Making a claim is an administrative process rather than an adversarial one, though it rarely feels that way when you are doing it while grieving or unwell.
It takes longer than most people expect, the order of steps matters, and the most common expensive mistake happens right at the beginning. This is the sequence.
Step one: find every policy
Do this before anything else, because people routinely claim on one policy when three existed.
Check every superannuation account. Most Australians have more than one, and each may carry its own insurance. Claiming on the main fund and overlooking two older accounts is the single most common way benefits go unclaimed.
You can see all superannuation accounts, including lost and ATO-held amounts, through myGov by linking the ATO. For a deceased person, the executor or next of kin can request this information.
Look for personally held policies. Check bank and credit card statements for regular premium payments, which is often the fastest way to find a policy nobody knew about. Check email for insurer correspondence, and contact any financial adviser, accountant or solicitor involved.
Do not forget the smaller ones. Employer group schemes, mortgage protection cover attached to a home loan, funeral cover, credit card insurance and cover attached to professional association memberships.
If you are unsure whether a policy exists, ask the fund or insurer directly. They will tell you.
Where a policy may exist but cannot be located, our article on how to avoid unclaimed payouts covers the search process in more detail.
Step two: notify, before you are ready
Contact the insurer or fund as soon as you know a claim is likely. You do not need documents to start, and there is no advantage in waiting until everything is assembled.
Ask for the claim pack, note the claim number, and record the name of the person you spoke to. Keep a log of every call from this point, with dates. It will be useful later even if nothing goes wrong.
Timing matters more for some claims than others. Death claims rarely have strict deadlines, but income protection and TPD policies commonly require notification within a set period or as soon as reasonably practicable, and unexplained delay can complicate a claim. If you have been unwell for months and are only now looking at this, notify now rather than waiting to feel organised.
Step three: assemble the documents
The document that takes longest is almost always the one you need first, so start these early.
For a death claim: a certified copy of the death certificate, which is issued by the Births Deaths and Marriages office in your state and can take several weeks. Proof of your own identity. The completed claim form. A medical certificate or attending doctor’s statement. The will, and in some cases a grant of probate or letters of administration, particularly where the benefit is payable to the estate.
For a TPD claim: the claimant statement, statements from your treating doctor and usually a specialist, a statement from your employer including a description of your duties, medical records and any imaging or specialist reports, and evidence of when you stopped work.
For an income protection claim: the claim form, medical certification, an employer statement, and financial evidence of your income such as payslips and tax returns. Expect to provide ongoing medical certificates, often monthly, for as long as the claim continues.
Certified copies are usually required rather than originals. A justice of the peace, pharmacist, police officer or lawyer can certify documents, and most are happy to.
Step four: understand who actually gets paid
This step catches families out, and it is worth understanding before the money moves.
Insurance held outside superannuation is paid to the policy owner or the nominated beneficiary. It is straightforward and usually the faster path.
Insurance held inside superannuation is different. A super death benefit does not automatically follow the will.
Where a valid binding death benefit nomination is in place, the trustee must pay according to it. Many nominations lapse after three years, so a nomination made years ago may no longer be valid.
Where there is no valid binding nomination, the trustee decides who receives the benefit, choosing among people who qualify as dependants under superannuation law and the deceased’s legal personal representative. That process takes months, the trustee is required to notify interested parties of its proposed decision, and there is a short window, generally 28 days, in which someone can object before it is finalised.
This is why an estate that looked simple can take the better part of a year to resolve, and why it is worth asking early whether a binding nomination exists.
Step five: the assessment
Once the claim is lodged, the insurer gathers evidence. Expect them to obtain full medical records going back many years, and for TPD and income protection claims, employment records and sometimes tax records.
You will usually be asked to sign a medical authority. Read it before signing rather than after. Some are drafted very broadly, and you are entitled to ask for a narrower authority limited to what is relevant.
An independent medical examination may be arranged, at the insurer’s cost, with a doctor of their choosing. This is normal. You can take someone with you, and you can ask for a copy of the report.
Surveillance is used in some income protection and TPD claims. It is lawful within limits, and knowing it happens is better than being surprised by it. The practical implication is simply to be accurate about your capacity rather than either overstating or understating it.
Timeframes. A straightforward death claim is often resolved within weeks to a few months once documents are complete. TPD claims commonly take six to twelve months, partly because most policies require a qualifying period, often three or six months away from work, before assessment properly begins. Whether a TPD claim succeeds often turns on which definition your policy uses, and our comparison of own occupation and any occupation cover explains why the same circumstances can produce different outcomes under different policies. Income protection claims move faster but require ongoing certification.
If things go quiet, call. Claims occasionally sit waiting on a document nobody told you about.
Step six: payment and tax
The tax treatment varies considerably depending on where the cover was held and who receives it.
Death benefits paid from a policy held outside superannuation are generally received tax free.
Death benefits paid from superannuation are generally tax free where the recipient is a dependant for tax purposes, which includes a spouse, a child under 18, a financial dependant and someone in an interdependency relationship. Adult children are usually not tax dependants, so the taxable component of a benefit paid to them can attract tax.
TPD benefits paid from superannuation are subject to superannuation rules. The money is preserved, meaning a condition of release such as permanent incapacity must be met before it can be withdrawn, and tax may apply to part of it, though concessions exist for people below preservation age. A large TPD benefit landing in a super account is not the same as money in your bank account, which surprises people.
Income protection benefits are assessable income and taxed at your marginal rate, which is why replacement ratios sit below full salary.
Once a benefit is paid, what happens next is its own decision, and one worth taking slowly. Our article on what to do after receiving a payout covers that period.
If the claim is declined or delayed
A declined claim is a decision, not the end of the matter.
Ask for the reasons in writing, along with the material the insurer relied on. You are entitled to both.
Use the insurer’s or fund’s internal dispute resolution process first. It is free, it has a defined response timeframe, and a meaningful number of claims are resolved at this stage, particularly where the issue is a missing document or a misunderstood definition.
If that does not resolve it, take the matter to the Australian Financial Complaints Authority. AFCA is free to consumers, its determinations bind the firm, and it considers the full picture rather than only whether a form was completed correctly. Time limits apply to lodging a complaint, so do not sit on a decision you disagree with.
For a superannuation death benefit, if you object to a trustee’s proposed decision you generally need to do so within 28 days of being notified, before the decision is finalised. That window is short and easy to miss.
Where a claim involves a dispute about what was said at application, our article on non-disclosure and why claims get denied explains what an insurer actually has to establish, which is a higher bar than most people assume.
For substantial or complex disputes, specialist insurance lawyers act in this area, many on a no-win-no-fee basis.
A warning about claims operators
You do not need to pay anyone a share of your benefit to lodge a claim.
Operators exist who approach people after an injury or a death, offer to manage the claim, and take a percentage of whatever is paid. Some are legitimate. Many charge substantial fees for work you could do yourself or that a lawyer would do more cheaply, and some are simply lead generators.
Lodging a claim is paperwork. It is tedious rather than difficult. If you want help, your fund has a claims team obliged to assist, and for disputes a specialist lawyer is a better option than a percentage arrangement with someone who cold-called you.
Practical things that help
Nominate one person to coordinate, particularly in families. Multiple people contacting the insurer separately slows everything down.
Keep every document and a log of every conversation.
Do not resign, accept a redundancy or change your employment status while a TPD or income protection claim is contemplated without checking how it affects your cover and your claim. Definitions often turn on your employment at a particular date.
Check whether you hold more than one TPD policy. You can generally claim on each of them.
And take your time on the parts that need care. The claim forms ask questions that shape the assessment, and a rushed answer about your work capacity is harder to correct later than it is to get right now.
If you are not sure what cover you or a family member held, that search is something we do as part of life insurance advice in Adelaide, and it costs nothing to ask.
If you are dealing with a death
Very little of this is urgent in the first weeks. The death certificate takes time to issue, and nothing much can proceed without it.
If you would like support, Griefline offers a free national helpline on 1300 845 745, and Lifeline is available on 13 11 14 at any hour.
Where we fit
We do not run claims disputes, and you do not need us to lodge a claim. What we can do is help you work out what cover existed, make sure nothing is missed across multiple superannuation accounts, and help you think through what to do with a benefit once it is paid.
Our life insurance advice page explains how we work, and you can get in touch whenever suits. There is no urgency to any of it.
Frequently asked questions
How do I claim life insurance in Australia?
Start by identifying every policy, including cover attached to each superannuation account you or the deceased held, then contact the insurer or fund to open a claim before assembling documents. You will need a certified death certificate for a death claim, proof of identity, a completed claim form and medical certification. The insurer then gathers medical and employment records and assesses the claim.
How long does a life insurance or TPD claim take?
A straightforward death claim is often resolved within weeks to a few months once documents are complete. TPD claims commonly take six to twelve months, partly because most policies require a qualifying period of three or six months away from work before assessment properly begins. Income protection claims move faster but require ongoing medical certification.
Does life insurance in super follow the will?
No. A superannuation death benefit does not automatically follow the will. Where a valid binding death benefit nomination exists, the trustee must follow it, but many nominations lapse after three years. Without a valid nomination, the trustee decides among people who qualify as dependants under superannuation law and the legal personal representative, which takes months and can be objected to.
What documents do I need for a TPD claim?
A claimant statement, statements from your treating doctor and usually a specialist, an employer statement describing your duties, your medical records including imaging and specialist reports, and evidence of when you stopped work. Expect the insurer to obtain further medical records directly and possibly to arrange an independent medical examination at its own cost.
Is a life insurance or TPD payout taxed?
It depends on where the cover was held and who receives it. Death benefits from a policy held outside super are generally tax free. Death benefits from superannuation are generally tax free to tax dependants such as a spouse or a child under 18, but adult children are usually not tax dependants and the taxable component can be taxed. TPD benefits paid from superannuation are preserved and may be partly taxable, with concessions below preservation age. Income protection benefits are assessable income.
What can I do if my claim is declined?
Ask for written reasons and the material relied on, then use the insurer’s or fund’s internal dispute resolution process, which is free. If that does not resolve it, take the matter to the Australian Financial Complaints Authority, which is free to consumers and whose determinations bind the firm. Time limits apply, and for a superannuation death benefit you generally have only 28 days to object to a trustee’s proposed decision.
Do I need a lawyer to make a claim?
Not to lodge one. Claims are administrative and your fund’s claims team is obliged to assist. Legal help is worth considering for a declined claim, a complex dispute or a contested superannuation death benefit, and specialist insurance lawyers often act on a no-win-no-fee basis. Be cautious about operators who approach you offering to manage a claim for a percentage of the benefit.
Important. This article contains general information only and does not take into account your objectives, financial situation or needs. It is not legal or tax advice. Claim processes, policy definitions, qualifying periods and tax treatment vary between insurers, funds and policies, and depend on your individual circumstances. Money Path does not act in insurance claim disputes. If a claim has been declined, contact AFCA or seek advice from a lawyer who specialises in insurance claims.
