Income Protection Claims in New South Wales (NSW)

In NSW, many superannuation funds provide income protection (IP) insurance coverage as part of their insurance offerings. IP insurance is designed to provide regular income payments to the insured member if they become temporarily unable to work due to illness or injury.The key aspects of income protection claims in NSW include:

1. Eligibility criteria: To qualify for an IP claim, the insured member must meet the policy’s definition of disability, which typically involves the inability to perform the duties of their regular occupation or any occupation for which they are reasonably qualified.
2. Waiting period: IP policies often have a waiting period, which is the initial period of disability during which no benefits are payable. Common waiting periods range from 14 days to several months.
3. Benefit payment period: The policy will specify the maximum period for which IP benefits will be paid, such as two years, five years, or until a specific age (e.g., 65).
4. Benefit amount: The IP benefit amount is typically calculated as a percentage of the insured member’s pre-disability income, subject to any maximum limits specified in the policy.
5. Claim process: The insured member must submit a claim to the superannuation fund, providing relevant medical evidence, employment records, and other supporting documentation as required by the insurer.
6. Assessment and decision: The insurer will assess the claim based on the provided evidence and the policy terms, and make a decision to approve or deny the claim.
7. Ongoing management: If the claim is approved, the insurer may periodically review the insured member’s condition and ongoing eligibility for IP benefits.

It’s crucial to seek legal advice and representation from experienced superannuation and insurance lawyers to navigate the complexities of IP claims, ensure compliance with legal requirements, and protect your rights and interests throughout the process.