A pre-existing condition is an illness or injury where the signs or symptoms existed before the date that your QSuper insurance cover or additional cover began. Some of our insurance cover comes with what’s known as a pre-existing exclusion period, which is the period during which we won’t pay an insurance benefit if the illness or injury you are claiming for relates to a pre-existing condition.

Default cover

In most circumstances, default cover for death, TPD cover and/or income protection cover has no pre-existing exclusion period as long as you are at work on the day your default cover starts. If you’re not at work on the day your default cover starts, an indefinite pre-existing exclusion period will apply until you have been at work for 30 consecutive days.

The default cover you obtain in the following circumstances will be subject to a five year pre-existing exclusion period:

  • if you open your account (not through your employer) or your account is opened because you’re the spouse of a QSuper member prior to 1 July 2017, or as a result of a family law split
  • if you have a QSuper Income account and your QSuper Accumulation account is opened as a result of a contribution (including consolidation from another fund)
  • if you move from a Defined Benefit account to an Accumulation account, but this will only apply to the part of the default cover you receive that is higher than your prospective benefit (see the Accumulation Account Insurance Guide for a definition of 'prospective benefit')
  • if you reduce your cover to less than the default level, then increase your cover back up to your default level of cover, but this will only apply to the increased amount
  • if your cover is obtained more than 120 days after starting employment with a default employer or Queensland Government employer.

 

Personalised cover

You should also know that a five year pre-existing exclusion period will also apply:

  • on any income protection cover you apply for1
  • on any additional death cover and TPD cover you apply for.

Similarly to your default cover, if you’re not at work on the day your increased cover or personalised cover starts, an indefinite pre-existing exclusion period will apply. However, once you’ve been at work for 30 consecutive days the pre-existing exclusion period will be reduced to five years.

An indefinite pre-existing exclusion period will apply if you were previously eligible to receive, entitled to receive or have received a TPD benefit or similar benefit from QSuper or anyone else, or if you had been diagnosed with a terminal illness before your default or increased cover started.

In all cases when a pre-existing exclusion period applies, you must be at work on the day that it expires, otherwise, the pre-existing exclusion period will continue to apply until you have been at work for 30 consecutive days.

In many cases you can request to have it removed, as long as you provide us with health and other information and we then accept your request. You can apply for this via Member Online, or call us and we’ll send you the appropriate form/s.

Paul Case study

Paul is 45 and has three units of default TPD cover, which do not have a pre-existing exclusion period. Paul decides to buy an additional three units of TPD cover (which do have a pre-existing exclusion period), so his total cover is:

Three units of default TPD cover

$262,080

Three units of additional TPD cover

$262,080

Total cover

$524,160

Please note that the case studies are provided for illustrative purposes only and the members shown aren’t real. It is assumed for the purpose of the case studies that all terms and conditions have been met. Additionally, figures may be rounded up for ease of understanding.

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1 If you are a casual employee employed by a Queensland Government employer or default employer you will have no pre-existing exclusion period on the first two units of income protection cover you apply for, providing you apply for this cover within 120 days of starting your job with your Queensland Government employer or default employer and the cover you apply for is a three year benefit period and a waiting period of the greater of accrued sick leave or 90 days.

Please note this information is a general summary only. Please refer to our Accumulation Account Insurance Guide for further information on terms, conditions and eligibility.