may be entitled to a lump sum. The policy will set out the definition of the trauma event and if you satisfy the definition, you get paid a lump-sum-usually regardless of whether you can work.
Many loans, credit cards and mortgages have insurance cover for the repayments if you become unfit for work, unemployed or pass away. Almost all policies exclude pre-existing conditions.
Claims for insurance and superannuation benefits can include:
You can be asked to give the fund or insurer financial and medical records, fill in activity statements and go to medico-legal examinations or rehabilitation assessments. Decisions can take a long time. It’s important to get help and advice with a claim.
If a claim is rejected, you can lodge an internal complaint with the fund/insurer. It will be necessary to lodge medical reports and other material to support your complaint If a complaint is rejected, you may then appeal to an ombudsman or tribunal or to lodge a court case. Time limits apply.
Always get legal advice about appeals.
If you have a Workers Compensation claim or a motor vehicle injury claim, you can still claim disability insurance benefits. If you receive a lump sum benefit it will not usually affect your compensation entitlements but you should always get advice. On the other hand, compensation payments can affect superannuation and insurance benefits, particularly income protection payments. Get advice.
If you are on a Disability Support Pension (DSP) or Centrelink New Start Benefits, you may be a good candidate for a superannuation or insurance claim-even if you haven’t worked for a long time.
If you get paid a superannuation or insurance lump sum, this will usually count towards the Centrelink assets test-unless you keep some or all of the benefit in a super fund. Income protection payments are treated as income under the Centrelink rules and can sometimes affect your entitlement to receive Centrelink. If you are paid superannuation insurance lump sums, they may be tax-free or you may only pay a little tax. Income protection payments are usually taxed as income, while superannuation pensions may be taxed concessionally. It’s important to get advice on all the above.