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Do you need a lawyer to make an insurance claim?

There is generally no need to use a lawyer to make an insurance claim through First Super. But it is entirely up to you, and you may choose to do so. Here are a few things to consider first.

When should you get a lawyer involved?

If your insurance claim is straightforward, a lawyer cannot add much to the process except costs.

First Super can help you:

  • work out your eligibility to claim
  • explain the process and answer your questions
  • help you complete any paperwork
  • keep you informed during the claims process

If your claim is successful, we will let you know and arrange payment. If your claim is declined, you should read the reasons why it was rejected and decide what to do next. Generally there will be three options.

  1. Accept the decision if it makes sense to you.
  2. Make a complaint to us if you do not agree with the decision. If you are still not satisfied with our decision/our insurer’s decision, or with how the complaint was handled, you can take your complaint to the Australian Financial Complaints Authority (AFCA). This is a free and independent complaint resolution process, which means you shouldn’t need a lawyer.
  3. If the decision doesn’t make sense to you, or AFCA rejects your complaint, you may want to consider hiring a lawyer. An advantage to waiting to hire one until now is you will have an insurance decision and all the other information a lawyer needs to advise you on your claim.

What should you look for when hiring a lawyer?

Make sure the lawyer understands superannuation

Superannuation claims are different to other insurance claims because superannuation is subject to different rules. Sometimes a lawyer who is experienced in (say) personal injury or workers compensation claims can make a superannuation claim more difficult because they lack detailed knowledge of the specific rules that apply to superannuation. An experienced superannuation lawyer can save you time and money.

So, how do you find a lawyer with the right experience?

If you are in Victoria, you can use the Law Institute of Victoria’s “Find your lawyer referral service” to find law firms near you that handle superannuation matters. You can search by “Superannuation and insurance claims” under “Legal issue”. This service provides a free 30-minute consultation and a referral to the law firm you have chosen. (You don’t have to use the online service – you can also simply call to speak with someone over the phone.)

There are similar services in New South Wales, Queensland, Tasmania, South Australia and Western Australia. Note that the online search functionality is different for each service, so you may need to adjust your search criteria.

Know what (and how) the lawyer will charge you

Your lawyer should be transparent about what they plan to charge you for their services. This will include a “costs agreement” upfront that explains the types of fees and when they must be paid. The costs charged are generally for the lawyer’s expertise and other payments that arise during the process, such as court costs.

You may be charged an hourly rate or a fixed fee. A fixed fee arrangement may be less common if there is uncertainty around how long the claim proceedings may take. You may be asked to pay an upfront fee or pay in stages. You should know fees can run into the tens of thousands of dollars if your claim is complex and drawn-out.

Some lawyers / firms offer “no win, no fee” arrangements. But this does necessarily mean there will be no out-of-pocket costs. And if you do win your case, you may be required to pay the lawyer a higher amount in fees (from the money you have received) than you would have with a different type of fee arrangement.

Can you use a lawyer at the start of your claim?

Absolutely. Whether we are dealing with you, or with your lawyer, we will aim to make your claims process as fast, efficient and fair as possible.

Just be aware, if you hire a lawyer early on, you may be paying them fees you don’t necessarily have to. And make sure they specialise in superannuation, so you are getting value for money.

Is you claim likely to be successful?

This obviously depends on the details of your claim. But in the 2023/24 financial year, First Super (with our insurer, MetLife) paid out around 87% of all claims, totalling more than $32 million.1

We do not try and stop claims from being successful – in fact, if there is a reasonable chance of your claim succeeding, we will go above and beyond to help make this happen.

1The total amount paid includes insured benefits and account balances for members with insurance for income protection, total and permanent disability, terminal illness and death.