Default cover and insurer
HESTA provides default Death and TPD cover for eligible members. Cover is currently underwritten by AIA Australia Limited. HESTA historically had higher default cover than many comparable funds reflecting its predominantly female, healthcare-focused membership.
Indicative default cover amounts (always check your Annual Statement for actuals):
| Age | Indicative default TPD cover |
|---|---|
| 25 | $130,000 – $250,000 |
| 35 | $220,000 – $400,000 |
| 45 | $200,000 – $360,000 |
| 55 | $80,000 – $160,000 |
Members in higher-risk roles (e.g. paramedic streams) may have additional or alternative cover. Voluntary additional cover is medically underwritten.
The TPD definition that applies to you
The standard definition is "Any Occupation": you must be unable to work again in any job for which you are reasonably suited by education, training or experience. The policy includes provisions for members not gainfully employed at the time of disablement (commonly an ADL-based test).
Mental health and burnout claims at HESTA
Mental health TPD claims represent a meaningful share of claims at HESTA, reflecting the realities of healthcare and community-services work. Common claim conditions include:
- Major depressive disorder, often treatment-resistant
- Complex PTSD from cumulative workplace trauma
- Vicarious trauma — particularly in social work, mental health, and emergency departments
- Anxiety disorders with significant occupational impairment
- Burnout-driven adjustment disorders
These claims usually require detailed treating-psychiatrist reports addressing function over time, history of treatment trials, and specific opinion on permanence. AIA commonly requests an Independent Medical Examination — attending is normal, not a sign of decline.
How to claim
- Notify HESTA of your intention to claim
- Receive and complete the claim pack — member statement, employer statement, treating-doctor reports, authorities
- AIA Australia Limited assesses against the policy definition (typically 3 to 9 months for mental health claims, 3 to 6 for physical)
- Trustee independently reviews and decides
- Approved claims pay out subject to condition of release
If your claim is declined
Common decline reasons:
- Insufficient evidence of permanence — particularly for episodic mental health conditions
- Insurer view that alternative occupations are open (despite specialty training only in nursing/healthcare)
- Pre-existing exclusion on voluntary cover
- Disputed date of stopping work
Internal dispute resolution then AFCA — see our guide to rejected TPD claims.
HESTA-specific tips
- Address the "Any Occupation" test specifically in treating-doctor reports. A nurse or paramedic with shoulder injury isn't necessarily "suited" to office work without retraining — this matters in the assessment.
- Mental health evidence quality matters most. Treating psychiatrists who provide detailed function-over-time reports get better outcomes than referrals to occupational psychiatrists who see you once.
- Multi-fund claims. Healthcare workers commonly hold cover at HESTA, AustralianSuper, and Aware Super simultaneously. Check all before lodging.
- Older policies. If your stopped-work date was prior to recent insurer changes, identify which policy applies — older OnePath terms may differ.