Guide to making an insurance claim

Depending on the type of claim you’re making, you’ll need to send us some documents for your claim to be assessed.  

Here are the insurance claims forms you may need. We’ve also included a list below of the documents that are used to assess each type of claim.  

Don't worry if you have trouble gathering all this information and answering all the questions in the forms at the start of this process. Just do as much as you can and we’ll let you know what else we need from you as your claim assessment progresses. 

The documents marked with an asterix are the ones we’ll need as early as possible so we can initiate your claim with our insurer (AIA).   

First, make a copy of the original document. Then take the original document and your copy to an authorised certifier. They’ll check your copy is the same as the original then stamp, sign and annotate the copy. 

Make sure every page of the documents is clearly noted “True copy of the original”. 

Each claim is unique and the length of time the process will take varies. While a Terminal Illness claim is generally assessed within a few weeks, Total and Permanent Disablement (TPD) and Salary Continue Insurance (Income Protection) claims can take a few months, depending on your circumstances and documentation requirements. 

We’ll keep you up to date through each step of the claims process. You can also reach out to your dedicated claims assessor at any time to get an update. 

We’ll let you know if your claim has been accepted.  

For accepted Salary Continuance (Income Protection) claims, you’ll be paid to your bank account as quickly as possible after the waiting period has expired. If there’s a super component to your benefit, this will be paid directly to your super fund.  

For accepted TPD or Terminal Illness claims, the payment will be added to your super account. You’ll need to meet the relevant super condition of release for the funds to be paid to you.  

You’ll receive detailed information about how your accepted claim will be paid in your claims kit. 

Your claim may be declined by the insurer. This generally means that the insurer has determined your claim doesn’t meet the policy requirements.  

Claims may also be deferred for a period of time for the insurer to determine the full extent of your disability and whether it’s permanent. 

As the Trustee, we have a dedicated Claims Committee to review all claims that are deferred or declined by the insurer. This makes sure all deferred and declined claims have been correctly assessed and that the claim decision is fair and reasonable. 

Our claims philosophy is to ensure that all valid claims are paid as soon as possible. 

We try to ensure that: 

• claims are assessed within reasonable timeframes and updates provided on a regular basis 

• the claims process is as straightforward and easy to understand as possible, including our member communications 

• all members are treated with compassion and empathy 

  • recognising that the lodgement of a claim means the member must be undergoing a challenging time; and   
  • appreciating that some members are particularly vulnerable. We will make allowances where appropriate for vulnerable members. 

• claims declined by the insurer are carefully reviewed and challenged where it: 

  • does not appear fair and reasonable; and 
  • appears inconsistent with the policy intent or the claim has been declined on overly technical grounds. 

To give effect to our claims philosophy, we’re careful to ensure that our insurer’s claims philosophy aligns with ours. We work closely with our insurer (AIA) so that successful claimants receive their entitlement in full and that medical and other appointments (including documentation) are only required where necessary.    

AIA has its own claims philosophy for CFS members, which is to help people when they need it most. They make sure every claim that should be paid is paid promptly and they always treat CFS members with empathy, respect and care. They understand that everyone has different needs and that CFS members’ health and wellbeing goes beyond payments. That’s why they offer supported return to work, work-readiness and wellbeing programs that are evidence-based and results driven, at the right time for the member.