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Lodging an Income Protection claim

You can download a claim form here. This claim form consists of three (3) sections. All pages must be completed in each section.

  • Section A – Completed by the person claiming [4 pages]
  • Section B – Completed by the treating doctor [2 pages]
  • Section C – Completed by the employer [2 pages]

You can also download a supporting documentation checklist. This includes documents such as Tax File Number (TFN) Declaration, 12 month wage report, any additional medical information and proof of ID.

You should contact our office to start the claims lodgement process as soon as you have been advised from your treating medical practitioner that your incapacity will be for a period of time greater than your waiting period.

If you are unsure on the number of days your waiting period is, please contact our office and one of our staff members will be able to provide this information or refer to your product factsheet if provided.

At a minimum, the following additional required documentation will need to be provided with your claim form:

  • Medical reports/certificates
  • Tax File declaration Form
  • 12 month wage report
  • Proof of ID
  • Workers compensation decision letter/s and payment summaries (if your injury/sickness is work related)

You can also download the supporting documentation checklist.

Once you have our claim form, you will need to complete all three (3) sections and provide any supporting documentation.

Section A – This is the section of the claim form you will need to complete yourself, ensure you fill out all the questions to not cause any unnecessary delay.

Section B – This section should be completed by your treating medical practitioner. If you are seeing a specialist and a general medical practitioner for your condition and unsure on who should complete this form, it is best if your general practitioner (who has all the information relating to your condition) completes the form. If you are only being treated by the specialist, then have the specialist complete the form.

Section C – This is to be completed by your employer. Please also ensure they supply the required wage history report when returning the form to you.

Once all forms have been completed, please provide to us, along with your supporting documentation, via:

Email:     info.eql@n2nclaims.com.au

Post:       n2n Claims Solutions, Locked Bag 3111, Rhodes, NSW 2138

Section A of the claim from (page 3) has a section to be completed for Authorised Representatives. Once this has been completed, our colleagues at n2n Claims can discuss all matters relating to your claim with this 3rd party.

We have an interpreting service you can use free of charge, The Translating and Interpreting Service (TIS National) who provide translating services in a wide range of languages. Please call 1800 131 450 (during normal business hours) and they will be able to assist you to communicate with us.

 

Managing my Income Protection claim

: The date on which you are certified unfit by a medical practitioner determines which policy your claim falls under. Any date of incapacity before the 9th of July 2024 would fall under your previous policy. In this example, the claim would fall under the previous policy.

Employer-Based Schemes

Your Income is calculated using your wages earned for the 52 weeks prior to your incapacity. If you commenced employment less than 52 weeks prior to your incapacity, then your income benefit is calculated using your wages earned since employment. This calculation will not include any additional working allowances such as living away from home, meals, tools or travel/car etc. A correctly completed Tax File Number (TFN) Declaration, must be received before payments can be processed.

Week 1 of your benefit period begins immediately after the 45-day waiting period.

Yes. All time lost for your claimed condition must be medically supported. Please ensure that all medical certificates provided by your doctor state the condition and period you are being certified unfit for. You will be asked to complete a Medical Declaration Form (MDF) every 4-6 weeks to ascertain further information regarding your condition. A certificate/MDF is required to be issued by a Psychiatrist or Psychologist for Claims relating to any Mental Health Conditions.

Benefits are processed fortnightly or monthly in accordance with the terms and conditions of the Policy. They can commence as early as the end of the first fortnight after the waiting period and are paid directly to you, the claimant. All of these payments are subject to Australian taxation requirements, and you will be provided with a PAYG summary at the end of the financial year.

All other income you receive during the same benefit period will be deducted from any eligible benefit payment, so it’s important that you declare all other income you receive whilst on claim with us. If you fail to advise us, a recovery may be sought.

If you have an approved workers compensation claim, this policy will make up the difference between your Workers Compensation benefit and 100% of your defined income.

We will require a copy of the Workers Compensation decision letter/s and payment summaries.

Your benefits will cease when you are fit to return to work.

If you are fit to go back to work on partial duties, and are not earning your Pre-Disability Income, then we can review making up the difference between what you are earning from your partial duties and our benefit amount.

Your benefits will cease when a medical practitioner certifies you are able to return to work on full duties.

If your claim is submitted direct to us, your employer will only be required to completed section C of the claim form. Our colleagues at n2n Claims would only notify EQL via correspondence that a claim had been lodged. No medical information is disclosed by n2n Claims.

If you are dissatisfied with any part of your claims handling or the outcome of your claim decision and wish to make a complaint or appeal the decision, please contact our complaints@n2nclaims.com.au who will start our Internal Dispute Resolution process.

No, your existing claim will remain with your current insurer and will not transfer to the new policy.

Your waiting period will restart unless your attempt to return to work occurs only once and lasts no more than 5 consecutive days.

 

Cover Under This Income Protection Policy

A Capital Benefit is a lump sum payment provided if you experience one of the specified incidents listed in your policy.

When an employer-provided income protection policy moves over to WIP, your cover is continuous, so there is no break in cover provided your employer continues to pay for your insurance. Your employer will provide WIP with a report declaring all employees included in the month. Your benefits may change from your previous policy, please refer to your employer or provided product factsheet.

You will only ever receive up to the highest maximum benefit under either policy. You are not entitled to receive two full benefits. We will work with you, assisting where we are able, to ensure the dual insurance process is as smooth as possible.

No, WIP has ensured the takeover terms of the policy recognise your latest period of unbroken cover under your previous insurer's policy when applying all provisions of WIP’s policy.

At the end of every month your employer will provide a report to WIP listing declared employees for the month. Our colleagues at n2n Claims Solutions use this report to confirm coverage in the event you make a claim. You do not need to provide us with any additional information.

100% of defined income for the first 13 weeks and 85% for the remainder of the claim. Subject to the maximum benefit per month of $60,000 ($13,846 per week).

If you are on Workers Compensation claim which occurred during our period of insurance, we will top up your payment up 100% of your defined income until the end of your Workers Compensation claim or 104 weeks whichever occurs first.

The benefit period is 104 weeks or to the date you turn 70, whichever occurs first. If on claim when you turn 70, you will be limited to an additional 52 weeks but only to a maximum of 104 weeks total benefit. If you are aged 70-75 years, your benefit period is 52 weeks or to the date you turn 75, whichever occurs first. If on claim when you turn 75, you will be limited to an additional 13 weeks but only to a maximum of 52 weeks total benefit. Aged 75 and over your benefit period will be limited to 13 weeks.

Your waiting period under this policy is 45 consecutive calendar days. If you return to work during the waiting period for less than 5 days, your waiting period does not recommence.

This policy does not have a maximum age limit. Income Protection Weekly Benefits coverage is not determined by age.

The benefit period is 104 weeks or to the date you turn 70, whichever occurs first. If on claim when you turn 70, you will be limited to an additional 52 weeks but only to a maximum of 104 weeks total benefit. If you are aged 70-75 years, your benefit period is 52 weeks or to the date you turn 75, whichever occurs first. If on claim when you turn 75, you will be limited to an additional 13 weeks but only to a maximum of 52 weeks total benefit. Aged 75 and over your benefit period will be limited to 13 weeks.

Under the lump sum Capital Benefits & Broken Bones Benefit, there is no maximum age limit with the exception of:

  • Permanent Total Disability – available to persons 65 years and under
  • Paraplegia/Quadriplegia – available to persons 69 years and under

Cover under this policy ends 7 days after you cease being employed and paid (resignation, termination or redundancy) by EQL and are no longer declared on the supplied monthly wage declaration. However, cover will remain continuous if you:

  1. commence a role at a new employer who holds a current WIP Income Protection policy, within 120 days, or
  2. take out a personal retail income protection policy through Canopy Insurance within 7 days.

Income means the average weekly income before personal deductions and income tax, excluding any reimbursement allowances (such as travel, accommodation, laundry, tool and meal), actually paid to you which was earned from your personal exertion from your usual employment with EQL. This is calculated using the 52 week period immediately preceding the last pay period prior to your Disablement. If you have had less than 52 weeks of Continuous Cover, your income will be averaged over the period of Continuous Cover.

This is a sickness that you have had treatment or advice or should reasonably been aware of prior to the commencement of this policy. However, this condition would be covered provided;

  • You have been given a full medical clearance and ceased all treatment for at least 6 months while covered under this policy, or
  • You have had at least 2 years of continuous cover under this policy prior to your disablement and been actively at work for at least the final 2 months of these 2 years prior to the claim disablement.

Yes, below is a summary of the Additional and Capital Benefits available under this Policy. For full terms, conditions, exclusions and definitions please refer to the Policy Wording.

Additional Benefits

Escalation Benefit After 12 months on claim, weekly benefit will increase by 5%.
Extended in Between Job Cover Cover will remain continuous if the employee commences a role at a new employer who holds a current WIP Income Protection policy, within 120 days.
Zero (0) day waiting period for Serious Medical Conditions If an approved claim is for any defined Serious Medical Conditions^ or the claimant has been hospitalised for more than 72 hours within 24 hours of the injury or sickness, their waiting period will be reduced to zero (0) days.
Loyalty Program Benefit Where this Policy has been in force for more than 2 years and the claimant has not had an approved claim within the most recent 2 years, the available claim benefit will commence 7 days earlier, once the Policy waiting period has been met.
Financial Planning Benefit Where an approved claim for a mental health condition or defined serious medical condition exceeds 26 weeks, the claimant may be offered the service of a WIP approved Financial Planning Provider up to the cost of $3,500 for the assistance.
Funeral Benefit In the event an employee passes away, we will reimburse the actual funeral cost up to the lessor of the equivalent of 100% of their defined income or $5,000.

 

Rehabilitation Assistance* Benefit may include us arranging training to assist return to work as well as behavioural or family counselling to cope with new disability. This benefit is up to $25,000.
Return to Work Assistance* Benefit may include us arranging professional assistance to improve physical and/or emotional condition. Assistance includes special equipment for and/or modifications to the claimant’s normal home or workplace. This benefit is up to $25,000.

*This benefit is payable at the absolute discretion of n2n Claims Solutions. No benefit would be payable if it would result in us contravening the Health Insurance Act 1973 (Cth), the Private Health Insurance Act 2007 (Cth) or the National Health Act, 1953 (Cth).

^Serious Medical Conditions includes one of the following conditions: Dementia; Motor Neuron Disease; Multiple Sclerosis; Primary Pulmonary Hypertension; Permanent Paralysis; Parkinson Disease; Stroke; Total Blindness; Total Deafness; Total Loss of Limb.

Refer to Policy Wording for the full definition.

 

Additional Benefits

As a result of an Injury, claimants may be entitled to a lump sum benefit for a permanent loss or disability up to $25,000 or a broken bone up to $2,000. These individual benefits are scaled up to the related maximum benefit.

Where this Policy has been in force for more than 2 years and you have not had an approved claim within the most recent 2 years, the available claim benefit will commence 7 days earlier, once the policy waiting period of 45 days has been met.

This means if you are entitled to this benefit, you need to be certified unfit for greater than 45 days and still wait that period, however your benefit calculation would commence from day 38.

This benefit may be available for approved claims and include us arranging training to assist return to work as well as behavioural or family counselling to cope with the new disability. This benefit is up to $25,000.

This benefit is payable at the absolute discretion of n2n Claims Solutions. No benefit would be payable if it would result in us contravening the Health Insurance Act 1973 (Cth), the Private Health Insurance Act 2007 (Cth) or the National Health Act, 1953 (Cth).

No, but aerial activities such as Hand Gliding are not covered by the policy. See below

“An Insured Person being a pilot or crew member of any aircraft; or engaging in any aerial activity except as a passenger in a properly licensed aircraft.”

WIP, n2n Claims Solutions and Canopy Insurance are all subsidiaries of the WIP Group. By keeping all parts of the process in house we can ensure that you are our main focus.

  • WIP – deals with the income protection policy design and the insurer
  • n2n Claims Solutions – handles your claims
  • Canopy Insurance – provides a platform to purchase personal retail income protection policies including gap, top up or full coverage

 

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