Insurance

Emily
Emilyon Tuesday, December 19 2017
9 Comments

Has anyone else had any issues with receiving insurance for the time that they were unable to work. I have insurance through my superfund and have today been told that my claim has been rejected as I’m not disabled. Yes I am back at work,part time and I pushed myself to go back sooner then what was probably best for me health wise. But now I feel like I am being punished. I was just very lucky to have a supportive family to lean on and a compassionate employer who sometimes allowed me to sit and sleep at work if that was what my body need it. What is the point of paying insurance if it is near impossible to receive any sort of payout. Feeling very disheartened at the moment

9 Responses

Hi Emily,

 

Oh gosh , your post has bought up so much which I know a lot of people will be able to relate to.  I did not delve into insurance myself however I know that your question is HUGE.  I bet you are feeling punished and I am so sorry for that. 

I hope that someone on Strokeline is able to point you in the right direction as to how to self advocate and what more you can do.

 

All the best.

Sue

 

Emily  what a cruel response from your insurance. What does the word disabled mean to the company.must you be in a wheel chair .i hope Stroke line can steer you in the right direction for help. No wonder you are disheartened after working hard to be at work. I am sure there will be enable members able to provide helpful  information and  support. Jenny

Hi Emily,

sadly I feel your pain. I had 3 strokes 2 years ago. The 3rd one was bad enough to be hospitalised. Unfortunately when I submitted my claim to my health insurance, it was rejected as my physical symtoms had resolved in under 24 hours. The neurologist even said to me when filling out the documents that thier definition of a Stoke was outdated and not realistic. I was put in a situation where I had to return to work quickly and hide my strokes from my friends and family as so we could quietly sell our business without anyone knowing the real reason. 

Tracy

Hi Emily (& other’s), 

 

i had a Stroke Oct 2016 - -“moderately severe”, which required me to learn to walk and speak again and leaving me -initially -with a useless left arm. 

While still in hospital (12 weeks) I had to fight Centrelink, who rejected my claim for Sickness Benefits  although I had s job tonteturn to, because I was/would be disabled, and who then rejected my claim for disability because I may return to work.. and that was only the beginning...

 

While I did not have Income Protection (to shield me from Centrelink), I did have Mortgage Insurance -but that was an almighty battle also. Initially, the insurer asked for medical records for previous 5 years. When they could not find any reason to “not” pay (I had no history of factors which they could use to invalidate my applicatio), they then asked for records for previous 10, and then all records available.

 

At this stage I explained that not only was I their customer and had been paying premiums which paid their wages, but that I was still in hospital and that their continued delays would easily become a stressor which may in fact lead to another stroke. Further, I explained that I had no option other than to contact the Insurance Ombudsman. I also demanded to speak to the supervisor of the Case Manager, who after I explained what had occurred instantly dealt with the matter herself., approved the application and at my suggested “retrained”  certain staff.

 

They honoured their contract and we moved forward negotiating the “conditions”.

My Mortgage was “back-paid” for the 3 months this debate had taken (I had to do this all myself-the hospital Social Worker became a liability).The Mortgage Insurance was for a period of up to 2 years and conditional upon not working for more than 15 hours (ie technically less than 2 standard days per week -a standard day being 7 hours and 35 minutes). 

 

Like you, in terrible financial circumstances -marooned on Newstart, despite a Centrelinkn assessment declarung me unable to work until August, I returned to a very supportive employer 2 days pw in May( far ahead of the original August date).

 

This was a start, and although it immediately cancelled out any $ payment from Centrelink, I retained the concession card and Mortgage Insurance, but still left me closer to poverty line than comfortable.

 

Returning to work was critical not only for $ but also my mental health -here was something where my defining feature was my professional skill, not my disability. 

 

Once i I returned to 3 days pw, Mortgage Insurance cut out, almost negating the $ benefit of increased work. When I discussed this with insurer, as a disincentive, whilst apologetic, she explained that government regulations made no allowance for partial or sliding scale support which could provide motivation and support to gradually increase working capacity. 

 

So so I am stuck -unable and unlikely to be able to work more than .6, with full time $ costs and responsibility, and no other financial support. (The Mortgage Insurance was for finite period -2years). 

 

I don’t want much -but 2 things would help enormously: a sliding scale of Insurance support, and ongoing Health Care status from Centrelink in recognition of the commitment to my willingness and commitment to working and supporting myself as best as I am able, but recognising the limitation of my capacity to do so. 

 

What do others think?

Jen

 

 

Hi Jen and everyone,

 

Your contributions of saying it "how it is" are so helpful !! I read with horror about the lengths you needed to go to Jen. 

I do recall forms being put into what was social services at the time which were "lost" three or more times. This added to the feeling of me being too complicated for the system. At 22, my husband and I out of our depth, in shock & grief, we did not pursue this. The difficulties any mention of my circumstances bought made me wish I had died instead of needing to put others in the position of not knowing what "to do with me."

Not a nice memory at all. 

 

 

Sue

 

 

Hi Emily,

It's a bit hard to know how to respond without knowign what type of insurance you are trying to claim so I'll go based on my experiences. Under my superannuation I was able to claim Income Protection but only after three months being off work. I tried to rerutn to work within this three month period but had to stop but my company counted the three months from the original date of my stroke. This payment was paid for two years but if i had been able to return to work it would have stopped immediately. 

TPD can also be paid through your super and generaaly is when you have been assessed as never being able to work agian (different companies have different definitions and criteria for this). 

The insurance companies do make it hard to claim, with copious amounts of paperwork to be completed, but it is possible to appeall their decisions.

Good luck with it all

Toni

Hi Emily

 

I'm sorry to hear about your experiences. The Superannuation Complaints Tribunal will be able to provide advice on whether you have grounds to appeal or complain. Their website is here: http://www.sct.gov.au/

 

You can call their helpline too: 1300 884 114.

 

Kind regards, Jude

Social worker, StrokeLine

1
Loading reply form...