CHOICE membership

"Bill Cover" or "Income Protection" Insurance

I have had “Bill Cover” insurance with Real Insurance for about 6 years.

In February 2020 I became unwell and was unable to work for a prolonged period, and in fact, I have been forced to retire with a chronic health condition.

After the appropriate waiting period, I lodged a claim with the company which was rejected by their assessor. The terms of the policy state that they will settle a claim if you are under 65 years old if you are working part time or full time, however, if you are over 65 years old, you must be unable to perform 2 of 5 activities of daily living stipulated by the company, these being - mobility, showering, toileting, feeding and dressing. The basis for the rejection was that despite a medical report, and the fact that I was unable to work, I was over 65 years old and could perform all of these activities, hence the assessor judged that I was ineligible for payment under the policy’s conditions.

Please be aware that it appears that once you are over 65 years old, this policy discriminates against you, and almost encourages you to be dishonest about your abilities.

The last comment on the rejection email stated that “if you have further questions or if we can be of assistance during this difficult time, please don’t hesitate to call us…” To be honest, I found this laughable as my need has been financial which is something that the company was not prepared to assist with, despite paying premiums for six years!

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Welcome to the community @nandhd

Your post has many good points to alert people to said insurance. I changed the title to make the topic more inclusive and hopefully attract more visibility. I trust you don’t mind.

Unfortunately you have learned that your ‘bill cover’ (aka ‘Income protection’) insurance is not worth the LCD it is displayed on since you turned 65. Many others discover their policies, sometimes through their Super Funds, are no better regardless of their age. Everyone should but does not review their Super funded policies as they do cost the member out of their accounts. Some of the insurance is excellent and good value, and some may be unnecessary, personal situation dependent.

Your Real policy is not the only one that is not what it might seem. Each of the policies has very specific requirements for lodging a claim. Many reports suggest they often make Centrelink’s hurdles seem like finely sanded level floors in comparison. They are very profitable lines of business for a reason.

Moneysmart’s primer seems just short of a sales pitch but explains what they are good for, not how they can give a false sense of security because of the requirements to successfully claim.

At younger ages with bills to pay it can make sense if one is incapactitated, but anyone with a policy would be very well served to read the exclusions, and the requirements to successfully claim, and give them up when they become junk.

A senior unable to take care of themselves may have more problems living than a bad credit rating or going bankrupt, and as we live longer those premiums between age 65 and being unable to perform ‘2 of the 5’ gets longer and longer.

Choice has also published, much in common with Moneysmart but then some value added.

Hopefully this will alert others to have a check of policies they may have, and then have a look at what those policies actually cover.

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It might be worth reaching out to a consumer law centre in your state. You may be able to lodge a complaint with the Australian Financial Complaints Authority, or ask for a refund of your premiums if you weren’t made aware of the limitations of the policy when you purchased it.

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@nandhd, would you clarify the Real policy you had? A check of the Realinsurance site today only shows ‘Income Protection’ rather than ‘Bill Cover’ insurance. The Income Protection policy ends at age 65 so you may have an older product they no longer sell, perhaps for obvious reasons given your experience.

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Welcome to the forum @nandhd.

I empathise with your predicament. My wife had Income Protection with Tower Insurance, and when we tried to make a claim on it they refused. After we appealed they sent out a private investigator, not once but twice to interview her for many hours each time. He told us that he was satisfied to our bona fides, So we were suprised when Tower required her to attend several appointments with a medical specialist who our GP knew and said was renound in the medical community for being sent around Australia as a hit man for the insurance companies. The medical specialist wrote a report which was short on fact and long on opinion which Tower relied to again refuse.
We appealed to the then Financial Service Ombudsman who it turns out were largely from the industry. They denied our appeal saying they saw no reason to reject Tower’s findings.

May I suggest that the Royal Commission into the Finance & Insurance Industry has not really changed things more than giving the walls a bit of a white wash.

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I’ve had a few interactions with the then FSA and more recently with AFCA who replaced them … to say my time would have been better used whittling unicorns would be an understatement.

From their website:

AFCA considers complaints that previously would have been handled by the Financial Ombudsman Service, the Credit and Investments Ombudsman and the Superannuation Complaints Tribunal. We are the dispute resolution scheme for financial services.

Essentially an obfuscated maze of criteria need to be completely satisfied before they will consider a complaint. Be prepared to have your understanding of ‘providing a financial service’ realigned to their rules, with responses like “company x is a member by virtue of providing (some other service) not what your complaint refers to” and/or “(service x) is not a ‘financial service’” in the case of providing a fully managed salary sacrifice product. That said, my experience with salary sacrifice providers has led me to the conclusion they are anything but ‘a service’, but I digress …

I could imagine a cynic suggesting they exist for their members to create the illusion of accountability …

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Welcome @nandhd

I was injured and contacted the insurer on a Credit card that was insured. The company ( financial institution) claimed that they no longer honoured the policy although they were still charging and receiving payment for this product. I contacted the Financial Services ombudsman and lodged a complaint. After jumping through several hoops and doing multiple backflips, as well as composing many many outlines of complaints, the FSO now named AFCA arranged a concilliation conference with the companies (both financial and insurance) both chose to blame the other bucking and bouncing responsibility. I forwarded a letter of displeasure to the insurer 8 weeks, after AFCA had ruled that the financial organisation had sold its policy under false pretences. Within 2 days I had the policy honoured and received a refund back to the date of cessation of the product.(9 months prior)

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Well done.

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