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Nearly all Victorian workers are members of a superannuation fund. At present, most worker’s employers are contributing 9% of the worker’s wage into a nominated superannuation fund. This money is invested and available upon retirement.
Many superannuation funds also arrange life insurance for members. A small amount is deducted from a worker’s superannuation contributions to pay for this insurance.
This insurance covers the death of a worker or their total and permanent disablement for employment. Some funds will also provide a temporary and total disablement benefit.
How do I know if I have insurance cover?
Generally, insurance cover only lasts for one month after the last superannuation contribution has been paid. The regular statement of benefits sent out by your super fund should show if you have death or permanent disability insurance and if so, how much will be paid.
Total and Permanent Disability
The definition of what is total and permanent disability (TPD) can vary from one fund to another. It is most commonly defined as the loss of various limbs, or “having been absent from work for six consecutive months, the worker is unable to return to his/her pre-injury employment or return to any other employment for which the worker is suited by education, training or experience.”
A claim on this insurance is made by the completion of a claim form provided by the superannuation fund, and Advice Line Lawyers would also provide any relevant medical reports. The fund or its insurer may also write for medical or other information and examinations with doctors may be arranged.
If the superannuation fund Trustees reject your TPD claim, review of the claim can be requested. If the review is unsuccessful, you can have the Superannuation Complaints Tribunal review the decision or alternatively make a claim against the Trustees in a court. You would need to establish that the fund breached its duty, eg it did not act fairly in all the circumstances.
Even if a judge would have decided the case differently to the Trustees a change may not be made to the Trustees’ decision, eg if the Trustees could reasonably have made the decision, it will not be overturned. Sometimes a court will send the claim back to the Trustees for re-determination.
For a total and permanent disability benefit decision to be reviewed by the Superannuation Complaints Tribunal, application must be made within 12 months of the original decision. You have 6 years to issue proceedings in a court to challenge the decision.
What if I am receiving WorkCover benefits?
If you are in receipt of WorkCover weekly payments of compensation you should be aware that if you access your superannuation contributions, or insured lump sum, you will probably face a preclusion period during which your weekly payments will be suspended. The Accident Compensation Act requires workers who receive a pension, or lump sum payment from a superannuation fund to give notice of the payment or lump sum, in writing, to their claims agent. This must be done within 14 days of first receiving payment. If you fail to comply with this requirement you may be found are guilty of an offence and can be prosecuted.
If you wish to withdraw or redeem your own contributions from a superannuation fund, whilst receiving WorkCover weekly payments, it may be possible to obtain approval from WorkCover to use the contributions for an approved capital expenditure and still keep receiving weekly payments.
It may be possible to roll the benefit over to another fund, or account within the original fund (if available) and allow the benefit (including the insured amount) to accumulate interest until your entitlement to weekly payments of compensation ceases.
Death Benefits
When a person dies a death benefit is usually paid by a superannuation fund. It is common for members to be requested to nominate beneficiaries to whom the member wishes the benefit to be paid, but the Trustees do not have to pay the benefit to those beneficiaries. Most trust deeds state that a death benefit must be paid to dependants of the member or to the estate of the member. The Trustees decide the proportion payable to each dependant.
A dependant is a person who was financially or emotionally dependent on the member or was entitled to receive financial assistance from the member. Dependants can include children, step children, parents and spouses of the member.
If a potential beneficiary is unhappy with a decision of the Trustees a review of that decision can be requested and further, the decision can be reviewed by the Superannuation Complaints Tribunal or a court.
If you want to be represented by an expert Melbourne lawyer, experienced in superannuation TPD claims, please contact us on:
t: advice line on (03) 9321 9988
e:
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