QLD Income Protection Insurance - Take This to Financial Ombudsman Service?

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Leah allen

Member
17 May 2016
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Hi.

My partner suffered an injury at work. We had income protection insurance and was accepted. After months of them threatening to cut off the benefits, they finally found a doctor who said he could be employed as a concreter, so they cancelled the policy and stopped payments. After 3 months of them putting us off with every request we made for the policy wording, or footage or doctor reports, we finally have appealed their decision with a lot of medical and professional evidence that shows he couldn't work doing anything that is in his job history as required.

Their answer with the IDR panel was to send to their lawyers. We have requested details of the IDR panel but had no answers as they are supposed to be transparent and now the lawyer has requested 3 pages worth of information that is mostly irrelevant and refuse to ask answer any of our questions.

The insurance company also sent through all of his medical and case histories to the lawyers with no approval from us or the disclosure we have signed with them stating that it was only for medical professionals only. I feel they have breached the privacy act and not supplied information required to us.

Any hints for taking this to the Financial Ombudsman Service?

Thanks all for your help and all ideas welcome
 

Michael T

Well-Known Member
9 April 2014
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454
Call FOS and have a conversation to see whether it is something they can assist with.
 

Tim W

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28 April 2014
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...swiftly and free.
But your services are not free, are they?
Your T&Cs describe how you take a 20% cut as a "service charge".

Now, I am not an Admin here, but I do like to see the place run in an orderly way.
On that basis, for convenience, here's a link to the Community Guidelines.
You are presumed to have already read them.
You may recall that one Guideline is "No soliciting for clients without a LawTap subscription".
As far as I can tell, you don't have one.
 
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457Visafraud

Well-Known Member
16 April 2017
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My partner suffered an injury at work
It seems like you didn't apply for a work related claim?
OK be ware that in this business game as usual there are insurance corporations lurking around to make a profit.
The first step was to apply for a work related injury so they would assess the injury, even so there is still a fight there but at the end WorkSafe would pay the salary.
This are the basics in any work related environments made to protect workers and their families.

I've a mate who was on a work related injury claim and was never paid without any reason for two years so she applied and sent the matter to the Court.
In the mean time she applied for the income protection from her superannuation, another fight there as you know, the company denied/didn't deny, slowed, ignored etc. etc. typical insurances' tactics but at the end the insurance has no more excuses because there was a work related injury claim in place SO they started paying monthly.
After around one year of getting money from the income protection she won the case in the court (before the Judge) so she got all money, three years wages plus income protection money.
The income protection insurance then wanted the money back because they said my friend got paid but my friend just ignored them.
Seven years late and until now she is enjoying the huge $$$ package.

Any hints for taking this to the Financial Ombudsman Service?
You venue is the AFCA www.afca.org.au/make-a-complaint/insurance but bare in mind that they (like every Ombudsman) have no compel power so they may not force the insurance pay your husband.
Happy to give more tips once you clarify some things.