The eligibility rules change a bit depending on your policy. But generally, you’ll be eligible for TSC if you become too sick or injured to work and:
||have joined your employer sponsored AMP super account,|
|✓||are a permanent employee, and|
work at least 15 hours of regular work a week.
You’re generally not eligible if you’re:
|✗||a casual employee
|✗||a contract employee
||a non-executive director|
||a family member in the employer sponsored plan.|
Too sick or too injured to work
This generally means just that – you can’t do your current job because you’re too sick or injured. You don’t have to have been injured or have fallen ill on the job.
There’s usually a minimum timeframe for the length of your illness or injury (eg being sick for three months), and it’s also assumed that you’re under ongoing medical care via a doctor, and you’re not working for an income.
The insurance assessment looks at whether you can carry out any one duty or combination of duties that are critical to the proper performance of your usual occupation.
How TSC is worked out and paid
Generally, we work out your TSC payment as a percentage of your salary - up to 75%. Although, there will be a maximum amount insured. Please refer to your insurance guide for more details.
How other income affects the TSC benefit
If you’re receiving an income from elsewhere while also being paid a total disability benefit, your TSC payments will be reduced by the amounts coming from these other sources, which include:
- income from your occupation
- regular payments from social security, compensation schemes, government authorities, or super pensions / insurance plans as a result of being ill or injured.
Investment earnings or unearned income won’t reduce your TSC payment.
Receiving TSC payments can have tax implications. You can learn more at via the ATO website or speak to a financial adviser to understand how they could affect you.
How long will it last?
If you’re eligible, your benefit period (how long you’ll receive TSC payments) will have been chosen by your employer. The details of your benefit period are available in your insurance guide or plan summary.
Your employer may have chosen one of the following benefit periods:
- Up to two years (the maximum for a contract employees)
- Up to five years
- Up to age 65
A few other things to be aware of:
- TSC benefit payments will stop if you’re also being paid a Total and Permanent Disablement benefit. However, some plans may allow TSC to continue to be paid after a TPD benefit is paid. Your plan summary and member statement will confirm if this is the case.
- Receiving TSC can have tax implications. We can’t give personal tax advice but you can find out more via the ATO or by talking to a financial adviser.
Example of working out a TSC payment
John’s insured income is $100,000, so this is the amount we base his TSC payments from. He is covered for 24 months (2 years) and has no superannuation contribution cover. John becomes totally and permanently disabled and claims TSC payments.
After a three-month waiting period, John’s payments are worked out as 75% of the first $100,000 of his salary which equates to $75,000 or $6,250 per month for two years.
Warning: This example is illustrative only and is not an estimate of the insured amount you will receive or fees and costs you will incur.
Frequently asked questions about TSC
What if I have a recurrent disability?
An additional claim is treated as a new claim when:
- you return to your usual job for 6 months or more, and
- the claim is for the same or a related cause.
In this instance, both the waiting period and benefit period will start again.
An additional claim is treated as a continuation of the previous claim when:
- a claim is made within 6 months of when your claim stopped
- the claim is for the same or a related cause.
In this instance, we will waive the waiting period, but the benefit period will not restart.
What’s superannuation contribution cover and how does it apply ?
Put simply - this is an additional insurance on top of Life, TPD or TSC cover, that your employer may provide under your plan. It provides:
- continued contributions into your super - up to 15% of your salary (depending on your product), which is
- paid only if you’re either totally or partially disabled.
How it works:
- Your employer chooses the amount of cover - if applicable, you'll find this in your, plan summary or member statement.
The total insured TSC cover, including superannuation contribution cover, cannot exceed the maximum TSC cover.
What exclusions apply to TSC?
Although we'll provide you cover in most scenarios, there are a few situations where we won't provide TSC payments when you become disabled directly as a result. These include:
- Intentional self-inflicted injury
- Any act of war, whether declared or not
- Any other limitation or restriction that specifically applies to you. If any of these do apply, you can find them in your original PDS.
Note: we don't see pregnancy or childbirth as an illness or injury. However, if you're disabled because of complications during pregnancy or while giving birth, we'll cover you.
When will TSC payments stop?
We'll stop paying TSC benefits if:
- You're no longer totally disabled based on information available to us
- You pass-away
- You become totally and permanently disabled - however, some plans may continue to provide TSC even if a TPD payment is paid. If this is the case for you, you can find confirmation in your insurance guide, plan summary or member statement
- You turn 65 (or the communicated end date of your plan)
- We have paid payments for the total applicable period ie two years, five years, or to age 65
- If you engage in or perform any job, or work for reward in any capacity, except where we agree the work is part of rehabilitation.
What happens if I stop working - not because of illness or injury?
We won’t pay any TSC benefits if you stop working or go on unpaid leave for any reasons other than injury or illness. We may stop, or suspend TSC benefits if:
- You’re incarcerated as a result of a criminal act, and we don’t have enough evidence to confirm you’re still totally disabled.
- You’re overseas, and we ask you to return to Australia for medical treatment or other medical assessments and you’re unable to do so.
- You’re totally or partially disabled and don’t undertake treatment or rehabilitation which could be reasonably expected to help you return to work.
- You don’t attend a medical examination, or don’t provide us other evidence we’ve asked for to assess whether benefits should be paid.
Insurance eligibility under super laws
On top of the eligibility criteria for each of the different insurances, there are also super laws around eligibility for insurance inside super.
Generally, under super laws, you may not be eligible for insurance if any of the following applies to you:
- you are aged under 25
- since opening the account, your balance hasn't reached $6,000
- your account hasn't received a contribution or rollover for 16 months.
you tell us you'd like default insurance (if you tell us within 120 days of joining your employer, you won't need to complete a full application or provide information about your health. However, after 120 days, you will need to complete a full application and provide information about your health.) Or,
Please check your insurance guide or plan summary for more information around eligibility rules and how they may affect you.
What you need to know
Products in the AMP Super Fund and the Wealth Personal Superannuation and Pension Fund are issued by N.M. Superannuation Proprietary Limited (N.M. Super) ABN 31 008 428 322 (trustee), which is part of the AMP group.
This information is provided by AWM Services Pty Ltd ABN 15 139 353 496, AFSL No. 366121 (AWM Services) and is general in nature only. It hasn’t taken your financial or personal circumstances into account. It’s important to consider your personal circumstances and read the relevant product disclosure statement or terms and conditions available from AMP at amp.com.au or by calling 131 267, before deciding what’s right for you.
The Complimentary super health check help is provided by AWM Services and is general advice only. It does not consider your personal circumstances. Taxation issues are complex. You should seek professional advice before deciding to act on any information on this webpage.
You can read our Financial Services Guide online for information about our services, including the fees and other benefits that AMP companies and their representatives may receive in relation to products and services provided to you. You can also ask us for a hardcopy. All information on this website is subject to change without notice. AWM Services is a part of the AMP group and can be contacted on 131 267 or email@example.com.
The information is current as at August 2021.