Contact the Fund if you have been unable to work due to illness or injury for the consecutive number of days for your specified waiting period.
We will obtain some information from you and then direct you on how to lodge a claim.
Depending on the information contained in your claim submission, you may be required to provide additional medical information or be asked to see an independent doctor or specialist.
If your claim is accepted and payments have commenced, 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.
If the claim was not successful, you may appeal the decision and provide further information to support your appeal through our internal complaints procedure.
Contact the Fund if you are ill or injured and a doctor has confirmed that you will not be able to return to work.
We will obtain some information from you and then direct you on how to lodge a claim.
Usually within five business days you will be provided with an update on your claim.
The insurer will request a doctor’s report directly from the members treating medical practitioner and the Fund will request the employer’s statement directly from the member’s employer.
Depending on the information in the original submission, you may be required to see an independent doctor or specialist or provide further information.
Once the requested information has been obtained by the Fund and the insurer, you will be advised if your claim has been approved.
If the claim was not successful, you may appeal the decision and provide further information to support your appeal through our internal complaints procedure.
Upon death of a member, the member’s nominated beneficiary or legal representative should advise the fund as soon as possible.
We will inform the member’s legal representative of what is required to claim death benefits. Typically this includes certified copies of the following:
- Death certificate
- Proof of name change (e.g. marriage certificate if there is a discrepancy between birth and death certificate)
Once all claim requirements have been met, the Fund will forward the relevant information to the insurer for assessment.
Once the requested information has been obtained by the Fund and the insurer, you will be advised if your claim has been approved.
For members who do not have a binding nomination, all potential beneficiaries will be advised of the Trustee’s decision and will have the opportunity to submit an ‘objection’ if applicable.
Claim Philosophy
The Trustee’s claim philosophy is:
legitimate claims are paid within a reasonable time frame
claimants are treated fairly and with respect
each claim is to be treated on its own merits
claims that do not satisfy the criteria for acceptance should be declined. Therefore, the Trustee does not have predetermined acceptance rates
claimants will have the opportunity to respond to any claim declined by the insurer
any new information submitted for a declined claim will be forwarded to the insurer for reassessment
