Sunsuper
insurance
claims
guide
Learn more about:
Making a claim
How a claim is assessed
1 July 2016
make your dreams
more than dreams
Getting Started
What has happened to you or your loved one?
You have an injury or sickness/illness which has
permanently stopped you from working
Please see Section 1: Total & permanent disability insurance claims
You’ve lost a loved one
Please see Section 2: Death insurance claims
You have an injury or sickness/illness which has
stopped you from working temporarily
Please see Section 3: Income protection insurance claims
You’ve been diagnosed with a terminal illness
Please see Section 4: Terminal illness claims
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41
At Sunsuper, we understand that making a claim can
be a stressful and difficult process. We appreciate that
the circumstances of every claim are as different as the
individuals making them.
To help you and your family through this difficult time, Sunsuper has a team of dedicated
and experienced staff who are able to assist you. Our Claims Team are trained specialists
who will handle your claims journey with compassion and professionalism.
We have developed this guide to help step you through the claims process. The following
sections contain all the information you will need to help you make a claim. From basic
details about the claim type and your eligibility through to in-depth guides on the
information required for each claim, this comprehensive guide aims to simplify the
process and explain all requirements in
simple steps that are easy for you to follow.
Our claims process has been designed
so that in most cases, you or your family
should not require the assistance of a
Sunsuper is committed to helping
you access your entitlements.
During 2014–15, Sunsuper paid
out just over $307 Million in
insurance claims.
lawyer when making a claim. If you need
help, our dedicated Claims Team is here to help guide you through the process. If you
choose to seek professional help, we recommend that you first determine the costs
involved in doing so and how they will impact your benefit payout. We give no priority to
claims lodged by professionals—all claims are dealt with in the same manner and follow
the same process.
Depending on the claim type, it can take up to six months or more for you to receive a
final decision on your application. Once we have received your application, it is reviewed
by us before being passed on to the Insurer who is ultimately responsible for assessing
the claim. The assessment process involves many steps—from working out whether
you are eligible to claim, through to evaluating claim documentation including medical
reports and other supporting evidence. While the process can be lengthy, we will strive
to expedite it for you and keep you informed of your claim’s status.
If you have any further questions, please contact your dedicated Claims Representative
or call our Contact Centre on 13 11 84.
SUNSUPER INSURANCE CLAIMS GUIDE
Contents
1 Total & permanent disability
insurance claims
1
1.1 What is Total & Permanent Disability (TPD)
Insurance? 3
1.2 What is considered?
3
1.3 How to make a TPD claim
4
1.4 What do TPD ‘claims packs’ contain? 5
1. Claim application 5
2. Medical Attendant’s statement
5
3. Employer statement
5
4. Benefit payment instruction 5
5. Centrelink Authority to Release
Personal Information
6
6. Authority to release personal Medicare
and Pharmaceutical Benefits Scheme (PBS)
claims information 6
1.5 What you will need to provide for your TPD claim6
6
Certified proof of your identity 1.6 The TPD insurance claim assessment process
8
1. Appointment of representative 19
2. Death benefit claim form 19
3. Employer statement
19
2.4 What you will need to provide in the death claim20
Certified proof of your identity 20
Death claims checklist
21
2.5 Death insurance claim assessment process
22
2.6 Frequently asked questions about death claims 25
Do I need a lawyer?
25
What is a binding death nomination?
25
Who is eligible to receive the benefit?
25
Legal Personal Representatives
25
What is a dependant?
25
What is an interdependent relationship?
25
What is a financial dependant?
25
What happens if the deceased member
committed suicide?
26
Are there any other exceptions?
26
Why does it take so long?
26
26
1.7 The TPD Assist insurance claim assessment
process
10
How much will I be paid?
TPD Assist’s Occupational Rehabilitation
13
What is the impact of where the benefit is paid? 26
What is a Family Provision application?
26
14
Will tax be payable on the benefit?
26
When can I make a TPD claim?
14
Will funeral expenses be reimbursed?
26
What if I am not sure I have insurance? 14
Why does it take so long?
14
Will I be eligible for an
anti-detriment payment?
26
Is there a Waiting Period? 14
How long do I have to lodge a claim?
14
1.8 Frequently asked questions about TPD claims 14
Do I need a lawyer?
Are there any injury or sickness/illness exceptions?14
3 Income protection
insurance claims
29
3.1 What is Income Protection (IP) Insurance
30
What happens if I have a self-inflicted injury?
14
3.2 How to make an IP claim 30
How much will it cost? 14
3.3 What does an IP ‘claims pack’ contain? 31
What happens if I am receiving Income
Protection payments?
14
What if I am self employed?
15
What if I am unemployed?
15
2 Death insurance claims
17
2.1 What is a Death claim?
18
2.2 How to make a Death claim 18
2.3 What does a Death benefit ‘claims pack’ contain? 19
1. Claim Application (Employee statement) 31
2. Treating Doctor’s Report 31
3. An Employer statement
31
4. Centrelink Authority to Release
Personal Information 31
5. Authority to release personal Medicare and
Pharmaceutical Benefits Scheme (PBS)
claims information 31
6. Tax File Number declaration 31
7. Bank Account Nomination form 31
3.4 What you will need to provide in your IP claim 32
Sunsuper insurance claims guide
Certified proof of your identity 32
Income Protection claims checklist
33
3.5 The IP claim assessment process
34
3.6 Frequently Asked Questions about IP claims
36
4.4 What you will need to provide in your TI claim 44
Certified proof of your identity 4.5 The TI claim assessment process
44
44
Do I need a lawyer?
36
Do I have IP insurance?
36
Coordination and assessment of your application 44
Is there a Waiting Period?
36
Payment of your claim
Do I have to re-start a Waiting Period if I return
to work?
36
Are there any exclusions or restrictions?
36
What happens if I’m partially disabled?
36
How much will I be paid?
4.6 Frequently Asked Questions about TI claims
44
45
Do I need a lawyer?
45
How much would I be entitled to?
45
36
What happens if I am receiving an Income
Protection payment?
45
When are benefit payments made? 36
How much will I be paid?
45
Will I pay tax on the benefit?
37
Are there any tax implications?
45
Will there be offsets to my benefit payment? 37
What happens if I have a recurring injury or
sickness/illness?
How do I prepare for the application process not
being completed before my death?
45
37
Occupational Rehabilitation in Super – ‘Work is
Good Medicine’
39
5 Proof of identity requirements 47
4 Terminal illness claims
41
4.1 What is a Terminal Illness (TI) claim?
42
How is terminal illness defined?
42
When do you need to prove your identity?
48
What is an acceptable identification document? 48
What if you’ve recently changed your name?
49
What do we mean by certified?
49
4.2 How to make a TI claim
42
Who can certify your identification documents
in Australia?
50
4.3 What does a TI ‘claims pack’ contain? 43
What if you live overseas?
51
1. Application for early release of benefit form
43
2. Employer statement
43
3. Authority to access information
43
4. Medical Practitioners certificate 43
5. Binding death nomination form
43
The Insurance claims guide provides information about making an insurance claim. For information about insurance cover, including eligibility and the terms and
conditions that apply, you should refer to the applicable Product Disclosure Statement (PDS). For a copy of the PDS, call us on 13 11 84.
General advice disclaimer The information in this guide is general information only and doesn’t take into account your personal objectives, financial situation
or needs. You should consider the appropriateness of any general information in this guide having regard to your own personal objectives, financial situation and
needs. You should consider the Product Disclosure Statement before making a decision. Call 13 11 84 or visit sunsuper.com.au for a copy. You should obtain
financial advice tailored to your personal circumstances. Call us if you would like to speak with one of our qualified financial planners.
Our phone based qualified financial planners provide simple advice about your Sunsuper account at no additional cost. More comprehensive advice may incur
a fee. Sunsuper employees provide advice as representatives of Sunsuper Financial Services Pty Ltd (ABN 50 087 154 818 AFSL No. 227867) (SFS), wholly
owned by the Sunsuper Superannuation Fund.
We are committed to respecting the privacy of personal information you give us. If you would like a copy of Sunsuper’s Privacy Policy visit sunsuper.com.au/privacy or
call 13 11 84. 13 11 84 sunsuper.com.au
1
Total & permanent
disability insurance
claims
We can appreciate that being
unable to work is a difficult and
uncertain time for you. We will
strive to ensure that we provide
you with all options available and
in the event you need to lodge a
claim we aim to have it processed in
a timely manner, so you can receive
a decision as quickly as possible.
1
Sunsuper offers two different categories
of TPD Insurance cover.
Standard, Tailored or Additional TPD insurance
cover may apply for members who:
a.Had Standard TPD cover in Sunsuper for life and
became disabled prior to 1 July 2016, or
b.Applied and were accepted for Tailored TPD cover in
Sunsuper for life, or
c.Have Standard or Additional cover in Sunsuper for life
Corporate or Sunsuper for life Business.
Further information for this cover is located in section 1.6.
TPD Assist cover may apply ...
... for members who have default TPD Assist cover (called
Standard TPD cover prior to 1 July 2016) in Sunsuper for
life and become disabled on or after 1 July 2016. Please
refer to section 1.7 for further information on this cover type.
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TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
1.1 What is Total & Permanent
Disability (TPD) Insurance?
Total and Permanent Disability (TPD) insurance is a type of
insurance cover which provides you financial support in the
event that you become totally and permanently disabled.
The term ‘totally and permanently disabled’ is defined in your
Product Disclosure Statement, but generally means that you will
be unable to ever work again in your own or any other occupation
for which you are suited by training, education or experience.
1.2 What is considered?
Having insurance cover doesn’t automatically mean that you
will receive a payment. The assessment process takes into
account the definition of TPD in place at the time you ceased
work, your current job or occupation, any education, training
and work experience you have, and the impact that your injury
or sickness/illness will have on your ability to work again.
The Insurer will contact your employer and your doctors to obtain
information, and they may also send you for additional tests and/
or examinations to a doctor of their choice. TPD definitions vary
If your TPD claim is approved, you are usually able to withdraw
between superannuation funds. Sometimes you may be eligible
your superannuation account balance and any insured benefit,
for a benefit from one fund but not from another fund.
allowing you and your dependants to pay debts or bills, or fund
your special medical needs. The amount of your lump sum payout
therefore depends on your superannuation balance, what type of
TPD cover you have and how much insurance cover you have at
the time of injury or sickness/illness.
If you don’t have insurance with us, you may still be able
to claim your super balance under a Permanent Incapacity
Benefit. Permanent Incapacity is defined in the Superannuation
Industry (Supervision) Regulations 1994 (Cth). Members
suffering from Terminal Medical Conditions may also be able to
access their super balance. Please contact the Claims Team for
further information.
What is the difference between TPD (Standard, Tailored and Additional)
and TPD Assist?
From 1 July 2016, Sunsuper introduced TPD
Assist insurance, which may be paid in up to
six annual support payments over a minimum
of five years, for members who continue to meet
the TPD Assist definition. In some circumstances
you may receive a single lump sum payment.
TPD Assist is designed to help minimise the
impacts of a severe illness or injury that prevents
you from earning a living. This cover provides
several unique features to assist you, including
no waiting period for the most common claim
types, access to occupational rehabilitation and
retraining in appropriate situations.
Depending on the cover held at your date of
disablement you may be eligible to claim for TPD
or TPD Assist. For further information regarding
your insurance cover please contact our Claims
Team on 13 11 84.
13 11 84 sunsuper.com.au
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1
TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
1.3 How to make a TPD claim
If you believe that you may be eligible to apply for a TPD
or TPD Assist claim, we are here to help you along the way.
To submit your claim, you need to complete the three major
steps listed below.
Please read all information we send to you carefully, and take
the time you need to gather all information required to complete
the claims process. You will need to answer several questions
the Insurer makes their decision in regards to your TPD or TPD
Assist claim.
We recognise that this may be a daunting task. Our Claims
Team is here to help you every step of the way, assisting
with your claim and helping to answer any questions you
may have.
Sunsuper has introduced an eClaims system to help simplify
the process and reduce the time taken to finalise the claim.
and provide us with additional information. Completing the claim
Please contact us as soon as you are able to on 13 11 84 if
form is the largest and most important step in this process: the
you would like help making a claim or have any questions.
details and evidence you provide will form the basis upon which
Step 1
Step 2
Before you call us, you will
need to prepare some basic
information about your claim
Call Sunsuper on 13 11 84
to start the claims process
This will allow us to start the claims process from
the moment we first speak to you.
The necessary information includes:
• Your Sunsuper membership number
• You can find this number in the top right
hand corner of your Annual Statement as well
as most other correspondence from Sunsuper
• Details about your injury or sickness/illness
• The date on which your injury first occurred
or your sickness/illness first presented itself
• Details and date of your diagnosis
• Details about your work status
You’ll be transferred to our Claims Team who
will be able to help with the first steps of the
claims process.
The Claims Team may:
• provide you with details of your current account
balance and insurance cover
• discuss with you any options you may
have or refer you to an expert to discuss
early assistance
• if appropriate, advise you of the documents and
information you need to provide for the claim to
be assessed, and
• if applicable, send you the TPD claim forms
for completion or if eligible, a link to eClaims to
lodge your claim online.
• The date you last worked
• The amount of hours you worked per week
leading up to your injury or sickness/illness
Step 3
Once all the required
information has been received
for this initial stage, we can begin the assessment
of your claim.
We will provide you with the name and contact
details of your own dedicated Claims Representative
who will assist with your claim and help answer any
questions you may have along the way.
4
Sunsuper insurance claims guide
1.4 What do TPD ‘claims
packs’ contain?
3. Employer statement
There are a number of forms that may need to be completed
time of your injury or sickness/illness. They will need to
when making a claim (detailed below). Please do not hesitate
provide information about the types of duties you performed in
to call the Claims Team if you have any questions. This will help
your role.
us to ensure that your claim is processed as quickly as possible.
1. Claim application
What is this form for? This form is to be completed by your
(previous) employer with whom you were employed at the
Tips: We recommend that you contact the HR department or
your direct manager from your (previous) employer, as this form
must be completed by an authorised person.
What is this form for? This form is to be completed by you. It
includes your contact information, employment details and basic
details about your injury or sickness/illness.
It will ask specific details about the work you were performing
leading up to your injury or sickness/illness, how your injury
or sickness/illness has affected your ability to work, whether
you’ve had a similar condition before and whether you intend to
4. Benefit payment instruction
What is this form for? This form asks how you would like to
receive your money should your claim be approved.
Tips: Providing this information to us at the start will ensure
that you can receive your payment without delay if your claim is
claim other benefits.
approved. If you are unsure of how you would like your payment
Tips: You must provide us with several pieces of information,
financial planners who will be able to assist you to make the
and these tips will help you to find them.
best decision for your individual circumstances.
made, we can arrange for you to speak with one of our qualified
• The ‘Trading name of last employer’ will be detailed on your
payslip or your Payment Summary (group certificate) – the
trading name of your last employer may not be the name you
know your employer as, so please check this carefully.
• ‘Fund of choice’ means the superannuation fund your
employer was paying into at the time of your injury or
sickness/illness.
If you are unsure about the dates and hours you worked, we
recommend that you contact the Human Resources department
of your (previous) employer or refer back to your payslips.
2. Medical Attendant’s statement
What is this form for? This form is to be completed by the
doctor who treated you at the time of your diagnosis. Their
statement will describe the nature and extent of your injury
or sickness/illness and provide evidence for it (such as medical
records, test results etc.).
Please note: So that we can make the process of lodging your
claim as easy as possible, in some instances our Insurer will
Why so many questions?
In order to properly assess your claim, the
Insurer requires detailed information from you,
your employer and your doctor.
While we recognise that your claim requires
a number of questions to be answered,
collecting as much information as possible
at the start will help validate your claim and
speed up the process.
We understand that this may be a daunting
task, and our Claims Team is here to help
you every step of the way. If you require
assistance, please contact the Claims Team.
contact your treating doctor directly for completion of this form.
If this is the case, this form will not be sent to you as it will be
sent directly to your doctor.
Tips: We recommend that you contact your doctor and let them
know that you are in the process of making a TPD claim. You
may be required to make an appointment with your doctor to
have them complete this statement. Please note that you will
be responsible for the costs of this appointment.
13 11 84 sunsuper.com.au
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1
TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
5. Centrelink Authority to Release
Personal Information
What is this form for? If you receive Centrelink benefits, you
will be required to complete this form to give authority to
Sunsuper and its Insurer to obtain information about your
benefits. This form allows the Insurer to access any information
or medical reports held by Centrelink which may help with the
assessment of your claim.
1.5 What you will need to
provide for your TPD claim
Completing your claim application is the largest and most
important step in your claim process. The details and evidence
you provide will form the basis upon which the Insurer makes
their decision. Providing us with all the information we require
and completing your forms correctly will speed up your claims
process. If information is missing or incomplete, we will need
Please note: This form is not required in every instance and will
to contact you to ask for it, which will delay your claim. We
only be included where necessary.
understand that completing the claims application may be a
6. Authority to release personal
Medicare and Pharmaceutical
Benefits Scheme (PBS)
claims information
step of the way. Please contact the Claims Team who will assist
Certified proof of your identity
What are these form for? These forms provide authority
You must provide a certified copy of your ID as proof of your
for release of information from both Medicare and the
identity (for example, a driver’s licence or passport).
daunting task, and our Claims Team is here to help you every
Pharmaceutical Benefits Scheme (PBS) directly to the Insurer to
assist them with the assessment of your claim.
you with any questions you have about the information we
require and completing your claim forms.
Why? Your super is your money, so for security purposes, we
need to be sure that the super belongs to the person submitting
Please note: These forms are not required in every instance
the claim. Understandably, you won’t want to send us your
and will only be included where necessary.
original documents, so we ask that you have a copy certified by
an authorised person.
Tips: See our Proof of Identity Requirements section for
Remember, if you need assistance
please call the Claims Team
6
Sunsuper insurance claims guide
information on what forms of ID are suitable and how to have
a copy certified.
TPD claims Checklist
Before you send your claim through,
make sure you have fully and
correctly completed the following
requirements:
□ Certified proof of ID
□ Claim Application
□ Medical Attendant’s statement
□ Employer statement
□ Benefit payment instruction
□ Centrelink Authority to Release
Personal Information (if required)
□ Authority to release personal
Medicare and Pharmaceutical
Benefits Scheme (PBS)
claims information (if required)
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1
TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
1.6 The Standard, Tailored and Additional TPD insurance claim
assessment process
The process outlined below applies if you had Standard TPD cover in Sunsuper for life and became disabled prior to 1 July 2016,
or applied and were accepted for Tailored TPD cover in Sunsuper for life, or have Standard or Additional cover in Sunsuper for life
Corporate or Sunsuper for life Business.
Claim forms are
received
Insurer assesses claim
Claim is declined
by Insurer
Claim is accepted
by Insurer
Sunsuper Trustee
reviews Insurer’s
decline of claim
Sunsuper Trustee
reviews Insurers’
acceptance of claim
and makes payment
Sunsuper Trustee
disagrees with decline
Claim is deferred
by Insurer
Sunsuper Trustee
upholds decision to
decline claim
Please note: the process for Permanent Incapacity claims (where there is no insurance) is similar to the above but does not involve the insurer.
Claim forms are received
Insurer assesses claim
Once we have received your claim forms, the Claims Team will
The Insurer will use the information you, your employer and your
review your application and ask you for any further information
treating doctor provide when making its assessment.
we require. Once we have received all the information we require
The Insurer may also:
for this initial stage, we can begin the assessment of your claim.
Throughout the life of the claim, the Claims Team will keep you
updated on its progress.
• ask for additional reports from your doctor/s
• ask you to provide more information
• ask your employer for more information, and/or
• make an appointment for you to have a medical examination
with an independent specialist/s.
The Insurer will pay for any additional medical reports they
request and examinations they arrange for you to attend.
Once all required information has been collected, the Insurer
will assess your claim and decide whether your claim meets the
relevant TPD definition, it will ‘accept’, ‘defer’ or ‘decline’ your claim.
8
Sunsuper insurance claims guide
Claim is accepted by Insurer
Claim is declined by Insurer
If your insurance claim is accepted by the Insurer, the insurance
If your insurance claim is declined by the Insurer, it will be
proceeds will be paid to Sunsuper and initially invested in
referred to the Sunsuper Trustee for review and consideration.
the Cash option. Funds will be held in this relatively stable
investment option until the Sunsuper Trustee finalises payment
to you.
If the Sunsuper Trustee disagrees with the decision of the
Insurer and believes that your claim should be reassessed,
your claim will be referred back to the Insurer for their
reconsideration. The Claims Team will contact you to advise
Sunsuper Trustee reviews
Insurer’s acceptance of claim
and makes payment
you of the next steps.
Sunsuper Trustee reviews
Insurer’s decline of claim
The Sunsuper Trustee and insurer recommendation will review
your claim. The Claims Team will then contact you to advise that
your claim has been approved. If you have already provided us
with payment instructions via the Benefit payment instruction
form (see page 4), we will pay your benefit accordingly. If your
If the Sunsuper Trustee agrees with the decision to decline
your claim, the Claims Team will contact you to advise you of
this outcome.
payment instructions have not been received, the Claims Team
If you disagree with this decision, you can lodge a written
will contact you to discuss your payment options.
complaint with Sunsuper. Your complaint will be investigated,
You have the choice of taking the payment in cash, leaving it
in your Sunsuper account or rolling it over to another approved
superannuation fund.
and if you are not satisfied with our response or we haven’t
responded within 90 days, you are then able to ask the
Superannuation Complaints Tribunal (SCT) whether you
are eligible to submit a complaint to them. The SCT is an
If you choose to take your benefit in cash (paid into your bank
independent body set up by the Commonwealth Government
account or via cheque), you’ll receive notification and details
to assist members (or their beneficiaries) in resolving certain
of the payment. PAYG tax will be withheld from your benefit
superannuation complaints. Before seeking the SCT’s help, you
where applicable.
must first lodge a complaint directly with Sunsuper. Time limits
If you choose to leave your benefit in Sunsuper, any insurance
proceeds will be moved into your chosen investment option(s)
(or the Lifecycle Investment Strategy where you haven’t made
affect when you can make a complaint to the SCT about a TPD
claim. Call the SCT on 1300 884 114 or visit their website
www.sct.gov.au for more information.
a choice).
Please note that if your claim is successful, you will no longer
be eligible to receive other default insurance cover from
Claim is deferred by Insurer
Sunsuper. To obtain cover in the future you would need to
re-apply for cover and provide evidence of your health. Your
application would be subject to acceptance by the insurer.
The Insurer may defer your claim for a period of time to
determine the full extent of your disability and to ascertain
whether it’s permanent. Your claim will be reviewed at the end
of this period, and either a decision will be made or your claim
may be deferred again.
13 11 84 sunsuper.com.au
9
1
TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
1.7 The TPD Assist insurance claim assessment process
The process outlined below applies for members claiming on TPD Assist cover in Sunsuper for life, where disablement occurred on or
after 1 July 2016. Where appropriate, occupational rehabilitation and retraining may be available with this type of cover to assist in
regaining the capability to earn a living. If you are unable to return to work and your TPD Assist claim is approved, you may receive up
to six annual support payments or a lump sum payment, subject to annual assessment and you continuing to meet the definition of
TPD Assist. The amount of a TPD Assist payment depends on your superannuation balance and how much insurance cover you have
at the time of injury or sickness/illness.
Claim forms are
received
Insurer assesses claim
Occupational
Rehabilitation
(if applicable)
10
Claim is declined
by Insurer
Claim is accepted
by Insurer
Sunsuper Trustee
reviews Insurer’s
decline of claim
Sunsuper Trustee
reviews Insurers’
acceptance of claim
and makes payment*
Sunsuper Trustee
disagrees with decline
Sunsuper Trustee
upholds decision to
decline claim
Sunsuper insurance claims guide
Claim is deferred
by Insurer
Annual Support
Payment or one off
Lump Sum
Claim forms are received
Sunsuper Trustee reviews
Insurer’s acceptance of claim
and makes payment
Once we have received your claim forms, the Claims Team will
review your application and ask you for any further information
The Sunsuper Trustee will review your claim. The Claims
we require. Once we have received all the information we require
Team will then contact you to advise that your claim has
for this initial stage, we can begin the assessment of your claim.
been approved. If you have already provided us with payment
Throughout the life of the claim, the Claims Team will keep you
instructions via the Benefit payment instruction form
updated on its progress.
(see page 4), we will pay your benefit accordingly. If your
payment instructions have not been received, the Claims Team
will contact you to discuss your payment options.
Insurer assesses claim
You have the choice of taking the payment in cash, leaving it
in your Sunsuper account or rolling it over to another approved
superannuation fund.
The Insurer will use the information you, your employer and your
If you choose to take your benefit in cash (paid into your bank
treating doctor provide when making its assessment.
account or via cheque), you’ll receive notification and details
The Insurer may also:
of the payment. PAYG tax will be withheld from your benefit
where applicable.
• ask for additional reports from your doctor/s
If you choose to leave your benefit in Sunsuper, any insurance
• ask you to provide more information
proceeds will be moved into your chosen investment option(s)
• ask your employer for more information, and/or
• make an appointment for you to have a medical examination
with an independent specialist/s.
(or the Lifecycle Investment Strategy where you haven’t made
a choice).
Please note that if your claim is successful, you will no longer
be eligible to receive other default insurance cover from
The Insurer will pay for any additional medical reports they
Sunsuper. To obtain cover in the future you would need to
request and examinations they arrange for you to attend.
re-apply for cover and provide evidence of your health. Your
Once all required information has been collected, the Insurer
application would be subject to acceptance by the insurer.
will assess your claim and decide whether your claim meets
the relevant TPD definition, it will ‘accept’, ‘defer’ or ‘decline’
your claim.
Claim is accepted by Insurer
Claim is declined by Insurer
If your insurance claim is declined by the Insurer, it will be
referred to the Sunsuper Trustee for review and consideration.
If the Sunsuper Trustee disagrees with the decision of the Insurer
If your insurance claim is accepted by the Insurer, the insurance
and believes that your claim should be reassessed, your claim
proceeds will be paid to Sunsuper and initially invested in the
will be referred back to the Insurer for their reconsideration.
Cash option. Funds will be held in this relatively stable investment
The Claims Team will contact you to advise you of the next steps.
option until the Sunsuper Trustee finalises payment to you.
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TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
Sunsuper Trustee reviews
Insurer’s decline of claim
Annual Support Payment
or one off Lump Sum
If the Sunsuper Trustee agrees with the decision to decline
TPD Assist claims can be paid in up to six Annual Support
your claim, the Claims Team will contact you to advise you of
Payments or a single lump sum. Annual Support Payments are
this outcome.
calculated as one sixth of your TPD cover amount as at your
If you disagree with this decision, you can lodge a written
complaint with Sunsuper. Your complaint will be investigated, and
if you are not satisfied with our response or we haven’t responded
within 90 days, you are then able to ask the Superannuation
Complaints Tribunal (SCT) whether you are eligible to submit a
Date of Disablement. If you are in receipt of Annual Support
Payments and your injury or illness continues to prevent
you from working an annual assessment will be undertaken.
This reassessment will be as close as possible to 12 months
after your prior Annual Support Payment
complaint to them. The SCT is an independent body set up by
If you are assessed as still being totally and permanently
the Commonwealth Government to assist members (or their
disabled an annual support payment will be paid. Where
beneficiaries) in resolving certain superannuation complaints.
deemed appropriate, our insurer will help determine what if any
Before seeking the SCT’s help, you must first lodge a complaint
ongoing rehabilitation and retraining services will assist..
directly with Sunsuper. Time limits affect when you can make a
complaint to the SCT about a TPD claim. Call the SCT on 1300 884
114 or visit their website www.sct.gov.au for more information.
If you are in receipt of Annual Support Payments and return
to work or become capable of returning to work (i.e. no longer
meeting the TPD Assist definition), part way through the five
year payment cycle the Annual Support Payments will cease.
Any remaining Death and TPD Assist cover may continue, based
Claim is deferred by Insurer
The Insurer may defer your claim for a period of time to
determine the full extent of your disability and to ascertain
whether it’s permanent. Your claim will be reviewed at the end
of this period, and either a decision will be made or your claim
may be deferred again.
Occupational Rehabilitation
(if applicable)
Occupational Rehabilitation may be appropriate in helping
some members return to work. Sunsuper will work with eligible
members, their treating doctors and employers to aid in recovery
and assist in returning to work. Participation in Occupational
Rehabilitation may be a compulsory part of the claims process.
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Sunsuper insurance claims guide
on your current age minus the total of any Annual Support Payments
paid during your claim. Premiums are adjusted accordingly.
TPD Assist’s Occupational Rehabilitation
At Sunsuper, we understand how meaningful it can be to
regain your ability to earn a living. When you are unable to
work due to illness or injury, your happiness and quality of
life can be greatly affected.
That’s why we may create an occupational rehabilitation
program to suit your individual needs as part of the TPD
Assist process. For eligible members, we will work with
you, your treating doctor and your employer to aid your
recovery and assist your return to work.
Your TPD Assist program may include:
• an initial assessment with your treating doctor to
identify your unique support needs
• engaging a an external occupational rehabilitation
provider
• guidance to help your treating doctor create a
personalised treatment plan for you
• coordination of support between your health
external rehabilitation consultant, treating doctor
and employer
• designing and implementing your own ‘return to
work’ plan—which may include re-skilling, retraining
and assisting your recovery via regular upgrading of
your work hours and duties as you improve
• work-related counselling and support for secondary
conditions (such as those that affect mental health)
• job-seeking advice and career guidance.
To see if occupational rehabilitation is appropriate for you,
or to find out more about how TPD Assist can help you
return to work, please call us on 13 11 84.
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TOTAL & PERMANENT DISABILITY INSURANCE CLAIMS
1.8 Frequently asked questions about TPD claims
Do I need a lawyer?
Our claims process has been designed so that in most cases,
you or your family should not require the assistance of a lawyer
when making a claim. We don’t give priority to claims lodged
by lawyers – all claims are dealt with in the same manner and
follow the same process. If you are thinking about seeking legal
help, we recommend that you first determine the costs involved
in doing so and how they will impact your benefit payout. We
recommend that you call us before seeking help from a lawyer.
When can I make a TPD claim?
If you are claiming for TPD, this means that you have been and
are still suffering from an ongoing and serious injury or sickness/
illness that is permanently preventing you from working or from
performing daily activities. To apply for a TPD claim, you must
satisfy the definition of ‘Total and Permanent Disability’ or
‘Total and Permanent Disability Assist’ and may need to meet
the ‘Waiting Period’ requirements. For definitions, refer to your
Insurance guide (Sunsuper for life and Sunsuper for life Business)
or your Corporate Plan guide (Sunsuper for life Corporate).
What if I am not sure I have insurance?
Waiting Periods do not apply to most TPD Assist claims. Please
check with the Sunsuper Claims Team for further information
about the type of claim you may be eligible to lodge.
How long do I have to lodge a claim?
The sooner you contact us regarding your intent to claim, the
quicker we can explore how we may assist you. To be eligible to
claim on TPD Assist and Tailored TPD insurance cover in Sunsuper
for life you must notify Sunsuper within five years of becoming
disabled. You may not be eligible to submit a claim if you contact
us after this period has ended. Please contact us as soon as you
are able to on 13 11 84 if you would like help making a claim or
have any questions.
Are there any injury or sickness/illness
exceptions?
You will not be eligible to make a TPD claim where your injury or
sickness/illness is caused, wholly or partly, directly or indirectly
from you being deployed to a hostile environment as part of
active military service.
• Login to Member Online and check your details at
sunsuper.com.au/memberonline
What happens if I have a
self-inflicted injury?
• review your most recent statement
In some instances, you will not be eligible to make a TPD claim
• or call us on 13 11 84
Why does it take so long?
There are many steps involved in assessing a claim. The process
is lengthy and can take a number of months. We and the Insurer
need to assess all relevant facts, including information from you,
your employer, your doctor and medical specialists to ensure
that the correct decision is made.
Is there a Waiting Period?
A waiting period may apply depending on the insurance
policy, as outlined in your Insurance guide (Sunsuper for life
and Sunsuper for life Business) or your Corporate Plan guide
(Sunsuper for life Corporate). The current Waiting Period for
a TPD claim, where one applies, is usually three months.
This means that you must have been absent from work as
a result of your injury or sickness/illness for a period of three
months or more before you can lodge a TPD claim.
if your injury or sickness/illness is caused by an intentional selfinflicted act. Please check with the Sunsuper Claims Team if this
applies to you.
How much will it cost?
To enable our Insurer to assess your claim, you’ll need to provide
medical evidence to support your application. The cost of
any information required to initiate the claim process is to be
met by you. This includes having a doctor complete a Medical
Attendant’s statement (if applicable). If the Insurer requests
additional information or reports from your doctor, or requests
an independent medical examination, the cost of these will be
paid by the Insurer.
What happens if I am receiving Income
Protection payments?
If you are receiving Income Protection payments, these will
continue as long as you satisfy the terms of the Income
Protection claim policy.
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Sunsuper insurance claims guide
What if I am self employed?
The process of making a claim remains the same irrespective
of whether you work for an organisation or work for yourself.
What if I am unemployed?
The assessment of your TPD claim may be based on a
different definition than if you were working. For definitions,
refer to your Insurance guide (Sunsuper for life and Sunsuper
for life Business) or your Corporate Plan guide (Sunsuper for
life Corporate).
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2
Death insurance
claims
We understand that dealing with
the loss of a loved one is a difficult
time. We are here to help you and
your family with the process of
applying for a death payment, and
we will do our best to help ensure
that your claim is dealt with as
quickly as possible.
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DEATH INSURANCE CLAIMS
2.1 What is a Death claim?
2.2 How to make a Death claim
A death claim is a claim for a deceased Sunsuper member’s
If you believe that you may be eligible to claim as a beneficiary
account balance. When the member had active death insurance
of the member, we are here to help throughout the claims
at their time of death, the death insurance cover is also included
process. The three major steps that you need to complete in
in the death claim.
order to submit your claim are listed below.
Step 1
Step 2
Before you call us, you will
need to prepare some basic
information about your claim
Call Sunsuper on 13 11 84
to start the claims process
This will allow us to start the claims process from
will be able to help with the first steps of the
You’ll be transferred to our Claims Team who
the moment we first speak to you.
claims process.
The necessary information includes:
The Claims Team will:
• The member’s Sunsuper membership number.
• confirm details of the member,
• You can find this number in the top
right hand corner of the member’s
Annual Statement as well as most other
correspondence from Sunsuper.
• advise you of the documents and information
you need to provide for the claim to be
assessed, and
• send you the claim forms for completion.
• The member’s date of birth.
• The member’s date of death.
• We will begin the death benefit claim process
as soon as we hear of a member’s death,
however formal notification is required for
any claim to proceed. We require a certified
copy of one of the following documents:
• death certificate
• coroner’s report
• autopsy report
• inquest finding
• a medical certificate of death, completed
by a registered medical practitioner.
Once we receive formal notification of the death,
the member’s existing account balance will be
switched into Sunsuper’s Cash Option, normally
within five working days. Funds will be held here
until the Sunsuper Trustee finalises payment to the
beneficiaries. This is a relatively stable investment
option subject to small growth and fluctuation.
Any insurance benefits will also be paid into
this option.
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Sunsuper insurance claims guide
Step 3
Complete and return the
claim forms
Please read all information we send to you
carefully, and take the time you need to gather
all information required to complete the claims
process. You will need to answer several questions
and provide us with additional information.
We recognise that this may be an emotional and
daunting task, and our Claims Team is here to help
you every step of the way. We will provide you with
the name and contact details of your own dedicated
Claims Representative who will assist with your claim
and help answer any questions you may have along
the way.
2.3 What does a Death benefit ‘claims pack’ contain?
The claims Pack includes a number of forms that you need to
Probate is a Court order that allows the Executor named in a
complete when making a claim for death benefits. Please do not
Will to manage the deceased individual’s estate and assets.
hesitate to call the Claims Team if you have any questions about
these forms as we want to ensure that your claim is progressed
as quickly as possible.
Letters of Administration: where the deceased has not left a
Will, a person may apply to the Supreme Court (in the State or
Territory in which the deceased resided) for a grant of Letters
1. Appointment of representative
of Administration. Generally, the deceased person’s next-of-kin
What is this form for: this form is to be completed if you wish
Probate, Letters of Administration allow the person appointed to
Sunsuper to communicate with, or release information to, a
administer the deceased’s estate. A person who is granted Letters
person or organisation acting on your behalf.
of Administration is called an ‘Administrator’.
Tips: Our claims process has been designed so that in most
3. Employer statement
cases you or your family should not require the assistance of
will be granted Letters of Administration. Similar to a grant of
a lawyer when making a claim. If you require assistance, our
What is this form for? This form is to be completed by the
dedicated Claims Team is here to help guide you through the
deceased member’s (previous) employer with whom they were
process. If you choose to seek professional help, we recommend
employed at the time of their death or immediately prior. This
that you first determine the costs involved in doing so and how
form will only be requested if there is active insurance at the
they will impact your benefit payout. We don’t give priority to
time of the deceased member’s death.
claims lodged by professionals – all claims are dealt with in the
same manner and follow the same process.
2. Death benefit claim form
Tips: We recommend that you contact the Human Resources
department from the deceased’s previous employer as this form
must be completed by an authorised person.
What is this form for: this form requests details about the
deceased Sunsuper member, including details about their
last employer and other superannuation accounts as well as
information about you, the claimant and your relationship to
the deceased. In order to ensure Sunsuper pays the correct
beneficiary, we are required to ask about the deceased
member’s family situation, including details about their spouse,
children, parents, living arrangements and financial affairs.
Tips: As this form references a lot of legal terms, we have
explained many of these below to make it quicker and easier for
you fill in this form.
A Will is a legal document that details how an individual’s
property and belongings are to be divided upon their death.
Under a Will, an ‘Executor’ – who is responsible for looking after
an individual’s estate – is appointed. Upon the individual’s death,
the executor will work out the individual’s assets, pay any debts
and then distribute the remaining assets in accordance with the
details of the Will.
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DEATH INSURANCE CLAIMS
2.4 What you will need to
provide in the death claim
Completing the claim forms is the largest and most important
step in the claim process. The details and evidence you provide
will form the basis upon which the Sunsuper Trustee and the
Insurer (if relevant) makes their decision. Providing us with all
the information we require and completing your forms correctly
will speed up your claims process. If information is missing or
incomplete, we will need to contact you to ask for it, which
will delay your claim. We understand that completing the claim
application may be a daunting and emotional task, and our
Claims Team is here to help you every step of the way. Please
contact the Claims Team who will assist you with any questions
you have about the information we require and completing your
claim forms.
Certified proof of your identity
You must provide a certified copy of your ID (for example,
a driver’s licence or passport) as proof of your identity.
Why? For security purposes we need to be sure of the identity
of the individual who is submitting the claim. Understandably,
you won’t want to send us your original documents, so we ask
that you have a copy certified by an authorised person.
Tips: See our Proof of Identity Requirements section for
information on what forms of ID are suitable and how to have
a copy certified.
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Sunsuper insurance claims guide
Death claims checklist
Before you send your claim through, make
sure you have fully and correctly completed
the following requirements:
□ A certified copy of your ID
□ Death benefit claim form
□ Employer statement
□ Full Certificate of Death – certified
□ Certificate of the deceased’s Birth or
an extract of Birth Entry
□ Last Will and Testament of the
deceased (if one was left)
□ Grant of Probate or Letters of
Administration (if already obtained)
□ Marriage Certificate of the deceased
(if applicable)
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DEATH INSURANCE CLAIMS
2.5 Death insurance claim assessment process
Claim forms are received
Claim is accepted
by the insurer
Insurer assesses claim
Sunsuper Trustee
assesses claim
Claim is declined by Insurer
Sunsuper trustee
disagrees with
insurer decision
Claim outcome is advised –
claim staking is required
Objection is received
Claim outcome is advised –
no claim staking is required
No objection is received
Sunsuper trustee agrees
with insurer decision
Claim payment
Please note: the process for Death claims for a deceased member’s account balance where there is no insurance, or where an insurance claim has been rejected,
is similar to the above but does not involve the insurer.
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Sunsuper insurance claims guide
Claim forms are received
Claim outcome is advised –
claim staking is required
Once we have received your claim form, your Claims
After a decision has been made, the Sunsuper Trustee will
Representative will review your application and ask you for any
contact all potential beneficiaries to advise where the benefit
further information we require. Once we have received all the
will be paid and in what proportions. This is referred to as
information we require for this initial stage, we can begin the
the ‘claim staking process’. Any interested parties who are
assessment of your claim. Throughout the claims process, your
unsatisfied with the determination will have 28 days to object.
Claims Representative will keep you updated on its progress.
Insurer assesses claim
Objection is received
If we receive an objection, we will contact all potential
Once you have provided the information requested, and we have
beneficiaries to advise them that an objection has been
confirmed that the member was insured at the date of death,
received and allow a period of time for any further submissions.
we will submit an insurance claim to the Insurer. If the insurer
The claim will then be resubmitted to the next claims committee
declines the claim, it is then referred to the Sunsuper Trustee
meeting where the Sunsuper Trustee will either confirm or
for review.
change the initial decision.
If the decision is confirmed, a confirmation letter will be sent
Claim is accepted
by the insurer
to the beneficiaries, which then allows another 28 days for
any potential beneficiaries still unsatisfied with the decision to
lodge a complaint with the Superannuation Complaints Tribunal
(SCT). If the decision is changed, applicants will once again
Once a claim is accepted by the insurer, it goes to the Sunsuper
Trustee to determine where the death benefit will be paid.
have 28 days to notify the Sunsuper Trustee of any objections.
If any party provides an objection to the revised decision, the
process of advising all interested parties and inviting further
submissions will be repeated before the claim is presented to
Sunsuper Trustee
assesses claim
Once all the information is obtained from possible beneficiaries,
the Sunsuper Trustee again.
Claim outcome is advised –
no claim staking is required
the claim is submitted to the Sunsuper Trustee to determine
where the benefit will be paid. The Claims Committee meets
once a month to make these decisions. Uncomplicated claims –
for example where there is a lifetime partner and no other
dependants – may be determined more frequently.
Claim staking is not required where a valid binding death
benefit nomination exists. It may also not be required where the
benefit amount is very small or in cases where there is only one
possible dependant.
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DEATH INSURANCE CLAIMS
Claim is declined by Insurer
If the claim is declined by the Insurer, it will be referred to the
Sunsuper Trustee for assessment. If the Sunsuper Trustee
disagrees with the decision of the Insurer and believes that the
claim should be approved, the claim will be referred back to the
Insurer for their reconsideration. Your Claims Representative
will contact you to advise you of the next steps. If the Sunsuper
Trustee agrees with the decision to decline the claim, your
Claims Representative will contact you to advise you of
this outcome.
If the Sunsuper Trustee agrees with the decision to decline the
claim, the Trustee will determine where the account balance
(excluding insurance proceeds) will be paid (please refer to the
Sunsuper Trustee assess claim section for further information).
If you disagree with this decision you can lodge a written
complaint with Sunsuper. Your complaint will be investigated,
and if you are not satisfied with our response or we haven’t
responded within 90 days, you are then able to ask the
Superannuation Complaints Tribunal (SCT) whether you
are eligible to submit a complaint to them. The SCT is an
independent body set up by the Commonwealth Government
to assist members (or their beneficiaries) in resolving certain
superannuation complaints. Before seeking the SCT’s help,
you must have first lodged a complaint directly with Sunsuper.
Time limits affect when you can make a complaint to the SCT
about a death claim. Call the SCT on 1300 884 114 or visit their
website www.sct.gov.au for more information.
Claim payment
Payment will generally be made to the beneficiaries within a
few days of the Sunsuper Trustee decision (if no claim staking
is required), or upon the 28 day objection period expiring,
provided there are no objections. For payment to be made, we
must have received certified proof of identity documents for the
beneficiaries, TFN (where applicable) and been notified how and
where the payment is to be made.
The Sunsuper Trustee will generally pay the benefit directly
to the beneficiaries determined, except in the case of minor
children, when we may pay to a parent or legal guardian on
behalf of a child, or pay to the Public Trustee.
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Sunsuper insurance claims guide
2.6 Frequently asked questions about death claims
Do I need a lawyer?
It is important to note, a de-facto relationship will generally
Our claims process has been designed so that in most cases,
basis. Also, in most cases, parents and friends aren’t considered
you or your family should not require the assistance of a lawyer
when making a claim. We don’t give priority to claims lodged
by lawyers – all claims are dealt with in the same manner and
follow the same process. If you are thinking about seeking legal
help, we recommend that you first determine the costs involved
in doing so and how they will impact your benefit payout. We
recommend that you call us before seeking help from a lawyer.
exist where a couple live together on a genuine domestic
dependants unless an interdependent relationship exists or the
person was dependant on the deceased for maintenance or
support at the time of death.
Legal Personal Representatives
Where a deceased has a valid Will, a legal personal
representative (LPR) is the executor of their estate. If no Will
What is a binding death nomination?
exists then the Supreme Court can appoint someone to be the
A binding death nomination is a legal instrument that binds
Letters of Administration’.
the Sunsuper Trustee to pay the death benefit to the deceased
member’s dependants, or legal personal representative nominated
by the deceased. Provided the nomination is valid and less than
LPR to administer the estate. This process is called a ‘Grant of
What is a dependant?
three years old, then the Sunsuper Trustee must pay the death
A dependant can be any spouse (including a de-facto), any
benefit in accordance with the nomination.
child, any person who was in an interdependent relationship
If the binding death benefit nomination is found to be invalid,
then the Sunsuper Trustee will use its discretion to determine how
the benefit is paid, much the same way as a preferred beneficiary
nomination. If there is a Court order that the Sunsuper Trustee
or any other person who the Sunsuper Trustee considers was
dependent on the deceased member for maintenance or support
(financial dependant), at the date of death.
is subject to, the Sunsuper Trustee will be bound to follow that
What is an interdependent relationship?
Court order. An invalid or lapsed nomination may still be used by
Someone can be in an interdependent relationship if they have a
the Sunsuper Trustee as a guide when paying the death benefit,
close personal relationship, they live together, one or each of them
however it does not ensure it will be paid in the same way as a
provides the other with financial support, and/or one or each of
valid binding death benefit nomination.
them provides the other with domestic support and personal care.
Who is eligible to receive the benefit?
Dependency can also arise where two people have a close
When deciding where the benefit will be paid, the Sunsuper
other with financial support or personal care because of a
Trustee will check to see if the deceased member had recorded
physical, intellectual or psychiatric disability.
their wishes concerning who their super benefits will be paid to
by completing a ‘binding death benefit nomination’. If there is a
valid binding death benefit nomination, the Sunsuper Trustee
is bound to pay the death benefit in accordance with that
nomination. If there is no binding death benefit nomination, or
the nomination is invalid, the Sunsuper Trustee will decide who
the death benefit will be paid to.
Regardless of whether there is a valid binding death benefit
nomination in place,the legislation dictates that a death
benefit can normally only be paid to a dependant, the deceased
member’s LPR, or a combination of deceased member’s
personal relationship, but don’t live together or provide each
A person wishing to be considered on the grounds of an
interdependent relationship will be asked to provide information
to substantiate the existence of the relationship. Examples of
this include, but are not limited to:
• evidence of a mutual commitment to a shared life
• evidence of jointly owned property or shared living costs
• public perception of a close personal relationship
• evidence of an intention that the relationship be permanent.
dependants and the LPR.
What is a financial dependant?
As a general rule, if there is no valid binding nomination,
A financial dependency may exist where you relied on the
a spouse (including a de-facto) and minor children will be given
deceased member for some or all of your financial needs (for
priority over other claimants (including adult children), especially
example, where you had an ongoing reliance on the deceased
claimants who were not financially dependent on the member.
member to assist with things such as rent or mortgage
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DEATH INSURANCE CLAIMS
payments, and without their assistance your standard of living
If the benefit is paid to the LPR, the death benefit is paid
could not be maintained).
directly to the deceased member’s estate and will be paid in
A person wishing to be considered on the grounds of financial
dependency will be asked to provide information to substantiate
the existence of dependency. This would require evidence
of either regular or irregular financial support from the
deceased member.
What happens if the deceased member
committed suicide?
In some instances, an insured death benefit will not be paid
where the death is caused by suicide or any intentional self-
accordance with the terms of the deceased member’s Will, and
will be subject to family provision claims and claims by any
creditors of the deceased member’s estate.
What is a Family Provision application?
A ‘Family Provision application’ is a challenge to a Will, which
occurs where a family member of the deceased feels that they
have not been adequately provided for under the Will.
Will tax be payable on the benefit?
inflicted act within 12 months of the deceased member’s
Generally tax is not payable if the benefit is paid to a
insurance cover start date. Please check with the Claims Team
dependant, unless the beneficiary is an adult child who is 18 or
to see if this applies in your circumstance.
more years of age and not ‘financially dependent’. Tax is also not
payable when paid to the LPR where the beneficiaries of the
Are there any other exceptions?
An insured death benefit will not be paid where the death is
caused, wholly or partly, directly or indirectly from the deceased
member being deployed to a hostile environment as part of
active military service.
Why does it take so long?
There are many steps involved in assessing a claim. The process
is lengthy and can take a number of months. Sunsuper needs
to assess all relevant facts to ensure that it is paying the death
estate are dependants of the deceased member under taxation
laws. Payment to most other beneficiaries will be taxable.
Tax on superannuation is complicated and we recommend you
speak to one of our qualified financial advisers to understand
how this will impact any benefits paid. Just call us on 13 11 84
to arrange an over the phone or in person appointment today.
Will funeral expenses be reimbursed?
Under the Sunsuper Trust Deed and superannuation law, there
is no specific provision that permits payment or reimbursement
benefit to the right person/people.
of funeral expenses from a superannuation death benefit. Any
How much will I be paid?
that payment, a dependant for superannuation purposes.
It is important that claimants understand that any insurance
Will I be eligible for an
anti-detriment payment?
benefit payable is determined at the date of the deceased
member’s death. The insurance benefit amounts shown on the
person who has paid funeral expenses is not, by reason only of
deceased member’s Annual statements or online are as at a
Some dependants may be eligible for an anti-detriment
specific time and may be different than the amount at the date
payment. This is essentially a payment that restores the
of their death.
deceased member’s super balance to what it would have
Total benefit paid will include the member’s account balance and
any insurance benefit payable.
What is the impact of where the benefit
is paid?
It is important to understand the impact of where the benefit
is paid. If the benefit is paid to a dependant, the death benefit
is paid directly to the person(s) and does not form part of the
deceased member’s estate. It is consequently excluded from
family provision claims against the deceased member’s estate
under relevant State or Territory legislation and from claims by
any creditors of the deceased member’s estate.
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Sunsuper insurance claims guide
been if contributions tax had not been paid on the taxable
contributions. If you are eligible for this payment, you will
automatically be paid a separate payment shortly after the
death benefit is paid. In some cases, PAYG tax on these
payments may be applicable.
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3
Income protection
insurance claims
We can appreciate that being
unable to work would be a difficult
and uncertain time for you. We will
strive to ensure that your claim is
processed in a timely manner so
you can receive a decision as quickly
as possible.
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INCOME PROTECTION INSURANCE CLAIMS
3.1 What is Income
Protection (IP) Insurance
Income Protection (IP) insurance provides you with a monthly
income while you’re unable to work due to temporary injury or
sickness/illness. It is intended to ease the financial burden of
your injury or sickness/illness by helping to cover the costs of
day-to-day living as well as your treatment costs.
To make an IP claim, you must meet the definition of ‘Total
Disability’ as outlined in your Insurance Guide (Sunsuper for life
and Sunsuper for life Business) or your Corporate Plan guide
(Sunsuper for life Corporate) and have become totally and
temporarily disabled while you were insured with Sunsuper.
3.2 How to make an IP claim
If you believe you that you may be eligible to apply for an IP
payment, we are here to help you along the way. To submit
your claim you need to complete three major steps:
Step 1
Step 2
Before you call us, you will
need to prepare some basic
information about your claim
Call Sunsuper on 13 11 84
to start the claims process
This will allow us to start the claims process from
the moment we first speak to you.
The necessary information includes:
• Your Sunsuper membership number
• You can find this number in the top right hand
corner of your Annual Statement as well as
most other correspondence from Sunsuper
You’ll be transferred to our Claims Team who
will be able to help with the first steps of the
claims process.
The Claims Team will:
• provide you with details of your current account
balance and insurance cover
• advise you of the documents and information you
need to provide for the claim to be assessed, and
• send you the IP claim forms for completion.
• Details about your injury/illness
• Date on which your injury first occurred or
your sickness/illness first presented itself
• Details and date of your diagnosis
• Details about your work status
• The date you last worked
• The amount of hours worked per week
leading up to your injury or sickness/illness
Step 3
Complete and return the
IP claim forms
Please read all information we send to you carefully,
and take the time you need to gather all information
required to complete the claims process. You will need
to answer several questions and provide us with
additional information. Completing the claim form is
the largest and most important step in this process:
the details and evidence you provide will form the
basis upon which the Insurer makes their decision in
regards to your IP claim.
We recognise that this may be a daunting task, and
our Claims Team is here to help you every step of the
way. We will provide you with the name and contact
details of your own dedicated Claims Representative
who will assist with your claim and help answer any
questions you may have along the way.
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Sunsuper insurance claims guide
3.3 What does an IP ‘claims pack’ contain?
There are a number of forms you will need to complete when
making an IP claim (detailed below). Please do not hesitate to
call the Claims Team if you have any questions. This will help us
to ensure that your claim is progressed as quickly as possible.
1. Claim Application
What is this form for? This form is to be completed by you. It
includes your contact information, employment details and basic
details about your injury or sickness/illness.
It will ask specific details about the work you performed leading
3. An Employer statement
What is this form for? This form is to be completed by your
employer with whom you were employed at the time of your
injury or sickness/illness. Your employer will be required to
detail the scope of your position and outline the types of duties
you performed in your role.
Tips: We recommend that you contact the Human Resources
department or your direct manager from your employer as this
form must be completed by an authorised person who worked
closely with you.
up to your injury or sickness/illness, how your injury or sickness/
illness has affected your ability to work, whether you’ve had
a similar condition before and whether you intend to claim
other benefits.
Tips: You must provide us with several pieces of information,
and these tips will help you to find them.
4. Centrelink Authority to Release
Personal Information
What is this form for? If you receive Centrelink benefits, you
must complete this form to give authority to Sunsuper and its
Insurer to obtain information about your benefits.
• The ‘Trading name of last employer’ will be detailed on your
payslip or your Payment Summary (group certificate)—the
Trading name of your last employer may not be the name you
know your employer as, so please check this carefully.
• ‘Fund of choice’ means the fund your employer was paying
into at the time of your injury or sickness/illness.
If you are unsure about the dates and hours you worked,
we recommend that you contact the Human Resources
department of your (previous) employer or refer back to your
previous payslips.
5. Authority to release personal
Medicare and Pharmaceutical
Benefits Scheme (PBS) claims
information
What are these form for? These forms provide authority
for release of information from both Medicare and the
Pharmaceutical Benefits Scheme (PBS) directly to the Insurer to
assist them with the assessment of your claim.
Please note: These forms are not required in every instance
2. Treating Doctor’s Report
and will only be included where necessary.
What is this form for? This form is to be completed by the
6. Tax File Number declaration
doctor who treated you at the time of your diagnosis. Their
statement will describe the nature and extent of your disability
What is this form for? We are required to advise the Australian
and provide evidence for it (such as medical records, test
Taxation Office that we are making income payments to you in
results etc.).
lieu of your salary.
Tips: We recommend that you phone your doctor and let them
know that you are in the process of making an IP claim. You may
be required to make an appointment with your doctor to have
them to complete this statement. Please note that you will be
responsible for the costs of this appointment and any other
costs involved in obtaining this statement.
7. Bank Account Nomination form
What is this form for? This form asks how you would like to
receive your money should your claim be successful.
Tips: Providing this information to us at the outset will ensure
that you can receive your payment without delay if your claim
is approved.
Remember, if you need assistance
please call the Claims Team
13 11 84 sunsuper.com.au
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INCOME PROTECTION INSURANCE CLAIMS
3.4 What you will need to
provide in your IP claim
Completing your IP claim forms is an important step in your
claim process. The details and evidence you provide will form
the basis upon which the Insurer makes their decision. Providing
us with all the information we require and completing your
forms correctly will speed up your claims process. If information
is missing or incomplete, we will need to contact you to ask for
it, which will delay your claim. We understand that completing
the claims application may be a daunting task, and our Claims
Team is here to help you every step of the way. Please contact
the Claims Team who will assist you with any questions you
have about the information we require and completing your
claim forms.
Certified proof of your identity
You must provide a certified copy of your ID as proof of your
identity (for example, a driver’s licence or passport).
Why? Your super is your money, so for security purposes,
we need to be sure that the super belongs to the person
submitting the claim. Understandably, you won’t want to send
us your original documents, so we ask that you have a copy
certified by an authorised person.
Tips: See our Proof of Identity Requirements section for
information on what forms of ID are suitable and how to have
a copy certified.
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Sunsuper insurance claims guide
Income Protection claims
checklist
Before you send your claim through, make
sure you have fully and correctly completed
the following requirements:
□ Certified proof of your ID
□ Claim Application
□ Treating Doctor’s Report
□ Employer statement
□ Centrelink Authority to Release
Personal Information (if required)
□ Authority to release personal Medicare
and Pharmaceutical Benefits Scheme
(PBS) Claims information (if required)
□ Tax File Number declaration
□ Bank Account Nomination form
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INCOME PROTECTION INSURANCE CLAIMS
3.5 The IP claim assessment process
Claim forms are received
Insurer assesses
the claim
Claim is accepted
by the Insurer
Claim is declined
by the Insurer
Claim outcome and
ongoing payment
Sunsuper Trustee reviews
Insurer’s decline of claim
Sunsuper Trustee
disagrees with decline
Sunsuper Trustee upholds
decision to decline
The Insurer may also:
Claim forms are received
• ask for additional reports from your doctor/s
• ask you to provide more information
• ask your employer for more information, and/or
Your dedicated Claims Representative will notify you once your
claim has been received. Your Claims Representative will review
your application and ask you for any further information we
• make an appointment for you to have a medical examination
with an independent specialist/s.
require. Once we have received all the information we require
The Insurer will pay for any additional medical reports they
for this initial stage, we can begin the assessment of your claim.
request and any examinations they arrange for you to attend.
Your Claims Representative will endeavour to keep you updated
on your claim’s progress each fortnight.
Insurer assesses the claim
Claim is accepted
by the Insurer
If your claim is accepted by the Insurer, we will contact you
to advise that your claim has been approved, arrange for
The Insurer will use the information you, your employer and your
payment directly to your bank account, and send you a payment
treating doctor provide when making its assessment.
confirmation letter.
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Sunsuper insurance claims guide
Claim outcome and
ongoing payment
Claim is declined by Insurer
If your claim is accepted and you remain unable to work,
If your claim is declined by the Insurer, this generally means
each month you will be asked to fill in a progress claim form
that the Insurer doesn’t regard you as ‘Totally Disabled’ or
and arrange for your treating doctor to complete a Medical
‘Partially Disabled’ according to the policy definition.
Attendant’s Statement form, so that the Insurer can consider
further payments. We will send these forms to you after each
payment, and you must return them at least 10 working days
before your next payment is due. Unless further medical
evidence is required, the prompt return of these forms will
Sunsuper Trustee reviews
Insurer’s decline of claim
ensure you receive your next payment on time. Please note you
are required to meet the cost for completion of these forms.
Benefit payments will generally continue until:
• you no longer satisfy the relevant definition, e.g. ‘Total
Disability’, ‘Limited Total Disability’ or ‘Partial Disability’
• you reach the end of the benefit payment period or you
turn 65 (whichever is earlier)
• you are employed under a Class 457, 422 or 418 working
All claims declined by the Insurer are referred to the Sunsuper
Trustee for assessment and consideration. If the Sunsuper
Trustee disagrees with the decision of the Insurer and believes
that your claim should be approved, your claim will be referred
back to the Insurer for their reconsideration. The Claims
Team will contact you to advise you of the next steps. If the
Sunsuper Trustee agrees with the decision to decline the
claim, your Claims Representative will contact you to advise
you of this outcome. If you disagree with this decision you
visa and the term of the Class 457, 422 or 418 visa
can lodge a written complaint with Sunsuper. Your complaint
expires, or you permanently depart Australia (whichever
will be investigated, and if you are not satisfied with our
occurs earlier)
response or we haven’t responded within 90 days, you may
• you reside overseas and have received 12 months
of payments, or
• your death.
ask the Superannuation Complaints Tribunal (SCT) whether you
are eligible to submit a complaint to them. Time limits apply that
affect when you can make a complaint to the SCT about an IP
claim. Call the SCT on 1300 884 114 or visit their website www.
sct.gov.au for more information.
13 11 84 sunsuper.com.au
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INCOME PROTECTION INSURANCE CLAIMS
3.6 Frequently Asked Questions about IP claims
Do I need a lawyer?
Are there any exclusions or restrictions?
Our claims process has been designed so that in most cases,
You will not be eligible to be paid an IP benefit if your injury
you or your family should not require the assistance of a lawyer
or illness/sickness is caused, wholly or partly, directly or
when making a claim. We don’t give priority to claims lodged
indirectly, from:
by lawyers – all claims are dealt with in the same manner and
follow the same process. If you are thinking about seeking legal
help, we recommend that you first determine the costs involved
in doing so and how they will impact your benefit payout. We
recommend that you call us before seeking help from a lawyer.
Do I have IP insurance?
Not all Sunsuper members have IP insurance. To check your
• deliberate self-inflicted injury or attempted suicide or self
destruction while sane or insane
• uncomplicated pregnancy, childbirth or miscarriage
• your deployment to a hostile environment as part of active
military service, or
• a criminal act committed by you.
level of cover, login to Member Online, review your Annual
Limited cover will apply to your Standard IP cover for a period of
Statement or call us on 13 11 84.
24 months and until you have been At Work for 30 consecutive
days at the end of the 24 month period.
Is there a Waiting Period?
In most cases, you will need to have been continuously unable
What happens if I’m partially disabled?
to work due to injury or sickness for a period of time: 30, 60,
A reduced monthly IP benefit may be payable if you become
90 or 180 days depending on your type of cover. The Waiting
‘Partially Disabled’. For definitions, refer to your Insurance
Period will begin from the date you are Totally Disabled and
guide (Sunsuper for life and Sunsuper for life Business) or
unable to work as certified by a medical practitioner.
your Corporate Plan guide (Sunsuper for life Corporate).
Do I have to re-start a Waiting Period
if I return to work?
How much will I be paid?
Generally, you may be able to return to work during the Waiting
Period, but it is important to contact us to check this applies
to you. If your waiting period is 30 days, you may be able to
work for up to five days without having to start the Waiting
Period again. If your Waiting Period is 60, 90 or 180 days, you
may be able to return to work for up to 10 days during that
time without having to re-start the Waiting Period. In these
circumstances, if you do return to work, your original Waiting
It is important to understand that any insurance benefit
amount is determined at the date you became disabled; the
insurance benefit amounts shown on your Annual statements
or in Member Online may therefore differ to the amount at your
disablement date.
The monthly benefit you will be paid will be the lower of:
• the level of cover selected by you less any offsets, and
• 75% of your monthly rate of Pre-Disability Income less any
Period may be extended by the number of days you work. If you
offsets, plus a superannuation contribution where this forms
return to work for longer than the periods specified above, then
part of your insured IP cover.
the Waiting Period may start again.
When are benefit payments made?
Once your claim has been accepted by the Insurer, your first
monthly payment will be paid in arrears one month after
the end of the waiting period. Subsequent payments are
made monthly.
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Will I pay tax on the benefit?
Your monthly benefit will be paid to you, less any PAYG tax
payable. You will receive a PAYG Payment Summary for IP
benefits paid to you during the financial year as soon as
possible after the 30th of June for inclusion in your annual
tax return.
Will there be offsets to my
benefit payment?
Your IP benefit payment may be reduced by the
following payments:
• Workers’ Compensation or Transport Accident Compensation
or similar legislation in relation to your injury or illness
• any other payments, statutory or otherwise, paid to you for
loss of income in relation your injury or sickness
• any other payments made under any disability income type
insurance policy, and/or
• any other lump sum payment which relates to loss of income
due to injury or illness (other than a TPD or terminal illness
benefit under the relevant Policy).
Your IP benefit payment may also be reduced by any sick
leave from your employer, however you are generally not
required to use all your sick leave before receiving an Income
Protection benefit.
What happens if I have a recurring
injury or sickness/illness?
Following a claim, if you make a further claim arising from
the same or related cause as the first claim, the further claim
will be:
a)treated as a separate claim if it occurred after you returned
to work for at least 6 continuous months, or
b)deemed to be a continuation of the original claim if made
within 6 months from the end of payments from the earlier
claim. A further Waiting Period will not apply in this case,
however the relevant benefit period will be adjusted to take
into account prior benefits paid under the relevant policy for
the original claim.
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Occupational Rehabilitation in Super –
‘Work is Good Medicine’
Returning to work can restore more than your
income: it helps to restore your identity and
self-esteem.
At Sunsuper, we work with our insurers to
offer you access to one of the largest and most
experienced rehabilitation teams. This means
that if you have suffered an injury, disability
or health condition, we can arrange workrelated rehabilitation to assist in your return to
meaningful work.
Together with our insurers, we work in
partnership with you, your treating health
professionals and employer to help you return
to suitable work as part of your recovery
plan. If you are unemployed, we can help you
improve your readiness for work and/or locate
suitable employment.
Occupational rehabilitation services may include:
• initial meetings with a rehabilitation provider
to identify your return to work needs
• workplace visits to identify solutions for
your return to work plan
• equipment to ensure you maintain your job
• career guidance to explore alternative work
options if you can’t work in your usual role
• improving your skills and capabilities so that
your return to work is sustainable.
Rehabilitation is not appropriate for everyone.
If you would like further information about
your rehabilitation options please speak with
your Claims Representative at Sunsuper by
calling 13 11 84.
Together we may be able to assist you in
getting back to work and back to a fuller life!
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4
Terminal illness
claims
We know this must be a distressing
and difficult time for you. We are
here for you to help resolve your
claim as quickly as possible.
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TERMINAL ILLNESS CLAIMS
4.1 What is a Terminal
Illness (TI) claim?
Cover for Terminal Illness (TI) is included as part of death cover
with Sunsuper. If your TI claim is approved, you will be able to
a)two registered medical practitioners have certified, jointly or
separately, that you suffer from an illness, or have incurred
an injury, that is likely to result in your death within the
period specified in the relevant insurance policy
b)at least one of the registered medical practitioners must
withdraw your superannuation account balance and any insured
be a specialist practicing in an area related to the illness or
benefit. If you don’t have insurance with us, you may be able to
injury suffered by the person, and
claim your super balance as a Terminal Medical Condition (TMC)
benefit.
c)for each of the certificates, the certification period has
not ended.
How is terminal illness defined?
A person is considered to be suffering a terminal illness
condition if two doctors certify the person is likely to pass away
within 12 or 24 months depending on the insurance policy that
applies to you, as set out in your Insurance Guide (Sunsuper for
4.2 How to make a TI claim
If you believe you that you are eligible to make a TI claim, we
are here to help you through the process. There are three major
steps you need to complete:
life and Sunsuper for life Business) or your Corporate Plan guide
(Sunsuper for life Corporate).* The definition is:
Step 1
Step 2
Before you call us, you will
need to prepare some basic
information about your claim
Call Sunsuper on 13 11 84
to start the claims process
This will allow us to start the claims process from
will be able to help with the first steps of the
You’ll be transferred to our Claims Team who
the moment we first speak to you.
claims process.
The necessary information includes:
The Claims Team will:
• Your Sunsuper membership number
• You can find this number in the top right hand
corner of your Annual Statement as well as
most other correspondence from Sunsuper
• Details about your terminal illness
• provide you with details of your current account
balance and insurance cover
• advise you of the documents and information you
need to provide for the claim to be assessed, and
• send you the TI claim forms for completion.
• Date on which your condition first
presented itself
• Details and date of your diagnosis
Step 3
Complete and return the
TI claim forms
Please read all information we send to you carefully,
and take the time you need to gather the information
required to complete the claims process. You will need
*
egardless of whether you have a 12 month or 24 month terminal
R
illness criteria for your insurance cover, to assess your account balance
under the Terminal Medical Condition (TMC) condition of release, 24
months applies. Depending on your situation, you may wish to consider
applying for a TMC benefit to access part of your account balance if
you don’t yet qualify for a TI insurance benefit. In this situation it is
important to leave enough money in your account for your insurance to
continue. Contact the Claims Team for more information.
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Sunsuper insurance claims guide
to answer several questions and provide us with
additional information.
We recognise that this may be a daunting task, and our
Claims Team is here to help you every step of the way.
4.3 What does a TI ‘claims pack’ contain?
1. Application for early release of
benefit form
To be eligible to claim on Terminal Illness, your doctors must
What is this form for? This form is to be completed by you.
certify that you are likely to pass away within the time specified
It includes your contact information, employment details and
basic details about your medical condition.
2. Employer statement
What is this form for? This form is to be completed by your
(previous) employer with whom you were employed at the time
of being advised of your medical condition.
Tips: We recommend that you contact the Human
Resources department or your direct manager from your
(previous) employer, as this form must be completed by an
authorised person.
3. Authority to access information
What is this form? We recognised that you may wish to have
someone act on your behalf during the claim process. This form
provides the authority required to nominate such a person.
4. Medical Practitioners certificate
in the relevant insurance policy (12 or 24 months). This form
needs to be completed by:
a)two registered medical practitioners who certify, jointly or
separately, that you suffer from an illness, or have incurred
an injury, that is likely to result in your death within a
period (the certification period) that ends not more than the
timeframe specified in the relevant insurance policy (12 or
24 months) after the date of certification, and
b)at least one of the registered medical practitioners must
be a specialist practicing in an area related to the illness or
injury suffered by the person, and
c)for each of the certificates, the certification period has
not ended.
5. Binding death nomination form
You may want to consider completing a Binding death benefit
nomination. This will give you certainty about who will receive
any death benefit, and in most cases it will also reduce the time
taken to pay the benefits to your beneficiaries.
13 11 84 sunsuper.com.au
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TERMINAL ILLNESS CLAIMS
4.4 What you will need to
provide in your TI claim
4.5 The TI claim assessment
process
Completing your TI claim application is the largest and most
Coordination and assessment of
your application
important step in the claim process. The details and evidence
you provide will form the basis upon which the Insurer makes
their decision. Providing us with all the information we require
and completing your forms correctly will speed up your claims
process. If information is missing or incomplete, we will need
to contact you to ask for it, which will delay your claim. We
understand that completing the claim application may be a
daunting and emotional task, and our Claims Team is here to
help you every step of the way.
Certified proof of your identity
You must provide a certified copy of your ID (for example, a
driver’s licence or passport) as proof of your identity.
We will check your application is complete and contact you if
we need further details. If you have insurance, your application
will be forwarded to our Insurer for initial assessment and
then sent on to the Sunsuper Trustee. Please note that Claims
Representatives do not review medical evidence or make any
decision about applications. They will act as a liaison between
you and the Sunsuper Trustee and/or the Insurer, and are there
to help answer any questions you may have during the process.
Payment of your claim
If your claim is accepted, payment will be made to you by the
Why? For security purposes we need to be sure of the identity
method you indicate on the application form. You will also
of the individual who is submitting the claim. Understandably,
receive a Member benefit statement.
you won’t want to send us your original documents, so we ask
that you have a copy certified by an authorised person.
Tips: See our Proof of Identity Requirements section for
information on what forms of ID are suitable and how to have
a copy certified.
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Sunsuper insurance claims guide
4.6 Frequently Asked Questions about TI claims
Do I need a lawyer?
How much will I be paid?
Our claims process has been designed so that in most cases,
It is important to note that the amount of any insurance benefit
you or your family should not require the assistance of a lawyer
payable is determined at the date of the most recent written
when making a claim. We don’t give priority to claims lodged
certification1. The insurance benefit amounts shown on your
by lawyers – all claims are dealt with in the same manner and
Annual Statements or online may be different than the amount
follow the same process. If you are thinking about seeking legal
at the date of the most recent written certification1. It is also
help, we recommend that you first determine the costs involved
important to note that any increases to benefit levels may be
in doing so and how they will impact your benefit payout. We
subject to ‘at work’ certification. Please refer to the Insurance
recommend that you call us before seeking help from a lawyer.
Guide or contact us on 13 11 84 for further information.
How much would I be entitled to?
Are there any tax implications?
If you are assessed as suffering a terminal medical condition,
Before taking your money early, you should investigate whether
you are entitled to cash-out your entire Sunsuper account
there may be tax implications for you or your dependants: for
balance. Additionally, if you have death insurance cover, you
example, eligibility for anti-detriment payments will change if
could apply to receive the amount you are insured for at the
a benefit amount is cashed out before death. We recommend
date of the most recent written certification1. Any death cover
you speak to a financial advisor to discuss your options in more
you have over this amount will remain as your new death
detail. Our qualified financial planners2 in our Member Advice
insurance cover, provided premiums continue to be paid and a
Centre can help on 13 11 84.
minimum balance is maintained, otherwise your insurance will
stop once the benefit has been paid.
What happens if I am receiving an
Income Protection payment?
If you are currently receiving an Income Protection payment
through Sunsuper, it will continue to be paid, subject to the
relevant benefit period, terms and conditions.
How do I prepare for the application
process not being completed before
my death?
A Binding death benefit nomination is a form that will allow
you to nominate who will receive your death benefit. This form
will ensure that we can pay any benefit from a successful claim
that is not processed until after your death to your nominated
beneficiaries as quickly as possible. Please contact us or read
our ‘Safeguarding your family’ fact sheet on our website for
more information.
1
‘Date of the most recent written certification’ means the date your doctor signs the written certification that certifies you suffer from an illness, or have incurred
an injury, that is likely to result in your death within 12 or 24 months from date of certification, depending on the relevant insurance policy.
2
ur phone based qualified financial planners provide simple advice about your Sunsuper account at no additional cost. More comprehensive advice may incur
O
a fee. Sunsuper employees provide advice as representatives of Sunsuper Financial Services Pty Ltd (ABN 50 087 154 818 AFSL No. 227867) (SFS), wholly
owned by the Sunsuper Superannuation Fund.
13 11 84 sunsuper.com.au
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5
Proof of identity
requirements
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5
PROOF OF IDENTITY REQUIREMENTS
when it comes to safeguarding your money; and no-one is
What is an acceptable identification
document?
immune. That’s why super funds will ask you to provide certain
Any one of the following documents will be accepted as
information and documents about your identity when you
primary identification:
Australia’s $2 trillion super pot represents a large and growing
temptation for criminals, with identity theft the biggest risk
request money from your account. We need to be sure that the
super belongs to the person making the claim. Getting your
identity documents together to access your money may seem
like an unnecessary hassle, but we can assure you it’s essential,
your protection is our top priority.
When do you need to prove your
identity?
All super funds, including Sunsuper, will ask you to provide
certified identification before paying any money out.
If you cannot provide us with one of the primary identification
documents outlined on this page, then we may accept two of
the documents listed in the table on the following page, one
document from each column. It’s important to note we cannot
accept documents that have expired. We also reserve the right
to request additional information to verify your identity before
paying your benefit claim.
• a driver’s licence or permit issued under a law of a State or
Territory, or equivalent authority of a foreign country, that
contains your photo, name, residential address and date of
birth (please copy and certify both front and back sections
if relevant)
• a passport issued by the Commonwealth
• a card issued under a law of a State or Territory for the
purpose of proving the person’s age which contains your
photo, name and date of birth (please copy and certify both
front and back sections if relevant), or
• a passport or a similar document issued for the purpose of
international travel or a national identity card issued for the
purpose of identification that:
A. contains your photo, name and signature
B. is issued by a foreign government, the United Nations
or an agency of the United Nations
C. if written in a language that is not understood
by the person carrying out the verification, is
accompanied by an English translation prepared by an
accredited translator.
If you don’t have any primary identification, see the table over
for acceptable forms of secondary identification.
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Sunsuper insurance claims guide
One document from this column
• A birth certificate or birth extract issued by a State
or Territory
• A citizenship certificate issued by the Commonwealth
• A citizenship certificate issued by a foreign government
• A birth certificate issued by a foreign government, the
United Nations or an agency of the United Nations
plus
One document from this column
A notice that:
a)was issued to you by the Commonwealth, a State or
a Territory within the preceding 12 months,
b) contains your name and your residential address, and
c)records the provision of financial benefits to you under
a law of the Commonwealth, State or Territory (as the
case may be).
• A pension card issued by the Department of Human
Services that entitles you to financial benefits
• A healthcare card issued by the Department of Human
Services that entitles you to financial benefits
A notice that:
a)was issued to you by the Australian Taxation Office
within the preceding 12 months,
b) contains your name and your residential address, and
c)records a debt payable to or by you to the
Commonwealth under Commonwealth law relating
to taxation.
A notice that:
a)was issued to you by a local government body or utilities
provider within the preceding three months,
b) contains your name and your residential address, and
c)records the provision of services by that local
government body or utilities provider to your address or
to that person.
In relation to a person under the age of 18, a notice that:
a)was issued to you by a school principal within the
preceding three months,
b) contains your name and your residential address, and
c) records the period of time you attended the school.
Note: If any of the approved documents have been issued by
a foreign government and are written in a language that is not
understood by the person carrying out the verification, the
documents must be accompanied by an English translation
prepared by an accredited translator.
Examples of acceptable linking documents are:
• certificate from the Births, Deaths and Marriages
Registration Office or relevant government source from the
issuing country (i.e. marriage certificate or change of name)
• deed poll or decree nisi.
What if you’ve recently changed
your name?
What do we mean by certified?
If you have changed your name and have not yet advised us,
We understand you’ll want to provide us with copies of your
you will need to provide what is called a ‘linking document’. A
linking document is used to prove a relationship exists between
two (or more) names.
identification documents rather than the originals. However,
you must have these copies ‘certified’ as a true copy of the
original. This means that you need to have a person who
is authorised to certify documents (see the section on the
following page) sight the original document and the copy of
the documents (e.g. a photocopy) to make sure both documents
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5
PROOF OF IDENTITY REQUIREMENTS
are identical, and then ‘certify’ all copied pages as true copies
by writing or stamping ‘certified true copy’ on them. They must
also sign and print their name on the document and record their
qualification (e.g. Justice of the Peace) and the date.
•
Accountant (member of ICA, ASA, IPA or CPA, ATMA, NTAA)
•
Veterinary surgeon
•
Bank officer, building society officer, credit union officer,
finance company officer – employed for five years or more
Who can certify your identification
documents in Australia?
• Justice of the Peace, commissioner of declarations, or
Only certain people are authorised to certify documents in
• police officer, sheriff or sheriff’s officer
Australia. Approved people include those who are currently
authorised to witness a statutory declaration under the
Statutory Declarations Regulations 1993 (Commonwealth),
commissioner of affidavits
• notary public
• Those who hold a Court position, such as a Bailiff, Judge,
Schedule 2, Part 1 and Part 2.
Magistrate, Registrar, or Deputy Registrar, Clerk, Master of
a court, CEO of a Commonwealth court
People authorised to certify your documents include a:
• Health professional, such as a Chiropractor, Dentist,
• Government representatives (elected): Federal, State or
Territory or Local
Medical practitioner, Nurse, Optometrist, Pharmacist,
Physiotherapist, Psychologist
• Public servants: Federal, State or Territory or Local –
employed for five years or more.
• Legal professional, such as a Legal practitioner, Patent
attorney, Trade marks attorney
• Teacher (full-time) at a school or tertiary
education institution
• Minister of religion, or marriage celebrant.
If you are unable to locate any of the above certifiers, others
may be accepted. We recommend you contact us on 13 11 84
to confirm who else we will accept as a certifier.
What does a certified identity document look like?
This is what a certified proof of identity document
should look like:
Copy of the document that identifies you, (i.e. your passport or
driver’s license – front and back)
Write or stamp “certified true copy” of original document
Have the authorised person sign the document
Authorised person’s stamp and registration number
(if applicable)
Name, qualification, phone number and address of
authorised person, and
Date of authorisation
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Sunsuper insurance claims guide
What if you live overseas?
• Judge of a Court or magistrate in an overseas jurisdiction
If your claim is submitted from outside Australia, we still require
• international Justice of the Peace (JP)
certified identification documents before we can pay out
• registrar or deputy registrar of a Court
your benefit.
The list of acceptable documents is still the same; however,
we can only accept certified identification documents that are
signed by an:
• Australian consular officer
• commissioner of oaths.
The person who is authorised to certify documents must sight
the original and the copy to make sure both documents are
identical, and then ‘certify’ all copied pages as true copies
by writing or stamping ‘certified true copy’ followed by their
• Australian diplomatic officer
signature, printed name, qualification (e.g. police officer)
• police officer of an overseas force
Examples of what is acceptable include:
and date. We also require evidence of the certifier’s status.
• notary public
Qualification
Certification Required
Police officer
Details of their police badge number
Judge or magistrate
Certificate of their appointment to their position
Justice of the Peace
Justice of the Peace stamp or number
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51
make your dreams
more than dreams
Contacting us is easy:
13 11 84 (+61 7 3121 0700 when overseas)
GPO Box 2924 Brisbane QLD 4001
sunsuper.com.au
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facebook.com/sunsuper
linkedin.com/company/sunsuper
Sunsuper Pty Ltd Sunsuper Superannuation Fund
ABN 88 010 720 840 ABN 98 503 137 921
AFSL No. 228975 SPIN SSR 0100 AU
MySuper Authorisation 98 503 137 921 996
Unique Super Identifier (USI) 98 503 137 921 001
Sunsuper is a member of The Association of Superannuation Funds
of Australia Limited (ASFA).
Copyright ©2016 Sunsuper Pty Ltd 1860 (07/16)
The Sunsuper insurance claims guide is prepared and issued
by Sunsuper Pty Ltd, the issuer and Trustee of the Sunsuper
Superannuation Fund (referred to as ‘the Fund’ or ‘Sunsuper’):