Claiming a terminal illness benefit

Call our Helpline on 1300 963 720 and we will help you with the first steps of the claim and inform you of what’s involved with the overall process.

• We will need to ask you about your medical condition to determine the correct benefit you may be entitled to claim. When you call, please have the following information on hand to initiate your claim:
  • your membership number,
  • details about your illness or injury,
  • the date on which your condition first presented itself,
  • the date of diagnosis, and
  • your life expectancy as advised by your treating doctor.
• We will discuss the options available to you to initiate your claim which are:
  • A Tele-claim - A representative from our Insurer, TAL Life Limited, will call you at a mutually convenient time to discuss your claim and the assessment process. During this call, the TAL claims assessor will collect information from you as required to complete your Member Statement. The information will include your personal details, current and historical medical history, and the circumstances surrounding your claimed condition. A written record or call recording will be kept and can be sent to you on request. Once the Member Statement is completed, the remaining documents needed, such as the Attending Doctor’s Report, will be sent to you via email or post for completion.
  • In Writing – Our Insurer will forward you all of the necessary claim forms for completion by you, your treating doctor and specialists.

Once your eligibility to claim is established, the relevant forms will need to be completed. These forms enable the assessment of your entitlement to receive a benefit payment in line with the superannuation laws and insurance policy terms and conditions.

• Claim forms – to be completed by you (or your Power of Attorney) if you haven’t participated in a tele-claim.
• Treating doctor and specialist form – your treating doctor and specialist will need to certify that even with medical treatment for your condition, your life expectancy is less than 24 months from the date of the certification.
• Benefit payment form – you will need to provide instructions of how you would like to receive the approved benefit. Payment can be made as a full or partial lump sum withdrawal and can be paid directly into your bank account via EFT or issued by cheque. Any benefit not paid to you will be retained within your superannuation account which you can access as needed.
• Certified Proof of Identity – For security purposes certified proof of your identity such as your driver’s licence or passport is required. A certified copy is simply a photocopy of an original document that has been sighted, signed and stamped as being a ‘certified true copy’ by an authorised person. Photocopies of certified documents cannot be accepted. More information on how to certify documents can be found on our website.

If you have death cover as part of your super, the Insurer will assess the claim for the insured component and determine whether you satisfy the policy requirements at the date you were certified terminally ill. The Insurer may ask for further information from you or your doctor/s if needed.

We will strive to reach an outcome as quickly as possible and will keep you regularly updated throughout the assessment process

All claims are referred to the Trustee office for approval once all of the required information, including the Insurer’s decision relating to insured benefit has been received. The Trustee is responsible for ensuring the decision is fair and reasonable and meets the early release benefit requirements as governed by superannuation legislation.

If your claim is approved, we will pay your benefit in accordance with your payment instructions.

If your claim is declined, we will let you know in writing of the reasons your claim does not satisfy the definitions.

Should this occur or if you disagree with the decision, you can request a review. You will have the opportunity to provide any further evidence to support your claim. All review requests are treated as formal complaints and are independently assessed by the Insurer and Trustee.

If you are not eligible to claim the insurance benefit, you may still be eligible for the early release of your super account balance due to your terminal illness.

If our Insurer approves your death benefit, the insurance payment will be allocated into your account balance to form a final total benefit amount. This total benefit amount may be paid to you once the Trustee approves the claim.

The benefit can be paid as:

• a full benefit payment via an Electronic Funds Transfer (EFT) or cheque; or
• a partial lump sum withdrawals from your super account when you need to.

If you choose to leave your benefit within super, the insurance proceeds together with your account balance will continue to accrue returns based on your chosen superannuation investment option/s.