Make a claim
It’s easier than you might think: When you let us know you’d like to consider claiming, we’ll pair you up with a dedicated case manager who personally oversees the process.
Please select your scheme so we can display the right information for you:
- ADF Super
- CSCri
- CSS
- DFRDB
- MilitarySuper
- PSS
- PSSap
Relevant content will appear after you select a scheme above.
This information is only applicable to PSSap and ADF Cover members, for more information on Insurance and Cover for other schemes please see our Insurance and Cover page
We're on your side
We independently review all claims decisions and work with the insurer if we think a claim has a reasonable chance of success. We put your best interests first.
Your case manager will work closely with you, your employer, our insurer and rehabilitation providers (where applicable) to coordinate an approach to get you back on your feet.
Did you know we expect you to reach out to your case manager whenever you need to? If you’re worried, have queries or concerns, just give them a call. They use their skills to do the heavy lifting to make sure the claims process is straightforward for you. Specifically, they’ll:
- help you with the paperwork and answer your queries
- be a direct contact for you, all the way through your claim
- monitor progress and talk to the insurer on your behalf
- keep you up-to-date with how your claim’s going
- make sure your claim is being assessed efficiently.
So, get in touch if you think you might claim - the sooner we know your situation, the sooner we can help.
-
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.
-
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.
-
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.
-
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.
-
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.
-
Call us before you complete any paperwork
After we verify you, we’ll talk you through what’s involved.
-
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.
-
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.
-
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.
We protect your privacy
We’re committed to protecting your privacy. We collect your personal information for the purposes of providing superannuation services to you (this includes the management of your insurance cover), improving our products and to keep you informed. We will only share your personal information where necessary for providing superannuation services to you. This may include disclosing your personal information to our scheme administrator, our insurer AIA Australia, our service providers or government or regulatory bodies. Your personal information may be accessed overseas by our service providers. Please see our privacy policy for full details. Your personal information will not be otherwise used or disclosed unless required or permitted under law. A full copy of our privacy policy as well as the privacy complaint process is available.
Your privacy is important to AIA Australia. By becoming a customer, or otherwise interacting or continuing your relationship with AIA Australia directly or via a representative or intermediary, you confirm that you agree and consent to the collection, use (including holding and storage), disclosure and handling of personal and sensitive information in the manner described in the AIA Australia Group Privacy Policy on AIA Australia’s website as updated from time to time (AIA Australia Privacy Policy). AIA Australia’s current Privacy Policy is available at http://www.aia.com.au or by calling 1800 333 613.
For further information please refer to Insurance and your PSSap super.