Income Protection/TPD Insurance etc

Discussion in 'Superannuation, SMSF & Personal Insurance' started by Jmillar, 30th Aug, 2017.

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  1. Jmillar

    Jmillar Well-Known Member

    Joined:
    26th Jun, 2015
    Posts:
    680
    Location:
    Sydney
    Hi guys,

    I've been going through the process of getting all my insurances in place for months and I feel like I haven't got anywhere. I'm using a broker who was recommended to me by someone I have a lot of trust in. Just wondering if I could get some advice though...

    At first they compared all the providers and we ended up applying with TAL insurance. TAL came back saying they would cover me etc but would exclude my knee (I've had a knee op, this is fair enough) and also my cervical spine. However I have NO pre-existing issues with my spine, and I'm not comfortable excluding this. I asked them to ask TAL for an explanation, but TAL just came back saying they won't cover me for this as I have "pre-existing issues"! I have no idea where they got this from, and they wouldn't provide more info when asked.

    I ended up running the application process again, this time with ClearView. ClearView have come back with the exact same thing, saying they won't cover me for my knee (fair enough) and my spine! They are saying they won't cover me for my spine, because when I did the questionnaire with the lady who did the medical test, I said that I have no pre-existing back issues, other than minor sore neck muscles sometimes when I spend a lot of time on the computer. If they count this as an "issue" well then 99% of the population would have the same thing.

    I refuse to have cervical spine... imagine in 50 years time I have a car accident and I don't get covered because of this so-called "pre existing issue"...

    Has anyone had similar issues? I obviously want to ensure I disclose everything when I apply, and I understand them being cautious but this is just ludicrous! My spine is perfectly fine and all my medical tests were 100% perfect.

    Also, they have also advised the below:
    They will offer Agreed Value for income protection for your base salary plus super. They will then offer indemnity cover for the balance of your income based on an average of 3 years.

    My salary is low, and I have a high commission percentage. Should I be concerned about the structure they're offering?

    Thanks!
     
    Jmillar, 30th Aug, 2017
    #1
  2. wylie

    wylie Moderator Staff Member

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    18th Jun, 2015
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    Location:
    Brisbane
    Did I recommend my guy? Not sure. But either way, what does the broker say.

    It sounds crazy that you mention a sore neck muscles when having used a computer. I agree that 99% of people would say the same.

    I would actually give the Insurance Ombudsman a call, but you need to escalate it firstly with the insurer I believe.

    I had a similar thing when I was arranging travel insurance. They wanted to know everything even as far back as a wedge resection I had at age 23 and then my caesarean births. I couldn't get an answer from anyone about how much detail... just kept being told "tell us everything, every medical issue you've ever had". So I did.

    So, I wrote down everything in depth, just as an exercise to show them how stupid this is. They wanted EVERY.SINGLE.DOCTOR.VISIT and when I gave them a lot of detail, they sarcastically mentioned "my novel". Bunch of sarcastic jerks!

    I just had to pay $45 to get cover though I have nothing wrong with me that wasn't fixed by a physio, sometimes years ago.

    What is one to do? Fail to mention something that has long been fixed, isn't actually a problem (like your honest mention of having a sore neck from working too long at a computer) and then find they try to wriggle out of a claim.

    Or tell them everything, every ache, every niggle and then have some numpty make a sarcastic comment about "too much information".

    Numpties!!!
     
    wylie, 30th Aug, 2017
    #2
    Archaon likes this.
  3. Archaon

    Archaon Well-Known Member

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    20th Mar, 2017
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    1,896
    Location:
    Newcastle
    Perhaps look into Trauma Cover as opposed to TPD, you will potentially have a TPD/Life Insurance policy in your works super.

    A Trauma Policy has A lot more avenues to claim, say losing a finger, where TPD is more likely to knock you back unless you actually lose the whole hand.

    (The above is what was explained to me by my insurance broker)
     
    Archaon, 31st Aug, 2017
    #3
  4. Dan Donoghue

    Dan Donoghue Well-Known Member

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    19th Jun, 2015
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    Location:
    Gold Coast, QLD
    The underwriter will be looking at your medical records and assessing accordingly. If there is a note in there that you have received treatment for back or neck (no matter how long ago, no matter if it was even a one off sports injury), they will either load it up or slap an exclusion on it. What was your knee op for? It may well be that whatever that was for "could" lead to spine issues or could indicate pre existing spine issues, they are trained to err on the side of caution.

    Without having access to your medical records, it's hard to say why they did this but if two separate companies have done it then there definitely is a reason even if you are unaware of it.

    Make sure you set your policy up as an extension to your existing cover (find out what cover you have in your super) as that will lower your premiums rather than a standalone policy (Basically if you want to be insured for 750K but your Super already insures you for 500K, they just insure you for a top up of 250K).
     
    Dan Donoghue, 31st Aug, 2017
    #4