Are you entitled to superannuation insurance?

Have you suffered an injury at work? Or perhaps you've stopped working due to illness? You might be entitled to an insurance payout from your superannuation fund.

Superannuation insurance covers you for injuries or disabilities that prevent you from working, regardless of whether the injury or illness was caused by a work-related incident. But what exactly does that look like?

To qualify for many superannuation total and permanent disability (TPD) policies, you need to prove that:

  • if you had not been injured or fallen ill, you'd be able to work a minimum of 30 hours per week
  • you're unable to return to the job you're qualified for.

Injured at work

An injury at work can often be simple to prove.

We once represented Craig*, who injured himself at work at the age of 41. He worked as a gardener and accidentally walked into a crossbar. As a result, he suffered spinal injuries and required a fusion of his cervical spine. His doctors declared him unfit to work in a manual role.

Fortunately, Craig qualified for weekly workers compensation payments and is still hoping to qualify for a common law lump sum payment. This has gone a long way to help him meet his financial commitments.

But on top of his workers compensation claim, Craig is also entitled to make a claim with his superannuation fund. He's covered for TPD by two superannuation funds – Cbus and First Super.

Because Craig has no formal education or experience in any duties other than manual roles, Cbus paid his TPD insurance benefit. Despite having almost the same eligibility requirements First Super rejected his claim.

First Super argued that Craig could return to sedentary duties and was therefore not entitled to a TPD payment. We helped Craig pursue legal action to obtain a $100,000 settlement from First Super’s insurer. This will go a long way to supporting Craig and his family, considering he'll never work again.

Illness outside work

To access your benefits, you don’t necessarily need to suffer a work related injury or illness. But there can be difficulties in accessing your benefits if you’re not employed or ‘at work’ when you suffer the injury or illness (e.g. if you had resigned at the time you suffered your injury or illness).

For example, we represented Lisa*, who worked in retail and was a member of REST super fund. When she was pregnant, she did what many expecting mothers do – she applied for maternity leave. Unfortunately, while on maternity leave, Lisa was diagnosed with multiple sclerosis (MS).

The MS prevented Lisa from returning to work, and her doctor declared her totally and permanently disabled for work. But when Lisa made a TPD insurance claim through her super fund, it was knocked back. REST rejected the claim because she was not physically 'at work' when she suffered the disability. Under the relevant insurance policy if you’re not ‘at work’ a harder disability definition can apply.

We argued on behalf of Lisa that, as her maternity leave was authorised by her employer, then she did in fact meet the 'at work' requirement of her policy. We managed to negotiate a TPD settlement for $37,000, which will make a considerable difference to Lisa and her young family.

Navigating an insurance claim with your insurance fund can be complicated. If you think you're unable to work due to an injury or illness, it's worth contacting a lawyer to talk about what insurance benefits your superannuation fund offers.

Unsure about what type of insurance your superannuation fund offers? Find out what your superannuation insurance entitlements are.

* Real name has been changed.

TOPIC: Superannuation
RELATED LEGAL SERVICES: Superannuation claims

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