How do the payouts work?
Your actual monthly payout will generally be the cover amount you selected. If your cover amount is more than 75% of your monthly income at the time of claim, your monthly payout will be reduced to 75% of your monthly income. Generally your monthly income will be calculated as a before tax average (if self-employed, after the deduction of any business expenses) over the last 12 months before the accident or illness happened.
If while you’re unable to work you receive other income (such as from another income protection policy, workers compensation or social security), your payout may be adjusted, but only if the combined amount exceeds 75% of your monthly income.
You can start receiving payouts once you have been unable to work (as approved by TOWER) for 30, 60 or 90 days, depending on the waiting period you have chosen. Payouts are made at the end of the month and will then continue each month you are unable to work up to 6, 12 or 24 months, depending on the payout period you have chosen. So for example, if you chose a 30-day waiting period your first payout would be 60 days after you were first unable to work.
When won’t I receive a payout?
To keep premiums as low as possible for as many people as possible you will not receive a payout for claims that arise directly or indirectly from:
- any mental health disorder, including anxiety disorders, depression, stress, adjustment disorders, eating disorders, emotional or behavioral disorders, disorders related to fatigue including chronic fatigue syndrome, drug or alcohol abuse, psychosomatic disorders, or any treatment complications;
- the taking of intoxicating liquor (We will not attempt to avoid a claim if you are at or under the legal blood alcohol limit for driving);
- the taking of drugs (other than those prescribed to you by a Medical Practitioner and taken in the correct dosage);
- pregnancy, unless you are unable to work (due to illness) for longer than 3 months after the pregnancy ends;
- terrorism, civil commotion or unrest, guerrilla or insurgent activities in a country outside Australia, if at the time the Australian Government has advised to reconsider the need to travel to, or advised against all travel to that country;
- war or an act of war;
- any intentional self-inflicted act;
- any other specific exclusions agreed with you first
If your plan is for ‘accident-only’, you will not receive payouts if you suffer an accident that is entirely or partially the result of, or contributed to by, an illness. If your plan is ‘illness only’, you will not receive payouts if you suffer an illness that is entirely or partially the result of, or contributed to by, an accident.
How can I claim if I need to?
Simply call us on 13 77 87 as soon as you’re unable to work because of the accident or illness (if applicable). We will send you a
claim form that needs to be completed and returned, together with proof of the condition for which you are claiming, your income and other relevant documentation (if applicable). You can ask for, and send in, claim forms during your waiting period.
Every month that you are unable to work, you will need to complete and submit a medical progress claim form so that we know you are still entitled to receive a payout.
Generally you will have to pay the costs of providing the initial and ongoing information or documentation to support your claim. However, TOWER will pay any costs for anything above our standard requirements.
It's really as simple as that but if you ever have any queries, simply call us on 13 77 87 for further information.