Frequently Asked Questions

Most super funds include default life insurance cover — typically a combination of life (death) cover, total and permanent disability (TPD) cover, and sometimes income protection. You were likely enrolled automatically when you joined the fund. Check your most recent super statement or call your fund to confirm.

The three main types are: Life (death benefit) insurance — pays a lump sum on death or terminal illness. TPD insurance — pays a lump sum if you become totally and permanently disabled. Income protection — pays a monthly benefit (usually 75% of income) if illness or injury stops you from working.

Yes — and this is important. Many Australians have accumulated multiple super accounts over their working life. Each fund may hold separate insurance cover. Claimsplus Lawyers will locate all your accounts and assess each one for a potential claim.

Cover can apply from your very first day of employment under some policies. However, pre-existing condition exclusions may apply during the first 12 months. We will review your specific policy wording to assess your entitlement.

Yes. Insurance cover often continues even after you’ve left an employer, as long as your super account remained active and premiums were being paid. We can check this for you as part of your free assessment.

The definition varies between insurers, but it typically means you are unable to ever return to work in a job suited to your education, training, or experience. Some policies use an ‘own occupation’ definition (unable to do your specific job) which can be easier to meet. We’ll assess the exact wording of your policy.

Most TPD claims take between 6 and 18 months from lodgement to payment. Complex cases or those that are denied and appealed can take longer. We will keep you informed throughout and push for the fastest possible resolution.

Yes. Mental health conditions — including severe depression, anxiety disorders, PTSD, and schizophrenia — can qualify for TPD if they permanently prevent you from working. Some policies have specific conditions or waiting periods for psychiatric claims, which we will review carefully.

No. A denial is not the end. Claimsplus Lawyers reviews denied TPD claims as a core part of our practice. We will assess the insurer’s reasoning, identify grounds for appeal, and pursue your claim through internal review, AFCA, or the courts if necessary.

In most cases, yes — you need to have ceased work due to your condition. However, the specific requirements depend on your policy. Some policies allow a claim if you can no longer perform your pre-injury job, even if you’ve returned to lighter duties. We’ll confirm the criteria that apply to you.

Most income protection policies pay 75% of your pre-disability income, up to a monthly cap defined in your policy. Some policies also include a superannuation contribution component on top of the income benefit.

Benefit periods vary. Common options are 2 years, 5 years, or to age 65. The benefit period is set out in your policy document. We will identify your specific benefit period and ensure you receive every payment you’re entitled to.

Most policies have a waiting period of 30, 60, or 90 days before payments begin. During this time, you are not paid. Payments begin after the waiting period ends, provided you continue to meet the disability definition.

Yes. Many policies cover psychological disabilities including anxiety, depression, PTSD, and burnout. However, some policies limit the benefit period for psychiatric claims to 2 years. We’ll review your policy for any restrictions.

Your payments will stop when you return to work, or are assessed as able to return. Some policies include partial or rehabilitation benefits if you return on reduced hours during recovery.

Under Australian superannuation law, a terminal medical condition requires certification by two medical practitioners (at least one being a specialist in the relevant field) that you are likely to die within 24 months despite available treatment.

Super funds are required to process terminal illness applications within 28 days of receiving a complete application. We ensure your application is complete from the first submission to avoid unnecessary delays.

You keep the payment. The certification is based on the prognosis at the time of claim. If your condition improves, your entitlement is not revised or reclaimed by the fund.

In most cases, yes. Super terminal illness payments are generally tax-free regardless of age under Australian tax law. We recommend confirming your specific situation with your accountant.

Yes. We can work with a legal guardian, an enduring power of attorney, or a family representative to manage the claim process on behalf of a person who is too unwell to act on their own behalf.

Eligible beneficiaries include: spouses and de facto partners, children (including adult children), financial dependants, and the deceased’s estate. The trustee of the super fund determines how the benefit is distributed if there is no binding death benefit nomination.

A binding nomination is a legal instruction to the super fund directing who should receive the benefit on death. If a valid binding nomination exists, the trustee must follow it. If there is no valid nomination, the trustee has discretion — which can lead to disputes.

The trustee will make a discretionary decision based on the available evidence of relationships and financial dependency. Claimsplus Lawyers can represent your interests in this process and, if the decision is unfair, escalate to AFCA or pursue legal action.

Uncontested claims can be resolved within 3–6 months. Contested claims, disputed nominations, or cases involving complex family structures may take 12–24 months. We push for the fastest resolution possible.

Each account may have separate insurance cover and must be claimed separately. Many people have forgotten accounts from past employment. Claimsplus Lawyers will locate all accounts and pursue all available benefits.

Common reasons include: pre-existing condition exclusions applied incorrectly, incorrect interpretation of the disability definition, insufficient medical evidence (often fixable), administrative errors, and unfair application of policy exclusions. Many denials are overturned on appeal.

Yes. AFCA complaints must generally be lodged within 6 years of the decision (or 2 years of becoming aware of grounds). You should act as soon as possible. Contact us even if some time has passed — there may still be options.

The Australian Financial Complaints Authority (AFCA) is a free, independent dispute resolution service. If your insurer upholds a denial internally, AFCA can review the decision and overturn it if it finds the insurer acted unfairly. AFCA decisions are binding on the insurer.

Unreasonable delays are grounds for a complaint to AFCA. You may also be entitled to interest on delayed payments. Claimsplus Lawyers can write to the insurer to demand a decision and, if necessary, escalate to AFCA immediately.

Possibly. Whether a previous settlement can be revisited depends on what you signed and how long ago. Contact us for a confidential assessment — don’t assume it’s too late without checking.

It means you pay our legal fees only if we successfully recover your entitlement. If we don’t win, you pay nothing. There are no upfront costs and no hidden charges for our legal work.

Our success fee is a percentage of the amount we recover for you. We will explain the exact fee structure at the start of your matter in a clear costs agreement — before any work begins. There are no surprises.

In most super insurance matters, there are minimal third-party costs. For AFCA complaints, there are no fees to you as a claimant. For court proceedings, there may be some disbursements (e.g. medical report costs) that we will discuss with you before incurring.

In most cases, we will fund or manage the cost of obtaining medical reports and other evidence required for your claim. Any disbursements will be discussed and agreed with you in advance.

Yes — completely. The free claim check carries no cost and no obligation. It’s an initial assessment to help us understand your situation and confirm whether we believe you have a viable claim. We only proceed with your informed consent.

Most people complete the online claim check in under 2 minutes. We’ll follow up within one business day with an initial assessment.

Between 6 and 18 months in most cases. Complex cases or those that involve appeals can take longer. We monitor progress actively and push for resolution.

Initial decisions are typically made within 3–6 months. If accepted, payments begin after the waiting period ends. If denied, the appeal process adds further time.

Super funds must process complete terminal illness applications within 28 days. We prioritise these cases for fast lodgement.

3–6 months for uncontested claims. Up to 24 months for disputed or complex matters involving multiple parties.

You’ll see a confirmation screen with next steps. Our team will review your submission and contact you within one business day to discuss your situation in detail.

No. After your free check, we’ll reach out for a relaxed, no-obligation conversation to understand your situation better. There’s no pressure and no commitment required at that stage.

Initially, just the basic information you provide in the claim check. As we progress, we may need your super fund details, medical records, and employment history — but we guide you through each step and can retrieve many documents on your behalf.

No. You don’t need to gather anything before reaching out. We can search for all your super accounts using ATO records, and retrieve policy documents and statements on your behalf.

We’ll tell you honestly. If we don’t believe your situation gives rise to a viable claim, we’ll explain why and, where possible, suggest what alternatives may exist. We only take on matters we believe have real merit.

You don’t need any documents to start. The free claim check only requires basic personal information. Once we confirm you have a viable claim, we’ll guide you through what’s needed — and retrieve much of it on your behalf.

Insurers require medical evidence confirming your diagnosis and functional limitations. This typically includes GP records, specialist reports, imaging results, and functional capacity assessments. We work with your treating practitioners to obtain this evidence.

We can locate all your superannuation accounts via ATO records using an authority form you sign. We’ll then contact each fund directly on your behalf.

For TPD and income protection claims, we’ll need evidence of your pre-disability occupation, income, and the date you stopped working. Payslips, tax returns, and employer records are all useful — but we help you gather what’s needed.

Keep all claim-related documents, correspondence, and medical records for the duration of your claim and at least 7 years afterwards. We maintain secure records for all active and resolved matters.