The Top 10 Insurance Claims Questions (and answers)

Below are the top 10 questions that are asked by people who are claiming on their Income Protection Insurance according to one of Australia's top personal insurance providers:

1. When do I get paid and what is my waiting period?
The waiting period is selected when you take out your insurance policies, and is the amount of time between when an injury/illness/accident occurs that prevents you from working and when the insurance company will begin paying benefits. This is one of the critical aspects of your policies and one which our insurance expert, Peter Dale, will discuss with you to determine the most appropriate policy for you. Your waiting period could be two, four, eight weeks and so on, depending on your ability to live without an income. Generally speaking, a longer waiting period will reduce your premiums. But this is an important issue that should be discussed with an experienced expert as other issues may also come into play. Regardless of the waiting period it is in your interests to lodge a claim as soon after injury/illness/accident as possible to notify your insurance company.

2. How much am I going to get paid?
While on Total Disability, you will be paid in line with the applicable benefit at the time of the disability as laid out in your insurance policy. While on Partial Disability, your benefit will be determined using the applicable formula and may vary depending on the amount you are able to work as well as any other benefit payments that you may be entitled to receive from other sources.

3. Why is the benefit on my Schedule different from the benefit I am receiving when I am on claim?
The benefit indicated on your Schedule of Insurance is the amount that you are entitled to, provided you are not on claim at the time of receiving the Schedule. The benefit that you are entitled to receive will increase each year, usually by a minimum of 3% or CPI (whichever is higher) unless you decline this option. If you purchase the option to increase your benefit while on claim, your benefit will only increase by the amount of CPI.

4. When and how often am I going to get paid?
Your first payment will be made once the claims assessor has accepted your claim and once the waiting period specified in your policy is over. If you are on Total Disability your payments will be made monthly in arrears. If you are on Partial Disability you will need to complete a Partial Disablement Questionnaire. When this has been received and assessed by the insurance company your payments will begin and they will continue for the period nominated.

5. I have paid my premiums for a long time - why do I have to fill out ongoing medical certificates to continue my claim?
Medical certificates are required to verify that you are under the care of a medical practitioner, which is a condition of income protection claims. They also allow the insurance company to keep updated on your medical condition.

6. Can I get an extension on my Medical Certificate/Progress Claim Form?
Extensions will be considered on a case-by-case basis, and any delay in returning this form can cause a delay in payment of your benefit.

7. Why do I have to go to an independent doctor when you already have information from my treating doctor?
Your insurance company may require this so that they can have an objective, independent and evidence-based opinion of your medical condition, your treatment plan and the disability levels that your condition may cause.

8. Why do I have to send in financial information?
When making a partial claim you will be asked for financial information as this is standard practice within the industry. When making a total disablement claim you would not be asked for financial information if it was provided at the initial underwriting stage. You may be asked for financial information at such time as a claim is being assessed so that the insurance company can verify that all the required information has been disclosed.

9. What happens with tax on the Income Protection benefits I receive?
Tax is not deducted from Income Protection benefits by the insurance company. It is your responsibility to remit the tax component of your IP benefit, so you must keep adequate records of all benefits received.

10. Why do I have to complete a Health Insurance Commission (HIC) Authority?
A HIC Authority is required from all clients to enable the insurance company to verify the medical information provided in your insurance application.

Contact our Insurance Specialist Peter Dale for more information today!