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Life Insurance Claims

3 simple steps to make the claims process go more smoothly during a difficult time.

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What you need to know

  • You need to find details of the life insurance policy in order to make a claim.
  • Get in touch with the relevant insurance provider, and complete any claim form as required.
  • Generally insurers have a claims process in place that is fast and uncomplicated in some cases.

Making a life insurance claim: Step-by-step

If you're about to make a claim or make sure your next of kin is familiar with the process, here are the simple steps to keep in mind:

Number 1

Find the policy documents

The relevant life insurance policy will have details of who to contact about a claim. You may be able to find details of the insurer you need via the deceased's bank statements.

If you can't locate a policy, The Financial Services Council (FSC) could help you out. They can reach out to their life insurance members and asking them to check their records.

Number 2

Get in touch with the insurer

You can usually let the insurer know you want to make a claim by calling them or by sending an email. They will let you know about the required documentation that you'll need to gather. You'll typically need to confirm:

  • The deceased's name
  • Their cause of death (stated on the death certificate)
  • The policy number
  • Your personal details

They'll need this and other information (such as a note from a GP, for example) ahead of any pay-out being made to a beneficiary or beneficiaries.

Number 3

File your claim

Once you've completed the claim form, submit it to your insurer. They will let you know if any additional details are required. Straightforward claims may take a couple of weeks to process. It can take months, however, for more complex cases to be finalised before any payment can be issued.

Clipboard with paper
Good to know
If your claim is for an ongoing income protection payment, may need to maintain your policy by updating your insurer with your health status.

Life insurance claim statistics

The table below shows claims and claims related dispute information for life insurance bought through insurers directly, financial advisers and held within a superannuation fund. Sourced via Moneysmart's claim comparison tool for 1 July 2020 and 30 June 2021 period.

InsurerClaims accepted rateAverage claim time (months)Disputes per 100,000 lives insuredPolicy cancellation rate
AIA Australia Limited***10.5%
AMP***12.1%
Allianz***8.9%
Asteron91.2%2.822.311.3%
Clearview95.3%4.215.313.2%
CommInsure***11.6%
HCF***11.5%
Hallmark***28.3%
Hannover Re90.2%1.819.112.9%
MLC89.7%0.60.011.3%
MetLife***6.9%
NobleOak98.1%1.10.07.2%
OnePath95.5%4.129.210.1%
QBE/Integrity***16.3%
St Andrews90.0%3.824.39.9%
Swiss Re87.3%3.810.78.0%
TAL87.1%2.924.211.8%
Westpac95.7%2.716.38.9%
Zurich***9.4%

*The number of finalised claims is too small to provide a reliable result.

InsurerClaims accepted rateAverage claim time (months)Disputes per 100,000 lives insuredPolicy cancellation rate
AIA Australia Limited97.0%1.75.515.3%
AMP95.9%0.97.515.7%
Asteron95.6%1.75.413.9%
Clearview***15.6%
CommInsure97.2%1.612.05.1%
Hallmark***12.0%
MLC96.0%1.26.216.5%
MetLife***22.9%
NobleOak***3.5%
OnePath98.1%2.03.410.2%
QBE/Integrity**0.05.5%
TAL97.5%1.26.015.7%
Westpac96.5%2.39.514.4%
Zurich97.7%1.410.810.6%

*The number of finalised claims is too small to provide a reliable result.

InsurerClaims accepted rateAverage claim time (months)Disputes per 100,000 lives insured
AIA Australia Limited97.3%1.01.9
AMP98.6%1.32.5
Asteron***
CommInsure97.0%1.61.2
Hannover Re97.7%1.05.6
MLC98.1%0.80.0
MetLife98.9%0.90.7
OnePath95.9%1.52.7
QInsure96.3%1.52.7
TAL98.4%0.90.6
Zurich***

Note: The policy cancellation rate is not shown for the superannuation fund sales channel as changes are mainly due to superannuation trustees changing the insurer of the fund.

Things to keep in mind when making a claim

  • Check the life insurance policy documentation. Life insurance policies and procedures do vary between providers, so it's worth checking the policy document with care. Or, you can simply contact the provider for verification.
  • Contact the insurance provider as soon as possible. Notify the insurer of your intention to claim at the first opportunity in what will understandably be a trying time for the family.
  • Keep a detailed record of your calls and contact. You may have to contact the life insurance provider on a number of occasions by phone, in writing, by email etc. Make sure that you keep notes of when you made contact, names of people you spoke to, copies of any letters and correspondence that you send in, etc.
  • Be organised and get all the required documents ready as soon as you can to start lodging in your claim. This can include things such as a copy of the death certificate and details about the policyholder’s doctor/surgeon.

How to sort out a life insurance dispute or complaint

  1. Check your policy. Before doing anything make sure you've read through your life policy to make sure you are actually covered. Check your policy, including the small print, to see whether you actually have a case or whether the insurance firm is acting in line with its terms and conditions.
  2. Speak to your provider. If you believe there is an issue after checking the policy, you should contact your insurer and explain your concerns and discuss what can be done to resolve the dispute. Often, a satisfactory conclusion can be reached simply by speaking to the insurer and discussing the issue.
  3. Put in a complaint with your insurer. If you're unhappy with the resolution after speaking with your insurer, you will need to go through your insurers dispute resolution process. This generally requires putting your complaint in writing. Your insurer will give you a timeframe of when this issue should be resolved.
  4. If all else fails: Australian Financial Complaints Authority. If you have gone through the dispute resolution process and you are still not satisfied with the outcome, you should contact the Australian Financial Complaints Authority (AFCA) or in the past, the Financial Ombudsman Service (FOS). Escalating your dispute may mean that you have to wait even longer for a resolution but if you have exhausted other avenues, this may be the route to take in order to get the dispute resolved once and for all.

Pre-existing medical conditions and life insurance disputes

A common cause of life insurance disputes revolves around pre-existing medical conditions. Each year, the AFCA is contacted by hundreds of cases of people following their income protection claim being rejected. Life insurers have typically rejected claims due to policyholders not informing them of pre-existing medical conditions related to their claim.

So, it's super important to disclose all known information to insurers before signing the life insurance contract. Many applicants will withhold details of pre-existing conditions or lifestyle habits in an attempt to save on their policy premiums. As part of the duty of disclosure in the contract, it is the individual's responsibility to state all information to the insurer to avoid this situation from happening.

Definition of a pre-existing medical condition

A pre-existing medical condition is commonly recognised as any condition:

  • That was previously diagnosed or investigated
  • Where there were symptoms that lead to the diagnosis prior to application
  • Or event that lead to the claim occurring took place
  • Prior to the official commencement date of the policy or the effective date of any increase of the policy sum-insured.

Life insurance claims and taxes

A life insurance benefit payout is not taxable at the time of a claim if the nominated beneficiaries are financially dependent on you. These generally include:

  • Spouse/partner;
  • Child/children under the age of 18;
  • Other financial dependents, such as siblings or ageing parents.

If you have nominated specific individuals as the benefactor of your life insurance policy and they are not financially dependent on you, there may be some tax implications and we'd encourage you to speak with a tax specialist.

Read more about life insurance tax deductions.

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