The Trustee’s philosophy is to assess each claim based on its own merit with integrity and compassion whilst ensuring that we are fair and reasonable to all stakeholders.
Members’ claims deserve to be managed efficiently:
- Recognising that the assessment of claims can be delayed through waiting for medical and other required information, ensuring that all claims are assessed within a reasonable timeframe.
- Maintaining confidentiality of all information.
- Working closely with the employer and the insurer to progress the claim.
- Ensuring all genuine claims are paid as soon as possible.
Members should expect help and support through the assessment process:
- Supporting Members by treating them with dignity and respect.
- Keeping Members regularly updated on the progress of their claim.
- For disability claims, utilising allied health professionals in the assessment of claims, to evaluate the level of disability and identify prospects for returning to work.
- Pursuing all legitimate insurance claims with the insurer. It is not in the best interests of the Plan Membership as a whole to pay out non-genuine claims.
- For disability claims, working with the employer to assist in a return to work when safe to do so.
Members are entitled to a transparent and fair approach to claims settlement:
- Reaching conclusions that are based on facts and sound reasoning.
- For disability claims, focusing on independent information from treating medical practitioners and medical specialists and independent medical experts.
- For death claims, focusing on identifying appropriate beneficiaries who are most affected financially while taking into account the Member’s wishes and superannuation law requirements.
- Reassessing claims where new information is provided or the Member requests a review.
The Trustee continues to manage both insured and self-insured claims.
As required by Prudential Standard SPS250, in selecting insurer(s) the Trustee places a strong focus on the claims philosophy of the insurer(s). The Trustee requires that the insurer(s) philosophy should be clearly articulated and aligned with the philosophy applied by the Trustee.