Terminal illness

How can you receive a terminal illness benefit from your life insurance policy? Read on to find out.

Terminal illness insurance is generally available as an option with your standard life insurance policy and provides a benefit when you're diagnosed with a terminal illness and are not expected to live for more than 12 months.

Why is this benefit important?

Although life insurance is designed to cover you in the event of a death, having a terminal illness benefit can be extremely useful. For example, it can help your family cover medical costs from the moment you are diagnosed. Data available from life insurance brand BT shows terminal illness accounting for a significant portion of claims:

What terminal illness benefits do life insurers provide?

BrandMaximum time left to live (as confirmed by a medical practitioner).How much is paid out?
Asteron24 monthsLife Cover sum insured less any payments Asteron has made payments for TPD or Trauma
BT24 monthsDeath benefit is paid as shown on certificate
ClearView12 monthsThe greater of your benefit amount at the date you die and premiums you have paid over the life of the policy
Comminsure24 monthsOriginal sum insured
MLC24 monthsOriginal sum insured
OnePath24 monthsLump sum benefit
TAL12 monthsWe pay a lump sum in the event of death or diagnosis of a Terminal Illness. The amount we pay is the Benefit Amount you choose.
Zurich Futurewise12 monthsOriginal sum insured
Zurich Wealth Protection24 monthsDeath benefit
ANZ12 monthsThe amount you're covered for is shown on your Policy Schedule.
NobleOak12 monthsUp to a maximum of $3 million
Virgin12 monthsUp to $1.5 million cover for death and terminal illness.
Zurich Ezicover12 monthsThe amount payable under this Death benefit is reduced by any amount paid under the Cash advance benefit.
InsuranceLine12 months$1.5 million
Real12 monthsOriginal sum insured
TAL12 monthsOriginal sum insured
WoolworthsNot mentionedOriginal sum insured

Data taken from brand product disclosure statements on May 2017. Benefits, conditions and amounts are subject to change at anytime.

Terminal illness benefits will usually be available after:

  • After your plan starts (if you are accepted)
  • Before the plan ends
  • Before you reach its expiry date

You will generally need to provide:

  • Proof of from an approved specialist confirming you are likely to pass away

What’s considered a terminal illness?

The definition of a terminal illness varies depending on your policy. If you hold cover outside your super, before paying a terminal illness benefit the insurer will need to be satisfied that you will likely pass away as a result of your illness within a timeframe of either 12 or 24 months. Check the fine print of your life insurance policy to find out which terminal illness timeframe applies to your cover.

  • If your cover is held inside your super, you can access a terminal illness benefit if you suffer an injury or illness that is likely to cause your death within the next 24 months.

Can I claim this benefit if I buy my policy after I’m diagnosed?

  • No. Life insurance provides financial protection for your loved ones against the unexpected, not for when you find out you’re sick.

When you apply for life insurance cover, you’ll need to provide some important details about your health and medical history. Depending on the type of policy, you may also need to undergo medical tests to determine your overall health. So if you’ve already been diagnosed as terminally ill, life insurers will refuse to provide you with any cover.

Expensive Australian medical costs

Rather than having to wait for you to pass away before receiving a benefit, your family can receive the immediate financial support they need

Terminal illness benefit vs a death benefit

Payout upon diagnosis

The main advantage of receiving a terminal illness benefit is that you receive quicker access to the proceeds of your life insurance policy. This allows you and your loved ones to cover the costs that could arise immediately after a diagnosis of terminal illness, such as medical expenses and an ongoing replacement income. Rather than having to wait for you to pass away before receiving a benefit, your family can receive the immediate financial support they need.

Choose how you spend you final moments

Receiving a terminal illness benefit instead of a death benefit also allows you to live the rest of your life how you want. Rather than stressing about money and providing for your family, a terminal illness benefit can help you tick a few items off your bucket list or to create some precious memories together with your family. In addition, instead of dealing with the stress of making a life insurance claim when you pass away, your family will be able to focus on grieving their loss.

family_holidays_shutterstock_252342829

What can I use a terminal illness benefit for?

There are no restrictions on how you can use a terminal illness benefit. While a large portion of the proceeds will most likely go towards providing for your family after you’re gone, you might also want to use some of the benefit for the following:

  • To cover the cost of specialist medical treatment
  • To pay for accommodation close to specialist medical facilities
  • To pay for the cost of transport to and from medical facilities
  • To cover the cost of palliative care
  • To replace the income of a family member who takes time off work to become your full-time carer
  • To take a holiday with your family or tick some other items off your bucket list

How do I make a claim for terminal illness?

online-claimsYou will need to follow a few simple steps to make a terminal illness claim under your life cover policy. After contacting your insurer, you will usually need to provide the following:

  • A completed claim form. Your insurer will send you a form to complete. Your treating doctor and specialist will also need to fill out sections of the form.
  • Proof of ID. You will need to provide a certified copy of your birth certificate, your current Australian passport or your driver’s licence.
  • Policy details. Next, you will need to provide your original policy document and policy schedule.
  • Medical information. Your insurer will also need copies of any relevant medical reports, test results and investigations performed.

Once you’ve submitted all the required information, your claim will typically be processed as quickly as possible.

How is terminal illness insurance different from critical illness cover?

Terminal illness insurance is different from critical illness insurance but the two terms are often used interchangeably.

  • Critical illness insurance. Critical illness cover (also known as trauma insurance) can be bought as either a standalone product or as part of your life insurance policy. The policy will provide you with a lump sum payment if you're diagnosed with any one of the critical illnesses listed in the policy document. These policies generally include caveats such as the insured must live for minimum number of days after being diagnosed, generally 20 to 30 days, before a benefit will be paid.
  • Terminal illness insurance. A terminal illness benefit is not available as a standalone product. It provides you with a benefit when you've been told that you have a maximum of 12 months to live.

Do I need to tell my insurer if I already have a terminal illness?

When applying for life insurance the insurance company will factor in your age, health employment, environment, an other activities, in order to be able to arrive at the correct premium for you to pay. It is important that you be honest in answering all these questions.

What if I withhold the truth?

If you fudge any area at all, when the time comes to make a claim, you may be declined.

Why do I need to disclose my health?

Most life insurance policies will look at your risk when:

  • Arriving at the correct premium to charge you for basic life insurance
  • Accepting your policy.
  • Providing you with benefits.

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Richard Laycock

Richard is the insurance editor at finder.com.au. He is on a mission to make insurance easier to understand.

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