When you make a TPD claim through your superannuation, there are actually two separate entities involved in the decision — the insurer and the super fund trustee. Understanding how they interact is important if you want to challenge a rejection.
The insurer's role
The insurer (e.g. AIA, TAL, MLC Life, Zurich) holds the TPD policy and assesses your medical and vocational evidence against the policy's definition. They make a recommendation — to pay or to decline. But this recommendation is not the final word.
The trustee's role
The super fund trustee is the legal owner of your policy and has a duty to act in your interests. They review the insurer's recommendation and make the final decision on whether to pay the claim. In theory, a trustee can reject an insurer's recommendation to decline — though in practice this is uncommon unless the claimant has raised it directly.
Why this matters for rejected claims
When you lodge a formal complaint (IDR), you are complaining to the trustee, not the insurer. The trustee must review the decision independently. This is a genuine second chance — and it's why the IDR process is more powerful than many people realise.
Similarly, AFCA complaints about super fund TPD decisions are made against the trustee. The trustee must then defend its decision, not the insurer.
Get the trustee on your side
Understanding that the trustee has an independent duty to you means you should address your IDR complaint to the fund directly — not just argue with the insurer's medical assessment. A trustee can be persuaded that their own obligations require them to pay even where the insurer's position is marginal. Start with our free eligibility check.