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).
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).
If we are unable to make a decision over the phone, you may need to provide:
To make a disability claim you may need to provide:
To make a terminal illness claim you may need to provide:
To make a death claim your dependants may need to provide:
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.
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.
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.
The time taken to reach a decision on a claim may vary as it is based on:
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.
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.
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.
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.
We will contact you within 10 business days of being notified about your claim and provide:
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.
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.
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:
If you are not satisfied with our response or handling of your complaint, you can contact the Australian Financial Complaints Authority (AFCA):
If you’re experiencing any difficulty with our claims process or have any questions, contact us to chat about how we can support you. Please call us on 1300 553 764, Monday to Friday 8.00am – 6.30pm (Sydney time). Alternatively, email us anytime at email@example.com.
A target market determination has been made for Protection Plans products. Please visit bt.com.au/tmd for any of our target market determinations.
The Insurer and Issuer is Westpac Life Insurance Services Limited ABN 31 003 149 157 AFSL 233728, except for Term Life as Superannuation, Income Protection as Superannuation and Income Protection Assured as Superannuation, issued by BT Funds Management Limited ABN 63 002 916 458 AFSL 233724 as Trustee of Retirement Wrap ABN 39 827 542 991. They are subsidiaries of Westpac Banking Corporation ABN 33 007 457 141 AFSL 233714, who does not guarantee the insurance. This information does not take into account your personal circumstances. Terms and conditions, and limitations and exclusions apply. Please read the Product Disclosure Statement to see if this insurance is right for you.
© Westpac Banking Corporation ABN 33 007 457 141 AFSL and Australian credit licence 233714