How to make an insurance claim

We all hope that we never have to make an insurance claim. But if you do, we’re here to help you.

If you need to make a claim, we want you to know that we’re here to help and make the process as smooth as possible for you.

Head to our Insurance Guide for a breakdown of what an insurance claim includes and involves. If you want more information on the claim process, download our How to make an insurance claim guide.

Ready to make a claim? The following information will guide you through the assessment process.

How does it work?

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Step 1 – Contact us first

Our dedicated staff can answer any questions, send you the relevant forms and paper work, and let you know what’s needed to simplify the whole process.

Step 2 – Complete our forms and lodge your claim

After contacting us, you'll need to complete and submit the forms provided to you and supply all requested information. Although many of our forms can be received and submitted electronically, we’re also happy to receive them in paper form. When you send us your forms, please attach all the documents requested in the claims pack that we’ll send you so that your claim can be adequately assessed.

If you're unsure about any of the questions or need assistance completing the forms, give us a call on 1300 130 780  and someone will be happy to help you. Sometimes asking for assistance can help avoid unnecessary delays.

Step 3 – Assessing your claim

We'll check your application and, if you're eligible to make a claim, we'll forward all your documents and information to our insurer to make their assessment.

At times, the insurer may request additional medical reports and examinations to help in their assessment. These costs will be paid for by the insurer.

Our insurer may also:

  • ask for additional reports from your doctor/s
  • contact you directly to ask for further information
  • ask your employer for more information
  • make an appointment for you to have a medical examination with an independent specialist/s.

Step 4 – Our insurer makes a decision about your claim

After considering the medical evidence and other information you provide, our insurer will decide whether you meet the relevant definition (for example, ‘TPD' for total and permanent disablement claims, or terminal illness) under their insurance policy.

Our insurer will then advise us on how they have assessed your claim and whether it should be accepted, deferred or declined.

Step 5 – We review our insurer's decision and device an outcome

We have a legal obligation to act in the best interests of all our members. This means that we need to independently review your claim and form our own opinion on whether our insurer's decision is the right one.

Our review of the insurer's decision will result in one of the following outcomes:

Accept

If your claim is accepted, you'll receive a letter from us informing you of this. We'll also send you information on how the benefit can/will be paid to you.

Defer

We may agree with our insurer's decision to defer your claim for a period of time to determine the full extent of your disability and whether it's permanent. Your claim will be reviewed again at the end of this period.

Decline

We may agree with our insurer's decision to decline your claim. In this case, we'll write to you stating the reason/s why we agree with our insurer's decision.

Step 6 – We review claims that are declined or deferred

If we disagree with our insurer's decision to decline or defer your claim, we may request that our insurer reconsider the claim or ask for further medical evidence. We’ll keep you informed on what is happening with your claim whilst this review process takes place.

When we finish the review process, your claim may be accepted, deferred or declined. Whatever the outcome, we'll let you know in writing.

 

What if your claim is denied?

If your claim is not successful, you’ll receive a letter explaining the reason why it was denied. If you don’t agree with the decision, we’ll facilitate a review process. This will include an independent review by our claims review committee to ensure a fair decision is made.

If you’d like to lodge an objection to our decision and request a review by the claims review committee, you must follow these steps:

  1. Lodge your objection in writing (within 28 days of receiving the letter denying your claim) and include the reasons for your objection and any additional information in support of your claim.
  2. Send your written objection to:
    The Complaints Officer
    LUCRF Super
    PO Box 211
    North Melbourne VIC 3051

If you’ve contacted us about your concern and you’re still not happy with the outcome of your claim or the way we handled it, you can raise a complaint with the Australian Financial Complaints Authority. See our FAQ page for further information.