QLD Employer income protection gone wrong

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10 December 2019
Hey guys. I’d appreciate your advice on an issue I’m having.

I broke my arm at home back in October.
I’m a tradesman so couldn’t work for a month. Luckily I had some savings and paid leave to use during this time.

But I’ve been paying quite a high premium for income protection for three years now (as part of a group cover with Coverforce) for 90% of my pretax income to be covered. I figured I may as well make a claim to use it and then leave my savings alone.

I made the claim a month ago and the statements confirmed my level of benefit was 90%. Except the payment amount is much lower. It works out to be about 60%. I call them up and was told “oh it’s capped at $xx” despite any percentage.

I’ve gone through the PDS twenty times and see no mention of this cap. The example they use in the PDS is pretty much exactly my situation and it explains the 90% calculation. But still says “payment amount = $1600 gross”.

I called the insurer again today and spoke to someone else. They were able to tell me that my employer put the cap on our paid benefits in December 2018, and that the union and employer agreed to this because too many benefits were being paid out.

It goes without saying that I, nor the other guys, have known about this and our premiums have been charged the same.

So it seems this is now an issue with us and our employer. The insurer says they weren’t liable to tell me because it’s a group cover and the employer should have told us. Coverforce don’t want a bar of it.

Meanwhile my employer (a huge company) is shying away, simply arguing that they didn’t agree to it and that’s that.

The difference in what I should have been paid was about $1700. Doesn’t sound like much but when you’ve been paying for something that was changed without you knowing... I just really feel like I’ve been screwed here and no one cares. If you calculate my premiums since the change was made it’s another $2700.

I’ve had a chat to a solicitor who said I have a case to claim that money plus my premiums back, since I wasn’t alerted to any change and therefore couldn’t agree to it. but I’m scared what repercussions that would have for me at work. I don’t want to be treated unfairly, especially since they are already ignoring me when I approach them about it.

I’d appreciate any advise you have more me. Should I pursue the insurer further or make this a case against my employer?