Frequently Asked Questions - Claims

You will be assigned a dedicated Claims Consultant who will communicate directly with you regarding your claim. We will provide you with their name and direct phone number so that you can easily contact them if you have any questions or require assistance.

Your Claims Consultant will begin the assessment of your claim once the initial requirements have been received. The time taken to reach a decision on a claim may vary as it is based on:

• Individual circumstances;
• Complexity of the claim;
• Level of information required to assess the claim;
• Availability and timeliness in obtaining the information required from all parties.

Customers can assist during the claim process by completing requests for information accurately and providing relevant information promptly. If you’re having any trouble providing information, please let your dedicated Claims Consultant know as soon as possible, so we can work with you to overcome delays and consider alternatives. It can also help if you share any relevant documents or records you hold, reducing the need to request these from third parties such as a health provider.

In general, the benefit payment will be paid to:

• the Policy Owner, or
• for any benefit payable on death where the Policy Owner is also the Insured Person: the nominated beneficiary(ies) if there is a valid nomination, or to the estate of the Policy Owner if there is no nominated beneficiary(ies).

In order to identify the individual entitled to the benefit payment, we may require Probate (if a Last Will and Testament exists) or Letters of Administration.

Yes. In certain circumstances we can pay where the sum insured is $100,000 or less, subject to conditions.

A legal document by which a person can allocate their assets after death.

Probate is recognition issued by the State/Territory Supreme Court that you are authorised by the deceased’s Will to act as Executor of their Estate.

Letters of Administration are issued by the State/Territory Supreme Court when the deceased did not have a valid Will, which allow the administrator to distribute the assets of the deceased.

An Executor has the duty to collect the assets of the person who has died, pay any debts, and then distribute the Estate in accordance with the terms of the Will.

An Administrator’s duty is similar to that of an Executor, however, they must distribute the Estate assets in accordance with the laws that govern what happens when a person dies intestate (without a will).

The requirements are to be provided/completed by the Executor or Administrator of the Estate, the policy owner, the nominated beneficiary or the next of kin.

Yes. However, where certified documents are required, these documents must contain the original ink signature of the person who certified them. Faxed or scanned copies cannot be accepted.

If you have any questions about your claim, you can contact your Claims Consultant. More information can be found on our website.

To ensure your claim progresses as quickly as possible, we ask that you work with us to provide all the information we need to assess your claim.

The life insurance industry has developed the Life Insurance Code of Practice which is designed to protect customers and ensure we provide a high standard of service. We played an active role in the development of the Code and we fully support its implementation. You can find a copy of the Code of Practice at www.cali.org.au/life-code.

The Code does not create any legal relationship between insurer and insured.

We subscribe to the Life Insurance Code of Practice. The Code outlines the time frames that we are required to meet when managing claims, as well as the steps that we must take to communicate with you at certain stages of a claim. For more information on the Life Insurance Code of Practice visit www.cali.org.au/life-code.

If a decision has not been made within six months, we must let you know the reasons for the delay. If a decision on your claim is going to be delayed, for example, because you have not provided some necessary information or we are having difficulty obtaining relevant information, we will get in touch with you to let you know the reason for the delay so that you have an opportunity to resolve this.

You will be assigned a dedicated Claims Consultant who will communicate directly with you regarding your claim. You’ll have their name and direct phone number so that you can easily contact them if you have any questions or require assistance.

Your Claims Consultant will begin the assessment of your claim once the initial requirements have been received. The time taken to reach a decision on a claim may vary as it is based on:

• Individual circumstances;
• Complexity of the claim;
• Level of information required to assess the claim;
• Availability and timeliness in obtaining the information required from all parties.

You can assist during the claim process by completing requests for information accurately and providing relevant information promptly. If you’re having any trouble providing information, please let your dedicated Claims Consultant know as soon as possible, so we can work with you to overcome delays and consider alternatives. It can help if you share any relevant information or documents you may hold, reducing the need to request this from third parties such as your accountant or health provider.

Once your claim is approved, your first benefit payment will generally be made a month after your Waiting Period has ended. In some cases we may make an Advanced partial payment of the first monthly benefit a fortnight after the waiting period ends. Subsequent benefit payments are then made monthly in arrears.

The Waiting Period is the amount of time you need to wait before benefits begin to accrue on your policy. The duration of the waiting period would have been nominated by you prior to your policy commencing.

Details of your Waiting Period can be found on your most recent policy schedule or membership certificate.

Most benefit payments require you to first wait for your Waiting Period to be completed prior to any payments being made. However, there are some benefits that may be payable during the Waiting Period. Details of these can be found in your Product Disclosure Statement.

You may still be eligible to claim either a full or reduced benefit depending on your Monthly Earnings. Your Claims Consultant can discuss this further with you.

Benefit payments are made to the Policy Owner(s).

The Policy Owner is the person or entity whose name is listed on the most recent policy schedule or membership certificate. For policies held inside superannuation, the Policy Owner is the trustee of the superannuation fund.

Benefits are paid by direct credit. The Policy Owner is eligible to receive the benefit payments under the policy, unless the benefit payment is for death, whereby the payment may be made to the Policy Owner, their estate, or nominated beneficiaries.  Please refer to the Product Disclosure Statement (PDS) for further information on who receives benefit payments.

We may be able to assist you by providing rehabilitation support. For more information, please contact your Claims Consultant.

Please contact your Claims Consultant.

In some circumstances we may request the Insured Person undergo a medical examination or testing by an Independent Medical Specialist in order to assist us with the assessment of your claim. If this is required, we will pay all reasonable costs associated with the appointment.

Once we have approved your claim and your Waiting Period has ended, you will not need to pay your premium for the duration of the claim.

If you are receiving income or payments for the same reason as the claim you have lodged with us, we may need to make adjustments to your benefit payments. Please discuss this with your Claims Consultant.

Benefit payments are typically taxable so they need to be declared to the Australian Taxation Office in your yearly tax return. However, please consult your financial planner or tax specialist regarding your individual situation.

Tax is not deducted from your benefit payments unless your policy is owned by a superannuation fund (excluding SMSFs).

The requirements are to be provided/completed by the Insured Person, except for the Medical Attendant’s Statement which is to be completed by the treating doctor/specialist.

If your condition prevents you from completing the form, assistance may be provided by a close relative or friend. Please ensure the full contact details of the person assisting you are provided as well as their relationship to you.

Yes. However, where certified documents are required, these documents must contain the original ink signature of the person who certified them. Faxed or scanned copies cannot be accepted.

If you are unable to provide one of the listed requirements, please provide an explanation at the bottom of the checklist.

You will be assigned a dedicated Claims Consultant who will communicate directly with you regarding your claim. We will provide you with their name and direct phone number so that you can easily contact them if you have any questions or require assistance.

Your Claims Consultant will begin the assessment of your claim once the initial requirements have been received. The time taken to reach a decision on a claim may vary as it is based on:

• Individual circumstances;
• Complexity of the claim;
• Level of information required to assess the claim;
• Availability and timeliness in obtaining the information required from all parties.

Customers can assist during the claim process by completing requests for information accurately and providing relevant information promptly. If you’re having any trouble providing information, please let your dedicated Claims Consultant know as soon as possible, so we can work with you to overcome delays and consider alternatives. It can help if you share any relevant documents or information you may hold, reducing the need to request this from third parties such as your health provider.

Benefit payments are made to the Policy Owner(s).

The Policy Owner is the person or entity whose name is listed on the most recent policy schedule.

Benefit payments are made by direct credit to the Policy Owner.

In some circumstances we may request the Insured Person to undergo a medical examination or testing by an Independent Medical Specialist to assist with the assessment of the claim. We will pay all reasonable costs associated with the appointment.

Yes. We assess your claim based on your diagnosis, not your ongoing income.

If you have any questions about your claim, you can contact your Claims Consultant. More information can be found on our website.

The requirements are to be provided/completed by the Insured Person.

If your condition prevents you from completing the requirements listed on the form, assistance may be provided by a close relative or friend. Please ensure the full contact details of the person assisting you are provided as well as their relationship to you.

Yes. However, where certified documents are required, these documents must contain the original ink signature of the person who certified them. Faxed or scanned copies cannot be accepted.

The life insurance industry has developed the Life Insurance Code of Practice which is designed to protect customers and ensure we provide a high standard of service. We played an active role in the development of the Code and we fully support its implementation. You can find a copy of the Code of Practice at www.cali.org.au/life-code.

The Code does not create any legal relationship between insurer and insured.

We subscribe to the Life Insurance Code of Practice. The Code outlines the time frames that we are required to meet when managing claims, as well as the steps that we must take to communicate with you at certain stages of a claim. For more information on the Life Insurance Code of Practice visit www.cali.org.au/life-code.

If a decision has not been made within six months, we must let you know the reasons for the delay. If a decision on your claim is going to be delayed, for example, because you have not provided some necessary information or we are having difficulty obtaining relevant information, we will get in touch with you to let you know the reason for the delay so that you have an opportunity to resolve this.

You will be assigned a dedicated Claims Consultant who will communicate directly with you regarding your claim. We will provide you with their name and direct phone number so that you can easily contact them if you have any questions or require assistance.

Your Claims Consultant will begin the assessment of your claim once the initial requirements have been received. The time taken to reach a decision on a claim may vary as it is based on:

• Individual circumstances;
• Complexity of the claim;
• Level of information required to assess the claim;
• Availability and timeliness in obtaining the information required from all parties.

Customers can assist during the claim process by completing requests for information accurately and providing relevant information promptly. If you’re having any trouble providing information, please let your dedicated Claims Consultant know as soon as possible, so we can work with you to overcome delays and consider alternatives. It can also help if you share any relevant documents or records you hold, reducing the need to request these from third parties such as a health provider.

Benefit payments are made to the Policy Owner(s).

The Policy Owner is the person or entity whose name is listed on the most recent policy schedule or membership certificate. For policies held inside superannuation, the Policy Owner is the trustee of the superannuation fund.

Benefit payments are made by direct credit to the Policy Owner.

The requirements are to be provided/completed by the Insured Person, except for the Medical Attendant’s Statement which is to be completed by the treating doctor/specialist.

If your condition prevents you from completing the requirements listed on the form, assistance may be provided by a close relative or friend. Please ensure the full contact details of the person assisting you are provided as well as their relationship to you.

Yes. However, where certified documents are required, these documents must contain the original ink signature of the person who certified them. Faxed or scanned copies cannot be accepted.

If you are unable to provide one of the listed requirements, please provide an explanation at the bottom of the checklist on the following page.

If you have any questions about your claim, you can contact your Claims Consultant. More information can be found on our website.

To ensure your claim progresses as quickly as possible, we ask that you work with us to provide all the information we need to assess your claim.

The life insurance industry has developed the Life Insurance Code of Practice which is designed to protect customers and ensure we provide a high standard of service. We played an active role in the development of the Code and we fully support its implementation. You can find a copy of the Code of Practice at www.cali.org.au/life-code.

The Code does not create any legal relationship between insurer and insured.

We subscribe to the Life Insurance Code of Practice. The Code outlines the time frames that we are required to meet when managing claims, as well as the steps that we must take to communicate with you at certain stages of a claim. For more information on the Life Insurance Code of Practice visit www.cali.org.au/life-code.

If a decision has not been made within six months, we must let you know the reasons for the delay. If a decision on your claim is going to be delayed, for example, because you have not provided some necessary information or we are having difficulty obtaining relevant information, we will get in touch with you to let you know the reason for the delay so that you have an opportunity to resolve this.

You will be assigned a dedicated Claims Consultant who will communicate directly with you regarding your claim. We will provide you with their name and direct phone number so that you can easily contact them if you have any questions or require assistance.

Your Claims Consultant will begin the assessment of your claim once the initial requirements have been received. The time taken to reach a decision on a claim may vary as it is based on:

• Individual circumstances;
• Complexity of the claim;
• Level of information required to assess the claim;
• Availability and timeliness in obtaining the information required from all parties.

Customers can assist during the claim process by completing requests for information accurately and providing relevant information promptly. If you’re having any trouble providing information, please let your dedicated Claims Consultant know as soon as possible, so we can work with you to overcome delays and consider alternatives. It can also help if you share any relevant documents or records you hold, reducing the need to request these from third parties such as a health provider.

The Policy Owner is the person or entity whose name is listed on the most recent policy schedule or membership certificate. For policies held inside superannuation, the Policy Owner is the trustee of the superannuation fund.

Benefit payments are made by direct credit to the Policy Owner.

In some circumstances we may request the Insured Person to undergo a medical examination or testing by an Independent Medical Specialist in order to assist us with the assessment of your claim. If this is required, we will pay all reasonable costs associated with the appointment.

If your condition prevents you from completing the requirements listed on the form, assistance may be provided by a close relative or friend. Please ensure the full contact details of the person assisting you are provided as well as their relationship to you.

Yes. However, where certified documents are required, these documents must contain the original ink signature of the person who certified them. Faxed or scanned copies cannot be accepted.

To ensure your claim progresses as quickly as possible, we ask that you work with us to provide all the information we need to assess your claim.

The life insurance industry has developed the Life Insurance Code of Practice which is designed to protect customers and ensure we provide a high standard of service. We played an active role in the development of the Code and we fully support its implementation. You can find a copy of the Code of Practice at www.cali.org.au/life-code.

The Code does not create any legal relationship between insurer and insured.

We subscribe to the Life Insurance Code of Practice. The Code outlines the time frames that we are required to meet when managing claims, as well as the steps that we must take to communicate with you at certain stages of a claim. For more information on the Life Insurance Code of Practice visit www.cali.org.au/life-code.

If a decision has not been made within six months, we must let you know the reasons for the delay. If a decision on your claim is going to be delayed, for example, because you have not provided some necessary information or we are having difficulty obtaining relevant information, we will get in touch with you to let you know the reason for the delay so that you have an opportunity to resolve this.