When people think about life insurance, trauma insurance or income protection, they often focus on premiums, product features and policy comparisons.
But the true test of any insurance policy comes at claim time.
Over the past few years, we’ve helped clients through a wide range of insurance claims. While every situation is different, one thing remains constant: a well-structured insurance portfolio can make an enormous difference when a person’s health, career or family circumstances suddenly change.
The Claims We See Are Often Not What People Expect
Many people assume insurance claims are mostly for catastrophic events. In reality, claims frequently arise from situations that could happen to almost anyone.
In the last few years we’ve assisted clients with claims arising from:
- Cancer diagnoses
- Mental health conditions including anxiety, depression and burnout
- Heart attacks and major cardiac procedures
- Accidents causing fractures and hand injuries
- Autoimmune diseases
- Long COVID
- Neurological conditions such as Parkinson’s disease and Multiple Sclerosis
For professionals such as doctors, dentists and specialists, even a relatively localised injury can have a significant impact on their ability to work. A hand injury, tremor, wrist condition or loss of fine motor function may prevent someone from practising their profession despite otherwise being in good health.
A Bicycle Accident That Changed Everything
One recent claim involved a dental specialist who suffered a bicycle accident that resulted in a serious hand injury.
The outcome was substantial, with income protection benefits paid while the client was unable to work and a Total and Permanent Disability (TPD) claim ultimately exceeding $1 million.
This illustrates how an accident outside the workplace can have life-changing financial consequences for highly skilled professionals.
Cancer Remains One of the Most Common Reasons for Claims
Cancer continues to be one of the leading causes of both trauma and income protection claims.
Recent examples include:
- A dentist who received a $200,000 trauma benefit following a heart tumour diagnosis.
- A radiologist whose bowel cancer claim resulted in a trauma payment exceeding $900,000.
- A GP whose trauma cover paid $300,000 following a carcinoma in-situ diagnosis.
- Multiple clients who received six-figure trauma benefits following breast cancer diagnoses.
In many cases, these lump sum payments provided financial breathing room, allowing clients to focus on treatment and recovery rather than worrying about income or debt.
Mental Health Claims Continue to Grow
Another trend we have seen is the growing number of legitimate mental health claims.
Recent claims have involved doctors, dentists, GPs and other professionals affected by anxiety, depression, stress and burnout.
One claim involved a GP who was unable to work due to mental health challenges and received ongoing income protection benefits. Another involved a dentist whose mental health condition resulted in a lengthy claim period and significant ongoing support.
Mental health conditions can be just as financially disruptive as physical illnesses, which is why robust income protection cover remains so important.
The Biggest Claim Is Not Always the Most Important
While some recent claims have exceeded $1 million, smaller claims are often equally valuable to the person receiving them.
Over the past year alone we have assisted clients with claims for:
- Broken wrists
- Ankle fractures
- Shoulder injuries
- Pregnancy complications
- Surgical recovery periods
- Hand and finger injuries
For many clients, receiving a few weeks or months of income protection benefits helped protect their savings and allowed them to recover properly before returning to work.
Insurance Is About More Than Policies
A successful claim is rarely just about the insurance contract.
It involves helping clients understand their options, lodging claim forms correctly, communicating with insurers, following up assessments and supporting families through what is often a difficult time.
The real value of insurance is revealed when a claim is paid and financial stress is removed at the moment it is needed most.
The claims we’ve helped facilitate over recent years are a powerful reminder that serious illness, injury or disability can affect anyone. The right cover cannot prevent these events from happening, but it can provide certainty, financial security and options when life takes an unexpected turn.
This is general information and limited in its scope. If you are considering buying or replacing and a Life Insurance policy then contact us to arrange a review for you. We can consider your individual circumstances, goals and needs and recommend a suitable insurer, product and structure to use. We work with several insurers and have extensive experience in helping to arrange claims.
At the time of writing, Life insurance and Financial Advice services are provided by Experien Insurance Services Pty Ltd (EIS) ABN 99 128 678 937 and Experien Financial Services Pty Ltd (EFS) ABN 32 631 346 757. EIS and EFS are a Corporate Authorised Representative (No. 320626 and No. 1274354) Count Financial Limited ABN 19 001 974 625, AFSL 227232. See our website for our Financial Services Guide and latest AFSL arrangements. Always read the Product Disclosure Statement issued by an Insurer before considering insurance.
