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Do advised clients get their claims paid more often?

Every year APRA release claims statistics on Australian life insurers claims data. These figures provide some interesting insights into the outcomes for direct life insurance customers (eg real insurance, NRMA life, NobleOak etc) and those customers who have taken out their insurance policies with an adviser.

APRA’s claims statistics and disputes report, which covered the 12 months to June 30 2021, showed that claims admittance rates across 20 insurers was 93%. This was significantly higher for those who had an adviser. For death claims,97% of claims were paid where an adviser was involved compared to 92% for those with no adviser (direct insurance).

In Total & Permanent Disability cover (TPD), 82% of advised claims were admitted during the 12 months compared to just 64% of non advised claims.

Income Protection also showed a significant difference with 95% of advised claims admitted vs 81% for non advised claims. Over 10,000 Income Protection claims were finalised in the 12 months to June 2021 with financial advisers vs 1,700 for non advised clients.

The APRA report highlights the need to seek advice when taking out what is a complex financial product.

If you currently have insurance in place which you would like reviewed or are interested in taking out a new insurance policy please get in touch with us today.

The information provided here is general only and does not consider your personal objectives, financial situation or needs. Before you decide to purchase a product, it is important to read the relevant PDS.

Zurich & Onepath offer vaccine protection

Whilst all retail life insurers have come out previously and said that there are no exclusions for Covid related claims or vaccine related claims, Zurich & Onepath have now announced that from Sept 1, 2021, existing clients with a Zurich or Onepath Life, Total & Permanent Disability (TPD) or Income Protection policy will have an additional $50,000 cover if they suffer a serious side effect from an approved Covid-19 vaccine. This is on top of any existing Life, TPD or Income Protection cover a client has with the insurer.

Whilst medical evidence indicates the likelihood of vaccine complications is extremely low, some people are concerned about the risk of a serious adverse reaction.

If you would like to know more about this positive initiative from Zurich & Onepath please contact us.

The information provided here is general only and does not consider your personal objectives, financial situation or needs. Before you decide to purchase a product, it is important to read the relevant PDS.


Income Protection changes are coming

New government regulations have been introduced that will reduce the benefits on new Income Protection policies written after October 1, 2021. The changes have been mandated by the Australian Prudential & Regulatory Authority (APRA) in response to concerns relating to billion dollar losses on Income Protection policies over the preceding years. These changes not only affect retail Income Protection policies but Income Protection within super as well.

If you currently have an Income Protection policy in place or can get one before October 1, 2021, you will maintain your existing higher benefits.

The changes include:

-Income is to be calculated on the last 12 months only, compared to some current policies offering the highest 12 months in the last 2 or 3 years. For Indemnity policies this is crucial as the insurers claims team go by these figures should a claim be lodged. This change will also have a big impact on self employed clients whose income varies from years to year as well as clients whose job/incomes have been affected by the covid lockdowns.

-Income replacement ratios are to be reduced to 70% from 75% currently. What this means is that if you earn $100,000 pa you can currently insure yourself for up to $75,000pa. Once these new changes are in place the maximum will be 70% meaning $70,000pa on an income of $100,000pa.

-Long benefit periods, such as to age 65 will remain although the way claims are assessed will change. Claims will be assessed under the own occupation definition for the first 2 years only and will then change to any occupation based on training, education and experience.

With the changes above impacting the quality of the Income Protection cover that can be applied for, it is important to consider reviewing your existing Income Protection policies or completing a new application before Oct 1, 2021.

Should you wish to discuss any of the above or would like a free review of your current insurances please don’t hesitate to contact us on 1800 737 926 or complete our contact form.

The information provided here is general only and does not consider your personal objectives, financial situation or needs. Before you decide to purchase a product, it is important to read the relevant PDS.

Myths about life insurance

Myth 1: Life insurance companies don’t pay claims

There’s a common perception that life insurance companies will do everything in their power not to pay a claim. In fact, 92% of life insurance claims are paid in the first instance. The term life insurance relates to all life insurance products such as Life cover, Income Protection, Total & Permanent Disability (TPD) and Trauma insurance (sometimes known as Crisis insurance).

As long as you fulfil your duty of disclosure when applying for the cover and you’re covered for the medical condition you’re claiming for, you can expect for your claim to be paid.

Myth 2: I won’t be covered if my health changes

Once your cover starts, you are covered for the life of the policy. The only time the life insurer can cancel your policy is due to non payment, policy expiry age or if you request for the policy to be cancelled. Your policy and premium won’t change as the result of your declining health should that occur.

Myth 3: You have to do lots of medical tests to get covered

Some life insurance policies sold through financial advisers like those at theinsurancequoter will require some medical tests before you get covered but may be as simple as a blood test and a GP examination. Generally these tests will only be required if the person is over a certain age, has pre existing conditions or applying for a large amount of cover. Should the insurer apply any exclusions or loadings, these will be communicated with the client first and be required to be signed off on.

Myth 5: Level premiums don’t go up

Level premiums are calculated based on your age when the cover started, not at the time of anniversary, which means premiums are generally averaged out over a number of years. This means they are more expensive than ‘stepped premiums’ at the beginning of the policy, but generally cheaper over the life of the policy. This also depends on the age of the insured person.

It’s important to note that level premiums may increase at the policy anniversary if this insurer has repriced their in-force policies. This has happened with many life insurers recently as they have increased both stepped and level premiums. Other factors that impact premiums are claims trends in the Australian population as well as low interest rates.

Whilst level premiums may still be suitable for some clients, it’s best to talk to a financial adviser who can help you plan on which way to go which depends on a number of factors.

Myth 6: The cover in my super is enough

Over 70% of Australian life insurance policies are held through superannuation funds. Whilst this cover is great to have, many of the policies only provide the minimum level of cover which isn’t enough for the majority of people.

Rice Warner estimates that the medium level of cover in superannuation only meets the 60% of the required amount of insurance for life cover, 13% for TPD insurance and just 17% for Income Protection.

Myth 8: I’ll be covered by my workers’ compensation

Workers’ compensation provides some protection for work related accidents or injuries but it doesn’t cover most illnesses, nor does it cover anything that happens to you when you’re not at work.

Even if you are covered by workers compensation, the benefits are typically capped in terms of the amount and duration of payments which means the cover could fall well short of what you really need.

Myth 9: Only the main breadwinner needs life insurance

This is a common myth that I’ve heard from many clients. Whilst the main breadwinner is vital to any family’s financial security , both members of a couple should consider their various life insurance options regardless of their role.

Imagine a breadwinner had to reduce their hours to look after a sick partner or to replace their partners role in the home.  If a non working partner or lower income earning partner became seriously ill or injured, their family would need a lot of assistance to replace their services.

If you’d like to discuss any of the content in this article and how it may apply to you, please give us a call on 1800 737 926 or fill out our contact form online.

The information provided here is general only and does not consider your personal objectives, financial situation or needs. Before you decide to purchase a product, it is important to read the relevant PDS.


Covid vaccine and Life Insurance

One of the main reasons people hold life insurance is to provide peace of mind for themselves and their families. Unfortunately, there has been scaremongering on social media incorrectly stating the Coronavirus vaccine is an experimental medical treatment and therefore having the vaccine is a self inflicted injury which could void a life insurance policy.

The Financial Services Council (FSC) represents the majority of life insurance companies and has come out and said this is incorrect. We have also had questions from several new clients recently who are worried that if they take the vaccine and something happens that they’re life insurance policy won’t cover them. This is not true.

An underwriter may apply an exclusion to a policy at the application stage but this is normally due to pre-existing medical issues and is always communicated to the client before the policy starts as well as having to be signed off by the client.

Hopefully this article clears up any misconceptions about the vaccine rollout and how life insurers view it.

If you currently have a policy in place that you would like reviewed or you are new to insurance and would like to speak to someone about taking out cover please don’t hesitate to contact us.


The information provided here is general only and does not consider your personal objectives, financial situation or needs. Before you decide to purchase a product, it is important to read the relevant PDS.

Why might I need Income Protection insurance

For the vast majority of working Australians our ability to earn an income is our single greatest financial asset. A loss of our potential to work and generate an income can have significant repercussions to our financial stability and goals for the future. Medical conditions that make you unable to work, such as an injury or illness, can be offset through the purchase of an Income Protection policy.

Income Protection benefits can be payable for events that last a short duration such as recovering from an injury  or surgery, right through to longer duration claims or those that impact the ability of the insured person to work the number of hours they were previously capable of. According to the Financial Services Council (FSC), in 2019, there were 5.8 million Income Protection policies in force with 95% of lodged claims paid, 33% of which were as a result of an accident.

The majority of Australian’s believe that insuring their car and house are the most important insurance decisions. This is worrying given that on 36% of Aussies are in a position to live off savings for four months or more if they lost their source of income. 16% (or about 2 million Australians) are living day to day and they could only survive for one week or more if they lost their jobs.

If you’re currently earning an income and do not have Income Protection cover in place or you have an Income Protection policy which you haven’t reviewed within the last 12 months please get in touch with us today.


The information provided here is general only and does not consider your personal objectives, financial situation or needs. Before you decide to purchase a product, it is important to read the relevant PDS.

Trauma insurance-More than just physical, heart attacks are emotional too

Experiencing a heart attack may lead to feelings of fear, trauma, sadness and anxiety. One recent study by the Australian Centre for Heart Health involving 900+ heart attack patients found that over 40% had increased levels of anxiety levels and 20% had symptoms of depression in the weeks following hospital discharge.

The same study found widespread anxiety and depression in patients a year later- one in four had significant anxiety and one in five were depressed. Left unaddressed, this can have serious health repercussions. These symptoms are often referred to as the cardiac blues.

There are many risk factors linked to developing the cardiac blues after a heart attack. These include pre-existing mental health conditions prior to the heart event, financial strain or other life stressors, being younger, having poor physical health or other chronic health problems, social isolation and cigarette smoking.

The circumstances around a heart attack can vary- it may arise out of the blue or be associated with a pre-existing health condition. Either way it can be a frightening , isolating experience. Experts believe the emotional consequences of a heart attack are not yet widely understood and require greater awareness. This also needs to be taken into consideration when taking out Trauma insurance which covers the life insured in the event of a heart attack. Not only does the cover need to provide a lump sum to cover medical expenses it also needs to provide funds for the life insured should they be unable to work after suffering a trauma event (assuming no Income Protection is in place).

Whilst having a Trauma insurance policy in place doesn’t reduce the risk of suffering from a heart condition, it may help ease both the mental and financially burden that comes with suffering from a heart attack.

*The information within is general advice only, prepared without taking into account any of your individual objectives, financial situation or needs. Before acting on this advice you should consider the appropriateness of the advice, having regard to your own objectives, financial situation and needs

Claims by Advised Clients Generally More Likely to Succeed

APRA’s latest life insurance claims and disputes statistics publication appears to reinforce that advised clients are more likely to be paid for death, TPD and Disability Income (Income Protection) claims.

APRA’s data on the admittance rate by cover type and channel for the 12 months to June 2020 shows that individual adviser cover for death was paid 96% of the time compared with 89% for individual non advised.

Advised cover is when a client obtains their insurance from a fully qualified financial adviser. Non advised cover is for insurance cover that is taken out within super, over the phone or internet with a direct insurer such as Real Insurance or through another avenue that does not involve a financial adviser. These statistics reinforce the need to take out fully underwritten cover through a financial adviser.

APRA also reported that advised TPD claims were 81% paid compared with 61% for non advised claims.

For Disability Income (Income Protection) advised clients recorded 94% compared to 85% for non advised clients.

A statement from APRA says the data is the product of a ”world leading” joint project between the authority and ASIC, aimed at making it easier to compare life insurers performance in handling claims and disputes.

In it’s executive summary to the full report APRA notes that generally, individual advised business shows higher admittance rates than individual non-advised for the same type of cover.

Another point for clients to consider is the potential cost of claim assistance. Generally clients who have a retail insurance policy through a financial adviser will receive claims assistance for free. Clients who have cover through their super or through a direct insurer may need to engage the services of a Lawyer to help with the claims which erodes the amount of cover payable should the claim be successful.


*The information within is general advice only, prepared without taking into account any of your individual objectives, financial situation or needs. Before acting on this advice you should consider the appropriateness of the advice, having regard to your own objectives, financial situation and needs

Life stages – Which insurance is right for me?

Life insurance is an important investment, but different types of coverage can deliver even better value at different points in your life.

Many of us put off thinking about life insurance until we’ve achieved a particular milestone in life such as buying a house or having children. Whilst these are no doubt important times to review your life insurance needs, life insurance is about more than just big game-life changing moments. By looking into coverage that’s suitable for you today, you’ll also be able to make smart decisions for the years ahead.

Getting ahead while you’re young

Your twenties are all about finding your place in the world. It’s a decade when you’re moving out of home, navigating the first steps of your career and travelling the world. While taking out life insurance so young might seem unnecessary to some, it can be a wise decision for others.

People in there twenties should also consider Income Protection and TPD insurance if they are  earning an income. Trauma insurance is also another type of insurance to consider as well as life insurance depending on the individual’s personal situation.

Getting your insurance cover organised while you’re young and fit means you’ll be able to avoid any loadings or exclusions which may hinder you when you’re older and medical conditions are more likely to be a problem. Taking out cover whilst young also means that ‘level premiums’ may be more suitable in order to save money on insurance premiums down the track.

Settling down and protecting your loved ones

Your insurance needs will probably change when you’re in your thirties, as this decade is when most people start settling down. According to the Australian Bureau of Statistics, our early thirties are when we’re most likely to get married and have our first child. Once these ‘life events’take place it is a good adviser to seek advice from a financial adviser who can customise your insurance to meet your needs and help provide financial security.

Planning for retirement and beyond

The prospect of retirement is on the horizon, sound financial advice is key to setting you up financial for the years ahead. While you may be looking forward to having fewer day-to-day responsibilities and expenses, there are still benefits to having life insurance in place in your golden years. 

Maintaining a life policy so that you can leave money for your partner after you die- a key part of estate planning- is a common reason retirees retain life insurance. Other circumstances that may encourage you to keep some cover in place may include the need to provide for dependents, setting aside money for your funeral or the desire to cover any outstanding debts.


The information within is general advice only, prepared without taking into account any of your individual objectives, financial situation or needs. Before acting on this advice you should consider the appropriateness of the advice, having regard to your own objectives, financial situation and needs


What questions to ask a financial adviser

Before you take out life insurance, make sure you ask the following questions with your financial adviser. Also remember that a lot of the online quoting sites provide general advice only. Our staff are qualified to provide financial advice and are qualified financial advisers that specialise in risk insurance.

  • What types of cover do i need?

Deciding what you need cover for is important. You can start off by asking yourself  (and your adviser, of course) can i do without these types of insurance?

Life cover: Pay’s a lump sum amount in the event of death or terminal illness. This is to cover such things as living expenses for your dependants, pay off debts, funeral costs, children’s schooling costs etc. A financial adviser will help not only with determining a suitable insured amount, but also how best to set up the policy and the possible tax implications on dependants.

Total and Permanent Disability (TPD) cover: This pays a lump sum should you become totally and permanently disabled and unable to work. TPD cover can help to pay out of pocket expenses, ongoing medical expenses, home modifications and to care of dependants if needed. A financial adviser will be able to explain the difference between own and any occupation.

Trauma cover: Also known as Crisis cover with some insurers. Trauma/Crisis cover pays a lump sum on the diagnosis of a serious illness or injury (eg heart attack, stroke or cancer). This amount can help with any medical costs associated with a Trauma/Crisis condition or help with an extended break from work. A financial adviser will be able to provide advice on what types of Trauma cover is available as well as additional extras such as reinstatement, life buyback, Trauma stand alone etc

Income Protection: Pays a monthly benefit to replace your income, if you are temporarily disabled and unable to work. You will need to determine how long you wait for the first payment should you be on claim (this is called the waiting period) and for how long you are paid (this is called the benefit period). Your financial adviser will also need to make sure your income is enough to justify the insured amount.

  • How much cover do i need?

When it comes to life insurance, everyone’s needs are different. Working out how much cover you need is as easy as sitting down with your financial adviser and determining a figure that is right for your personal situation. Your financial adviser will then assess the right amount of cover for you based on your personal circumstances including: your total debt position, income, assets including superannuation and property plus your family circumstances such as education and childcare needs.

  • How long do i need to be protected for:

Nobody knows what the future will bring. That’s why it helps to plan ahead. You should start your insurance relationship with an expectation that your insurance needs will be continually adapted to your needs. The rule of thumb is that your need for financial protection decreases over time. For example, if you pay off your mortgage,reduce debts and no longer have dependants to look after financially, you may wish to review your cover.

You should keep your policy as long as you require financial protection. A good financial adviser should review your policy every 12 months to make sure the insured amounts are still suitable and to make any changes should your situation change.

  • What should i look out for?

Buying life insurance isn’t difficult, but it does take some thought as well as comprehensive research. There are many companies online offering their services but it is important to take time to consider your choices and always make sure you:

-Are aware of injuries/illnesses the insurance covers

-Work closely with your financial adviser to understand your personal needs,objectives and financial situation

-Understand how your medical history/occupation/pastimes will influence your cover and potentially how much you pay

-Beware of shortcuts. Some direct insurers do not cover for things such as mental health, injuries whilst being intoxicated etc.

-Understand your medical history so you can disclose everything to your financial adviser. That way you’ll make sure the cover is right for you and there will be no issues should you need to make a claim.

-Be aware of the ongoing cost. Ask your financial adviser to provide you with a future forecast of premiums. This is so you can plan how you will pay your insurances in the years to come.

  • What is the best way to pay- stepped or level premiums

Insurance premiums will generally increase over time-simply because your health risks increase with age. Most insurers offer two common ways of paying, and managing, the costs of your insurance over time.

Stepped premiums- This means each year as your policy renews, the premium increases. This means your premiums will get older as you age

Level premiums-These are more expensive upfront but generally cheaper over the life of the policy (depending on the age the level premium is taken out). A level premium won’t increase yearly with age although is not guaranteed to stay the same as insurers can increase both level and stepped premiums out of cycle.

A good financial planner will be able to advise whether a stepped or level premium is most suitable for your situation.

Want to know more?

If you would like to discuss any of the content in this article and how it may apply to you, please fill out our contact form online or call us on 1800 737 926.


*The information on this site is of a general nature. It does not take your specific needs or circumstances into consideration, you should look at your own financial position, objectives and requirements and seek financial advice before making any financial decisions.


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