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Income Protection Claim Guide

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Income protection claim refers to a financial benefit that can be claimed by individuals who have been unable to work due to an illness or injury, and who have an income protection insurance policy in place.

Income protection insurance

Income protection insurance is a type of policy that provides a regular income to policyholders who are unable to work due to illness or injury, for a specified period of time.

Generally, income protection insurance covers you for about 75% of your pre-injury salary for a minimum of 2 years, until age 65 or even life. The frequency of payments, age limit restrictions and the length of time you are entitled to claim for benefits vary between policies. In addition, payments may cease if your employment is terminated or if you have been paid a TPD claim benefit.

Policy terms also tend to vary relating to how severe your condition needs to be for you to qualify for benefits. Some policies will pay you an income protection benefit only where you are unable to perform your usual job, while others pay where you cannot perform any occupation for which you are suited based on your education, training or experience.

Some policies may have an offset clause. This means that the benefit payout you receive from the insurer may be reduced if you have received other income while you have been unable to work, such as WorkCover payments or Centrelink benefits.

Who is eligible to make an income protection claim?

Individuals who have an income protection insurance policy in place and who are unable to work due to illness or injury may be eligible to make an income protection claim. To be eligible, policyholders typically need to have been off work for a certain period of time, known as the waiting period. The waiting period can vary depending on the policy, but is typically between 14 and 90 days.

How to successfully claim income protection?

To successfully claim income protection, policyholders need to follow the process outlined by their insurance provider. This typically involves providing evidence of their illness or injury, as well as providing proof of their income prior to their illness or injury. The policyholder may also be required to provide evidence of their ongoing medical treatment and any other information relevant to their claim. Once you’ve lodged your claim, the decision will usually take 3 to 4 months, although this can vary.

What to do if income protection claim is rejected?

If an income protection claim is rejected, policyholders have the right to dispute the decision. This may involve providing additional evidence to support their claim, or appealing the decision through the insurer’s internal dispute resolution process. If the policyholder is still not satisfied with the outcome, they may be able to escalate their complaint to an external dispute resolution scheme, such as Court.

Why would income protection claim be denied?

An income protection claim may be denied for a number of reasons. Some common reasons include:
– The policyholder has not satisfied the waiting period
– The policyholder has not provided sufficient evidence of their illness or injury
– The policyholder’s illness or injury is not covered under the policy
– The policyholder has not provided sufficient evidence of their income prior to their illness or injury

Can I make an income protection claim if I’m on Centrelink?

Yes, individuals who are receiving Centrelink benefits may still be eligible to make an income protection claim. However, it is important to note that the income protection benefit may affect their Centrelink payments. It is recommended to consult with Jameson Law before making an income protection claim.

Can I make an income protection claim if I have workers compensation claim or motor vehicle accident claim?

Yes, individuals who have a workers compensation claim or motor vehicle accident claim may still be eligible to make an income protection claim. However, the income protection benefit may be reduced if the individual is already receiving compensation payments for their injury or illness. It is recommended to consult with Jameson Law before making an income protection claim.

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