Would Your Insurance Work the Way You Expect When You Need It?

Regulator figures give useful context. APRA’s data to 31 December 2025 shows most death claims are admitted, while TPD claims are admitted less often and take longer to decide, because they turn on definitions and medical evidence in a way a death claim rarely does.

Those are industry averages across many policies and insurers. They cannot tell you how your own claim would go, and differences between the ways cover is bought reflect how differently it is designed and assessed, not that one way is better. What they do show is where claims tend to become harder, and that is where the checks below come in.

Many people hold more cover than they realise, and less of the right kind. It can sit in an employer’s super fund, in an old fund they no longer think about, and in a policy taken out years ago.

Start by listing every policy, inside and outside super, with the amount and type of cover in each. Then ask whether the total still matches your life now. A larger mortgage, children, a partner’s change in income or a new business can all leave cover that was right five years ago well short of what the household would need.

Definitions decide a claim, and they vary more than people expect.

TPD is where they carry the most weight. For TPD cover inside super, the usual question under the superannuation regulations is whether you are unlikely to work again in any job you are reasonably qualified for by education, training or experience. Cover held outside super can use other definitions, including own occupation in some policies. Neither is automatically better. What matters is knowing which applies to each policy you hold.

“For TPD cover held inside super, the usual question is whether you could work in any job you are reasonably qualified for by education, training or experience.”

Income protection has its own terms. The waiting period sets how long you must be unable to work before benefits start, the benefit period sets how long they can be paid, and each policy sets out how your income is worked out. All of these shape what a claim delivers, and all are easier to check on a quiet afternoon than during a recovery.

Cover can lapse without anyone deciding to cancel it. By law, a super fund cancels insurance on an account that has had no contributions or rollovers for 16 months, unless you tell it you want to keep it. Premiums that stop being paid outside super can end a policy too. A change of job, a gap in work or a consolidation of super accounts is the moment to check.

Since 2021, people applying for life cover have had a duty to take reasonable care when answering the insurer’s questions. Answer every question carefully, and keep a copy of the application and your answers. If the insurer later questions something, your own record is the fastest way to resolve it.

If a claim decision does not seem right, ask for the reasons and the information it relied on. A complaint goes first to the insurer or super fund, and if that does not resolve it, AFCA offers “free, independent dispute resolution”, as Moneysmart explains.

Most of these checks are easier with someone who reads policies every day. Before a claim, a Ryker adviser can:

• 1
  find all the cover you hold, inside and outside super, and set it out in one place
• 2
  review the definitions, waiting periods and benefit periods that would apply
• 3
  check whether the amount of cover still matches your debts and the people who depend on you
• 4
  look at what the cover costs, and whether it is affordable over the years you need it

From 8 October 2026, new genetic testing protections also limit how life insurers can use genetic test results when assessing applications, which is worth knowing before applying for new cover.

Checklist

• ✓
  List every policy you hold, including cover inside each super fund
• ✓
  Check the amount of cover still matches your debts and dependants
• ✓
  Know which definition applies to any TPD cover, and whether it is inside or outside super
• ✓
  Note the waiting period and benefit period on any income protection policy
• ✓
  Keep copies of applications, policy schedules and key letters
• ✓
  Keep super accounts with insurance active, or tell the fund you want to keep the cover
• ✓
  If you may need to claim, notify the insurer or fund promptly, and contact your adviser for help with the process

Brokers meet clients at the moments cover matters most: a larger loan, a first home, a refinance after a change in family circumstances. Two questions open the conversation.

The first identifies the risk. The second gives the client a practical next step, and it is a natural point to bring Ryker in. Ryker works alongside the broker to review the client’s cover, so their protection keeps pace with their lending.