How our people think about claims
At OnePath, we maintain a commitment to empathy, understanding and fairness in our claims procedure. Here you can learn more about how we approach the claims process and what that means for you.
We know that if you’re claiming, it's a difficult time for you
We know that if you’re claiming, it's a difficult time for you
We understand the emotional stress when you're not well, and promise that every interaction you have with us will support you at this time.
We’re here to support you when you need us most
We’re here to support you when you need us most
Our promise is to pay all genuine claims. We’re not in the business of denying claims for illegitimate reasons, or for profit. Our expert claims team assesses all claims impartially and fairly.
We know that come claim time, how quickly we work is important
We know that come claim time, how quickly we work is important
We provide a speedy tele-claims service for some claim types, that allows for claims lodgement with reduced requirements. We also know immediate support is crucial. That’s why, on OneCare Life Cover policies, we offer an Advance Assistance Benefit that will pay in advance of $25,000 of your Life Cover, to help cover pressing expenses, while we continue to finalise the claim.
We support you beyond payment of the claim
We support you beyond payment of the claim
- We offer grief counselling for life insurance claims, to assist you in an emotionally difficult time.
- We also support and enable income protection customers with temporary disability claims to return to work sooner and regain their independence. For example, we offer personalised in-home assistance with claims forms for customers claiming for mental health, while working alongside the customer's doctor. If a home visit isn’t desired, we can deliver this support over the phone.
- We also offer personalised mental health coaching to help income protection customers claiming on anxiety and depression in the comfort of their own home.
Real people providing real support
The impact of illness or injury, and the journey to recovery, is different for everyone. But the desire to protect and maintain quality of life stays the same. That’s why, at OnePath, our claims decisions are made by real people with warm hearts and a genuine passion for helping customers.
We know that the outcomes of our claims decisions, and the time we take to arrive at those decisions, can have significant impact on peoples’ future. We assign dedicated claims specialists for this reason. To get guidance through the process, and assistance in gathering everything required, you should only have one name to refer to, one person who understands your situation as deeply as needed.
We understand that making a claim can be daunting. It can be a physically, emotionally and financially vulnerable time for you. Our promise is to be there for you when you need it most – it’s the only reason we exist.
Our claims team is filled with passionate people who have dedicated their career to working with people going through a difficult time. It’s why we’re the most respected* claims team in the country. Our goal is to maintain that status, by upholding a promise to you, our customers.
Our promise
- We will treat you with absolute empathy and dignity from the minute you claim with us, which is reflective of your unique circumstances.
- All your interactions with us will be founded on sensitivity and respect because we understand that you may be medically, financially or emotionally vulnerable.
- Our starting position is to pay the claim. We will thoroughly assess your claim on its merits, to achieve the fairest outcome.
- We will continue to deliver the highest quality standards in the industry and operate as a financially strong organisation, so you can have faith that your claim will be paid.
- We will focus on enabling you to return to independence and wellness, in a way that is appropriate to you. We want to make sure you can get back on your feet and to your happiest.
As signatories to the Life Insurance Code of Practice, an industry-wide claims benchmarking guide, we commit to and uphold the standards set out in the Code, but we see these standards as the minimum – our aim always is to do more than what the Code sets out.
We don't decline claims lightly
Sometimes there are cases where the evidence from different sources is inconsistent, in that some evidence supports acceptance and some evidence supports declining a claim.
In situations like this, we consult with our medical specialists to ensure we deeply understand the situation before making a decision. These specialists are independent – which we value in helping us to determine the right thing to do in each individual circumstance.
We hold regular Claims Review Forums with leaders of our business. The job of this group is to take expert medical advice, and consider complex claims such as those outside of terms and conditions, or claims involving innocent mistakes around disclosures. An approach like this is critical to reach just outcomes for our customers.
Prior to making a claim decision, we present you with our review of your unique claim circumstances. This interim step is set in place to provide you with the opportunity to put forward all evidence in favour of us paying your claim prior to us making a decision. We also provide you with a clear internal and external escalation path if you are dissatisfied with our decision.
We know you may not agree with our claims decisions on occasion, but we strive to make sure there is clarity in the decision making process, and clarity on what to do next should you disagree.
OneCare is issued by Zurich Australia Limited (Zurich) trading as OnePath Life (OneCare) ABN 92 000 010 195, AFSL 232510. OneCare Super is issued by OnePath Custodians Pty Limited (OnePath Custodians) ABN 12 008 508 496, AFSL 238346. Zurich and OnePath Custodians are not related bodies corporate.
We recommend that you read the OneCare Product Disclosure Statement and Policy Terms available at www.onepath.com.au or by calling 133 667 before deciding whether to acquire, or to continue to hold the product.
We know you may not agree with our claims decisions on occasion, but we strive to make sure there is clarity in the decision making process, and clarity on what to do next should you disagree.