Disability insurance: What to do if your claim is delayed

For many people, the disability insurance that is held within their superannuation fund is an important safety net, providing financial security during times of need.

However, the road to claiming these benefits is often challenging, especially when there are delays by super fund trustees and insurers.

In this article, we will explain the issues faced by people claiming disability insurance and how we can help you navigate this complex process.

Challenges claiming Disability Insurance

Recent reports show the increasing rate of delays to resolve disability insurance claims within superannuation funds.

These delays are often because super fund trustees (the people who manage the fund and policies) fail to comply with guidelines, such as the ASFA/FSC Insurance in Superannuation Claims Handling Guidance Note. This note outlines specific actions trustees should take within five business days from when they receive a completed claim.

This includes:

• acknowledging they have received your claim
• assessing necessary information, and
• providing a summary of the claim process.

The story of our client, Jason, is an example of the struggles many people face. Jason made a claim for Total and Permanent Disability (TPD) insurance due to a left shoulder and neck injury, a result of a workplace incident in November 2018. He submitted the claim to the fund trustee Mercer in March 2023, but it was not sent on to the fund’s insurer, TAL, until July 2023.

This delay caused immense financial strain, and Jason needed to make hardship claims on his mortgage. This was compounded by his own health struggles and his wife’s serious illness, and the situation became even more dire.

This is not an isolated incident.  In several instances, Mercer, the super fund trustee, has failed to inform our clients about receiving their TPD insurance benefit from the insurer.

How legal support can empower your claim

The delays in claim resolution have led to an increasing number of claimants withdrawing their claims before an assessment decision is made. Many feel overwhelmed and unsupported throughout the process, impacting their focus on medical treatment and well-being.

These delays can be complex, but having experienced legal advice plays a pivotal role in supporting people with their claims dispute process. A report from ASIC reviewing TPD insurance shows that people with legal representation were much less likely to withdraw their claims, emphasizing the importance of support in reducing ‘claim fatigue’ where the process becomes overwhelming.

Here at Maurice Blackburn Lawyers, we’re experienced in these kinds of claims and offer crucial support to people going through the process, and make sure that they are set up to navigate the claims process effectively. This includes helping to prepare detailed and compelling evidence to support a claim and advocating on our client’s behalf all the way through to secure the benefits they’re entitled to.

Advocating for Fair and Timely Claims Process

The challenges faced by disability insurance claimants within super funds, particularly the delays caused by trustees and their insurers, often result in significant financial and emotional strain. The case of our client, Jason, is just one example of many that showcases the need for efficient and supportive processes.

As experienced lawyers in superannuation insurance claims, we are here to help. Our role is to be your ally and support you to navigate these challenges, so you can focus on well-being and treatment, instead of bureaucratic delays.