Family member w Depression - Income Protection Insurance - 5 months and still no approval

Melb336
Community Member

Hi everyone,

Firstly let me say what a great space this is. I certainly wish that it was available when many years ago I was struggling with depression. Please keep up the good work.

I was hoping to seek some assistance / advice from the forum here.

A family member of mine is going through quite a tough time and has been doing so since late last year.

In March this year, they left work in order to look after themselves. I think this was the right decision and we all support that decision. The good news is that with the support of the entire family, they are getting better.

But the problem is that since March, this person has had no income (has their own family to support - the rest of our family has been helping in the interim). They had an income protection insurance policy that we all believed would provide some financial support. The claim was submitted in late March with all the necessary supporting documentation from their GP and the insurer's psychiatrist.

It is now August, and despite almost daily calls to the insurer, ANZ, the claim has still not been approved (or rejected).

The lack of income is now adding to the stress of the situation and I worry that if it goes on for too much longer, then all the great progress that we have made as a family will be undone - all because of the incredibly slow process ANZ is putting us through.

As I mentioned, despite daily calls, they always have an excuse. They keep insisting there are no red flags or reasons that they can see that it shouldn't be approved... yet here we are...5 months on and nothing.

It has completely defeated the purpose of having such a policy in the first place.

I find ANZ's conduct and treatment of my family member disgracefully unconscionable and want to move beyond their internal complaints system - all in the hope to get a resolution!

Does anyone have advice as to who best to get in touch with? Is the insurance industry covered by the financial services ombudsmen? Should I contact my local Federal member of Parliament? Who else might be able to help? I am at a bit of a loss because it seems we are floating in a grey area where no one wants to help...

Any advice / and or pointers that any of you could provide would be so greatly appreciated.

I am genuinely concerned that if this goes on any longer, the stress will simply become too much.

Warm regards to you all

5 Replies 5

Sophie_M
Moderator
Moderator
Hi Melb336, welcome to the forums.

As a start, we'd suggest looking at this page of our website: https://www.beyondblue.org.au/about-us/about-our-work/discrimination-in-insurance

Melb336
Community Member

Thanks Sopie_M - really appreciate the quick response.

I did have a read through that section of your website, sadly though it doesn't really address any complaints / accountability processes that I can pursue.

As I mentioned, the frustrating part of this is that the claim hasn't been rejected, but neither has it been approved. So we can't argue discrimination etc. as we are without a ruling.

5 months with no response is completely unacceptable. I have carefully read the PDS and T&C's and it explicitly includes mental health as part of the coverage.

What is the point of paying years in premiums if they are going to simply not respond - let along approve the claim.

The stress that this is causing is now exacerbating the underlying issues and I really can't see a clear picture as to who can help.

These big banks are out of control. No sense of compassion or humanity whatsoever. Very sad..

Thanks again to anyone who might be able to point me in the right direction

Hi there

my husband is covered under his work super protection for 2 years but he has already been ill for 16 months so I started the claims approval process with his income protection company which has a 2 year waiting period (he took out private insurance many years ago when the kids were born). I started it in May and they are still working through the medical information.

Firstly I would make sure they have all the information they need, by the sounds of it they do. Then the individual will need to formally complain - likely in writing via e-mail and ask for a response. If nothing then the following information is from the FOS brochure on income protection

If your insurer denies your claim or unreasonably
delays paying a claim, you have the right to
complain. Your first step should be to complain
directly to the financial services provider through
the company’s internal dispute resolution process.
Most disputes are resolved this way.
If you are unhappy with the response you receive
or if you don’t get a response within 45 days
(21 days in cases of financial difficulty), you
should lodge a dispute with an external dispute
resolution service. Depending on the nature of
the complaint, this may be through FOS or the
Superannuation Complaints Tribunal (SCT).

Thankyou kindly Winterfell. Quite helpful 🙂

All the best to you and your husband

geoff
Champion Alumni
Champion Alumni
hi Melb, what Winterfell has told you is correct, but it should be started right away, plus I would contact the Ombudsmen https://www.fos.org.au/ as well as your local member and this banking site which is set by ANZ is a form for you to fill in, '
'www.anz.com.au/resources/7/5/7592f01c.../banking-ombudsman-complaint.pdf'

Hope this helps you but to have no income for 5 months is terrible, please keep us informed. Geoff.