What we pay? Why we might decline a claim? And, what you can do to make your claim as easy as possible.
Personal information
Financial information
Medical information
In 2018 we paid almost $1.62 billion to more than 26,000 Australians and their families' #. Of the total claims we paid, 62% helped our customers continue living their lives while recovering from an injury or illness. Included below are the most common reasons for making a claim##.
Including Breast & Pancreatic Cancers accounted for
%
of all the claims we paid.
Life Insurance
TPD Insurance
Recovery Insurance
Income Protection
One in two Australians will be diagnosed with cancer by the age of 85.(1)
Including Back Pain & Sciatica
%
of all the claims we paid.
Life Insurance
TPD Insurance
Income Protection
Arthritis and other musculoskeletal conditions affect around one in three (30%) Australians.(2)
Including Joint Dislocation & Bone Fracture
%
of all the claims we paid.
Life Insurance
TPD Insurance
Recovery Insurance
Income Protection
Almost half a million Australians are hospitalised each year as a result of injury.(3)
Including Post-Traumatic Stress Disorder & Depression
%
of all the claims we paid.
Life Insurance
TPD Insurance
Income Protection
Almost half (45%) of all Australians will experience a mental health condition in their lifetime.(4)
Including Heart Attack and Stroke
%
of all the claims we paid.
Life Insurance
TPD Insurance
Recovery Insurance
Income Protection
Cardiovascular disease affects one in six Australians.(5)
Delivering on the promises we make to our customers and paying all legitimate claims is very important to us. All life insurance has certain limitations that apply to cover and conditions that must be met for a claim to be paid. This helps to ensure the cost of cover remains as fair and affordable as possible for all existing and new policy holders. The terms of your cover will differ depending on the type of cover you hold and may also differ depending on your personal circumstances.
It’s important that you read the relevant documents relating to your policy to understand what your policy covers and what it doesn’t and if there are any conditions that must be met in order to make a claim. To help you understand why we might decline a claim, we’ve listed some of the common reasons why a claim may not be paid, however these examples may or may not relate to your type of cover.
If you have any questions, contact us or speak with your financial adviser. If your cover is provided through your super fund, reach out to them directly as they’ll be able to answer any questions.
Life Insurance can help protect you and your family financially should you pass away or suffer an illness or injury where you are unable to earn an income. However, terms and limitations will apply to your cover and in order to qualify for a benefit if you lodge a claim, certain conditions must be met.
Most life insurance policies contain limitations and exclusions which prevent you from being eligible to receive a benefit if your claim relates to that exclusion or limitation. In addition certain events, medical conditions, sports or pastimes may be excluded in your insurance or your cover may be limited. This will typically differ depending on your policy, cover type and personal circumstances.
Correctly answering questions – or disclosing information requested – is vital when applying for insurance. The information you provide enables us to determine whether cover can be offered, on what terms cover may be offered and to ensure that your premiums are calculated correctly.
If, through avoidance, misrepresentation or fraudulent intent you did not provide us with honest, accurate and complete information when you applied for insurance, your claim may be declined. Alternatively, we may need to vary your cover taking into consideration the information that should have been disclosed at the time of application.
Important note: #. Claims statistics based on TAL total number of claims paid in 2018. ##. Claims statistics based on total claims paid under TAL products (excluding funeral insurance). (1). Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW. (2). Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW. (3). Australian Institute of Health and Welfare: Pointer SC 2018. Trends in hospitalised injury, Australia 1999–00 to 2014–15. Injury research and statistics series no. 110. Cat. no. INJCAT 190. Canberra: AIHW. (4). Australian Bureau of Statistics. (2009). National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007. ABS: Canberra. (5). Australian Bureau of Statistics, 2018, National Health Survey: First results, 2017-18, ABS cat. no. 4364.0.55.001, December.
