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14 Mar 2025 20:08
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  •   Home > News > International

    Australian Super member says delays in processing his insurance claim almost left him homeless

    An Australian Super member has hit out at the fund for delays in processing an insurance claim for disability related payments. His case comes as corporate watchdog ASIC issues a warning to super funds that delay death and disability payments to their members.


    Shannon Pincombe has spent almost a year fighting his super fund, Australian Super, for disability related payments. 

    He worked in property maintenance when he fell from the roof and injured his back in 2012.

    His physical situation deteriorated over the years — he's had two lower back surgeries, is unable to work and cannot walk properly — so he put in a claim for income protection with his super fund in September 2022.

    Mr Pincombe says TAL, the insurer for Australian Super, took so long to process his claim that he had to borrow funds from loved ones to avoid becoming homeless.

    "It impacted my life massively, like emotionally, knowing that I had no income, I wasn't able to support my children," Mr Pincombe said.

    [RELATED VIDEO ON AUSTRALIAN SUPER ASIC COURT ACTION]

    "The process is just so protracted and so stretched out, and it's really very difficult, and it's had a huge impact on my mental health."

    He says Australian Super via TAL originally approved his claim and said he'd be paid in nine days.

    But it he says then it took the insurer roughly 10 months respond to his claim, and he questions whether it was worth paying his super fund hefty insurance premiums over years.

    "I supplied all the medical information that they requested, certificates of capacity, you know, all of the information regarding the injuries that I'd had. MRIs reports, everything," he said.

    Eventually Mr Pincombe was accepted by WorkCover to cover the costs.

    "In May of 2023, two months before my superannuation insurer got back to me, the WorkCover authority had already approved a claim," he said.

    Mr Pincombe says TAL told him that because he's receiving WorkCover, he may not be eligible for full income protection from his super fund.

    He says he had to go ahead and accept WorkCover because, "I couldn't live on nothing. I was living essentially off the goodwill of others".

    Mr Pincombe says he is waiting for another surgery which he hopes will fix his lower back and that he can return to work and be "a contributing member of society".

    "I ran my own business, you know, I was self-determining, and then, you know, have a fall, have a nasty accident, and all that's taken away from me in the blink of an eye," he said.

    A spokesperson for Australian Super said it had contacted its insurer about Mr Pincombe's claim.

    "AustralianSuper and its insurer have to know how much workers compensation is being paid in order to know how much income protection insurance is required to be paid out," the spokesperson said.

    "Since this claim was approved in July 2023, the insurer made multiple attempts to get that information and is still waiting.

    "We are very keen to hear from the former member to make sure the claim can be finalised."

    ASIC takes Australian Super to court and puts other funds on notice

    While Mr Pincombe's case may not be an example of the fund breaking the law, Australia's corporate watchdog ASIC is suing Australian Super over failures in handling death benefit claims.

    It alleges the superannuation giant was responsible for delays of up to four years in processing nearly 7,000 claims.

    "We are particularly concerned when, at a time of deep distress, the actions of a super fund contribute to making a difficult situation even harder," ASIC's deputy Sarah Court said.

    "The failures and delays we allege in this case are serious and have real life impacts."

    It's the second time the regulator has called out super funds for failing to pay out insurance claims after launching legal action against Cbus last year for delays in processing more than 10,000 death and disability payments.

    Cbus has apologised for the delays and has committed to compensating affected members.

    It also comes as a Coalition-headed Senate inquiry called for an overhaul of Australia's $4 trillion super industry amid 'conflicts of interest'.

    On Thursday, in response to ASIC's action against Australian Super over death benefits claims processing, the super fund said it's "considering ASIC's claim carefully and will respond on the substance of the claim in due course".

    It said there had been a backlog of claims post COVID when there had been a "sharp increase in member deaths".

    It noted that in April last year it took some of its processing of death claims in-house.

    "Bringing this function in house strengthens our ability to deliver this important service efficiently and empathetically," the fund said.

    Australian Super also welcomed "the regulator's industry-wide attention on this matter".

    ASIC is set to release its report into death benefit payment claims in the superannuation industry in the coming weeks.

    The regulator has signalled other funds could come under fire.


    ABC




    © 2025 ABC Australian Broadcasting Corporation. All rights reserved

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