Accessing documents held by a superannuation trustee or insurer
During the assessment of an insurance claim an insurer or superannuation trustee will have possession of documents which are relevant to the claim. These can include documents specifically about the claim or more general documents like the policy terms and conditions or agreements about the administration and processing of claims. Commonly the insurer or trustee will assert that they are not required to provide a claimant with documents. There are 3 means by which a claimant may be entitled to documents. They are pursuant to their right as a beneficiary of the superannuation trust; under Section 1017C of the Corporations Act 2001; or pursuant to Australian Privacy Principle 12 which is part of the Privacy Act 2008.
Beneficiaries of a superannuation trust
As a beneficiary of a superannuation trust the general rule is that you are entitled to access “trust documents” and a superannuation trustee is obliged to give access on request. This ordinarily means the trust deed itself and any annexures to it or rules about how the trust is administered, account information and the like. It can also include policies of insurance under which you are an insured member and any ancillary documents about how claims are managed. As with all general rules there are exceptions. An example is that a trustee does not have to disclose documents that are provided to them in confidence or which may contain commercially sensitive material.
The Corporations Act expands upon a claimant’s right to include access to documents which will assist them to understand their entitlement to benefits which are part of their particular superannuation product. This is arguably broader than just trust documents. Documents generated during the course of an insurance claim through superannuation could be caught by this Act if they will help the claimant to understand their entitlements. The obligation to provide documents is imposed on the issuer of the relevant superannuation product. This can include both the insurer and superannuation trustee. There are exceptions to this obligation which do not require the disclosure of internal working documents or documents containing trade secrets or commercially sensitive material.
Finally the Australian Privacy Principles provide for access to personal information held by Government Agencies and private corporations. Insurers are corporations and usually the trustee of a super fund is a corporation also or it may be a Government Agency if it is managing funds for public servants. Personal information can be contained in medical reports and records obtained during a claim. Most documents in an insurance claim will contain personal information and this is arguably a broader right again to access documents including internal working documents that might be excluded under other avenues.
These are just some of the obligations imposed on insurers and superannuation trustees to provide documents and information. If an insurer or trustee refuses access to documents they are required to explain reasons why and those reasons can be challenged in an appropriate case.
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