Income Protection Insurance Claims Process - Steps To Be Followed

Income protection insurance enables you to have an income stream if you encounter an illness or injury that causes you to discontinue working permanently. With the income protection cover, you will be able to get monthly payments for up to two years, or you can choose a cover that will offer you monthly payments up to the age of 65. The income protection insurance claims process can be quite straightforward or complex, depending on the case at hand.

Making A Claim

Once you are unable to work due to an injury or illness, you will need to contact your insurer and notify them of your current status. The insurer will send you a claim form that you will need to fill, together with other documents that will be required from you. The insurer will then assess your claim based on the information you give them in the claim form and the documents that you provide like the medical reports. The insurer may also require more assessments to be carried out and they will pay for these.

Decision

Once the assessment has been completed, a decision is made on whether or not to honor the claim. The decision period will be determined based on how complex the case is; some take a few weeks to be approved while others may take even longer. The insurer may need to contact you for additional information to help assess the claim and come up with a conclusive decision. Some claims may also be declined if the claimant has not satisfied the conditions for a payout.

If your insurance is held under a superannuation fund and the claim is declined by the insurer, your application will normally be forwarded to your superannuation fund trustee. The trustee will confirm whether or not the decision of the insurer is justified as per the insurance policy conditions and the superfund's regulations. The decision of the trustee is then communicated to you. If you still get a negative response and are not satisfied, you still have a lifeline. You can contact the Superannuation Complaints Tribunal, which has been set up by the Federal Government to handle complaints by members.

Payments

If your application is approved, the insurer will contact you and inform you of the decision. You will be advanced a monthly payment after the PAYG tax has been deducted from your benefits. Normally, a pay slip will be availed together with each monthly payment, and a payment summary will also be given to you at the end of the financial year. As long as you are receiving income protection payments, you will not be charged any costs of the income protection cover. If your insurance is held in a superannuation fund, then up to ten percent of your salary will be forwarded to the super fund as an employer contribution.

Continuous Assessment

Even after your income protection payments have been approved, the income protection insurance claims process will continue. This is because a monthly assessment has to be conducted to ascertain that you are still eligible to receive the monthly payments. A monthly report will need to be filled jointly by you and your doctor, which is then forwarded to your insurer to confirm that you are still eligible for the payments.

Kerrie peacock is a proficient insurance researcher in Australia and you can greatly benefit from her resources. For details on a cover that can work for you visit www.mecovered.com.au/income-protection-insurance-claims-process.

This article was published on 30 Jul 2014 and has been viewed 444 times
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