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Request Received

Employer's Statement
Thank you, your submission has been received.

Next steps

You are required to complete these additional forms to finalize your request.
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Request Saved

Employer's Statement
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Request Cancelled

Employer's Statement
Your application has been cancelled and will not be processed.

Starting the claim

Employer's Statement
Fields marked with * are required
This form is to be completed by the Employer (where possible the Employee’s direct manager) and relates to a claim for:

Total and Permanent Disablement (TPD)Income Protection (IP)Both TPD and IP
It will take approximately 20-30 minutes to complete and you may be required to upload scanned copies of:
Job descriptionRehabilitation reports and incident reportsSick leave payslipsProof of earnings (payslips) for the 12 months prior to the employee's last physical day at workLeave reports (annual leave, sick leave)Termination documentsAny other information that will assist in the assessment of the claim
You can save the form at any time, should you not have these documents readily available.

Please ensure you complete this form in full, as assessment of this claim may be delayed if the information provided is incomplete.

Employer details

Employer's Statement
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Employee details

Employer's Statement
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Date of birth

Employment details

Employer's Statement
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Employment details

Prior to the date the employee ceased all duties was he/she working in a reduced capacity or on alternative or restricted duties? *
Are there alternative duties the employee would be able to perform if they are unable to return to their normal duties? *
Would you support a return to work program? *
Is there a return to work co-ordinator to assist the employee with a return to work program? *
Are you aware of any other claims being lodged by the employee?

Additional Information

Employer's Statement
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Additional information

Document upload

Employer's Statement
Fields marked with * are required
Job Description
File:
Rehabilitation and Incident Reports
File:
Proof of earnings (payslips for the 12 months prior to ceasing work)
File:
Leave reports (annual leave, sick leave)
File:
Termination documents
File:
Other
File:
Please note maximum upload size is 25MB.

Declaration

Employer's Statement
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Privacy statement

TAL is bound by obligations imposed by current privacy legislation. Information received or requested from you is handled in accordance with these obligations. TAL requires that all entities adhere to relevant privacy obligations when dealing with personal and sensitive information about our customers.
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Insurance is provided by TAL Life Limited ABN 70 050 109 450 AFSL 237848 to VIS Nominees Pty Ltd ABN 11 006 586 367 AFSL 235097 as trustee of The Victorian Independent Schools Superannuation Fund ABN 37 024 873 660