How to make a claim

An insurance claim can make a big difference during tough times. Whether the claim is for yourself or a loved one, letting us know early on means we can settle things as quickly as possible.

Call us on 1800 331 685 to start your claim or to let us know of a member’s passing.

Our claims process

When you lodge your claim, you’ll have a dedicated member of our team looking after you from start to finish.

How long your claim takes depends on the type of claim and its circumstance, as well as how quickly we receive documents and information. Your case manager will keep you updated and answer any questions you have.

Lodging a death claim or terminal illness claim

Once you’ve let us know you intend to make a claim, we’ll let you know what information you’ll need to provide.

  • More about lodgement

    We’ll usually need certified copies of ID documents to ensure the payment reaches the right person. This could include the ID of dependants and other beneficiaries.

    If a loved one has passed away, we may ask for:

    • a certified copy of the death certificate
    • a signed Medicare or Pharmaceutical Benefits Scheme (PBS) request form
    • a report from their treating doctor or specialist a coroner’s report
    • a Medicare history report.

    If you or a loved one are terminally ill, we may ask for:

    • medical certification from 2 of your treating doctors
    • additional information from your doctors
    • a medical assessment from an independent specialist or practitioner
    • a Medicare history report.

Assessment

We’ll start assessing your claim based on the information provided or work with our Insurer to do so.

We might need to contact you or other people, like your doctor or other potential beneficiaries, for more information.

  • More about assessment

    Where there is no binding beneficiary nomination, we’ll need to consider all possible beneficiaries. These may include those named in a non-binding beneficiary nomination, in your loved one’s Will, your Will, or any of your dependants.

Decision and payment

We’ll let you know your claim outcome and, if your claim is approved, will make payment arrangements.

Lodging a disability or income protection claim

Once you’ve let us know you intend to make a claim, we’ll let you know what information you’ll need to provide.

  • More about lodgement

    We’ll usually need certified copies of ID documents to ensure the payment reaches the right person.

    We may also need:

    • reports from your doctors, specialists and allied health providers 
    • a medical assessment from an independent specialist or practitioner on your condition or your capacity to work
    • financial information.

    You can authorise us to get the required information for you.

Assessment

We’ll start assessing your claim based on the information provided, or work with our Insurer to do so.

We might need to contact you or other people (like your doctor) for more information.

Decision and payment

We’ll let you know your claim outcome and, if your claim is approved, make payment arrangements. We’ll also detail any waiting periods that may apply and outline the conditions for ongoing payments.

  • More about payments

    We’ll usually make regular reviews of your entitlements. How often we review your case depends on the type and cause of your claim.

    As a guide:

    • Disablement claims are reviewed every 2 years.
    • Temporary incapacity and income protection claims are reviewed every 6 months.
     

We're dedicated to fair, stress-free claims

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Fairness

We promise a fair and reasonable assessment of your claim.
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We'll stand up for you

If we don’t agree with our insurer’s decision, we’ll dispute it on your behalf.
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Here for you

We’re here to support you and make your claim as quick and easy as possible.

If you don't agree with our decision

If you think our decision doesn’t meet your needs or doesn’t consider new or changed information, you can ask us to review your claim.

After our review, we’ll let you know whether our decision has changed or stays the same.

We are committed to delivering the best results. If you still don’t agree, you can lodge an objection with the Australian Financial Complaints Authority (AFCA).

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If you have any questions about our claims process, please call 1800 331 685 or contact us.
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