Coronavirus and insurance claims: Your questions answered

At QSuper, we’re committed to providing our members and their employers with the information they need during the current COVID-19 health crisis.

Here are the most common questions we’ve received about how the COVID-19 pandemic will impact any current or future insurance claims made by QSuper members.

Please note that the answers given are general information only: Each and every QSuper member’s claim is unique to their situation. Members currently going through the claims process should always contact their Claims Manager if their circumstances have changed.

Q: If a member is already on an income protection claim and their workplace is closed due to COVID-19, what income protection payments will be paid?

A: If a member is on claim and has been impacted by a workplace closure, they should discuss their situation with their Claims Manager and employer. The Claims Manager will work in partnership with the member, their employer, and healthcare professionals to make sure the member is paid in accordance with their medical capacity.

Q: If a member is medically required to self isolate, but is not unwell with COVID-19 and has some capacity for work, will their income protection payments be impacted?

A: It depends of the members’ personal circumstances. To receive income protection payments, a member must be “totally and temporarily” or “partially and temporarily” disabled solely because of the injury or illness that caused them to stop work.

A member will be paid income protection payments in accordance with their medical capacity, as discussed with their doctor and Claims Manager. This means if they have some capacity to work, their income protection payments may be impacted.

If the member’s situation changes, please contact their Claims Manager who will partner with the member, their employer, and healthcare professionals to achieve the best possible outcome for all involved.

Q: Are work from home arrangements approved by the member’s employer acceptable as alternative work arrangements for employees on graduated return to work programs?

A: Generally, if an employer supports working from home, the member’s graduated return to work plans can be revised to accommodate these new arrangements. These plans will be revised in partnership with the member, their employer, and healthcare professionals on an ongoing basis as per the normal graduated return to work plan arrangements.

Q: If a member is scheduled to attend an independent medical exam appointment or disability assessment, will this go ahead?

A: When reasonably required and relevant to their claim, members who are receiving income protection payments will be asked to attend independent medical exam appointments. This is because we need to be satisfied that a member remains either “totally and temporarily” or “partially and temporarily” disabled to be able to pay income protection payments.

The health of our members and community is a key priority, so our claims team is working on ways to continue to partner with treating doctors to allow for the required medical evidence to be obtained as efficiently as possible.

For example, members can attend tele-appointments with their doctors where available, or if a member’s normal treating specialist isn’t available, other sources of medical information may be provided in consultation with the member’s Claims Manager.

Q: Is a member required to provide ongoing medical certificates and medical updates if they can’t get appointments with their doctor? Will you continue to pay until they can obtain a medical certificate?

A: For income protection payments to be paid, we need to be satisfied that a member remains either “totally and temporarily” or “partially and temporarily” disabled. This means we may ask for medical certifications and medical updates when reasonably needed and relevant to the member’s claim.

We understand that it may not be possible for some members to physically visit their doctors at the moment, so a member’s Claims Manager will work with them to find a solution to allow for required medical evidence to be obtained as efficiently as possible.

For example, members may be able to attend tele-appointments with their doctor or provide other sources of medical information to make sure their income protection payments can continue.

This is general information only, using sources that we believe are reliable and accurate at the time of publication. We take all possible care when preparing this material, but we cannot give a warranty in respect to the information we have provided. This means the QSuper Board or any of its representatives take no responsibility for any errors or omissions, including those negligently made. The QSuper products are issued by the QSuper Board (ABN 32 125 059 006, AFSL 489650) as trustee for QSuper (ABN 60 905 115 063). Consider whether the product is right for you by reading the product disclosure statement (PDS) available from our website or by calling us on 1300 360 750. © QSuper Board