Things to know about making a claim on income protection insurance

How good is that feeling of waking up on payday knowing your bank account has been topped up? Whether it’s a sigh of relief or excitement at something you’ve been looking forward to buying, payday is one of the best perks of being an adult (that, and snacking on cheese at midnight). 

For the tens of thousands of Kiwis who find themselves unable to work each year due to severe sickness or injury, income protection insurance is what helps to ensure those ‘paydays’ continue to roll in, even when you can’t work. 

Here’s what you need to know about making an income protection insurance claim. 

Understanding the income protection insurance claims process

The income protection insurance claims process can be relatively straightforward but you have to provide detailed information by completing the claim form, where you’ll share the sickness or injury event that you’re claiming for. You’ll have to provide medical reports from your doctor, as well as your employment details.

To avoid delays with your claim being processed, it’s essential that you double check all the details and try to provide all the information your insurer has requested can when submitting your claim. 

Informing your insurer

If you're unable to work due to sickness or injury, you should submit the claim as soon as possible – why delay claiming your benefit, right? Being prompt can help reduce any delays with the assessment of your claim. For example, with OneChoice, you’re encouraged to put through your claim within 120 days of the insured event (sickness or injury) - but the sooner the better. 

To get started, dig out your Policy Document. This should be in your files from when you set up your insurance policy, or you could find it on your insurer’s website. This should give you a guideline of what you’ll need to do to make a claim. 

Next, find the Income Protection Insurance Claim form from your insurer. This should be easy to find on their website or by giving them a call. 

This form will give you a list of any documents you’ll need to gather before lodging your claim. 

Gathering required documents 

Every insurer differs, but essentially, you have to show proof of identity and proof of income. As such, these are some of the common documents you’ll need to send in with your claim: 

  • The completed claim form
  • A certified copy of your passport, driver’s licence or birth certificate
  • Medical reports from your specialist or doctor 
  • Proof of employment including payslips, or your most recent tax return if you are self-employed

What’s a certified copy?

Basically, a certified copy is a photocopy of an original document that has been signed by an official witness, who sees both documents side by side and confirms that the copy matches the original.

The witness can be a Justice of the Peace, a solicitor, an accountant, a doctor, a bank manager or police officer who is authorised to witness and certify documents. You can check for a full list of acceptable witnesses, and any additional criteria with your insurance provider.

They typically have to include a statement similar to this on every page of the photocopy being certified: I certify that this is a true copy of the original document. They also must add their full name, date, signature, registration number (if they have one), and their title and qualification or occupation that makes them eligible to certify documents (as per your insurance provider’s guidelines).

Managing the claims process

The claim begins once your insurer receives all of your completed documents. They will then assign a case manager to see it through the rest of the way.

As the claims process makes its way through each step, it can help to know what to expect.

Understanding waiting periods

Waiting periods are standard in income protection insurance policies. They refer to the time that you will need to wait between the date that your sickness or injury first occurred, to when you can start receiving benefit payments from your insurance company.

This could be as short as four weeks, or even as long as 52 weeks (AKA a year) depending on your policy.

Waiting periods impact your premiums, with shorter waiting periods typically resulting in higher premiums and vice versa. In the meantime, you may need to rely on sick leave, holiday pay, and savings.

For example, with OneChoice Income Protection Insurance, you can choose from either a 30-day or 90-day waiting period.

Understanding the ACC claims process with income protection

Aotearoa is great for many things. Our pies, our baches, and ACC (the Accident Compensation Corporation).

The ACC provides insurance cover for any eligible person in the country who has been injured in an accident (whether you were injured at work, home, or out and about). While you recover, ACC will pay up to 80% of your income, up to a maximum of $2350.62 per week, which works out to about $10,214 per month. Please note this information is accurate as of the April 2024 update from ACC. Please check ACC resources to stay up to date with any changes.

However, keep in mind that ACC only applies to eligible injuries due to accident – it generally doesn’t cover sickness.

If that’s all about as clear as Rotorua’s famous mud baths (another great part of NZ), don’t hesitate to visit our website and discover more about OneChoice Income Protection Insurance.