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If you are unable to work due to illness or injury, IP cover can provide you with regular monthly benefit payments. IP can be paid if:

  • You’re totally disabled and unable to do any work, or
  • You’re partially disabled and can do some of your work in a limited capacity, by either reduced hours, or duties, or both, as a result of your illness or injury.

The maximum amount payable is either:

  • Your sum insured (this is the amount of IP cover you have), or
  • Up to 85% of your pre-disability income (this is the actual salary you were earning at the time you stopped working, and it can be higher or lower than your sum insured).

Once your pre-disability income is confirmed as part of your claim, the benefit payable to you is up to 75% of your salary, with a remaining balance of up to 10% paid into your super account as a contribution. If your sum insured is lower than your pre-disability income, then the full sum insured is paid directly to you.

If your claim is approved, monthly payments are paid in arrears one month after the end of the waiting period and continue for the duration of the benefit period, as long as you remain medically supported as being unfit for duties.

Your claim can stop and restart as you recover and return to work, depending on your circumstances. Your Claims Assessor will let you know when this occurs and will guide you through the process.

It’s all in the guide

For full details on the insurance cover we offer, including important definitions of key terms relating to permanent incapacity claims, refer to our handy Insurance in your super guide for members.

Download

Calculating your benefit

Your IP benefit may also include a contribution to your Catholic Super account. The contribution depends on the amount of IP cover you have and your monthly income. Where your amount of IP cover is:

  • 75% or less of your monthly income, no super contribution will be paid.
  • More than 75% but less than 85% of your monthly income, the super contribution paid will be the amount of your IP cover less 75% of your monthly income.
  • 85% or more of your monthly income, the super contribution paid will be 10% of your monthly income.

Your monthly income is determined differently depending upon whether you are a permanent employee, casual employee, or self-employed at the time of your illness or injury.

We may reduce your IP monthly benefit by the amount of any of the following benefits you are entitled to as a result of your inability to work:

  • Income protection benefit payments from another insurance policy or superannuation fund
  • Sick leave payments made to you by your employer
  • Court or out-of-court settlements relating to loss of income or loss of earning capacity that are directly or indirectly related to the illness or injury that forms the basis of your benefit being paid
  • Worker’s compensation or motor accident compensation payments accident compensation or other similar benefits paid under State, Territory or Federal legislation, such as the Department of Veterans’ Affairs.

But your benefit will not be reduced by:

  • Pension payments through your superannuation fund
  • Income earned from your investments, including rental income
  • Lump sum total and permanent disability, trauma or terminal illness benefit payments (including lump sum superannuation benefits)
  • Annual leave or long service leave entitlements paid to you by your employer
  • Centrelink or other government welfare payments
  • Other termination payments (including redundancy or severance).

How the claims process works

Call our Service Centre and we’ll help you with the first steps of the claim and inform you of what’s involved with the overall process.

We’ll need to ask you a few questions to help determine the correct benefit you may be entitled to claim. For example we’ll ask you for:

  • Your Catholic Super membership number
  • Details of your injury or illness
  • The date you first consulted your doctor about the condition preventing you from working and the date your doctor first certified that you were unfit to work
  • Details of the employer/s you were employed with prior to ceasing work, and
  • The last day you were actively At Work, together with your work status prior to ceasing work.

In addition to the information collected, the following documents will be needed to commence the initial assessment of your claim against the insurance policy terms and conditions. The Insurer will review your medical condition together with your medical history and employment circumstances.

  • Initial information form – to be completed by you (or your Power of Attorney).
  • Medical statement – to be completed by your treating doctor. Copies of relevant medical reports and test results that support your illness or injury should be attached to the completed report. Any costs associated with completing this form will need to be covered by you.
  • Employer statement – to be completed by your employer at the time you stopped working.
  • Tax file number declaration – to be used in determining the amount of tax (if any) that needs to be deducted from your benefit payment. 
  • Certified proof of identity – for security purposes, certified proof of your identity such as your driver’s licence or passport is required. A certified copy is simply a photocopy of an original document that has been sighted, signed and stamped by an authorised person as being a ‘certified true copy’. Photocopies of certified documents cannot be accepted.

Once the completed forms are returned, we’ll lodge your claim with our Insurer, and you’ll be assigned a dedicated case manager for the duration of your claim assessment. 

To reach a decision on your claim or to continue your ongoing benefit payments, the Insurer may also request:

  • That you provide further information
  • Additional medical reports
  • Further information from your employer
  • Any claim files held with other insurers or any other third party such as Worker’s Compensation.

During the initial assessment of your claim, any fees associated with requesting additional medical reports and examinations will be paid by the Insurer. Any fees associated with the completion of the General Medical Statement and ongoing medical reports after a claim has been approved are paid by you.

Your claim will be assessed against the terms and conditions of the insurance policy at the date of your injury or illness (including any exclusions and/or pre-existing conditions you may have). The nature of your claim, the date of disablement and any additional information required to reach an outcome will influence the overall assessment processing time of your claim.

Our Insurer will strive to reach an outcome as quickly as possible and we’ll keep you regularly updated throughout the assessment process.

What’s considered in the assessment of an IP claim?

Being approved for monthly IP benefits depends on a number of factors. The driving factor is the definition of partial disability or total disability for IP in place at the time you ceased work and were medically diagnosed as being unfit for work. These definitions have changed over the years and can vary between products and super funds. 

Other factors, such as your employment status, work duties and earnings – all immediately prior to the date of disability, your medical capacity, and the impact that your injury or illness has on you, are all taken into consideration when assessing your claim.     

Information will be gathered from your employer, doctors and specialists, or any other organisations you may have lodged a claim with, to enable the Insurer to assess your claim correctly, fairly and within reason. The Insurer may also ask for additional tests or medical opinions from doctors of their choice.

Being approved for monthly IP benefits depends on a number of factors. The driving factor is the definition of partial disability or total disability for IP in place at the time you ceased work and were medically diagnosed as being unfit for work. These definitions have changed over the years and can vary between products and super funds. 

Other factors, such as your employment status, work duties and earnings – all immediately prior to the date of disability, your medical capacity, and the impact that your injury or illness has on you, are all taken into consideration when assessing your claim.     

Information will be gathered from your employer, doctors and specialists, or any other organisations you may have lodged a claim with, to enable the Insurer to assess your claim correctly, fairly and within reason. The Insurer may also ask for additional tests or medical opinions from doctors of their choice.

If your claim is approved, the Insurer will inform you in writing, and confirm the date your benefit commences, your monthly benefit amounts, and if any tax is deducted. 

If your claim is declined, we’ll let you know in writing why your medical condition doesn’t satisfy the relevant definitions.  Before formally declining your claim, we’ll write to you to give you an opportunity to provide any further evidence to support your claim. Should this occur, and if you disagree with the decision, you can request a review. All review requests are treated as formal complaints and are independently assessed by the Insurer and Trustee.

If our Insurer approves your IP claim, monthly benefit payments will be paid in arrears and commence one month after the end of your Waiting Period. The Insurer will pay your monthly benefit electronically to your nominated bank account.

Once benefit payments have started, the Insurer may require your doctor to complete a Progress Medical Statement, so they can assess if you qualify for ongoing IP payments.

More about the claims process

How long does it take?

There are several steps involved in assessing a claim, with the length of time depending on personal circumstances and the availability of information we require from you, your employer, your doctors and specialists to assess your claim.

Our Insurer aims to finalise most claims within two months or sooner.

Where a decision can’t be reached within two months, the Insurer will write to you to let you know the reasons for the delay. 

How is your benefit paid?

Once your pre-disability income is confirmed as part of your claim, the benefit payable to you is up to 75% of your salary, with a remaining balance of up to 10% paid into your super account as a contribution. If your sum insured is lower than your pre-disability income, then the full sum insured is paid directly to you.

If your claim is approved, monthly payments are paid in arrears one month after the end of the waiting period and they continue for the duration of the benefit period, as long as you remain medically certified as being unfit for duties.

Your claim can stop and restart as you recover and return to work, depending on your circumstances. Your Claims Assessor will let you know when this occurs and will guide you through the process.

Waiting periods

The waiting period is the minimum number of consecutive days that must pass before any benefit may become payable. Our waiting periods can be either 30, 60 or 90 days, and the period starts from the first date that you’re medically certified as being totally disabled. Check your account via Member Online to confirm the waiting period that applies to you.

Benefit periods

The benefit period is the maximum length of time for which a benefit is payable, once the waiting period has finished and you remain medically certified as being unable to return to full work.

What about tax?

IP benefits are paid as taxable income and, like salary and wages, they attract Pay As You Go (PAYG) tax. The tax will be deducted from the benefit before it’s paid to you and remitted to the Australian Taxation Office.

We're here to help

Remember, we’re here if you need us for assistance with the claims process, or if you have any queries about the progress of a claim, or for any insurance related queries.

Contact us

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