Should you see a lawyer about your insurance claim?
From the experts at Mine Wealth + Wellbeing
Insurance can sometimes seem complicated. So when a super fund member thinks they might be eligible to claim on their disablement or income protection insurance, offers by law firms to 'take the worry out of making a claim' can be attractive.
In our experience, most insurance claims made by our members are straight-forward, with our insurer paying out over 95 per cent of all claims.
Usually all the member has to do is fill out the relevant forms and get the necessary medical certificates.
Our role in all insurance claims is to act as your advocate. We’re not the insurance company and we don’t represent the insurance company. We represent our members. Engaging a lawyer before contacting your super fund can sometimes significantly delay your claim due to additional correspondence or unnecessary legal and technical complications and arguments. We have many examples and experiences where claims would have settled much quicker if the member’s lawyers hadn’t been involved.
Engaging a lawyer can also leave you out of pocket for the lawyer’s fee, which can amount to thousands of dollars. Some lawyers may not charge up front, but request a percentage of your benefit if your claim is successful. This can significantly reduce any payout you receive.
We’re here to help with your insurance claim
Our role as a super fund is to look after our members' best interests and, as mentioned earlier, in the claims process we act as your advocate. Super fund trustees are legally obliged to help you with your claim if it has a reasonable chance of success. We’ll work with you and the insurer to assess your claim and ensure you receive fair treatment from the insurer assessing your claim.
Whether you need help preparing your claim or just want to find out if you’re eligible, we can explain what insurance you’re entitled to and assist you through the claims process.
If you’re a Mine Wealth + Wellbeing member and need help preparing your claim, filling out forms, gathering information or you need advice on what to do next, give us a call on 13 MINE (13 64 63). We’re familiar with our insurance terms and processes and can assist you with the claims process without the additional costs of engaging a lawyer.
What if the claim is rejected or is taking too long?
Sometimes a claim can be delayed if we need more information from you, your doctor or employer. If your claim isn’t progressing smoothly or is delayed, you should contact us and we’ll follow up on your claim and explain what is happening. If your claim is declined, we’ll review the decision and supporting materials to ensure your claim is fairly assessed.
If you’re not satisfied with the outcome of our review, you have two options. You can make a formal complaint to our Complaints Officer or you can go to court. If you make a complaint and you don’t receive a response within 90 days or you’re not happy with the response, you then have the right to take your complaint to the Superannuation Complaints Tribunal (SCT). The SCT is an independent body set up by the government to resolve complaints by super fund members or their beneficiaries. This is a free service and the decisions the SCT makes are binding on both parties.
If you decide to go to court, your lawyer can provide you with valuable assistance. However, this option isn’t free, so it’s important to ask your lawyer about the associated costs.
Not a Mine Wealth + Wellbeing member? You’re welcome to join and enjoy access to this advice service to get on track and start making confident financial choices.
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If you have a superannuation question and think the answer might benefit other Mining Family Matters readers too, please ask away!
This is general information only and does not take into account your financial situations, needs or objectives. Before acting, you should consider whether the information is appropriate for you and read our Product Disclosure Statement (PDS). If there’s any inconsistency between this document and the PDS or Trust Deed the terms of the PDS or Trust Deed prevail. This information is based on our understanding of current Australian laws and assumes they will remain unchanged.
Issued by AUSCOAL Superannuation Pty Ltd ABN 70 003 566 989 AFSL 246 864 Trustee for Mine Wealth and Wellbeing Superannuation Fund ABN 16 457 520 308. Mine Wealth + Wellbeing Financial Advice is a trading name Mine Wealth and Wellbeing Services Pty Ltd ABN 49 051 315 014 a Corporate Authorised Representative of Adviser Network Pty Ltd ABN 25 056 310 699 AFSL 232729.