Question 1

Do I have a superannuation, life insurance, or disability insurance claim?

Accepted Answer

There are many different types of insurance-related claims available to individuals who have suffered injury or illness and are no longer able to return to work in the same capacity.

It can be hard to know where to start. We always recommend speaking to one of our superannuation and insurance claims experts for a quick, obligation-free analysis of your situation to determine your rights and ability to make a claim upfront.

Generally speaking though, there are four types of insurance benefits that you may be able to access depending on your circumstances and the policies by which you are covered.

Total and Permanent Disability (TPD)

If you’re sick or wounded and have been off work for three months or more, then you may be eligible for a TPD insurance benefit. Click to read more about TPD claims.

Income Protection

This is sometimes called Total and Temporary Disability (TTD) or Temporary Salary Continuance (TSC). If you have this type of insurance and can’t work, you may be eligible to receive a monthly benefit for a set period of time that pays up to 75% of your gross income. Click to read more about income protection claims.

Trauma claims

If you have been diagnosed with a defined medical condition or suffer a specific ailment, you may be eligible to receive a lump sum, regardless of whether you can continue to work or not.

Life Insurance or Death Benefit claims

A lump sum will be paid to the nominated person (usually a spouse or child), upon the insured person’s death. Click to read more about death benefit claims.

Question 2

What are the requirements for making a superannuation or insurance claim?

Accepted Answer

The requirements for making a claim differ depending on the type of claim you are making.

For TPD claims you need to show that because of the injury or illness, you cannot do your job, and you cannot do any of the other jobs for which you have education, training or experience.
It’s not necessary for you to prove that someone else was at fault.

For Income Protection claims you need to show that you cannot do your job, you are under the care of a doctor, and that you’re not working for a wage or income.

The criteria for claiming benefits differ from policy to policy so it is important that you get legal advice as soon as possible.

Question 3

Who pays the insurance benefit?

Accepted Answer

In the case of insurance and superannuation claims, it’s the insurer who will pay benefits. In some cases, this is through your private life insurer, superannuation fund, employer sickness and accident insurer, and even mortgage and credit card insurers.

Contact us to arrange an obligation-free consultation to assess your case confidentially.

Question 4

How do I find my disability insurance?

Accepted Answer

Most working Australians are members of a superannuation fund, and it is very common for funds to provide a level of insurance cover to their members. It’s possible that you have disability insurance that you’re not aware of.

Even if you don’t have superannuation, you may have your own life insurance policy, or your employer may provide you with some form of accident and sickness policy.

You may also have mortgage insurance that will help you make the repayments if you cannot work.

Our lawyers are experts and can help you find out if you have any disability insurance available, so contact us today.

Question 5

How much can I claim?

Accepted Answer

How much a person can claim very much depends on the type of insurance claim you are making and the facts of your particular situation.

Death, total and permanent disability and trauma benefits usually provide you with a lump sum payment, regardless of your wage or salary. These payments are usually income tax-free.

Income protection benefits are based on a percentage of up to 75% of your gross wage for a set period of time. The benefit is subject to income tax. It can also be reduced if you’re receiving WorkCover statutory payments, Centrelink benefits or other insurance benefits at the same time, but not always.

You can usually find the amount of your benefit in your annual member benefit statements or on the schedule that comes with your insurance policy, but a lawyer should be able to let you know as well once they know more about your situation.

Question 6

How long will the superannuation or insurance claim take?

Accepted Answer

Most insurance benefit claims can take between twelve and eighteen months to be assessed by a fund or insurer. In less complex cases, it’s possible for it to be assessed earlier – it just depends on the nature of your case.

Question 7

Can rejected claims be appealed?

Accepted Answer

Superannuation funds and insurers don’t always get decisions about your claim right. If a fund or insurer has rejected your claim, you can appeal their decision and they’ll have to undertake a formal review process. If necessary, fresh medical evidence can be submitted in support of your claim at this time.

If your claim is rejected again, there’s still a chance that you can successfully appeal your claim through the Courts.

Question 8

What are the time limits in superannuation or insurance claims?

Accepted Answer

Time limits apply for various insurance claims so it’s best to seek legal advice as soon as possible.

With regards to superannuation claims, generally speaking there are no time limits, but a claim should be lodged as soon as possible. The sooner a claim is lodged, the sooner the fund or insurer will begin assessing your claim, which can lead to a speedier resolution to help you get back on your feet.

There is a six-year time limit to file court proceedings in most cases. Usually that six-year period commences when a fund or insurer rejects your claim for the first time, but that is not always the case. It’s important to seek accurate and expert legal advice as soon as possible to ensure your rights are protected.

There is also a two-year time limit to file a complaint in the Superannuation Complaints Tribunal.

When you’re ready, we’ll be more than happy to discuss your circumstances and offer legal advice specific to your situation.

Question 9

How much will it cost?

Accepted Answer

Shine Lawyers work on a No win no fee\* basis for all superannuation and insurance claims so you’ll only pay our fee if you win your case at the end of the claim. We are open and honest about what we charge because the last thing you want to stress about is money.

We offer a fixed fee on most superannuation and insurance claims. The amount of legal costs we charge will depend on the amount of work required to resolve your claim.

\*Conditions apply

Question 10

How can I find out more about Shine Lawyers?

Accepted Answer

Shine Lawyers are expert superannuation and insurance claims lawyers that can help you get the benefits you need following your injury or illness. Our experts can provide the right advice for your situation and provide a free super claims check.

Click on the link below for more information about how Shine Lawyers can help.

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Question 11

Where are Shine Lawyers located?

Accepted Answer

Shine Lawyers have offices in the following locations. As part of our service offering, home or hospital appointments can be arranged at your convenience.

Our compensation experts are in the following locations:

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