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Fact sheet Claiming an Income Protection benefit

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					    Fact sheet
    Claiming an Income Protection benefit
    If you have Income Protection cover and become disabled and temporarily unable to work
    due to an illness, injury or accident, you may be eligible to claim an Income Protection benefit.
    If you are unsure if you have this type of cover, please contact us on 1300 300 273.


What is Income Protection?
Income Protection provides a monthly benefit for a period of             Easy steps to making a claim
up to two years when you are unable to work temporarily due
                                                                     Step 1 – Intention to claim
to a disability caused by illness or injury. (If you are a member
of the FinSuper Division you may have elected long-term              • Tell us you wish to lodge a claim for an Income Protection
Income Protection cover, which provides a monthly benefit              benefit by calling us on 1300 659 337.
until age 65.)                                                       • We will send you all the relevant information and
                                                                       documentation you and your doctor need to complete and
Income Protection cover in AustralianSuper is provided through
                                                                       provide to us to get the process underway. Your employer
a policy with CommInsure (the ‘Insurer’).
                                                                       will also need to provide us with relevant information before
                                                                       we can lodge a claim.
How much is my benefit worth?
If the Insurer accepts your claim application for an Income          Step 2 – Lodging the claim
Protection benefit, your monthly benefit will be the lesser
                                                                     • Complete the forms and return them to us along with all
of either:
                                                                       necessary documentation.
• $500 for each unit of Income Protection cover you have, or         • We will forward everything to CommInsure for assessment.
• 85% of your salary (75% salary + 10% super),
   subject to a maximum of $20,000 per month.                        Step 3 – Assessing the claim
Income Protection benefit amounts up to 75% of your salary
                                                                     • CommInsure assesses your claim and makes a
are paid directly to you. Any additional benefit of up to 10% will
                                                                       determination as to whether you are eligible to receive
be paid to your AustralianSuper account and taxed as if it were
                                                                       benefits under the Policy. It is important to note that
an employer contribution.
                                                                       CommInsure may ask for additional information or
Please also note that your monthly benefit may be reduced by           for a progress medical report from your doctor.
the amount of income you receive from other sources such             • CommInsure will not assess your claim until your waiting
as Workers’ Compensation, sick leave payments and benefits             period has expired.
payable under other Income Protection policies. It may also
be reduced by the amount of income earned from working               Step 4 – Paying the benefit
elsewhere or any income the Insurer reasonably expects you
                                                                     • If your claim is accepted, you will be notified by
to earn if you are able to resume work while disabled at
                                                                       CommInsure.
reduced hours after your waiting period expires.
                                                                     • CommInsure will deduct PAYG tax before paying you
What are the waiting periods?                                          a monthly benefit in arrears.
The waiting period is the time you are required to be                • You will receive a payslip with each payment and at the end
continuously disabled before an Income Protection benefit              of the financial year you will receive a payment summary.
becomes payable. You must be totally disabled for at least           • Up to 10% will be remitted to AustralianSuper as an
14 of the first 19 consecutive days of the waiting period to           employer contribution.
qualify for a benefit. The waiting period commences on the
day a medical practitioner examines you and certifies that you       Step 5 – Ongoing eligibility
are (temporarily) totally disabled.                                  • At the end of each assessment period (which is determined
AustralianSuper Industry or Personal Plan members with                 by CommInsure), you and your doctor will be required to
Income Protection cover have either a 30- or 90-day waiting            complete a report for CommInsure to show that you are
period before a claim can be lodged. (If you are a member of           still eligible to receive the Income Protection benefit.
the FinSuper Division you have a waiting period of the greater
of 30 days or your accumulated sick leave entitlement.)


  www.australiansuper.com	                                                                                   						1300	659	337
   Claiming an Income Protection benefit (continued)

What will it cost to lodge a claim?                                                    Your complaint will be investigated and a response forwarded as
You will need to pay the cost of obtaining the initial Medical                         quickly as possible; however, responses may take up to 90 days.
Attendant’s Statement completed by your treating doctor                                To make a complaint contact:
or specialist. Should the Insurer ask for a progress medical                                        The Complaints Officer
report you may also be responsible for the cost of getting the                                      AustralianSuper
report completed. There may also be other costs associated                                          Locked Bag 999
with claiming a benefit such as mailing claim forms to us or                                        Carlton South Vic 3053
calling your employer.
                                                                                       If you are not satisfied with AustralianSuper’s handling of your
What happens if my claim is declined?                                                  complaint or its resolution, you may contact the Superannuation
If the Insurer determines that your claim is declined this                             Complaints Tribunal (SCT). The SCT is an independent body
generally means that the Insurer does not regard you as                                set up by the Federal Government to assist members (or their
having met the conditions for an Income Protection benefit.                            beneficiaries) to resolve certain superannuation complaints. The
In this instance your claim will be referred to the Claims                             SCT may be able to help you resolve your complaint, but only
Review Committee (CRC).                                                                after you have used AustralianSuper’s own complaints-handling
                                                                                       process.
Claims Review Committee (CRC)                                                          You can contact the SCT on 1800 780 808 for more
The CRC is set up by the Fund Trustee. Its job is to ensure                            information.
that the Insurer’s decisions are reasonable and comply with
the insurance contract and the Fund’s Trust Deed. If the
CRC disagrees with the Insurer’s decision it may ask                                              How to contact us
the Insurer to reconsider your claim or ask for further                                   If you have any questions, we’re here to help.
information. Alternatively, the CRC may agree with the
Insurer’s assessment. You will be notified of the outcome                                 Call:    1300 659 337
of the CRC meeting and given a reason for the decision.                                   Email: email@australiansuper.com

What if I am not satisfied?                                                               Mail: AustralianSuper Insurance
                                                                                                Locked Bag 999
If your claim is declined and you disagree with the decision
                                                                                                Carlton South Vic 3053
or you are not satisfied with the way your claim has been
handled, you may lodge a complaint in writing with the Fund.




Trustee of AustralianSuper (ABN 65 714 394 898)
This document is a summary only of the main features of the Income Protection insurance cover for AustralianSuper members. Further details are included in the
AustralianSuper Trust Deed and the Group Income Protection Policy between AustralianSuper and CommInsure. While every care has been taken in preparing this
document, benefits can only be paid in accordance with the Trust Deed and Rules of AustralianSuper and the Group Income Protection Policy in force at the relevant time.
                                                      ,
Issued by AustralianSuper Pty Ltd, ABN 94 006 457 987 AFSL 233788, RSEL L0000796, the Trustee of AustralianSuper, RSE R1001693.

  www.australiansuper.com	                                                                                                                    						1300	659	337
                                                                                                                                                             September 2007

				
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Description: Fact sheet Claiming an Income Protection benefit