Making a Terminal Illness claim
Making an insurance claim can be a difficult task, we’re here to help guide you through what to expect if you need to make a Terminal Illness (TI) claim.
If you believe you could be eligible to apply for a TI payment, call us on 1800 060 312 or email email@example.com.
Starting your claim
Once we’ve confirmed your eligibility to start the claims process, we’ll get some paperwork to you and ask for supporting documentation and other important information to help the process run smoothly. Initially you will need to provide us with:
- Your name and date of birth - Your member number would be helpful but is not required
- Details about your terminal illness - Details and the date of your diagnosis
There is no set time frame for how long an insurance claim takes.
Submit your application
Complete the forms we send you and return them along with all of the necessary supporting documents. These include, but aren’t limited to, forms to be completed by your treating doctor and specialists describing the nature and extent of your illness and medical reports and medical evidence that may support your application. Your eligibility to submit a claim will be assessed.
The Insurer will assess your application
The Insurer will use the information you provided when making an assessment. The insurer may also request relevant information from other sources, such as independent experts if this is required. You will be informed of any such steps taken to assess your claim. You may also be asked to provide further information such as further reports from your doctor(s).
The Insurer’s decision
Once your application has been assessed you’ll be advised whether it has been successful.
If your application is declined
If your application is declined, this generally means that the Insurer has not formed the opinion, based on all the evidence provided, that you meet the requirements for a Terminal Illness benefit to be paid. The insurer will explain its reasons for the decision and your application will be referred to the legalsuper Trustee. The Trustee has a responsibility to review the Insurer’s decisions, to ensure they are reasonable and meet the conditions set out in the legalsuper Trust Deed and insurance policy.
You also have the right to request that the legalsuper Trustee or the insurer to reconsider any decision to decline your claim, and this request can be accompanied with new evidence or further submissions as to why you consider you meet the conditions for payment of a TI benefit.
If your application is accepted
You will be required to give us instructions as to how to make payment to you.