What Does Trauma Insurance Cover? Meaning and Definition
02/09/2024
Trauma insurance cover provides a lump payment for severe injuries
Our experienced critical illness lawyers help you make a trauma insurance claim when diagnosed with a serious illness (or major trauma), on a 100% no win, no fee basis. Successfully claiming trauma insurance benefits (also known as a critical illness benefit) provides a lump sum payout and financial support for you and your loved ones at a challenging time.
Contact our skilled insurance lawyers to simplify the claims process with expert legal advice and quality legal representation. Our No Financial Risk policy means you pay when you win and zero if you lose, with fixed or capped legal fees. It’s free to know your situation.
Trauma insurance (also known as critical illness insurance or recovery insurance) pays a lump sum when diagnosed with a significant illness or injury. Generally, your medical condition or injury must be listed within your insurance policy to have a successful critical illness insurance claim. Therefore, it is essential you review the policy terms and seek legal advice on whether your coverage and how to satisfy the policy definitions.
Aussie Injury Lawyers will investigate your insurance policies for free and let you know your legal options. All our skilled insurance claim legal services are 100% No Win, No Fee with upfront fixed or capped pricing. Contact us now for a complimentary case assessment on 1300 873 252.
Get free expert advice and professional legal support from our experienced Australian critical illness lawyers about the legal process and the value of your potential trauma payout!
Many Australian superannuation funds and insurance companies provide the option to purchase a critical illness policy that covers specific medical conditions or certain types of surgery, as outlined in the policy. This type of policy is called trauma insurance (or critical illness insurance), which entitles you to a lump sum benefit if you suffer from one of the listed conditions. This payment can help cover medical expenses.
Trauma cover differs from income protection insurance policies, which usually provides ongoing payments that replace lost income for medical conditions that temporarily prevent you from working.
With the support of an experienced terminal illness insurance lawyer, you can increase your chance of receiving the maximum policy benefits.
Senior lawyers understand the legal process and what it takes to win against large insurers with deep pockets. Get the guidance and support you need for an efficient and effective critical illness insurance claim.
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The conditions covered by your Trauma policy will be outlaid in your Product Disclosure Statement (PDS). Usually, these critical medical conditions will already be covered – stroke, heart attacks, cancer, terminal illness and Alzheimers. Other conditions typically covered include major organ replacements, major burn injuries and motor neurone disease.
Other long-term illness and medical conditions frequently included in a trauma policy’s criteria and generally eligible for critical illness insurance benefits include (but are not limited to)
You should carefully review your trauma insurance policy to understand your exclusions and waiting periods for prior medical conditions.
Trauma insurance payouts vary considerably in Australia. How much you receive generally relies on the policy value and your circumstances. Typically, trauma insurance policies provide a lump sum payment to a policyholder with a successful claim for a serious medical condition or injury.
The amount of the payment typically ranges from $50,000 to $2 million and is based on a range of factors. However, some trauma insurance policies pay out only a portion of the insured amount for minor conditions.
Aussie Injury Lawyers let you know your claim value for free – Call 1300 873 252
In Australia, you need compelling medical evidence (including the severity criteria) that satisfies the critical illness policy terms and conditions. Consequently, a successful outcome relies on the insured person providing:
A terminal or critical illness claim typically takes about two months to process but sometimes as long as four months. However, you can have a shorter timeframe by providing complete and accurate information upfront.
The length of time for a successful claim relies on several factors:
Making a successful terminal illness claim requires careful preparation and a comprehensive understanding of the insurer’s expectations for meeting policy terms.
When you want a speedy payout, we recommend you seek legal advice from an experienced insurance litigation lawyer who can guide you through the process.
If your critical illness claim is denied, don’t panic; you have the option to appeal the insurer’s decision. Most insurers will provide a reason for the rejection, and this response requires careful examination. Some common denial reasons include:
Experienced lawyers can help you understand the appeals process and prepare strong arguments to reverse a decision. They can also advise on any potential legal remedies if your case is unsuccessful in the appeals process.
Before filing a trauma insurance claim, you need to understand the terms & conditions of your policy and what is covered, particularly any exclusions or limitations. Also, make sure you are following your treatment plan.
Once you know your policy protects your condition, contact your insurer as soon as possible and give them all the details they need to assess your claim. Keeping notes of all interactions with your insurance provider, including any transactions.
You will need compelling evidence of your medical condition, such as reports and receipts from your doctor and other documents like identification or financial information.
Once you have an accepted critical illness claim, your insurer will begin benefit payment proceedings, which could be a lump sum payment or recurring payments for a set period.
Life insurance companies often seek to minimise liability, so you might struggle to access your full insurance entitlements. Many people find that working with skilled lawyers, like our legal team, is their best chance of having a successful critical illness claim.
Aussie Injury Lawyers offer informed legal advice on a 100% no win no fee basis with a 99% success rate. Give yourself your best chance of winning by calling us now on 1300 873 252.
If you or someone you know suffers from one of these medical conditions and may be eligible to make a Trauma or Critical Illness claim, contact our expert legal team for a free legal review of your unique circumstances – Call 1300 873 252
Trauma Insurance pays a lump sum if you’re diagnosed with one of the severe medical conditions listed in your policy. The money can help cover any lifestyle changes needed to manage your condition and any ongoing therapy you need.
If you suffer a significant medical condition resulting in permanent impairment or an extended hospital stay, you may need to take extra time off work or cut back your hours. Major medical traumas often require home modifications to cope with any changes to your mobility.
Trauma insurance provides badly needed funds at a critical time, helping relieve anxiety and allowing you to focus on recovery.
Trauma insurance provides cover for when you suffer a significant medical condition. You will usually receive a lump sum payout if you acquire an illness/injury covered by your policy. Your benefit can help fund your medical expenses and treatment that your health insurance may not cover.
Your trauma payout is helpful if you have spent your savings and utilised your sick leave. The conditions most often covered by all insurers include heart attack, strokes, cancer, Alzheimer’s & terminal illness. To view the medical conditions covered by your policy, we advise you to read your PDS and contact our legal team for free advice.
Legislative changes took effect on 1 July 2014, making getting trauma insurance through your Superannuation impossible. You could still make a claim if you had trauma insurance before this date. This cover provides financial protection for various medical conditions such as cancer, heart attack and stroke.
Trauma insurance benefits are paid when you acquire a severe medical condition listed in the T&Cs with your policy. Your assessment is not dependent on your capacity to work or your level of disability.
If you can no longer work because you became totally and permanently disabled because of an illness or injury, then you might make a TPD Claim.
So, if you have a heart attack, you could receive a Trauma payout, but you would only get a TPD payout if your heart attack prevents you from working again. Our TPD lawyers can explain the claims process and the eligibility requirements.
Most Australian insurers do not cover critical illness for mental health conditions like anxiety, depression and PTSD. However, when a psychological or psychiatric disorder stops you from working again, you could successfully claim a lump sum TPD payout.
More about mental illness TPD claims here >
You can claim trauma benefits and Total and Permanent Disability (TPD) insurance for the same serious injury, illness or major trauma. Trauma insurance policies provide a lump sum payment when you suffer from a serious medical condition, which is defined in the policy. Common eligible conditions include heart attack, stroke or cancer. TPD covers you when you can’t work again in your usual occupation due to an illness, injury or recognised mental illness.
Hardworking and straight-talking, our experienced superannuation and insurance legal team is dedicated to delivering results for you. We understand how challenging life can be when things go wrong, and our law firm is here to help you access financial support in difficult times.
The expert team at Aussie Injury Lawyers is led by Kerry Splatt, an Accredited Specialist in Personal Injuries law. His expertise, combined with over 100 years of collective legal experience, guarantees your success. Reach out. Let us show you how we can assist you and your loved ones when the unexpected happens.
Trauma insurance cover provides a lump payment for severe injuries
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