• Making an insurance claim

  • Although you may not like to consider the prospect of having to make a claim on your superannuation insurance benefits, it’s important to become familiar with the claims process in case the need should ever arise.
  • Our insurer

    • The insurance benefits offered to Australian Catholic Superannuation members are provided by our insurer, OnePath. OnePath is part of the ANZ Banking Group which has been in operation for over 175 years. OnePath is one of Australia’s leading providers of life and general insurance and has a strong record of claim payments.

      Below is the current approved claim rate for all claims made (since 1 July 2006 to October 2015) by members of the Fund:

      Type of claim Fund approval rate
      Income protection (temporary salary continuance – TSC) 98.05%
      Death 99.60%
      Terminal illness 98.88%
      Total and permanent disablement (TPD) 90.00%

      OnePath and Australian Catholic Superannuation are committed to ensuring that all genuine claims are treated with understanding and in an efficient manner.

  • Is a lawyer required to make a claim?

    • Many members believe they require legal representation to make a claim, but this is not the case.

      In fact, the vast majority of genuine claims are straight-forward and all claims can be lodged directly through Australian Catholic Superannuation.

      Many members are already experiencing great financial stress at the time of making a claim and this can be exacerbated further once costly legal fees are deducted from members’ benefit entitlements.

      It’s also important to note that there are appeals procedures in place should you not be satisfied with the way that your claim has been assessed.

      So, prior to signing a contract with a lawyer to act on your behalf, you should expect the procedures, costs, timeframe and risks involved in taking the matter to court to be clearly explained to you. It’s possible that you could not only lose the case, but also have costs awarded against you. In this case, you would have to pay your own lawyers and the legal costs incurred by the insurer. This can prove to be a very expensive and uncertain course of action.

      Outlined below is a simple step-by-step guide on making an insurance claim directly through our Fund.

  • Claiming an income protection (TSC) benefit

      1. Contact the Fund if you are ill or injured and have been unable to work for the consecutive number of days of your specified waiting period.
      2. We will then arrange for the required claim forms to be sent to you for completion. Completed forms should be returned to our office.
      3. We will then forward your paperwork to OnePath. They will confirm employment details with your employer and assess your claim.
      4. Depending on the information contained in the original forms, you may be required to provide additional medical information or asked to see an independent doctor or specialist.
      5. Once all requested information is obtained by the Fund and the insurer, you will then be advised whether or not your claim has been approved.
      6. If your claim is accepted and once payments commence to you, a monthly medical report will be required from your medical practitioner for the duration of your benefit period, or until you are able to return to work.
      7. If your claim was not successful, you are able to appeal the decision and provide any further information that may support your appeal. You are also able to lodge an official complaint through Australian Catholic Superannuation’s internal complaints procedure.
  • Claiming a total and permanent disablement benefit

      1. Contact the Fund if you are ill or injured and your doctor has confirmed that you will not be able to return to work.
      2. We will then send out the relevant forms to you, your employer and your doctor for completion. Completed forms should be returned to our office.
      3. We will then forward your paperwork to OnePath for assessment of your claim.
      4. Depending on the information contained in the original forms, you may be required to provide additional medical information or asked to see an independent doctor or specialist.
      5. Once all requested information is obtained by the Fund and the insurer, you will then be advised whether or not your claim has been approved.
      6. If your claim was not successful, you are able to appeal the decision and provide any further information that may support your appeal. You are also able to lodge an official complaint through the Fund’s internal complaints procedure.


      Even if you do not have TPD insurance cover, you should still contact the Fund as you may be able to claim your accumulated superannuation balance.

  • Claiming a death benefit

      1. Upon the death of a member, the member’s nominated beneficiary or legal personal representative should advise the Fund of these circumstances as soon as possible.
      2. We will then inform all beneficiaries, or the member’s legal personal representative, of what is required in order to assess their claim for death benefits. Typically, this may include provision of contact details for the member’s legal personal representative, as well as certified copies of the following documents:
        •  Death certificate
        •  Birth certificates (for the deceased and any dependant children)
        •  Proof of name change (e.g. marriage certificate, if the name on the death certificate is different to that which appeared on the deceased’s birth certificate)
        •  Will, Probate or Letters of Administration. 
      3. Once all claim requirements have been met, the Fund will forward the relevant information on to the insurer for assessment.
      4. When an insurance benefit is paid to the Fund by the insurer, the Trustee will then determine how the benefit is to be distributed between the member’s nominated beneficiaries and/or estate. This process is conducted by the Fund’s Insurance and Complaints Resolution Committee on behalf of the Trustee. Where members have made a binding death benefit nomination on their account, the distribution process is simplified because the member’s instructions are binding on the Trustee.
      5. Where any party is not satisfied with the decision of the Trustee, a complaint can be made through the Fund’s internal complaints procedure.
  • What to do if your claim is not approved

    • At Australian Catholic Superannuation, we have an extremely high rate of approval for claims paid, as shown in the approval rate table above.

      However, in the event that your claim is refused and you feel dissatisfied with the explanation given as to why, you can request that the Fund take your claim back to the insurer for reassessment—perhaps with further evidence included to substantiate the claim. This process may require you to submit to an independent medical assessment, the costs of which are normally paid by the insurer.

      Negotiation and conciliation is worth the time involved, as a dispute can often be resolved by thorough investigation and mutual agreement.

      If you still remain unsuccessful and wish to challenge the decision and escalate your claim, then the next step would be to send a formal written complaint to the Fund’s Complaints’ Officer. The Trustee will try to resolve your complaint quickly and fairly, in consultation and negotiation with the insurer.

      In the event that you’re not satisfied with the Trustee’s decision, or if the decision is not made within 90 days, you may take the complaint further by forwarding it to the Superannuation Complaints Tribunal (SCT).

      Superannuation Complaints Tribunal

      The SCT is an independent body set up by the Government to hear complaints by members or their beneficiaries against certain types of decisions made by superannuation fund trustees.

      A determination will be made by the SCT. It’s only if you wish to challenge this the SCT determination that you would normally require the services of a lawyer.

      The SCT will not hear a complaint if court proceedings have already commenced. However, you are still entitled to take legal action if you lose your action with the SCT.

      The SCT process is also available to members should they be dissatisfied with the outcome of their claim.

      You can write to the SCT after you have lodged a complaint through the Fund’s internal complaint procedures.

      There’s no cost to members to make use of this service.

  • Need more information?

    If you would like more information on how to go about making an insurance claim or to check on the progress of an existing claim, call us on 1300 658 776.

    You can also call us for over-the-phone financial advice so we can help you determine whether your current type and level of insurance cover is adequate for your personal circumstances.

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