Injured and need help? Lawyers are super in superannuation claims

July 10, 2019

The last thing you want to do when you’re injured or ill is battle it out with a superannuation provider for financial support.

Many superannuation customers are unaware that the annual fees they pay may include several types of insurance, namely:

  • Income protection cover, which pays you an income stream for a set period if you are unable to work due to injury or illness;
  • Total and permanent disability cover, which pays you a benefit if you are seriously disabled and are unable to work again; and
  • Death cover (or life insurance) where your beneficiaries receive a financial benefit when you die.

Knowing what entitlements you or your loved ones are owed under superannuation cover can make the difference in your family being financially secure. If you are unsure what you are entitled to, or if you have been rejected for any superannuation based claim already, you should seek legal advice.

It’s Tricky for a Reason

Remember, your insurers make more money when you pay premiums but make no successful claims. For this reason, the superannuation claim process is arduous and loopholes are often relied on by companies to deny claims.

Though the process for claiming superannuation benefits is reportedly designed for customers to manage their own claims, the requirements put in place by superannuation companies are often unnecessarily complex. It’s easy to be buried in paperwork when each claim form is between 20 and 30 pages long, and there is little internal support available for claimants who have been neglected by claim assessors.

Superannuation providers are not fast in approving submitted claims, and in our experience have at times simply rejected an entire claim for containing small errors rather than communicating with clients to fix the issues. At Websters Lawyers we are highly experienced in completing complex claims for our clients without error, saving you the headache of tricky fine print and avoiding unnecessary delays in getting you the money you need.

Pitfalls of Claim Requirements

Whilst it is reasonable that superannuation providers may require claimants to validate their claims, the processes for such validation can venture into the realm of the irrational.

Providers have been known to send claimants to doctors who specialise in areas not specific to their claimant’s injuries, or to ‘doctor shop’ and send a claimant to two of the same kind of doctor and cherry-pick the report which least supports a benefit claim.

It is also not uncommon for claimants to be placed under surveillance by superannuation and insurance providers in an attempt to gain evidence that the claimant is less injured than they have previously described.  The problem is that many times the activities reported on are taken out of context and aren’t the ‘smoking gun’ that the insurers think.

Getting legal advice at the beginning of your claim can help you become aware of such pitfalls.  Having a lawyer handle your claim can also help dissuade providers from making unreasonable validation requests of you, helping you avoid stress and weaknesses in your claim.

Competing Interests

When no beneficiary is specifically named in a person’s death cover insurance benefits, their loved ones can find themselves embroiled in a dispute for life insurance. We highly recommend that you seek advice from a lawyer as soon as is practicable in such matters, as you will likely be called on to complete an application for these benefits very quickly and to supply supporting statements. A lawyer’s support can prove to be invaluable when your claim is the first to be processed and your statements are drawn in a concise legal manner.

A Provider’s Initial Rejection Is Not Final

If you have already independently submitted a claim to a superannuation or insurance provider and have been knocked back, come speak to one of our solicitors.

Claims are often rejected due to small errors that can be identified and remedied by a practiced lawyer. You may also dispute the rejection decision if you disagree with the findings, and ask that a different claims assessor be assigned to your matter. It is vital that you seek legal support in these instances, as a lawyer may be able to identify mistakes of law and fact which a claims assessor may overlook or be not be aware.

Supporting You Through Litigation

Though most of the superannuation and insurance claims we complete are approved and paid out to our clients without litigation, it is occasionally necessary to take litigious steps get a fair outcome. When you have exhausted the avenues available to you through the provider itself, we can advise and assist you through the next steps, which might involve making a complaint to the Superannuation Complaints Tribunal initially, or taking the case to Court.

Though litigating a claim can seem unnerving, our experienced barristers and solicitors are able to guide you step by step through the court process and keep you fully informed as to your prospects of success and what will be required of you.

Time to Make a Claim

If you are unsure as to what superannuation benefits you are entitled to, wish to make a claim for superannuation entitlements and/or have been rejected already for a claim, it’s time to call the personal injury and estates teams at Websters Lawyers. Contact us today for a free first interview.

For more information about Superannuation and TPD claims click here.