In the insurance industry, weasel words are often used to create vagueness and ambiguity in policies. When it comes to making an insurance claim, this lack of clarity can be used to benefit the insurance company and make it easier for them to deny your claim. At Life Matters Claims, we know that the difference between a successful and unsuccessful insurance claim comes down to wording and understanding terminology. Therefore we’ve put together a series of articles and videos designed to help you understand what weasel words are and how they might affect you when it comes to making an insurance claim. In this article, we want to break down three of the most common weasel words used in the insurance industry; pre-existing condition, default cover and total and permanent disability.
Pre-existing Condition
Simply put, this term is used by insurance companies to deny a claim due to a pre-existing medical condition the applicant might have. So, what does it mean? Well, that really depends. Like all weasel words, the term ‘pre-existing condition’ is intentionally vague and could refer to just about anything. High blood pressure, high cholesterol, diabetes, enlarged prostate, and back pain might all be considered pre-existing conditions. If an insurance company determines you had any of these conditions prior to your policy being enacted they might seek to deny your insurance claim on the grounds of ‘pre-existing condition’. One of the issues with this weasel word is that an applicant might not be aware of a pre-existing condition before their policy is enacted. If the insurance company can determine that the signs or symptoms of the condition existed at any time up to and including the day on which you became insured under the policy, they can deny the claim, regardless of whether you were aware of it.
Default Cover
When you join a Superfund, you are automatically provided with a default level of coverage calculated by ‘units’, which equate to a dollar amount. This is your default cover. The purpose of default cover is to allow more people to have basic insurance without having to take out a private policy. Most Superannuation funds automatically provide you with income protection, total and permanent disability (TPD) and death cover. Unfortunately, this automatic cover is not something that is easily understood or known about by many people. Like most things in the insurance world, it’s not as simple as that. The number of units applied by default may change purely based on your age. As your monthly premiums and costs continue to go up, the potential payout might actually be going down.
Total and Permanent Disability
The term ‘Total and Permanent Disability’ is intentionally misleading. Many people don’t realise they are eligible for a Total and Permanent Disability (or TPD) payment as they think their injury or illness is not severe enough, and this is what the insurance company wants you to believe. The truth is, in most cases if you are unable to work within your previous skill set due to an injury or illness, you could be eligible for a TPD payout. The eligibility of this claim is based on your previous skills, education and experience; when you can no longer use these skills, you could be eligible. This is true for both physical and mental illnesses. Processing a TPD Claim can be very intimidating, that’s why we’ve created some resources to help you better understand everything there is to know about Total and Permanent Disability insurance. If you are looking to make a TPD Claim, this article will give you a rundown on everything you need to know. Another article, put together by the experts at Life Matters Claims, answers one of the most common questions we get asked about TPD, which is ‘Can I still work after a Total and Permanent Disability payout?’
So there you have it, some of the more common weasel words you’ll come across when dealing with insurance companies. If you need help navigating the murky waters of the insurance world, don’t hesitate to get in touch with Life Matters Claims.