My insurer has stopped paying my income protection insurance benefits. What do I do?

If you find yourself temporarily unable to work due to ill-health and you’re one of the few Australians with income protection insurance, it comes as a great relief when your insurer accepts your income protection claim.

However, after making some initial payments, insurers will often find ways to stop paying these benefits, citing a range of different reasons. If you’re relying on these payments to keep food on the table, this can be immensely stressful!

This article provides practical information on what you can do if your insurer stops making income protection payments.

What is income protection insurance?

Income protection insurance usually provides you with a monthly benefit if you cannot perform your income producing duties due to illness or injury.

Depending on the policy you have, income protection benefits can be payable for two years, five years, until age 65 or even for the rest of your life.

Some Australian superannuation funds offer income protection insurance by default to all of their members, including REST and AMIST.

Why would an insurer stop payment of income protection benefits?

Ultimately, insurers are businesses and it’s not in their interests to pay ongoing benefits for a long period of time. As such, insurers will often find excuses to cut an insured person off from their ingoing income protection payments.

Some of the common reasons we’ve seen insurers give for ceasing income protection insurance payments include:

  • the insured person wasn’t regularly attending appointments with their doctor, even if no further treatment is available to them;
  • the insured person did not submit a form at the exact time;
  • the insurer believes the insured person is able to return to work, even if only part time or casual basis; and/or
  • the insurer believes that the person didn’t disclose certain pre-existing medical conditions which existed when they applied for the policy.

To justify these decisions, the insurer may make a range of investigations, including:

  • asking you to attend an independent medical examination with a particular medical specialist; and/or
  • asking your treating doctor (for example, your GP) for detailed reports about your past, current and future medical treatment.

What can I do?

Know your rights.

If you are yet to make an income protection you are entitled to legal representation and Littles can help you.

If you have already lodged an income protection claim and the insurer is asking that you attend medical appointments, requesting extra reports from your doctors or asked you to meet with an investigator, Littles may be able to ensure that your payments continue before they are cut off.

Or if your income protection claim has been rejected by a superannuation fund or insurer, you may be entitled to have the decision reviewed through an internal resolution procedure.

If your complaint has been upheld, you may be able to litigate in a court or lodge a complaint with the Australian Financial Complaints Authority (AFCA).

There are strict time limits to challenge an insurer’s decision, so it’s important you seek legal advice as soon as possible.

What is the Littles difference?

Put simply, Littles are experts in superannuation and insurance law matters.

Our insurance team has helped thousands of consumers claim their entitlements, and our Head of TPD and General Insurance has extensive industry knowledge and insight on how to maximise your prospects of success.

We also speak your language, at sixteen languages and counting.  Forget paying for a translator or for a lawyer who doesn’t understand you and your cultural background.

All our superannuation and insurance law matters are conducted on a no win, no fee basis, and we don’t charge you upfront for any disbursements necessary to prosecute your claim.

If you would like superannuation and insurance law advice, reach out to Littles today by using our free Claim Checker.

About the author

Rowan McDonald

Littles’ Head of TPD and General Insurance, Rowan McDonald, is an expert in insurance and superannuation law.  Rowan has over thirteen years of experience in the industry and has prosecuted thousands of successful insurance claims for consumers.

Having worked in the industry for over a decade, Rowan has an extensive industry contact list and regularly presents to disability support groups, financial industry professionals and multicultural organisations.

Rowan has also advised some of Australia’s top insurers, giving him unrivalled insight into the claim process from all perspectives.  Rowan takes a pragmatic and common-sense approach to the advice he provides his clients.

For your free, personal consultation get in touch with Rowan today.

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