I am talking about life, TPD and income protection insurances within Super.
I thought it was as easy as make claim for car insurance. But some said it is complicated and need lawyer involved.
How Difficult Is It to Claim Insurance from Super Fund?
tooblue on 18/02/2021 - 15:30
Comments
Great work! Knowing when and when not to use a lawyer is a great judgement. They are friggen ridiculous.
ANZ actually contacted us first and once the paperwork was lodged, sent us a cheque within about 2 weeks.
Very broad differences in all three claims. Will also depend on fund somewhat. Not a lawyer, but I do provide limited advice on these types of claims professionally.
No insurance is simple, but I'd be somewhat surprised if a lawyer was needed as standard for any of these.
As ever, it depends.
From a death perspective, firstly you're either dead or you're not (not withstanding some policies that have early payout for terminal illness). After that, it becomes a matter of whether or not you were in anyway dishonest with respect to what you did (or more to the point didn't) disclose as to your health and medical status at the time of getting the insurance.
On TPD, you need to meet the relevant definition. You also need to understand that there are different rules for TPD held within Super vs. outside. The big thing here, in layman's terms, is that you need to demonstrate (again, per the specific definitions relevant) that you are "unable to ever work again in any job suited to your education, training or experience". This is often a high bar to clear.
On salary continuance, you need to demonstrate that you are unable to work, and will need to demonstrate this on an ongoing/periodic basis, depending on the nature of the issue (i.e. a "catastrophic injury" with effectively no chance of recovery is viewed quite differently to a broken leg). The big problem for insurers with salary continuance is that many people effectively want to view it as "they don't have to work any more" (this is also a problem for the person making these claims, but that's another story) and so they need to satisfy themselves as to your ongoing eligibility.
To contrast the above with car insurance, you need to remember that assuming no fraud, etc., a car accident has clearly happened and its simply a matter of determining who is at fault and off you go. Contrast this with particularly TPD and salary continuance and you have medical opinions, physical/mental capabilities, etc. that can be quite subjective, not to mention the "biopsychosocial" factors that may be at play.
The other problem is, at claim time, you're probably not at the top of your game.
Often you'll need someone else to do the running around and "fighting" for you. That person might be a family member or a financial planner (who sold you the policy) or you might just go straight to a lawyer.
if I change the superfund I lose the insurance, isn't it? is there a way to continue?
most funds will recognise the prior insurance. but you need to be accepted into the new before you close the old
thanks
See a financial planner but two things i was told 1) have a binding nomination (makes the nominee decide the payout rather than the super fund trustee which makes the process complicated) 2) Have TPD insurance cover for your own occupation (needs top-up outside super)
The financial planner i used is really good and he processes the claims should it be required as well. Happy to PM if you need contact.
+1 for binding nomination, if you are reading this and haven't done it, stop, and go print off the form for your super fund now. The last thing you want is your family having to deal with more stress claiming.
There are different types of policies thst can be set up inside of super. Group vs retail policies. The only ones I've had negative experiences with are group policies. Generally cheaper but more difficult to claim on. Can't get cheap and easy to claim in my opinion.
It is complicated. My claim took close to 12 months to pay out & they tried to deny the claim for various reasons which I was always able to counter with doctors & other reports. I am not upset with them trying to deny it, they need to make sure the claim is legit. If the reasoning for your claim has some holes in it they will try and take advantage of that. I didn't use a lawyer and just calmly persisted for the time of the claim, presenting evidence in response to their allegations. At times I wondered if I was giving them too much information which I didn't need to about my life & wondered if a lawyer might have blocked some of these requests or made things progress quicker. At the end of the day I don't regret not using a lawyer.