Making a life insurance claim is easy when you know who to talk to, what documents you need to provide, and you have a clear understanding of how long the process will take. It also helps to know what avenues you can pursue if you’re unsatisfied with the process or outcome.
Here’s what you need to do to successfully file a life insurance claim.
Talk to the right people
Speak directly via phone or email to the company or organisation where you bought the policy from.
Depending on where you bought the policy, you may need to talk to your:
- Insurer – talk to the insurance company directly
- Superannuation fund
- Insurance broker or financial advisor
- Employer – If your policy is part of an employment arrangement
When you first contact the person or organisation, they’ll let you know how to make a life insurance claim, including the forms you need to submit. Be prepared to give your policy number as well, so that the policy holder can identify who you are, and confirm that your policy is current and valid.
If you’re unable to contact your policy holder directly due to physical or emotional stress, ask a trusted friend or relative to do so on your behalf.
Common information you need to provide
Depending on the nature of your life insurance policy, and the intent of your claim, you’ll need to provide a range of documentation and evidence.
Some of the most common information you must provide include:
- Policy document – Have the original copy of your document policy with you. Whether it be a digital or physical file, make sure it’s in a safe place and easily accessible. If you’ve lost your original policy document, this may delay the claims process and you may also be required to pay a fee to process a new policy.
- Medical history – Depending on the intent of your claim, this may include a doctor’s certificate, death certificate, medical tests, or medical reports. Any medical information must be provided by a licensed health practitioner. If your claim relates to your inability or incapacity to work due to a disability, you’ll need to provide relevant medical information from a licensed doctor, one who specialises in the condition that is affecting your inability to work.
- Financial documents – This includes payslips, tax returns, and financial statements. Your employer can provide this for you. Or, if you’re self-employed, you’ll need to prepare this information yourself.
- Employment information: You may need to provide documents related to your work duties, including the physical requirements of your job, and how many hours you work per week.
Your insurer may ask you to supply more information than what is listed in this article. Additionally, they may ask to speak directly to your regular doctor, or ask you to undergo an independent medical examination by a specialist of their choosing. From there, the doctor will report directly to the insurer about the results.
How long your claims process will take
Once you’ve provided all the relevant information, your insurer will determine the outcome of your claim within 2 months of being notified of your intention to claim. Longer waiting periods may apply for claims that do not relate directly to income protection or a loss of income.
Refer to the Life Insurance Code of Practice to find out what the standard waiting periods are when making a life insurance claim.
How to complain about a life insurance claims process or outcome
If you’re unsatisfied with the process or outcome as it relates to your life insurance claim, make a complaint to the insurer directly. Any reputable organisation should have a dedicated complaints channel where you can express your concerns and receive practical feedback and support.
Alternatively, if you’re still unsatisfied with your insurer, contact the Australian Financial Complaints Authority to file a complaint and receive a free dispute resolution service.
When to consult an insurance claims specialist
If your life insurance claim has been rejected – or you’ve received less than what you feel you’re entitled to – and you’ve exhausted all other avenues, McDonnel Schroder can help you.
Our highly experienced and accredited lawyers will assess the circumstances of your case, give you honest and practical legal advice, and determine your chances of a successful outcome. Your first consultation with us is absolutely free with no obligation.
From there, if we feel that you have a strong case, we’ll guide you through legal proceedings to help you achieve the best possible outcome. Depending on your circumstances, you may be able to benefit from our services on a no win, no fee basis.