INSURANCE. Life insurance claims. Your step-by-step guide

Transcription

1 INSURANCE Life insurance claims Your step-by-step guide

2 Life insurance claims process Step 1 Contact your adviser or call our Claims Helpline To make a claim contact your adviser or call our Claims Helpline on and: Quote the policy number as this will help us to locate your policy details quickly. For privacy purposes you will need to give your name, your relationship to the life insured, the insured s date of birth and address, together with such other information that may be required. Provide, where possible, the date of death, and brief details if known. Within 24 hours of receiving the call, we will send the appropriate claim form, with a covering letter detailing our specific requirements to the address you advise. Step 2 Correctly complete the forms we send to you and provide any other information we need To assess your claim we require the following documents: The letter accompanying the claim form will detail the initial requirements to assess the claim. To commence the assessment of the claim, we require the following documents: The fully completed claim form, including signatures where indicated, of the party legally entitled to claim the benefits. A certified copy of the life insured s full Birth Certificate (a copy of the Marriage Certificate is also required for married females). A certified copy of the full Death Certificate showing the cause of death. In some cases where the death is referred to the Coroner, we may also require a copy of the Coroner s Report.

3 The Privacy Statement attached to the claim form. The original policy document must be returned. For non-superannuation policies where the deceased life insured is also the policy owner and there is no nominated beneficiary, if the sum insured is less than $50,001, we will require a certified copy of the Will. For non-superannuation policies where the deceased life insured is also the policy owner and there is no nominated beneficiary, if the sum insured is greater than $50,000, we will require a certified copy of the Grant of Probate of the Will or Letters of Administration. For superannuation policies under OnePath Custodians Pty Limited (OnePath Custodians) a certified copy of a Will is required if one has been made. Step 3 We assess the claim Once we receive the completed claim form and the initial documents requested, we will begin to assess the claim. In some cases we require a report from Medicare Australia on the life insured s Medicare and/or Pharmaceutical Benefits Schedule history. On receipt of these records we may require further information from the service providers listed. Once all the requirements have been met and considered, a decision is made on the claim. Step 4 Determine who receives the benefit Non-superannuation policies and superannuation policies under an external trustee If the policy is owned by someone other than the life insured the benefit is payable to the policy owner. If the policy is owned by the deceased life insured and does not have a nominated beneficiary, the benefit is payable to the estate of the deceased.

4 Superannuation policies under OnePath Custodians Unless there is a current Binding Nomination of Beneficiary, OnePath Custodians has discretion to determine who will receive a benefit and in what proportions. Of course, OnePath will consider only non binding nominations. Where there is more than one claimant, OnePath Custodians will obtain submissions from all claimants prior to making a decision. Step 5 On successful assessment we pay the insured amount Non-superannuation policies and superannuation policies under an external trustee When we have fully completed our assessment and determined that the terms of the policy have been met, the benefit will be paid (or commence being paid if the instalment benefit payment type applies) to the policy owner(s) or the beneficiary(ies). Superannuation policies owned by OnePath Custodians Once OnePath Life Limited (OnePath Life) has assessed the claim and determined that the terms of the policy have been met, the claim will be passed to the Trustee to decide whom the benefits will be paid to and in what proportions.

5 Answers to commonly asked questions Q What is a certified copy? A This is a signed photocopy of an original document. The photocopy needs to be endorsed as being a copy of the original document sighted and signed by a Justice of the Peace, Commissioner of Affidavits, notary, solicitor, accountant, doctor, pharmacist, police officer or bank manager. Q Where can a copy of a Birth or Marriage Certificate be obtained? A If the life insured was born or married in Australia, a copy may be obtained by application from the Registrar of Births, Deaths, and Marriages in their State or Territory. Q What can be used as evidence of age if the life insured was born outside of Australia? A A certified copy of any of the following will be accepted: an Australian Naturalisation or Citizenship Certificate a current Australian Passport an Australian Permanent Resident s Visa. In addition, if available, a certified copy of the full Birth Certificate from the country of birth will be accepted. Q What is the original policy document and why is it required? A There is only one policy document which was issued to you at the time you purchased the policy. The policy document includes the Policy Schedule and Memorandum of Transfer. They are both required as proof of entitlement to the benefits provided by the policy. Q Is completion of the Memorandum of Transfer required? A No, it needs to be left as is, as proof that the policy has not been transferred or ownership assigned to another party.

6 We understand that when you need to make a claim, it s not always straightforward. We would like to help make things easier.

7 Five easy steps 1. contact your adviser or call our Claims Helpline 2. correctly complete the forms we send to you and provide any other information we need 3. we assess the claim 4. determine who receives the benefit 5. on successful assessment we pay the insured amount. A policy can only be taken out after completing an Application Form contained in the Product Disclosure Statement (PDS) and the application is accepted by OnePath Life and a policy schedule is issued. To learn more about your benefit, please refer to your Policy Schedule and the Policy Terms. A Product Disclosure Statement is available at onepath.com.au. You should consider the PDS before deciding to acquire or continue to hold the product.

8 How do I make a claim? To make a claim contact your adviser or call: Claims Helpline (Weekdays between 8.30am and 5.00pm, Sydney time) Where do I send my claim documents? OnePath Life Retail Claims GPO Box 4148 Sydney NSW 2001 OnePath Life Limited (OnePath Life) ABN AFSL Kent Street, Sydney NSW 2000 This information is current at November 2010 but is subject to change. Updated information will be available free of charge from onepath.com.au. It may not be reproduced without prior permission of OnePath Life. Australia and New Zealand Banking Group Limited (ANZ) ABN is an authorised deposit taking institution (Bank) under the Banking Act 1959 (Cth). OnePath Life is owned by ANZ it is the issuer of the product but it is not a Bank. Except as set out in the issuer s contract terms (including the PDS), this product is not a deposit or other liability of ANZ or its related group companies. None of them stands behind or guarantees the issuer. L0137/1110 onepath.com.au