Cbus Accident & Sickness Frequently Asked Questions
Below is a list of FAQs. If you have a question that is not on the list please contact one of the friendly Cbus Accident & Sickness Insurance team on 1300 362 146 or email us your questions and we will respond within 24 hours during business hours.
Is my occupation covered?
Most occupations are covered. However there are certain high risk occupations unfortunately that cannot be covered. For example, underground mining, tunneling, explosives, police force. Please contact our office should you have any queries.
Am I able to claim for Income protection, if I lose my job or became redundant?
Cbus Accident and Sickness Insurance does not cover redundancy, only for disability that prevents you from working in your usual occupation as a result of an Accident or Sickness. Should you lose your job whilst receiving accident or sickness benefits, and still suffer from the disability claimed, payment of claim benefits can continue up to the maximum benefit period (subject to the terms and conditions of the Policy).
What is an excess period?
You will be paid loss of income benefits insured for when the insurer accepts your claim and as soon as your chosen excess period is over. This means that you will not be paid any benefits during the chosen “excess period”. This is NOT backdated to the date when you were first disabled. Your benefit payment will start from the day your chosen excess period ends provided you continue to be disabled.
If I go back to work part-time will my benefit payment stop?
If you go back to work part time, the disability benefit will continue as long as you provide a medical certificate to say that you are still suffering from the condition that you were on claim for, but the benefit will be offset against any income earnt. Business Expenses insurance for self-employed persons (if applicable) will also be offset against any income earnt.
What if I have a recurrence of the disability?
If you have received compensation under the Weekly Benefits section of the Table of Benefits and while your policy is in force suffer a recurrence of Temporary Total or Temporary Partial Disablement from the same or related causes within 6 consecutive months of your return to your usual occupation on a full time basis, the Insurer will consider such Disablement to be continuation of the prior claim period.
No additional waiting period applies in this event and the period of recurring Disablement will be aggregated with the prior claim period.
Is my premium going to be deducted out of my superannuation account?
This cover is provided outside of your Cbus superannuation account therefore premiums cannot be deducted from your superannuation account. The premium requires to be paid to IFS Insurance Solutions, who administer Cbus Accident and Sickness Insurance. The premium may be tax deductible, please speak with your accountant or financial advisor for further clarification.
Can you tell me what my superannuation balance is?
You need to contact Cbus Super directly on 1300 361 784.
Who pays my claim should I be disabled under my policy?
The insurer, Insurance Australian Limited trading as CGU and Accident and Health International Underwriting who act as an agent of the Insurer. IFS Insurance Solutions administers the Cbus Accident and Sickness Insurance for Cbus Members.
What can you tell me about the Income Protection product available from Cbus members inside the Fund?
You will need to contact Cbus directly on 1300 361 784 as the product offered and requirements are different.
Does the premium increase as I get older?
Provided there are no changes to your existing insurance cover when first taken out, your insurance premium will not increase as you get older, unless the Insurer increases insurance premiums for everyone covered under the scheme.
Do I look at my Net income or Gross Income, for calculating the insurance premium?
The pre-tax income (Gross Income) is required to calculate your premium if you are Employed. And in case of Self-Employed its pre-tax income but after deducting your business expenses.
Is the premium tax deductible?
Your premium may be tax deductible, excluding the capital benefits premium. Please note that this is general advice only and confirmation should be sought through your tax advisor or the Australian Tax Office.
Do I need to use all my sick leave before I can claim for income protection?
No. You do not have to use all of your sick leave entitlements if you are an employee before you can claim.
What is one of the main requirements in lodging a claim for accident and sickness insurance?
You must be disabled within 12 months of incurring an accident or sickness. The accident or sickness you are claiming for must NOT be one of the exclusions if it is shown on your policy schedule or renewal schedule.
Will I get a refund in insurance premiums paid in case of a mid-term policy cancellation?
Yes, you can cancel the policy mid-term and you will be eligible for a pro-rata refund of the insurance premium paid Please note that the administration fee is not refundable.
Can I change my cover mid-term?
Yes, the policy can be changed anytime to suit your wage insurance requirements and a pro-rata adjustment will be made to the premium. This is subject to acceptance by the Insurer.
Is Critical Illness or Trauma part of Capital Benefits Cover?
Critical illness or Trauma is not covered under this policy and it is not part of Capital Benefits Cover. Lump Sum Capital Benefits are payable as a result of injury only.
Can I claim if I have returned to work before the excess period expires?
No. You have to be off work continuously for more than your chosen excess period to be entitled to lodge a claim.
What happens if I have two accident and sickness insurance policies at the same time?
You cannot receive more in claim benefits than what you have earnt An offset provision applies for example, if your chosen weekly benefit is $2000 and your simultaneous policy pays you a weekly benefit of $1200, in this case your Cbus Accident and Sickness policy will pay you $800.This is subject to your actual earnings and claims assessment by the Insurer.
What happens if I am injured at work and unable to work as a result of the injury?
If you work for an employer, normally workers compensation applies. You may be eligible for a top up benefit dependent upon what level of cover you have selected.
If you are self-employed you will be paid up to the amount that you have insured yourself for as long as the insured amount represents what you have earnt.
What happens if I am injured or sick overseas?
The policy provides cover for loss of income 24 hours per day 365 days a year, worldwide which is subject to the cover outlined in your Policy Schedule or Renewal Schedule (whichever is the latter representing your current period of insurance).
Am I covered for all sports related injuries?
Depending upon the sport which must be non-professional, cover may or may-not apply. Please contact the Cbus Accident and Sickness Insurance call centre to discuss further.
What is the minimum and maximum age to access Cbus Accident and Sickness Insurance?
You have to be between the ages of 16 to 65 to apply for cover.
Can I apply for cover if I am casual or work part-time?
Yes you can. Please contact our office for more details.
Does this policy cover medical expenses?
No. Medical expenses are not covered under this policy. This is an Income protection policy which covers you for the loss of income due to Accidental injury or Sickness.
Do I have to submit a medical examination before I can apply for cover?
No medical examination is required at the time of application however, the insurer may request for a medical examination at their expense during the course of an accepted claim.
Is there a qualifying period for my insurance cover to commence?
There is no qualifying period required before you can access insurance cover. Once your application has been accepted by the Insurer and you have paid for the premium, you will have access to insurance from the date cover commences.
What is the definition of earnings at the time of claim?
If the Insured Person is self-employed:
The Insured Person’s gross weekly income derived from personal exertion after deducting any expenses necessarily incurred in deriving that income, averaged over the period of twelve months prior to the date of disablement commenced or over such shorter period that the Insured Person has been continuously self- employed.
If the Insured Person is an employee:
The Insured Person’s gross weekly rate of pay inclusive of overtime payments, bonuses, commissions and allowances averaged over the period of twelve months prior to the date of disablement commenced or over such shorter period that the Insured Person has been continuously employed.
What are the general exclusions under this policy?
No benefits are payable:
1. For any condition resulting from Injury or Sickness which:
is deliberately caused by the Insured Person or which is self–inflicted;
occurs as a result of war, invasion or civil war;
results from being engaged in any aerial activity other than as a passenger in a licensed aircraft;
results from taking part in or training for any professional sporting activity.
2. For any condition attributable to pregnancy or childbirth or complications of these unless the Insured Person is continuously confined to bed on advice from a duly qualified medical practitioner and the term of the pregnancy has not exceeded 26 weeks.
3. For any Injury or Sickness that is directly or indirectly caused by any pre-existing condition for which a duly qualified medical practitioner was consulted or for which medication or treatment was prescribed within six months immediately prior to becoming insured under this policy. This time frame includes a condition, the symptoms of which would have caused a reasonable person to seek medical advice or treatment.
4. In respect of any Injury or Sickness directly or indirectly caused by or contributed to by an Act of Terrorism
5. For any Injury or Sickness that results from the illegal or criminal acts of the Insured Person.