In this episode, Billy and Andrew take a closer look at an important part of financial planning that many people hope they never have to deal with: making an insurance claim. The focus is on permanent disability (TPD) and income protection insurance, including what happens when something goes wrong, how a claim begins and some of the key factors that can influence the process.
For many Australians, insurance may be held through superannuation or as a retail insurance policy. But understanding that you have cover is only one part of the equation. The type of policy you have, whether it has gone through underwriting, what you disclosed when the cover was established and the definitions contained within the policy can all become important if you eventually need to make a claim.
Billy and Andrew explain why the claims process generally begins with notifying the insurer and completing the required documentation, as well as why medical records and other evidence are used to assess whether a claim meets the relevant policy definition. They also discuss the importance of being transparent when taking out insurance, particularly where a pre-existing medical condition may later be relevant to a claim.
The episode also explores some of the practical differences between income protection and TPD claims. For income protection, the amount ultimately paid can depend on the income being earned around the time of the claim, while TPD policies can have significantly different definitions, including own occupation and any occupation.
The discussion is particularly relevant for anyone who has personal insurance, insurance through superannuation, or is reviewing their broader financial planning and risk management strategy. It also highlights the potential value of having professional support during a claim, when dealing with insurers and managing the administrative requirements may be difficult while someone is focused on their health and recovery.
This podcast contains information that is general in nature. It does not take into account the objectives, financial situation, or needs of any particular person. You need to consider your financial situation and needs before making any decisions based on this information. This information is provided by Billy Amiridis & Andrew Nicolaou of 360 Financial Strategists Pty Ltd, authorised representatives and credit representatives of Akumin Financial Planning – AFSL 232706.
Episode Highlights
- Why full underwriting can matter: Understand how insurance that has been assessed upfront can differ from automatically accepted or default cover when it comes to the claims process.
- How an insurance claim begins: Learn why notifying the insurer and starting the required documentation are important early steps after an insured event.
- Why accurate disclosure matters: Understand how insurers can compare medical information and records with what was disclosed when the policy was established.
- How income affects income protection: Discover why the benefit amount shown on an income protection policy does not necessarily mean that amount will automatically be paid at claim time.
- The importance of TPD definitions: Understand the distinction between own occupation and any occupation definitions and why they can produce different outcomes.
- Why your work history can matter: See how previous training, education and occupational experience can affect how an any occupation TPD definition applies.
- The role of an adviser during a claim: Learn how professional support can help with paperwork, insurer communication and interpreting medical or policy-related information.
- Why claims timing matters: Understand why the length of time required to approve a claim can have significant financial and emotional consequences.
- Consider the tax outcome: Learn why tax treatment can affect the amount ultimately available from a TPD or income protection claim.
