How claims are assessed, the duty to take reasonable care, the Life Insurance Code of Practice, complaints to AFCA, and the mistakes that leave people uncovered.
Insurance only matters on the day you claim, and that is where most problems show up: cover that lapsed in an old super account, an answer on the application that the insurer later says was wrong, a TPD definition that the claim does not quite meet, or an income protection benefit reduced by workers' compensation payments.
These guides explain how a claim is assessed and what you can expect from the insurer, starting with the claims and complaints guide. They cover the duty to take reasonable care that replaced the old duty of disclosure, the Life Insurance Code of Practice, complaints to AFCA, offsets for workers' compensation and other payments, and the mistakes that most often leave people without cover.
The official bodies are ASIC and Moneysmart (conduct and consumer guidance), APRA (prudential regulation of life insurers and super funds), the ATO (tax and lost super), the Financial Services Council (which publishes the Code) and the Australian Financial Complaints Authority. If a claim involves a large sum or a dispute about medical evidence, a lawyer who handles insurance and super claims can review it, often before you sign anything.
Claims, Mistakes and Official Sources
How to take a life, TPD, trauma or income protection dispute to AFCA: internal complaints first, time limits, what AFCA can decide, and a step-by-step plan.
Claims, Mistakes and Official Sources
How the duty to take reasonable care not to make a misrepresentation works for Australian life insurance, what insurers can do if you breach it, and the 3-year rule.
Claims, Mistakes and Official Sources
How income protection benefits are reduced by workers' compensation, transport accident payments, sick leave, other cover and Centrelink, state by state, with arithmetic.
Claims, Mistakes and Official Sources
Step-by-step guide to claiming on life, TPD, trauma and income protection cover in super or retail, what evidence to gather, timeframes, and how to complain.
Claims, Mistakes and Official Sources
What the Life Insurance Code of Practice covers in Australia, the claims, underwriting and vulnerability standards, how it is monitored, and how to use it in a complaint.
Claims, Mistakes and Official Sources
The common mistakes with life, TPD, trauma and income protection cover in Australia, from lapsed super cover to cancelling too early, with what each one costs.
