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Can an insurer stop paying my income protection insurance benefits?

 


Options available when the insurer terminates your income protection benefits

We have seen many cases where an insurer first accepts an income protection claim, but after a period of paying the person, the insurer makes further investigations and decides to stop paying the benefits. The reasons for stopping payments can be many and varied. The question is, what can you do if the insurer stops paying your income protection benefits?

What is income protection insurance?

Income protection policies usually provide you with a monthly benefit if you cannot work for a period due to illness or injury. Depending on the policy you have, those benefits can be payable for 2 years, 5 years, til age 65 and sometimes (but rarely) for the rest of your life.

What reasons might an insurer terminate payment of income protection benefits?

There are many and varied reasons the insurer may stop paying your income protection benefits. Some common reasons we’ve seen are:

  1. The person wasn’t regularly attending their doctor;
  2. The insurer no longer believes that the person is unable to work due to their medical condition;
  3. The insurer believes that the person didn’t disclose certain medical conditions which existed when the policy was applied for (non-disclosure).

To make these decisions, the insurer may ask that you attend a medical appointment with a consultant doctor (an independent medical examination (IME) or medicolegal appointment). They might also ask your treating doctor for detailed reports about your past, current and future medical treatment.

Get help if your income protection benefits are terminated

We have assisted many people in each of the above situations. If an insurer has used any of the above reasons to stop paying you your income protection benefits, or they are asking that you attend medical appointments or requesting extra reports or documents from your doctors, you should get some legal advice to discuss your options.

If you require assistance or advice about anything to do with your income protection claim, call 03 9448 8048 for free advice.

The issues above can be complex depending on your situation. In particular, non-disclosure cases are very “fact dependant" and there are small things that you might say to an insurer that could greatly affect your case. So, if an insurer is investigating non-disclosure (it may be that they are making these investigations if they are now asking about your medical history prior to the date your policy started) seek legal advice as soon as possible.

We can work out whether you have a case in an efficient and simple way, so you won’t have to provide us with enormous volumes of documents. In many cases, we can understand your case via a simple phone call.

When we act for people (and we only ever represent individuals, never the insurance company), we handle all communications with the insurer so you won’t have to worry about that anymore.

Free advice and no upfront fees

We conduct all of our investigations for free. If you have a claim, we will act for you on a no win, no fee basis.

If you would like more advice on the matters outlined in this article, please get in touch directly with today’s blog writer, superannuation and insurance lawyer Paul Watson.

Phone

Melbourne: 03 9448 8048

Brisbane: 07 3013 4300

Anywhere else in Australia:  03 9448 8048

Email

[email protected]

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