Total and Permanent Disablement insurance cover

Everything you need to know about Total and Permanent Disablement insurance cover

What is a TPD benefit?

Total and Permanent Disablement (TPD) cover pays a lump sum benefit to provide you with financial support if it is determined that you have been totally and permanently disabled and are unable to ever work again in any occupation.

The TPD benefit is comprised of two components:

• Superannuation account balance – Your account balance made up of personal contributions (if any), employer contribution, and accumulated earnings, less fees and taxes.
• TPD cover – The insured amount (if any) that you held at the date of disablement.

Who can be paid a TPD benefit?

Any member with TPD cover who qualifies as per the policy definition, meeting the definition of Total and Permanent Disablement. Your account balance is also payable where you become permanently incapacitated.

How do I claim a TPD benefit? What documents are required?

In order to fulfil its duty to decide who should be paid a TPD benefit, the Trustee must gather certain information about the member. This information helps the Insurer and the Trustee of Australian Food Super to determine if you are Totally and Permanently Disabled per the definition set out in the insurance policy, the Fund’s Trust Deed, and Superannuation Law.

The information required includes, but is not limited to:

• An accurately completed Initial Member Statement
• Medical reports and clinical notes for the period of illness or injury
• Medical Statements – Two suitably qualified medical practitioners from whom you have been receiving medical treatment must complete these forms. We require two medical certificates before payment can be made to ensure that disability superannuation benefits are taxed at the correct rate.
• A certified copy* of the member’s proof of age and identity
• Education, Training & Experience Statement (or Resume)
• Employer Statement to be completed by your last employer

* A certified copy is a copy of an original document that an authorised person (e.g. Justice of the Peace) has certified as being a true copy of the original. For details of who might be qualified to make this certification please refer to the Australian Food Super fact sheet “Statutory Declaration and Certified Copy”.

Why does the Trustee have to gather this information?

In addition to determine whether you are eligible for a TPD benefit, any insurance cover is subject to the terms and conditions set out in the insurance policy. A member must prove to the insurer that they are entitled to the insurance by providing information including proof of age, proof of disability, evidence that the member was eligible for cover and that the level of cover provided is correct.

What are the steps involved in making a claim?

• Contact us – Please contact us first:
  Email: InsuranceClaims@ausfoodsuper.com.au
  Phone: 1800 808 614.
  Once we obtain the initial information from you, we will then provide any claim forms you need to complete.
• Complete paperwork and provide documents – You will need to provide all the necessary information in order for the claim to be assessed. It’s really important that you take your time to complete all forms correctly and ensure all necessary documents have been provided. This includes two doctors’/specialist reports. If information is missing or incomplete, we will need to contact you to request this, which may cause delays.
• Insurer review – Once all the forms and supporting documents are received, your claim will be assessed by the Insurer (if there is insurance on the account). The Insurer may require additional information from you, your doctors, employer etc.
• Insurer’s decision – The insurer will make a decision and accept or decline the claim. If your claim is accepted and you have provided two doctors’ reports stating that you are not likely to return to any occupation, it will be sent to the Trustee for approval. If it is declined by the Insurer, the Trustee will review the decision.
• Trustee decision – If the claim is approved, we will send you the payment instructions details for you to complete. Once you send those details to us, we can finalise your claim. If your claim is declined, a decline letter will be sent to you.

** Please note that if your TPD was accepted and your death cover is greater than your TPD cover, we will send you a form to complete if you would like the difference between the two to retain on your account as death cover only.