Income protection claims are benefits paid to people who cannot work because of illness or injury and who hold an income protection policy.
Income protection insurance
Income protection insurance pays a regular benefit when you are unable to work due to illness or injury for a set period. Most policies insure about 75% of your pre-injury salary for a minimum of two years, sometimes to age 65 or for life. Payment frequency, age limits and benefit periods vary by policy. Payments may stop if your employment ends or if you receive a TPD or related insurance payout.
Policies also differ on how severe your condition must be. Some pay if you cannot perform your own occupation. Others require that you cannot perform any occupation for which you are suited by education, training or experience.
Many policies include an offset clause. Your benefit may be reduced if you receive other income while off work, such as Centrelink payments or workers compensation.
Who is eligible to make an income protection claim?
Policyholders who cannot work because of illness or injury may be eligible, subject to their policy terms. You usually must serve a waiting period, commonly 14 to 90 days. Check your Product Disclosure Statement and speak with Jameson Law if you are unsure about eligibility.
How to successfully claim income protection?
Follow your insurer’s process. Provide medical evidence of your condition, proof of pre-disability income and details of ongoing treatment. Your insurer may request treating doctor reports and specialist assessments. After lodgement, decisions often take 3 to 4 months, though timeframes vary. Keep copies of everything and record calls and dates. If you need help preparing the claim pack, our team can assist with evidence and submissions.
What to do if an income protection claim is rejected?
You can dispute the decision. Ask for written reasons and provide further evidence. Use the insurer’s internal dispute resolution process. If you remain dissatisfied, escalate to the Australian Financial Complaints Authority (AFCA) or seek court review where appropriate. For strategy and time limits, contact Jameson Law.
Why would an income protection claim be denied?
Common reasons include:
- Waiting period not met
- Insufficient medical or income evidence
- Condition or cause excluded under the policy
- Offsets reduce the benefit to nil
Can I claim income protection if I am on Centrelink?
Yes. You may still claim, but the benefit could affect your Centrelink entitlements because of income tests. Get advice before you lodge and disclose all payments accurately. See Services Australia for current rules.
Can I claim income protection if I have a workers compensation or motor vehicle accident claim?
Yes. You may be eligible for income protection while also pursuing motor vehicle accident or workers compensation claims. Your income protection benefit may be reduced by those payments under the policy’s offset clause. Review the wording carefully and obtain advice on how different benefits interact.
