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 eligibility.

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.

Most super-based TPD policies assess whether you are unlikely to ever return to work in an occupation suited to your education, training, or experience — this is the ‘any occupation’ test. Some policies use an ‘own occupation’ test, which only looks at whether you can return to the specific job you were doing. The exact policy wording determines which test applies.

Most TPD claims take between 6 and 18 months. Complex cases involving appeals or disputes may take longer. We keep you updated at every stage.

Yes. Depression, anxiety, PTSD, and other psychiatric conditions are common grounds for TPD claims. Many policies cover mental health — the key issue is work capacity, not diagnosis alone. We review your policy terms carefully.

Yes, in some cases. If you had multiple super funds with active TPD insurance at the relevant time, you may be able to make more than one claim. Each claim is assessed separately based on policy wording, cover status, and medical evidence.

No. Insurers assess work capacity, not how unwell you are. They consider whether your condition is permanent, whether treatment has stabilised, your ability to perform suitable work, and whether retraining is realistic.

TPD benefits are usually paid into your super account first. Tax generally applies when money is withdrawn, not when the insurer pays the fund. The outcome depends on your age, fund type, withdrawal method, and whether the payment qualifies as a disability super benefit. Obtain advice from a qualified tax or financial adviser before withdrawing.

A TPD claim does not automatically stop Centrelink payments. TPD payments from super are generally not treated as compensation. However, once withdrawn, the funds may affect payments such as DSP, Carer Payment, or Age Pension under income and assets tests.

No. Many claims are declined because the definition was applied incorrectly, medical evidence did not address the right issues, or the claim was not properly prepared. Decisions can often be challenged or reconsidered with further evidence.

Most policies pay 70–75% of your pre-disability income, sometimes with an additional super contribution component. The exact amount depends on your policy terms, your income at the time you stopped working, and any offsets that apply.

Benefit periods vary by policy — typically 2 years, 5 years, or to age 65 (less common in super policies). We identify your specific benefit period and manage the claim for its full duration.

In many policies, the definition of disability shifts over time. Initially, the insurer assesses whether you can perform your own occupation. After a defined period (often 2 years), the test may shift to any suitable occupation based on your education, training, and experience. Many policies become harder to qualify for over time.

You do not always need to be completely unable to work. Some policies allow partial disability claims where you return in a reduced capacity and your income drops. The insurer may pay a proportionate benefit based on lost income.

Yes. Depression, anxiety, PTSD, and other psychiatric conditions are common grounds for income protection claims. The key issue is whether your condition affects your capacity for work. Some policies have specific limitations for mental health — we review your policy terms carefully.

Income protection payments are generally treated as assessable income and are usually taxable. Tax may be withheld before payment, and you may need to include payments in your tax return. Individual advice may be appropriate as outcomes can vary.

Income protection payments can affect Centrelink entitlements. Payments are generally treated as income, which may reduce benefits such as JobSeeker, DSP, or other income-tested payments. In some cases, Centrelink payments may reduce, or the insurer may offset IP payments if other income is received.

If you have a workers compensation claim, income protection may still apply. However, payments are often offset or reduced — you generally cannot receive full payments from both sources simultaneously.

Under Australian superannuation law, a terminal medical condition requires certification by two medical practitioners (at least one a specialist in the relevant field) that you are likely to die within 24 months despite available treatment. This is a strict legal definition, not a general medical assessment.

No. TPD is based on inability to work. Terminal illness claims are based on life expectancy under strict legal criteria. In some cases both types of claims may be relevant, but they are assessed separately.

If made under the terminal medical condition rules, super lump sum payments are generally tax-free regardless of age, provided the legal definition is met at the time of payment. If the criteria are not met, different tax rules may apply. Accuracy in medical certification is critical.

Medical certifications are only valid for a limited period (for example, 24 months from certification). If that period expires before the claim is resolved, new certification may be required. These claims are time-sensitive.

Yes. Claimsplus can work with a legal guardian, power of attorney, carer, or family representative if you are not able to manage the process yourself.

It can, depending on whether funds remain inside super or are withdrawn and how they are used. Lump sum withdrawals may affect assets tests, and income generated from funds may affect income tests. Centrelink treatment varies based on individual circumstances.

A death benefit is generally paid to dependants under super law (spouse, de facto partner, children, financial dependants, interdependency relationships) or to the member’s legal personal representative (estate). The trustee decides unless a valid binding nomination directs payment.

A binding nomination, if valid and current, directs the trustee to pay the benefit to the nominated person(s). A non-binding nomination is only a guide — the trustee retains full discretion. If there is no nomination at all, the trustee decides, which can lead to delays or disputes.

No. Tax treatment depends on who receives the benefit. Payments to tax dependants (generally spouse, de facto, minor children, certain financial dependants) are often tax-free. Payments to non-tax dependants — most commonly independent adult children — may be taxed on the taxable component. The tax/non-tax dependant distinction is critical.

Not necessarily. Super is not automatically part of the estate. The trustee decides who receives the benefit unless a valid binding nomination directs it to the estate. If the benefit is paid to the estate, it is then distributed according to the will — but routing through the estate can affect timing and may have tax implications.

Disputes between partners, former partners, children, stepchildren, and the estate are common — especially where there is no valid binding nomination. The trustee assesses competing claims by reviewing relationships and financial dependency. Unfair decisions can be challenged through AFCA or the courts.

Many super accounts include life insurance (death cover), which can significantly increase the total benefit paid. However, cover must have been active at the time of death, and conditions or exclusions may apply. We check all accounts for insurance, including old or forgotten super funds.

Straightforward claims with a valid binding nomination can be resolved within 3–6 months. Claims involving no nomination, multiple potential beneficiaries, or disputed dependency may take 12–24 months.

Yes. There are limits on how long you have to request a review or escalate a complaint. Delaying action may affect your ability to rely on certain evidence or access particular dispute resolution pathways. Taking steps early preserves your options.

The Australian Financial Complaints Authority (AFCA) is a free, independent dispute resolution body. AFCA does not simply re-run your claim — it assesses whether the decision-making process and outcome were appropriate, whether policy terms were applied correctly, and whether the available evidence supports the decision.

A claim does not need to be formally declined to be in dispute. Delays may suggest issues in the assessment process, particularly repeated requests for similar information, ongoing reviews without a decision, or extended timeframes without explanation. Delays can create financial pressure and may need to be actively addressed.

Resubmitting the same evidence without addressing the specific gaps identified in the decision is one of the most common mistakes. A dispute usually requires a different approach — not a repeat of the original claim. The focus should be on whether the evidence properly addresses the policy definition.

No. Insurer-appointed medical opinions are one input in the assessment process. They are not determinative. Where there is genuine disagreement between treating specialists and insurer-appointed assessors, the quality, recency and relevance of evidence on each side matters.

Common mistakes include: accepting a rejection without reviewing the reasoning, resubmitting the same evidence without addressing gaps, focusing on diagnosis instead of policy criteria, missing time limits for escalation, assuming insurer medical opinions are final, and not understanding trustee discretion in death benefit matters.

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.