Making a claim
Making a claim for a Total and Permanent Disablement Benefit
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We know it’s tough to think about, but Super SA is here to help you prepare for the unexpected.
If you are permanently injured and unable to work, your Total and Permanent Disablement (TPD) benefit may be equal to the sum of your Triple S account, and the total value of your insurance (subject to approval by Super SA).The Super SA Board must approve the payment of any TPD benefit so don't resign until you have the Board's written approval. Speak to Super SA before you leave your employment.
If you have already left work because of your incapacity, a benefit may still be considered, but you will need to prove that your employment ended as a direct result of incapacity. See the Making a TPD Claim Kit for details.
To make a claim, you must:
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- Be under age 701
- Provide details of your condition, and
- Provide a medical report completed by your Medical Practitioner and a Specialist Medical Practitioner, and
- Lodge your claim within 2 years of the commencement of the incapacity.
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If your employment has already been terminated on the grounds of TPD, you must additionally:
• Satisfy the Super SA Board that you have a permanent incapacity that aligns with the scheme’s definition of permanent disablement in the Regulations, and
• Be incapacitated for all kinds of work for at least six months after termination and make your claims within two years of termination.
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Can I claim TPD insurance for terminal illness?If you are suffering from terminal illness, and it is likely to result in your death in the next 24 months, your TPD Insurance may be paid.
To make a claim, you must:
- Be under age 702
- Provide two medical reports, one completed by your Medical Practitioner and another by your Specialist Medical Practitioner, and
- Satisfy the Super SA board that you have a terminal illness.
It is important you are aware that if you receive a terminal illness benefit, your legal spouse or estate will not be able to claim an insurance benefit in the event of your death.
This means you can only make a Death and TPD Insurance claim once.
When Super SA has received your claim, it may take up to three weeks before you will know the outcome. If it’s likely to take longer than this, Super SA will let you know.
Terminal illness benefits may be paid even if you don’t have insurance (equal to the sum of your Triple S account) within your account. The benefit may also be paid subject to a claim being approved without you terminating your employment.
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When am I not covered in the Triple S Scheme?
- When you no longer work within the SA public sector
- If you’re a spouse member and the Triple S member is no longer a member of the scheme (ie, withdraws their Triple S balance), or when they are no longer your spouse
- If you had a medical condition that existed at the time you joined Triple S, and you have been working in the public sector less than six months3
- Where a claim arises from suicide within the first 12 months after the commencement or increase in the level of cover
- If you were formerly in the Lump Sum Scheme and Pension Scheme, but later became part of Triple S without ceasing employment, you won’t be covered for any medical condition on TPD Insurance, including terminal illness, for 24 months from the date your Triple S membership commenced.
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1 Or under 65 in the Fixed (closed) Insurance Death and TPD Product.
2 Or under 65 in the Fixed (closed) Insurance Death and TPD Product.
3 Once you have completed six months of active work, you will only be covered for all medical conditions on the default units of cover you received on joining, including pre-existing medical conditions. Conditions may apply to any additional units.
2 Or under 65 in the Fixed (closed) Insurance Death and TPD Product.
3 Once you have completed six months of active work, you will only be covered for all medical conditions on the default units of cover you received on joining, including pre-existing medical conditions. Conditions may apply to any additional units.
