How to Make an Income Protection Claim (Step by Step)

When can you make a claim?🔗

You can make an income protection claim when you are unable to work due to illness or injury and your policy is active. Three things need to line up before payments begin:

• You must meet the disability definition in your policy. Most use one of two: “own occupation” (you can't perform the duties of your specific job) or “any occupation” (you can't work in any job suited to your education, training, or experience, a much higher bar).
• You must be under the regular care of a medical practitioner. Insurers want active, ongoing treatment, not a single GP visit from six weeks ago.
• Your waiting period must expire. This is the gap between becoming disabled and when payments start. Common waiting periods are 14, 30, 60, or 90 days. The shorter it is, the sooner money arrives (and the higher your premium). See our guide on the waiting and benefit period trade-off.

Step-by-step: how to make an income protection claim🔗

1. Notify your insurer as soon as possible. Don't wait until your waiting period is nearly over. Contact your insurer (or your super fund if your cover is inside super) the moment you know you'll be off work for an extended period.
2. Complete the claim forms. Your insurer sends a claim pack with a claimant statement (your version of events) and an attending physician's statement (your doctor describes your condition and prognosis). Fill these in carefully and completely.
3. Provide medical evidence. The backbone of your claim: GP certificates, specialist reports, hospital records, and ongoing medical certificates for the duration of your claim.
4. Provide employer and income documentation. Insurers verify your pre-disability income, so gather payslips (last 12 months), your most recent tax return, and an employer statement. Self-employed? Add BAS, profit and loss statements, and business tax returns.
5. Submit everything and confirm receipt. Send your completed pack together where possible, confirm the insurer has received it, and ask for a reference number.
6. Provide ongoing proof of disability. Once approved, most insurers require monthly medical certificates and periodic reviews. Missing a certificate can pause your payments.

What documents do you need?🔗

Here's the full checklist:

• Completed claimant statement form
• Attending physician's statement (completed by your doctor)
• GP and specialist medical certificates
• Hospital records (if applicable)
• Payslips for the last 12 months
• Most recent personal tax return
• Employer statement confirming your inability to work
• Proof of identity (driver's licence, passport)

If you're self-employed, also include BAS statements, profit and loss statements, and business tax returns. Missing even one document can push your assessment back by weeks.

How the waiting period and benefit period affect your payments🔗

These two features directly control when you get paid and for how long. The waiting period is the excess period you must be disabled before payments begin. It's not a processing delay: if your waiting period is 30 days, you must be continuously unable to work for 30 days before your first payment is triggered. The benefit period is how long payments continue, commonly 2 years, 5 years, or to age 65. The longer it is, the higher your premium, but the longer your safety net lasts.

Worked example: you have a 30-day waiting period and a benefit period to age 65. You're injured on 1 July. Your waiting period expires on 31 July. Once your claim is approved, you receive your first monthly payment covering from 31 July onward, and payments continue monthly as long as you remain disabled and meet your policy's definition. Most policies pay 70 to 75% of your pre-disability income.

How long does an income protection claim take?🔗

It depends on how complex your claim is and how quickly you provide complete documentation. For a straightforward claim (clear diagnosis, solid medical evidence, complete paperwork), expect an initial acknowledgement within 1 to 5 business days and assessment completed in 4 to 8 weeks. For a complex claim (disputed disability definition, mental health conditions, self-employment income verification, or missing documents), timelines can stretch to 3 to 6 months or longer. Staying proactive and submitting complete documentation upfront are the best ways to keep your claim moving.

Claim stages: what happens and when🔗

Why claims get delayed or denied🔗

Understanding the common pitfalls is half the battle.

• Non-disclosure at application. If you didn't disclose a pre-existing condition when you took out the policy, the insurer may void it or exclude that condition. The most common and most avoidable reason for denial.
• Insufficient medical evidence. A single vague GP note won't cut it for a long-term claim.
• The disability definition isn't met. You might be genuinely unwell but not meet the specific threshold, especially under “any occupation” wording.
• The waiting period hasn't expired. No payments before it ends, no matter how fast the insurer processes.
• Policy exclusions. Conditions excluded at underwriting (say a pre-existing back injury) won't be paid.
• Missing income documentation or a lapsed policy. Insurers can't calculate a benefit without verified income, and there's no cover if premiums lapsed.

Tips to give your claim the best chance🔗

• Notify early and get the paperwork moving immediately.
• See your doctor consistently. Gaps in treatment create gaps in evidence.
• Get a specialist involved if your condition warrants it. Their reports carry more weight than GP notes alone.
• Submit a complete claim pack. Use the checklist above; one missing document delays everything.
• Read your policy wording so you know exactly which disability definition applies.
• If your claim is denied, appeal it. You have the right to an internal review, and if that fails you can lodge a free complaint with AFCA.

The bottom line: an income protection claim rewards organisation. Understand your policy, prepare your evidence, notify early, and respond fast to every request. If it's denied and you believe it's wrong, AFCA's free dispute resolution is your backstop.

❓ Frequently asked questions🔗