The level of Death and TPD insurance members receive when they join Triple S is as follows:
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- Alicia Merritt
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1 > 1 Triple S Death and Total and Permanent Disablement (TPD) insurance provides cover to help ease the financial burden in case of your illness, injury or death. The level of Death and TPD insurance members receive when they join Triple S is as follows: Full time and part time employees: 2 standard units Casual employees: 2 Standard units Police and Ambulance members 1 : 6 Standard units Lump Sum and Pension Scheme members who salary sacrifice/receive a co-contribution: nil The initial units of cover are provided to you regardless of your current state of health and medical history. 2 Triple S Spouse member insurance Voluntary Death Only insurance is only available to Triple S Spouse members. Six-month pre-existing medical condition period Triple S TPD Insurance does not cover you for a medical condition that existed at the time you joined Triple S until you have been working for six months. Once you have completed six months of active work, you will be covered for pre-existing medical conditions on your two units of Standard cover. Conditions may apply to additional units. Description Eligibility Cost Maximum Benefit Death and TPD cover Provides you with an insured benefit, payable in the event of your total and permanent disablement, or to your spouse 1 or estate in the event of your death (plus your super balance). If you are under 65 years of age and an active member of Triple S. Note: not available to spouse members. Standard $0.75 per unit Fixed refer to Fixed cover section Working part-time or full-time: $1,500,000 of Death and TPD cover Casual employee: $750,000 of Death and TPD cover Benefit Provides insured members under the age of 65 with a lump sum insurance entitlement in the event of death, total and permanent disablement, or terminal illness. Death Only cover Provides you with an insured benefit, payable to your spouse or estate in the event of your death. This benefit is paid in addition to your Triple S account balance. If you are under 65 years of age and a Triple S Spouse member. You are not required to meet any employment conditions to apply. Note: spouse members in Triple S are only able to apply for Death Only Insurance. Standard $0.50 per unit Fixed refer to Fixed cover section $1,500,000 of Death Only cover Provides insured members under the age of 65 with a lump sum insurance entitlement in the event of death. 1 Members of Triple S who are employed as SA Police Officers, SA Ambulance Operational staff and SA Ambulance staff who transferred into Triple S from the SA Ambulance Service Superannuation Scheme. 2 Limitations apply to members with a pre-existing medical condition who have been working under six months.
2 > 2 Tim is currently 34 years old. When he became a member of Triple S, he automatically received two units of Standard Death and TPD Insurance but, in order to cover his mortgage and other commitments, he chose to apply for another two units. At a cost of $3.00 per week, Tim has four units of Standard cover valued at $300,000. Tim must remember that, when he turns 35, the value of his four units of Standard cover will reduce to $288,000. Standard Cover One Unit ($) One Unit ($) Up to 34 75, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , not offered Standard cover The value, or worth, of a unit of Standard cover is linked to your age. Once you reach age 35, the value of a Standard unit gradually decreases each year. For example, if you are aged 34, one unit is worth $75,000, but at age 45, one Standard unit is worth $42,000. Standard Death Only Cover One unit ($) One Unit ($) Up to 34 75, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , not offered Cost of Standard cover Standard Death and TPD Insurance costs 75 cents per unit per week. Therefore, two units of Standard Death and TPD Insurance will cost $1.50 per week and so forth. Standard Death Only Insurance costs 50 cents per unit per week. Therefore, two units of Standard Death Only Insurance will cost $1.00 per week and so forth.
3 > 3 If you require further information on Super SA s underwriting processes, please contact the Claims Management team on or medicalsuper@sa.gov.au. Payment of premiums Insurance premiums are deducted from your super balance. Super SA will keep you informed of any changes to premiums. Casual employees and insurance Casual employees are not required to have Death and TPD Insurance. If you do not require insurance you need to complete and return the Casual Employees Opt Out of Death and TPD Insurance form to Super SA. Casual employees working less than nine hours per week, or for periods that average less than nine hours per week over a three month period cannot apply for additional units of cover. Members who don t automatically receive initial cover Triple S Spouse members (see information on Death Only Insurance in this fact sheet) Lump Sum Scheme, Pension Scheme and Police Pension Scheme members who are also members of Triple S, do not automatically receive two units of Standard cover. However, these members can apply to purchase insurance through Triple S in addition to the insurance provided through their current super scheme. Members ineligible for insurance Triple S members not eligible for insurance include: Members aged 65 and over Non-active or preserved Triple S members SA public sector employees who are employed for a specified period and are remunerated by a fee, allowance or commission (eg members of boards and committees). Conditions under which Death and TPD insurance cover does not apply Your cover will cease: if you do not have enough money in your account to meet the cost of your insurance for full-time and part-time employees, when employment is terminated for Casual employees who work nine or more hours per week for periods of three months; 12 months following the date last worked. Death and TPD Insurance while you re on Leave Without Pay You can choose to suspend your Death and TPD Insurance cover while you re on Leave Without Pay (LWOP) and you will not be charged costs for insurance for this period. To do this, contact Super SA. Note however, when your insurance cover is reinstated you will only be covered for accidental injury within the first year. Terminal Illness Active Triple S members are covered for Terminal Illness. If you are diagnosed with a terminal illness, you can receive your TPD Insurance entitlement and the balance of your accounts without having to terminate your employment. If you do not have Death and TPD Insurance or you have terminated your employment, you can claim the balance of your Triple S account on the grounds of terminal illness. Eligibility criteria for claiming Terminal Illness You must satisfy the Super SA Board that you have an illness or condition that is likely, in the opinion of two medical practitioners (one being a specialist in the relevant field), to result in your death within 12 months of the day on which the opinion is given. If you receive a Terminal Illness entitlement, you will not be entitled to any further Triple S insurance cover, including Death, TPD and Income Protection Insurance.
4 > 4 Eligibility criteria for claiming Total and Permanent Disablement Insurance: You must satisfy the Super SA Board that your incapacity for all kinds of work is at least 60% and is likely to be permanent. The Super SA Board must approve the payment of a total and permanent disablement entitlement. Therefore, do not resign or accept termination on account of ill health or medical conditions without first getting written approval from the Super SA Board. Your employment must be terminated on the grounds of total and permanent disablement before you reach age 65. If you resigned because of your incapacity or your employment was terminated as a result of unsatisfactory performance due to your incapacity, you must have been incapacitated for all kinds of work at the date of termination and for at least six months since terminating employment. If your employment was terminated due to the expiry of a fixed term contract, your medical condition must have existed before the expiry of the contract and caused incapacity for all types of work for six months since the expiry of the contract. If your employment was terminated without first receiving approval from the Super SA Board and you wish to lodge a claim for total and permanent disablement, you must do so within two years of terminating employment for it to be considered. For example, if John terminated his employment on 1 November 2011, he must apply for his TPD entitlement within two years, ie by 1 November Total and Permanent Disablement Insurance may not be approved if you refuse or fail to submit to reasonable medical treatment that would likely assist in your rehabilitation to work. Former contributors of the Lump Sum Scheme and Pension Scheme who became Triple S members without ceasing employment, will not be covered for any pre-existing medical condition on their Total and Permanent Disablement Insurance, including terminal illness, for 24 months from the date their Triple S membership commenced. This does not apply to Triple S Death Insurance. Entitlements payable upon death Triple S has no provision for you to nominate a preferred beneficiary in the event of your death. Your entitlement will be paid to your spouse and/or putative spouse 1, upon your death. If you do not have a spouse/putative spouse, your entitlement will be paid to your Estate. You should therefore ensure that your Will reflects your wishes regarding the distribution of your Estate. Changing your insurance Opting out: Part time and full time employees cannot opt out of Death and TPD Insurance. Casual employees can suspend their Death and TPD Insurance at any time by completing the Casual employees Opt Out of Death and TPD Insurance form available on our website. If you do opt out you can always apply for insurance again at any time if your needs change. However you will only be covered for accidental causes within the first year of reinstating your cover. Increasing: If you are happy with the value of your Standard Death and TPD Insurance (if any), you do not need to do anything. However, if you decide you want a higher level of Death and TPD Insurance, you have the option of applying for additional units of Standard Death and TPD Insurance. Further information is available in the Applying for insurance section.
5 > 5 Cost of Fixed cover This depends on your age when you bought units. For members who already have Fixed cover the cost remains the same regardless of age. Fixed cover Members are no longer able to apply for Fixed units of cover. However, members who already have Fixed cover prior to the cessation of this offering on 13 November 2014 retain their current level of cover. Members with Fixed insurance can only increase their level of cover by opting out of Fixed insurance and switching to Standard cover. Members with Fixed Insurance also have the option of reducing their level of Fixed cover. You cannot mix units of Standard and Fixed cover at the same time. Members should be aware that unlike Fixed cover, the value of Standard cover decreases over time. Members with Fixed cover who wish to change their level of cover must use the Triple S Changes to Fixed Insurance form which is available to download from the website. Fixed Death and TPD Cover ($75,000 per unit) Age unit(s) purchased 20 & under not offered Fixed Cover Death only ($75,000 per unit) Age unit (s) purchased 20 & under not offered
6 > 6 1 Spouse/putative spouse In general terms, the person must have been living with the member at the date of death of the member and: lived continuously with the member for a period of three years immediately before the date of death, or lived with the member for an aggregate period of three out of four years immediately before the date of death, or a child has been born of the relationship of whom both partners are the natural parents. A couple of the same sex living in a relationship that has the distinguishing characteristics of a married relationship, who have been living together continuously for the preceding three years, or living together for not less than an aggregate of three years out of the preceding four, are also putative spouses. Applying for insurance To purchase units of Standard cover, you will need to complete and return the Triple S Changes to Insurance form to Super SA which can be downloaded from the Super SA website. Members with Fixed cover who wish to change their level of cover to Standard, or decrease their level of Fixed cover, must use the Changes to Fixed Insurance form. If you apply to change your insurance cover, your new cover is effective from the date Super SA receives your application. Once the cover is approved, the cost is backdated to when we received your application and the amount is deducted from your super balance. Does Super SA use premium loadings? Unlike many insurance providers, Super SA does not load, or increase premiums for members who have certain medical conditions, undertake certain activities or have different types of jobs. Pre-existing medical conditions When applying for extra insurance Super SA may apply limitations to your Death Only or Death and TPD Insurance due to any pre-existing medical conditions or activities (eg heart disease or smoking). When you complete the Insurance form, you will be asked questions about your medical history and you will need to provide details of any medical conditions. If you do not disclose a previous or existing medical condition and a claim is later made for Death or TPD Insurance, the entitlement may be reduced. Limitations A limitation refers to an increased risk of illness or disablement. For example, a person who has heart problems, now or in the past, is more likely to suffer heart disease in the future than a person who does not have heart problems. If you do have a limitation placed on your insurance, it is important to remember that you are still covered for all other events not related to the limitation. Super SA has a smoking policy, which means if you are, or have been a smoker in the last five years, you will have a smoking related illnesses limitation placed on your cover. Once you have ceased smoking for a period of five years, this limitation may be removed by providing a statutory declaration. Super SA also has a weight and height policy, which means if you are under or over what is considered a healthy weight range for your height you will have a weight related illnesses limitation placed on your Income Protection cover. To enable removal of this limitation you must be within the indicated weight range corresponding to your height for at least 12 months. It is important to note that the final decision of whether or not to fully insure you lies with the Super SA Board. If the Super SA Board feels your pre-existing illness or injury puts you at a greater risk of illness or injury, they have the right to apply limitations to the cover. What does the limitation mean for me? If Super SA places a limitation on your Death and TPD Insurance cover, any future claims you make which are medically connected to your limitation will be declined. During the claim process, Super SA will ascertain if there is a connection when reviewing your medical history and will seek expert medical opinions. If there is a proven connection between your limitation and your illness or disablement, any claim for Death and TPD will be declined. What if I do not disclose a medical condition on my application form? When a member lodges a claim for insurance, part of the claim process is to review the claim/medical information received in conjunction with your original
7 > 7 application. If there is medical evidence stating that a condition or symptoms existed before you were granted your additional insurance, and this was not disclosed on your application, Super SA has the right to deny this insurance claim. This is known as non-disclosure, and any insurance cover can be declined where non-disclosure occurs. How to make a claim To make a claim for Death or TPD Insurance, contact Super SA. The time taken to assess your claim depends on the conditions you have and the information that s available. A claim can take anywhere from a few weeks to several months, particularly if we have to wait for information from doctors. We will keep you informed of progress and how you may be able to help us if there are any delays outside of Super SA s control. Further information The following Product Disclosure Statement (PDS) and fact sheets may be helpful if read in conjunction with the information presented above: Income Protection Insurance Leave Without Pay Triple S spouse members and spouse accounts fact sheet Triple S PDS Fact sheets on a range of topics relating to your super are available on the Super SA website and from Super SA. Alternatively, if you have any enquiries regarding fees or any other matters raised in this fact sheet, please contact Super SA. Contact us Address Ground floor, 151 Pirie Street Adelaide SA 5000 (Enter from Pulteney Street) Postal GPO Box 48, Adelaide, SA supersa@sa.gov.au Call (08) (for regional callers) Website Disclaimer The information in this document is intended to help you understand your entitlements in Triple S. Super SA does its best to make sure the information is accurate and up to date. However, you need to be aware that it may not include all the technical details relevant to the topic. For the complete rules of Triple S, please refer to the Southern State Superannuation Act 2009 and Southern State Superannuation Regulations The Act and accompanying Regulations set out the rules under which Triple S is administered and entitlements are paid. You can access a copy from the Super SA website. Triple S is an exempt public sector superannuation scheme and is not regulated by the Australian Securities and Investments Commission (ASIC) or the Australian Prudential Regulation Authority (APRA). Super SA is not required to hold an Australian Financial Services Licence to provide general advice about Triple S. The information in this document is of a general nature only and has been prepared without taking into account your objectives, financial situation or needs. Super SA recommends that before making any decisions about Triple S you consider the appropriateness of this information in the context of your own objectives, financial situation and needs, read the Product Disclosure Statement (PDS) and seek financial advice from a licensed financial adviser in relation to your financial position and requirements. Super SA and the State Government disclaim all liability for all claims, losses, damages, costs or expenses whatsoever (including consequential or incidental loss or damage), which arise as a result of or in connection with any use of, or reliance upon, any information in this document. The Chant West ratings logo is a trademark of Chant West Pty Limited and used under license. SuperRatings does not issue, sell, guarantee or underwrite this product. Go to for details of its rating criteria.
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