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Insurance forms

To apply for additional insurance cover, submit a new claim or track an existing claim please login to Statewide Super Online and go to the Insurance tab.

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

Insurance forms

  • Forms
    PDF

    Additional Default Cover form (File size 328 KB)

    If you are a new member of Statewide Super you have the opportunity to increase your insurance cover within 90 days of joining the fund without needing to provide any medical evidence. 

    PDF

    Transfer of insurance form (File size 381 KB)

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

    PDF

    Reduce or cancel insurance form (File size 241 KB)

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

    PDF

    Application to change occupation category (File size 292 KB)

    Please use this form if you want to apply to change your Occupation Category.

    PDF

    Insurance application and personal statement form (File size 344 KB)

    Please use this form if you want to apply for new cover or if you are seeking to increase your level of insurance cover.

    PDF

    NTG insurance opt-in form (File size 361 KB)

    Please use this form if you are an NTG member and wish to opt-in to obtain insurance cover through Statewide Super.