You’ve just been diagnosed with a serious illness. Or maybe you’ve had an injury and can’t work. The last thing you need is to be buried in claim forms and chasing an insurer on the phone while going through the hardest stretch of your life. That’s where AMGENT steps in.
Insurance is designed to protect you — but making a claim isn’t always as simple as it should be. Insurers ask for documentation. They request medical reports. They go quiet. Months pass. And you’re still waiting.
At AMGENT Wealth Management, we manage the entire claims process on your behalf. Not just the paperwork — the follow-up, the escalation, the pushback, and where needed, the referral to a specialist lawyer who can identify compensation you may not even know you’re entitled to.
Here’s exactly how it works.
Types of Claims We Assist With
| Claim Type | What It Covers | Typical Timeframe |
|---|---|---|
| Life / Death Benefit | Lump sum paid on death of the insured | 4 – 8 weeks |
| Terminal Illness | Early release of life benefit on terminal diagnosis | 2 – 4 weeks (priority) |
| Total & Permanent Disability (TPD) | Lump sum if you are unable to ever work again | 3 – 6 months |
| Income Protection | Monthly benefit if temporarily unable to work | 4 – 8 weeks, then ongoing |
| Trauma / Critical Illness | Lump sum on diagnosis of a specified condition | 4 – 8 weeks |
How the Process Works — Six Steps
Call AMGENT Before You Call the Insurer
The moment a claim event occurs — or looks likely — call your AMGENT adviser first. We’ll confirm your coverage, set realistic expectations, and start preparing immediately. That single call can save weeks of avoidable delay.
We Review Your Policy and Coverage
We check that your policy is active, premiums are current, and the event is covered under the policy definitions. We also identify exclusions, waiting periods, and parallel policy entitlements. If your cover is inside superannuation, we manage both stages — insurer acceptance and super trustee release.
We Prepare the Entire Claim Pack
We coordinate everything — claim forms, medical certificates, specialist reports, attending physician statements, employer earnings documents, and super fund forms. A complete, well-prepared pack from the start means fewer follow-up requests and a faster path to a decision.
We Actively Follow Up with the Insurer
Lodging the claim is just the beginning. AMGENT contacts the insurer every five business days for the first four weeks, and at least every ten business days after that. We escalate to claims managers when progress stalls and lodge formal complaints if delay becomes unreasonable. We also screen every insurer request before it reaches you — if it’s excessive, duplicative, or unnecessary, we push back on your behalf.
We Manage the Decision — Whatever It Is
Accepted: we coordinate payment and the super trustee release. More information needed: we respond quickly with your medical team. Declined: we review the grounds, pursue internal dispute resolution, and if needed escalate to the Australian Financial Complaints Authority (AFCA) — a free external service for all consumers.
IMPORTANT: If we think you should speak to a lawyer to take matters further, we will refer you to one on a no-win no-fee basis.
Payment, Tax Advice, and a Full Financial Review
Once your benefit is paid, we sit down with you to cover the tax treatment of the payment, investment options for any lump sum, updates to your estate plan and beneficiary nominations, and whether your ongoing insurance needs have changed. We make sure you’re set up well for what comes next.
Could You Be Entitled to More Than Your Policy Benefit?
Here’s something many people don’t realise — your insurance benefit might not be the only entitlement available to you. Depending on your circumstances, you may also have rights relating to:
- Interest on delayed benefit payments
- Workers’ compensation or WorkCover where the condition arose from a workplace incident
- Common law damages where employer negligence or a third party contributed to your situation
- Compensation for insurer or trustee misconduct causing additional financial loss
Your Rights Throughout the Process
As your adviser, we’re bound by the Corporations Act 2001 and obligated to act in your best interests at all times. Beyond that, you also have rights as a claimant:
- The right to be kept informed at every stage — AMGENT contacts you at least every two weeks
- The right to request copies of all correspondence between AMGENT and your insurer
- The right to dispute a declined claim through AFCA, free of charge — 1800 931 678 | afca.org.au
- The right to seek independent legal advice at any stage
Frequently Asked Questions About Insurance Claims
How long does an insurance claim usually take?
It depends on the type of claim and how complex your situation is. As a general guide, life and death benefit claims are often assessed within 4–8 weeks, income protection within 4–8 weeks for the initial decision (then reviewed monthly), trauma claims within 4–8 weeks, and TPD claims can take 3–6 months because of the depth of medical and occupational evidence required.
Why should I call AMGENT before I contact the insurer?
Calling us first means we can confirm what you’re covered for, spot any potential issues early, and help you position the claim correctly from day one. It also means the insurer deals with a complete, well-prepared claim pack, which reduces the risk of delays caused by missing information or misunderstandings.
Do you charge extra fees for helping with a claim?
In most cases, we manage claims support as part of our ongoing advice relationship — not as a separate standalone fee. If a situation is unusual and requires a different fee structure, we’ll explain it clearly upfront before you decide how to proceed.
What if the insurer keeps asking for more information?
Part of our job is to act as a buffer between you and the insurer. We review every request before passing anything on to you. If the insurer is asking for information that’s excessive, repetitive, or not obviously relevant, we’ll query or challenge it on your behalf so you’re not doing unnecessary work during an already stressful time.
What happens if my claim is declined?
If your claim is declined, we don’t stop there. We will refer you to a specialist lawyer to review the reasons in detail, check them against your policy wording, and discuss options for internal dispute resolution with the insurer. Where appropriate, we help you escalate the matter to the Australian Financial Complaints Authority (AFCA), which is a free and independent complaints body.
Can I make a complaint to AFCA myself?
Yes. Any consumer can complain directly to AFCA about an insurance claim decision or delay. We can help you prepare the complaint, gather supporting documents, and structure your timeline so the case is presented clearly and professionally.
Could I be entitled to compensation as well as my insurance benefit?
Possibly. In some situations, there may be additional entitlements — for example, interest on delayed payments, workers’ compensation, or common law damages where negligence is involved. Where we see a potential claim beyond the insurance policy itself, we’ll refer you to a specialist insurance or personal injury lawyer to explore those options.
Do you work with clients outside Melbourne or interstate?
Yes. Many of our insurance claim clients are based interstate or overseas, particularly UK expats with Australian super and insurance. Most of the process can be managed via video call, phone, secure document upload, and email, so geography is rarely a barrier.
Can you help if my insurance is inside my super fund?
Absolutely. A lot of cover in Australia sits inside superannuation. In those cases, there are usually two decision-makers — the insurer and the super fund trustee. We manage both stages, from the initial insurer assessment through to the trustee’s release of the benefit from your super fund.
What’s the first step if I’m not sure whether I even have cover?
The simplest first step is to contact us and let us review your existing super statements and policy documents. We’ll identify what cover you have, what it’s likely to pay in different scenarios, and where there might be gaps or overlaps in your protection.
Ready to Start a Claim or Review Your Cover?
Contact your AMGENT adviser today. Read more about our process here and we’ll handle the rest.
General information only. This article does not constitute personal financial, legal, or tax advice. Individual circumstances vary — always consult a qualified adviser for advice specific to your situation.
AMGENT Wealth Management Pty Ltd is a Corporate Authorised Representative (No. 001318113) and Benjamin James Russell Waite is an Authorised Representative (No. 001004141) of Spark Advisors Australia Pty Ltd ABN 34 122 486 935 AFSL 380552.