Actors, TV/Radio announcers considered working hazardous jobs when claiming Total and Permanent Disability (TPD) cover.
Depending on the terms of your insurance policy, you may be ‘excluded’ from claiming an insurance benefit based on what your occupation is. Many people are unaware that they may be working in an occupation that does not give them full insurance cover at the time they make the claim.
Most people can get a TPD benefit if they satisfy the ‘standard’ TPD test. You are able to make a claim under standard TPD cover if you are unlikely ever to return to work.
How can you be restricted to claim for compensation?
One insurer in particular, AIA Australia, is known for refusing standard TPD cover for people they say are working in ‘Hazardous Occupations’. MLC sometimes does something similar with ‘special risk’ occupations. OnePath also apply restrictions in respect of some insured workers.
This may be a cause for concern for you if your life insurance is held through superannuation funds including BT Life and MLC.
What are the effects when certain workers are excluded from TPD cover?
The effect of insurers excluding workers in certain jobs from standard TPD cover, means that claimants are required to meet the much more difficult requirements of the ‘Activities of Daily Living’ test, which requires that the claimant is “continuously and totally unable to perform at least two of the following activities of daily living as a certified by a qualified medical practitioner; bathing, dressing, eating, toileting and transferring”.
David Schmolke’s claim was refused for working in a hazardous occupation
David Schmolke is one such claimant who thought he was covered for insurance, only to be advised by AIA Australia that he was not, because he was working in a ‘Hazardous Occupation’ as a construction worker. AIA Australia refused to pay Mr Schmolke’s claim.
What do Insurance companies consider hazardous jobs?
So, what is a hazardous job, according to your insurance company? You might be surprised. Some insurers treat Actors, TV/Radio Announcers, Massage Therapists, Models, Musicians, Property Developers, Tennis Coaches, Car Park Attendants, Dancers, Disc Jockeys, Fitness Instructors or Freelance Journalists as if they were working in hazardous jobs.
An interstate truck driver may not be able to claim under a standard TPD definition, but an interstate coach driver can. If you think that sounds ridiculous, we agree.
If your claim has been rejected because you were working in a ‘Hazardous Occupation’ you may be able to challenge the decision.
To speak with a lawyer to review your file on an obligation-free basis, please contact us here.