Make a claim

1. Call us before you complete any paperwork

   Call us right way. Even if you have a process underway for the injury or sickness - for example with your employer - or if you’re on leave, just let us know. We’ll talk you through what’s involved and start the claims process with you, which includes giving you a claims pack.

   Call us on 1300 725 171

2. Complete the paperwork and lodge your claim

   Work with your dedicated case manager to complete and submit the forms in the claims pack. We’ll check your application and give your documents to the insurer.

3. Sit tight as the insurer assesses your claim and makes a decision

   The insurer uses the information you’ve given us to assess your claim to decide whether, in its opinion, you’ve met the requirements under the policy to access your benefit. Usually, your case manager will be the go-between, between you and the insurer - but sometimes the insurer may contact you directly if they think it’ll help speed up the assessment.

   The insurer will decide if they are going to accept or decline your claim. They’ll let us know how they reached their decision, then it’s over to us.

4. We'll review the decision independently

   We’re legally obliged to (and of course we want to) act in your best interest, so we’ll always review the insurer’s claim decision.

   During this review, we’ll assess whether we agree with the insurer’s decision.

5. Your claim is accepted or declined

Claim accepted

Income Protection

If your Income Protection claim is accepted, we’ll write to let you know:

• that we’ll pay your monthly benefit payments directly to you and pay 15.4% contributions into your PSSap account. We’ll let you know how much you’ll receive and when, plus how much your PSSap super contributions will be and when we’ll make them.
• whether you’ll be able to access a rehab program designed to help you get back to where you’d like to be.
• what to expect while you’re receiving a benefit, for example, any ongoing assessment and monitoring that’s necessary.

TPD or Terminal Illness

If your TPD or Terminal Illness claim is accepted, we’ll write to let you know:

• that your benefit will be paid into your super account and when this will happen
• if your benefit payment will be a lump sum or if it will be set up as an income stream
• if we can release your super account balance under super law.

Note that while we can use a lot of the information you’ve given us for an insurance claim to make a decision about your super balance, we may be in touch if we need more information.

Claim declined

If your claim is declined and:

• we don’t agree with insurer’s decision, we’ll ask them to reconsider your claim or to arrange more medical evidence. The claim will go back through the assessment process (step 3) and your case manager will keep you up to speed with what’s going on.
• we agree with the decision, we’ll write to let you know why it was declined and why we agree.

If we agree with the insurer, your case manager will also let you know how to request a review and how to lodge a formal complaint. If you do this, and you’re not satisfied with how we manage your formal complaint (or you don’t get our response within 90 days of submitting your complaint), you may contact the Australian Financial Complaints Authority on 1800 931 678 or via info@afca.org.au or at afca.org.au.

Losing someone close to you is one of the hardest things that you might have to go through. We want to make the process of making a claim as simple as possible.

1. Call us before you complete any paperwork

   After we verify you, we’ll talk you through what’s involved.

   Call us on 1300 725 171

2. We'll give you a form to complete

   As a potential beneficiary, a case manager will give you a form to complete. If there’s a valid binding beneficiary nomination in place, we’ll make payments to that beneficiary. If there’s no binding nomination, we’ll work out who the customer’s dependants are or who the executor is.

3. Sit tight as the insurer assesses your claim and makes a decision

   Everyone has 28 days to object to the decision

   If potential beneficiaries or other interested parties object to our decision, we’ll request evidence from them to support the objection. The evidence goes to the Reconsiderations Committee that decides if the objection changes the original decision.

   If anyone has complaints about decisions made by CSC or the Reconsiderations Committee, they can complain to the Australian Financial Complaints Authority at afca.org.au within 28 days.

4. We'll pay beneficiaries

   We’ll distribute the super balance and any insurance benefit (if applicable and approved) to the beneficiaries. Beneficiaries should seek advice about whether there are any tax obligations they need to meet. See your financial advisor or visit the Australian Tax Office website.