Skip to Main Content

Insurance and benefit forms

To apply for additional insurance cover, please login to Statewide Super Online. Other insurance forms can be found here.

These files are PDF documents. If you have any trouble, try downloading the latest version of Adobe Reader.

Insurance

  • Insurance
    PDF

    Automatic Acceptance form (File size 249 KB)

    If you are a new member of Statewide Super you have the opportunity to increase your insurance cover within 60 days of joining the fund without needing to provide any medical evidence. 

    PDF

    Transfer of insurance form (File size 374 KB)

    If you are a member of Statewide Super, you may be eligible to transfer any existing Life, Total and Permanent Disablement (TPD) insurance or Income Protection (IP) insurance.

    PDF

    Reduce or cancel insurance form (File size 216 KB)

    Please use the this form if you want to reduce or cancel your insurance cover. 

    PDF

    Terminal illness insurance claim form (File size 915 KB)

    Please use this form if you want to make a Terminal Illness claim. Please consider your eligibility to claim for any other insurance you hold with Statewide Super. 

    PDF

    TPD insurance claim form (File size 1.4 MB)

    Please use this form if you want to make a claim for Total and Permanent disablement. Please consider your eligibility to claim for any other insurance you hold with Statewide Super. 

    PDF

    Income protection claim form (File size 1.5 MB)

    Please use this form if you want to make an Income Protection claim. Please consider your eligibility to claim for any other insurance you hold with Statewide Super.

    PDF

    Application to change occupation category (File size 235 KB)

  • Benefits
    PDF

    Terminal illness benefit (no insurance held) form (File size 632 KB)

    Please use this form if you want to make a claim for Terminal Illness.

    PDF

    TPD benefit claim form (File size 483 KB)

    Please use this form if you want to make a claim for Total and Permanent disablement.