Making a claim

We all hope we never have to make a claim. However, when things do go wrong and you’re involved in an accident, suffer from illness or experience a loss we're here to help guide you through the process. 

TelstraSuper and MLC Life Insurance’s Joint Claims Philosophy

Together with our insurer, MLC Limited (MLC Life Insurance), our joint claims philosophy is to act in the best interest of TelstraSuper members and provide support in their times of need. We are committed to compassionately guiding members through the claims process. As TelstraSuper’s insurer, MLC Life Insurance endeavours to make the right decisions and supports ethical and fair outcomes for TelstraSuper members.

Both TelstraSuper and MLC Life Insurance will work together to:

  • explain the claims process in simple and easy to understand terms
  • assist you to complete the requirements of the claim process, based on your individual circumstances
  • have your claim finalised as quickly and efficiently as possible.

TelstraSuper will act as your advocate to ensure that our Insurer, MLC Life Insurance, and any other third parties involved in your claim are also act in accordance with this philosophy.

We understand that this may be a difficult time, so we’ll both do our best to make the claims process as straight-forward as possible for you, with consultants acting in a consistent, fair, professional and empathetic manner. If you are well prepared and you have all the information that we need, making a claim is usually straightforward.

How to make a claim?

We have adopted a simple and compassionate approach to claims and have outlined the step-by-step process in the following documents. 

Situation

Helpful Documents

Are you claiming as a result of a death? Making a death claim
Have you suffered a serious injury or illness?

Making an income protection claim

Have you been diagnosed with a terminal illness? making a terminal illness claim

How is a TPD or Income Protection claim assessed?

If you make a Total & Permanent Disablement (TPD) or Income Protection claim, TelstraSuper and our insurer, MLC Life Insurance, will assess your condition based on the requirements of the relevant insurance policy and the TelstraSuper Trust Deed.

Key terms commonly used are italicised and are further explained in your Insurance Guide available at telstrasuper.com.au/pds

TPD

In order for a claim to be accepted, you must have TPD cover at the time your accident or sickness occurs and generally, you must meet at least one of these definitions:

  • Unable to work

    In the six months prior to your date of disablement, you were performing gainful work for at least 15 hours per week.

    Since then:

    • you have been off work for 3 consecutive months because of your accident or sickness, and
    • you have participated in your employer’s rehabilitation program

    MLC and TelstraSuper must find that you are unlikely to ever perform gainful work for which you are reasonably qualified by education, training or experience.

     
  • Day One (meaning a specified medical condition)

    In the six months prior to your date of disablement, you were performing gainful work for at least 15 hours per week.

    Since then:

    you have been continuously off work or if unemployed, continuously unable to accept work, because of a condition listed in the relevant policy (a Day One condition).

    MLC’s assessment must find that:

    • you are unlikely to ever perform paid work for which you are reasonably suited by education, training or experience, and
    • you are likely to be disabled for life.

    You can lodge a TPD claim without waiting 3 consecutive months since your sickness or accident first occurred.

     
  • Activities of daily working & severe mental disorder

     In the six months prior to your date of disablement:

    • you did not perform work for at least 15 hours per week at any time and,
    • you were performing domestic duties.

    Since then:

    • you are permanently unable to perform at least two of five everyday working activities as a result of your accident or sickness, and
    • this has been the case for 6 continuous months or more from your date of disablement.

    MLC’s assessment must find that you are unlikely to ever perform any gainful work for which you are reasonably qualified by education, training or experience.

    OR

    In the event where you suffer a severe mental disorder you have been:

    • regularly attending and undertaking medical treatment recommended by a medical practitioner with respect to that disorder, and
    • diagnosed by a psychiatrist, and
    • assessed by a psychiatrist appointed by MLC as having an impairment of 19% or more on the Psychiatric Impairment Rating Scale.

    MLC’s assessment must find that you are unlikely to ever perform any gainful work for which you are reasonably qualified by education, training or experience.

     
  • Domestic duties

    In the six months prior to your date of disablement:

    • you did not perform work for at least 15 hours per week at any time and, 
    • you were performing domestic duties for a minimum of 15 hours per week averaged over the shorter of:
      • 6 months, and
      • the period of time you have been performing the domestic duties prior to your date of disablement.

    Since then:

    • you have been under the ongoing care of a medical practitioner as a result of your accident or sickness, and
    • you have been unable to work or perform any domestic duties for 3 consecutive months, and
    • you are likely to require ongoing care from a medical practitioner.

    MLC’s assessment must find that you will never again be able to perform domestic duties or any gainful work for which you are reasonably qualified by education, training or experience.

     

Income Protection

In order for a claim to be accepted, you must have Income Protection cover at the time of your accident or sickness and must generally meet at least one of these definitions:

  • Total disability

    Immediately before your date of disablement you were in employed on a permanent basis, including as a contractor.

    Since then:

    • you have been absent from employment with your employer due to accident or sickness for the whole of your applicable waiting period, and
    • you are not working in any occupation, and
    • you are under the ongoing care of a medical practitioner.

    MLC and TelstraSuper must find that you are unable, for the time being, to perform the regular duties of your regular occupation due to accident or sickness.

    You will receive Income Protection benefit payments until one of the following occurs:

    • you return to work**, or
    • you are no longer totally disabled, or
    • your benefit payment period ends, or
    • you reach age 65, or
    • you die.
    **If after a period of receiving a total disability benefit you have partially returned (or are capable of partially returning) to your regular occupation, you may be eligible for a partial disability benefit.

     

     
  • Partial disability

    Immediately before your date of disablement you were employed on a permanent basis, including as a contractor.

    During the first 12 days of the waiting period, you were totally disabled due to accident or sickness for at least 7 days.

    For the balance of the waiting period:

    • you have returned (or are capable of returning) to your regular occupation, and
    • you are under the ongoing care of a medical practitioner, and
    • your income is less than your pre-disability income due to your accident or sickness.

    You will receive Income Protection benefit payments until one of the following occurs:

    • you are no longer partially disabled, or
    • your benefit payment period ends, or
    • you reach age 65, or
    • you die.

    If after a period of receiving a partial disability benefit you are unable to do your regular occupation, you may be eligible for a total disability benefit.

     

Ready to lodge a claim?

Once you're ready to lodge your claim give us a call on 1300 033 166. If you have any questions throughout the process we're here to help you. See our Frequently Asked Questions on Death, Income Protection, TPD and Terminal Illness claims.

View our Vulnerable Consumers Policy

Need help with translation?

TelstraSuper recognises that some of our members and their dependants are from non-English speaking backgrounds and may need help with translation or interpretation when making a claim. We've partnered with the National Translation Services to provide this service at no charge to our members or their dependants. Please let us know if you would like to make use of this service by calling us on 1300 033 166.

What if I’m not happy with the review process or the outcome of a TPD, Income Protection or Terminal illness claim?

You’ll be given the opportunity to review all of the information obtained as part of assessing your claim. You’ll also be able to provide additional evidence to support your claim.

If your claim has an insurance component and our insurer, MLC Life Insurance, decides your claim is unsuccessful, TelstraSuper will review the decision on your behalf to ensure that it is a fair and reasonable decision. You’ll have the opportunity to provide further evidence and you can ask TelstraSuper and MLC Life Insurance to review the decision if new evidence is received.

Once a final decision is made to you in writing and, if you’re still dissatisfied, you may contact the Australian Financial Complaints Authority (AFCA). The AFCA is an independent body set up by the government to assist in the resolution of certain complaints in relation to superannuation.

If your insurance claim is unsuccessful, you may still be eligible to access the funds in your superannuation account. We can guide you through this process.

See our Claims Frequently Asked Questions