Understanding claims and claiming

What you can expect from us throughout the claim process

Here we explain in detail what to expect throughout the insurance claims process. We provide you with the information required for each type of claim, claim timeframes and what to do if your claim is declined or should you wish to provide feedback on your claim experience.

If you need to make a claim, the first thing to do is call us on 1300 553 764 Monday to Friday 8.00am to 6.30pm (Sydney time).

Information required when submitting a claim

Below is a general guide of information that we may need to assess your claim and why this information is needed. Requirements may vary depending on the individual circumstances of your claim. Where possible, we will tailor the initial requirements to your circumstances when you call us.

The type of information that we will require from you will depend on the type of cover held on your policy(s).

Loss of income (Income Protection & Business Overheads)

If we are unable to make a decision over the phone, you may need to provide:

Initial claim forms (which we will send to you) that include sections for you and your treating doctor/specialist, to help us understand your circumstances and medical condition/s.
Any relevant medical information you may hold, such as copies of medical reports, test results and/or specialist letters, to help us understand the nature of your medical condition/s. This can save time should we require this from your treating health provider.
Documents that help to confirm your income prior to your disablement, this will vary depending on whether you are self-employed or an employee. This may include payslips, tax returns, Notice of Assessment’s, or relevant business statements.
Certified copy of your driver’s licence, birth certificate or passport, to confirm your identification and age.

Permanent disability (Total and Permanent Disability)

To make a disability claim you may need to provide:

Initial claim forms (which we will send to you) that include sections for you and your treating doctor/specialist, to help us understand your circumstances and medical condition.
Any relevant medical information you may hold, such as copies of medical reports, test results and/or specialist letters, to help us understand the nature of your medical condition/s. This can save time should we require this from your treating health provider.
Occupational information to understand your work history, including education, training, and experience.
Depending on the relevant policy terms applicable to your circumstances, documents that help to confirm your income prior to your disablement as well as post disablement. This may include payslips, tax returns, Notice of Assessment’s, or relevant business statements.
Certified copy of your driver’s licence, birth certificate or passport, to confirm your identification and age.

Term Life Insurance (Terminal illness)

To make a terminal illness claim you may need to provide:

Initial claim forms (which we will send to you) that include sections for you, your treating doctor and your treating specialist, to help us understand your medical condition and life expectancy.
Any relevant medical information you may hold, such as copies of medical reports and/or investigations performed, to help us understand the nature of your medical condition. For example, histopathology for a cancer claim. This can save time should we require this from your treating health provider/s if necessary.
Certified copy of your driver’s licence, birth certificate or passport, to confirm your identification and age.
Certified Power of Attorney or Enduring Guardian, in the instance that you are not well enough to complete and provide this information independently.

Term Life Insurance (Death benefit)

To make a death claim your dependants may need to provide:

A completed claim form, to help us understand the deceased’s details and circumstances of their death.
A certified copy of the deceased’s birth certificate, drivers’ licence or passport to confirm the deceased’s identification and age.
A certified copy of the deceased’s Will (if available), so we can identify beneficiaries.
For policies with a sum insured of more than $100,000, evidence of a grant of Probate or Letters of Administration are required to distribute the benefit. Where a valid legal Will exists, the appointed executor applies to a Court for a grant of Probate. Where no legal Will exists, usually the closest next-of-kin applies to a Court for a grant of Letters of Administration.
For policies with a sum insured of $100,000 or less, we may be able to pay a benefit without requiring the production of any Probate or Letters of Administration. We may require a Statutory Declaration to enable payment of the benefit.

Forms required when submitting a claim

We will require written consent if we need to access your personal information, including sensitive health information. We request your consent via the below two forms.

Consent for Accessing Health Information	This form is used to access any of your health information, we’ll inform you of our intent to seek health information prior to requesting it. We will explain what is required and why it’s needed to assess your claim. We only ask for health information that is reasonably needed to assess your claim.
General Authority and Privacy Consent	This form is used for all non-health related information requests, such as employers and other insurers. We will only use your consent to obtain information that we reasonably believe is relevant to your claim. We will inform you each time that we use your consent and explain why the information required is necessary.

If you require assistance providing these initial supporting documents and information to make a claim, our Initial Claim Support Service is readily available. This service helps you with the initial claims process, from completing the claim form to helping you provide us with the necessary requirements. This support service is provided either face-to-face in your home (or an agreed location), via telephone or video conference.

For more information or to arrange the Initial Claim Support Service, contact us on 1300 553 764, Monday to Friday 8.00am – 6.30pm (Sydney time).

If you’re unable to complete and provide this information, or if you are completing the information on behalf of the insured person, please provide a certified copy of a Power of Attorney or Enduring Guardian, to allow us to work with you in managing the claim on the customer’s behalf.

How long will the claim assessment take?

The time taken to reach a decision on a claim may vary as it is based on:

Individual circumstances;
Complexity of the claim;
Level of information required to assess the claim;
Availability and timeliness in obtaining the information required from all parties.

The time since a claimable event occurred can also impact how long it will take to assess a claim, as it can be more difficult to obtain information when a claim is lodged late. So, it is helpful to let us know as soon as possible.

Customers can assist during the claim process by completing requests for information accurately and providing relevant information promptly. If you’re having any trouble providing information, please let your dedicated Claims Consultant know as soon as possible, so we can work with you to overcome delays and consider alternatives. It can help if you share any relevant medical information you may hold, reducing the need to request this from your health provider.

Life Code of Practice

We subscribe to the Financial Services Council Life Insurance Code of Practice. The Code outlines the time frames that we are required to meet when managing claims, as well as the steps that we must take to communicate with you at certain stages of a claim. See more information on the Life Insurance Code of Practice.

Income Protection claims

For most Income Protection claims, a decision will be made no later than two months after notification, or two months after the end of the waiting period (whichever is later). If a decision has not been made within two months, we must let you know the reasons for the delay.

If your payment is going to be delayed, for example, because you have not provided some necessary information, we will get in touch with you to let you know the reason for the delay so that you have an opportunity to resolve this.

All other Life Insurance claims

For most claims, a decision will be made no later than six months after notification of the claim. If a decision has not been made within six months, we must let you know the reasons for the delay.

If a decision on your claim is going to be delayed, for example, because you have not provided some necessary information or we are having difficulty obtaining relevant information, we will get in touch with you to let you know the reason for the delay so that you have an opportunity to resolve this.

How often can you expect to hear from us?

We will contact you within 10 business days of being notified about your claim and provide:

an explanation of your cover (including any waiting period before payments will be made)
the claim process, including what further information you will need to provide, and
why certain information is necessary, so a decision can be made on your claim.

If required, we will be in touch with you to give you an update at least every 20 business days, unless otherwise agreed with you.

Once we have the requested information and have completed our enquiries, you will be notified of the claim decision within 10 business days.

What to do if your claim is declined

If your claim is declined, we’ll provide you with the reasons for this in writing as well as the documents and information that we have relied on to reach the claim decision. Prior to making a final decision, we will provide you with an opportunity to respond and provide additional information.

If you were not provided with the documents and information that we have relied on to reach the claim decision, you have the right to request them, and we will provide them to you within 10 business days. If you disagree with our decision, you can request that we review it. Alternatively, you can access our complaints process. See more information on our feedback and complaints process.

What to do if you would like to provide feedback or raise a complaint

We are committed to providing you with efficient and caring service, and our people are dedicated to ensuring we can help you.

If you do not think we have lived up to this promise and you have a concern or complaint, we want to listen and ensure your issue is dealt with in a fair and balanced way.

To make a compliment, complaint, or suggestion about our claims process, please leave us some feedback so that we can work with you to improve our services.

To do this you can:

Contact our Customer Relations team on 132 135 Monday to Friday 8.30am – 5.30pm (Sydney Time).
Alternatively, you can post your suggestions to BT, GPO Box 2675, Sydney NSW 2001.
Email us at liferesolutionsbt@btfinancialgroup.com

See more information on our feedback and complaints process.

If you are not satisfied with our response or handling of your complaint, you can contact the Australian Financial Complaints Authority (AFCA):

Online: www.afca.org.au
Email: info@afca.org.au
Phone: 1800 931 678 (free call)
Mail: Australian Financial Complaints Authority GPO Box 3 Melbourne VIC 3001