Trauma Insurance Claims and Critical Illness Lawyers

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 – Call Now – 1300 873 252

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Trauma Insurance Claims for Critical Illness

Trauma insurance (also known as critical illness 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.

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Trauma Insurance Claims

Trauma Insurance Definition

Many Australian superannuation funds and insurance companies offer the option of taking out an insurance policy for specific medical conditions or certain types of surgery as specified 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.

Trauma insurance differs from income protection insurance policies, which typically cover any medical condition that temporarily prevents you from working.

More about income protection claims >

Photo of a sick man signing a critical illness claim form

Expert Terminal Illness Insurance Legal Advice

With the support of an experienced terminal illness insurance lawyer, you can increase your chance of receiving the maximum policy benefits. They comprehensively understand the 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.

Choosing Aussie Injury Lawyers for your case means having peace of mind with our No Win, No Fee, No Risk guarantee. Pay when you win and nothing if you lose. Your comprehensive case investigation is free, so Call Now 1300 873 252

Types of Critical Medical Conditions for Trauma Insurance Claims

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.

A long list of critical illnesses are generally eligible for critical illness insurance benefits, including (but not limited to)

  • Major head injuries
  • Heart Surgery
  • Aplastic anaemia
  • Some brain tumours
  • Benign spinal tumour
  • Blindness
  • Chronic organ failure    
  • Cognitive loss
  • Coma
  • Acquired Deafness        
  • Dementia        
  • Encephalitis
  • Some Heart conditions        
  • HIV   
  • Loss of limb
  • Paralysis
  • Loss of speech
  • Meningitis and or meningococcal disease
  • Motor neurone disease Multiple Sclerosis     
  • Muscular dystrophy
  • Parkinson’s disease
  • Lung Removal  
  • High Blood Pressure in the Lungs
  • Chronic diabetes       
  • Advanced osteoporosis   
  • Chronic rheumatoid arthritis

It would be a good idea to carefully review your trauma insurance policy to understand your exclusions and waiting periods for prior medical conditions.

How Much is a Trauma Insurance Payout?

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. Thankfully, Aussie Injury Lawyers let you know your claim value for free – Call 1300 873 252

How Long Does a Critical Illness Claim Take?

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:

  • The complexity of the case.
  • Issues with obtaining medical evidence or information from other sources.
  • The insurance company could also delay the review process.

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.

What If My Critical Illness Claim is Denied?

If your critical illness claim is denied, don’t panic, there is an option to appeal the outcome. Most insurers will provide a reason for the rejection, and this response requires careful examination. Some common denial reasons include not meeting policy definitions, missing or incorrect information, or a policy exclusion.

An experienced lawyer 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.

More about rejected claims >

What If My Critical Illness Claim is Denied?

Undoubtedly, a critical or terminal illness diagnosis is confronting and can seriously disrupt your life. Besides the financial burden of medical costs, you could have other losses associated with the diagnosis that can have long-term impacts. This is where our experienced critical illness claim lawyers can help.

Our disability and illness insurance legal team specialise in helping people diagnosed with a terminal or critical condition receive all their due insurance entitlements. They will investigate and assess the policy terms and negotiate with insurance companies on behalf of their clients to ensure they receive the total amount of their benefits in a timely manner.

How to Make A Critical Illness Insurance Claim in 5 Steps


Know Your Policy Terms

 Before filing a claim, you must understand the terms & conditions of your policy and what is covered, particularly any exclusions or limitations.


Contact Your Insurer

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.


Gather Evidence

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.


Receive Your Critical Illness Insurance benefit

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.


Get Legal Advice

Insurers often seek to minimise liability, so you could struggle to access your due benefits successfully. Many people find their best chance of having a successful critical illness claim is to work with an experienced terminal illness insurance lawyer.

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.

Australia Wide Trauma Insurance & Critical Illness Claims Advice

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

Brisbane | Sydney | Melbourne | Perth

A person reading a trauma insurance policy document

Critical Illness & Trauma Insurance Claim FAQs

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 get a Trauma payout, but you would only get a TPD payout if your heart attack stopped you from working again.

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.

More about making TPD claims >

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Meet Your Legal Team

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 we are here to help you get back to normal. The expert team at Aussie Injury Lawyers is led by Kerry Splatt, an Accredited Specialist in Personal Injuries law. His expertise together with over 100 years of combined legal experience is your guarantee of success. Reach out. Let us show you how we can assist you and your loved ones when the unexpected happens.

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