Claims philosophy

 

Our philosophy

Cbus recognises that its members and beneficiaries making an insurance claim are experiencing a life-altering illness or injury, or the death of a loved one. We know that you will likely have limited time, ability and focus to manage a claim. We will treat all claimants with compassion, dignity and respect, and provide a claims process that is simple, timely and transparent. We will also observe the principles of privacy and confidentiality in our dealings with you.

Our approach

We will explain the claims process to you and set reasonable expectations. We will help you understand the requirements and how to make a claim and ensure that the insurer conducts a fair, reasonable and timely assessment. We will communicate with you in a proactive, open and empathetic way, ensuring that you are kept informed throughout the process.

Paying legitimate claims

If you are eligible and have a legitimate claim, we will do everything we can so that it is paid in a timely and efficient manner.

Help when you need it

With our assistance, and advocacy when needed, we will support you to deal with any issues that may arise in relation to your cover or claim. This means you do not need to engage a lawyer, although it is your right to do so if you wish. 

If your claim may be declined, we will give you an opportunity to review the evidence obtained and make submissions or provide additional evidence before a final decision is made. We will explain the process to do this or assist you if required. If your claim is declined, we will have the decision reviewed by appropriately skilled and experienced staff, and if we consider the claim has reasonable prospects of success, we will take all reasonable steps to pursue it on your behalf.

If your claim has been declined and new evidence is provided, we will work with the insurer so that the decision is thoroughly and properly reviewed considering all existing and new evidence.

If your claim is accepted but we believe that the decision has been unreasonably delayed, we will proactively pursue a claim for interest on your behalf.