At times, a deceased may have made a separate nomination for a specific beneficiary for that policy

This means that the policy will not form a part of the deceased’s estate, and the beneficiaries of the will (along with anyone claiming Family Provision) will not receive any benefit from the policy.

12-Month Family Provision Deadline

Under the Succession Act 2006 (NSW), family provision claims must be filed within 12 months of the deceased’s death. Policies with binding death benefit nominations bypass the estate entirely, making it crucial to identify these early when considering a family provision claim.

Including Insurance Policies in the Estate

However, there may be ways in which the policy can instead be included as part of the estate. This is a complicated area of law, and so we advise that you seek legal advice from those with extensive experience in contested wills law. If you are a beneficiary of a will, or are intending to file a family provision claim, our lawyers will be able to advise you on how to best proceed, ensuring the best outcome for you.

Types of Life Insurance Nominations

Life insurance policies may have binding nominations (which must be followed by the trustee), non-binding nominations (where the trustee has discretion), or no nomination at all. Our NSW estate disputes team can investigate whether nominations are valid, current, or have lapsed, and advise on strategies to include insurance proceeds in your family provision claim where appropriate.

Types of Insurance Claims We Help With

While many people think of “life insurance claims” as a single service, there are actually several distinct types of insurance claims we help families recover on. Understanding these differences is crucial to ensuring you receive the full benefits you’re entitled to.

Life Insurance & Death Benefit Claims

When someone passes away, a life insurance death benefit becomes payable to their beneficiaries. Unlike family provision claims under the Succession Act, these benefits may bypass the estate entirely if there’s a binding nomination in place. We help families identify all applicable policies, verify beneficiary status, and ensure insurers process claims promptly under their duty of good faith obligations under the Insurance Contracts Act 1984.

Total & Permanent Disability (TPD) Claims 

TPD insurance claims are distinct from death benefits. Under the Superannuation Industry (Supervision) Act 1993, members with severe permanent disability can claim through superannuation insurance claims mechanisms. TPD is defined as a condition where you’re unlikely, due to illness or injury, to ever engage in gainful employment for which you’re reasonably qualified by education, training or experience. 

Common qualifying conditions include permanent spinal cord injuries, amputation of limbs, total loss of vision, severe mental illness preventing work, and progressive neurological conditions like motor neurone disease or Parkinson’s disease. TPD claims typically require medical evidence from two doctors and can take up to six months to assess.

Income Protection Claims 

Income protection claims protect your regular income if you become unable to work due to illness or injury. These policies typically provide monthly benefits to replace your lost earnings during the period you cannot work. While often accessed through superannuation, standalone income protection policies are also common. We help claimants navigate waiting periods, income definitions, and any disputes with insurers about work capacity assessment.

Trauma and Critical Illness Insurance Claims 

Trauma or Critical Illness insurance pays a lump-sum benefit upon diagnosis of specified serious illnesses (heart attack, stroke, cancer, organ transplant, etc.). Unlike disability insurance that requires you to be unable to work, trauma insurance pays on diagnosis alone. These claims are typically processed faster than TPD or disability insurance claims.

How We Can Help

We are unique in offering No Win – No Fee service in the area of contesting wills. We are dedicated to helping you achieve the best outcome, guiding you through every step of the process.

Our Surry Hills, Sydney office serves clients across NSW including Sydney, Parramatta, Liverpool, Newcastle, and Wollongong. If you believe a life insurance policy should form part of an estate, or if you’ve been unfairly excluded from a binding nomination, our will disputes lawyers can assess your options during a free initial consultation.

So give us a call today on 1300 757 467 to set up a free initial consultation.

What Happens If My Claim Is Rejected? 

Unfortunately, life insurance claims can face rejection or disputes. Insurers may reject claims for various reasons: ambiguity in policy terms, failure to disclose relevant medical history, claims outside the policy definition, or misunderstanding about beneficiary eligibility. Under the Insurance Contracts Act 1984, insurers have a duty to act toward policyholders with utmost good faith, which includes providing clear reasons for denial.

Internal Review Process 

If your claim is denied, the first step is requesting an internal review. The insurer must respond to your internal review request within a specific timeframe (typically 21 days for initial response, longer for complex cases). During this review, you can provide additional medical evidence, clarify policy coverage, or correct any misunderstandings.

Escalating to AFCA 

If the internal review is unsuccessful or you’re unhappy with the decision, you can lodge a complaint with the Australian Financial Complaints Authority (AFCA). AFCA is an independent dispute resolution body that can review the insurer’s decision and award compensation if it finds the denial was unreasonable. According to AFCA’s annual reviews, claim denials and delays remain major areas of complaint. You must attempt an internal review first before the AFCA can consider your complaint at no cost to you.

Timeframes for Appeals 

The timeframe for an appeal depends on the complexity of your case and the insurer’s responsiveness. Simple denials may be resolved within weeks, but complex cases involving multiple evidence submissions or medical disputes can take several months. Our lawyers help accelerate this process by presenting evidence strategically and pressuring insurers to meet their statutory obligations.

How Long Will My Claim Take? 

Most life insurance claims in Australia are assessed and paid relatively quickly. Under ASIC Regulatory Guide 175 (which sets standards for handling such claims), insurers must assess death benefit claims within six months of receiving complete documentation. For income-related claims like income protection, the timeframe is two months from receipt or after any waiting period expires.

However, these are maximum timeframes, not typical timeframes. According to Australian life insurance data, 71% of claims settle within two weeks, another 20% within two months, and the remaining claims take longer. TPD claims typically take longer (up to six months) because they require more extensive medical assessment.

Several factors can slow your claim: incomplete medical evidence, disputes over occupational definitions (especially for TPD), policy coverage ambiguities, or insurer negligence. We help by ensuring all required documentation is submitted upfront, chasing insurers who delay unnecessarily, and escalating to AFCA if deadlines are missed.