If you get ill or injured and can't work for a while, or become Involuntarily Unemployed (if you have Involuntary Unemployment Cover), we understand how stressful this can be so it's very important that you advise us of the claim as soon as you can. We'll do everything we can to make sure things run as smoothly as possible.
How to make a claim
Things you'll need to support a claim
- A complete Medical Practitioners form, if applicable
- A certified copy of proof of your identity such as your driver's license or passport
We may need you to send us evidence of your income, involuntary redundancy and job seeking; or other relevant documents depending on the nature of your claim. For Involuntary Unemployment for example, a certified copy of your notice of redundancy from your employer and a certified copy of your Separation Certificate would be required. We will discuss this with you when you call us to advise that you wish to make a claim.
You'll need to email, fax or post these documents so we can promptly review your claim.
Your claim will be taken care of by your own personal claims case manager.
We pay income protection benefits one month in arrears, after the waiting period has finished. For example, if your waiting period is 28 days, and you become eligible to claim on 1st September, you'll see out this waiting period, and receive your payment at the end of October for benefit period 1 October to 30 October. After this, you'll receive your benefit payment at the end of each month, until your benefit period expires or you return to good health and/or work.
Please note that under Bonus Cover, benefits for some common injuries, such as broken bones, and illnesses such as a heart attack accrue faster - starting from day one of your Sickness or Injury.
Every month that you are out of action, you may need to complete and send us a progress claim form as requested by your case manager so that we know you are still entitled to receive a payout. You are generally responsible for the cost of providing the initial and ongoing information to support your claim. You can discuss this in further detail with your claims manager.
- Your Waiting Period: is the time you need to be continuously 'Out of Action' or redundant before benefits start to accrue. Benefits are then paid monthly in arrears while you're getting medical care or looking for new employment.
Note about Involuntary Unemployment Cover: You’ll need to have held the cover for 6 months before you become involuntarily redundant, then also be unemployed for 28 days.
- Your Benefit Period: is the amount of time you can receive payments when you're unable to work due to sickness or injury. These payments will continue as required up to the end of your chosen Benefit Period.
Note about Involuntary Unemployment Cover: You could receive a monthly benefit for up to 3 months.
Here are some examples of how it all works...
Need additional support?
As part of the assessment of an application or a claim, it is sometimes necessary to request our customers be examined by an independent medical specialist or, for a claim, to attend rehabilitation related services.
In all cases, we will try to organise appointments to take place close to your home, to ensure as little inconvenience as possible for you. However, for our customers living in rural or regional communities, if a suitable provider is not located in your local area, Virgin Life Insurance will pay reasonable costs for your transport costs to attend the medical appointment.
If flights and accommodation are required for you to attend medical assessments, we will organise this for you. If there is a medical reason you cannot travel alone, we will also consider paying any travel costs for someone to accompany you. Prior approval is required from Virgin Life Insurance prior to the appointment.
For our disabled customers, please speak to your Customer Service Representative or Claims Case Manager to ensure that there is suitable access for you at the medical appointment.
In all cases, please speak to your Virgin Life Insurance Customer Service Representative or Claims Case Manager prior to incurring any expenses to confirm what payments can be reimbursed. They are committed to helping you find a suitable solution.
We recognise that some of our customers may find it difficult to attend medical appointments or to obtain the necessary documentation in the timeframes we request to keep your application or claim open.
When this is a challenge, we will work with you to agree on reasonable timeframes and assist you in booking medical appointments or obtaining the required documentation to support your application or claim.
Where we are requesting information, we will contact you at intervals to keep you updated about the process. It is also important for you to keep your Virgin Life Insurance Customer Service Representative or Claims Case Manager updated on your efforts or we may inadvertently close your application or claim.
If you are experiencing difficulties, please speak to your Virgin Life Insurance Customer Service Representative or Claims Case Manager who will be able to help you.