How to make an insurance claim

We will deliver on the promise we make to every customer, ensuring they understand and feel confident in how we will handle their claim. 

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We will be there for our customers to help them realise their best life.

Our customer commitment
We recognise every customer’s situation is unique. We work with our customers and their dependents transparently, fairly and with respect and empathy.

Providing more than financial support
We provide more than financial assistance. We partner with a range of stakeholders to help our customers return to work and to live an active life wherever we can.

Offering tailored solutions
We select the best solution for our customers based on their individual situation, providing the right support and management at the right time.

Empowering our people
Our people are equipped with the experience to effectively manage claims across their portfolio, supported by internal and third-party expertise, best-in-class tools and an ongoing focus on professional development.

Ensuring a sustainable business
We manage our risks across the portfolio and apply our deep insights to ensure we contribute to a profitable AMP Insurance business that can support our customers today and in the future.

At Resolution Life we see our role as more than just paying a claim. We create tailored solutions to help customers and their family should something happen. Whilst this may involve paying a financial benefit, depending on the nature of the claim, it may also involve rehabilitation or working with them on a return-to-work program.

Our claims philosophy is simple; helping people when they need it most. We make sure every claim that should be paid is paid promptly and we always treat your customers with empathy, respect and care.

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We look after you with a fair, fast claims process and dedicated support.

You trust MLC Life Insurance to protect you and your family, and we promise to be there when you need us.

Throughout life, and especially at claim time, we deliver on this promise by getting the basics right, providing dedicated expert care, and supporting the health and wellbeing of you and your family.

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Our business is about being there for our customers when they need it most. So we aim to pay every legitimate claim we receive, as fast as we can and with compassion and care.

We pride ourselves on delivering exceptional customer experiences and guiding customers through some of the most difficult moments in their lives. It’s what makes us different in the market and what drives us to keep improving the claims service we provide.

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Our claims philosophy is to provide a smooth path throughout the claims journey by assessing each claim on its own merit with integrity, compassion and fairness. Our goal is to assist our customers when they need it most.

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We stand by our claims’ philosophy and our commitment to paying claims.

• We will treat customers how we would like to be treated.
• We show empathy and respect when customers are medically, financially or emotionally vulnerable.
• We assess and pay claims in a fair and timely manner.
• We assess each claim on its merits with guidance from appropriate specialists.
• We manage disability claims in a way that supports the customers’ return to wellness.
• We operate within a clearly defined risk management and governance framework and the highest quality standards.

To find out whether you have any insurance through your AMP super account, simply register or login to My AMP. If you do have insurance in your super, the details will be provided there. You can also check your insurance confirmation letter or annual statement. 

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People suffering a terminal illness may be able to receive an early payment of life insurance up to a maximum amount (depending on the policy). Any payable amount over the maximum will be paid to their beneficiaries after they pass away.

Please note: Under superannuation law, the terminal illness test for releasing funds is may be different to the operation of your insurance policy, and both will need to be approved before funds are released to you. If you’re an AMP super member, please see your insurance guide for policy terms.

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If you have Total and Permanent Disablement cover, and meet the eligibility criteria, you can submit a claim. Usually the part of the TPD definition you’re assessed under depends on how many hours you work a week, or your employment status. Generally for AMP policies: 

• If you held TPD cover before 1 December 2021 and the date of your disability was also prior to this date, and you were working under 10 or 15 hours per week (depending on your product), then generally your claim would be assessed under a more restrictive definition known as the activities of daily living (ADL) part.
• If you hold TPD cover and the date of your disability is on or after 1 December, then: 

               o   if you worked at any time in the 16 months before your disability, you’d be assessed based on your ability to work in any occupation for which you are suited by education, training or experience.

              o   if you didn’t work at any time in the 16 months or more before your disability, then you’ll be assessed based on your ability to perform those basic activities associated with work.

There will also be other parts of the TPD definition that the insurer may assess you against (and not the above), based on your disability – these may include loss of limbs and/or sight, cognitive impairment and listed disabilities (such as quadriplegia). If you have insurance through AMP super, you can see your TPD definition in your insurance guide or plan summary.

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Sometimes we will need more information to assess your claim according to your circumstances. For example, we require two doctor reports in order to meet the conditions of release, otherwise it will affect the way your claim is taxed. Your claims manager will contact you to discuss what we need from you and why.

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Total Salary Continuance (or income protection) is insurance for when you can’t do your current job because you’re too sick or injured. You don’t have to have been injured or have fallen ill on the job.

There’s a minimum timeframe before you can make a claim - this is called a waiting period. If you have insurance through AMP super, you can see yours in your insurance guide or plan summary. It’s also usually assumed that you’re under ongoing medical care via a doctor, and you’re not working for an income.

The insurance assessment looks at whether you can carry out any one duty or combination of duties that are critical to the proper performance of your usual occupation.

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We’re here to support you through your claim. If you have a question, simply give us a call on 1300 366 214 and we can discuss what you need and answer any questions you have. 

It depends on the type of claim you’re making and your particular circumstances, here’s a general guide: 

• Total and permanent disablement claims can take up to (but typically no longer than) six months.
• Total salary continuance claims can take up to (but typically no longer than) two months.
• Life insurance claims can take up to (but typically no longer than) 6 months after the death certificate is received. 

You will be notified by the insurer if your claim will take a longer time to process.

Insurance is offered as part of many of our super plans and is provided by an external insurer.

As your super provider, we’re here to support you through the claims process in whatever way we can. That means we can act as a ‘go-between’ for you and your insurer.

Once a claim is lodged, we won’t be able to see what the status of your claim is until an outcome is generated, but we can check-in on your behalf, especially if you’re not receiving documentation within the timeframes the insurer has promised.

If a claim is declined, we’ll also review the outcome to understand why. If we find that your claim should have been approved, we’ll work with the insurer to overturn the decision.

Finally, if a claim is approved, we will organise the payment of that claim through to you.  

There can be delays if the insurer doesn’t have all the information they need to process your claim. For example, a life insurance claim can’t be processed until the insurer has the death certificate.

We can work with you to help you submit all the claim information required, and the insurer might be in touch if they need further information before continuing the process.  

Once a claim is being processed, you should receive an update at least every 20 days, and any questions you’ve submitted should be responded to within 10 business days.

If you’re not receiving these updates in a timely manner, please let us know and we can follow up for you. 

Generally, if you receive income from other sources while you are being paid a monthly TSC benefit, then that benefit may be reduced by those payments. This may be called an offset in your plan.

How offsetting is applied to your benefit payment, and the other income sources that are offset vary across products and plans. We’ve provided some general information below, but it’s important to check the terms that apply to you. If you have insurance with AMP Super, check your insurance guide or plan summary (available in MyAMP) to see your terms and conditions.

How offsets are applied to TSC benefit payments

Depending on your product or plan, your benefit payment may be offset:

• so that it doesn’t exceed 75% (or the percentage applicable to your plan) of your pre-disability income, or
• as a straight offset off your benefit payment.

Sources of income that may offset your benefit payments

• Workers’ Compensation, Motor Accident Compensation, Social Security (or similar legislation) in relation to your injury or illness
• Any statutory or other government payments for loss of income, earning capacity, or any other economic loss, in relation to your injury or illness
• Any disability, injury or sickness insurance type policy (other than a lump sum Total and Permanent Disablement benefit)
• Sick leave that you receive at the same time as being paid a benefit

The following sources of income are generally not offset:

• Annual leave and long service leave
• Termination (redundancy) entitlements
• Income earned from investments

If you receive payments as a lump sum, the insurer will generally convert them into monthly payments to offset accordingly.