Death claims factsheet

This factsheet provides information about making a claim to receive Death (or Terminal Illness) benefits from the fund.
 

What is a Death benefit claim?

A Death (or Terminal Illness) benefit is a lump sum, one-time payment to a member’s dependants as financial support if they die or to a member who is diagnosed with a terminal illness and has a life expectancy of less than 24 months. For terminal illness claims, the benefit paid is simply an early payment of the Death benefit. The lump sum paid can consist of the member’s super balance and any Death insurance cover held with the fund.

When you make a Death or Terminal Illness benefit claim, you are making a request to receive these benefits from the fund.

 

When you can make a claim

To make a claim to access a Death or Terminal Illness benefit through the fund, you first need to meet certain eligibility criteria.

 

Who is eligible to claim a Death (or Terminal Illness) benefit?

Whether you’re eligible to claim a Death benefit will depend on several factors:

  • The type of insurance cover the late member held with the fund
  • Any exclusions or limitations that apply to the member’s cover
  • Any beneficiaries nominated by the member before their passing
  • Your relationship with the member (e.g. spouse, child, dependant)

Whether you’re eligible to claim a Terminal Illness benefit will depend on:

  • The type of insurance cover you hold with the fund
  • Any exclusions or limitations that apply to your cover
  • The date of the terminal illness diagnosis (must be on or after the start date of your cover)
  • Medical evidence of your diagnosis and life expectancy of less than 24 months

As part of the claims process, we will look at the information available and perform an eligibility assessment to determine whether you’re eligible to claim a Death or Terminal Illness benefit.

 

How you can make a claim

If you’re thinking of making a claim, you, your dependant or your legal representative will need to contact us by phone (1300 360 907) or email to let us know of your intent to claim and the type of claim you wish to make. The sooner you contact us, the better.

Before you contact us, make sure you have the following information to help us determine whether you’re eligible to make a Death benefit claim:

  • The member number of the late member
  • The member’s date of birth
  • Personal details of the member’s dependants or legal representative

For a Terminal Illness benefit claim, make sure you have your member number and date of birth on hand when you contact us.

Once you contact us, a Member Care Case Consultant will walk you through the claims process and help you understand what to expect.

 

What to expect during the Death (or Terminal Illness) claims process

When you need to make an insurance claim, it can often be an emotional and stressful time. That’s why throughout the claims process, you can expect our team to handle your claim with deep empathy and care.

To help you know what to expect during the Death (or Terminal Illness) claims process, below is a step-by-step guide of what happens when you make a claim.

 

Detailed claims process:

1. You contact us
  • Call or email us to let us know the member has passed away or you’ve been diagnosed with a terminal illness and that you intend to claim.
  • We’ll outline the eligibility criteria and key steps in the claims process.
2. We contact you
  • A Member Care Case Consultant will be assigned to support you through the process and will send you the relevant form(s)* so we have the right information to process your claim.
  • You will be given contact details for your assigned Member Care Case Consultant to keep you informed and connected during the process.
3. You complete claim forms
  • You’ll complete the forms sent to you and return to us.
  • With the forms, you’ll need to send us supporting documents*, as indicated on the forms.
  • We’ll review the information you give us plus the information already available to determine whether you’re eligible to make a claim.
4. We’ll review your claim
  • If you’re eligible, we’ll review and process your claim.
  • For Death benefit claims, this step includes reviewing any binding or non-binding nominations made by the late member to determine who will receive the Death benefits (to learn more, see the Who receives the benefits? section below).
  • After we review the beneficiary nominations, if there are no valid binding nominations and the late member had children over the age of 18, the Member Care Case Consultant may contact eligible dependants to begin a claim staking process. This process requires each dependant to confirm whether they want claim the part of the Death benefit they’re entitled to, by completing a Claim Staking form within 28 days of being contacted.
5. Your claim is lodged with the insurer
  • For Death benefit claims, if the late member held no Death cover with the fund when they passed away, we’ll let you know the outcome of the claim and pay the super balance to the eligible dependants. If the late member held Death cover with the fund, we’ll lodge your claim with the insurer and notify you when we do.
  • For Terminal Illness benefit claims, if you held no Death cover with the fund when you were diagnosed with a terminal medical condition, we’ll pay your super balance to you. If you held Death cover with the fund, we’ll lodge your claim with the insurer and notify you when we do.
6. Your claim is assessed
The insurer will review your claim and may ask for more information. If more information is needed to assess your claim, we’ll let you know.
7. Your claim is resolved
  • The insurer will confirm their decision to either accept or decline your claim. We’ll let you know the outcome and the next steps.
  • If the insurer accepts your claim, we’ll pay the super balance plus insurance benefits to the eligible dependants.
  • If the insurer declines your claim, we’ll review the insurer’s decision based on information collected during the claims process.
  • If your claim is denied after we’ve reviewed the insurer’s decision, we’ll tell you the reasons for the decision and how you can make a complaint if you’re not satisfied.

 

*Notes:

  • Relevant forms for Death benefit claims: Death Notification form.
  • Relevant forms for Terminal Illness benefit claims: Members Statement form, Specialist’s Medical Report form, and Treating Doctor’s Report form.
  • Supporting information for Death benefit claims: contact details for any children of the late member over the age of 18, plus certified copies of the late member’s death certificate, driver’s licence or passport, spouse’s driver’s licence or passport, and any applicable Will and Probate.
  • Supporting documents for Terminal Illness claims: member’s certified proof of identification.

 

How long is the claims process?

The length of the claims process depends on several factors and the circumstances of your claim. No two claims are the same. However, we will do all we can to process your claim as quickly as possible and keep you informed of its progress. To help us do so, we ask that you contact us as soon as you can if you plan to make a claim and respond promptly to any requests for more information.

 

What benefits are paid?

If your Death benefit claim is accepted, you’ll either receive:

  1. The portion of the late member’s super balance; or
  2. The portion of the late member’s super balance plus any insurance benefits;

to which you’re entitled as a dependant of the late member.

For a Terminal Illness benefit, you’ll either receive:

  1. Your super balance; or
  2. Your super balance plus any insurance benefits.

Once a Terminal Illness benefit is paid, this cancels any Total and Permanent Disablement cover you hold with the fund.

 

Who receives the benefits?

Before any Death benefits are paid, we’ll look at any binding beneficiary nominations made by the member before they passed. If these nominations are valid (i.e. the beneficiaries were dependants of the late member at the date the member passed away), the nominated individuals will receive the benefit payments.

If the binding nominations are invalid, we’ll look at any non-binding beneficiary nominations and determine how the late member’s super balance will be distributed to their dependants. In doing so, we’ll consider:

  • The late member’s dependants:
    • current spouse
    • children (including adopted children, current stepchildren, current de-facto stepchildren)
    • financially dependent individuals
    • interdependent Individuals
  • How much each dependant relied on the late member for financial support

As Terminal Illness benefits are paid before the member’s passing, these benefits are paid to the terminally ill member.

 

Are taxes paid for benefits received?

You may need to pay tax on any Death benefits paid from the fund. This depends on how your benefit is paid, your relationship with the late member and your age. The amount you receive may also impact any other income you receive from sources such as Centrelink or workers’ compensation. To understand the financial impact and what taxes you may need to pay, please seek independent advice.

Terminal Illness benefits paid by the fund are tax-free.

 

We’re here for you

If you have any questions or need support at any point during the claims process, we’re here to help.

To contact our in-house Member Care Team, click here.