Who can claim a superannuation insurance benefit?

Whether your patient can make a claim for a superannuation insurance  benefit will depend on a number of factors. They might have a claim for a superannuation insurance benefit if:

  • they are prevented from working in their usual job for medical reasons or because of an incapacity; and
  • at the time they developed this condition or incapacity  they were a member of a superannuation fund; and
  • they were under 65 years of age at the time they developed this condition or incapacity.

It does not matter how your patient’s condition or incapacity came about. Many people receiving compensation (such as  ComCare or the Centrelink Disability Support Pension) can claim. People who suffer an unexpected event that prevents them from working, such as stroke, cancer or a neurological condition, are also able to claim. The superannuation insurance benefit will normally remain available, even if your patient has already accessed some or all of their preserved super (their contributions).

Generally, your patient does not have to be unfit for all work to access a TPD lump sum benefit. For example, if their qualifications are limited and they have only ever engaged in manual work (and can never return to such work), their claim is likely to succeed. This is often true even if the insurer’s doctor or rehabilitation specialist says that they could do sedentary work, such as an office job. If an employer offers your patient a different job because of their condition or incapacity your patient may still be able to claim a TPD benefit if the job is one they are not trained or qualified to perform. Patients who are working on a part- time basis as a result of their condition or incapacity may also be entitled to a TPD benefit.

If your patient already suffered from a disability at the time they joined their superannuation fund, this in itself will not prevent them from accessing a superannuation insurance  benefit.